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COVID-19 has challenged the mental health of healthcare workers confronting it world-wide. Our study identifies the prevalence and risk of anxiety among emergency healthcare workers confronting COVID-19 in Pakistan. We conducted a cross-sectional survey in an Emergency Department using the Generalized Anxiety Scale (GAD-7), and questions about sources of anxiety. Of 107 participants, 61.7% were frontline workers. The prevalence of anxiety was 50.5%. Nonparametric tests determined that nurses, younger and inexperienced staff, developed significant anxiety. Multivariate ordinal regression determined independent risk factors for developing anxiety were younger age (OR 2.11, 95% CI 0.89–4.99) and frontline placement (OR 1.34, 95% CI 0.33–1.66). Significant sources of stress were fear of infecting family (P = 0.003), lack of social support when the health care providers were themselves unwell (P = 0.02) and feelings of inadequate work performance (P = 0.05). Our study finds that HCWs’ anxiety is considerable. Appropriate measures for its alleviation and prevention are required.
Pre-existing health conditions may exacerbate the severity of coronavirus disease 2019 (COVID-19). We aimed to estimate the case-fatality rate (CFR) and rate ratios (RR) for patients with hypertension (HBP) and diabetes mellitus (DM) in the New York state. We obtained the age-specific number of COVID-19 confirmed cases and deaths from public reports provided by the New York State Department of Health, and age-specific prevalence of HBP and DM from the Behavioral Risk Factor Surveillance System 2017. We calculated CFR and RR for COVID-19 patients with HBP and DM based on the reported number of deaths with the comorbidity divided by the expected number of COVID-19 cases with the comorbidity. We performed subgroup analysis by age and calculated the CFR and RR for ages of 18–44, 45–64 and 65+ years, respectively. We found that the older population had a higher CFR, but the elevated RRs associated with comorbidities are more pronounced among the younger population. Our findings suggest that besides the elderly, the young population with comorbidity should also be considered as a vulnerable group.
The ten-item short form of the Autism-Spectrum Quotient (AQ-10) has been used to efficiently assess autistic traits in the general population; however, the psychometric properties of the AQ-10 in terms of its internal reliability and its unifactorial structure have recently been questioned. In the present study (N = 797), whether the internal reliability is increased when the AQ-10 is applied with six rather than the conventional four response categories has been investigated. Moreover, correlational and confirmatory factor analyses were conducted to examine the reason for potential inhomogeneity within the AQ-10. The results suggest that the internal reliability of the AQ-10 was slightly increased but is still unsatisfactory, likely due to the incompatibility of items from two subdimensions: attention to detail and imagination. With six of the AQ-10 items, crucial aspects of the autistic personality may be measured, but other important aspects would be neglected; thus, the measure requires further psychometric development.
Only studies in the UK on individuals dying from coronavirus disease 2019 (COVID-19) in hospital have been published, to date. Cremation law requires collection of clinical information that can improve understanding of deaths in both hospital and community settings. Age, sex, date and place of death, occupation, comorbidities and where infection acquired was recorded for all deaths from COVID-19, between 6 April and 30 May, for whom an application was made for cremation at a South Wales' crematorium. Of 752 cremations, 215 (28.6%) were COVID-19 (115 (53.5%) male and 100 (46.5%) female). Median age was 82 years (youngest patient 47 and the oldest 103 years). Over half the deaths (121/215: 56.3%) were over 80 years. Males' odds of dying in hospital, rather than the community were 1.96 times that of females (95% confidence intervals (CI) 1.03–3.74, P = 0.054) despite being of similar age and having a similar number of comorbidities. Only 21 (9.8%) of 215 patients had no comorbidities recorded. Patients dying in care homes were significantly older than those dying in hospital (median 88 years (interquartile (IQ) range 82–93 years) vs. 80 years (IQ range 71–87 years): P < 0.0001). Patients dying in hospital had significantly more comorbidities than those dying in care homes (median 2: IQ range 1–3 vs. 1: IQ range 1–2: P < 0.001). Sixty three (29.3%) of infections were hospital acquired and a further 55 (25.6%) acquired in care homes. In a series, of hospital and community deaths, persons over 80 with an average two comorbidities predominated. Men were more likely to die in hospital. Half the infections were acquired in hospitals or care homes with implications for management of the pandemic.
We prove a number of results related to a problem of Po-Shen Loh [9], which is equivalent to a problem in Ramsey theory. Let a = (a1, a2, a3) and b = (b1, b2, b3) be two triples of integers. Define a to be 2-less than b if ai < bi for at least two values of i, and define a sequence a1, …, am of triples to be 2-increasing if ar is 2-less than as whenever r < s. Loh asks how long a 2-increasing sequence can be if all the triples take values in {1, 2, …, n}, and gives a log* improvement over the trivial upper bound of n2 by using the triangle removal lemma. In the other direction, a simple construction gives a lower bound of n3/2. We look at this problem and a collection of generalizations, improving some of the known bounds, pointing out connections to other well-known problems in extremal combinatorics, and asking a number of further questions.
In December 2019, the first confirmed case of pneumonia caused by a novel coronavirus was reported. Coronavirus disease 2019 (COVID-19) is currently spreading around the world. The relationships among the pandemic and its associated travel restrictions, social distancing measures, contact tracing, mask-wearing habits and medical consultation efficiency have not yet been extensively assessed. Based on the epidemic data reported by the Health Commission of Wenzhou, we analysed the developmental characteristics of the epidemic and modified the Susceptible-Exposed-Infectious-Removed (SEIR) model in three discrete ways. (1) According to the implemented preventive measures, the epidemic was divided into three stages: initial, outbreak and controlled. (2) We added many factors, such as health protections, travel restrictions and social distancing, close-contact tracing and the time from symptom onset to hospitalisation (TSOH), to the model. (3) Exposed and infected people were subdivided into isolated and free-moving populations. For the parameter estimation of the model, the average TSOH and daily cured cases, deaths and imported cases can be obtained through individual data from epidemiological investigations. The changes in daily contacts are simulated using the intracity travel intensity (ICTI) from the Baidu Migration Big Data platform. The optimal values of the remaining parameters are calculated by the grid search method. With this model, we calculated the sensitivity of the control measures with regard to the prevention of the spread of the epidemic by simulating the number of infected people in various hypothetical situations. Simultaneously, through a simulation of a second epidemic, the challenges from the rebound of the epidemic were analysed, and prevention and control recommendations were made. The results show that the modified SEIR model can effectively simulate the spread of COVID-19 in Wenzhou. The policy of the lockdown of Wuhan, the launch of the first-level Public Health Emergency Preparedness measures on 23 January 2020 and the implementation of resident travel control measures on 31 January 2020 were crucial to COVID-19 control.
Expansion of cultivated lands and field management impacts greenhouse gas (GHG) emissions from agriculture soils. Soils naturally cycle GHGs and can be sources or sinks depending on physical and chemical properties affected by cultivation and management status. We looked at how cultivation history influences GHG emissions from subtropical soils. We measured CO2, N2O, and CH4 fluxes, and soil properties from newly converted and continuously cultivated lands during the summer rainy season in calcareous soils from south Florida. Newly converted soils had more soil organic matter (OM), more moisture, higher porosity, and lower bulk density, leading to more GHG emissions compared to historically cultivated soils. Although more nutrients make newly converted lands more desirable for cultivation, conversion of new areas for agriculture was shown to release more GHGs than cultivated lands. Our data suggest that GHG emissions from agricultural soils may decrease over time with continued cultivation.
The coronavirus disease 2019 (COVID-19) pandemic is currently the most critical challenge in public health. An understanding of the factors that affect severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection will help fight the COVID-19 pandemic. This study sought to investigate the association between SARS-CoV-2 infection and blood type distribution. The big data provided by the World Health Organization (WHO) and Johns Hopkins University were used to assess the dynamics of the COVID-19 epidemic. The infection data in the early phase of the pandemic from six countries in each of six geographic zones divided according to the WHO were used, representing approximately 5.4 billion people around the globe. We calculated the infection growth factor, doubling times of infection and death cases, reproductive number and infection and death cases in relation to the blood type distribution. The growth factor of infection and death cases significantly and positively correlated with the proportion of the population with blood type A and negatively correlated with the proportion of the population with blood type B. Compared with the lower blood type A population (<30%), the higher blood type A population (⩾30%) showed more infection and death cases, higher growth factors and shorter case doubling times for infections and deaths and thus higher epidemic dynamics. Thus, an association exists between SARS-CoV-2 and the ABO blood group distribution, which might be useful for fighting the COVID-19 pandemic.
Health care workers (HCWs) are vulnerable to the risk of infections and could become vectors of onward transmission of coronavirus disease 2019 (COVID-19). Little is known about the factors which could contribute to increased COVID-19 infection among HCWs in Nigeria. We aimed at assessing the causes of COVID-19 infection among HCWs. We used a qualitative study design to conduct in-depth interview among 16 frontline HCWs participating in the COVID-19 response in Kwara State, Nigeria. Colaizzi's phenomenological method was used in the qualitative analysis of data. We found that HCWs were aware of their vulnerability to the COVID-19 infection, and the reasons attributed included poor knowledge of IPC measures for COVID-19, inadequate supply of personal protective equipment (PPE), poor political will and inadequate health facilities (HFs) management support. Improved political will and better involvement of HFs management teams in infection prevention and control (IPC) systems are needed to reduce the risk for COVID-19 infection among HCWs. We recommend scale-up training on IPC measures particularly hand washing and use of PPE as well as the development of effective points of care risk assessment with a high index of suspicion in HFs.