Common cardiovascular risk factors and in-hospital mortality in 3,894 patients with COVID-19: survival analysis and machine learning-based findings from the multicentre Italian CORIST Study.

BACKGROUND AND AIMS: There is poor knowledge on characteristics, comorbidities and laboratory measures associated with risk for adverse outcomes and in-hospital mortality in European Countries. We aimed at identifying baseline characteristics predisposing COVID-19 patients to in-hospital death. METHODS AND RESULTS: Retrospective observational study on 3894 patients with SARS-CoV-2 infection hospitalized from February 19th to May 23rd, 2020 and recruited in 30 clinical centres distributed throughout Italy. Machine learning (random forest)-based and Cox survival analysis. 61.7% of participants were men (median age 67 years), followed up for a median of 13 days. In-hospital mortality exhibited a geographical gradient, Northern Italian regions featuring more than twofold higher death rates as compared to Central/Southern areas (15.6% vs 6.4%, respectively). Machine learning analysis revealed that the most important features in death classification were impaired renal function, elevated C reactive protein and advanced age. These findings were confirmed by multivariable Cox survival analysis (hazard ratio (HR): 8.2; 95% confidence interval (CI) 4.6-14.7 for age ≥85 vs 18-44 y); HR = 4.7; 2.9-7.7 for estimated glomerular filtration rate levels <15 vs ≥ 90 mL/min/1.73 m2; HR = 2.3; 1.5-3.6 for C-reactive protein levels ≥10 vs ≤ 3 mg/L). No relation was found with obesity, tobacco use, cardiovascular disease and related-comorbidities. The associations between these variables and mortality were substantially homogenous across all sub-groups analyses. CONCLUSIONS: Impaired renal function, elevated C-reactive protein and advanced age were major predictors of in-hospital death in a large cohort of unselected patients with COVID-19, admitted to 30 different clinical centres all over Italy.

Drivers of social influence in the Twitter migration to Mastodon.

The migration of Twitter users to Mastodon following Elon Musk's acquisition presents a unique opportunity to study collective behavior and gain insights into the drivers of coordinated behavior in online media. We analyzed the social network and the public conversations of about 75,000 migrated users and observed that the temporal trace of their migrations is compatible with a phenomenon of social influence, as described by a compartmental epidemic model of information diffusion. Drawing from prior research on behavioral change, we delved into the factors that account for variations of the effectiveness of the influence process across different Twitter communities. Communities in which the influence process unfolded more rapidly exhibit lower density of social connections, higher levels of signaled commitment to migrating, and more emphasis on shared identity and exchange of factual knowledge in the community discussion. These factors account collectively for 57% of the variance in the observed data. Our results highlight the joint importance of network structure, commitment, and psycho-linguistic aspects of social interactions in characterizing grassroots collective action, and contribute to deepen our understanding of the mechanisms that drive processes of behavior change of online groups.

Urban form and COVID-19 cases and deaths in Greater London: An urban morphometric approach.

The COVID-19 pandemic generated a considerable debate in relation to urban density. This is an old debate, originated in mid 19th century's England with the emergence of public health and urban planning disciplines. While popularly linked, evidence suggests that such relationship cannot be generally assumed. Furthermore, urban density has been investigated in a spatially coarse manner (predominantly at city level) and never contextualised with other descriptors of urban form. In this work, we explore COVID-19 and urban form in Greater London, relating a comprehensive set of morphometric descriptors (including built-up density) to COVID-19 deaths and cases, while controlling for socioeconomic, ethnicity, age and co-morbidity. We describe urban form at individual building level and then aggregate information for official neighbourhoods, allowing for a detailed intra-urban representation. Results show that: (i) control variables significantly explain more variance of both COVID-19 cases and deaths than the morphometric descriptors; (ii) of what the latter can explain, built-up density is indeed the most associated, though inversely. The typical London neighbourhood with high levels of COVID-19 infections and deaths resembles a suburb, featuring a low-density urban fabric dotted by larger free-standing buildings and framed by a poorly inter-connected street network.

Social dimensions impact individual sleep quantity and quality.

While sleep positively impacts well-being, health, and productivity, the effects of societal factors on sleep remain underexplored. Here we analyze the sleep of 30,082 individuals across 11 countries using 52 million activity records from wearable devices. Our data are consistent with past studies of gender and age-associated sleep characteristics. However, our analysis of wearable device data uncovers differences in recorded vs. self-reported bedtime and sleep duration. The dataset allowed us to study how country-specific metrics such as GDP and cultural indices relate to sleep in groups and individuals. Our analysis indicates that diverse sleep metrics can be represented by two dimensions: sleep quantity and quality. We find that 55% of the variation in sleep quality, and 63% in sleep quantity, are explained by societal factors. Within a societal boundary, individual sleep experience was modified by factors like exercise. Increased exercise or daily steps were associated with better sleep quality (for example, faster sleep onset and less time awake in bed), especially in countries like the U.S. and Finland. Understanding how social norms relate to sleep will help create strategies and policies that enhance the positive impacts of sleep on health, such as productivity and well-being.

A complicated case of whole-lung lavage: a case report.

Introduction: We report a life-threatening case of severe respiratory failure due to a pulmonary alveolar proteinosis (PAP) secondary to lysinuric protein intolerance (LPI), complicated by a pre-existing right pneumothorax, which we treated using a rescue whole-lung lavage (WLL). To date, in the literature, there are no cases of WLL performed in this condition. Clinical condition: Patient was referred to our center because of rapidly worsening dyspnea and deterioration of gas exchange, caused by a secondary form of PAP which required an immediate therapeutic option such as the one offered by WLL. On physical examination, bilateral crackles were present, and peripheral blood oxygen saturation was 78% on oxygen with a FiO2 of 40%. Interventions: After stabilizing the clinical conditions with oxygen therapy erogated through a high-flow nasal cannula, shortly after admission, we performed a rescue WLL among two procedures. The procedure was very effective, and the patient was later discharged without oxygen therapy and in good clinical condition. Conclusion: Our case report represents a chance to help fill the gap of knowledge relative to secondary forms of PAP. The patient we presented suffers from a very rare genetic condition (LPI) that only has a few reported cases in the literature and has a very low prevalence which makes it difficult to produce the affected people:newborns ratio. We believe that difficult and rare cases like this one can improve our understanding of the disease and, most importantly, of how much the only therapeutic option we had, a rescue WLL, is effective to improve gas exchange and radiological features, despite being performed in these severe respiratory conditions.

Multidimensional tie strength and economic development.

The strength of social relations has been shown to affect an individual's access to opportunities. To date, however, the correspondence between tie strength and population's economic prospects has not been quantified, largely because of the inability to operationalise strength based on Granovetter's classic theory. Our work departed from the premise that tie strength is a unidimensional construct (typically operationalized with frequency or volume of contact), and used instead a validated model of ten fundamental dimensions of social relationships grounded in the literature of social psychology. We built state-of-the-art NLP tools to infer the presence of these dimensions from textual communication, and analyzed a large conversation network of 630K geo-referenced Reddit users across the entire US connected by 12.8M social ties created over the span of 7 years. We found that unidimensional tie strength is only weakly correlated with economic opportunities ([Formula: see text]), while multidimensional constructs are highly correlated ([Formula: see text]). In particular, economic opportunities are associated to the combination of: (i) knowledge ties, which bridge geographically distant groups, facilitating the knowledge dissemination across communities; and (ii) social support ties, which knit geographically close communities together, and represent dependable sources of social and emotional support. These results point to the importance of developing high-quality measures of tie strength in network theory.

Epidemic dreams: dreaming about health during the COVID-19 pandemic.

The continuity hypothesis of dreams suggests that the content of dreams is continuous with the dreamer's waking experiences. Given the unprecedented nature of the experiences during COVID-19, we studied the continuity hypothesis in the context of the pandemic. We implemented a deep-learning algorithm that can extract mentions of medical conditions from text and applied it to two datasets collected during the pandemic: 2888 dream reports (dreaming life experiences), and 57 milion tweets (waking life experiences) mentioning the pandemic. The health expressions common to both sets were typical COVID-19 symptoms (e.g. cough, fever and anxiety), suggesting that dreams reflected people's real-world experiences. The health expressions that distinguished the two sets reflected differences in thought processes: expressions in waking life reflected a linear and logical thought process and, as such, described realistic symptoms or related disorders (e.g. nasal pain, SARS, H1N1); those in dreaming life reflected a thought process closer to the visual and emotional spheres and, as such, described either conditions unrelated to the virus (e.g. maggots, deformities, snake bites), or conditions of surreal nature (e.g. teeth falling out, body crumbling into sand). Our results confirm that dream reports represent an understudied yet valuable source of people's health experiences in the real world.

The language of opinion change on social media under the lens of communicative action.

Which messages are more effective at inducing a change of opinion in the listener? We approach this question within the frame of Habermas' theory of communicative action, which posits that the illocutionary intent of the message (its pragmatic meaning) is the key. Thanks to recent advances in natural language processing, we are able to operationalize this theory by extracting the latent social dimensions of a message, namely archetypes of social intent of language, that come from social exchange theory. We identify key ingredients to opinion change by looking at more than 46k posts and more than 3.5M comments on Reddit's r/ChangeMyView, a debate forum where people try to change each other's opinion and explicitly mark opinion-changing comments with a special flag called delta. Comments that express no intent are about 77% less likely to change the mind of the recipient, compared to comments that convey at least one social dimension. Among the various social dimensions, the ones that are most likely to produce an opinion change are knowledge, similarity, and trust, which resonates with Habermas' theory of communicative action. We also find other new important dimensions, such as appeals to power or empathetic expressions of support. Finally, in line with theories of constructive conflict, yet contrary to the popular characterization of conflict as the bane of modern social media, our findings show that voicing conflict in the context of a structured public debate can promote integration, especially when it is used to counter another conflictive stance. By leveraging recent advances in natural language processing, our work provides an empirical framework for Habermas' theory, finds concrete examples of its effects in the wild, and suggests its possible extension with a more faceted understanding of intent interpreted as social dimensions of language.

From Reddit to Wall Street: the role of committed minorities in financial collective action.

In January 2021, retail investors coordinated on Reddit to target short-selling activity by hedge funds on GameStop shares, causing a surge in the share price and triggering significant losses for the funds involved. Such an effective collective action was unprecedented in finance, and its dynamics remain unclear. Here, we analyse Reddit and financial data and rationalize the events based on recent findings describing how a small fraction of committed individuals may trigger behavioural cascades. First, we operationalize the concept of individual commitment in financial discussions. Second, we show that the increase of commitment within Reddit pre-dated the initial surge in price. Third, we reveal that initial committed users occupied a central position in the network of Reddit conversations. Finally, we show that the social identity of the broader Reddit community grew as the collective action unfolded. These findings shed light on financial collective action, as several observers anticipate it will grow in importance.

Heterogeneous rarity patterns drive price dynamics in NFT collections.

We quantify Non Fungible Token (NFT) rarity and investigate how it impacts market behaviour by analysing a dataset of 3.7M transactions collected between January 2018 and June 2022, involving 1.4M NFTs distributed across 410 collections. First, we consider the rarity of an NFT based on the set of human-readable attributes it possesses and show that most collections present heterogeneous rarity patterns, with few rare NFTs and a large number of more common ones. Then, we analyze market performance and show that, on average, rarer NFTs: (i) sell for higher prices, (ii) are traded less frequently, (iii) guarantee higher returns on investment, and (iv) are less risky, i.e., less prone to yield negative returns. We anticipate that these findings will be of interest to researchers as well as NFT creators, collectors, and traders.

Mapping the NFT revolution: market trends, trade networks, and visual features.

Non Fungible Tokens (NFTs) are digital assets that represent objects like art, collectible, and in-game items. They are traded online, often with cryptocurrency, and are generally encoded within smart contracts on a blockchain. Public attention towards NFTs has exploded in 2021, when their market has experienced record sales, but little is known about the overall structure and evolution of its market. Here, we analyse data concerning 6.1 million trades of 4.7 million NFTs between June 23, 2017 and April 27, 2021, obtained primarily from Ethereum and WAX blockchains. First, we characterize statistical properties of the market. Second, we build the network of interactions, show that traders typically specialize on NFTs associated with similar objects and form tight clusters with other traders that exchange the same kind of objects. Third, we cluster objects associated to NFTs according to their visual features and show that collections contain visually homogeneous objects. Finally, we investigate the predictability of NFT sales using simple machine learning algorithms and find that sale history and, secondarily, visual features are good predictors for price. We anticipate that these findings will stimulate further research on NFT production, adoption, and trading in different contexts.

Streetonomics: Quantifying culture using street names.

Quantifying a society's value system is important because it suggests what people deeply care about-it reflects who they actually are and, more importantly, who they will like to be. This cultural quantification has been typically done by studying literary production. However, a society's value system might well be implicitly quantified based on the decisions that people took in the past and that were mediated by what they care about. It turns out that one class of these decisions is visible in ordinary settings: it is visible in street names. We studied the names of 4,932 honorific streets in the cities of Paris, Vienna, London and New York. We chose these four cities because they were important centers of cultural influence for the Western world in the 20th century. We found that street names greatly reflect the extent to which a society is gender biased, which professions are considered elite ones, and the extent to which a city is influenced by the rest of the world. This way of quantifying a society's value system promises to inform new methodologies in Digital Humanities; makes it possible for municipalities to reflect on their past to inform their future; and informs the design of everyday's educational tools that promote historical awareness in a playful way.

The Dreamcatcher: Interactive Storytelling of Dreams.

Sleep scientists have extensively validated the continuity hypothesis, according to which our dreams reflect what happens during our waking life. Yet, only a few attempts have been made to increase the general public's awareness about the benefits of dream analysis in better understanding and improving our daily life. We designed "The Dreamcatcher," an interactive visual tool that explores the link between dreams and waking life through a collection of dream reports. We conducted a user study with 154 participants and found a 25% increase in the number of people believing that dream analysis can improve our daily lives after interacting with our tool. The visualization informed people about the potential of the continuity hypothesis to a surprising extent, to the point that it increased their concerns about sharing their own dream reports, thus opening new questions on how to design privacy-aware tools for dream collection.

Heparin in COVID-19 Patients Is Associated with Reduced In-Hospital Mortality: The Multicenter Italian CORIST Study.

INTRODUCTION: A hypercoagulable condition was described in patients with coronavirus disease 2019 (COVID-19) and proposed as a possible pathogenic mechanism contributing to disease progression and lethality. AIM: We evaluated if in-hospital administration of heparin improved survival in a large cohort of Italian COVID-19 patients. METHODS: In a retrospective observational study, 2,574 unselected patients hospitalized in 30 clinical centers in Italy from February 19, 2020 to June 5, 2020 with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection were analyzed. The primary endpoint in a time-to event analysis was in-hospital death, comparing patients who received heparin (low-molecular-weight heparin [LMWH] or unfractionated heparin [UFH]) with patients who did not. We used multivariable Cox proportional-hazards regression models with inverse probability for treatment weighting by propensity scores. RESULTS: Out of 2,574 COVID-19 patients, 70.1% received heparin. LMWH was largely the most used formulation (99.5%). Death rates for patients receiving heparin or not were 7.4 and 14.0 per 1,000 person-days, respectively. After adjustment for propensity scores, we found a 40% lower risk of death in patients receiving heparin (hazard ratio = 0.60; 95% confidence interval: 0.49-0.74; E-value = 2.04). This association was particularly evident in patients with a higher severity of disease or strong coagulation activation. CONCLUSION: In-hospital heparin treatment was associated with a lower mortality, particularly in severely ill COVID-19 patients and in those with strong coagulation activation. The results from randomized clinical trials are eagerly awaited to provide clear-cut recommendations.

Lopinavir/Ritonavir and Darunavir/Cobicistat in Hospitalized COVID-19 Patients: Findings From the Multicenter Italian CORIST Study.

Background: Protease inhibitors have been considered as possible therapeutic agents for COVID-19 patients. Objectives: To describe the association between lopinavir/ritonavir (LPV/r) or darunavir/cobicistat (DRV/c) use and in-hospital mortality in COVID-19 patients. Study Design: Multicenter observational study of COVID-19 patients admitted in 33 Italian hospitals. Medications, preexisting conditions, clinical measures, and outcomes were extracted from medical records. Patients were retrospectively divided in three groups, according to use of LPV/r, DRV/c or none of them. Primary outcome in a time-to event analysis was death. We used Cox proportional-hazards models with inverse probability of treatment weighting by multinomial propensity scores. Results: Out of 3,451 patients, 33.3% LPV/r and 13.9% received DRV/c. Patients receiving LPV/r or DRV/c were more likely younger, men, had higher C-reactive protein levels while less likely had hypertension, cardiovascular, pulmonary or kidney disease. After adjustment for propensity scores, LPV/r use was not associated with mortality (HR = 0.94, 95% CI 0.78 to 1.13), whereas treatment with DRV/c was associated with a higher death risk (HR = 1.89, 1.53 to 2.34, E-value = 2.43). This increased risk was more marked in women, in elderly, in patients with higher severity of COVID-19 and in patients receiving other COVID-19 drugs. Conclusions: In a large cohort of Italian patients hospitalized for COVID-19 in a real-life setting, the use of LPV/r treatment did not change death rate, while DRV/c was associated with increased mortality. Within the limits of an observational study, these data do not support the use of LPV/r or DRV/c in COVID-19 patients.

Disentangling the Association of Hydroxychloroquine Treatment with Mortality in Covid-19 Hospitalized Patients through Hierarchical Clustering.

The efficacy of hydroxychloroquine (HCQ) in treating SARS-CoV-2 infection is harshly debated, with observational and experimental studies reporting contrasting results. To clarify the role of HCQ in Covid-19 patients, we carried out a retrospective observational study of 4,396 unselected patients hospitalized for Covid-19 in Italy (February-May 2020). Patients' characteristics were collected at entry, including age, sex, obesity, smoking status, blood parameters, history of diabetes, cancer, cardiovascular and chronic pulmonary diseases, and medications in use. These were used to identify subtypes of patients with similar characteristics through hierarchical clustering based on Gower distance. Using multivariable Cox regressions, these clusters were then tested for association with mortality and modification of effect by treatment with HCQ. We identified two clusters, one of 3,913 younger patients with lower circulating inflammation levels and better renal function, and one of 483 generally older and more comorbid subjects, more prevalently men and smokers. The latter group was at increased death risk adjusted by HCQ (HR[CI95%] = 3.80[3.08-4.67]), while HCQ showed an independent inverse association (0.51[0.43-0.61]), as well as a significant influence of cluster∗HCQ interaction (p < 0.001). This was driven by a differential association of HCQ with mortality between the high (0.89[0.65-1.22]) and the low risk cluster (0.46[0.39-0.54]). These effects survived adjustments for additional medications in use and were concordant with associations with disease severity and outcome. These findings suggest a particularly beneficial effect of HCQ within low risk Covid-19 patients and may contribute to clarifying the current controversy on HCQ efficacy in Covid-19 treatment.

Our dreams, our selves: automatic analysis of dream reports.

Sleep scientists have shown that dreaming helps people improve their waking lives, and they have done so by developing sophisticated content analysis scales. Dream analysis entails time-consuming manual annotation of text. That is why dream reports have been recently mined with algorithms, and these algorithms focused on identifying emotions. In so doing, researchers have not tackled two main technical challenges though: (i) how to mine aspects of dream reports that research has found important, such as characters and interactions; and (ii) how to do so in a principled way grounded in the literature. To tackle these challenges, we designed a tool that automatically scores dream reports by operationalizing the widely used dream analysis scale by Hall and Van de Castle. We validated the tool's effectiveness on hand-annotated dream reports (the average error is 0.24), scored 24 000 reports-far more than any previous study-and tested what sleep scientists call the 'continuity hypothesis' at this unprecedented scale: we found supporting evidence that dreams are a continuation of what happens in everyday life. Our results suggest that it is possible to quantify important aspects of dreams, making it possible to build technologies that bridge the current gap between real life and dreaming.

Tesco Grocery 1.0, a large-scale dataset of grocery purchases in London.

We present the Tesco Grocery 1.0 dataset: a record of 420 M food items purchased by 1.6 M fidelity card owners who shopped at the 411 Tesco stores in Greater London over the course of the entire year of 2015, aggregated at the level of census areas to preserve anonymity. For each area, we report the number of transactions and nutritional properties of the typical food item bought including the average caloric intake and the composition of nutrients. The set of global trade international numbers (barcodes) for each food type is also included. To establish data validity we: i) compare food purchase volumes to population from census to assess representativeness, and ii) match nutrient and energy intake to official statistics of food-related illnesses to appraise the extent to which the dataset is ecologically valid. Given its unprecedented scale and geographic granularity, the data can be used to link food purchases to a number of geographically-salient indicators, which enables studies on health outcomes, cultural aspects, and economic factors.

FaceLift: a transparent deep learning framework to beautify urban scenes.

In the area of computer vision, deep learning techniques have recently been used to predict whether urban scenes are likely to be considered beautiful: it turns out that these techniques are able to make accurate predictions. Yet they fall short when it comes to generating actionable insights for urban design. To support urban interventions, one needs to go beyond predicting beauty, and tackle the challenge of recreating beauty. Unfortunately, deep learning techniques have not been designed with that challenge in mind. Given their 'black-box nature', these models cannot be directly used to explain why a particular urban scene is deemed to be beautiful. To partly fix that, we propose a deep learning framework (which we name FaceLift) that is able to both beautify existing urban scenes (Google Street Views) and explain which urban elements make those transformed scenes beautiful. To quantitatively evaluate our framework, we cannot resort to any existing metric (as the research problem at hand has never been tackled before) and need to formulate new ones. These new metrics should ideally capture the presence (or absence) of elements that make urban spaces great. Upon a review of the urban planning literature, we identify five main metrics: walkability, green spaces, openness, landmarks and visual complexity. We find that, across all the five metrics, the beautified scenes meet the expectations set by the literature on what great spaces tend to be made of. This result is further confirmed by a 20-participant expert survey in which FaceLift has been found to be effective in promoting citizen participation. All this suggests that, in the future, as our framework's components are further researched and become better and more sophisticated, it is not hard to imagine technologies that will be able to accurately and efficiently support architects and planners in the design of the spaces we intuitively love.

Cartographic Design of Cultural Maps.

Throughout history, maps have been used as a tool to explore cities. They visualize a city's urban fabric through its streets, buildings, and points of interest. Besides purely navigation purposes, street names also reflect a city's culture through its commemorative practices. Therefore, cultural maps that unveil socio-cultural characteristics encoded in street names could potentially raise citizens' historical awareness. But designing effective cultural maps is challenging, not only due to data scarcity but also due to the lack of effective approaches to engage citizens with data exploration. To address these challenges, we collected a dataset of 5000 streets across the cities of Paris, Vienna, London, and New York, and built their cultural maps grounded on cartographic storytelling techniques. Through data exploration scenarios, we demonstrated how cultural maps engage users and allow them to discover distinct patterns in the ways these cities are gender-biased, celebrate various professions, and embrace foreign cultures.