Disease-related Parameters Research Articles

Happiness and depression in psoriasis: a cross-sectional study in Germany

PurposePrior research on the psychological consequences of skin diseases has focused on assessing mental comorbidities. The aim of this study was to investigate subjective well-being in a large sample of individuals affected by psoriasis, a chronic inflammatory skin disease, and to explore the associations with depression and disease-related parameters such as disease severity.MethodsA cross-sectional online survey was conducted from March to June 2019. The link to the questionnaire was shared on websites and Facebook pages of psoriasis patient organizations and campaigns. Participants filled in validated scales measuring subjective well-being—operationalized as positive affect (PA), negative affect (NA) and satisfaction with life (SWL); and depression.ResultsThe data of 722 participants were analyzed. Exploratory factor analysis supported the differentiation of PA, NA, SWL, and depression as four different constructs. The respondents reported lower levels of PA than healthy individuals and judged themselves to be less happy and were less satisfied with their lives than the general population (except age group 65 + years). 40.3% of respondents were screened positive for depression. More severe psoriasis was associated with lower affective well-being and a higher risk for depression.ConclusionThe results of this study empirically supported the differentiation of subjective well-being and depression as different constructs in individuals with psoriasis, and underline the large mental burden of the disease which goes beyond a higher risk for depression. Measures of well-being should thus be incorporated in both research and clinical practice in patients with psoriasis in order to achieve a more comprehensive picture of the mental burden of this disease.

Characteristics of hospitalised COVID-19 patients and parameters associated with severe pneumonia.

BackgroundAfter the first case of coronavirus disease 2019 (COVID‐19) was reported in China in December 2019, it caused a global pandemic, including Turkey.ObjectivesThe aim of this study was to analyse the characteristics of hospitalised COVID‐19 patients and assess the parameters related to severe pneumonia.MethodsIncluded in the study were hospitalised COVID‐19 patients with positive naso‐oropharyngeal swabs. Patients’ demographics, admission symptoms, laboratory and radiological findings were recorded retrospectively.ResultsOf 1013 patients, 583 were males (57.6%) and 430 were females (42.4%), with a mean age of 53.7 ± 17.9. More than half of the patients had at least one comorbidities, the most common of which were hypertension and diabetes mellitus. Cough (59.8%), fatigue (49.5%) and fever (41.2%) were the most common presenting symptoms. Of the hospitalised COVID‐19 patients, 84.9% had pneumonia and 83.5% had typical radiological COVID‐19 appearances (94.5%: ground‐glass areas). The most common laboratory findings were high C‐reactive protein (CRP) (73.6%) and lactate dehydrogenase (LDH) (46.2%) levels, as well as lymphopenia (30.1%). Severe pneumonia was present in 28.1% of COVID‐19 patients. Multivariate logistic regression analysis indicated that advanced age, hypotension, anaemia and elevated CRP and LDH serum levels were independent risk factors for the severity of COVID‐19 pneumonia (P = .011, .006, .017, .003 and .001, respectively).ConclusionThis study, as one of the first multicentre studies about characteristics of COVID‐19 in Turkey, may guide about disease‐related parameters and severity of pneumonia. Age, blood pressure, complete blood count and routine biochemical tests (including CRP and LDH) would appear to be important parameters for the evaluation of the severity of COVID‐19 pneumonia.

Antifungal Activity of Propyl-Propane-Thiosulfinate (PTS) and Propyl-Propane-Thiosulfonate (PTSO) from Allium cepa against Verticillium dahliae: In Vitro and in Planta Assays.

Verticillium wilt, caused by Verticillium dahliae, is the most devastating soil-borne fungal disease of olive trees worldwide. Currently, there is no effective measure available to control the pathogen in diseased plants in open field conditions. Searching more effective and sustainable solutions are a priority for the olive sector. The existing alternatives for disease control include the use of biological control microorganisms and compounds of natural origin from plants, such as Alliaceae. Propyl propane thiosulfinate (PTS) and propyl propane thiosulfonate (PTSO) are two organosulfur compounds derived from Allium cepa with a widely documented antimicrobial activity. The aim of this study was to evaluate the antifungal activity of PTS and PTSO against the defoliating and non-defoliating V. dahliae pathotypes. Firstly, several in vitro tests were performed (Minimum Antifungal Concentration, susceptibility studies according to the Kirby–Bauer disk-diffusion method, antifungal activity through aerial diffusion and effect on mycelial growth). The ability of both compounds to sanitize soil was evaluated using a sterile substrate inoculated with V. dahliae. Finally, challenges in growth chambers were carried out. PTS and PTSO generated growth inhibition zones in agar diffusion and the gas phase, and the mycelial growth of all the V. dahliae strains was significantly altered. The V. dahliae population in soil was considerably reduced after the sanitization. Finally, in planta assays demonstrated the ability of these compounds to reduce disease related parameters and their contribution to control the phytopathogen. In conclusion, the results showed that the PTS and PTSO from Allium cepa display in vitro and in vivo antifungal activity against V. dahliae and suggested that both compounds could be used as natural and environmentally friendly tools for Verticillium wilt management.

Epidemiology and factors predicting survival of amyotrophic lateral sclerosis in a large Chinese cohort.

Background:Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder associated with loss of motor neurons. Our objective was to explore the epidemiology, clinical features, and survival factors of 1809 patients with ALS.Methods:We analyzed 1809 ALS patients, who were recruited from the Peking University Third Hospital from January 2005 to December 2015. Demographic data and disease-related parameters were collected. Kaplan-Meier curves were used to compare survival time. Cox proportional hazards function and the hazard ratio were used to identify adjusted prognostic predictors.Results:The results showed that the average annual incidence in Beijing alone was 0.38 cases/100,000 person-years and the mean age of onset was 48.88 ± 11.35 (95% confidence interval [CI]: 48.17–49.85) years. The median survival time from onset to death/tracheostomy was 58.89 ± 33.03 (95% CI: 51.46–63.84) months. In the adjusted Cox proportional hazard model, age of onset, diagnosis delay, rate of disease progression (Amyotrophic Lateral Sclerosis Functional Rating Scale Revised decline [points/month]), and body mass index all had an independent effect on survival in ALS.Conclusions:Our study provides information on epidemiology, clinical features, and survival factors of patients with ALS in China. These results can be helpful in clinical practice, clinical trial design, and validation of new tools to predict disease progression.

ANALYSIS OF SOCIODEMOGRAPHIC CHARACTERISTICS OF EARLY AND ADVANCED STAGE CHRONIC KIDNEY DISEASE PATIENTS

Objective:It was aimed to investigate sociodemographic features of chronic kidney disease patients, analyze difference of these features in early and advanced stage patients, find correctable factors that may change course of disease and to find new solutions in treatment and follow-up. Materials & Methods:Predialysis 345 patients diagnosed with chronic kidney disease were retrospectively analyzed. Patients were divided into early and advanced stages. Patients with Glomerular Filtration Rate 30 ml / min were defined as early stage, <30 ml / min as advanced stage. Sociodemographic and disease related features and laboratory parameters of patients were analyzed. Results:In the study, 243 (70.4%) patients were early stage and 102 (29.6%) patients were advanced stage chronic kidney patients. Most common etiologies are; In early stage, chronic glomerulonephritis (30.5%), diabetes mellitus (16.9%) and genetic diseases (16.0%), while at advanced stage, diabetes mellitus (34.3%), hypertension (16.7%) and unknown causes (15.7%) were. Alcohol use was higher and regular drug use was lower in early stage patients compared to advanced stage patients. In advanced stage patients, habit of exercising regularly was found to be low compared to early stage patients. Conclusion:It was found that there were correctable factors that could change course of disease. These factors differed in early and advanced stages. It is necessary to be aware of these factors for slower progressive of disease and take precautions for correctable factors from early stages of disease.

Current state of non-hematologic cancer-associated thrombosis at a tertiary care hospital in India

IntroductionCancer-associated thrombosis is a leading cause of morbidity and mortality in malignancy patients. Prophylactic anticoagulation is under-utilized and the cost of low-molecular-weight heparin (LMWH) and direct oral anticoagulants is a major barrier in developing countries. Material and methodsA retrospective analysis was performed of all cancer-associated thrombosis patients attending the thrombosis clinic at a tertiary-level referral hospital based in North India between 2011 and 2015. Patient demographics and disease-related parameters were collected and analyzed. ResultsA total of 771 patients attended the thrombosis clinic during study period, of which 64 cases were malignancy-associated. Of these, 56% of the patients were female and 20% were bedridden. The median age was 48.5 years, adenocarcinoma (48%) being the most common histological subtype. Gynecological malignancies (30%) were the most common malignancies, followed by genitourinary (11%) malignancies. Most of the cases occurred during first year of diagnosis (51%), and only 14% occurred after 3 years. Most of the patients were on combined treatment. Almost 40% of the patients developed thrombosis within 30 days of surgical treatment. Lower limb thrombosis was the most commonly seen type (56%), while abdominal and pulmonary thrombosis were both seen in 5%. Patients were managed with LMWH and vitamin K antagonists (84.3%) and only 6.25% with LMWH alone. Direct oral anticoagulants were not commonly used during the study period. DiscussionAt the hospital studied, most of the cases occurred early in the disease course. Postoperative prophylaxis could have contributed towards reducing thrombosis in the peri-operative period. Early suspicion and prompt treatment can improve quality of life in such patients.

Digital Approaches for a Reliable Early Diagnosis of Psoriatic Arthritis.

Psoriatic arthritis (PsA) is a chronic inflammatory disease that develops in up to 30% of patients with psoriasis. In the vast majority of cases, cutaneous symptoms precede musculoskeletal complaints. Progression from psoriasis to PsA is characterized by subclinical synovio-entheseal inflammation and often non-specific musculoskeletal symptoms that are frequently unreported or overlooked. With the development of increasingly effective therapies and a broad drug armamentarium, prevention of arthritis development through careful clinical monitoring has become priority. Identifying high-risk psoriasis patients before PsA onset would ensure early diagnosis, increased treatment efficacy, and ultimately better outcomes; ideally, PsA development could even be averted. However, the current model of care for PsA offers only limited possibilities of early intervention. This is attributable to the large pool of patients to be monitored and the limited resources of the health care system in comparison. The use of digital technologies for health (eHealth) could help close this gap in care by enabling faster, more targeted and more streamlined access to rheumatological care for patients with psoriasis. eHealth solutions particularly include telemedicine, mobile technologies, and symptom checkers. Telemedicine enables rheumatological visits and consultations at a distance while mobile technologies can improve monitoring by allowing patients to self-report symptoms and disease-related parameters continuously. Symptom checkers have the potential to direct patients to medical attention at an earlier point of their disease and therefore minimizing diagnostic delay. Overall, these interventions could lead to earlier diagnoses of arthritis, improved monitoring, and better disease control while simultaneously increasing the capacity of referral centers.

Tooth Loss Is Associated with Disease-Related Parameters in Patients with Rheumatoid Arthritis and Ankylosing Spondylitis-A Cross-Sectional Study.

Background: The aim of this cross-sectional study was to investigate potential associations between periodontal inflamed surface area (PISA) and tooth loss with disease-related parameters in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Methods: Patients who attended the Department of Nephrology and Rheumatology, University Medical Centre Goettingen, Germany, were included. The oral examination comprised the detection of the number of remaining teeth and periodontal condition based on staging and grading matrix. Based on periodontal pockets with positive bleeding on probing, the periodontal inflamed surface area (PISA) was determined. Disease related parameters were extracted from the patients’ records. Results: In total, 101 (RA) and 32 participants (AS) were included. Patients with RA had 22.85 ± 4.26 and AS patients 24.34 ± 5.47 remaining teeth (p < 0.01). Periodontitis stage III and IV was present in 91% (RA) and 81.2% (AS) of patients (p = 0.04). Associations between PISA and disease-related parameters were not found in both groups (p > 0.05). In RA, a higher age (p < 0.01), C-reactive protein (p = 0.02), disease activity (p < 0.01) and prednisolone intake (p < 0.01) were associated with fewer remaining teeth. In AS, a higher age (p = 0.02) and increased Bath Ankylosing Spondylitis Metrology Index (p = 0.02) were associated with a lower number of remaining teeth. Conclusions: Tooth loss is associated with disease activity, especially in RA individuals. Dental care to prevent tooth loss might be recommendable to positively influence oral health condition and disease activity in RA and SA patients.

Cardiac biomarkers in patients with epilepsy.

Objective: To determine the frequency of deranged cardiac biomarkers and associated socio-demographic factors among patients of epilepsy presenting at our hospital. Study Design: Cross-sectional study. Setting: Department of Medicine, Sheikh Khalifa Bin Zyed Al-Nyhan Hospital Rawalakot. Period: August 2019 to September 2020. Material &amp; Methods: We evaluated 85 consecutive patients who presented at Department of Medicine, Sheikh Khalifa Bin Zyed Al-Nyhan hospital. Cardiac Biomarkers (Troponin I, CK-MB and pro-BNP) and EKG were requested in all patients. The questionnaire used for interview consisted of demographic details and disease related parameters (duration of epilepsy and number of antiepileptic drugs). Results: Out of 85 patients included in the study, 35 (41.2%) were male while 45 (58.8%) were female. Out of these 85 patients of epilepsy, 15 (17.6%) had one or more cardiac biomarker positive while 70 (82.4%) had no change in ECG or any positive cardiac biomarker. All ECG changes were non-specific. After applying the logistic regression, we found that long duration of illness and poly-pharmacy had significant association with the presence of positive cardiac biomarkers among the patients of epilepsy. Conclusion: Less than 1/5th of the patients with epilepsy had positive cardiac biomarkers or ECG changes in our study. Patients with longer duration of epilepsy or those whose epilepsy has been managed with more than one drug were found more at risk of having abnormal cardiac biomarkers in our target population.

Comparison of constipation and nutritional status with disease-related parameters in chronic obstructive pulmonary disease patients.

The aim of the study was to determine the effects of constipation symptoms and nutritional status on disease-related parameters, such as disease duration, spirometry test and quality of life, of chronic obstructive pulmonary disease (COPD) patients. The research was performed with 48 COPD patients attending the centre from January 2019 to August 2019. Assessment of constipation symptoms was done by Constipation Severity Instrument (CSI), whereas for quality of life assessment, St. George's Respiratory Questionnaire (SGRQ) was used. Patient's nutritional status was determined by food frequency questionnaire. Body mass index (BMI) and fat-free mass index (FFMI) of the patients were identified with the bioelectrical impedance analysis (BIA) method. Statistical assessment of data was done with SPSS 22 program. According to the relationship between CSI scores and COPD disease parameters, there was a weak positive correlation between the CSI obstructive defecation subscale and SGRQ activity score and weak positive correlation between CSI colonic inertia subscale and COPD duration from the diagnosis. We found a weak negative correlation between protein intake percentage and SGRQ impact score. As the disease duration increased, the total fat, polyunsaturated fatty acids and vitamin E intake of individuals were determined to reduce. According to our results, there were some changes in the nutrient intake depending on the duration of COPD, and possible constipation in COPD patients may affect the quality of life.

Serum lipocalin-2 and carotid artery intima-media thickness in relation to obesity in eugonadal males over forty with venogenic erectile dysfunction.

Obesity is a risk factor for erectile dysfunction and atherosclerosis. Lipocalin-2 is an adipocytokine with proinflammatory properties involved in several disorders with metabolic alterations. Our aim was to study the relation of serum lipocalin-2 and carotid artery intima-media thickness (CIMT) to obesity in erectile dysfunction. Serum lipocalin-2 and CIMT were measured in 25 obese and 25 nonobese eugonadal patients over forty with venogenic erectile dysfunction and 25 healthy controls. Their relation to different patient- and disease-related parameters was studied. Results revealed lipocalin-2 to be significantly higher in obese compared with nonobese patients and with controls, and in nonobese patients compared with controls. CIMT was lower in controls compared with both obese and nonobese patients. In obese and nonobese patients, lipocalin-2 was positively correlated with disease duration, body mass index, waist circumference and end-diastolic velocity. Lipocalin-2 was negatively correlated with the short form of the international index of erectile function scores in both groups. In conclusion, the elevated lipocalin-2 in obese and to a lesser extent in nonobese patients and its association with disease severity points to its potential value as a diagnostic marker and a possible therapeutic target that could ameliorate the metabolic derangement associated with erectile dysfunction.

Hepatic Scaling Factors for In Vitro-In Vivo Extrapolation of Metabolic Drug Clearance in Patients with Colorectal Cancer with Liver Metastasis.

In vitro-in vivo extrapolation (IVIVE) linked with physiologically based pharmacokinetics (PBPK) modeling is used to predict the fates of drugs in patients. Ideally, the IVIVE-PBPK models should incorporate systems information accounting for characteristics of the specific target population. There is a paucity of such scaling factors in cancer, particularly microsomal protein per gram of liver (MPPGL) and cytosolic protein per gram of liver (CPPGL). In this study, cancerous and histologically normal liver tissue from 16 patients with colorectal liver metastasis were fractionated to microsomes and cytosol. Protein content was measured in homogenates, microsomes, and cytosol. The loss of microsomal protein during fractionation was accounted for using corrections based on NADPH cytochrome P450 reductase activity in different matrices. MPPGL was significantly lower in cancerous tissue (24.8 ± 9.8 mg/g) than histologically normal tissue (39.0 ± 13.8 mg/g). CPPGL in cancerous tissue was 42.1 ± 12.9 mg/g compared with 56.2 ± 16.9 mg/g in normal tissue. No correlations between demographics (sex, age, and body mass index) and MPPGL or CPPGL were apparent in the data. The generated scaling factors together with assumptions regarding the relative volumes of cancerous versus noncancerous tissue were used to simulate plasma exposure of drugs with different extraction ratios. The PBPK simulations revealed a substantial difference in drug exposure (area under the curve), up to 3.3-fold, when using typical scaling factors (healthy population) instead of disease-related parameters in cancer population. These indicate the importance of using population-specific scalars in IVIVE-PBPK for different disease states. SIGNIFICANCE STATEMENT: Accuracy in predicting the fate of drugs from in vitro data using IVIVE-PBPK depends on using correct scaling factors. The values for two of such scalars, namely microsomal and cytosolic protein per gram of liver, is not known in patients with cancer. This study presents, for the first time, scaling factors from cancerous and matched histologically normal livers. PBPK simulations of various metabolically cleared drugs demonstrate the necessity of population-specific scaling for model-informed precision dosing in oncology.

High blood glucose levels are associated with fibrosis/cirrhosis progression in chronic hepatitis C

ABSTRACT Chronic hepatitis C (CHC) leads eventually to liver fibrosis, advanced hepatic disease and related deaths. Therefore, it is very important to assess clinical risk factors associated with rapid CHC and hepatic fibrosis progression. Former studies reported diabetes mellitus synergistic interactions with other host factors to fibrosis progression. Here, we aimed to evaluate the association between elevated blood glucose levels and CHC progression according to METAVIR system in patients chronically infected with HCV-genotype 4 and to evaluate the correlation between elevated glucose levels and liver- and viral-related biochemical parameters. A total of 160 patients with CHC (80 with liver fibrosis and 80 with cirrhosis) and 40 healthy volunteers, negative for HCV, were included. Our results revealed that cirrhotic patients had high (P = .0001) fasting (169.1 ± 50.2 mg/dL), postprandial (208 (123–320) mg/dL), and random (176.8 ± 51 mg/dL) glucose levels compared to patients with liver fibrosis (105.0 ± 32, 120 (105-135), and 113.5 ± 35 mg/dL, respectively). Mean serum fasting, postprandial and random glucose levels were significantly (P = .0001) increased with an increase in fibrosis stages, F1< F2< F3< F4. Blood glucose levels were also significantly (P < .05) correlated with liver disease related biological parameters and HCV-Ab titer. In conclusion, our results highlighted the fibrogenic impact of elevated glucose levels on CHC patients.

ASSOCIATION OF HYPERTENSION WITH QUALITY OF LIFE AND MEASURES OF MENTAL AND PHYSICAL HEALTH IN PATIENTS WITH RHEUMATIC DISEASES

Abstract Objective: Increased prevalence of hypertension has been reported among patients with rheumatic diseases implicating autoimmune pathways and chronic inflammation. However, these patients commonly present mental health disorders, physical disability and impaired quality of life, which may as well interfere with hypertension. In the present study, we investigated the association of hypertension with quality of life and measures of mental and physical health in a large cohort of patients with rheumatic diseases. Design and method: Among consecutive patients attending the outpatient Rheumatology Clinic, health-related quality of life and anxiety were evaluated using the EuroQol 5D (EQ-5D) utility index and the Hamilton Anxiety Scale (HAM-A), respectively. The Health Assessment Questionnaire Disability Index (HAQ-DI), and the HAQ Pain Visual Analogue Scale (VAS-Pain) were used as measures of physical disability and arthritis-related pain, respectively. Hypertension was defined according to the 2018 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines. Results: A total of 464 individuals (81.7% females) with a mean age of 55.5 ± 13.8 years were included. Rheumatoid arthritis was the most common rheumatic disease (32.8%), followed by osteoarthritis (17.0%) and seronegative spondyloarthropathies (11.4%). Mean systolic/diastolic blood pressure (BP) was 130.3 ± 19.9/79.5 ± 10.5 mmHg and prevalence of hypertension reached 58.6% and. Patients with hypertension presented significantly higher HAM-A levels [16 (10–23) vs 13 (9–20.5), p = 0.014), higher HAQ-DI score (0.94 ± 0.79 vs 0.60 ± 0.61, p &lt; 0.001), lower EQ-5D score (0.50 ± 0.24 vs 0.59 ± 0.24, p &lt; 0.001), and higher VAS-pain [50 (25–75) vs 44.5 (10–70) %, p = 0.017], compared to normotensive patients. Multivariate analysis accounting for cardiovascular risk factors and disease-related parameters revealed an independent inverse association between systolic BP and quality of life (beta = –0.224, p = 0.022). Conclusions: Patients with rheumatic diseases and comorbid hypertension presented increased levels of anxiety, disability and pain and diminished quality of life compared to their normotensive counterparts. The association between BP and quality of life remained significant even after adjustment for other factors, revealing the complexity of the psycho-physical mode. Whether hypertension negatively affects quality of life in patients with chronic rheumatic disorders or vice versa impaired quality of life leads to increased BP, warrants further investigation.

Poor\xa0physical activity levels and cardiorespiratory fitness among patients with childhood-onset takayasu arteritis in remission: a cross\u2010sectional, multicenter study

BackgroundIt is currently unknown whether patients with childhood-onset Takayasu disease (c-TA) are prone to physical inactivity and poor aerobic capacity. In this study, we assessed physical activity levels and cardiorespiratory fitness along with health-related quality of life (HRQL) and various traditional and non-traditional risk factors in patients with c-TA vs. healthy controls.Methodsc-TA patients with non-active disease (n = 17) and age- and sex-matched healthy controls (n = 17) were enrolled in the study. We assessed physical activity levels, aerobic capacity, body composition, systemic inflammation, cardiometabolic markers, disease-related parameters, and HRQL.Resultsc-TA patients showed greater time spent in sedentary behavior (P = 0.010), and lower moderate-to-vigorous physical activity (P > 0.001) and lower step counts per day (P > 0.001). VO2peak (P < 0.001) and chronotropic response (P = 0.016) were significantly lower in patients with c-TA and they had worse HRQL in physical domain (P < 0.001), lower bone mineral content and density, and higher insulin levels vs. healthy controls (all P ≤ 0.05).Conclusionsc-TA patients exhibited reduced physical activity levels and aerobic capacity, worse cardiometabolic risk factors and HRQL parameter compared with healthy peers. Physical inactivity and aerobic deconditioning emerge as potentially novel risk factors for c-TA. The role of physical activity interventions in preventing poor outcomes and improving HRQL in c-TA remains to be explored.

REVIEW ON PREDICTING DISEASE SEVERITY – LEARNING ALGORITHMS AS CLASSIFIERS FOR DATA WAREHOUSE ENVIRONMENTS

When research fields such as biological and medical arenas are considered, computer science-based applications have been utilized on an increasing basis. In the process, data has accumulated in significant amounts. In particular, most of the big data that has resulted has accrued from experimental and medical results that are reported. The eventuality is that in the healthcare platforms, data mining techniques have been employed towards timely predictions of conditions with which patients present, a process achieved through data analysis. Also, the data analyses have strived to discern correlations among disease-related variables or parameters in otherwise voluminous information. It is also notable that data mining has received increasing adoption in the healthcare field because of the perceived ability to provide room for informed decision-making, reliable treatment decisions, and the detection of potential fraudulence when it comes to health care service payments. While these interplays point to a promising trend regarding the utilization of data mining and disease severity prediction, the eventual bid data has proved to be so complex that the use of traditional methods of data processing and analyzing is deemed less effective. In addition, given data warehouse, the use of traditional methods towards data extraction makes it difficult to discern some of the hidden intersections, pointing to the importance of a new approach for data classification and disease severity prediction. The aim of this review paper was to demonstrate how the use of classifiers in the form of machine learning algorithms could be utilized in the prediction of the severity of diseases. Indeed, the context of the research entailed warehouse environments. To have an ideal kernel established towards data classification (that would then enable additional diagnostic tests), some of the machine learning algorithms that were investigated included SVM (support vector machine) and ANN (artificial neural network). From the review outcomes, it was established that when machine learning algorithms are used to obtain trend similarities in disease severity through predictive analytics, similar severity magnitudes of the given diseases could be projected in terms of their probabilities of and trends in occurrence. Also, the review outcomes demonstrated that disease severity prediction through machine learning algorithms is an insightful practice because it allows for the prediction of patients’ conditions, as well as the prevision of room for optimal decision-making regarding treatment modalities to be adopted by healthcare firms.

Retrospective Analysis of Early Impact of COVID-19 on Systemic Cancer Treatment—A Pilot Study

Abstract Introduction Cancer care during the coronavirus disease 2019 (COVID-19) pandemic is challenging as the patients are at an increased risk of developing complications compared with the general population. Objectives This study was conducted to assess the impact of COVID-19 pandemic and nationwide lockdown on systemic cancer care. Materials and Methods This comparative descriptive study was conducted in the Department of Medical Oncology and Haematology in a tertiary care center in India. The study compared and analyzed the consecutive patient data of two different units in the Department of Medical Oncology in the pre-COVID phase (PCP) and post lockdown relaxation phase (PLRP). We represented the categorical data in frequency and percentage, and chi-squared test was used to analyze the variables. Results Patients were categorized based on demographic, disease-related, and hospital visit-related parameters and a significant drop noted in patients who utilized a prebooking facility (p = 0.0001), in the number of patients aged &gt;50 years (p = 0.004), number of patients who presented with hematological malignancies (p = 0.006), and who came for follow-up (p = 0.0001). The other parameters remained statistically insignificant. Conclusions During PLRP, active systemic cancer care seems to have been less affected, whereas follow-up of patients and visits of elderly patients were significantly reduced. If the pandemic remains under control, cancer care may not get compromised. This shows the importance of flattening the curve for quality management of other diseases during a pandemic.

Psychological features of adult patients with langerhans cell histiocytosis.

BackgroundThe prevalence of psychological symptoms and the co-occurrence of substance abuse disorders in adult patients with Langerhans cell histiocytosis (LCH) has not been previously explored. We aimed to use validated scales to evaluate depression and anxiety symptoms experienced by adult LCH patients.MethodsIn this cross-sectional study, all consecutive adult LCH patients seen at our national reference center between January 2012 and January 2013 were asked to complete the following instruments: the Hospital Anxiety and Depression scale (HADS); Barratt Impulsiveness Scale, Version 10 (BIS-10); and Cannabis Use Disorders Identification Test (CUDIT). Self-reported scores on these scales were used to determine the point prevalence of clinically significant psychological symptoms and substance use disorders in LCH patients. Patient profiles in terms of psychological features were assessed by principal component analysis including the HADS and BIS-10 instruments values, followed by hierarchical clustering. Fisher exact tests and Wilcoxon tests were used to examine the associations between disease-related parameters and high levels of anxiety and impulsivity.ResultsSeventy-one adult LCH patients, mainly with pulmonary LCH (PLCH), completed the evaluations. Clinically significant anxiety and depression symptoms were reported by 22 (31%) and 4 (6%) subjects, respectively. Impulsivity was detected in 14% (10/71) of the patients. Seventeen percent (12/71) of the patients used cannabis on a regular basis, with 50% of these individuals (6/12) exhibiting scores consistent with cannabis use disorder. Three derived clusters of patients were identified in the principal component analysis; these patient clusters differed in successful weaning from tobacco at the time of evaluation (p = 0.03). In univariate analyses, isolated PLCH and the use of psychotropic treatments were statistically associated with clinically significant anxiety symptoms.ConclusionsHigh levels of anxiety and impulsivity are common in adult patients with LCH. The consequences of these symptoms for the management of LCH patients warrant further evaluation.

Novel COVID-19 Mortality Rate Prediction (MRP) Model for India Using Regression Model With Optimized Hyperparameter

The main objective of this study is to estimate the future COVID-19 mortality rate for India using COVID-19 mortality rate models from different countries. Here, the regression method with the optimal hyperparameter is used to build these models. In the literature, numerous mortality models for infectious diseases have been proposed, most of which predict future mortality by extending one or more disease-related attributes or parameters. But most of these models predict mortality rates from historical data. In this paper, the Gaussian process regression model with the optimal hyperparameter is used to develop the COVID-19 mortality rate prediction (MRP) model. Five different MRP models have been built for the U.S., Italy, Germany, Japan, and India. The results show that Germany has the lowest death rate in 2000 plus COVID-19 confirmed cases. Therefore, if India follows the strategy pursued by Germany, India will control the COVID-19 mortality rate even in the increase of confirmed cases.

Short communication: Identifying key parameters for modelling the impacts of livestock health conditions on greenhouse gas emissions

Improved animal health can reduce greenhouse gas (GHG) emissions intensity in livestock systems while increasing productivity. Integrated modelling of disease impacts on farm-scale emissions is important in identifying effective health strategies to reduce emissions. However, it requires that modellers understand the pathways linking animal health to emissions and how these might be incorporated into models. A key barrier to meeting this need has been the lack of a framework to facilitate effective exchange of knowledge and data between animal health experts and emissions modellers. Here, these two communities engaged in workshops, online exchanges and a survey to i) identify a comprehensive list of disease-related model parameters and ii) test its application to evaluating models. Fifty-six parameters were identified and proved effective in assessing the potential of farm-scale models to characterise livestock disease impacts on GHG emissions. Easy wins for the emissions models surveyed include characterising disease impacts related to feeding.