Unlike past, preteens and teens today lead a mentally and emotionally charged life along with the exacting physical rigors of their daily life. Apart from sports, academics, parents and peers the ...mentioned age group is also spending a considerable amount of time in the virtual, digital world of social media connectivity along with its various appendages. Unregulated social media exposure often makes life a tightrope existence for these children and adolescents. Studies have shown that the increasing use of social media and technology is having a negative impact on the physical and mental health of children and teenagers by making them more prone to anxiety, depression, and other psychological disorders, as well as by making them more susceptible to future health problems. In this light of increased stress and health problems with growing social media usage, this paper reviews studies and proposes yoga as a mind-body alternative medicine intervention to improve physical and mental health conditions. It also highlights the efficacy of yoga as a complementary therapy enhancing overall wellbeing of children. After reviewing relevant available literature, we conclude that Yoga has the potential to be a promising complementary therapy for children and adolescents but more efforts are required to find most effective application and implementation methods for the same.
The rate of acute kidney injury (AKI) associated with patients hospitalized with Covid-19, and associated outcomes are not well understood. This study describes the presentation, risk factors and ...outcomes of AKI in patients hospitalized with Covid-19. We reviewed the health records for all patients hospitalized with Covid-19 between March 1, and April 5, 2020, at 13 academic and community hospitals in metropolitan New York. Patients younger than 18 years of age, with end stage kidney disease or with a kidney transplant were excluded. AKI was defined according to KDIGO criteria. Of 5,449 patients admitted with Covid-19, AKI developed in 1,993 (36.6%). The peak stages of AKI were stage 1 in 46.5%, stage 2 in 22.4% and stage 3 in 31.1%. Of these, 14.3% required renal replacement therapy (RRT). AKI was primarily seen in Covid-19 patients with respiratory failure, with 89.7% of patients on mechanical ventilation developing AKI compared to 21.7% of non-ventilated patients. 276/285 (96.8%) of patients requiring RRT were on ventilators. Of patients who required ventilation and developed AKI, 52.2% had the onset of AKI within 24 hours of intubation. Risk factors for AKI included older age, diabetes mellitus, cardiovascular disease, black race, hypertension and need for ventilation and vasopressor medications. Among patients with AKI, 694 died (35%), 519 (26%) were discharged and 780 (39%) were still hospitalized. AKI occurs frequently among patients with Covid-19 disease. It occurs early and in temporal association with respiratory failure and is associated with a poor prognosis.
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Given the high risk of infection-related mortality, patients with end-stage kidney disease (ESKD) may be at increased risk with COVID-19. To assess this, we compared outcomes of patients with and ...without ESKD, hospitalized with COVID-19. This was a retrospective study of patients admitted with COVID-19 from 13 New York hospitals from March 1, 2020, to April 27, 2020, and followed through May 27, 2020. We measured primary outcome (in-hospital death), and secondary outcomes (mechanical ventilation and length of stay). Of 10,482 patients with COVID-19, 419 had ESKD. Patients with ESKD were older, had a greater percentage self-identified as Black, and more comorbid conditions. Patients with ESKD had a higher rate of in-hospital death than those without (31.7% vs 25.4%, odds ratio 1.38, 95% confidence interval 1.12 - 1.70). This increase rate remained after adjusting for demographic and comorbid conditions (adjusted odds ratio 1.37, 1.09 - 1.73). The odds of length of stay of seven or more days was higher in the group with compared to the group without ESKD in both the crude and adjusted analysis (1.62, 1.27 - 2.06; vs 1.57, 1.22 - 2.02, respectively). There was no difference in the odds of mechanical ventilation between the groups. Independent risk factors for in-hospital death for patients with ESKD were increased age, being on a ventilator, lymphopenia, blood urea nitrogen and serum ferritin. Black race was associated with a lower risk of death. Thus, among patients hospitalized with COVID-19, those with ESKD had a higher rate of in-hospital death compared to those without ESKD.
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Purpose
In silico imaging clinical trials are emerging alternative sources of evidence for regulatory evaluation and are typically cheaper and faster than human trials. In this Note, we describe the ...set of in silico imaging software tools used in the VICTRE (Virtual Clinical Trial for Regulatory Evaluation) which replicated a traditional trial using a computational pipeline.
Materials and methods
We describe a complete imaging clinical trial software package for comparing two breast imaging modalities (digital mammography and digital breast tomosynthesis). First, digital breast models were developed based on procedural generation techniques for normal anatomy. Second, lesions were inserted in a subset of breast models. The breasts were imaged using GPU‐accelerated Monte Carlo transport methods and read using image interpretation models for the presence of lesions. All in silico components were assembled into a computational pipeline. The VICTRE images were made available in DICOM format for ease of use and visualization.
Results
We describe an open‐source collection of in silico tools for running imaging clinical trials. All tools and source codes have been made freely available.
Conclusion
The open‐source tools distributed as part of the VICTRE project facilitate the design and execution of other in silico imaging clinical trials. The entire pipeline can be run as a complete imaging chain, modified to match needs of other trial designs, or used as independent components to build additional pipelines.
Outcomes of patients hospitalized with coronavirus disease 2019 (COVID-19) and acute kidney injury (AKI) are not well understood. The goal of this study was to investigate the survival and kidney ...outcomes of these patients.
Retrospective cohort study.
Patients (aged≥18 years) hospitalized with COVID-19 at 13 hospitals in metropolitan New York between March 1, 2020, and April 27, 2020, followed up until hospital discharge.
AKI.
Primary outcome: in-hospital death. Secondary outcomes: requiring dialysis at discharge, recovery of kidney function.
Univariable and multivariable time-to-event analysis and logistic regression.
Among 9,657 patients admitted with COVID-19, the AKI incidence rate was 38.4/1,000 patient-days. Incidence rates of in-hospital death among patients without AKI, with AKI not requiring dialysis (AKI stages 1-3), and with AKI receiving dialysis (AKI 3D) were 10.8, 31.1, and 37.5/1,000 patient-days, respectively. Taking those without AKI as the reference group, we observed greater risks for in-hospital death for patients with AKI 1-3 and AKI 3D (HRs of 5.6 95% CI, 5.0-6.3 and 11.3 95% CI, 9.6-13.1, respectively). After adjusting for demographics, comorbid conditions, and illness severity, the risk for death remained higher among those with AKI 1-3 (adjusted HR, 3.4 95% CI, 3.0-3.9) and AKI 3D (adjusted HR, 6.4 95% CI, 5.5-7.6) compared with those without AKI. Among patients with AKI 1-3 who survived, 74.1% achieved kidney recovery by the time of discharge. Among those with AKI 3D who survived, 30.6% remained on dialysis at discharge, and prehospitalization chronic kidney disease was the only independent risk factor associated with needing dialysis at discharge (adjusted OR, 9.3 95% CI, 2.3-37.8).
Observational retrospective study, limited to the NY metropolitan area during the peak of the COVID-19 pandemic.
AKI in hospitalized patients with COVID-19 was associated with significant risk for death.
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Background: Poultry enteritis is an important multifactorial disease. Chicken Astrovirus (CAstV) usually associated with enteritis. The aim of this study was to investigate the occurrence of CAstV in ...poultry enteritis cases, its molecular characterization, phylogenetic analysis and gross and microscopic examination of intestine and liver specimen affected with CAstV.
Methods: Total 604 dead poultry birds from commercial poultry farms affected with enteritis were examined for presence of CAstV. Intestinal samples of four birds were pooled to make one biological sample. CAstV was detected by reverse transcriptase PCR (RT-PCR) using ORF-1b gene specific primers. Molecular characterization was carried out by partial gene sequencing.
Result: CAstV was detected in 20.52% (31/151) of samples. Highest prevalence (49.29%) was observed in 0-1 week old chicks. The partial molecular characterization revealed high similarity of the nucleotide sequence from India (97% to 93%) and from USA, Brazil, Poland and Korea (94 to 92%). Further similarity of amino acid sequences of CAstV from India (100% to 98%) and from USA, Brazil, Poland and Korea (98 to 97%) was observed. Histopathological examination revealed villous atrophy, congestion and atrophic cystic glands in sub-mucosa of intestine. Further severe congestion and hemorrhages along with infiltration of inflammatory cells in liver parenchyma was observed.
To extend the preservation of donor hearts beyond the current 4–6 h, this paper explores heart cryopreservation by vitrification—cryogenic storage in a glass‐like state. While organ vitrification is ...made possible by using cryoprotective agents (CPA) that inhibit ice during cooling, failure occurs during convective rewarming due to slow and non‐uniform rewarming which causes ice crystallization and/or cracking. Here an alternative, “nanowarming”, which uses silica‐coated iron oxide nanoparticles (sIONPs) perfusion loaded through the vasculature is explored, that allows a radiofrequency coil to rewarm the organ quickly and uniformly to avoid convective failures. Nanowarming has been applied to cells and tissues, and a proof of principle study suggests it is possible in the heart, but proper physical and biological characterization especially in organs is still lacking. Here, using a rat heart model, controlled machine perfusion loading and unloading of CPA and sIONPs, cooling to a vitrified state, and fast and uniform nanowarming without crystallization or cracking is demonstrated. Further, nanowarmed hearts maintain histologic appearance and endothelial integrity superior to convective rewarming and indistinguishable from CPA load/unload control hearts while showing some promising organ‐level (electrical) functional activity. This work demonstrates physically successful heart vitrification and nanowarming and that biological outcomes can be expected to improve by reducing or eliminating CPA toxicity during loading and unloading.
Heart cryopreservation by vitrification and nanowarming has immense promise for transforming transplant medicine. Here, comprehensive validation of the approach, including machine perfusion loading/unloading of cryoprotective agents (CPA) and magnetic nanoparticles, cooling to a vitrified state, and fast and uniform radiofrequency rewarming without crystallization or cracking is shown. Nanowarmed hearts maintain histologic appearance and endothelial integrity similar to CPA load/unload controls with some organ‐level (electrical) functional activity.
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