Excess non-COVID-19-related mortality among inflammatory bowel disease decedents during the COVID-19 pandemic

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic disrupted healthcare in the United States.AIM To investigate COVID-19-related and non-COVID-19-related death and characteristics associated with excess death among inflammatory bowel disease(IBD)decedents.METHODS We performed a register-based study using data from the National Vital Statistics System,which reports death data from over 99%of the United States population,from January 1,2006 through December 31,2021.IBD-related deaths among adults 25 years and older were stratified by age,sex,race/ethnicity,place of death,and primary cause of death.Predicted and actual age-standardized mortality rates(ASMRs)per 100000 persons were compared.RESULTS 49782 IBD-related deaths occurred during the study period.Non-COVID-19-related deaths increased by 13.14%in 2020 and 18.12%in 2021[2020 ASMR:1.55 actual vs 1.37 predicted,95%confidence interval(CI):1.26-1.49;2021 ASMR:1.63 actual vs 1.38 predicted,95%CI:1.26-1.49].In 2020,non-COVID-19-related mortality increased by 17.65%in ulcerative colitis(UC)patients between the ages of 25 and 65 and 36.36%in non-Hispanic black(NHB)Crohn’s disease(CD)patients.During the pandemic,deaths at home or on arrival and at medical facilities as well as deaths due to neoplasms also increased.CONCLUSION IBD patients suffered excess non-COVID-19-related death during the pandemic.Excess death was associated with younger age among UC patients,and with NHB race among CD patients.Increased death at home or on arrival and due to neoplasms suggests that delayed presentation and difficulty accessing healthcare may have led to increased IBD mortality.

Trends of Cirrhosis-related Mortality in the USA during the COVID-19 Pandemic

Immunocompromised status and interrupted routine care may render patients with cirrhosis vulnerable to the coronavi-rus disease 2019(COVID-19)pandemic.A nationwide data-set that includes more than 99%of the decedents in the U.S.between April 2012 and September 2021 was used.Projected age-standardized mortality during the pandemic were esti-mated according to prepandemic mortality rates,stratified by season.Excess deaths were determined by estimating the difference between observed and projected mortality rates.A temporal trend analysis of observed mortality rates was also performed in 0.83 million decedents with cirrhosis between April 2012 and September 2021 was included.Following an increasing trend of cirrhosis-related mortality before the pandemic,with a semiannual percentage change(SAPC)of 0.54%[95%confidence interval(CI):(0.0-1.0%),p=0.036],a precipitous increase with seasonal variation occurred dur-ing the pandemic(SAPC 5.35,95%CI:1.9-8.9,p=0.005).Significantly increased mortality rates were observed in those with alcohol-associated liver disease(ALD),with a SAPC of 8.44(95%CI:4.3-12.8,p=0.001)during the pandemic.All-cause mortality of nonalcoholic fatty liver disease rose stead-ily across the entire study period with a SAPC of 6.79(95%CI:6.3-7.3,p<0.001).The decreasing trend of HCV-related mortality was reversed during the pandemic,while there was no significant change in HBV-related deaths.While there was significant increase in COVID-19-related deaths,more than 55%of the excess deaths were the indirect impact of the pandemic.We observed an alarming increase in cirrhosis-related deaths during the pandemic especially for ALD,with evidence in both direct and indirect impact.Our findings have implications on formulating policies for patients with cirrhosis.

Transmission patterns of COVID-19 in the mainland of China and the efficacy of different control strategies: a data-and model-driven study

Background:The coronavirus disease 2019(COVID-19)outbreak has seriously endangered the health and lives of Chinese people.In this study,we predicted the COVID-19 epidemic trend and estimated the efficacy of several intervention strategies in the mainland of China.Methods:According to the COVID-19 epidemic status,we constructed a compartmental model.Based on reported data from the National Health Commission of People's Republic of China during January 10-February 17,2020,we estimated the model parameters.We then predicted the epidemic trend and transmission risk of COVID-19.Using a sensitivity analysis method,we estimated the efficacy of several intervention strategies.Results:The cumulative number of confirmed cases in the mainland of China will be 86763(95%CI:86067-87460)on May 2,2020.Up until March 15,2020,the case fatality rate increased to 6.42%(95%CI:6.16-6.68%).On February 23,2020,the existing confirmed cases reached its peak,with 60890 cases(95%CI:60350-61431).On January 23,2020,the effective reproduction number was 2.620(95%CI:2.567-2.676)and had dropped below 1.0 since February 5,2020.Due to governmental intervention,the total number of confirmed cases was reduced by 99.85%on May 2,2020.Had the isolation been relaxed from February 24,2020,there might have been a second peak of infection.However,relaxing the isolation after March 16,2020 greatly reduced the number of existing confirmed cases and deaths.The total number of confirmed cases and deaths would increase by 8.72 and 9.44%,respectively,due to a 1-day delayed diagnosis in non-isolated infected patients.Moreover,if the coverage of close contact tracing was increased to 100%,the cumulative number of confirmed cases would be decreased by 88.26%on May 2,2020.Conclusions:The quarantine measures adopted by the Chinese government since January 23,2020 were necessary and effective.Postponing the relaxation of isolation,early diagnosis,patient isolation,broad close-contact tracing,and strict monitoring of infected persons could effectively control the COVID-19 epidemic.April 1,2020 would be a reasonable date to lift quarantine in Hubei and Wuhan.

Topological evolution of coexpression networks by new gene integration maintains the hierarchical and modular structures in human ancestors

We analyze the global structure and evolution of human gene coexpression networks driven by new gene integration. When the Pearson correlation coefficient is greater than or equal to 0.5, we find that the coexpression network consists of 334 small components and one "giant" connected subnet comprising of 6317 interacting genes. This network shows the properties of power-law degree distribution and small-world. The average clustering coefficient of younger genes is larger than that of the elderly genes(0.6685 vs. 0.5762). Particularly, we find that the younger genes with a larger degree also show a property of hierarchical architecture. The younger genes play an important role in the overall pivotability of the network and this network contains few redundant duplicate genes. Moreover, we find that gene duplication and orphan genes are two dominant evolutionary forces in shaping this network. Both the duplicate genes and orphan genes develop new links through a "rich-gets-richer"mechanism. With the gradual integration of new genes into the ancestral network, most of the topological structure features of the network would gradually increase. However, the exponent of degree distribution and modularity coefficient of the whole network do not change significantly, which implies that the evolution of coexpression networks maintains the hierarchical and modular structures in human ancestors.

Review of Technologies for High-Voltage Integrated Circuits

High-Voltage power Integrated Circuits(HVICs) are widely used to realize high-efficiency power conversions(e.g., AC/DC conversion), gate drivers for power devices and LED lighting, and so on. The Bipolar-CMOS-DMOS(BCD) process is proposed to fabricate devices with bipolar, CMOS, and DMOS modes, and thereby realize the single-chip integration of HVICs. The basic integrated technologies of HVICs include High-Voltage(HV) integrated device technology, HV interconnection technology, and isolation technology. The HV integrated device is the core of HVICs. The basic requirements of the HV integrated device are high breakdown voltage, low specific on-resistance,and process compatibility with low-voltage circuits. The REduced SURFace field(RESURF) technology and junction termination technology are developed to optimize the surface field of integration power devices and breakdown voltage. Furthermore, the ENhanced DIelectric layer Field(ENDIF) and REduced BULk Field(REBULF) technologies are proposed to optimize bulk fields. The double/triple RESURF technologies are further developed, and the superjunction concept is introduced to integrated power devices and to reduce the specific on-resistance. This work presents a comprehensive review of these technologies, including the innovation technologies of the authors’ group,such as ENDIF and REBULF, substrate termination technology prospective integrated technologies and HVICs in wide band gap semiconductor materials are also discussed.

Analysis of Time-domain Electromagnetic Scattering Problem by Multiple Cavities

The time-domain multiple cavity scattering problem,which arises in diverse scientific areas,has significant industrial and military applications.The multiple cavities,embedded in an infinite ground plane,is filled with inhomogeneous media characterized by variable dielectric permittivities and magnetic permeabilities.Corresponding to the transverse electric,the scattering problem can be studied by the Helmholtz equation in frequency domain and wave equation in time-domain respectively.A novel transparent boundary condition in time-domain is developed to reformulate the cavity scattering problem into an initial-boundary value problem in a bounded domain.The well-posedness and stability of the reduced problem are established.Moreover,a priori energy estimates for the electric field is obtained with minimum regularity requirement for the data and an explicit dependence on the time by studying the wave equation directly.

Stability analysis of a fractional-order cancer model with chaotic dynamics

In this paper,we develop a three-dimensional fractional-order cancer model.The proposed model involves the interaction among tumor cells,healthy tissue cells and activated effector cells.The detailed analysis of the equilibrium points is studied.Also,the existence and uniqueness of the solution are investigated.The fractional derivative is considered in the Caputo sense.Numerical simulations are performed to illustrate the effectiveness of the obtained theoretical results.The outcome of the study reveals that the order of the fractional derivative has a significant effect on the dynamic process.Further,the calculated Lyapunov exponents give the existence of chaotic behavior of the proposed model.Also,it is observed from the obtained results that decrease in fractional-order p increases the chaotic behavior of the model.