High Death Toll Research Articles

Особенности ведения пациентов с сахарным диабетом и COVID-19

Objective of the Review: To systematise the information on the incidence of diabetes mellitus (DM) in patients who had the novel coronavirus infection; on the features of virus mechanism activation and pathological cascades in the body; on potential ways to control blood glucose during COVID-19. Key Points. During the novel coronavirus pandemic (COVID-19) associated with high death toll in all countries, specific groups of patients were identified, where the death rate was higher than the mean figures. These groups include DM patients. DM is associated with a high risk of severe coronavirus infection and is the second common comorbidity during COVID-19. DM, degree of its compensation and complications progression impact prognosis, coronavirus infection clinical course and survival. Therefore, effective teamwork of the healthcare professionals and patient is essential. The primary objective of coordination is creation of a clear algorithm of DM management during COVID-19: strict blood glucose monitoring and prompt intensification both of antihyperglycemic therapy and specific ethiopathogenetic management of COVID-19. Conclusion. DM patients require special attention and timely adequate assistance both in outpatient and inpatient settings. Long-term follow-up of DM patients after COVID-19 to minimise the risk of DM complications is also very important. Keywords: COVID-19, diabetes mellitus, novel coronavirus infection.

Covid-19 pandemic and The Nigerian primary healthcare system: The leadership question

Since the outbreak of the Covid-19 pandemic, the pathetic nature of the Nigeria healthcare system has become more glaring. In First World countries, the ravaging nature of the pandemic, marked by a high death toll, elicits trepidation among Nigerian citizens. What is more, these fears are not necessarily as a result of the lethal nature of COVID-19 but rather, they are consequent of certain conditions amongst which include: an inept and unconcerned leadership, accompanied by dilapidated health institutions characterized by poor working conditions and incentives. It is in lieu of these unhealthy conditions that the dreaded disease found its footing in the Nigerian environment. Against this background, this paper argues that the outbreak of Covid-19 pandemic in Nigeria, its local dispersion occasioned by paucity of medical personnel and supplies due to decades of neglect of health care system is worrisome. This study recommends an overhaul of the healthcare system with the aim of achieving a robust health care system for Nigerian citizens. Thus far, various scholars have focused on corrupt leadership practices of Nigerian leaders without a detailed and in-depth study on the nexus between the health sector and this failure. It is this obvious gap in scholarship that this present study sets out to fill. The paper adopts a qualitative approach which will be anchored on primary and secondary sources of historical methodology. Thus, its significance lies in its ability to bring to the fore the nexus between leadership failure in Nigeria and the neglect of primary healthcare system. It will also expose the vulnerability of the Nigerian rich and poor in the face of the global pandemic.

Fear and depression linked to COVID-19 exposure A study of adult twins during the COVID-19 pandemic

Millions of people have been impacted by the novel coronavirus (COVID-19) pandemic worldwide. High infection rates and death tolls, combined with social distancing measures, may have unintended psychological consequences on individuals. The goal of this study was to examine the interrelations between COVID-19 exposure, fear of COVID-19, and depression among a community-based sample of adult twins. We further explored whether fear of COVID-19 mediated the association between COVID-19 exposure and depression. 732 same-sex adult twin pairs (78.1% MZ, 21.9% DZ) completed an online survey examining their feelings in May 2020. About one-fifth of the participants reported having any COVID-19 exposure. Most participants (>80%) were somewhat concerned about themselves or their household members being infected by COVID-19. The average depression level was relatively low (M = 0.9 out of 6). We found that COVID-19 exposure was related to increased fears of COVID-19 and depression, and that depressive feelings increased with fear of COVID-19. The correlation between COVID-19 exposure and depression was partially mediated by fear of COVID-19. However, these associations were confounded by familial influences. As society navigates through the pandemic, it is essential to implement public health strategies to help individuals cope with the concerns and fears about COVID-19.

Epidemiological Characteristics of COVID-19 in Mexico and the Potential Impact of Lifting Confinement Across Regions

The novel coronavirus SARS-CoV-2 has paralyzed our societies, leading to self-isolation and quarantine for several days. As the 10th most populated country in the world, Mexico is on a major threat by COVID-19 due to the limitations of intensive care capacities, about 1.5 hospital beds for every 1,000 citizens. In this paper, we characterize the COVID-19 pandemic in Mexico and projected different scenarios to evaluate sharp or gradual quarantine lifting strategies. Mexican government relaxed strict social distancing regulations on June 1, 2020, deriving to pandemic data with large fluctuations and uncertainties of the tendency of the pandemic in Mexico. Our results suggest that lifting social confinement must be gradually sparse while maintaining a decentralized region strategy among the Mexican states. To substantially lower the number of infections, simulations highlight that a fraction of the population that represents the elderly should remain in social confinement (approximately 11.3% of the population); a fraction of the population that represents the confined working class (roughly 27% of the population) must gradually return in at least four parts in consecutive months; and to the last a fraction of the population that assumes the return of students to schools (about 21.7%). As the epidemic progresses, deconfinement strategies need to be continuously re-adjusting with the new pandemic data. All mathematical models, including ours, are only a possibility of many of the future, however, the different scenarios that were developed here highlight that a gradual decentralized region deconfinement with a significant increase in healthcare capacities is paramount to avoid a high death toll in Mexico.

Air pollution and skin disorders.

Air pollution is being shown to play an increasing causation role in our most common skin diseases. Acne, hyperpigmentation, atopic dermatitis, and psoriasis have been shown to be influenced by air pollution. It is important for pollution to be added as a risk factor for these skin disorders, and thus we must discuss mitigating its negative affects with patients. Air pollution is the contamination of outdoor (ambient) and indoor (household) environments by any chemical, physical, or biological agent that modifies the natural characteristics of the atmosphere. Nearly all (90%) of the world’s population experience daily pollution. In 2019, air pollution was considered by the World Health Organization to be the biggest environmental health risk to humans, responsible for killing more than 7 million people prematurely every year. Preliminary studies link air pollution to COVID-19 deaths, as there were high death tolls in some of the most globally polluted areas. Air pollution affects many organ systems such as cardiovascular, pulmonary, central nervous, reproductive, and integumentary systems. In this study, we detail the current evidence linking specific skin and health disorders to air pollution.

Parametric and non-parametric estimation of extreme earthquake event: the joint tail inference for mainshocks and aftershocks

In an earthquake event, the combination of a strong mainshock and damaging aftershocks is often the cause of severe structural damages and/or high death tolls. The objective of this paper is to provide estimation for the probability of such extreme events where the mainshock and the largest aftershocks exceed certain thresholds. Two approaches are illustrated and compared – a parametric approach based on previously observed stochastic laws in earthquake data, and a non-parametric approach based on bivariate extreme value theory. We analyze the earthquake data from the North Anatolian Fault Zone (NAFZ) in Turkey during 1965–2018 and show that the two approaches provide unifying results.

Recalibrating pandemic risk leadership: Thirteen crisis ready strategies for COVID-19

Good leadership is widely regarded as a crucial component of risk and crisis management and remains an enduring theme of more than 40 years of inquiry into emergencies, disasters, and controversies. Today, the question of good leadership has come under the spotlight again as a key factor shaping how successfully nations have dealt with the COVID-19 global health crisis. Amidst plummeting levels of public trust, the worst recession of the G7, and the highest death toll in Europe, the UK’s pandemic leadership response has faced especially stern accusations of incompetence and culpability for what has been described as the most catastrophic science policy failure for a generation. Addressing these issues, this paper argues for the adoption of a more pluralised UK leadership approach for handling COVID-19. Particularly, it is contended that as COVID-19 is a multifaceted problem that presents many varied and distributed challenges, UK leadership should employ a differentiated range of strategic mechanisms and processes to help improve substantive understandings and decision-making, support collective resilience, and build adaptive capacities as the crisis continues. The paper accordingly identifies and elaborates thirteen strategies, drawing on lessons and insights from the risk and crisis management field, that are proposed to serve as a useful heuristic to help guide UK pandemic leadership in this endeavour. To illustrate the value and application of each strategy, examples are provided of noteworthy leadership responses to COVID-19 observed internationally thus far, as well as leadership problems that have hampered the UK’s pandemic response. In conclusion, it is suggested that in as far as the conduct expected of leaders during a pandemic, or any other crisis, should maintain and be reflective of democratic values and standards of legitimacy, these strategies may also provide broadly applicable normative criteria against which leadership performance in handling COVID-19 may be judged as crisis ready.

Remembering the Super-Typhoon: Some, but Not All, Qualities of First-Hand Survivor Memories of Natural Disaster Are Similar to Near Death Experience and Flashbulb Memory Accounts.

The strongest storm in Philippines history, super-typhoon Haiyan, barreled through central Philippines in 2013 and left a high death toll and extensive destruction in its wake. Past studies have investigated Fading Affect Bias (FAB) in extremely negative situations like the death of a loved one and found that the FAB generally occurs in those extreme situations, but this study is the first to assess FAB in first-hand memories for a natural disaster survival situation. The FAB phenomenon is the tendency for emotional intensity associated with negative memories for events to fade over time and emotional intensity for positive events stays relatively stable over time. Researchers collected memories for the super-typhoon from survivors three years after the event. Results showed that negative emotional intensity for the event faded after the event. Emotion in comparison positive memories for non-typhoon events did not fade, and emotion in comparison negative memories faded, following results in several other FAB studies. The Positive and Negative Affect Scale (PANAS) was used as an initial assessment of mood before the study began, and PANAS scores reliably predicted current emotional intensity scores. Memory vividness and emotional intensity in first-hand accounts of a natural disaster experience behave like vividness and intensity in flashbulb memories, but details in first-hand accounts are similar to the amount of details in memories of near-death experiences. How memory rehearsal behaves in relation to time elapsed since event has yet to be captured for first-hand survival experiences.

U.K. COVID-19 DIARY

The U.K. government struggled to contain the outbreak of COVID-19. Its delay in introducing a lockdown, widespread testing of those who might be infected, and restrictions on the entry of visitors from countries where the virus was rife, as well as its decision to order the transfer of patients from hospitals to care homes without testing them, contributed to the high death toll from the virus. The government swiftly introduced measures to minimize the unemployment and business failures that might have resulted from the lockdown. It provided income support for employees and the self-employed, loans for businesses, and assistance for the unemployed. When the number of new COVID-19 cases began to fall, the government switched its attention to easing the restrictions imposed during the lockdown because of concerns about the deterioration in the economy.

Patterns of suicide in Kuwait from 2014 to 2018

ObjectivesSuicide is a public health problem in many countries around the world and is one of the top ten causes of death internationally. We performed a retrospective study from 2014 to 2018 to study the patterns of suicide in Kuwait. Study designAfter reviewing files from the General department of Criminal Evidence, we collected a total of 297 in our study period that were signed out as suicide fatalities. MethodsThe relationship between demographic factors (e.g. age, sex, residential area) and suicides were studied using various statistical methodologies. ResultsThe majority of the 297 samples were in the age range of 19–35 years (180; 60.6%) and 36–65 years (107; 36%). Males constituted the majority of cases (241; 81.1%). The sample consisted of 20 different nationalities. More than half of the 297 samples were Indian (179; 60.2%), whereas Kuwaitis were a minority (22; 7.4%). Hanging was the preferred method of suicide in our study population (269; 90.6%). The governorate of Ahmadi had the highest death toll (89; 30%), followed by Farwaniyah (77; 25.9%) and Jahra (64; 21.5%). ConclusionThe government of the State of Kuwait needs to target the group that has the largest number of fatalities by increasing education and awareness of employers and employees to the danger of this condition and the driving factors that lead people to it.

Healthcare Crisis in Bangladesh during the COVID-19 Pandemic.

.The COVID-19 pandemic has had a severe impact worldwide. Developed countries, such as the United States, United Kingdom, Italy, and Spain, had their highly efficient medical infrastructure greatly stressed and suffered from high death tolls. Similarly, Bangladesh, a poverty-stricken South Asian country, is losing its battle against the pandemic, but mainly because of its incompetent healthcare system. The casualties are escalating and public sufferings are becoming unimaginable. On this backdrop, this perspective piece discusses the healthcare crisis in Bangladesh during the pandemic. This article also identifies three responsible issues for the country’s deteriorating health care: 1) poor governance and increased corruption, 2) inadequate healthcare facilities, and 3) weak public health communication.

The assessment of landslides disaster mitigation in Java Island, Indonesia: a review

The frequency of landslides and the fact that a large number of people live in the landslides-prone areas lead to a high death toll in Java Island, Indonesia – over 1,112 people in the period between 1999 and 2005. Indonesian National Disaster Management Agency (Badan Nasional Penanggulangan Bencana [BNPB]) reported 2,766 landslides that occurred in Java from 2014 to 2019, with 662 deaths. From its state, it looks as if Indonesia 's disaster mitigation is still weak. It is very essential to a deep understanding of landslides disaster mitigation weakness in Indonesia with the approach of governments, researchers, and local communities action. This research is a review of landslides disaster mitigation in Java Island with the approach of governments, researchers, and local communities action. Furthermore, the purpose of this study is to highlight the driving forces of landslides disaster mitigation in Java Island, Indonesia.
 From the assessment of each stakeholder (government, researchers, and local communities), the driving forces of landslides disaster mitigation in Java Island are the central government has commanding disaster management activities to local governments. However, the implementation of landslides disaster mitigation at the regional level has some obstacles such as the lack of residential development planning.Many landslide research results have only become scientific papers but the landslides-prone areas have not been fully paid attention by the local government such as the absence of landslide danger warning signs.In addition, the level of preparedness and awareness among local communities is not constant at any given time. Usually, community preparedness levels can be high following a disaster. It is likely, however, to diminish over time.

Revealing the targets and mechanisms of vitamin A in the treatment of COVID-19.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), an epidemic disease characterized by rapid infection and a high death toll. The clinical diagnosis of patients with COVID-19 has risen sharply, especially in Western countries. Globally, an effective treatment for COVID-19 is still limited. Vitamin A (VA) exhibits pharmacological activity in the management of pneumonia. Thus, we reason that VA may potentially serve as an anti-SARS-CoV-2 regimen. In this study, bioinformatics analysis and computation assays using a network pharmacology method were conducted to explore and uncover the therapeutic targets and mechanisms of VA for treating COVID-19. We identified candidate targets, pharmacological functions, and therapeutic pathways of VA against SARS-CoV-2. Bioinformatics findings indicate that the mechanisms of action of VA against SARS-CoV-2 include enrichment of immunoreaction, inhibition of inflammatory reaction, and biological processes related to reactive oxygen species. Furthermore, seven core targets of VA against COVID-19, including MAPK1, IL10, EGFR, ICAM1, MAPK14, CAT, and PRKCB were identified. With this bioinformatics-based report, we reveal, for the first time, the anti-SARS-CoV-2 functions and mechanisms of VA and suggest that VA may act as a potent treatment option for COVID-19, a deadly global epidemic.

Uncovering antibody cross-reaction dynamics in influenza A infections.

Influenza viruses are a cause of large outbreaks and pandemics with high death tolls. A key obstacle is that flu vaccines have inconsistent performance, in the best cases up to 60% effectiveness, but it can be as low as 10%. Uncovering the hidden pathways of how antibodies (Abs) induced by one influenza strain are effective against another, cross-reaction, is a central vexation for the design of universal flu vaccines. We conceive a stochastic model that successfully represents the antibody cross-reactive data from mice infected with H3N2 influenza strains and further validation with cross-reaction data of H1N1 strains. Using a High-Performance Computing cluster, several aspects and parameters in the model were tested. Computational simulations highlight that changes in time of infection and the B-cells population are relevant, however, the affinity threshold of B-cells between consecutive infections is a necessary condition for the successful Abs cross-reaction. Our results suggest a 3-D reformulation of the current influenza antibody landscape for the representation and modeling of cross-reactive data. The full code as a testing/simulation platform is freely available here: https://github.com/systemsmedicine/Antibody_cross-reaction_dynamics. Supplementary data are available at Bioinformatics online.

Agent-based modeling and simulations of terrorist attacks combined with stampedes

As a global problem, the terrorism leads to high death tolls each year. During terrorist attacks, the direct death is caused by terrorists attacking civilians. However, indirect death caused by stampedes should not be underestimated. Under great panic, most civilians were running disorderly, rushing into limited number of Exits, which causes stampede injuries and deaths. To explore this dual-mechanism dynamics, we build the agent-based modeling of particle system. Civilians lose blood when attacked, which is the attack mechanism, or crashed and trampled by others civilians, which is the stampede mechanism. For all civilians, the blood variable determines the physical status of being strong, healthy, weak, injured, and dead. Five key factors, such as the perception range, the number of Exits, the density of civilians, the number of terrorists, and attack strategies, are introduced into the model. We run each simulation repeatedly for multiple times and take the averaged survival rate, attack death, and stampede death as robust outcomes. The collision damage has the phase transition effects between stampede and attack deaths. The perception range R have the peak effect on the survival rate and the trough effect on both stampede and attack deaths. It expands understandings of human behavior dynamics, and helps to predict the dynamics and outcomes in advance. The optimal perception range can be solved accordingly, to practically guide the public facility planning and regular emergency training in real-life.

Selenium Deficiency Is Associated with Mortality Risk from COVID-19.

SARS-CoV-2 infections underlie the current coronavirus disease (COVID-19) pandemic and are causative for a high death toll particularly among elderly subjects and those with comorbidities. Selenium (Se) is an essential trace element of high importance for human health and particularly for a well-balanced immune response. The mortality risk from a severe disease like sepsis or polytrauma is inversely related to Se status. We hypothesized that this relation also applies to COVID-19. Serum samples (n = 166) from COVID-19 patients (n = 33) were collected consecutively and analyzed for total Se by X-ray fluorescence and selenoprotein P (SELENOP) by a validated ELISA. Both biomarkers showed the expected strong correlation (r = 0.7758, p < 0.001), pointing to an insufficient Se availability for optimal selenoprotein expression. In comparison with reference data from a European cross-sectional analysis (EPIC, n = 1915), the patients showed a pronounced deficit in total serum Se (mean ± SD, 50.8 ± 15.7 vs. 84.4 ± 23.4 µg/L) and SELENOP (3.0 ± 1.4 vs. 4.3 ± 1.0 mg/L) concentrations. A Se status below the 2.5th percentile of the reference population, i.e., [Se] < 45.7 µg/L and [SELENOP] < 2.56 mg/L, was present in 43.4% and 39.2% of COVID samples, respectively. The Se status was significantly higher in samples from surviving COVID patients as compared with non-survivors (Se; 53.3 ± 16.2 vs. 40.8 ± 8.1 µg/L, SELENOP; 3.3 ± 1.3 vs. 2.1 ± 0.9 mg/L), recovering with time in survivors while remaining low or even declining in non-survivors. We conclude that Se status analysis in COVID patients provides diagnostic information. However, causality remains unknown due to the observational nature of this study. Nevertheless, the findings strengthen the notion of a relevant role of Se for COVID convalescence and support the discussion on adjuvant Se supplementation in severely diseased and Se-deficient patients.

The United States’ Response to COVID-19: Learning through Reflection

When analyzing the global humanitarian crisis known as the SARS-CoV-2 virus (which causes the disease COVID-19), it is important to analyze the response of the United States so it is possible to learn from any mistakes. Since a global pandemic was completely unprecedented to the United States government, it did not have a concrete plan or solution prepared to deal with the outbreak. COVID-19 exposed the flaws in the United State's ability to deal with pandemics which, consequently, has now led to the U.S. to have the highest death toll in the world.

Particulate Matter and COVID-19 Disease Diffusion in Emilia-Romagna (Italy). Already a Cold Case?

As we prepare to emerge from an extensive and unprecedented lockdown period, due to the COVID-19 virus infection that hit the Northern regions of Italy with the Europe’s highest death toll, it becomes clear that what has gone wrong rests upon a combination of demographic, healthcare, political, business, organizational, and climatic factors that are out of our scientific scope. Nonetheless, looking at this problem from a patient’s perspective, it is indisputable that risk factors, considered as associated with the development of the virus disease, include older age, history of smoking, hypertension and heart disease. While several studies have already shown that many of these diseases can also be favored by a protracted exposure to air pollution, there has been recently an insurgence of negative commentary against authors who have correlated the fatal consequences of COVID-19 (also) to the exposition of specific air pollutants. Well aware that understanding the real connection between the spread of this fatal virus and air pollutants would require many other investigations at a level appropriate to the scale of this phenomenon (e.g., biological, chemical, and physical), we propose the results of a study, where a series of the measures of the daily values of PM2.5, PM10, and NO2 were considered over time, while the Granger causality statistical hypothesis test was used for determining the presence of a possible correlation with the series of the new daily COVID19 infections, in the period February–April 2020, in Emilia-Romagna. Results taken both before and after the governmental lockdown decisions show a clear correlation, although strictly seen from a Granger causality perspective. Moving beyond the relevance of our results towards the real extent of such a correlation, our scientific efforts aim at reinvigorating the debate on a relevant case, that should not remain unsolved or no longer investigated.

Change in helmet use behavior enforced by CCTV cameras with automatic helmet use detection system on an urban arterial road

Objective Many developing countries experience a high death toll among motorcycle users (both drivers and passengers), primarily due to a relatively low rate of helmet use resulting from ineffective helmet law enforcement. The objectives of this study are to explore the change in helmet use behavior due to helmet use enforcement by closed-circuit television (CCTV) camera technology with an automatic helmet use detection system and to identify the factors associated with helmet use along an urban arterial road in the city of Khon Kaen, Thailand. Methods Data collection was carried out on 49,128 samples by video cameras installed at 5 signalized intersections during 2 periods, namely, before and during the CCTV camera enforcement. The study applied logistic regression analysis to determine factors associated with helmet use and to compare the ratio of helmet use for each variable according to the odds ratio. Results The study found that CCTV camera enforcement could increase helmet usage at all study intersections by 5.3%. The results imply that 4 factors, including riding status, number of passengers, day of week, and traffic conditions, significantly affected helmet use both before and during the CCTV camera enforcement. Remarkably, 2 more variables, age and police inspection, significantly affected helmet use during the CCTV camera enforcement period. Conclusions This study confirms that CCTV camera enforcement can be an important driving force for changing helmet use behavior, particularly for child passengers. Moreover, CCTV camera enforcement can support enforcement by extending coverage to a 24-h period and to intersections without police inspection.

Collaboration in Mass Violence: The Case of the Indonesian Anti-Leftist Mass Killings in 1965–66 in East Java

ABSTRACT The aim of this article is to examine further the concept of collaboration in genocide and mass killings through the case study of anti-communist mass killings in Indonesia in 1965–66. High degree of civilian involvement in the killings has misled to a conclusion that the state (in this case, the Indonesian army) did not have a significant role in the killings. The Indonesian state and some scholars interpret the violence as a result of horizontal conflict between the communists and religious or nationalist groups; or violence that could not be generated an overarching pattern, because in some areas the army took the lead, while in other areas, it was the civilians. This article examines the killings in East Java, one of the provinces with a high death toll. Previous studies in this province conclude that civilians were dominant in taking actions against the communists and leftists. However, this does not mean that the army did not have a significant role in the violence. Through the analysis of the newly-accessed East Java military (Kodam V Brawijaya) archives collection, this article will show that although mass killings were executed by civilians in early October 1965 in East Java, they became coordinated and systematic under the military command since mid-October 1965. Readings on the archives strongly show that the military structurally facilitated the violence, while on the other hand, civilians collaborate with the military to remove Indonesian leftists. The collaboration in East Java shows a structurally coordinated move to persecute the communists.