On 2025-01-16 06:08:40, user xPeer wrote:

Courtesy review from xPeerd.com

Summary:<br /> The manuscript titled "Typhinder: Rapid, low-cost colorimetric detection of Salmonella Typhi bacteriophages for environmental surveillance" presents a novel colorimetric assay designed to detect Salmonella Typhi (S. Typhi) bacteriophages in environmental water samples. This study primarily focuses on areas with poor sanitation infrastructure, including regions in Brazil, Côte d’Ivoire, Nepal, and Niger, demonstrating high sensitivity and specificity of the assay. The work indicates potential applications in public health surveillance, particularly in resource-limited settings, by providing a cost-efficient method (approximately $2.40 per sample) that does not require sophisticated equipment.

Potential Major Revisions:

1. Validation and Methodological Robustness:<br /> One key concern is the validation of the colorimetric assay only against the double agar overlay method. More comprehensive testing against additional molecular techniques like PCR/qPCR, which are considered gold standards for pathogen detection, is essential to determine the assay's accuracy and reliability under diverse environmental conditions. This gap was acknowledged in the discussion section.

2. Sample Diversity and Detection Limit:<br /> The study demonstrates that the detection limit is 28 PFU/mL, which although sensitive, may need further optimization to ensure applicability in environments with even lower pathogen concentrations. Additionally, the research did not provide adequate comparative data from different environmental contexts, such as varying water sources with potential inhibitors like antibiotics, which could affect assay reliability.

3. Comprehensive Data Analysis:<br /> The study's reliance on environmental surveillance data lacks integration with epidemiological data and molecular-based assessments of typhoid burden. Correlating phage detection with rates of clinical typhoid fever incidents would offer stronger evidence of the assay's utility in public health management. Future studies should aim to establish these correlations more explicitly.

Potential Minor Revisions:

Typographic and Grammatical Errors:<br /> 1. Page 2, Line 1: "particularly in low-resource settings with inadequate sanitation." - Repetition of the phrase "particularly in low-resource settings", consider rephrasing for clarity.<br /> 2. Page 6, Line 3: "require precise data on where typhoid is most prevalent, yet current surveillance methods are expensive and limited in scope..." - The sentence structure could be improved for readability.<br /> 3. Page 9, Line 5: "Antimicrobial resistance among S. Typhi strains poses serious challenges to effective treatment and may lead to higher mortality..." - Consider rephrasing for clarity.

Formatting Issues:<br /> The figures and tables should be better integrated into the text for improved readability. For example, citing Table 1 and Figure 2 explicitly within the corresponding discussion for context will aid readers' understanding.

AI Content Analysis:<br /> - Estimated AI-generated content: Given the extensive detail and specific nature of the subject, it is estimated that the manuscript has less than 5% AI-generated content.<br /> - Highlighted AI-detected sections: The introductory summary and some instances of repetitive phrasing suggest possible AI involvement.<br /> - Epistemic impact: Minimal as the core research contributions and data seem original and substantive.

Recommendations:

1. Enhanced Validation:<br /> Incorporate a broader range of validation techniques, particularly molecular methods like qPCR, to establish the assay's robustness across different environmental samples and contexts.

2. Addressing Limitations:<br /> Include detection methods for concurrent fecal contamination to provide contextual data, enhancing the reliability of typhoid phage detection results as environmental indicators.

3. Future Studies:<br /> Focus future research on correlating phage presence with clinical incidence of typhoid fever, and explore structural analysis of phage-host interactions. This will substantiate the assay's efficacy in public health interventions and policy-making.

Overall, the manuscript provides a promising tool for typhoid fever surveillance in low-resource settings, with significant public health implications. Addressing the detailed critiques will strengthen the manuscript and its potential impact.

On 2025-02-05 20:08:07, user Daniel Corcos wrote:

Gotzsche and Jorgensen claim to have found a high level of overdiagnosis after mammography screening. However, the method they use does not allow them to distinguish between cancers related to overdiagnosis and those caused by X-rays. Yet, when measuring the delay in the appearance of excess cancers, it becomes clear that, in addition to the excess corresponding to the lead time due to detection, there is a significant excess of delayed-onset cancers, which are therefore caused by X-rays ( https://www.biorxiv.org/content/10.1101/238527v1.full ; Corcos D & Bleyer, NEJM, 2020). These cancers explain the failure of screening at decreasing breast cancer mortality observed at 13 years by the authors.

On 2025-02-10 12:39:18, user MINGXIN LIU wrote:

This preprint has been published in International Journal of Medical Informatics and can be accessed at: " https://doi.org/10.1016/j.ijmedinf.2024.105673 ."

The title of the published version has been changed to "Evaluating the Effectiveness of advanced large language models in medical Knowledge: A Comparative study using Japanese national medical examination". Readers are encouraged to refer to the published version for the final peer-reviewed content.

On 2025-02-12 20:00:36, user Aron Troen wrote:

Review Part III

Results and Discussion<br /> Quantity of food trucked in: No source is cited for the figure of a pre-war baseline of 150-180 food-transporting trucks per day. This number is inconsistent with Israeli and UN sources. According to a document published in June by the Food Security Cluster, only 23% of UN recorded incoming goods to Gaza (not including fuel) before 7 October were food or food production inputs ( https://fscluster.org/sites/default/files/2024-06/Gaza%20imports%20and%20food%20availability%2015_may_V2%202.pdf) "https://fscluster.org/sites/default/files/2024-06/Gaza%20imports%20and%20food%20availability%2015_may_V2%202.pdf)") . If one is to rely on those UN statistics, the pre-war monthly average of trucks carrying food into Gaza was 2,288 (an average of approximately 100 trucks per working day in a normal month). Another UN source is the OCHA online Gaza crossings dashboard according to which during Jan-Sep 2023 a total 27,434 trucks carrying food entered Gaza, representing a monthly average of 3,048 trucks. <br /> The comparison in Figure 1 between the mean daily number of trucks for each week during the war with the "pre-war number of food-carrying trucks" per working day is highly misleading since it assumes that the number of working days remained steady. The distortion is significant because between 21 October and 5 May the crossings were open almost every day, as opposed to the 5-day work week in the period before the war. The following chart shows the monthly figures of UNRWA and COGAT compared to the monthly pre-war average of 2,288 trucks carrying food.

Compare it with Figure 1 from the article, which tells an entirely different story for the same period (blue columns represent trucks carrying food) in which is all but one week at the end of April the number of trucks carrying food was below the pre-war average:

Contribution of different food sources [to the northern and southern regions] (Table 1 & Figure 4)<br /> The result and discussion devote substantial attention to the relative distribution of food between the northern and southern regions. The governates designated as North and South Gaza are not explicitly defined. The only explanation for how the author determined the distribution of food deliveries between Northern and southern-central Gaza is as follows:<br /> "Until Israel re-opened the northern Erez and Erez West crossings, trucks had to leave south-central Gaza to resupply the north. We reconstructed the number of these trucks over time based on published information and data shared by WFP. As no data on content were available, we simulated their caloric equivalent by repeatedly sampling from the empirical distribution of calories per truck obtained from the UNRWA dataset (see below and Figure S1, Annex). The remaining trucked food was attributed to the south-central region."

The breakdown of that amount between northern and central-southern Gaza is based on an incomplete dataset (Commodities Received.xlsx) that appears to be missing the bulk of supplies by the private sector, appearing in the COGAT data ( https://gaza-aid-data.gov.il/main/) "https://gaza-aid-data.gov.il/main/)") , and which provided a significant share of supplies to the north. The dataset shows that during January and February 84 trucks were delivered to the north (according to the Logistics cluster). According to the same file, during March and April there only 20 private sector trucks delivered aid to the north. However, according to COGAT, deliveries to the north at that time were carried out mostly by the private sector, which are not fully covered by UN data. The flow of aid within Gaza and its regional distribution is difficult to ascertain. Media sources have provided conflicting reports from different sources. But they underscore the need to clarify precisely how the study assigned the regional food supply. For example, a story by the Associated Press from February 28 2024, reported that the UN had not been involved in aid deliveries to the North that month. According to one of COGAT's reports, during the first half of March they "facilitated over 150 aid trucks to the north" ( https://gaza-aid-data.gov.il/media/qtvbs5u0/humanitarian-situation-in-gaza-cogat-assessment-mar-15.pdf) "https://gaza-aid-data.gov.il/media/qtvbs5u0/humanitarian-situation-in-gaza-cogat-assessment-mar-15.pdf)") . In addition, COGAT claimed in a tweet from March 25 that UNRWA had not submitted a single request for delivering food to northern Gaza in six weeks ( https://x.com/cogatonline/status/1772316633605812511) "https://x.com/cogatonline/status/1772316633605812511)") . Thus, the methodology for determining the distribution of aid between northern and southern-central Gaza appears to be flawed since it almost entirely disregards aid deliveries by the private sector, which had a significant share of the total deliveries to the north during that period. Findings and conclusions that are contingent on this issue cannot be fully evaluated until this is corrected.

Main findings

The authors insinuate that the shortfall in the adequacy of food aid is solely due to intentional Israeli actions. For a subtle example of this the authors write that “Patterns in the diversity and caloric value of food trucked-in suggest that humanitarian actors may not have optimised the selection of what aid was allowed into Gaza.”. The food diversity findings suggest the humanitarian actors, who are responsible for deciding what is supplied to Gaza may not have optimized the selection of the aid. However, the use of the word “allowed” insinuates that the fault for this lies with Israel. The correct word should be “delivered”. Israel is responsible under international law for facilitating the entry of humanitarian aid. It is not responsible for selecting, procuring or delivering the aid. The fact that there was a considerable decline in food availability the first months of the war should not be surprising. Israel did not initiate the war, and should not be expected to have in place the logistics capacity for providing food to over 2 million conflict-affected people immediately after a strategic surprise attack. These major efforts, facilitated by the international community acting together with Israel, eventually yielded results as demonstrated by the study’s findings (eg. “a steep increase in food availability occurred from late April 2024, coinciding with the reopening of crossings into northern Gaza, and by June acute malnutrition prevalence appeared to be relatively low…”. [As noted above, “reopening” is a misleading term for the conversion of the Hamas-damaged Erez crossing from a pedestrian to a trucking terminal].

Similarly, one might ask why the Hamas failed to prepare for the needs of the Gazan civilian population under its governance, while it demonstrably prepared meticulously for the attack that was intended to provoke retaliation.

The authors seem intent to find Israel alone at fault, to encourage political pressure on Israel. They criticize “operations to deliver food via air or sea [as] cost-inefficient and a poor substitute for diplomatic pressure to merely reopen crossings”, stating in passing that “the 230M USD cost of the JLOTS operation [43] was higher than the entire humanitarian aid budget for the Central African Republic in 2024”. A back of the envelope calculation examining this assertion, and using WFP statements that their “emergency response [in Gaza] requires USD 740 million to provide support for up to 1.1 million people monthly” ( https://www.un.org/unispal/wp-content/uploads/2024/04/WFP-Palestine-Emergency-Response-External-Situation-Report-18-23-April-2024.pdf) "https://www.un.org/unispal/wp-content/uploads/2024/04/WFP-Palestine-Emergency-Response-External-Situation-Report-18-23-April-2024.pdf)") , shows that USD 740 per 1.1 persons monthly translates to 22.4 dollars per person per day. This means that the cost of the air-dropped food was only 29% higher than the delivery of land-based humanitarian food-aid. Thus, an equally plausible alternative interpretation of the resource expenditure might be that the air and sea operations, involving cooperation of USA, Jordanian, Israel and other Arab militaries to assist the Palestinian civilian population, could be considered a valuable attempt to circumvent the challenges to land-based humanitarian aid-operations during fierce fighting between Hamas and the IDF, as well as a means of exerting diplomatic pressure on the combatants. The policy implications and cost effectiveness of political pressure to increase food influx via land crossings are not obvious.

Comparing the resources allocated by the international community to the Palestinian population versus the long list of other pressing humanitarian crises, out of proper concern for emergency-affected civilian populations, is indeed a vexed question. Clearly, a critical and balanced discussion of this issue is beyond the scope of this paper. However, if one insists on raising this important question, one might also question the efficiency of the billions of dollars donated to Gaza over the past decade by the international community, including from UNRWA, and how the funds, which were intended for civil and humanitarian development, were misappropriated by Hamas for a massive military buildup to the attack including the construction of hundreds of kilometers of military tunnels and the stockpiling tens of thousands of rockets and launchers, embedding them in their civilian population ( https://www.wsj.com/world/middle-east/hamas-gaza-humanitarian-aid-diverted-cf356c48; https://govextra.gov.il/unrwa/unrwa/#:~:text=Update%206%2F8%2F24%3A,massacre%20are%20credible%20and%20true; https://www.nytimes.com/2024/12/08/world/middleeast/hamas-unrwa-schools.html?unlocked_article_code=1.f04.lcW3.n2kj8akEfM-M&smid=nytcore-ios-share&referringSource=articleShare; https://www.atlanticcouncil.org/blogs/new-atlanticist/how-to-reform-unrwa-to-improve-palestinian-lives-and-israeli-security/) "https://www.atlanticcouncil.org/blogs/new-atlanticist/how-to-reform-unrwa-to-improve-palestinian-lives-and-israeli-security/)") .

Limitations

The authors acknowledge several of the more obvious limitations and assumptions described above. However, they minimize or arbitrarily dismiss these weaknesses and proceed to make tendentious interpretations in support of their preferred policy implications. For example, they write that they relied heavily on a single UNRWA dataset “which appears highly complete and well-curated” without explaining how they make that subjective and unsupported assertion. The authors are demonstrably aware of the controversy and limitations of the data, yet they feign ignorance and avoid placing the data in the context of the known controversy writing that the data “may be biased by systematic under- or over-reporting UNKOWN TO US”. This knowingly downplays and misrepresents the CERTAIN under-reporting of UNRWA trucking data which the official disclaimer states clearly on the online dashboard and in the dataset that they provide for review: “We [UNRWA] are unable to provide comprehensive monitoring of cargo for the following reasons: i) safety and security concerns, which continue to prevent UN staff from maintaining constant presence at Kerem Shalom, therefore severely impacting our ability to cross-reference UN cargo, and record data from INGO, Red Cross and commercial trucks, and ii) delays and/or denials in approvals for UN to retrieve, count and move UN humanitarian aid from Kerem Shalom to other parts of the Gaza Strip, which mean that we are unable to fully verify all trucks which have transited the land crossings. We will resume presentation of comprehensive data once the situation at the crossing allows.” Similarly, the acknowledgement of “considerable uncertainty about population denominators” does not logically lead to the conclusion that this would “…have only marginally affected our estimates”.

Policy Implications

The conclusion of the article makes politicized recommendations that are disconnected from the findings. The authors’ recommendation to “reinstate UNRWA’s role as an independent and experienced on-the-field monitor” is unsupported, and the summary dismissal and evaluation of COGAT data as “not of sufficient quality to guide decision-making”, reflects bias rather than a balanced analysis. Considerations relating to the role that international actors can and should play is determined by far more complex factors that are the partial shipping data analyzed here.

The claim that Israel, “as the de facto occupying power”, did not ensure sufficient food availability to Gaza (while acknowledging the relatively short period of deficiency), vastly oversimplifies the complex dynamics of the conflict and the multifaceted factors affecting food availability. This claim appears intended to promote the use of the study as “evidence” supporting “forensic efforts” (in the courts) to prove allegations that “Israel deliberately has starved Gaza’s population”, presenting as fact a disputed interpretation of Israeli combat operations in Gaza as constituting occupation, and hence its obligations under international law, while ignoring weighty arguments to the contrary. This view also ignores corresponding obligations of Hamas as the governing power in Gaza, and the role of international humanitarian actors. The legal questions on this point are far beyond the scope of this review, but there is no basis in the data provided to make this claim – it is simply presented as an unsubstantiated assertion. In order to evaluate the morality, legitimacy or legality of the Israeli military strategy in response to the Hamas attacks and terror infrastructure, including its impact on food availability, it is necessary to examine and understand the strategy challenges in conditions of military asymmetry, the large-scale use of human shields to protect Hamas forces, and urban warfare as exist in Gaza. The authors of this article appear to be unaware of this central dimension in the issues they are claiming to address. Given the slanted narrative, the selective and biased use of data and their interpretation, and the far-reaching and unsupported conclusions, it is difficult to escape the impression that this study is aimed at providing a prosecution with ostensibly credible academic findings, rather than advancing open-ended research in support of humanitarian efforts.

Timely and reliable data are crucial to address the critical needs of the war-affected civilian population of Gaza. There is no doubt that data “on the civilian impacts of the war in Gaza”, and “situational awareness on food security in Gaza” are “important to inform appropriate humanitarian response”. It is also undoubtedly true that “humanitarian actors should review whether there is adequate coordination and technical expertise in place to ensure that what food is allowed into Gaza is both calorically efficient and diverse enough to maintain the best-possible diet, especially for population groups most vulnerable to malnutrition”. How a retrospective simulation of the food supply informs “situational awareness” is less obvious. Slanted, simplistic and politicized framing of the findings that ignore complexity, place the onus on Israel alone, and overlook the role of Hamas, the agency of Palestinian civil society, and the responsibility and obligations of the international community, do not advance scholarly discourse, nor will it strengthen the cooperation that is urgently needed to strengthen humanitarian efforts to benefit the civilians of Gaza.

On 2025-02-16 02:16:55, user Michael Pazianas, MD wrote:

Low BMD can be a common finding in both osteoporosis and renal osteodystrophy—two distinct histological diagnoses with distinct pathophysiology. While a low BMD and a T-score below -2.5 are often used to define osteoporosis, this finding does not necessarily indicate an osteoporotic etiology. Non-osteoporotic causes should be considered.

In this study, the authors included patients with CKD who were diagnosed with osteopenia or osteoporosis based solely on BMD measurements, rather than bone biopsy findings. However, low BMD in these patients could stem from other forms of renal osteodystrophy, such as adynamic bone disease or osteomalacia, rather than true osteoporosis.

"Given this premise, a more accurate and clinically relevant title might be: 'Low BMD Prevalence in Cardiovascular Kidney Metabolic Syndrome: Implications for Mortality.' The current title promotes an overly simplified approach that risks making the already challenging task of successfully managing these patients—particularly those with CKD—an even more distant prospect. This concern is especially relevant because antiresorptive therapies, commonly prescribed for osteoporosis, are contraindicated in adynamic bone disease, a pathology prevalent in CKD, as well as in osteomalacia."

On 2025-02-21 05:08:41, user Evan Stanbury wrote:

The paper refers to "a chronic debilitating condition after COVID-19 vaccination, often referred to as Post-Vaccination Syndrome" (which it calls PVS). This should not be confused with a common chronic debilitating condition after viral infection, often referred to as Post-Viral Syndrome (also PVS). This paper could confuse many, so it would be better to call the sick cohort something different from "PVS".

On 2025-02-22 17:25:17, user Shawn M wrote:

The study's questionnaire has significant design flaws. The main issue is how the questions are worded - they repeatedly ask about 'health conditions that you have had as a result of vaccine injury.' This phrasing assumes vaccines caused these health problems before even asking the question. It's like asking 'When did you stop stealing?' instead of 'Have you ever stolen anything?'<br /> This problematic wording can influence how people respond in two ways. First, it might lead people to automatically connect their health issues to vaccines without considering other possible causes. Second, by focusing only on vaccine-related problems, the questionnaire misses important information about people's overall health that could explain their symptoms.<br /> These issues make it difficult to trust the study's findings because we can't tell if the health problems reported were actually caused by vaccines or if they happened for other reasons that weren't explored.

On 2025-02-23 19:55:05, user Jan Páleš wrote:

Hello, I cant find any Ees formula in the reference 10...

On 2025-03-07 03:42:49, user mehrdad alemi wrote:

The COVID-19 pandemic posed unprecedented challenges for countries worldwide. Despite international sanctions, Iran managed to respond effectively to this crisis by relying on its domestic capacities.

Among the actions taken by Iranian scientists, researchers, and physicians:

1. Production of Domestic Vaccines: Iran became one of the countries producing COVID-19 vaccines by developing domestic vaccines such as Noora.

2. Expansion of Diagnostic and Treatment Capacity: The development of diagnostic kits, the increase in the number of equipped laboratories, and the production of medical equipment, including ventilators, contributed to better crisis management.

3. Healthcare System Management: The establishment of field hospitals, the strengthening of medical infrastructure, and the implementation of health restrictions at critical times played a significant role in reducing infection and mortality rates.

4. Research and Innovation: The publication of reputable scientific articles and the conduction of clinical studies on Iranian vaccines strengthened Iran’s scientific standing in this field.

On 2025-03-10 13:27:10, user Feng Gu wrote:

Hi, Please check the published version here: https://www.doi.org/10.1038/s41746-025-01501-9

On 2025-03-30 09:52:42, user Isatou Sarr wrote:

Over time, immunity from both vaccination and previous infection can decrease, leading to an increased risk of breakthrough infections. This phenomenon is particularly noticeable as the immune response fades, and the virus continues to evolve.This waning immunity presents a challenge for public health strategies that rely heavily on initial vaccination or infection-induced protection. Boosters become crucial in reinforcing the immune system and restoring protective antibody levels, especially for vulnerable populations such as the elderly or those with underlying health conditions. Moreover, the emergence of new variants, often with mutations that allow them to evade existing immunity, further complicates the picture. These variants can spread more easily and cause illness in individuals who were previously protected, necessitating ongoing adaptation of vaccines and preventative measures to keep pace with viral evolution. Continuous monitoring of variant spread, vaccine effectiveness, and the duration of immunity are essential for informed decision-making and effective mitigation strategies.

On 2025-04-09 12:24:29, user Breck wrote:

My colleague wants to know why you didn’t mention any testing for the flu. Did you test for the flu?

On 2025-04-10 22:33:05, user Will wrote:

My first comment should be: <br /> I noticed that Table 2 mentions Covid 19 under "Abbreviations" but in the actual table there is no Covid 19 variable. Could you clarify that please?

On 2025-06-04 21:03:24, user Meg McSorley wrote:

The unadjusted risk estimates are exactly the same as the adjusted, down to the confidence intervals and p-values?

Where is table 1, comparing baseline characteristics of the comparison groups (vaccinated and unvaccinated)? This would inform which covariates should be included in the model. This is actually the most important table because the vaccinated likely do have different characteristics than the unvaccinated that would affect the risk estimates.

How was influenza ascertained? Self-report? Employee Health testing? Why aren’t raw numbers reported?

Is there a reference for the Vaccine Efficacy calculation? Is there a statistical rationale for this calculation?

On 2025-04-23 20:04:44, user Maiwenn wrote:

Hi - this article is now available in the WHO Bulletin: https://pmc.ncbi.nlm.nih.gov/articles/PMC11978406/pdf/bullworldhealthorgan-103-4-BLT.24.292167.pdf <br /> DOI: 10.2471/BLT.24.292167

On 2025-04-30 07:16:59, user Frédéric Derbré wrote:

This preprint is now published on Cell Reports : https://www.cell.com/cell-reports/fulltext/S2211-1247(25)00219-0?uuid=uuid%3A08f5e5ab-1371-444d-b8cf-ba64672613f3 Is it possible to inform the readers on Medrxiv ?

On 2025-05-13 14:50:33, user Jasmohan Bajaj wrote:

this is now published in Clinical and Translational Gastroenterology https://journals.lww.com/ctg/abstract/9900/a_national_survey_shows_a_dilemma_towards_sbp.397.aspx

On 2025-05-28 23:11:26, user Evolutionary Health Group wrote:

We at the Evolutionary Health Group ( http://evoheal.github.io/) "http://evoheal.github.io/)") really enjoyed this paper. Here are our highlights.

Investment in ensemble forecasts resulted in better calibration and less variable predictions

Work bridged the gap between theory and policy; builds infrastructure for future data integration

Climate zone analysis balanced the desire for model generalizability, the need for sufficient historical data to characterize each zone, and the risks of unrealistically grouping diverse regions together.

Limitations of individual models including the provision of confidence intervals was honestly presented

On 2025-06-04 05:27:15, user Sira Jam Munira wrote:

This paper is now published in the “Journal of public health research” and the link-

https://doi.org/10.1177/22799036251337641

On 2025-06-04 17:34:59, user Sarah Jorgensen wrote:

Questions for the authors: <br /> From the results, 11 children started GAHT within 12 months of GnRHa initiation and another 20 within 12-24 months (total 31, 31/94 (33%)), yet in the discussion, "more than half of the participants had initiated gender-affirming hormones over the 24-month follow up period." Could the authors resolve this apparent discrepancy?

59 patients were assessed at 24 months. If 31 were not assessed because they started GAHT, there still appears to be 4 children unaccounted for. Were they lost to follow-up? What was their status at last assessment?

Details on psychiatric medications at baseline and initiated during follow-up would be of interest and could be considered for inclusion as time-varying covariates in models.

Given that 4-9 years have elapsed since GnRHa initiation, why was this analysis limited to 24 months follow-up? At the very least it would be of interest to know vital status and how many ultimately went on to receive GAHT versus desisted.

On 2025-06-07 15:03:33, user Nicolai Krekiehn wrote:

The git link does not work for me. I would like to test an use your model. Who is the contact?

On 2025-06-24 11:20:26, user Christopher Hickie wrote:

Could Tracy Beth Høeg please show evidence of reported affiliations with Sloan MIT and UCSF Emergency Medicine as I am not finding any listing for her for either.

On 2025-08-28 17:40:53, user gzuckier wrote:

Just a typo of some sort, I assume, but<br /> "-0.85 (95% Cl: [-0.48 --0.37]) for dose 3" can't be correct.

On a related note, however, I can't avoid a nagging suspicion of bias from the fact that some of the estimates used to support <br /> "concerning evidence of a higher-than-expected fetal loss rate" <br /> are not statistically significant is missing from the paper and must be intuited by the reader, as in <br /> "1.9 (95% CI: 0.39-3.42]) for dose 3";<br /> particularly when it's specifically noted with respect to estimates involving COVID infections <br /> "all the 95% CIs of the respective observed-to-expected differences included 0 (Table S8)."

The main findings, however, do not have this problem.

My humble suggestion is to include these other findings as "suggestive but not reaching statistical significance."

Or perhaps, since the results given for week 14 seem to be significant but are diluted by nonsignificant later results, that should be pointed out?

On 2025-06-26 00:25:38, user Pegah Khosravi wrote:

We are pleased to share that this preprint has now been peer-reviewed and published in Biological Methods and Protocols. The final version of the article is available at: https://doi.org/10.1093/biomethods/bpaf032

On 2025-07-01 18:15:13, user Yogev wrote:

This manuscript is now published in a peer reviewed journal, and can be found in: https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1593221/full

On 2025-07-14 22:06:03, user Pedro Rocha wrote:

This work has been published in its entirety in a peer-reviewed journal. The published version is available at: https://journal.unoeste.br/index.php/cv/article/view/5016/3709 , doi: 10.5747/cv.2024.v16.v379

On 2025-07-15 16:59:57, user zlmark wrote:

The preprint relies on survey data that shows clear evidence of sampling protocol violations, including improper household selection, failure to screen for residency, and geographic deviations confirmed by GPS data.

In several cases, inconsistencies appear to have been retroactively edited to align with protocol.

Data from two teams—Gaza9 and Gaza3—raise particular concern, with demographic anomalies and mortality figures that suggest possible manipulation or fabrication.

These issues compromise the representativeness of the sample and call into question the reliability of the resulting estimates.

A full analysis of these issues is available here: <br /> https://markzlochin.substack.com/p/design-vs-execution-in-gaza-mortality

On 2025-07-29 02:44:01, user Qiwen Yang wrote:

The article has been published at: https://doi.org/10.1093/ehjqcco/qcaf064

On 2025-08-08 09:31:31, user David Fournier wrote:

Dear authors, commenting on the recent Nat. comm. release, did you actually studied the direct connection in the samples from encode ad brains you studied between histone modifications and actual expansions? i dont see a plot of histone modifications versus repeat expansions directly plotted from the same individual. Did you check that? Thanks.

On 2025-08-11 18:12:37, user Aluoch Naomi Roosevelt wrote:

A good paper

On 2025-12-04 07:03:00, user Paul Olale wrote:

Very insightful with very viable best practices worth emulating in future cholera response expeditions as well.

On 2025-08-15 08:47:16, user Jouke- Jan Hottenga wrote:

Nice paper!

Population stratification severly influences HWE, which is known as the Wahlund effect. Hence, also the much larger SNP removal in mixed populations.

Imputation and phasing software in general assume HWE. Which might a) be a reason to apply HWE beforehand and b) will thus likely result in all markers also being in HWE post imputation.

With kind regards, Jouke

On 2025-08-20 13:21:16, user Anthony Clanton wrote:

Thank you for the opportunity to comment on your well-constructed manuscript. We appreciate the authors’ efforts to advance the STARD-IONM framework and promote rigor in reporting diagnostic accuracy for IONM. We would like to highlight the importance of clarifying partial recovery scenarios within the STARD-IONM framework. While the manuscript provides valuable discussion on reversible and irreversible signal changes, it does not explicitly define or address partial recovery—cases in which IONM signals improve but do not return to baseline. These common scenarios are clinically relevant and may reflect incomplete injury or partial mitigation. To improve clarity and consistency, we suggest considering the following additions:

• Clearly define “partial recovery” and distinguish it from full recovery and persistent deterioration.<br /> • Include guidance on how to classify and report partial recovery in diagnostic accuracy studies, particularly when calculating sensitivity, specificity, and predictive values.<br /> • Provide illustrative examples or decision frameworks to support consistent interpretation and reduce bias in outcome classification.

We would also like to emphasize that the STARD-IONM checklist does not currently call for authors to specify which muscles, nerves, or anatomical structures were included in the intraoperative monitoring plan, nor does it recommend reporting which signals changed and then recovered or failed to recover. While item 10a under “Test Methods” may implicitly suggest this level of detail, making this expectation explicit would be beneficial. Such information is frequently absent in studies evaluating IONM, yet it is essential for interpreting outcomes and ensuring reproducibility.

Thank you again for your commitment to transparency and community engagement. These additions could further strengthen the STARD-IONM framework and help ensure it serves the entire research community effectively.

Kent Rice, Kevin McCarthy, Anthony Clanton & Adam Doan

On 2025-09-21 16:07:08, user practiCalfMRI wrote:

The authors should address the issue of brain/CSF motion as a potential source of error in the MISL difference images.

On 2025-10-02 15:15:56, user Soumik Mandal wrote:

This preprint has been published at: https://www.nature.com/articles/s41746-025-01972-w

On 2025-10-05 04:11:20, user Mohammad Golam Kibria, PhD wrote:

The GitHub code link doesn't work.

On 2025-10-07 12:53:16, user Ronald wrote:

It an interesting paper to read

On 2025-10-07 13:01:22, user Evolutionary Health Group wrote:

We at the Evolutionary Health Group ( https://evoheal.github.io/ ) really enjoyed this paper.

Here are our highlights:

Asks what role the microenvironent (including antibiotic administration) plays in shaping the phenotypic traits of S. aureus.

Shows increase in MRSA associated with coexistant pseudomons infection and ciprofloxacin.

Monoinfected (SA only) cases showed increased pigment and biofilm production. Coinfected (SA and pseudomonas) cases showed reduce pigment and biofilm production. Two of these phenotypic shifts coincided with ABX treatment, and these patients had significantly more MRSA infections

On 2025-11-11 03:39:57, user Evolutionary Health Group wrote:

We at the Evolutionary Health Group ( https://evoheal.github.io/) "https://evoheal.github.io/)") really enjoyed this paper.

Here are our highlights:

As wastewater surveillance expands, not all systems will have the same infrastructure or sampling practice. Adjusting for flow allows standardization across plants of different sizes or environmental conditions.

Cost is a main barrier to sustained wastewater surveillance. This paper demonstrates that reducing sampling still yields stable real-time trends in the reproduction number, R, suggesting that wastewater surveillance can scale well without major budget requirements.

This model does not require clinical data for calibration, which demonstrates that wastewater surveillance can be a primary, rather than a secondary, disease monitoring system capable of tracking transmission even when clinical surveillance is poor.

The publication of a real-time reproduction number dashboard helps public health officials track seasonal waves without having to interpret raw wastewater concentrations, bridging scientific output and real-world action.

On 2020-04-04 18:33:11, user Jhansi Dan wrote:

Do anyone have data from last saturday/sunday for Virginia state. I remember seeing the peak date as April 28th and it shows May 20 now. I deduce flattening of curve. Please share the graphs. I wish they have archives for past data to compare.<br /> Thank You

On 2020-04-08 15:59:31, user Vee_Kay wrote:

Why have they dropped individual state numbers in the IHME projections? Instead they go to other countries that is of little interest to US....

On 2020-04-06 12:58:13, user Maria wrote:

A very accurate study, which explains the high rate of spread of Sars-CoV2. I would repeat it in dark and cold rooms, keeping air samples also in the dark, since UV light and heat damage the virus. This could reveal why only nude RNA is found.

On 2020-06-26 22:10:08, user kpfleger wrote:

On what date did the VDD protocol (table 1) commence? Is it possible to analyze COVID-19 outcomes (fatality, ventilator need, ITU admission, etc.) by baseline 25OHD on admission for before vs. after the VDD protocol started, as they did in the Singapore study: https://www.medrxiv.org/con... (which perhaps you should also cite BTW)? Or was 25OHD status not assessed for COVID-19 patients before the VDD protocol began?

On 2020-06-30 14:23:56, user John H Abeles wrote:

Estimates ( Stanford U ) for herd immunity are at around 40% or less ( Ionnaidis; Levitt)

On 2020-07-03 18:28:19, user Mark Pollington wrote:

Heterogeneous is clearly an important factor in determining herd immunity. However, in the developed counties discussed in this paper surely this will have been masked by the introduction of various non-pharmaceutical interventions.<br /> I was therefore fascinated to see how this problem could be tackled.

However, the equations outlining susceptibility do not appear to have been followed up to fit the parameters to data. Indeed, the discussion simply alludes to the authors fitting CVs which are an order of magnitude less than the susceptibility values used in the main paper!

Given the lack of evidence, then, why are arbitrarily susceptibility factors as high as 4 used? Why publish graphs which are so far removed from reasonable expectations? Unless politically motivated?

Clearly further research needs to be done to establish reasonable susceptibility factors, but I can't see any effective proposals in the paper. Computationaly intensive data fitting exercises with the inherent uncertainties in the data are certainly not the way to go!

On 2020-07-05 11:49:14, user OxImmuno Literature Initiative wrote:

https://www.immunology.ox.a...

On 2020-07-06 22:03:04, user Charles White wrote:

Full data and release for peer review? RNA detection only or did you culture in human epithelial cells?

On 2020-04-14 17:31:09, user Troy D wrote:

Why arent they using Zinc?

On 2020-07-11 23:36:55, user Monil Majmundar wrote:

Study showed corticosteroid was associated with lower risk of Icu transfer, intubation, mortality and higher probability of discharge.<br /> Corticosteroid was associated with 85% lower risk of primary outcome that is composite of icu transfer, intubation and death. 84% lower risk of icu transfer, 69% lower risk of intubation and 47% lower risk of mortality. 3.65 times higher probability of discharge.

On 2020-07-12 18:45:47, user Mario Moisés Alvarez wrote:

Please let us know if this contribution has been useful.<br /> Very, very best from Mx!

On 2020-07-13 18:19:24, user Dana C. wrote:

This study simply takes the estimated number of firearms in America and the annual firearm death rate then assigns a ratio. They apply this ratio to new firearm purchases with little or no adjustment for rioting, calls to defund police departments etc. The source of much of the data used is from The Gun Violence Archive which does not allow open access to it's data, it's criteria in forming and gathering it's data and is an openly anti gun organization.The results of this study have not been peer reviewed or subjected to any critical scrutiny. The results of this study are misleading at best and political biased and fraudulent at worst. It's no secret that a study can be manipulated to produce the desired end result which is clearly the result here. I have one question for those who prop up their ideologies with pseudo science, why are the 400,000 homicides (this is the most conservative estimate) that are prevented by legal/lawful gun owners annually never included in studies such as this?

On 2019-07-11 21:22:22, user Guyguy wrote:

EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Wednesday, July 10, 2019

The epidemiological situation of the Ebola Virus Disease dated July 9, 2019:

131 Contaminated health workers<br /> 3 health workers, including 2 vaccinated, are among the new confirmed cases (1 in Beni, 1 in Kalunguta and 1 in Katwa). The unvaccinated Kalunguta health worker died in a community health center.<br /> The cumulative number of confirmed / probable cases among health workers is 131 (5% of all confirmed / probable cases), including 41 deaths.

Since the beginning of the epidemic, the cumulative number of cases is 2,437, of which 2,343 are confirmed and 94 are probable. In total, there were 1,646 deaths (1,552 confirmed and 94 probable) and 683 people healed.<br /> 358 suspected cases under investigation;<br /> 9 new confirmed cases, including 6 in Beni, 1 in Mambasa, 1 in Kalunguta and 1 in Katwa;<br /> 5 new confirmed case deaths:<br /> 5 community deaths, 2 in Beni, 1 in Oicha, 1 in Mambasa and 1 in Kalunguta;

Data on deaths of confirmed cases managed by Ebola Treatment Centers are not available this Wednesday.

EPIDEMIOLOGICAL SURVEILLANCE

New health area affected: Mambasa (Ituri). The first case is an 8-year-old boy residing in Mambasa who had been to Beni with his mother. His mother, confirmed Ebola, died in Beni on June 19, 2019 but she was not buried in a dignified and secure manner. After developing the disease, the boy returned to Mambasa with his uncle. He died at the Mambasa Reference General Hospital.<br /> 156,851Vaccinated persons<br /> The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 19 May 2018.<br /> 73,466,784 Controlled people<br /> 80 entry points (PoE) and operational health checkpoints (PoC).<br /> Source: Ministry of Health press team on the state of the response to the Ebola epidemic in the Democratic Republic of Congo

On 2019-07-17 03:34:18, user Guyguy wrote:

EBOLA DRC - Evolution of the response to the Ebola outbreak in the provinces of North Kivu and Ituri on Sunday, July 14, 2019<br /> The epidemiological situation of the Ebola Virus Disease dated July 13, 2019:<br /> Since the beginning of the epidemic, the cumulative number of cases is 2,489, of which 2,395 confirmed and 94 probable. In total, there were 1,665 deaths (1,571 confirmed and 94 probable) and 698 people healed.<br /> 335 suspected cases under investigation;<br /> 12 new confirmed cases, including 6 in Mabalako, 4 in Beni, 1 in Katwa and 1 in Butembo;<br /> 10 new deaths of confirmed cases:<br /> 3 community deaths, including 1 in Mabalako, 1 in Beni and 1 in Katwa;<br /> 7 deaths at Ebola Treatment Center, including 4 in Beni, 2 in Mabalako and 1 in Butembo;<br /> 4 people recovered from Ebola Treatment Center, including 3 in Butembo and 1 in Beni.

Confirmed Ebola Patient from Butembo Supported at Goma Ebola Treatment Center

This Sunday, July 14, 2019, a pastor from South Kivu arrived in Goma after a short stay in Butembo. The 46-year-old pastor traveled from Bukavu to Butembo via Goma on Thursday, July 4 for an evangelistic mission. During his stay in Butembo, the pastor preached in seven churches where he regularly laid hands on Christians, including the sick. His first symptoms appeared on 9 July when he was still in Butembo. He was treated at home by a nurse until he left by bus for Goma on Friday, 12 July.

On the route between Butembo and Goma, the bus passed through 3 health checkpoints, namely Kanyabayonga, Kiwanja and OPRP. During the checks, he did not seem to show signs of the disease. In addition, at each checkpoint, he has written different names and surnames on the lists of travelers, probably indicating his desire to hide his identity and state of health.

As soon as he arrived in Goma on Sunday morning, he went to a health center because he did not feel well and started having a fever. No other patients were in the health center, reducing the risk of nosocomial infections of others. Nurses and doctors at the health center who recognized the symptoms of Ebola immediately alerted the response teams in Goma who transferred him to the Ebola Treatment Center (ETC). Around 15:00, the result of the lab test confirmed that he was Ebola positive. If his state of health permits, the patient will be transferred by ambulance to the ETC of Butembo to continue his care as of Monday, as provided by the procedure of the contingency plan.

It is important for people to stay calm. Due to the speed with which the patient has been identified and isolated, as well as the identification of all bus passengers from Butembo, the risk of spreading to the rest of the city of Goma remains low. Caution is still required. In order to avoid the contamination of additional people in Goma, it is urgent to break the chain of transmission by carrying out the following actions:<br /> Decontaminate the health center in which the patient has passed;<br /> Identify and vaccinate all contacts of the patient without exception;<br /> Track and limit contact movement for 21 days.<br /> Since November 2018, the Ministry of Health and the World Health Organization (WHO) have put in place an Ebola response planning and preparation system in the city of Goma due to the large influx of travelers from affected by the epidemic. The rapid detection of the patient by medical teams at the Goma health center proves the effectiveness of the city's preparedness activities to cope with the importation of potential Ebola patients. As part of this preparation, more than 3,000 health workers in Goma have been vaccinated and trained in the detection and management of Ebola patients.

In addition, the transport company has shown great professionalism in having a passenger register and making this register available to response teams to identify all passengers on the bus. The bus driver and the 18 other passengers have been identified and their vaccination will begin on Monday, July 15, 2019.

The collaboration of the entire population is necessary to prevent the spread of the epidemic in Goma. Beyond the medical arsenal, the Ministry of Health recalls that the response against Ebola is above all community.

As a reminder, the recommendations of the Ministry of Health are as follows:<br /> Follow basic hygiene practices, including regular hand washing with soap and water or ashes;<br /> If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu civil protection hotline directly;<br /> If you are identified as an Ebola patient contact, agree to be vaccinated and followed for 21 days;<br /> If a person dies because of Ebola, follow the rules for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.<br /> For all health professionals, observe the hygiene measures in the health centers and declare any patient with symptoms of Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding).<br /> If all citizens respect the sanitary measures advocated by the Ministry of Health, it is possible to ensure that this case of Ebola detected in Goma is a sporadic case that does not cause a new outbreak.<br /> Source: Ministry of Health press team on the state of the response to the Ebola epidemic in the Democratic Republic of Congo

On 2019-07-14 20:05:47, user Edward Tufte wrote:

Please please integrate excellent image with the text, so that adjacent text describes the image.<br /> Segregating text and image is for antique publishers only. Also your preprint will have more readers than any journal article, so do your best by those readers. If it is ever published, you can<br /> re-segregate text and image for the commercial publisher.

On errors in medical measurement, this good study: “Covariates are often measured with error, introducing bias and imprecision. Practices regarding covariate measurement error were assessed via a systematic review of general medicine and epidemiology literature. In original research published in 2016 in 12 high-impact journals,<br /> only 247 (44%) of the 565 original research publications reported measurement errors, <br /> only 18 publications (7% of 247) used methods to investigate or correct for measurement error.”

Excellent article by Timo B. Brakenhoff, Marian Mitroiu, Ruth H. Keogh, Karel G.M. Moons, Rolf Groenwold, Maarten van Smeden, “Measurement error is often neglected in medical literature,” Journal of Clinical Epidemiology, March 2018, 89-97, edited.

On 2019-09-30 05:56:18, user Guyguy wrote:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT SEPTEMBER 27, 2019

The epidemiological situation of the Ebola Virus Disease dated September 27, 2019

Saturday, September 28, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,186, of which 3,072 are confirmed and 114 are probable. In total, there were 2,128 deaths (2014 confirmed and 114 probable) and 989 people healed. <br /> • 446 suspected cases under investigation; <br /> • 3 new confirmed cases, including: <br /> • No cases in North Kivu; <br /> • 3 in Ituri, including 2 in Mandima and 1 Komanda; <br /> • No new confirmed deaths have been recorded; <br /> • No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 160 (5% of all confirmed / probable cases), including 41 deaths. • Vaccination rings were opened Friday, September 27, 2019 around confirmed cases of September 26 in the Mambasa Health Area located in the health zone of Mambasa in Ituri; <br /> • The satellite ring vaccination around the confirmed case of 20.09.2019 that started the disease in Beni continues in the health areas of Lisasa and Kalunguta in Kalunguta in the province of North Kivu; <br /> • Since the beginning of vaccination on August 8, 2018, 229,484 people have been vaccinated; <br /> • The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 20 May 2018. • Since the beginning of the epidemic, the total number of travelers checked (temperature measurement) at the sanitary control points is 99,958,288; <br /> • To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.

As a reminder, the recommendations of the MULTISECTORAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE are as follows:

1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes;
2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number;
3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days;
4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.
5. For all health professionals, observe the hygiene measures in the health centers and declare any person with symptoms of # Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding). <br /> If all citizens respect these health measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic.

On 2019-10-04 08:05:29, user Guyguy wrote:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT 02 OCTOBER 2019 <br /> Thursday, October 03, 2019 <br /> Since the beginning of the epidemic, the cumulative number of cases is 3,198, of which 3,084 are confirmed and 114 are probable. In total, there were 2,137 deaths (2023 confirmed and 114 probable) and 995 people healed. <br /> 427 suspected cases under investigation; <br /> 1 new case confirmed in Ituri in Mandima; <br /> 1 new confirmed case;1 person cured out of the CTE in North Kivu in The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths. <br /> 17th day without response activities in the Lwemba Health Area in Mandima, Ituri.<br /> LEXICON <br /> • A community death is any death that occurs outside a Ebola Treatment Center. <br /> • A probable case is a death for which it was not possible to obtain biological samples for confirmation in the laboratory but where the investigations revealed an epidemiological link with a confirmed or probable case.<br /> NEWS<br /> Prime Minister ready to implement the commitments of the Head of State through the ST / CMRE <br /> - Prime Minister, Sylvester Ilunga Ilukamba, considers that the commitments of the Head of State, President Félix-Antoine Tshisekedi Tshilombo, recalled from the top of the UN platform, are relayed in the field by the effectiveness of leadership and the Coordination of the Government of the Democratic Republic of the Congo through the Technical Secretariat of the Multisectoral Ebola <br /> - He said it during a meeting he chaired this Thursday, October 03, 2019 with the ST / CMRE delegation led by his Technical Secretary Prof. Jean-Jacques Muyembe Tamfum who was accompanied by Dr. Kebela and Prof. Michel Kaswa; <br /> - From this meeting, we note that as early as next week, the Prime Minister will bring together the ministers of Health, Budget and Finance to support the interventions of the response; <br /> - To this end, he stressed that the multisectoral vision of the response is, at the same time, to end the Ebola Virus Disease and to respond to the security and socio-economic needs of the populations affected by this epidemic ; <br /> - He promised that his government will support the approach of the Technical Secretariat of the CMRE to work for the Strengthening of the whole health system of the DRC; <br /> - Since July 20, 2019, the Head of State, the President of the Republic Félix-Antoine Tshisekedi Tshilombo, is coordinating the response to the epidemic to the Ebola virus disease and has decided to entrust the responsibility of the Technical Secretariat of the Multisectoral Committee to a team of experts under the direction of Professor Jean-Jasques Muyembe Tamfum; <br /> - The mission of the technical secretariat is to put in place all innovative measures that are urgent and indispensable for the rapid control of the epidemic.<br /> VACCINATION<br /> - Preparation of the Vitamin A Polio Immunization Campaign and Mebendazole Deworming in the 17 health zones of the Butembo Antenna, an area affected by Ebola Virus Disease; <br /> - 17 days already without opening rings around 5 confirmed cases in the Lwemba health area in Mandima in Ituri due to interethnic conflicts and insecurities. <br /> - An expanded vaccination ring was opened around the confirmed case of September 30, 2019 in Biakatp health area in Mandima in Ituri after dialogues and sensitizations carried out by the communication and psycho-social subcommittees; <br /> - Since vaccination began on 8 August 2018, 232,160 people have been vaccinated; <br /> The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 20 May 2018.<br /> MONITORING AT ENTRY POINTS- A FONER Komanda checkpoint provider (PoC) was abducted on Wednesday 02 October 2019 by unidentified men who released him 75 km from the PoC. This provider of surveillance at the Control Points has already resumed its daily services; <br /> - Since the beginning of the epidemic, the cumulative number of travelers checked (temperature measurement ) at the sanitary control points is 101,714,685 ; <br /> - To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.<br /> As a reminder, the recommendations of the MULTISECTORAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE are as follows: <br /> 1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes; <br /> 2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number; <br /> 3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days; <br /> 4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination. <br /> 5. For all health professionals, observe the hygiene measures in the health centers and declare any person with symptoms of Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding). <br /> If all citizens respect these health measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic.

On 2019-10-16 12:44:35, user GuyguyKabundi Tshima wrote:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT OCTOBER 11, 2019<br /> Saturday, October 12, 2019<br /> Since the beginning of the epidemic, the cumulative number of cases is 3,212, of which 3,098 are confirmed and 114 are probable. In total, there were 2,148 deaths (2034 confirmed and 114 probable) and 1031 people cured.<br /> 466 suspected cases under investigation;<br /> 2 new confirmed cases at CTE in Ituri in Mandima;<br /> 2 new confirmed deaths, including:<br /> 2 community deaths in Ituri in Mandima;<br /> No confirmed deaths in CTE;<br /> 3 people healed from the CTE, including 2 in Ituri in Komanda and 1 in North Kivu in Katwa;<br /> No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths.

NEWS

Organization of a press conference on the evolution of Ebola Virus Disease in Kinshasa<br /> - The Technical Secretary of the Multisectoral Committee for Ebola Virus Epidemic Response (CMRE), Prof. Jean Jacques Muyembe Tamfum chaired this Saturday, October 12, 2019 in Kinshasa a press conference during which he gave an update on the 10th epidemic Ebola Virus Disease in the DRC since its declaration on August 1 , 2018 to date;<br /> - To this end, he showed the strategies used in the response of this epidemic and spoke of the recourse to technological innovations, while recalling that the Head of State, President Félix-Antoine Tshisekedi Tshilombo, placed him at head of the technical secretariat of CMRE, with two main missions. This includes ending the epidemic as soon as possible and capitalizing on the achievements of this epidemic to strengthen the DRC's health system, starting with the three provinces affected by this epidemic;<br /> - Speaking of the evolution of the response, he reported some tangible progress, notably from July 2019, where 90 confirmed cases per week were recorded, or 15 per day, while currently there are fewer than 20 case by week, ie 1 to 3 cases per day, or even zero cases confirmed as the 05 October 2019 last. " In this period, three provinces were active (North and South Kivu, as well as Ituri), while today only the province of Ituri is affected . Today, only 9 zones are affected of the 22 recorded in July 2019, "said the technical secretary of the CMRE;<br /> - He said that for now the epidemic is concentrated in the North from where it came before revealing itself in Mangina and Mabalako in North Kivu. Hence all efforts are concentrated to put an end to this epidemic as quickly as possible;<br /> - Regarding strategies to end this epidemic, the Pof. Muyembe spoke about the change of approach that is now multisectoral and that at present, the outline of the epidemic is placed under the leadership of the presidency of the Democratic Republic of Congo with as coordinator the Prime Minister. This committee has a technical secretariat which directs the general coordination managed by Prof. Steve Ahuka and the provincial sub-coordinators of the response;<br /> - The second strategy was to maintain the motivation of the teams on the spot. This has been regularized with the support of the World Bank. An operating budget is now given to the coordination in Goma as well as all the co-ordination;<br /> - The other strategy is to give more importance to national leadership. A partnership has been built with WHO, UNICEF and MSF that support coordination in Goma. Nationals are at the forefront and partners support. This has changed a lot on the field, says Professor Muyembe;<br /> - Finally, notes the Technical Secretary, innovations have been made with this epidemic with the use of experimental vaccines, first RVSV zebov from Merck with belt vaccination which has shown its effectiveness;<br /> - " It is time to use a new vaccine, following the recommendations of the SAGE expert group that advises WHO on immunization. On May 15, 2019, this group recommended using an adjusted dose of the RVSV vaccine to prevent a possible shortage due to the fact that the epidemic lasts a long time, "Prof. Muyembe;<br /> - He added: " His second recommendation was to use a second preventive vaccine. After proposals, it is the Johnson & Johnson vaccine that presents the most data on the scientific level . He announced that the teams are prepared to give correct communication and to vaccinate the population;<br /> - He recalled that this second vaccine is used in West Africa since 2013, will also be used in Rwanda and Goma to protect the Congolese compatriots of Goma, where more than 64,000 of them cross the border daily. to go to Gisenyi and vice versa;<br /> - The first batch of the J & J vaccine, 500 000 doses can arrive in the DRC from 18 October 2019 and vaccination can begin in early November 2019 in two communes of Goma to extend later in other provinces;<br /> - The clinical trials carried out by the DRC will serve the world, since now two molecules tested are now available to break the chain of transmission during the next appearances of the Ebola virus.<br /> - " From this year, Ebola became a curable disease because we found medicines to cure the sick. It can also be avoided by immunization, especially if in both cases, one arrives in time, "concluded the technical secretary of the Multisectoral Committee for the Response to the Ebola Virus Disease Epidemic Muyembe Tamfum.

VACCINATION

• A new vaccination ring was opened around two confirmed cases from 10 October 2019 in the Biakato Health Area in Mangina / AS Biakato mine with low participation due to a strong community reluctance;
• Vaccination of newly recruited front-line staff continues at Kyondo Reference Hospital and Kayna Health Zone in Bulinda, North Kivu;
• Continuation of Local Polio Vaccination Days integrated with Vitamin A supplementation and Mebendazole deworming in 17 health zones at the Butembo antenna in North Kivu;
• Since the beginning of vaccination on August 8, 2018, 237,165 people have been vaccinated;
• The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 20 May 2018.

MONITORING AT ENTRY POINTS

• Since the beginning of the epidemic, the total number of travelers checked (temperature measurement ) at the sanitary control points is 105,171,551 ;
• To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.

As a reminder, the recommendations of the MULTISECTORAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE are as follows:

1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes;
2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number;
3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days;
4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.
5. For all health professionals, observe the hygiene measures in the health centers and declare any person with symptoms of # Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding).<br /> If all citizens respect these health measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic.

On 2019-10-18 23:18:45, user GuyguyKabundi Tshima wrote:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT OCTOBER 16, 2019<br /> Thursday, October 17, 2019<br /> Since the beginning of the epidemic, the cumulative number of cases is 3,228, of which 3,144 are confirmed and 114 are probable. In total, there were 2,158 deaths (2044 confirmed and 114 probable) and 1038 people healed.<br /> 443 suspected cases under investigation;<br /> 1 new confirmed case in North Kivu, including:<br /> 1 case in North Kivu in Mabalako;<br /> No cases in Ituri;<br /> 4 new confirmed deaths in North Kivu, including:<br /> 1 community death in North Kivu in Mabalako;<br /> 3 deaths confirmed at CTE in North Kivu in Mabalako;<br /> No healed person left CTE;<br /> No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths.

LEXICON<br /> • A community death is any death that occurs outside a #Ebola Treatment Center.<br /> • A probable case is a death for which it was not possible to obtain biological samples for confirmation in the laboratory but where the investigations revealed an epidemiological link with a confirmed or probable case.

NEWS<br /> NOTHING TO REPORT

VACCINATION<br /> - A satellite ring was opened in Mambasa prison around the confirmed case of 12 October 2019 in Nyakunde;<br /> - Continuation of expanded ring vaccination in Mataba in the health zone of Kalunguta around the 2 confirmed cases of 12 October 2019;<br /> - Continuation of the vaccination of newly recruited front-line staff (PPL) in the Kyondo (HGR Kyondo) and Kayna Health Zones (Bulinda Health Area), Musienene (Kimbulu Reference Health Center) and Butembo (Vulindi Health Area);<br /> - Preparation of the vaccination of biker taximen in the sub-coordinations of Butembo, Beni, Mangina in Mabalako in North Kivu and Mambasa in Ituri.<br /> - Since the beginning of vaccination on August 8, 2018, 239,139 people have been vaccinated;<br /> - The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 20 May 2018.

MONITORING AT ENTRY POINTS<br /> - Nasty destruction of huts and launching leaflets against providers at PoC Kolikoko;<br /> - Since the beginning of the epidemic, the total number of checked travelers (temperature rise) at the sanitary control points is 106,999,606 ;<br /> - To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.

As a reminder, the recommendations of the MULTISECTORAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE are as follows:

1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes;
2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number;
3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days;
4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.
5. For all health professionals, observe the hygiene measures in the health centers and declare any person with symptoms of # Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding).<br /> If all citizens respect these health measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic.

On 2019-11-16 01:59:42, user Guyguy wrote:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT 14 NOVEMBER 2019

Friday, November 15, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,292, of which 3,174 are confirmed and 118 are probable. In total, there were 2,195 deaths (2077 confirmed and 118 probable) and 1070 people healed.<br /> • 508 suspected cases under investigation;<br /> • No new confirmed cases;<br /> • 2 new deaths of confirmed cases in North Kivu, including 1 in Beni and 1 in Mabalako;<br /> • 3 healed people released from CTE in North Kivu in Mabalako;<br /> • No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 163 (5% of all confirmed / probable cases), including 41 deaths;

NEWS

Continuation of vaccination with the 2nd Ebola vaccine in two health zones of Karisimbi in Goma

• Vaccination continues in the health zones of Majengo and Kahembe in Karisimbi (Goma);<br /> • A total of 40 people were vaccinated, including 34 adults and 6 children under 18;<br /> • This vaccination began on Thursday, November 14, 2019 with the Ad26.ZEBOV / MVA-BN-Filo vaccine, produced by Janssen Pharmaceuticals for Johnson & Johnson. This second vaccine was approved on 22 October 2019 by the Ethics Committee of the School of Public Health of the University of Kinshasa and 23 October 2019 by the National Ethics Committee.

VACCINATION

• 40 people were vaccinated with the 2nd Ad26.ZEBOV / MVA-BN-Filo vaccine (Johnson & Johnson) in the two Health Zones of Karisimbi in Goma;<br /> • Since the start of vaccination on August 8, 2018 with the rVSV-ZEBOV vaccine, 252,249 people have been vaccinated;<br /> • Approved October 22, 2019 by the Ethics Committee of the School of Public Health of the University of Kinshasa and October 23, 2019 by the National Ethics Committee, the second vaccine, called Ad26.ZEBOV / MVA-BN -Filo, is produced by Janssen Pharmaceuticals for Johnson & Johnson.<br /> • This new vaccine comes in addition to the first, the rVSV-ZEBOV, the vaccine used until then (since August 08, 2018) in this epidemic. Manufactured by the pharmaceutical group Merck, after approval of the Ethics Committee on May 20, 2018, it has recently been approved.

MONITORING AT ENTRY POINTS

• A 38-year-old woman from Beni for Nzanga in Mutwanga, North Kivu, high-risk contact was intercepted at PK5 checkpoint (PoC) in Beni. She is in contact with a source case notified to Beni on 03 November 2019;<br /> • Since the beginning of the epidemic, the total number of checked travelers (temperature increase) at the sanitary control points up to 13 November is 116,622,388 ;<br /> • To date, a total of 112 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.

As a reminder, the recommendations of the MULTISECTORAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE are as follows:

1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes;
2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number;
3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days;
4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.
5. For all health professionals, observe the hygiene measures in the health centers and declare any person with symptoms of # Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding).<br /> If all citizens respect these health measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic.

On 2019-10-11 18:31:08, user Miguel wrote:

Interesting paper. It is really usefull to understand how P4 concept spread all over the world.<br /> RBMFC performed and published an special number about Quaternary prevention concept. Was lead by Marc Jamoulle and he encourage people from all over to send manuscripts. The year of the publication was 2015. That probably caused the increment of titles duriing this year. 2015 was also the year of the Iberoamerican Family Medicine in Uruguay. It was attend for an important number of P4 leaders ( included Jamoulle). Finally you must know there are a lot of publications (grey literatura) that are not allowed to be published. And the leadership of the P4 WONCA international gruop is in Uruguay.

On 2020-01-24 19:36:35, user Jeremy Ho wrote:

https://www.tandfonline.com...

On 2020-01-24 20:05:36, user Warren Li wrote:

How could the ascertain rate be as low as 4.8-5.5%? I don't see clearly the basis or fitted evidences for this assumption?

On 2020-01-26 00:39:20, user Jimmy Shih wrote:

One can also argue the parameters and assumptions used in such transmission model.<br /> The main point is not the results of the model, but rather the methodology in predictions.<br /> How can a researcher in thousands of mile away with no background of anything other than academics know the parameters and assumptions.<br /> Chinese government should do whatever she could to do the predictions as she controls all data and formulate policies based on the predictions results.

On 2020-01-27 04:11:13, user Mavrick55 wrote:

A city the size of Wuhan would have at least 40K beds in their hospital’s combined with a population of 11M. Why was it 2 days ago we saw film of over crowded hospitals with dead in corridors. Build more beds fast adding 2 more critical care units to be finished in a week. I think the estimates given above are quite conservative actually. I believe a million or more will be infected by mid February.

On 2020-01-31 21:48:51, user Carl Asplund wrote:

Some things I'm wondering about: <br /> Line 61 - "smaller" should be "larger"<br /> Line 72 - The first date (year) is wrong<br /> Lines 87-88 - What are the additional modelling assumptions made here? The model on line 45 doesn't support R values less than 1.

On 2020-02-12 22:27:46, user Dudley Poole wrote:

Anybody bother to figure out the higher "susceptibility" in males relative to their over representation in the Chinese population?

On 2020-02-12 23:48:47, user StockShaman wrote:

What we need to know is how long out of the host does this virus last ?

On 2020-02-13 05:13:34, user Ogi Dido wrote:

Singapore has special case of transmission. There are meeting of one company that some one as carrier spreading the virus to other meeting member. That's why Singapore evident is higher than the model prediction. meanwhile for Thailand the evidence below the model. It seem the model must be corrected again, excluded Singapore or give a note. Also for Japan recent days there are outbreak in two cruising ship,

On 2020-02-13 16:35:13, user dontlistentothepundits wrote:

To the study authors <br /> What medications did the patients receive during their hospitalization ? Were any of them taking Avelox or other Fluoroquinolones or antibiotics that have side effects that include the kidneys ?

On 2020-03-04 19:29:21, user David Do wrote:

Somebody researched on this yet ? Somebody should confirm this.

On 2020-03-08 18:37:04, user Jyotishka Das wrote:

Dear Authors,<br /> The work that you people have done is really interesting, and in times like this we must stand with each others in whatever we can. Being a student researcher at IIEST, Shibpur in the field of deep learning, it would be of immense help if you could kindly share the dataset with me for purely academic purpose. My contact email is : dasjyotishka@gmail.com . Thanks

On 2020-03-12 07:59:45, user objkshn wrote:

What about this study from March, 2020 that indicates the virus lives for up to 9 days on certain surfaces? https://www.journalofhospit...

On 2020-03-14 06:52:08, user Muhammad Yousuf wrote:

Hypokalemia is caused by SARS-CoV-2 virus due to its affinity for the Angiotensin Converting Enzyme (ACE) receptor that is present in the lungs, heart, blood vessels and the gastrointestinal tract of humans. It has been suggested from animal experiments that medications inhibiting this receptor (called ACEI or ARBs) could be a potential management strategy(1-2). Because ACEI and ARBs are medications mainly use for high blood pressure and would lower the BP, it is recommended that these medications should at least be used in patients with COVID-19 who are already suffering from hypertension or whose BP is not lower than 100 mm Hg systolic.

It would also be interesting to know the recovery and death rate of COVID-19 patients with hypertension or heart failure who were already using an ACEI or ARB medications compared with those who were not on suchmedications.

Abbreviations: ACEI= Angiotensin Converting Enzyme Inhibitors, ARBs= Angiotensin Receptor Inhibitors, BP= Blood pressure

References<br /> 1. Gurwitz D. Angiotensin receptor blockers as tentative SARS-CoV-2 therapeutics. Drug Dev Res. 2020 Mar 4. doi: 10.1002/ddr.21656. [Epub ahead of print]<br /> 2. Dimitrov, D. S. The secret life of ACE2 as a receptor for the SARS virus. Cell, 2003; 115(6), 652–653.

On 2020-03-22 17:24:40, user Jacob Madzan wrote:

The low potassium could be caused by a continual use of IV saline

On 2020-03-19 18:32:34, user Travis Pendell wrote:

Im far from a dr, but this doesnt mean that those with type o are less likely to get/carry it, but rather tgey are less likely to need blood tranfusions? This is based on how much blood was used? Type o just doesnt get it as bad... as often?... based on this right?

On 2020-03-22 14:14:29, user Rachelle Omenson wrote:

I'm interested to know how this mirrors the actual population in China at the time of testing? If the percentages of blood types getting the virus or not mirrors the abundance in the population this is bad data.

On 2020-03-21 19:46:18, user ???? ?????????? ??????? wrote:

it seems like a mistake at the end of Table1 for Cumulative<br /> number of cases

On 2020-03-21 21:07:21, user Elisabeth Bik wrote:

Cross posting a concern I also posted on PubPeer.

The protocol for the treatment was approved by the French National Agency for Drug Safety on March 5th 2020. It was approved by the French Ethic Committee on March 6th 2020. The paper states that patients were followed up until day 14, although I don't see any data from day 14 in the paper.

Since the paper was submitted for publication on March 16 in the International Journal of Antimicrobial Agents, the 14 day timeline seems to be impossible. Could the authors clarify how this statement in the Procedure matches the 10-day interval between ethical approval and preprint submission? <br /> "Patients were seen at baseline for enrolment, initial data collection and treatment at day-0, and again for daily follow-up during 14 days."

On 2020-03-24 13:35:07, user Sinai Immunol Review Project wrote:

Summary: Retrospective study of the clinical characteristics of 752 patients with pneumonia infected with SARS-CoV2 , admitted at Chinese PLA General Hospital, Peking Union Medical College Hospital, and affiliated hospitals at Shanghai University of medicine & Health Sciences. This study compares peripheral blood from healthy controls from the same regions in Shanghai and Beijing, and COVID-19 patients to standardize a reference range of lymphocyte counts stratified by age.

Key findings: Lower levels of lymphocyte counts - CD4 and CD8 T cells- correlated with disease severity (T cell counts were significantly lower in critical patients (in intensive care units, ICU) vs non-ICU). Based on 14,117 normal controls in Chinese Han population (ranging in age from 18-86) the authors recommended that reference ranges of people with CD3+ lymphocytes below 900 cells/mm3, CD4+ lymphocytes below 500 cells/mm3, and CD8+ lymphocytes below 300 cells/mm3 be considered high risk of severe COVID-19. However, COVID-19 patients were not stratified by age. This study reported that the levels of D-dimer, C-reactive protein and IL-6 were elevated in COVID-19 pts., indicating clot formation, severe inflammation and cytokine storm, but these parameters were not shown for healthy controls Authors compare data from patients in Shanghai and Beijing with patients in Wuhan, but clinical data from patients in Wuhan are not presented and it is unclear where data from Wuhan were obtained. The authors suggest a correlation between mortality rates and lymphocyte counts when comparing different regions in China, but this claim is not substantiated by data analysis. The authors should revise their title to emphasize disease severity (and not mortality).

Importance: This study sets a threshold to identify patients at risk by analyzing their levels of lymphocytes, which is an easy and fast approach that may stratify individuals that require intensive care Although the study is limited (only counts of lymphocytes are analyzed and not its profile) the data is statistically robust to correlate levels of lymphopenia with disease severity.

By María Casanova-Acebes

On 2020-03-24 22:52:54, user Sinai Immunol Review Project wrote:

Title: Clinical findings in critically ill patients infected with SARS-CoV-2 in Guangdong Province, China: a multi-center, retrospective, observational study?<br /> Immunology keywords: clinical outcomes, prognosis, critically ill patients, ICU, lymphopenia, LDH

Main findings: <br /> This work analyses laboratory and clinical data from 45 patients treated in the in ICU in a single province in China. Overall, 44% of the patients were intubated within 3 days of ICU admission with only 1 death.<br /> Lymphopenia was noted in 91% of patient with an inverse correlation with LDH. <br /> Lymphocyte levels are negatively correlated with Sequential Organ Failure Assessment (SOFA) score (clinical score, the higher the more critical state), LDH levels are positively correlated to SOFA score. Overall, older patients (>60yo), with high SOFA score, high LDH levels and low lymphocytes levels at ICU admission are at higher risk of intubation.<br /> Of note, convalescent plasma was administered to 6 patients but due to limited sample size no conclusion can be made.

Limitation of the study: While the study offers important insights into disease course and clinical lab correlates of outcome, the cohort is relatively small and is likely skewed towards a less-severe population compared to other ICU reports given the outcomes observed. Analysis of laboratory values and predictors of outcomes in larger cohorts will be important to make triage and treatment decisions. As with many retrospective analyses, pre-infection data is limited and thus it is not possible to understand whether lymphopenia was secondary to underlying comorbidities or infection. <br /> Well-designed studies are necessary to evaluate the effect of convalescent plasma administration.

Relevance: This clinical data enables the identification of at-risk patients and gives guidance for research for treatment options. Indeed, further work is needed to better understand the causes of the lymphopenia and its correlation with outcome.

Review by Emma Risson and Robert Samstein as part of a project by students, postdocs and faculty at the Immunology Institute of the Icahn school of medicine, Mount Sinai.

On 2020-03-25 11:59:06, user Ned wrote:

Can you share the sequence of the modified spike protein? The stabilized soluble protein with the his tag. I could not find it. Thanks

On 2020-03-26 16:04:12, user Sinai Immunol Review Project wrote:

Title: Meplazumab treats COVID-19 pneumonia: an open-labelled, concurrent controlled add-on clinical trial

Keywords: Meplazumab, CD147, humanized antibody, clinical trial <br /> Main findings: This work is based on previous work by the same group that demonstrated that SARS-CoV-2can also enter host cells via CD147 (also called Basigin, part of the immunoglobulin superfamily, is expressed by many cell types) consistent with their previous work with SARS-CoV-1. 1 A prospective clinical trial was conducted with 17 patients receiving Meplazumab, a humanized anti-CD147 antibody, in addition to all other treatments. 11 patients were included as a control group (non-randomized). <br /> They observed a faster overall improvement rate in the Meplazumab group (e.g. at day 14 47% vs 17% improvement rate) compared to the control patients. Also, virological clearance was more rapid with median of 3 days in the Meplazumab group vs 13 days in control group. In laboratory values, a faster normalization of lymphocyte counts in the Meplazumab group was observed, but no clear difference was observed for CRP levels.

Limitations: While the results from the study are encouraging, this study was non-randomized, open-label and on a small number of patients, all from the same hospital. It offers evidence to perform a larger scale study. Selection bias as well as differences between treatment groups (e.g. age 51yo vs 64yo) may have contributed to results. The authors mention that there was no toxic effect to Meplazumab injection but more patient and longer-term studies are necessary to assess this.

Significance: These results seem promising as for now there are limited treatments for Covid-19 patients, but a larger cohort of patient is needed. CD147 has already been described to facilitate HIV 2, measles virus 3, and malaria 4 entry into host cells. This group was the first to describe the CD147-spike route of SARS-Cov-2 entry in host cells 1(p147). Indeed, they had previously shown in 2005 that SARS-Cov could enter host cells via this transmembrane protein 5). Further biological understanding of how SARS-CoV-2 can enter host cells and how this integrates with ACE2R route of entry is needed. Also, the specific cellular targets of the anti-CD147 antibody need to be assessed, as this protein can be expressed by many cell types and has been shown to involved in leukocytes aggregation 6. Lastly, Meplazumab is not a commercially-available drug and requires significant health resources to generate and administer which might prevent rapid development and use.

1. Wang K, Chen W, Zhou Y-S, et al. SARS-CoV-2 Invades Host Cells via a Novel Route: CD147-Spike Protein. Microbiology; 2020. doi:10.1101/2020.03.14.988345
2. Pushkarsky T, Zybarth G, Dubrovsky L, et al. CD147 facilitates HIV-1 infection by interacting with virus-associated cyclophilin A. Proc Natl Acad Sci USA. 2001;98(11):6360-6365. doi:10.1073/pnas.111583198
3. Watanabe A, Yoneda M, Ikeda F, Terao-Muto Y, Sato H, Kai C. CD147/EMMPRIN acts as a functional entry receptor for measles virus on epithelial cells. J Virol. 2010;84(9):4183-4193. doi:10.1128/JVI.02168-09
4. Crosnier C, Bustamante LY, Bartholdson SJ, et al. BASIGIN is a receptor essential for erythrocyte invasion by Plasmodium falciparum. Nature. 2011;480(7378):534-537. doi:10.1038/nature10606
5. Chen Z, Mi L, Xu J, et al. Function of HAb18G/CD147 in Invasion of Host Cells by Severe Acute Respiratory Syndrome Coronavirus. J Infect Dis. 2005;191(5):755-760. doi:10.1086/427811
6. Yee C, Main NM, Terry A, et al. CD147 mediates intrahepatic leukocyte aggregation and determines the extent of liver injury. PLOS ONE. 2019;14(7):e0215557. doi:10.1371/journal.pone.0215557

Review by Emma Risson and Robert Samstein as part of a project by students, postdocs and faculty at the Immunology Institute of the Icahn school of medicine, Mount Sinai.

On 2020-03-27 14:17:30, user Adam Roberts wrote:

Hello<br /> I would like to highlight the citizen science, antimicrobial discovery project, with the same name; https://www.lstmed.ac.uk/pu...<br /> All the best<br /> Adam

On 2020-03-30 13:57:15, user Sinai Immunol Review Project wrote:

Summary: Based on a retrospective study of 85 hospitalized COVID patients in a Beijing hospital, authors showed that patients with elevated ALT levels (n = 33) were characterized by significantly higher levels of lactic acid and CRP as well as lymphopenia and hypoalbuminemia compared to their counterparts with normal ALT levels. Proportion of severe and critical patients in the ALT elevation group was significantly higher than that of normal ALT group. Multivariate logistic regression performed on clinical factors related to ALT elevation showed that CRP >= 20mg/L and low lymphocyte count (<1.1*10^9 cells/L) were independently related to ALT elevation—a finding that led the authors to suggest cytokine storm as a major mechanism of liver damage.

Limitations: The article’s most attractive claim that liver damage seen in COVID patients is caused by cytokine storm (rather than direct infection of the liver) hinges solely on their multivariate regression analysis. Without further mechanistic studies a) demonstrating how high levels of inflammatory cytokines can induce liver damage and b) contrasting types of liver damage incurred by direct infection of the liver vs. system-wide elevation of inflammatory cytokines, their claim remains thin. It is also worth noting that six of their elevated ALT group (n=33) had a history of liver disease (i.e. HBV infection, alcoholic liver disease, fatty liver) which can confound their effort to pin down the cause of hepatic injury to COVID.

Significance of the finding: Limited. This article confirms a rich body of literature describing liver damage and lymphopenia in COVID patients.

Review by Chang Moon as part of a project by students, postdocs and faculty at the<br /> Immunology Institute of the Icahn school of medicine, Mount Sinai.

On 2020-04-03 07:50:32, user BoghosLArtinian wrote:

In times of lethal pandemics any safe treatment that shows the slightest benefit should be tried before waiting for large scale scientific studies to be completed, to prove efficacy of treatments, and losing thousands of lives in the process.

On 2020-11-21 00:29:25, user Richard Wachterman wrote:

Will airlines allow during flight since they do not allow masks that have exhaust holes? I realize that there are options for putting filters over the exhaust valve, but do we know if the airlines will accept that.

On 2020-12-04 16:17:03, user sdharbinger wrote:

I have three reservations about aspects of this study.

Firstly, the study tried to emulate a Randomised Control Trial by isolating consideration and analysis of each component for their potential as a single magic bullet agent and it never recorded or analysed enough data on a far greater range of different agents when they are taken in combination as part of integrated protocols. For example the Eastern Virginia Medical School protocol advocates supplementing with a combination of Vitamin C, Vitamin D, Quercetin, Zinc, Melatonin and Vitamin B complexes. Many also advocate Selenium, Magnesium, Folic Acid, NAC or Elderberry Syrup to name but a few.

Any combination of these agents could possibly help to build immunity because they act in different ways in different parts of the immune system and collectively certain protocols might show highly significant improvements in outcomes. There is no reason why the ZOE.app could not have collected data on all popular supplements and then analysed the data looking to see how effective different combinations were. This ability in principle to have collected virtually unlimited data from millions of subjects is what potentially makes the ZOE.app far superior to any RCT with virtually real time results and reports. If the Zoe app had given users the chance to enter a full range of supplements instead of restricting to them to just 6, then it would have been possible to analyse the effects of these agents when used in different combinations. In trying to emulate the 'gold standard' design and functionality of RCTs the ZOE.app and the study it generated: ignored the huge advantages that the ZOE.app has over RCTS in principal and in potential practices.

Secondly the study restricted its analysis to a question of whether people taking various supplements would go on the have a positive PCR test. The general problem with this measure is that no-one supposed that any of these supplements would provide complete prophylaxis against Covid-19 and that people were taking vitamins in the hope that if they caught Covid-19 that they would experience less severe illness on account of a better immune system. The best metric in these terms would have been to assess the relative hospitalisation rates between those taking supplements or not and not simply reduced evaluation to just prophylaxis.

Thirdly, the study failed to record what dosages of supplements people were taking which potentially have a large effect on outcomes.

On 2020-12-06 20:15:11, user Murilo Perrone wrote:

It appears to me that the 8 patients on the treatment group who did not make it where exactly the ones who failed to reach adequate levels of 25OHD (above 30 ng/mL). The chart indicates that 5 patients from the treatment group failed even to reach 20 ng/ml. Unfortunately, the study gives no clue about this possible correlation, but that's my best guess.

I noticed that ventilation machine requirement was reduced by more than 50% in treatment group, but all 8 patients from treatment group who required it didn't survive. There is an indication that their outcome was predictable. IMHO, their specific data should be analyzed.

On 2020-12-11 16:41:00, user Richard Neher wrote:

Review of version 1 of this manuscript -- 2020-12-11:

Kemp and colleagues present a case of persistent SARS-CoV-2 infection and analyze the molecular evolution that unfolded within the host in detail. This case is not dissimilar from two recently described cases (Choi et al (10.1056/NEJMc2031364), Avanzato et al (10.1016/j.cell.2020.10.049)). In contrast to these previous cases, Kemp et al investigate within-host evolution using deep sequencing and trace the frequencies of different variants through time. They characterize three diverged variants with different mutations and deletions in the spike protein, some of which reduce neutralization titers of convalescent plasma in a pseudo-typed lentivirus. Overall, the work in this paper is well performed and it provides convincing evidence of in-vivo antibody escape.

I have a number of suggestions to improve the presentation, strengthen the conclusions, and to remove/tone down parts that might be misleading.

* Fig 2A: The radial tree in Figure 2 is rather unhelpful. The labels are hardly readable and distances between samples are very hard to judge from the radial presentation. A rectangular tree indicating major clades and the different within-host samples would be better.

* Fig 2B & 4B: I think the figure would be improved by changing the scale bar to correspond to one or two mutations (currently the scale bar is given in mutations per site and is roughly 6 mutations in 2B, 2 mutations in 4B). Zero-length branches in the ML trees should be collapsed into polytomies. Bootstrap values on SARS-CoV-2 trees are pretty useless. Better to label the branches with (number of) mutations that fall on the branch in a parsimony or ML reconstruction. This has a one-to-one correspondence to bootstrap values and is more interpretable.

* The purple line in Fig 3B suggests an iSNV at frequency 30% on day one that persists at a frequency around 30% until day 82. This iSNV doesn't seem to be affected by the fixation of other iSNVs at time points 66 or 82 days. Would be good to look into this. It could indicate population structure which would imply parallel evolution. Or it could be an artifact (more likely). Either way, this should be looked at and discussed.

* To understand the rapid shifts in dominating variants better, it would be helpful to include a discussion of their frequencies when they are rare. It makes a difference to the interpretation if the minor variants are present at 10%, 1%, or 0.1%. The reader currently has to piece this together from supplementary table 3 and there are some discrepancies: The S:64G variant seems to be very rare after day 95 (not detected by high coverage Illumina) while the linked S330S is still picked up (at high frequency in low coverage data??). Mutations 200H,240I,258S are missing from supplementary table 3.

* Fig 5 would be more useful on a logscale. Bar charts should be avoided, individual data points need to be shown.

* the description of how evolutionary rates are estimated from within-host data is very short. I would caution against over-interpreting these estimates for two reasons: (i) Phylogenetic estimates are done with consensus sequences and thus ignore minor variation. (ii) rate estimates likely depend a lot on how the within-host variation is rooted and how the root height is constrained. The error of the mean rates (table S2) seems way too small in some cases (1% of the main) calling the entire procedure into question. I would cut this as I don't think this is reliable and it is not central to the paper.

* Similarly, the logistic fit to T39I in ORF7a (Supp Fig 6) is not evidence for selection. I don't see what this figure adds that is not visible in Fig 3. All that Fig S6 shows is that the variant was rare at day one and then bounced around frequency 0.5 between day 30 and 60. There is no reason to fit a logistic and insinuate selection.

* the distances presented in Fig S5 seem rather large (two-fold larger than what I would have guessed from the tree).

* accession numbers for consensus sequences and reads need to be provided.

On 2020-12-13 09:54:35, user @nsmartinworld wrote:

This is now infamous as Sweden’s hospitals are at capacity.

On 2020-12-15 23:02:05, user E. de Moya wrote:

You should contact Mr. Wallukat and Celltrend, both researching autoantibodies in postviral Postural Tachycardia Syndrome (POTS) and ME/CFS. It would be interesting to see, if long-haulers also have amongst others, adrenergic and muscarinic aabs

On 2020-12-15 23:58:58, user Samantha Braun wrote:

What was used as the placebo?

On 2020-12-18 09:01:57, user Frank Conijn wrote:

For as to why in the latter version(s) the analysis regarding face masks was deleted, see the comments under version 2 on https://www.medrxiv.org/con....

On 2020-12-21 00:47:06, user Nikunj Bhagat wrote:

This paper has now been published by NeuroImage:Clinical and readers can access it at https://doi.org/10.1016/j.n...

On 2021-01-16 09:55:59, user Guillaume wrote:

please correct reference 22 to published version, thanks! https://www.nature.com/arti...

On 2021-01-21 18:33:05, user Calogero wrote:

Slovak people were forced to participate to the testing under threat of losing their jobs. One months after testing we were and now still are among the countries with higher deaths rate pro capite in the world. People had to wait per hours outside in severe november weather to be tested and after that wait inside for the results risking to be infected. During the weeks after testing the number of daily pcr tests was significantly lowered, that is reason why there were less new covid cases after testing. And despite whole scientific and medical community is contrary to the wide-testing, it is to be repeated next week, same conditions, not tested not allowed to go to the work, risking unexcused absence standing on the words of minister of labour, without any financial compensation. Unbelievable but true. (sorry for my english)

On 2021-01-23 13:21:08, user Dušan wrote:

"All authors declare that they have no conflicts of interest"

Have a look at Jarcuška's organisation Euromedpro which is sponsored by GSK and Pfizer.

On 2021-01-24 08:54:43, user ad4 wrote:

Can the authors please provide a list / file of all input parameters (with error intervals) used in the model and make all code publicly available.

On 2021-01-25 17:46:56, user Yin Aphinyanaphongs wrote:

who is the corresponding author?

On 2020-09-13 07:52:10, user OxImmuno Literature Initiative wrote:

https://www.immunology.ox.a...

On 2021-07-10 22:08:06, user Mazzs wrote:

Australia is currently showing good data on precise outcomes for delta variant cases.

On 2020-09-13 08:20:33, user OxImmuno Literature Initiative wrote:

https://www.immunology.ox.a...

On 2020-09-16 02:09:39, user Peter Lange wrote:

Thanks, interesting paper. To my knowledge reporting appears complete but may I suggest statement that the paper is consistent with the relevant EQUATOR guideline and completion of the check-list - I think it would be STARD?

On 2020-09-16 21:22:39, user Philippa Wells wrote:

Our paper has now been published in The Lancet Rheumatology: https://www.thelancet.com/j...

On 2020-09-23 08:05:12, user Bastien Boussau wrote:

This preprint has been peer-reviewed by Peer Community In Mathematical and Computational Biology @PCI_MathCompBio. The reviews can be seen here: https://mcb.peercommunityin.org/public/rec?id=1&reviews=True

On 2020-09-23 18:54:07, user ???? ????? wrote:

Good work but l want to ask if the patients who died they had risk factor for thrombosis or not

On 2020-09-24 00:34:03, user Peter Olins wrote:

@Bjorn, <br /> Perhaps I'm missing something, but I don't understand why you assume a 12-second interval between breaths when the resting rate for adults is typically one breath every 3-5 seconds. In addition, I suspect that a high breath rate would be expected for people socializing and eating lunch in a crowded restaurant. <br /> What effect would a 4-fold increase in respiration have on your calculations?

Peter Olins, PhD.

On 2020-09-24 19:07:43, user Steve Schaffner wrote:

The paper reports that Rh-positive blood type and mortality are positively correlated. According to Supplemental Table 3 (which doesn't seem to be accessible from the preprint server), mortality is also positively correlated with Rh-negative status. Since people can only be Rh+ or Rh-, this is not possible. I suspect the authors didn't remove samples with missing blood type information before doing the calculation -- information that is more likely to be missing for those who survived. If this is what happened, the high correlation with Rh+ type simply reflects the high prevalence of Rh+ in the population.

On 2020-09-24 20:42:31, user Marcus Roscher wrote:

Interesting findings... but one might not agree with their interpretation: strong but late measures as in most countries lead to many also lethal cases and then a sudden case drop. If the tested seropositive group is representative enough to deduce 44-66% infection rate of the population is questionable IMHO. And if so we don’t know what influence it really had on the case evolution (considering possible reeinfections or weak till no immunity with mild and no symptoms) ... so it’s not clear if there is a kind of herd immunity and second in such short time. On the other hand this would mean we would have 400-500 death per 100k population in older societies in order to reach some kind of Heard- immunity. What a price!

On 2020-09-29 06:52:41, user Robert Stephens wrote:

Could it be that the infection fatality rate (IFR) within a community may be determined by the dominant mode/s of transmission within that community? In Mumbai for instance, the adjusted IFR in the Dharavi slum community was 0.076% but in the non-slum community the IFR was 0.27% for the same period (https://www.medrxiv.org/con... "https://www.medrxiv.org/content/10.1101/2020.08.27.20182741v1)"). This discrepancy is unlikely to be on account of genetic factors, prior exposure to other coronaviruses, and perhaps is not due to age differences either.

Poor sanitation in slums may have resulted in cases of spread through contaminated water. Orofaecal transmission may have resulted in "safer" infections (gastrointestinal infections, oral mucosal & upper respiratory tract infections). <br /> In communities without sanitation issues, transmission of virus via airborne routes perhaps occurs more frequently. Airborne exposure to virus is potentially more toxic than non-airborne exposure as the transmission is more directed to lungs.

Robert Stephens MB BS FACD

On 2021-03-16 09:37:40, user Luandrie Potgieter wrote:

How can one get the data that was used to test the methods in this paper?

On 2020-09-29 22:53:36, user Guillermo Ruiz-Irastorza wrote:

The paper has been already published in PLoS One 2020 Sep 22;15(9):e0239401. doi: 10.1371/journal.pone.0239401. eCollection 2020.

On 2020-09-30 14:37:10, user tjo wrote:

Were the 62 patients in that experiment all from the ED group, or was it a mix on inpatients and ED?

On 2020-10-05 08:20:30, user NMN wrote:

The way it is presented in the abstract seems misleading to me, it presents itself as a report of a mass screening of nearly 2000 individuals, in which saliva outperformed NP swabs, but this is not really an accurate picture of what they found.

They have 2 cohorts. <br /> 1) a contact tracing (CT) cohort of 161 individuals, of which 47 were positive by NP and/or Saliva. I would not consider contact tracing of less than 200 individuals to be “mass screening”<br /> 2) An airport mass screening cohort of 1763 individuals, of which 5 were positive by NP and/or saliva.

The saliva outperformed the NP swabs in the CT cohort only, with 44/47 positives for saliva compared to 41/47 positives for NP swabs.<br /> NP swabs outperformed the saliva in the mass screening cohort, with 5/5 positives by NP swab, and 4/5 positives by saliva. These numbers are too low to make conclusions for mass screening though.

Furthermore, it seems that there are math errors in the sensitivities that they report.<br /> They report sensitivities of NP and saliva as 86% and 92% respectively, yet there is no way to arrive at these %s from the numbers in their tables.

Sensitivities for NP vs saliva in:<br /> CT cohort only: 87.2 vs 93.6% (41 vs 44 /47)<br /> Mass Screen cohort only: 100 vs 80% (5 vs 4 /5)<br /> Combined cohorts: 88.5 vs 92.3% (46 vs 48 /52)

On 2020-10-09 06:56:14, user Reetpetit wrote:

Thank you for a very interesting study.

@Mark Wilson <br /> Sounds like your mind is already made up, which is unhelpful.

In the IZA study of the introduction of face masks in Germany - which was particularly interesting as it happened on slightly different dates in different regions, allowing for a synthetic control - face masks were shown to have reduced Covid transmission by about 40%.

On 2020-10-12 13:15:33, user Anechidna wrote:

Vitamin D, which one? The assumption is D3 but D2 is the most commonest form of supplemental vitamin D in the belief that it is converted into D3 which it isn't. Very sloppy work to talk about Vitamin D when you were performing your research on a specific form. The research also indicates elevating levels of D2 in an attempt to drive up D3 results in suppression of D3 levels. So either get the required skin sunlight interaction allowing for skin tone or get D3 in its proper supplemental form as D3.

On 2020-10-16 15:39:56, user Mithun Aswath wrote:

The dosage of HCQ is much higher than normal recommended dose. The British Medical journal suggests only 200-400mg per day. But in this they can three - four times the dosage.

There is a trial in Belgium with low dose HCQ which has shown efficacy.

Maybe WHO needs to do proper trial for HCQ as a prophaltic like it's used for Malaria with a proper dosage and not a high one.

Also Vitamin D and Zinc benefits should be studied quickly as it's a cheap and easy immunity builder.

On 2020-10-16 19:04:34, user rick wrote:

The results contradict those published in NEJM for remdesivir. This trial is slightly larger, but the NEJM study was better described, and more homogeneous in its methods. It's unclear to me how the two patient populations compare, although some comments here suggest that, in this trial, they tended to be fairly sick. I would also like to see more work on this drug given early. By the time a person is hospitalized, their immune response to the virus may be more important than viral load, and antivirals can't do anything about that.

On 2020-10-16 21:49:42, user Carlos Stalgis wrote:

The question I have is different. Do we really believe that this type of trial design and implementation is good enough to answer the questions posed? I don't know of any other trial such as this one. It seems that they tested the design and not the drugs. In addition, they should not use the generic term IFN but the more specific interferon-beta. Not all IFNs work the same as antivirals.

On 2020-10-17 01:47:55, user EntropicInfo wrote:

Seems odd for this preprint not to provide any information about time from symptom onset to antiviral administration. Was time from symptom onset omitted from the paper or simply not recorded?

On 2020-10-18 08:46:08, user Amichai Perlman, PharmD wrote:

The use of 99% confidence intervals for subgroups in the meta-analysis in figure 4 obscures the subgroup difference which is suggested by the data. Using 95% confidence intervals and formal test for interaction, the difference in the effect of remdesivir on mortality between ventilated and non-ventilated patients would likely be considered "significant" according to standard meta-analysis reporting procedures. While this is a post hoc analysis and therefore is not conclusive, and should not be portrayed as such, its total dismissal does not seem warranted, both in terms of accepted statistical standards, and in terms of the effect size (it is identical to that shown for dexamethasone in non-ventilated patients on oxygen the Recovery trial).

On 2020-10-18 11:36:53, user Benjamin Himes wrote:

Nice ideas, I hope it matures into some useful tech. There are a few holes in the experimental design (or at least the presentation of such.)

Full review is accessible on Zenodo.

https://doi.org/10.5281/zen...

On 2020-10-18 23:05:10, user Joe B wrote:

Would have been interesting to also examine use of fentanyl, dexmedetomidine and propofol in these patients. Also, since there is no IV formulation of melatonin available (we had the IND for it), presumable oral melatonin was used. The bioavailability of it is very low, about 15% (already published data years ago). So, the doses used would have been important to know also. Sort of shocking that P&S is using so much in terms a atypical antipsychotics in patients who presumably have ICU dementia, generally not recommended by SCCM guidelines.

On 2020-10-20 09:17:45, user Anne Hartmann wrote:

Dear Prof. Kähler, <br /> thank you very much for your study. <br /> Unfortunately, we think that some aspects are not considered correctly and some mentioned conclusions therefore can not be drawn. We summarized our comments in a statement on our blog (statement is available in German as well as English)<br /> https://blogs.tu-berlin.de/....<br /> Kind regards<br /> Anne Hartmann, member of the research group of Prof. Kriegel

On 2020-10-20 14:15:11, user Robbert Bentvelsen wrote:

This trial was published: N Engl J Med 2020; 383:494-496 DOI: 10.1056/NEJMc2016321

On 2020-10-21 14:36:25, user Stephen B. Strum wrote:

It would be important to see if hospitals in urban settings have superior outcomes re death rates versus rural medical facilities. It would also be important to know if the issue of viral load as it relates to the population wearing masks (e.g., high-mask wearing versus intermediate vs low-mask wearing) plays a role.

On 2020-10-22 21:10:27, user Critical Dissection wrote:

Dear author,

After reading your article, here are my comments. I will start out with positive; the abstract was greatly laid out. I like how it is broken down to individual parts. It helped me navigate that section better. Your discussion section hits a variety points discussed in the paper and wrap it up nicely. Now to discuss certain things that were missing. Presentation is very important, and the paper lack the proper flow to achieve that presentation, for example table 1 was not present as a unique table but broken down into two pages which can be confusing for some. The figures were not explained, and conclusion had to be made from the caption and some information. A major issue in deciding if this method works is the sample size and lack of a control population. Further trials would have to be done as indicated in the study limitations, bias should be minimized in next group and a control group containing patients needing ablation but never had one before would be recommended.

On 2020-10-27 00:19:10, user Critical Dissection wrote:

Dear author,

Thank you for posting this article! It was truly very informative and will likely have important implications in resolving disorders of the heart, or possibly in other diseases and organs one day. I appreciated how thoroughly you expanded upon the criteria, explained considerations and acknowledged limitations, particularly in the discussion section. Additionally, patients' medical history and data were depicted very well through the tables in the Results section, so this was helpful in providing additional background. Overall, the methods and discussion sections were very detailed and provided excellent insight on this topic.

I have some feedback and recommendations for this study and article that I believe will help to improve clarity and reach a wider audience. First, it may be helpful to include more background about atrial flutters and ablation techniques in the introduction section. This would allow a more diverse audience of readers to understand the paper's contents without referring to external sources. Further, the results were not explained in great detail, so it was slightly difficult to interpret the figures presented. There was a more substantial mention of these results in the discussion section, but there may be some merit in including a direct explanation of each figure. Lastly, the small sample size likely caused bias in the results, as mentioned in the study limitations. The study would reach a larger category of patients if the criteria were less specific, so I would love to see a follow-up study, perhaps with expanded scope.

Overall, this article was very interesting! I do not have much background in the field, so I found some parts difficult to understand without reviewing external sources, and I believe there are some improvements that could be made to make this article more accessible to the public and the study more generalizable. Thank you, and I hope to see some future studies on this topic!

On 2020-10-23 06:01:42, user Martijn Hoogeveen wrote:

Pre-proof is nu online https://authors.elsevier.co...

On 2020-10-24 19:58:34, user Per Sjögren-Gulve wrote:

Why not use multiple logistic regression and examine age plus additional predictive variables (continuous awa categorical) together + interaction terms? Studies can be numbered/ID:d and included as one predictive variable in a common dataset. In that way, differences in distribution of the other predictive variables between the studies can be considered or - if there are no such differences - rejected and datasets pooled.

On 2020-10-26 08:37:35, user Jan wrote:

Very nice study! But I'm wondering how much antibody levels und numbers of specific B and T cells in the blood really tell us about protection. Is there any data out there about numbers specific plasma cells in the bone marrow or presence of tissue resident memory cells, e.g. in the lung - maybe from autopsies?

On 2020-10-26 13:14:19, user Stefan Dombrowski wrote:

I am not a fan of these respositories. They may well contain research that has been rejected by the peer review process and thus cannot find a legitimate outlet. And, now that this study has been submitted to the world via this repository it very likely cannot be subjected to the gold standard of peer review-- the double blind peer review process. CNBC and other media outlets have been sloppy by disseminating this study broadly given its lack of scientific vetting.

On 2020-10-28 06:10:32, user DenSvenskeSkeptikern wrote:

My question is this; is this a cross-section study? They just tested cognitive abilities whose results were below the average otherwise and then conclude the cognitive decline must be chronic? I mean, you would need to do follow-up to even begin suggesting it is chronic, right?

If things improve even though it might take weeks or even months, then it isn't chronic is it? Also, wouldn't you suffer (maybe temporary) cognitive decline if you end up in the ICU because of how intense that is for your body no matter why you ended up there?

Is it likely my questions would be indirectly answered as the article goes through the peer-review process where they might realize the logical flaws or the possibly too weak evidence they base their conclusions on?

On 2020-10-28 11:35:36, user David Simons wrote:

I have interpreted the inclusion criteria for the "Severe SARS-CoV-2 infection" group to include those within the biobank that died during March to July. If that's not the case and it's only individuals who died with COVID-19 on their death certificate you need to make this clearer. I understand that there have been a high proportion of COVID-19 related deaths in the community but this has definitely not been the only cause of death in these 4 months. If you are intent on using this to include individuals I think you'd need to run a sensitivity analysis on your results to investigate what happens when you exclude these individuals from your analytic sample.

Further, an in-hospital test is not an adequate proxy for disease severity. The reference you site can also not clearly support that statement. There are multiple reasons for in-hospital testing of non-severe individuals. Some of these include; staff of the hospital (or family member of staff), at risk groups (i.e. those attending the hospital for regular dialysis or chemotherapy) and those that attend the emergency department but do not get admitted to hospital. There are several ways you can mitigate against this depending on what data you have available. One option would be to use length of stay combined with in-hospital mortality to support your definition of severity, for example, if a significant proportion of your participants are admitted and discharged within less than 2 days it's unlikely they have severe disease. A further option if available would be to explore their requirement for supplementary oxygen, enrollment into RECOVERY or similar trial with inclusion of only severe disease or treatment with dexamethasone/remdisivir. If none of these are possible having a sensitivity analysis where you remove those with known comorbidities that increase the probability of asymptomatic screening or where the disease may not be severe at testing (i.e. renal dialysis patients or chemotherapy patients) and healthcare workers may strengthen this assumption.

Hope these are helpful comments.

On 2020-10-28 17:49:44, user Sam Wheeler wrote:

How often should a healthy 40-year-old person take the flu shot, for maximum protection? Every 2 months, until real covid-19 vaccine is available?

Does vaccine brand matter? Egg-free vaccines better? Egg-free flu vaccines are unavailable in most European countries, where could an European consumer buy them and how?

On 2020-10-28 21:36:35, user IJ wrote:

The SNPs were found using a GWAS that controlled for vitamin D supplementation, and thus measured the genetic association with unsupplemented vitamin D levels. However, the question we are interested in is the relationship of COVID-19 outcomes with actual vitamin D levels, including supplementation for those who are already taking supplements. Since the decision to supplement is affected by unsupplemented vitamin D levels, this study needs to account for supplementation.

In particular, those with low vitamin D levels are more likely to be advised to take supplements. Could it be that those with genetic predisposition towards low levels might be taking supplements that raise their vitamin D levels, on average, more than is needed to compensate for the genetic predisposition? In that case, genetic predisposition for low vitamin D could _negatively_ correlate with actual vitamin D level, which would reverse the interpretation of the results.

On 2020-10-29 07:12:38, user reality tester wrote:

orange county prevalence 12% equates to 7.6 x higher than reported? 61,000 cases reported x 7.6 = 463,000 divide by 3.1 mil population equals 15% at least as of today... add 35% of those who have innate immunity as research published in Science and Nature indicates, and OC is at herd immunity threshold... no wonder hospitalizations are decreasing on 7 day moving averages, and daily deaths likewise dropping, despite more "cases" as tallied by positive swabs ...

On 2020-10-29 16:33:54, user Najmul Haider wrote:

Dear Readers-- the original article of this Preprint is Published as a Peer review article at "BMJ Global Health". You can download the published article from here: https://gh.bmj.com/content/...