Latitude and longitude as drivers of COVID-19 waves' behavior in Europe: A time-space perspective of the pandemic

BACKGROUND

Social restrictions and vaccination seem to have shaped the pandemic development in Europe, but the influence of geographical position is still debated. This study aims to verify whether the pandemic spread through Europe following a particular direction, during the period between the start of the pandemic and November 2021. The existence of a spatial gradient for epidemic intensity is also hypothesized.

METHODS

Daily COVID-19 epidemiological data were extracted from Our World in Data COVID-19 database, which also included vaccination and non-pharmacological interventions data. Latitude and longitude of each country's centroid were used as geographic variables. Epidemic periods were delimited from epidemic surge data. Multivariable linear and Cox's regression models were performed for each epidemic period to test if geographical variables influenced surge dates. Generalized additive models (GAM) were used to test the spatial gradient hypothesis with three epidemic intensity measures.

RESULTS

Linear models suggest a possible west-east shift in the first epidemic period and features a significant association of NPIs with epidemic surge delay. Neither latitude nor longitude had significant associations with epidemic surge timing in both second and third periods. Latitude displays strong negative associations with all epidemic intensity measures in GAM models. Vaccination was also negatively associated with intensity.

CONCLUSIONS

A longitudinal spread of the pandemic in Europe seems plausible, particularly concerning the first wave. However, a recurrent trend was not observed. Southern Europe countries may have experienced increased transmissibility and incidence, despite climatic conditions apparently unfavourable to the virus.

Estimating infant mortality risk in Uruguay using artificial neural networks

Background

Uruguay has a national electronic live birth certificate that includes variables of risk factors for infant mortality. Accurate risk stratification of newborns is needed to optimize the use of resources for homes visits. Artificial neural networks are computational tools that have been used successfully in many types of prediction problems.

Objective

To develop a neural network able to estimate the risk of infant mortality using information available in the electronic live birth and mortality certificate in Uruguay.

Methods

A historical cohort of records of newborns in Uruguay from 2014 to 2017 was used. The variables of the electronic live birth certificate were considered for the model. Infant mortality was obtained from the national mortality registry. A multilayer perceptron was trained with a random sample of 70% of the cohort; the remaining 30% was the validation set. The variables included were birth weight, Apgar score at 5 minutes, number of prenatal consultations, maternal educational level, multiple pregnancy and cohabiting father. ROC curve analysis was performed.

Results

The 2014-2017 birth cohort contains 187,388 records. 1,307 children under one year died (IMR 6.97 per 1,000 births). The area under the curve (AUC) was 88.7%, 95% CI [87.6% - 89.8%]. The optimal cut-off point of pseudoprobability of infant mortality was 0.008 (78.9% of sensibility and 82.4% of specificity). The IMR in high-risk newborns identified by the neural network was 32.8 per 1,000 births.

Conclusions

The neural network identifies high-risk newborns at the time of entering the data in the electronic live birth certificate as other models have done. This information could be used to plan and implement preventive actions.

Key messages

In Uruguay, high-risk newborns can be identified by applying artificial intelligence to data collected routinely. The procedure can be applied in other countries with electronic birth certificate.

Development of an infant mortality risk score in Uruguay

Background

The Ministry of Public Health of Uruguay incorporated a comprehensive home visit before 7 days of discharge to monitor children at risk of infant mortality. In this context, a precise risk stratification of newborns is needed to optimize the implementation of the home visit.

Objective

Implement a validated infant mortality risk score for Uruguay using the national electronic live birth certificate.

Methods

Electronic records of newborns from 2014 to 2017 were used to develop the score. The variables of the electronic live birth certificate were considered for the model and data of Infant mortality was obtained from the national mortality registry. A multivariate binary logistic regression model was estimated with a random sample of 80% of the cohort, the remaining 20% was the validation set. ROC curve analysis was performed. R software was used.

Results

The 2014-2017 birth cohort contains 187,388 records. 1307 children under one year died (IMR 6.97 per 1,000 births). The variables included in the final model were birth weight, APGAR score at 5 minutes, number of prenatal visits, maternal educational level and father living at home. The area under the curve (AUC) was 89%, CI 95% [87% - 91%]. Two cut-off points were defined: 0.4% and 2%. Less than 0.4% was considered low risk (IMR 1.4 per 1,000 births), between 0.4 and 2% was considered intermediate risk (IMR 7.1 per 1,000 births) and more than 2% was considered high risk (IMR 99.2 per 1,000 births).

Conclusions

The score identifies high-risk newborns at the time of entering the data in the electronic live birth certificate. This information could be used to plan and implement the home visit and other actions, according to the level of risk identified.

Key messages

In Uruguay, high-risk newborns can be identified using data collected routinely. The procedure could be applied in other countries with electronic birth certificate.

Spread of Ebola virus disease based on the density of roads in West Africa

On March 23rd 2014 the World Health Organization announced that a new Ebola outbreak had appeared in West Africa involving three countries. The objective of this study was to show how a road density index (RDI) could be constructed and a study of its association with Ebola cases during the outbreak. The study was carried out at the district level across the affected countries. RDI was calculated by km2 of territory as a proxy for the mobility of the population. To calculate this index, the number of km of road constructed in each district was estimated and subsequently divided by the area of each district expressed in km2. The accumulated incidence of Ebola was calculated per district. A generalised linear model with a Poisson distribution was used. The RDI varied from 0.12 to 0.84 between the districts. An RDI increase of 0.01 indicates a 3% increase in Ebola infection risk (RR is 1.03; CI 1.03-1.04). The density of the road network can influence the increased incidence of Ebola cases in the affected zone. An exhaustive mapping of the area could help the relevant organisations to manage another outbreak in the future and it could help the distribution of resources in an emergency situation.

Excess all-cause and influenza-attributable mortality in Europe, December 2016 to February 2017

Since December 2016, excess all-cause mortality was observed in many European countries, especially among people aged ≥ 65 years. We estimated all-cause and influenza-attributable mortality in 19 European countries/regions. Excess mortality was primarily explained by circulation of influenza virus A(H3N2). Cold weather snaps contributed in some countries. The pattern was similar to the last major influenza A(H3N2) season in 2014/15 in Europe, although starting earlier in line with the early influenza season start.

Increase in gonorrhoea among very young adolescents, Catalonia, Spain, January 2012 to June 2013

Binary file ES_Abstracts_Final_ECDC.txt matches

[Development of the scale of cognitive reserve in Spanish population: a pilot study]

INTRODUCTION

Lately, the interest in cognitive reserve has increased notably in view of the lack of correlation between cerebral damage and observed clinic symptoms. However, there is no consensus on which measure of cognitive reserve is the most accurate.

AIM

To develop the scale of cognitive reserve in Spanish population and to study its psychometric properties.

SUBJECTS AND METHODS

Ninety-five healthy subjects collaborated in the pilot study. The reliability of the scale was calculated with the internal consistency. A group of experts were consulted for the study of the content validity. In relation to criterion validity, correlations between two measures, autoperception and premorbid intelligence, and the scale were estimated.

RESULTS

The analysis revealed a high reliability of the scale (alpha = 0.81) and a suitable content validity. Furthermore, there were statistically significant and mild correlations between the scale and premorbid intelligence (-0.31), and mood state (0.25).

CONCLUSIONS

The scale of cognitive reserve could be considered as a suitable instrument to measure cognitive reserve in Spanish population. Nevertheless, more research is required.

Brain potentials reflect access to visual and emotional memories for faces

Familiar faces convey different types of information, unlocking memories related to social-emotional significance. Here, the availability over time of different types of memory was evaluated using the time-course of P3 event related potentials. Two oddball paradigms were employed, both using unfamiliar faces as standards. The infrequent targets were, respectively, artificially-learned faces (devoid of social-emotional content) and faces of acquaintances. Although in both tasks targets were detected accurately, the corresponding time-course and scalp distribution of the P3 responses differed. Artificially-learned and acquaintance faces both elicited a P3b, maximal over centro-parietal sites, and a latency of 500ms. Faces of acquaintances elicited an additional component, an early P3 maximal over frontal sites: with a latency of 350ms. This suggests that visual familiarity can only trigger the overt recognition processes leading to the slower P3b, whereas emotional-social information can also elicit fast and automatic assessments (indexed by the frontal-P3) crucial for successful social interactions.

Comparative effects of a glucocorticosteroid, theophylline and the peptido-leukotriene-antagonist CGP 45715A on antigen-induced early and late phase airway response and inflammatory cell influx in sensitised guinea pigs

A novel model of allergic early and late-phase reaction in the airways of conscious guinea pigs was developed and the effect of established and novel antiasthmatic drugs on peak of immediate response, late phase response and associated inflammatory cell influx investigated. Guinea pigs were sensitised twice in adjuvant (50 mg/kg silica + 0.1 ml/kg Bordetella pertussis). Under cover of 10 mg/kg i.p. mepyramine guinea pigs exhibited still a pronounced immediate reaction. During a screening phase about 75% of guinea pigs demonstrated a late phase reaction of decrease of tidal volume between 4-10 h after ovalbumin inhalation. In a cross over study theophylline at 50 mg/kg p.o. (-1 h before ovalbumin) tended to attenuate not only the peak of the immediate reaction by about 69% (P>0.05, n = 12), but inhibited the airway late phase response significantly (P<0.05, 5-10 h, n = 12). Methylprednisolone (40 mg/kg p.o. 1 h before ovalbumin) did not inhibit the immediate response, but the late phase response. In contrast the cysteinyl-leukotriene antagonist CGP 45715A (Iralukast; 30 mg/kg p.o. 2 h before ovalbumin) neither interfered with the peak of the immediate, nor with the late phase response. When bronchoalveolar lavage by orotracheal route was performed 24 h after ovalbumin inhalation, total cell count, eosinophils, neutrophils, macrophages and lymphocytes were significantly increased in ovalbumin-controls compared to sham (n = 5; P<0.05). Methylprednisolone reduced significantly the antigen-induced increase of total cell count and eosinophil number. Neither theophylline nor the cysteinyl-leukotriene receptor antagonist attenuated the antigen-associated cell influx. The results do not provide evidence for a major role of cysteinyl-leukotrienes in the late phase response and inflammatory cell influx in this model.

In vivo role of the adenosine A3 receptor: N6-2-(4-aminophenyl)ethyladenosine induces bronchospasm in BDE rats by a neurally mediated mechanism involving cells resembling mast cells

Activation of the adenosine A3 receptor subtype by the agonist N6-2-(4-aminophenyl)ethyladenosine is shown here to induce bronchospasm (increased pulmonary resistance and decreased pulmonary compliance) in BDE strain rats. The effect is substantially reduced by pretreating the rats with compound 48/80, disodium cromoglycate (30 micrograms/kg) or epinastine (10 micrograms/kg), which is compatible with involvement of mast cells. It is also substantially reduced by combined vagotomy and atropinization or by pretreatment with the NK2 receptor antagonist L-659,877, suggesting involvement of neuropeptide-mediated neural pathways. The mechanism by which activation of the adenosine A3 receptor induces bronchospasm is distinct from the mechanism by which activation of the adenosine A1 receptor induces bronchospasm. In particular, the A1 agonist 2-chloro-N6-cyclopentyladenosine can increase pulmonary resistance independently of mast cell activation. These results are in accord with the concept that a pathway exists in vivo by which activation of mast-like cells can activate axon reflexes, that adenosine acting through its A3 receptor can potentially up-regulate this pathway and that antiallergic substances such as disodium cromoglycate and epinastine may interfere with this pathway.

Isolation and characterization of cytotoxic and antibacterial tetrasaccharide glycosides from Ipomoea stans

Three new tetrasaccharide glycosides, differing from one reported previously in the type of short-chain fatty acids ester-linked to the tetrasaccharide core, have been isolated and identified from an oligosaccharide fraction of Ipomea stans. Preliminary screening tests showed that the fraction containing these compounds had pronounced cytotoxicity towards three human tumor cell lines as well as specific antibiotic activity against two bacterial strains.

In-situ Titration of Initiator-Consuming Impurities in Solution Anionic Polymerization

An in situ titration of initiator-consuming impurities in amonic polymerizations, using 1,10-phenantroline as an indicator, was developed. The results show that even when impurities are present, it is possible to destroy them prior to the initiation of the polymerization reaction and achieve a better control of molecular weights by adding accurate known quantities of initiator.

Volatile Constituents of Montanoa tomentosa and Lippia graveolens

The constituents of the volatile oils of MONTANOA TOMENTOSA and LIPPIA GRAVEOLENS, were investigated using capillary GC/MS. Borneol acetate, beta-cubebene, and beta-caryophyllene were found to be the major constituents of the volatile oil of M. TOMENTOSA, while P-cymene, 1,8-cineol, thymol, and carvacrol were the major volatile components of L. GRAVEOLENS. The possible correlation between the high concentration of monoterpenes and the alleged antifertility effect of the title plants is discussed.