Showing papers by "University of Hertfordshire published in 2020"

Management of post-acute covid-19 in primary care.

Abstract: ### What you need to know Post-acute covid-19 (“long covid”) seems to be a multisystem disease, sometimes occurring after a relatively mild acute illness.1 Clinical management requires a whole-patient perspective.2 This article, intended for primary care clinicians, relates to the patient who has a delayed recovery from an episode of covid-19 that was managed in the community or in a standard hospital ward. Broadly, such patients can be divided into those who may have serious sequelae (such as thromboembolic complications) and those with a non-specific clinical picture, often dominated by fatigue and breathlessness. The specialist rehabilitation needs of a third group, covid-19 patients whose acute illness required intensive care, have been covered elsewhere.3 In the absence of agreed definitions, for the purposes of this article we define post-acute covid-19 as extending beyond three weeks from the onset of first symptoms and chronic covid-19 as extending beyond 12 weeks. Since many people were not tested, and false negative tests are common,4 we suggest that a positive test for covid-19 is not a prerequisite for diagnosis. ### How common is it? Around 10% of patients who have tested positive for SARS-CoV-2 virus remain unwell beyond three weeks, and a smaller proportion for months (see box 1).7 This is based on the UK COVID Symptom Study, in which people enter their ongoing symptoms on a smartphone app. This percentage is lower than that cited in many published observational …

The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings.

Abstract: Preliminary clinical data indicate that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with neurological and neuropsychiatric illness. Responding to this, a weekly virtual coronavirus disease 19 (COVID-19) neurology multi-disciplinary meeting was established at the National Hospital, Queen Square, in early March 2020 in order to discuss and begin to understand neurological presentations in patients with suspected COVID-19-related neurological disorders. Detailed clinical and paraclinical data were collected from cases where the diagnosis of COVID-19 was confirmed through RNA PCR, or where the diagnosis was probable/possible according to World Health Organization criteria. Of 43 patients, 29 were SARS-CoV-2 PCR positive and definite, eight probable and six possible. Five major categories emerged: (i) encephalopathies (n = 10) with delirium/psychosis and no distinct MRI or CSF abnormalities, and with 9/10 making a full or partial recovery with supportive care only; (ii) inflammatory CNS syndromes (n = 12) including encephalitis (n = 2, para- or post-infectious), acute disseminated encephalomyelitis (n = 9), with haemorrhage in five, necrosis in one, and myelitis in two, and isolated myelitis (n = 1). Of these, 10 were treated with corticosteroids, and three of these patients also received intravenous immunoglobulin; one made a full recovery, 10 of 12 made a partial recovery, and one patient died; (iii) ischaemic strokes (n = 8) associated with a pro-thrombotic state (four with pulmonary thromboembolism), one of whom died; (iv) peripheral neurological disorders (n = 8), seven with Guillain-Barre syndrome, one with brachial plexopathy, six of eight making a partial and ongoing recovery; and (v) five patients with miscellaneous central disorders who did not fit these categories. SARS-CoV-2 infection is associated with a wide spectrum of neurological syndromes affecting the whole neuraxis, including the cerebral vasculature and, in some cases, responding to immunotherapies. The high incidence of acute disseminated encephalomyelitis, particularly with haemorrhagic change, is striking. This complication was not related to the severity of the respiratory COVID-19 disease. Early recognition, investigation and management of COVID-19-related neurological disease is challenging. Further clinical, neuroradiological, biomarker and neuropathological studies are essential to determine the underlying pathobiological mechanisms that will guide treatment. Longitudinal follow-up studies will be necessary to ascertain the long-term neurological and neuropsychological consequences of this pandemic.

The 16th Data Release of the Sloan Digital Sky Surveys: First Release from the APOGEE-2 Southern Survey and Full Release of eBOSS Spectra

Abstract: This paper documents the sixteenth data release (DR16) from the Sloan Digital Sky Surveys; the fourth and penultimate from the fourth phase (SDSS-IV). This is the first release of data from the southern hemisphere survey of the Apache Point Observatory Galactic Evolution Experiment 2 (APOGEE-2); new data from APOGEE-2 North are also included. DR16 is also notable as the final data release for the main cosmological program of the Extended Baryon Oscillation Spectroscopic Survey (eBOSS), and all raw and reduced spectra from that project are released here. DR16 also includes all the data from the Time Domain Spectroscopic Survey (TDSS) and new data from the SPectroscopic IDentification of ERosita Survey (SPIDERS) programs, both of which were co-observed on eBOSS plates. DR16 has no new data from the Mapping Nearby Galaxies at Apache Point Observatory (MaNGA) survey (or the MaNGA Stellar Library "MaStar"). We also preview future SDSS-V operations (due to start in 2020), and summarize plans for the final SDSS-IV data release (DR17).

The Origin of Elements from Carbon to Uranium

Abstract: To reach a deeper understanding of the origin of elements in the periodic table, we construct Galactic chemical evolution (GCE) models for all stable elements from C (A=12) to U (A=238) from first principles, i.e., using theoretical nucleosynthesis yields and event rates of all chemical enrichment sources. This enables us to predict the origin of elements as a function of time and environment. In the solar neighborhood, we find that stars with initial masses of M>30M_\odot can become failed supernovae if there is a significant contribution from hypernovae (HNe) at M~20-50M_\odot. The contribution to GCE from super asymptotic giant branch (AGB) stars (with M~8-10M_\odot at solar metallicity) is negligible, unless hybrid white dwarfs from low-mass super-AGB stars explode as so-called Type Iax supernovae, or high-mass super-AGB stars explode as electron-capture supernovae (ECSNe). Among neutron-capture elements, the observed abundances of the second (Ba) and third (Pb) peak elements are well reproduced with our updated yields of the slow neutron-capture process (s-process) from AGB stars. The first peak elements, Sr, Y, and Zr, are sufficiently produced by ECSNe together with AGB stars. Neutron star mergers can produce rapid neutron-capture process (r-process) elements up to Th and U, but the timescales are too long to explain observations at low metallicities. The observed evolutionary trends, such as for Eu, can well be explained if ~3% of 25-50 M_\odot hypernovae are magneto-rotational supernovae producing r-process elements. Along with the solar neighborhood, we also predict the evolutionary trends in the halo, bulge, and thick disk for future comparison with galactic archaeology surveys.

Automated Visual Defect Detection for Flat Steel Surface: A Survey

Abstract: Automated computer-vision-based defect detection has received much attention with the increasing surface quality assurance demands for the industrial manufacturing of flat steels. This article attempts to present a comprehensive survey on surface defect detection technologies by reviewing about 120 publications over the last two decades for three typical flat steel products of con-casting slabs and hot- and cold-rolled steel strips. According to the nature of algorithms as well as image features, the existing methodologies are categorized into four groups: statistical, spectral, model-based, and machine learning. These works are summarized in this review to enable easy referral to suitable methods for diverse application scenarios in steel mills. Realization recommendations and future research trends are also addressed at an abstract level.

Deep Channel Learning for Large Intelligent Surfaces Aided mm-Wave Massive MIMO Systems

Abstract: This letter presents the first work introducing a deep learning (DL) framework for channel estimation in large intelligent surface (LIS) assisted massive MIMO (multiple-input multiple-output) systems. A twin convolutional neural network (CNN) architecture is designed and it is fed with the received pilot signals to estimate both direct and cascaded channels. In a multi-user scenario, each user has access to the CNN to estimate its own channel. The performance of the proposed DL approach is evaluated and compared with state-of-the-art DL-based techniques and its superior performance is demonstrated.

Understanding the Complex of Suicide in Depression: from Research to Clinics

Abstract: Objective Amongst psychiatric disorders, major depressive disorder (MDD) is the most prevalent, by affecting approximately 15-17% of the population and showing a high suicide risk rate equivalent to around 15%. The present comprehensive overview aims at evaluating main research studies in the field of MDD at suicide risk, by proposing as well as a schematic suicide risk stratification and useful flow-chart for planning suicide preventive and therapeutic interventions for clinicians. Methods A broad and comprehensive overview has been here conducted by using PubMed/Medline, combining the search strategy of free text terms and exploded MESH headings for the topics of 'Major Depressive Disorder' and 'Suicide' as following: ((suicide [Title/Abstract]) AND (major depressive disorder [Title/Abstract])). All articles published in English through May 31, 2019 were summarized in a comprehensive way. Results Despite possible pathophysiological factors which may explain the complexity of suicide in MDD, scientific evidence supposed the synergic role of genetics, exogenous and endogenous stressors (i.e., interpersonal, professional, financial, as well as psychiatric disorders), epigenetic, the hypothalamic-pituitary-adrenal stress-response system, the involvement of the monoaminergic neurotransmitter systems, particularly the serotonergic ones, the lipid profile, neuro-immunological biomarkers, the Brain-derived neurotrophic factor and other neuromodulators. Conclusion The present overview reported that suicide is a highly complex and multifaceted phenomenon in which a large plethora of mechanisms could be variable implicated, particularly amongst MDD subjects. Beyond these consideration, modern psychiatry needs a better interpretation of suicide risk with a more careful assessment of suicide risk stratification and planning of clinical and treatment interventions.

Which conditions should be considered as disorders in the International Classification of Diseases (ICD-11) designation of “other specified disorders due to addictive behaviors”?

Abstract: © 2020 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

3D-Structured Carbonized Sunflower Heads for Improved Energy Efficiency in Solar Steam Generation.

Abstract: Solar steam generation is regarded as a perspective technology, due to its potentials in solar light absorption and photothermal conversion for seawater desalination and water purification. Although lots of steam generation systems have been reported to possess high conversion efficiencies recently, researches of simple, cost-effective, and sustainable materials still need to be done. Here, inspired by natural young sunflower heads' property increasing the temperature of dish-shaped flowers by tracking the sun, we used 3D-structured carbonized sunflower heads as an effective solar steam generator. The evaporation rate and efficiency of these materials under 1 sun (1 kW m-2) are 1.51 kg m-2 h-1 and 100.4%, respectively, beyond the theoretical limit of 2D materials. This high solar efficiency surpasses all other biomass-based materials ever reported. It is demonstrated that such a high capability is mainly attributed to the 3D-structured top surface, which could reabsorb the lost energy of diffuse reflection and thermal radiation, as well as provide enlarged water/air interface for steam escape. 3D-structured carbonized sunflower heads provide a new method for the future design and fabrication of high-performance photothermal devices.

Commentary: COVID in care homes-challenges and dilemmas in healthcare delivery.

Abstract: The COVID-19 pandemic has disproportionately affected care home residents internationally, with 19-72% of COVID-19 deaths occurring in care homes. COVID-19 presents atypically in care home residents and up to 56% of residents may test positive whilst pre-symptomatic. In this article, we provide a commentary on challenges and dilemmas identified in the response to COVID-19 for care homes and their residents. We highlight the low sensitivity of polymerase chain reaction testing and the difficulties this poses for blanket screening and isolation of residents. We discuss quarantine of residents and the potential harms associated with this. Personal protective equipment supply for care homes during the pandemic has been suboptimal and we suggest that better integration of procurement and supply is required. Advance care planning has been challenged by the pandemic and there is a need to for healthcare staff to provide support to care homes with this. Finally, we discuss measures to implement augmented care in care homes, including treatment with oxygen and subcutaneous fluids, and the frameworks which will be required if these are to be sustainable. All of these challenges must be met by healthcare, social care and government agencies if care home residents and staff are to be physically and psychologically supported during this time of crisis for care homes.

An ALMA survey of the SCUBA-2 CLS UDS field: physical properties of 707 sub-millimetre galaxies

Abstract: We analyse the physical properties of a large, homogeneously selected sample of ALMA-located sub-mm galaxies (SMGs) detected in the SCUBA-2 CLS 850-$\mu$m map of the UKIDSS/UDS field. This survey, AS2UDS, identified 707 SMGs across the ~1 sq.deg. field, including ~17 per cent which are undetected in the optical/near-infrared to $K$>~25.7 mag. We interpret the UV-to-radio data using a physically motivated model, MAGPHYS and determine a median photometric redshift of z=2.61+-0.08, with a 68th percentile range of z=1.8-3.4 and just ~6 per cent at z>4. The redshift distribution is well fit by a model combining evolution of the gas fraction in halos with the growth of halo mass past a threshold of ~4x10$^{12}$M$_\odot$, thus SMGs may represent the highly efficient collapse of gas-rich massive halos. Our survey provides a sample of the most massive, dusty galaxies at z>~1, with median dust and stellar masses of $M_d$=(6.8+-0.3)x10$^{8}$M$_\odot$ (thus, gas masses of ~10$^{11}$M$_\odot$) and $M_\ast=$(1.26+-0.05)x10$^{11}$M$_\odot$. These galaxies have gas fractions of $f_{gas}=$0.41+-0.02 with depletion timescales of ~150Myr. The gas mass function evolution at high masses is consistent with constraints at lower masses from blind CO-surveys, with an increase to z~2-3 and then a decline at higher redshifts. The space density and masses of SMGs suggests that almost all galaxies with $M_\ast$>~2x10$^{11}$M$_\odot$ have passed through an SMG-like phase. We find no evolution in dust temperature at a constant far-infrared luminosity across z~1.5-4. We show that SMGs appear to behave as simple homologous systems in the far-infrared, having properties consistent with a centrally illuminated starburst. Our study provides strong support for an evolutionary link between the active, gas-rich SMG population at z>1 and the formation of massive, bulge-dominated galaxies across the history of the Universe.

More than smell. COVID-19 is associated with severe impairment of smell, taste, and chemesthesis

Abstract: Recent anecdotal and scientific reports have provided evidence of a link between COVID-19 and chemosensory impairments such as anosmia. However, these reports have downplayed or failed to distinguish potential effects on taste, ignored chemesthesis, generally lacked quantitative measurements, were mostly restricted to data from single countries. Here, we report the development, implementation and initial results of a multi-lingual, international questionnaire to assess self-reported quantity and quality of perception in three distinct chemosensory modalities (smell, taste, and chemesthesis) before and during COVID-19. In the first 11 days after questionnaire launch, 4039 participants (2913 women, 1118 men, 8 other, ages 19-79) reported a COVID-19 diagnosis either via laboratory tests or clinical assessment. Importantly, smell, taste and chemesthetic function were each significantly reduced compared to their status before the disease. Difference scores (maximum possible change+/-100) revealed a mean reduction of smell (-79.7+/- 28.7, mean+/- SD), taste (-69.0+/- 32.6), and chemesthetic (-37.3+/- 36.2) function during COVID-19. Qualitative changes in olfactory ability (parosmia and phantosmia) were relatively rare and correlated with smell loss. Importantly, perceived nasal obstruction did not account for smell loss. Furthermore, chemosensory impairments were similar between participants in the laboratory test and clinical assessment groups. These results show that COVID-19-associated chemosensory impairment is not limited to smell, but also affects taste and chemesthesis. The multimodal impact of COVID-19 and lack of perceived nasal obstruction suggest that SARS-CoV-2 infection may disrupt sensory-neural mechanisms.

A Multi-Stable Memristor and its Application in a Neural Network

Abstract: Nowadays, there is a lot of study on memristor-based systems with multistability. However, there is no study on memristor with multistability. This brief constructs a mathematical memristor model with multistability. The origin of the multi-stable dynamics is revealed using standard nonlinear theory as well as circuit and system theory. Moreover, the multi-stable memristor is applied to simulate a synaptic connection in a Hopfield neural network. The memristive neural network successfully generates infinitely many coexisting chaotic attractors unobserved in previous Hopfield-type neural networks. The results are also confirmed in analog circuits based on commercially available electronic elements.

Firing multistability in a locally active memristive neuron model

Abstract: The theoretical, numerical and experimental demonstrations of firing dynamics in isolated neuron are of great significance for the understanding of neural function in human brain. In this paper, a new type of locally active and non-volatile memristor with three stable pinched hysteresis loops is presented. Then, a novel locally active memristive neuron model is established by using the locally active memristor as a connecting autapse, and both firing patterns and multistability in this neuronal system are investigated. We have confirmed that, on the one hand, the constructed neuron can generate multiple firing patterns like periodic bursting, periodic spiking, chaotic bursting, chaotic spiking, stochastic bursting, transient chaotic bursting and transient stochastic bursting. On the other hand, the phenomenon of firing multistability with coexisting four kinds of firing patterns can be observed via changing its initial states. It is worth noting that the proposed neuron exhibits such firing multistability previously unobserved in single neuron model. Finally, an electric neuron is designed and implemented, which is extremely useful for the practical scientific and engineering applications. The results captured from neuron hardware experiments match well with the theoretical and numerical simulation results.

Tracking SARS-CoV-2 in Sewage: Evidence of Changes in Virus Variant Predominance during COVID-19 Pandemic

Abstract: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), responsible for the ongoing coronavirus disease (COVID-19) pandemic, is frequently shed in faeces during infection, and viral RNA has recently been detected in sewage in some countries. We have investigated the presence of SARS-CoV-2 RNA in wastewater samples from South-East England between 14th January and 12th May 2020. A novel nested RT-PCR approach targeting five different regions of the viral genome improved the sensitivity of RT-qPCR assays and generated nucleotide sequences at sites with known sequence polymorphisms among SARS-CoV-2 isolates. We were able to detect co-circulating virus variants, some specifically prevalent in England, and to identify changes in viral RNA sequences with time consistent with the recently reported increasing global dominance of Spike protein G614 pandemic variant. Low levels of viral RNA were detected in a sample from 11th February, 3 days before the first case was reported in the sewage plant catchment area. SARS-CoV-2 RNA concentration increased in March and April, and a sharp reduction was observed in May, showing the effects of lockdown measures. We conclude that viral RNA sequences found in sewage closely resemble those from clinical samples and that environmental surveillance can be used to monitor SARS-CoV-2 transmission, tracing virus variants and detecting virus importations.

ICON 2019: International Scientific Tendinopathy Symposium Consensus: Clinical Terminology

Abstract: Persistent tendon pain that impairs function has inconsistent medical terms that can influence choice of treatment.1 When a person is told they have tendinopathy by clinician A or tendinitis by clinician B, they might feel confused or be alarmed at receiving what they might perceive as two different diagnoses. This may lead to loss of confidence in their health professional and likely adds to uncertainty if they were to search for information about their condition. Clear and uniform terminology also assists inter-professional communication. Inconsistency in terminology for painful tendon disorders is a problem at numerous anatomical sites. Historically, the term ‘tendinitis’ was first used to describe tendon pain, thickening and impaired function (online supplementary figure S1). The term ‘tendinosis’ has also been used in a small number of publications, some of which were very influential.2 3 Subsequently, ‘tendinopathy’ emerged as the most common term for persistent tendon pain.4 5 To our knowledge, experts (clinicians and researchers) or patients have never engaged in a formal process to discuss the terminology we use. We believe that health professionals have not yet agreed on the appropriate terminology for painful tendon conditions. ### Supplementary data [bjsports-2019-100885supp001.pdf] The authors of this paper, a group of international clinical and research experts from different disciplines, aimed to achieve a consensus in terminology for persistent tendon disorders. We ran a Delphi and consensus process that culminated in a face-to-face meeting at the fifth International Scientific Tendinopathy Symposium (ISTS) in Groningen, the Netherlands, on 26 September 2018 (placeholder for sentence about the other two papers and accompanying editorial if they get accepted). Here, we present the resulting consensus statements on terminology for persistent tendon pain. Our two-stage Delphi design, consensus process consisted of an online survey followed by a face-to-face meeting. One of us (AS) drafted 11 statements about terminology …

Prolonged low-dose methylprednisolone in patients with severe COVID-19 pneumonia

Abstract: Background In hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia, progression to acute respiratory failure requiring invasive mechanical ventilation (MV) is associated with significant morbidity and mortality. Severe dysregulated systemic inflammation is the putative mechanism. We hypothesize that early prolonged methylprednisolone (MP) treatment could accelerate disease resolution, decreasing the need for intensive care unit (ICU) admission and mortality. Methods We conducted a multicenter observational study to explore the association between exposure to prolonged, low-dose MP treatment and need for ICU referral, intubation, or death within 28 days (composite primary end point) in patients with severe COVID-19 pneumonia admitted to Italian respiratory high-dependency units. Secondary outcomes were invasive MV-free days and changes in C-reactive protein (CRP) levels. Results Findings are reported as MP (n = 83) vs control (n = 90). The composite primary end point was met by 19 vs 40 (adjusted hazard ratio [aHR], 0.41; 95% CI, 0.24-0.72). Transfer to ICU and invasive MV were necessary in 15 vs 27 (P = .07) and 14 vs 26 (P = .10), respectively. By day 28, the MP group had fewer deaths (6 vs 21; aHR, 0.29; 95% CI, 0.12-0.73) and more days off invasive MV (24.0 ± 9.0 vs 17.5 ± 12.8; P = .001). Study treatment was associated with rapid improvement in PaO2:FiO2 and CRP levels. The complication rate was similar for the 2 groups (P = .84). Conclusion In patients with severe COVID-19 pneumonia, early administration of prolonged MP treatment was associated with a significantly lower hazard of death (71%) and decreased ventilator dependence. Treatment was safe and did not impact viral clearance. A large randomized controlled trial (RECOVERY trial) has been performed that validates these findings. Clinical trial registration. ClinicalTrials.gov NCT04323592.

Dimethyl sulfoxide: a central player since the dawn of cryobiology, is efficacy balanced by toxicity?

Abstract: Dimethyl sulfoxide (DMSO) is the cryoprotectant of choice for most animal cell systems since the early history of cryopreservation. It has been used for decades in many thousands of cell transplants. These treatments would not have taken place without suitable sources of DMSO that enabled stable and safe storage of bone marrow and blood cells until needed for transfusion. Nevertheless, its effects on cell biology and apparent toxicity in patients have been an ongoing topic of debate, driving the search for less cytotoxic cryoprotectants. This review seeks to place the toxicity of DMSO in context of its effectiveness. It will also consider means of reducing its toxic effects, the alternatives to its use and their readiness for active use in clinical settings.

COVID-19: The Hidden Impact on Mental Health and Drug Addiction

Abstract: © 2020 Chiappini, Guirguis, John, Corkery and Schifano. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY - https://creativecommons.org/licenses/by/4.0/). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Photons as a 21st century reagent.

Abstract: A pharmaceutical industry viewpoint on how the fundamental laws of photochemistry are used to identify the parameters required to implement photochemistry from lab to scale. Parameters such as photon stoichiometry and light intensity are highlighted within to inform future publications.