Which outcomes are most important to measure in patients with COVID-19 and how and when should these be measured? Development of an international standard set of outcomes measures for clinical use in patients with COVID-19: a report of the International Consortium for Health Outcomes Measurement (ICHOM) COVID-19 Working Group

Objectives: The COVID-19 pandemic has resulted in widespread morbidity and mortality with the consequences expected to be felt for many years. Significant variation exists in the care even of similar patients with COVID-19, including treatment practices within and between institutions. Outcome measures vary among clinical trials on the same therapies. Understanding which therapies are of most value is not possible unless consensus can be reached on which outcomes are most important to measure. Furthermore, consensus on the most important outcomes may enable patients to monitor and track their care, and may help providers to improve the care they offer through quality improvement. To develop a standardised minimum set of outcomes for clinical care, the International Consortium for Health Outcomes Measurement (ICHOM) assembled a working group (WG) of 28 volunteers, including health professionals, patients and patient representatives. Design: A list of outcomes important to patients and professionals was generated from a systematic review of the published literature using the MEDLINE database, from review of outcomes being measured in ongoing clinical trials, from a survey distributed to patients and patient networks, and from previously published ICHOM standard sets in other disease areas. Using an online-modified Delphi process, the WG selected outcomes of greatest importance. Results: The outcomes considered by the WG to be most important were selected and categorised into five domains: (1) functional status and quality of life, (2) mental functioning, (3) social functioning, (4) clinical outcomes and (5) symptoms. The WG identified demographic and clinical variables for use as case-mix risk adjusters. These included baseline demographics, clinical factors and treatment-related factors. Conclusion: Implementation of these consensus recommendations could help institutions to monitor, compare and improve the quality and delivery of care to patients with COVID-19. Their consistent definition and collection could also broaden the implementation of more patient-centric clinical outcomes research

Five Hundred Years of Hydrological Drought in the Upper Colorado River Basin

This article evaluates drought scenarios of the Upper Colorado River basin (UCRB) considering multiple drought variables for the past 500 years and positions the current drought in terms of the magnitude and frequency. Drought characteristics were developed considering water-year data of UCRB’s streamflow, and basin-wide averages of the Palmer Hydrological Drought Index (PHDI) and the Palmer Z Index. Streamflow and drought indices were reconstructed for the last 500 years using a principal component regression model based on tree-ring data. The reconstructed streamflow showed higher variability as compared with reconstructed PHDI and reconstructed Palmer Z Index. The magnitude and severity of all droughts were obtained for the last 500 years for historical and reconstructed drought variables and ranked accordingly. The frequency of the current drought was obtained by considering two different drought frequency statistical approaches and three different methods of determining the beginning and end of the drought period (annual, 5-year moving, and ten year moving average). It was concluded that the current drought is the worst in the observed record period (1923-2004), but 6th to 14th largest in terms of magnitude and 1st to 12th considering severity in the past 500 years. Similarly, the current drought has a return period ranging from 37 to 103 years based on how the drought period was determined. It was concluded that if the 10-year moving average is used for defining the drought period, the current drought appears less severe in terms of magnitude and severity in the last 500 years compared with the results using 1- and 5-year averages.National Science Foundation/[CMS-0239334]/NSF/Estados UnidosUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigaciones Geofísicas (CIGEFI

Antifungal activity of extracts from Brazilian Cerrado plants on Colletotrichum gloeosporioides and Corynespora cassiicola Atividade antifúngica de extratos de plantas do Cerrado brasileiro sobre Colletotrichum gloeosporioides e Corynespora cassiicola

This study aimed to determine the antifungal activity of leaf aqueous and hydroethanolic extracts of 10 plants from the Brazilian Cerrado on Colletotrichum gloeosporioides and Corynespora cassiicola. Antifungal activity was measured through the incorporation of each extract in a culture media or spore suspension, at 50% concentration relative to the volume, determining respectively the mycelial growth and the spore germination. Then, the percentages of mycelial growth inhibition and spore germination inhibition were obtained based on the comparison with the control. The extracts had a variable action on the phytopathogens, from mycelial growth stimulation for Aristolochia esperanzae and Byrsonima verbascifolia extracts to complete inhibition of mycelial growth and spore germination for Myracrodruon urundeuva and Lafoensia pacari extracts. M. urundeuva, L. pacari and Caryocar brasiliense leaf extracts had antifungal activity against Colletotrichum gloeosporioides and Corynespora cassiicola; the hydroethanolic extracts presented more antifungal activity than the aqueous extracts, and spore germination of both phytopathogens was more affected than their mycelial growth.<br>O objetivo deste trabalho foi determinar a atividade antifúngica de extratos aquosos e extratos hidroetanólicos de folhas de 10 plantas do Cerrado brasileiro sobre Colletotrichum gloeosporioides e Corynespora cassiicola. A determinação da atividade antifúngica foi realizada pela incorporação do extrato em meio de cultura ou na suspensão de esporos, na concentração de 50% em relação ao volume, determinando-se, respectivamente, o crescimento micelial e a germinação de esporos. Em seguida, pela comparação com a testemunha, foram obtidas as percentagens de inibição do crescimento micelial e da germinação dos esporos. Foi constatado comportamento variável dos extratos sobre os fitopatógenos, desde o estímulo no crescimento micelial para os extratos de Aristolochia esperanzae e Byrsonima verbascifolia, até a inibição completa do crescimento micelial e dagerminação dos esporos para os extratos de Myracrodruon urundeuva e Lafoensia pacari. Extratos de folhas de L. pacari, de M. urundeuva e de Caryocar brasiliense apresentaram atividade antifúngica sobre Colletotrichum gloeosporioides e Corynespora cassiicola; os extratos hidroetanólicos proporcionaram mais atividade antifúngica que os extratos aquosos, e a germinação de esporos de ambos os fitopatógenos foi mais afetada que o crescimento micelial