Predictors of mortality among hospitalized COVID-19 patients and risk score formulation for prioritizing tertiary care—An experience from South India

BACKGROUND: We retrospectively data-mined the case records of Reverse Transcription Polymerase Chain Reaction (RT-PCR) confirmed COVID-19 patients hospitalized to a tertiary care centre to derive mortality predictors and formulate a risk score, for prioritizing admission. METHODS AND FINDINGS: Data on clinical manifestations, comorbidities, vital signs, and basic lab investigations collected as part of routine medical management at admission to a COVID-19 tertiary care centre in Chengalpattu, South India between May and November 2020 were retrospectively analysed to ascertain predictors of mortality in the univariate analysis using their relative difference in distribution among ‘survivors’ and ‘non-survivors’. The regression coefficients of those factors remaining significant in the multivariable logistic regression were utilised for risk score formulation and validated in 1000 bootstrap datasets. Among 746 COVID-19 patients hospitalised [487 “survivors” and 259 “non-survivors” (deaths)], there was a slight male predilection [62.5%, (466/746)], with a higher mortality rate observed among 40–70 years age group [59.1%, (441/746)] and highest among diabetic patients with elevated urea levels [65.4% (68/104)]. The adjusted odds ratios of factors [OR (95% CI)] significant in the multivariable logistic regression were SaO(2)3; 3.01 (1.61–5.83), Age ≥50 years;2.52 (1.45–4.43), Pulse Rate ≥100/min: 2.02 (1.19–3.47) and coexisting Diabetes Mellitus; 1.73 (1.02–2.95) with hypertension and gender not retaining their significance. The individual risk scores for SaO(2)3–11, Age ≥50 years-9, Pulse Rate ≥100/min-7 and coexisting diabetes mellitus-6, acronymed collectively as ‘OUR-ARDs score’ showed that the sum of scores ≥ 25 predicted mortality with a sensitivity-90%, specificity-64% and AUC of 0.85. CONCLUSIONS: The ‘OUR ARDs’ risk score, derived from easily assessable factors predicting mortality, offered a tangible solution for prioritizing admission to COVID-19 tertiary care centre, that enhanced patient care but without unduly straining the health system

Multidimensional evaluation of scientific inputs and output: A study of Asean / Vignes Gopal Krishna

This thesis analyzed the importance of scientific research through scientific collaboration, social networking sites and journal impact factors. The rapid growth of science, technology and innovation has inspired scientific publications with international collaborators in high impact journals. Social networking sites are useful as a virtual alternative for expanding research opportunities, though some researchers feel that it is more for social communications. Diachronous impact factor has gained attention among diverse agents as a tool to evaluate significance of Institute for Scientific Information’s indexed journals. Most productive researchers in Malaysia chose the collaborators who have the highest number of scientific publications. Significant differences in both rates and strengths of scientific collaborations were observed among most productive authors except for most productive institutions through Kruskal-Wallis test. The rates of scientific collaboration between the local and international institutions have been low because of poor networking ability among local researchers. Lower research visibility would reduce the demand for scientific collaboration. Scientific collaboration between researchers in Malaysia and the ASEAN countries have been low because of limited talents in writing joint papers. Socimetrics and Conversational Analysis have reflected significant research conversations among active participants from Malaysia in Facebook. Researchers from Singapore, Thailand, Vietnam, Indonesia and the other ASEAN member states preferred physical instead of virtual medium for research communications. LinkedIn has pointed out limited research communication between researchers from Singapore and Thailand via Socimetrics and Conversational Analysis. It neglects Brunei, Indonesia, Laos and others from the analysis for revealing limited research participations in LinkedIn. There iv were also Intellectual interactions between Malaysia, Pakistan, India, the USA and Australia in Facebook and LinkedIn through Socimetrics and Conversational Analysis. The most suitable measure for evaluating performing Malaysian journals both in the short-term and long-term is diachronous impact factor based on unique citing sources. It has showed the non-overlapping effects (62 percent) in revealing “true” scientific performance and fairness of the journals through forward approach in Malaysia. In Thailand, the diachronous impact factor, based on unique citing subject categories, took the lead to remove the biasness of classical impact factor. In Philippines, Diachronous impact factors based on citing organizations and unique citing sources have removed the biasness of existing impact factors. Diachronous impact factor based on citation concentration index allows both first-comer and latecomer journals in Economics to improve their scientific visibility in a fairer way. It removes the bias in short-term impact factor. The discussions on scientific collaborations, social networking sites and journal impact factors would allow policymakers to maintain the effective resource allocations

Impact of severe chronic periodontitis on oral health-related quality of life

Purpose: To assess the impact of extent and severity of chronic periodontitis (CP) on oral health-related quality of life (OHRQoL). Materials and Methods: A cross-sectional comparative study was performed on subjects from multiple dental centres in Malaysia using a questionnaire covering sociodemographics, OHRQoL using the Malaysian Oral Health Impact Profile questionnaire, OHIP-14(M) and self-reported symptoms. Participants with severe CP were age-and gender-matched with periodontally healthy/mild periodontitis (HMP) participants based on inclusion and exclusion criteria. Full mouth periodontal examination was performed on participants. Outcome measures were OHIP-14(M) prevalence of impact and severity of impact scores. Results: One hundred and thirty (130) participants comprising 65 severe CP and 65 HMP participants were included in the study. Prevalence of impact on OHRQoL was significantly higher in the severe CP than HMP group, with an odds ratio of 3. Mean OHIP-14(M) score was significantly higher in the severe CP (18.26 ± 10.22) compared to HMP (11.28± 8.09) group. The dimensions of psychological discomfort and functional limitation, and factors such as 'discomfort due to food stuck' and 'felt shy' were impacted more in severe CP compared to HMP group (p < 0.05). When compared with the HMP group, generalised severe CP participants showed higher prevalence of impact on OHRQoL [OR=5] (p < 0.05) compared to localised severe CP [OR=2] (p = 0.05). Participants who had experienced self-reported symptoms had statistically significant impacts on OHRQoL. Conclusions: Severe CP had a greater impact on OHRQoL compared to HMP. Impacts were mainly for functional limitation and psychological discomfort dimensions. When considering extent of disease, the impact on OHRQoL was mostly in generalised severe CP subgroup. © Quintessenz