Our experience of COVID-19 at a large District General Hospital in the North West of England

Objective: To determine the mortality rate, discharge rate, current admissions, and comorbid conditions in our patients along with a view to further investigate high mortality rates observed at our hospital. Methodology: This retrospective epidemiological study aims to review patients presenting with COVID-19 at a District General Hospital in the north west of England. A total of 514 patients were admitted with a positive COVID-19 swab from March 17, 2020 to midnight May 20, 2020 have been included in this study. All patients admitted with COVID-19 positive swabs were included in the study. Patients discharged from the Emergency Department were excluded. The data was assessed daily by the Clinical Audit and Effectiveness Team and cross referenced across multiple sources to ensure accuracy.  Results: From March 17, 2020 to May 20, 2020 a total of 514 patients were admitted with a positive COVID-19 swab. Out of the 514 patients, 284 (55%) were male while 230 (45%) were female (Figure 1). Among the 514 patients admitted, 236 (45.9%) died, 263 (51.2%) were discharged, 1 (0.2%) was discharged and then readmitted, 1 (0.2%) was transferred while 13 (2.5%) are still admitted at the hospital. Out of the 236 patients who died, 144 (61%) were male and 92 (39%) were female. 130 (49%) of the 263 patients discharged were male and 133 (51%) were female. One female patient was discharged but then readmitted and one male patient was transferred. Out of the 13 patients still admitted at the hospital, 9 (69%) are male and 4 (31%) are female (Fig 2). Upon review of the pre-existing comorbid conditions of the patients, it was noted that 101 (20%) patients had no comorbid conditions, 59 (11%) had one comorbid condition, 93 (18%) had two comorbid conditions, 106 (21%) had three and 155 (30%) had four or more comorbid conditions. Conclusion: Patients with comorbid conditions are more prone to COVID-19 in terms of severity. Due to high mortality rates observed in our study, we propose further research to review the high susceptibility to severe COVID-19 infection in the population of North West, England

Advances on Network Protocols and Algorithms for Vehicular Ad Hoc Networks

Vehicular Ad Hoc Network (VANET) is an emerging area of wireless ad hoc networks that facilitates ubiquitous connectivity between smart vehicles through Vehicle-to-Vehicle (V2V) or Vehicle-to-Roadside (V2R) and Roadside-to- Vehicle (R2V) communications. This emerging field of technology aims to improve safety of passengers and traffic flow, reduces pollution to the environment and enables in-vehicle entertainment applications. The safety-related applications could reduce accidents by providing drivers with traffic information such as collision avoidances, traffic flow alarms and road surface conditions. Moreover, the passengers could exploit an available infrastructure in order to connect to the internet for infomobility and entertainment applications.Lloret, J.; Ghafoor, KZ.; Rawat, DB.; Xia, F. (2013). Advances on Network Protocols and Algorithms for Vehicular Ad Hoc Networks. Mobile Networks and Applications. 18(6):749-754. doi:10.1007/s11036-013-0490-7S749754186Lloret J, Canovas A, Catalá A, Garcia M (2013) Group-based protocol and mobility model for VANETs to offer internet access. J Netw Comput Appl 36(3):1027–1038. doi: 10.1016/j.jnca.2012.02.009Khokhar RH, Zia T, Ghafoor KZ, Lloret J, Shiraz M (2013) Realistic and efficient radio propagation model for V2X communications. KSII Trans Internet Inform Syst 7(8):1933–1953. doi: 10.3837/tiis.2013.08.011Ghafoor KZ (2013) Routing protocols in vehicular ad hoc networks: survey and research challenges, Netw Protocol Algorithm 5(4). doi: 10.5296/npa.v5i4.4134Ghafoor KZ, Bakar KA, Lloret J, Ke C-H, Lee KC (2013) Intelligent beaconless geographical routing for urban vehicular environments. Wirel Netw 19(3):345–362. doi: 10.1007/s11276-012-0470-zGhafoor KZ, Bakar KA, Lee K, AL-Hashimi H (2010) A novel delay- and reliability- aware inter-vehicle routing protocol. Netw Protocol Algorithms 2(2):66–88. doi: 10.5296/npa.v2i2.427Dias JAFF, Rodrigues JJPC, Isento JN, Pereira PRBA, Lloret J (2011) Performance assessment of fragmentation mechanisms for vehicular delay-tolerant networks. EURASIP J Wirel Commun Netw 2011(195):1–14. doi: 10.1186/1687-1499-2011-195Zhang D, Yang Z, Raychoudhury V, Chen Z, Lloret J (2013) An energy-efficient routing protocol using movement trend in vehicular Ad-hoc networks. Comput J 58(8):938–946. doi: 10.1093/comjnl/bxt028Ghafoor KZ, Lloret J, Bakar KA, Sadiq AS, Mussa SAB (2013) Beaconing approaches in vehicular Ad Hoc networks: a survey. Wirel Pers Commun. doi: 10.1007/s11277-013-1222-9Sadiq AS, Bakar KA, Ghafoor KZ, Lloret J (2013) An intelligent vertical handover scheme for audio and video streaming in heterogeneous vehicular networks. Mobile Netw Appl. doi: 10.1007/s11036-013-0465-8Khamayseh YM (2013) Network size estimation in VANETs. 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Iron Behaving Badly: Inappropriate Iron Chelation as a Major Contributor to the Aetiology of Vascular and Other Progressive Inflammatory and Degenerative Diseases

The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular "reactive oxygen species" (ROSs) can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. We review the considerable and wide-ranging evidence for the involvement of this combination of (su)peroxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation). The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic) importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, etc...Comment: 159 pages, including 9 Figs and 2184 reference