Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Assistência bibliográfica durante a escrita de textos científicos : uma abordagem com modelos de linguagem pré-treinados

Scientific output includes the production of textual artifacts, as scientific papers and research projects. Scientific writing, in turn, presents its own challenges. One of them is to face information overload in literature, which hinders contextualization of a new document with the most relevant information of its research area. In face of this difficulty, in this work we will investigate ways of embedding sentences and paragraphs of scientific texts, with the purpose of content recomendation along scientific writing. Through automated scanning of databases of publishers Springer and Elsevier, a local mirror was built for access of research papers, from which it was possible to obtain a corpus with 40 thousand papers from Computer Science journals. Pre-trained language models were used to obtain embedding for words or wordpieces for a sample of 1605 papers. Using these representations, aggregation methods for generating embeddings for sentences and paragraphs were investigated. Embedding strategies for these textual elements were evaluated in two aspects. Firstly, in their capacity of reflecting the aggregation of paragraphs within sections of already published papers. Secondly, they were used frozen to train a bidirectional long short-term memory (BiLSTM) neural network for the task of classifying wether a text fragment and an abstract belonged to the same paper. In both situations, a better performance was obtained with embeddings from bidirectional encoder representations from Transformers (BERT), specifically with a version pre-trained on a scientific corpus (SciBERT). Also in both circumstances, embeddings of sentences obtained by taking the mean of pre-trained word embeddings, weighted considering the word frequency, showed worse performance when compared to the mean of vectors after removing stopwords. Paragraph embeddings using the encoding of a sequence of sentences with a BiLSTM presented superior performance when compared to simple mean of sentence vectors and, when applied to the introduction of a scientific paper in test set, was able to return its own original paper within the 5% most likely ones, on average. A qualitative demonstration of content recommendation which integrates the result of both analyses is presented. Considering the studied strategies, automated bibligraphical assistance during production of scientific texts was feasible, with potential for improvement with more optimized hierarchical BiLSTMs.A produção científica inclui a geração de artefatos textuais, como artigos científicos e projetos de pesquisa. A escrita científica, por sua vez, apresenta desafios próprios. Um deles é lidar com a sobrecarga de informação na literatura, que dificulta a contextualização de um novo documento com as informações mais relevantes da área de pesquisa. Diante desse desafio, neste trabalho são investigadas formas de se representar vetorialmente sentenças e parágrafos de textos científicos, com o propósito de recomendar conteúdo relevante durante sua escrita. Por varredura automatizada das bases de dados das editoras Springer e Elsevier, foi construído um espelho para acesso local de artigos científicos, do qual foi possível ser extraído corpus com 40 mil artigos de periódicos de Ciência da Computação. Modelos de linguagem pré-treinados foram usados para se obter vetorizações de palavras ou fragmentos de palavras para uma amostra de 1605 artigos. A partir dessas representações, métodos de agregação para gerar representações de sentenças e de parágrafos foram investigados. Estratégias de vetorização para os elementos textuais foram avaliadas em dois aspectos. Primeiramente, na capacidade de refletir a agregação de parágrafos dentro das seções dos artigos já publicados. Em seguida, foram usadas fixadas para treinar uma rede recorrente de longa memória de curto prazo bidirecional (BiLSTM) na tarefa de determinar se um fragmento de texto e um resumo pertenciam a um mesmo artigo científico. Nas duas situações, atingiu melhor desempenho a vetorização com representações de codificador bidirecional por transformadores (BERT), na variante pré-treinada em corpus de textos científicos (SciBERT). Também nos dois cenários, a representação de sentenças pela média dos vetores pré-treinados, ponderada a partir da frequência do elemento, mostrou desempenho inferior quando comparada à média simples dos vetores após remoção das palavras de parada (stopwords). A representação de parágrafos a partir da codificação de uma sequência de sentenças por uma BiLSTM se mostrou superior quando comparada à simples média dos vetores de sentenças e, quando aplicada à introdução de um artigo científico no subconjunto de teste, foi capaz de retornar o resumo do próprio artigo dentre os 5% mais prováveis, em média. Uma demonstração qualitativa da recomendação de conteúdo que integra o resultado das duas abordagens é apresentada. A partir das estratégias investigadas, a assistência bibliográfica automatizada durante a produção de textos científicos se mostrou viável, podendo ser melhorada com a otimização de redes com BiLSTMs hierárquicas.São Cristóvão, S

<b>Body composition and socioeconomic factors in patients with hepatic steatosis

The study aimed to evaluate the association of the components of body composition (body mass index – BMI, waist circumference, basal metabolism, body fat percentage, fat weight, fat free percentage and lean weight) with gender, age, income and schooling in patients with hepatic steatosis. Descriptive and survey study, with quantitative analytical approach. Data were collected through ultrasound and bioimpedance tests. The significance was p < 0.05 and software used was SPSS 22.0. A sample of 114 patients with hepatic steatosis, 70.1% were women. The mean age was 46.2, only 11.4% had normal BMI. The mean BMI was 30.4, waist circumference 100.2 cm, fat percentage 37.97%, basal metabolism 1451.9 kcal, fat weight 31.0 kg. Statistical differences in several variables in relation to gender and age were found. However, no statistically significant differences were found regarding schooling and income. Changes in body composition were obvious in patients with hepatic steatosis.

Prevalence of overweight and associated factors in a metropolitan area in the Northeast of Brazil

Objective: This article aimed to identify the clinical and socio-demographic profile of overweight adults evaluated through survey and anthropometric measurements in the city of Aracaju, Sergipe, Brazil. Methods: Descriptive transversal outline survey-type study in a quantitative analytical approach. The sample was composed of 690 individuals who randomly sought four reference centers in the municipality of Aracaju for abdominal ultrasonography. Anthropometric measurements were taken between July 2013 and July 2014. The following variables were analyzed: age, gender, income, schooling, comorbidities, waist girth and body mass index (BMI). The statistical program Statistical Package for the Social Sciences (SPSS) 22.0 was chosen, and significance level was p<0.05. Results: 494 women (71.6%) and 196 men (28.4%) were analyzed. The average age was 39.4 years, and 42.3 years for obese patients. Regarding BMI, 52.9% of patients presented normal BMI; 31.2% were overweight; 10.4% presented level 1 obesity; 4.5%, level 2; and 1.0%, level 3. The BMI was significantly higher among the hypertensive ones (p=0.001), with poor schooling (p=0.004), and those with higher income (p=0.003). Average waist circumference was 104.94 cm among the obese portion. Conclusion: The observed high prevalence of overweight in the studied adults is in accordance with the national epidemiologic tendency, which allows classifying the situation as a public health problem in the evaluated municipality

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures