Cardiovascular mortality in Northern Ireland during the 2008-2014 financial crisis years: who got the worst hit?

Background: Internationally, cardiovascular mortality and economic recessions showed an established relationship. Northern Ireland was badly affected by the global financial crisis in 2008-2014 but little is known in terms of how cardiovascular mortality was affected. Objective: The aim of the present study was to investigate the potential impact of the 2008 economic crisis on the annual cerebrovascular accidents CVA and ischaemic heart disease IHD related mortality in Northern Ireland. Method: Mortality data were extracted from Northern Ireland Statistics and Research Agency database. We utilized generalized linear regression Poisson modelling to estimate the impact of economic crisis on the IHD and CVA mortality. Results: We found a significant increase of IHD-deaths during the financial crisis years in males over the age of 65 (β = 49.466, p value = 0.003) and females over the age of 65 (β = 57.721, p value = 0.001). However, CVA-mortality in the post crisis years rose significantly for females who were 65 years or older (β = 56.010, p value = 0.005) but not for males. The rest of the age groups were not significantly affected in terms of either CVA or IHD mortality. Conclusion: For the total population the only age category with significant increase in both IHD and CVA mortality in the post-2008 era was the over 65 (p values < 0.001 and = 0.012, respectively) Declaration of interest: None. Keywords: IHD, CVA, Northern Ireland, economic recession, working-age, socio-economic change

Optimization of energy consumption in cloud computing datacenters

Cloud computing has emerged as a practical paradigm for providing IT resources, infrastructure and services. This has led to the establishment of datacenters that have substantial energy demands for their operation. This work investigates the optimization of energy consumption in cloud datacenter using energy efficient allocation of tasks to resources. The work seeks to develop formal optimization models that minimize the energy consumption of computational resources and evaluates the use of existing optimization solvers in testing these models. Integer linear programming (ILP) techniques are used to model the scheduling problem. The objective is to minimize the total power consumed by the active and idle cores of the servers’ CPUs while meeting a set of constraints. Next, we use these models to carry out a detailed performance comparison between a selected set of Generic ILP and 0-1 Boolean satisfiability based solvers in solving the ILP formulations. Simulation results indicate that in some cases the developed models have saved up to 38% in energy consumption when compared to common techniques such as round robin. Furthermore, results also showed that generic ILP solvers had superior performance when compared to SAT-based ILP solvers especially as the number of tasks and resources grow in size

Chronic Neutrophilic Leukemia with Monocytosis

Chronic neutrophilic leukaemia is a very rare disease with diagnosis based on persistent leucocytosis >25×103/μl and monocytes <1×103/μl. The revised WHO criteria 2016 included CSF3R gene mutations as a diagnostic finding. We report the case of a 77-year-old man who was found to have asymptomatic persistent mature neutrophilic leucocytosis with monocytosis. Molecular study confirmed the presence of a CSF3R gene mutation in the absence of morphological or genetic features of myelodysplasia or other forms of myelodysplastic syndrome. The patient’s medical history was significant for coronary artery disease, hypertension, chronic obstructive pulmonary disease, bilateral cystic bronchiectasis, moderate pulmonary hypertension, tuberculosis treated 27 years previously, hypothyroidism, and a thyroid nodule. He had hepatosplenomegaly but no lymphadenopathy, and no other malignancy was seen on computed tomography (CT) scanning. At the time of evaluation, he was free of symptoms and had no evidence of infection or drug-induced leucocytosis. The patient was referred to an oncology centre and treated with hydroxyurea and subsequently azacitidine. However, he developed pancytopenia with bone marrow aplasia. He died with neutropenia sepsis. The presence of persistent monocytosis in this case created a diagnostic dilemma as to whether the disease was a variant of chronic neutrophilic leukaemia or was reactive monocytosis

Carbapenem use correlates with percentage of patients with COVID-19 in intensive care units

Background: The first wave of COVID-19 pandemic may have significantly impacted antimicrobial consumption in hospitals. The objective of this study was to assess the evolution of carbapenem consumption and describe the implemented measures during the first year of the COVID-19 pandemic. Methods: We calculated carbapenem consumption for all the hospital and for intensive care units (ICU) for three periods: baseline (before COVID-19 cases, January 2019-February 2020), and the period of COVID-19 cases as a pre-intervention (March-August 2020) and a post-intervention phase (September 2020-December 2021). Results: During the study period, the percentage of admitted COVID-19 patients increased in the months of April-August of 2020 (pre-intervention period) from 5 to 26% of total admitted patients. The consumption of carbapenems (DDD/1000 patient days) increased from a mean of 67.1 at baseline to 142.9 pre-intervention. In ICUS, there was an increase in the mean from 125.7 to 240.8 DDD/1000 patient days. After interventions, the DDD/1000 patient days decreased by 49.5% overall the hospital and by 36% in ICUs. For the post-intervention period, there was a correlation between COVID-19 cases and carbapenem usage in the ICU but not the overall hospital. Conclusion: An increase in the antimicrobial consumption during the first wave of COVID-19 pandemic was noticed, especially in the ICU. Antimicrobial stewardship programs are essential to reduce consumption rate