Prognostic indicators and outcomes of hospitalised COVID-19 patients with neurological disease: An individual patient data meta-analysis

Background Neurological COVID-19 disease has been reported widely, but published studies often lack information on neurological outcomes and prognostic risk factors. We aimed to describe the spectrum of neurological disease in hospitalised COVID-19 patients; characterise clinical outcomes; and investigate factors associated with a poor outcome. Methods We conducted an individual patient data (IPD) meta-analysis of hospitalised patients with neurological COVID-19 disease, using standard case definitions. We invited authors of studies from the first pandemic wave, plus clinicians in the Global COVID-Neuro Network with unpublished data, to contribute. We analysed features associated with poor outcome (moderate to severe disability or death, 3 to 6 on the modified Rankin Scale) using multivariable models. Results We included 83 studies (31 unpublished) providing IPD for 1979 patients with COVID-19 and acute new-onset neurological disease. Encephalopathy (978 [49%] patients) and cerebrovascular events (506 [26%]) were the most common diagnoses. Respiratory and systemic symptoms preceded neurological features in 93% of patients; one third developed neurological disease after hospital admission. A poor outcome was more common in patients with cerebrovascular events (76% [95% CI 67–82]), than encephalopathy (54% [42–65]). Intensive care use was high (38% [35–41]) overall, and also greater in the cerebrovascular patients. In the cerebrovascular, but not encephalopathic patients, risk factors for poor outcome included breathlessness on admission and elevated D-dimer. Overall, 30-day mortality was 30% [27–32]. The hazard of death was comparatively lower for patients in the WHO European region. Interpretation Neurological COVID-19 disease poses a considerable burden in terms of disease outcomes and use of hospital resources from prolonged intensive care and inpatient admission; preliminary data suggest these may differ according to WHO regions and country income levels. The different risk factors for encephalopathy and stroke suggest different disease mechanisms which may be amenable to intervention, especially in those who develop neurological symptoms after hospital admission

The impact of informal irrigation practices on soil drainage condition, soil pollution and land suitability for agriculture in El Saf area of El Giza Governorate

The study area was selected in El Saf District of El Giza Governorate in Egypt, covering 21461.4 ha of Nile sediments and their outskirts of alluvial higher and lower terraces. The aim of this study was to assess the impact of informal irrigation practices on drainage deterioration, soil pollution and land suitability for agricultural use using the satellite LDCM data 2013. From the lower alluvial terraces (partly cultivated using wastewater), the drainage flows westward via descending slopes resulting in land deterioration in both the alluvial lower terraces and alluvial plain of River Nile. The drainage conditions are excessively drained soils in the alluvial upper terraces within soils of Typic Haplocalcids, sandy skeletal, but in the lower terraces it partly occurred within soils of Typic Torriorthents, sandy skeletal. Moderately well drained soils occurred in soils of Typic Torriorthents, sandy in the alluvial lower terraces, while in the alluvial plain of Nile sediments are Sodic Haplotorrerts, fine. Poorly drained soils in the lower alluvial terraces have soils of Typic Epiaquents, sandy associated with Sodic Psammaquents and Aquic Haplocalcids, coarse loamy, while in the alluvial plain of River Nile the soils are Halic Epiaquerts, fine. Very poorly drained soils (submerged areas) are scattered spots in both the lower alluvial terraces and the alluvial plain. In the alluvial plain of River Nile, 1967.1 ha become not suitable for the traditional cultivated crops, while in the alluvial terraces 3251.0 ha are not suitable for the proposed cultivation of Jojoba plants. Heavy metals of Cadmium (Cd), Cobalt (Co), Lead (Pb) and Nickel (Ni) were added to the soil surface and sub-surface in the irrigated areas by wastewater in the lower alluvial terraces (moderately well drained soils), but Cd and Co exceeded the standards of permissible total concentrations in these soils. The same metals were added to soil sub-surface layers in the alluvial plain (poorly drained soils), but Co exceeded the total permissible concentrations. Continuing these informal irrigation practices, drainage condition will be deteriorated in extra areas and all heavy metal concentrations will exceed the standards of permissible levels. Improving the land qualities of drainage is required and Jojoba cultivation is proposed to replace the edible crop cultivation in the alluvial terraces to avoid the heavy metal contamination risk and to be used for developing a bio-fuel crop production of renewable energy

Aspectos hematológicos de caprinos (Capra hircus) da raça Canindé criados no Rio Grande do Norte

Objetivou-se com este trabalho estudar o perfil hematológico de caprinos (Capra hircus) da raça Canindé, criados no Estado do Rio Grande do Norte, como também a busca de valores de referência que se adequem à nossa região. Foram coletadas amostras sanguíneas de 58 animais clinicamente sadios, distribuídos em 4 grupos (machos acima de 5 meses, fêmeas gestantes, fêmeas não gestantes e filhotes até 4 meses de idade). A partir de única amostra de sangue de cada animal foram realizados o eritrograma (contagem de hemácias, hematócrito, hemoglobina, volume corpuscular médio e concentração de hemoglobina corpuscular média) e o leucograma (contagem total e diferencial de leucócitos). Os dados obtidos foram avaliados por meio do teste de Tukey para variáveis paramétricas e Kruskal-Wallis seguido pelo teste de Dunn para não paramétricos em nível de significância de (p<0.05). Os resultados apontam para existência de maiores quantidades de He nos machos adultos e fêmeas não gestantes, diferente do que ocorre com o VCM; já com relação ao leucograma temos que os eosinófilos mostram-se mais elevados nas fêmeas adultas e os monócitos se elevam quando na presença da gestação. Os valores deste trabalho podem servir de referência para raça Canindé, tornando possível futuras interpretações para os parâmetros verificados, além de subsidiar novos estudos em animais hígidos ou doentes. Mostra a necessidade de pesquisas que evidenciem as condições semiáridas de manejo e alimentação, bem como a avaliação dos fatores de variação, sobre constituintes do sangue, que levem em conta o sexo, a idade e estado fisiológico dos animais

Prognostic indicators and outcomes of hospitalised COVID-19 patients with neurological disease: An individual patient data meta-analysis

BackgroundNeurological COVID-19 disease has been reported widely, but published studies often lack information on neurological outcomes and prognostic risk factors. We aimed to describe the spectrum of neurological disease in hospitalised COVID-19 patients; characterise clinical outcomes; and investigate factors associated with a poor outcome.MethodsWe conducted an individual patient data (IPD) meta-analysis of hospitalised patients with neurological COVID-19 disease, using standard case definitions. We invited authors of studies from the first pandemic wave, plus clinicians in the Global COVID-Neuro Network with unpublished data, to contribute. We analysed features associated with poor outcome (moderate to severe disability or death, 3 to 6 on the modified Rankin Scale) using multivariable models.ResultsWe included 83 studies (31 unpublished) providing IPD for 1979 patients with COVID-19 and acute new-onset neurological disease. Encephalopathy (978 [49%] patients) and cerebrovascular events (506 [26%]) were the most common diagnoses. Respiratory and systemic symptoms preceded neurological features in 93% of patients; one third developed neurological disease after hospital admission. A poor outcome was more common in patients with cerebrovascular events (76% [95% CI 67-82]), than encephalopathy (54% [42-65]). Intensive care use was high (38% [35-41]) overall, and also greater in the cerebrovascular patients. In the cerebrovascular, but not encephalopathic patients, risk factors for poor outcome included breathlessness on admission and elevated D-dimer. Overall, 30-day mortality was 30% [27-32]. The hazard of death was comparatively lower for patients in the WHO European region.InterpretationNeurological COVID-19 disease poses a considerable burden in terms of disease outcomes and use of hospital resources from prolonged intensive care and inpatient admission; preliminary data suggest these may differ according to WHO regions and country income levels. The different risk factors for encephalopathy and stroke suggest different disease mechanisms which may be amenable to intervention, especially in those who develop neurological symptoms after hospital admission

Prognostic indicators and outcomes of hospitalised COVID-19 patients with neurological disease: An individual patient data meta-analysis

BackgroundNeurological COVID-19 disease has been reported widely, but published studies often lack information on neurological outcomes and prognostic risk factors. We aimed to describe the spectrum of neurological disease in hospitalised COVID-19 patients; characterise clinical outcomes; and investigate factors associated with a poor outcome.MethodsWe conducted an individual patient data (IPD) meta-analysis of hospitalised patients with neurological COVID-19 disease, using standard case definitions. We invited authors of studies from the first pandemic wave, plus clinicians in the Global COVID-Neuro Network with unpublished data, to contribute. We analysed features associated with poor outcome (moderate to severe disability or death, 3 to 6 on the modified Rankin Scale) using multivariable models.ResultsWe included 83 studies (31 unpublished) providing IPD for 1979 patients with COVID-19 and acute new-onset neurological disease. Encephalopathy (978 [49%] patients) and cerebrovascular events (506 [26%]) were the most common diagnoses. Respiratory and systemic symptoms preceded neurological features in 93% of patients; one third developed neurological disease after hospital admission. A poor outcome was more common in patients with cerebrovascular events (76% [95% CI 67-82]), than encephalopathy (54% [42-65]). Intensive care use was high (38% [35-41]) overall, and also greater in the cerebrovascular patients. In the cerebrovascular, but not encephalopathic patients, risk factors for poor outcome included breathlessness on admission and elevated D-dimer. Overall, 30-day mortality was 30% [27-32]. The hazard of death was comparatively lower for patients in the WHO European region.InterpretationNeurological COVID-19 disease poses a considerable burden in terms of disease outcomes and use of hospital resources from prolonged intensive care and inpatient admission; preliminary data suggest these may differ according to WHO regions and country income levels. The different risk factors for encephalopathy and stroke suggest different disease mechanisms which may be amenable to intervention, especially in those who develop neurological symptoms after hospital admission.Thrombosis and Hemostasi

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic

Abstract: The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world. Protocol registration: The stage 1 protocol for this Registered Report was accepted in principle on 12 May 2020. The protocol, as accepted by the journal, can be found at https://doi.org/10.6084/m9.figshare.c.4878591.v1 © 2021, The Author(s), under exclusive licence to Springer Nature Limited

Author Correction: A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic

Correction to: Nature Human Behaviour https://doi.org/10.1038/s41562-021-01173-x, published online 2 August 2021. In the version of this article initially published, the following authors were omitted from the author list and the Author contributions section for “investigation” and “writing and editing”: Nandor Hajdu (Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary), Jordane Boudesseul (Facultad de Psicología, Instituto de Investigación Científica, Universidad de Lima, Lima, Perú), Rafał Muda (Faculty of Economics, Maria Curie-Sklodowska University, Lublin, Poland) and Sandersan Onie (Black Dog Institute, UNSW Sydney, Sydney, Australia & Emotional Health for All Foundation, Jakarta, Indonesia). In addition, Saeideh FatahModares’ name was originally misspelled as Saiedeh FatahModarres in the author list. Further, affiliations have been corrected for Maria Terskova (National Research University Higher School of Economics, Moscow, Russia), Susana Ruiz Fernandez (FOM University of Applied Sciences, Essen; Leibniz-Institut für Wissensmedien, Tübingen, and LEAD Research Network, Eberhard Karls University, Tübingen, Germany), Hendrik Godbersen (FOM University of Applied Sciences, Essen, Germany), Gulnaz Anjum (Department of Psychology, Simon Fraser University, Burnaby, Canada, and Department of Economics & Social Sciences, Institute of Business Administration, Karachi, Pakistan). The changes have been made to the HTML and PDF versions of the article

In COVID-19 health messaging, loss framing increases anxiety with Little-to-No concomitant benefits: Experimental evidence from 84 countries

The COVID-19 pandemic (and its aftermath) highlights a critical need to communicate health information effectively to the global public. Given that subtle differences in information framing can have meaningful effects on behavior, behavioral science research highlights a pressing question: Is it more effective to frame COVID-19 health messages in terms of potential losses (e.g., “If you do not practice these steps, you can endanger yourself and others”) or potential gains (e.g., “If you practice these steps, you can protect yourself and others”)? Collecting data in 48 languages from 15,929 participants in 84 countries, we experimentally tested the effects of message framing on COVID-19-related judgments, intentions, and feelings. Loss- (vs. gain-) framed messages increased self-reported anxiety among participants cross-nationally with little-to-no impact on policy attitudes, behavioral intentions, or information seeking relevant to pandemic risks. These results were consistent across 84 countries, three variations of the message framing wording, and 560 data processing and analytic choices. Thus, results provide an empirical answer to a global communication question and highlight the emotional toll of loss-framed messages. Critically, this work demonstrates the importance of considering unintended affective consequences when evaluating nudge-style interventions