Associations of psychological wellbeing with COVID-19 hospitalization and mortality in adults aged 50 years or older from 25 European countries and Israel

BackgroundLower psychological wellbeing is associated with poor outcomes in a variety of diseases and healthy populations. However, no study has investigated whether psychological wellbeing is associated with the outcomes of COVID-19. This study aimed to determine whether individuals with lower psychological wellbeing are more at risk for poor outcomes of COVID-19.MethodsData were from the Survey of Health, Aging, and Retirement in Europe (SHARE) in 2017 and SHARE's two COVID-19 surveys in June–September 2020 and June–August 2021. Psychological wellbeing was measured using the CASP-12 scale in 2017. The associations of the CASP-12 score with COVID-19 hospitalization and mortality were assessed using logistic models adjusted for age, sex, body mass index, smoking, physical activity, household income, education level, and chronic conditions. Sensitivity analyses were performed by imputing missing data or excluding cases whose diagnosis of COVID-19 was solely based on symptoms. A confirmatory analysis was conducted using data from the English Longitudinal Study of Aging (ELSA). Data analysis took place in October 2022.ResultsIn total, 3,886 individuals of 50 years of age or older with COVID-19 were included from 25 European countries and Israel, with 580 hospitalized (14.9%) and 100 deaths (2.6%). Compared with individuals in tertile 3 (highest) of the CASP-12 score, the adjusted odds ratios (ORs) of COVID-19 hospitalization were 1.81 (95% CI, 1.41–2.31) for those in tertile 1 (lowest) and 1.37 (95% CI, 1.07–1.75) for those in tertile 2. As for COVID-19 mortality, the adjusted ORs were 2.05 (95% CI, 1.12–3.77) for tertile 1 and 1.78 (95% CI, 0.98–3.23) for tertile 2, compared with tertile 3. The results were relatively robust to missing data or the exclusion of cases solely based on symptoms. This inverse association of the CASP-12 score with COVID-19 hospitalization risk was also observed in ELSA.ConclusionThis study shows that lower psychological wellbeing is independently associated with increased risks of COVID-19 hospitalization and mortality in European adults aged 50 years or older. Further study is needed to validate these associations in recent and future waves of the COVID-19 pandemic and other populations

Performance Analysis and Optimization Design of a Dual-Mode Reconfigurable Ankle Joint Parallel Rehabilitation Mechanism

In this study, a dual-mode reconfigurable parallel ankle joint rehabilitation mechanism is proposed to meet the needs of patients in different ankle rehabilitation stages. This mechanism can switch between the 1T2R (where R represents rotation and T represents translation) and 2T1R motion modes. The screw theory and the modified G-K formula were used to analyze and verify the degree of freedom of the mechanism. The non-parasitic motion characteristics were analyzed by examining the topological structure of the mechanism. An inverse kinematics model was established using the closed-loop vector method, and the mechanism’s singularity was analyzed based on the Jacobian matrix. The Jacobian matrix and the numerical method were used to compare and analyze the workspace index, the rotational dexterity index and the load capacity performance index before and after the introduction of branched chains with actuation redundancy. A particle swarm optimization algorithm was used to optimize the geometric dimensional parameters of the mechanism. The results show that the mechanism exhibits the characteristics of a parallel mechanism without parasitic motion in the two motion modes. Using branched chains with actuation redundancy can significantly improve the rotational dexterity and load capacity performance index, without affecting the workspace index. Compared to the original mechanism, the kinematic performance of the optimized mechanism is significantly improved. It is concluded that the proposed mechanism can meet the needs of ankle joint activity training in the 1T2R motion mode and the needs of ankle joint proprioception training in the 2T1R motion mode, which can better meet the needs of patients in different rehabilitation stages

Multivariate Drought Risk Analysis for the Weihe River: Comparison between Parametric and Nonparametric Copula Methods

This study analyzed the multivariate drought risks for the Wei River basin by characterizing the interdependence between the standardized precipitation index (SPI) and the standardized precipitation evapotranspiration index (SPEI). Both parametric and nonparametric copulas were adopted to quantify the dependence between the SPI and SPEI. The results indicated that the Gaussian copula demonstrated the best fit in most cases, while the nonparametric copula method showed superiority over the parametric models at only one out of eighteen meteorological stations. The joint return periods (TOR, TAND, and TKendall) were computed through copula modeling, providing valuable insights into the co-occurrence of extreme drought events. For the SPI and SPEI with a 50-year return period, the TOR values range from 25.5 to 37.9 years, the TAND values fluctuate between 73.4 and 1233 years, and the TKendall values range from 60.61 to 574.71 years, indicating a high correlation between the SPI and SPEI in the study area. The spatial analysis revealed varying patterns across the basin with some regions more prone to experiencing simultaneous drought conditions characterized by both the SPI and SPEI. Furthermore, our results indicated that the SPEI exhibited more severity in drought characterization than the SPI due to its consideration of temperature effects. The disparities in the spatial features of the SPI and SPEI underscore the importance of incorporating multiple meteorological factors for a comprehensive drought risk analysis. This research contributes to a better understanding of the drought patterns and their joint risks in the Wei River basin, offering valuable information for drought preparedness and water resource management

Short-Term Peg-IFN α-2b Re-Treatment Induced a High Functional Cure Rate in Patients with HBsAg Recurrence after Stopping Peg-IFN α-Based Regimens

Little is known about the treatment of patients with hepatitis B surface antigen (HBsAg) recurrence after being clinically cured by peginterferon alpha(peg-IFN-α)-based regimens. This study aimed to investigate the efficacy and safety of peg-IFNα-2b in re-treating patients with HBsAg recurrence after stopping peg-IFN α-based regimens. In this two-center, prospective observational study, 33 patients with HBsAg recurrence after stopping peg-IFN α-based regimens were enrolled and re-treated with an individualized course of peg-IFN α-2b. The hepatitis B virus (HBV) vaccine could be injected immediately after HBsAg clearance, according to patients’ willingness. All patients were monitored and followed-up for 48 weeks after peg-IFN α-2b re-treatment stop. The primary endpoint was HBsAg clearance at the end of follow-up. At baseline, all patients had HBsAg levels of <10 IU/mL and undetectable HBV DNA, with the median HBsAg level of 1.66 (0.56–2.87) IU/mL. After a median of 24 (24–30) weeks of peg-IFN α-2b re-treatment, 87.9% (29/33) of the patients achieved HBsAg clearance again and 66.7% (22/33) of the patients achieved HBsAg seroconversion. At the end of follow-up, the HBsAg clearance and HBsAg seroconversion rates decreased to 78.8% (26/33) and 51.5% (17/33), respectively. Furthermore, 88.9% (16/18) of the patients with HBsAg clearance benefited from receiving the HBV vaccine therapy. Generally, both peg-IFN α-2b and HBV vaccine therapy were well tolerated. A high functional cure rate can be achieved by a short-course of peg-IFN α-2b re-treatment in patients with HBsAg recurrence after stopping peg-IFN α-based regimens. Furthermore, injecting HBV vaccine is beneficial after HBsAg clearance