Meteorological factors, ambient air pollution, and daily hospital admissions for depressive disorder in Harbin: A time-series study

BACKGROUND The literature has discussed the relationship between environmental factors and depressive disorders;however,the results are inconsistent in different studies and regions,as are the interaction effects between environmental factors.We hypo-thesized that meteorological factors and ambient air pollution individually affect and interact to affect depressive disorder morbidity.AIM To investigate the effects of meteorological factors and air pollution on depressive disorders,including their lagged effects and interactions.METHODS The samples were obtained from a class 3 hospital in Harbin,China.Daily hos-pital admission data for depressive disorders from January 1,2015 to December 31,2022 were obtained.Meteorological and air pollution data were also collected during the same period.Generalized additive models with quasi-Poisson regre-ssion were used for time-series modeling to measure the non-linear and delayed effects of environmental factors.We further incorporated each pair of environ-mental factors into a bivariate response surface model to examine the interaction effects on hospital admissions for depressive disorders.RESULTS Data for 2922 d were included in the study,with no missing values.The total number of depressive admissions was 83905.Medium to high correlations existed between environmental factors.Air temperature(AT)and wind speed(WS)significantly affected the number of admissions for depression.An extremely low temperature(-29.0℃)at lag 0 caused a 53%[relative risk(RR)=1.53,95%confidence interval(CI):1.23-1.89]increase in daily hospital admissions relative to the median temperature.Extremely low WSs(0.4 m/s)at lag 7 increased the number of admissions by 58%(RR=1.58,95%CI:1.07-2.31).In contrast,atmospheric pressure and relative humidity had smaller effects.Among the six air pollutants considered in the time-series model,nitrogen dioxide(NO_(2))was the only pollutant that showed significant effects over non-cumulative,cumulative,immediate,and lagged conditions.The cumulative effect of NO_(2) at lag 7 was 0.47%(RR=1.0047,95%CI:1.0024-1.0071).Interaction effects were found between AT and the five air pollutants,atmospheric temperature and the four air pollutants,WS and sulfur dioxide.CONCLUSION Meteorological factors and the air pollutant NO_(2) affect daily hospital admissions for depressive disorders,and interactions exist between meteorological factors and ambient air pollution.

An Ontology-Based Question Answering System for University Admissions Advising

Question-Answer systems are now very popular and crucial to support human in automatically responding frequent questions in manyfields.However,these systems depend on learning methods and training data.Therefore,it is necessary to prepare such a good dataset,but it is not an easy job.An ontol-ogy-based domain knowledge base is able to help to reason semantic information and make effective answers given user questions.This study proposes a novel chatbot model involving ontology to generate efficient responses automatically.A case study of admissions advising at the International University–VNU HCMC is taken into account in the proposed chatbot.A domain ontology is designed and built based on the domain knowledge of university admissions using Protégé.The Web user interface of the proposed chatbot system is developed as a prototype using NetBeans.It includes a search engine reasoning the ontology and generat-ing answers to users’questions.Two experiments are carried out to test how the system reacts to different questions.Thefirst experiment examines questions made from some templates,and the second one examines normal questions taken from frequent questions.Experimental results have shown that the ontology-based chatbot can release meaningful and long answers.The results are analysed to prove the proposed chatbot is usable and promising.

The effects of cold region meteorology and specific environment on the number of hospital admissions for chronic kidney disease:An investigate with a distributed lag nonlinear model

Objective:To explore the effects of daily mean temperature(°C),average daily air pressure(hPa),humidity(%),wind speed(m/s),particulate matter(PM)2.5(μg/m3)and PM10(μg/m3)on the admission rate of chronic kidney disease(CKD)patients admitted to the Second Affiliated Hospital of Harbin Medical University in Harbin and to identify the indexes and lag days that impose the most critical influence.Methods:The R language Distributed Lag Nonlinear Model(DLNM),Excel,and SPSS were used to analyze the disease and meteorological data of Harbin from 01 January 2010 to 31 December 2019 according to the inclusion and exclusion criteria.Results:Meteorological factors and air pollution influence the number of hospitalizations of CKD to vary degrees in cold regions,and differ in persistence or delay.Non-optimal temperature increases the risk of admission of CKD,high temperature increases the risk of obstructive kidney disease,and low temperature increases the risk of other major types of chronic kidney disease.The greater the temperature difference is,the higher its contribution is to the risk.The non-optimal wind speed and non-optimal atmospheric pressure are associated with increased hospital admissions.PM2.5 concentrations above 40μg/m3 have a negative impact on the results.Conclusion:Cold region meteorology and specific environment do have an impact on the number of hospital admissions for chronic kidney disease,and we can apply DLMN to describe the analysis.

A 365-Day Record of Maternal Admissions in Intensive Care Unit at the University of Port Harcourt Teaching Hospital in Nigeria

BACKGROUND. The intensive care unit provides critically ill patients with the necessary monitoring, care and supports to optimize their organ/system functions. Parturients are often at risk of sudden deteriorations or exacerbation of chronic illnesses from direct or indirect causes and would often require admissions into the intensive care or high dependency unit. This study is aimed at looking at the trends of maternal admissions in 365 days at the intensive care unit of a tertiary teaching hospital in Southern part of Nigeria, a country that contributes significantly to the global proportion of maternal morbidity and mortality. METHODS. The study adopted a retrospective approach. All critically ill parturients admitted and requiring organ support or close monitoring in the ICU had their files and ICU documents reviewed. The review was held from January-December 2018. RESULTS. Thirty-nine (39) parturients with a mean age (years) of 33 ± 1.3 were admitted, representing 2.9% of annual deliveries. All admissions were postnatal and came predominantly from the unbooked labour ward (51%) and the time lag from maternal deteriorations to presentation to the ICU was 72 ± 10 hours. The main indications for admissions were due to postpartum haemorrhage (33.3%), complications of hypertensive disorders of pregnancy (30.9%) and sepsis (25.6%). Nineteen (48.7%) patients died from obstetric haemorrhage, complications of hypertensive disorders of pregnancy, sepsis and pulmonary embolism. CONCLUSION. The trend of maternal admissions at this specific time frame reflects the burden of maternal critical care in our environment. It highlights the need to holistically tackle the known scourge with improved care.

Association between Ambient Air Pollution and Hospital Emergency Admissions for Respiratory and Cardiovascular Diseases in Beijing: a Time Series Study

Objective To investigate the association between ambient air pollution and hospital emergency admissions in Beijing. Methods In this study, a semi-parametric generalized additive model （GAM） was used to evaluate the specific influences of air pollutants （PM10, SO2, and NO2） on hospital emergency admissions with different lag structures from 2009 to 2011, the sex and age specific influences of air pollution and the modifying effect of seasons on air pollution to analyze the possible interaction. Results It was found that a 10μg/m3 increase in concentration of PMlo at lag 03 day, SO2 and NO2 at lag 0 day were associated with an increase of 0.88%, 0.76%, and 1.82% respectively in overall emergency admissions. A 10 lag/m3 increase in concentration of PM10, SO2 and NO2 at lag 5 day were associated with an increase of 1.39%, 1.56%, and 1.18% respectively in cardiovascular disease emergency admissions. For lag 02, a 10 μg/m3 increase in concentration of PM10, SO2 and NO2 were associated with 1.72%, 1.34%, and 2.57% increases respectively in respiratory disease emergency admissions. Conclusion This study further confirmed that short-term exposure to ambient air pollution was associated with increased risk of hospital emergency admissions in Beijing.

The Weather Temperature and Air Pollution Interaction and Its Effect on Hospital Admissions due to Respiratory System Diseases in Western China

Air pollution has ever become a global major public health problem.Previous studies showed that air pollution is associated with excessive mortality and morbidity of respiratory disease[1-2].The extreme weather temperature can impact human health and the thermal stresses can lead not only to direct deaths and illnesses,but also to aggravation of respiratory disease[3-4].Though the independent

Epidemiological profile of alcoholic liver disease hospital admissions in a Latin American country over a 10-year period

BACKGROUND Alcoholic liver disease(ALD)is a major cause of chronic liver disease worldwide.AIM To describe the epidemiological profile and mortality rates of patients with ALD admitted to public hospitals in different regions of Brazil from 2006 to 2015.METHODS This is a descriptive study that evaluated aggregate data from the five Brazilian geographic regions.RESULTS A total of 160093 public hospitalizations for ALD were registered.There was a 34.07%increase in the total number of admissions over 10 years,from 12879 in 2006 to 17267 in 2015.The region with the highest proportion(49.01%)of ALD hospitalizations was Southeast(n=78463).The North region had the lowest absolute number of patients throughout the study period,corresponding to 3.9%of the total(n=6242).There was a 24.72%increase in the total number of ALD deaths between 2006 and 2015.We found that the age group between 50 and 59 years had the highest proportion of both hospitalizations and deaths:28.94%(n=46329)of total hospital admissions and 29.43%(n=28864)of all deaths.Men were more frequently hospitalized than women and had the highest proportions of deaths in all regions.Mortality coefficient rates increased over the years,and simple linear regression analysis indicated a statistically significant upward trend in this mortality(R^2=0.744).CONCLUSION Our study provides a landscape of the epidemiological profile of public hospital admissions due to ALD in Brazil.We detected an increase in the total number of admissions and deaths due to ALD over 10 years.

Interdialytic Weight Gain in Hemodialysis Patients: Worse Hospital Admissions and Intradialytic Hypotension

Introduction: Interdialytic weight-gain (IDWG) has been linked to various complications in hemodialysis (HD) patients. Method: Prospective clinical-observational study to evaluate the effect of IDWG in HD patients on the rate of hospital admissions over a 12-month period, and the impact of high IDWG on the frequency of IDH. Results: Of the 240 patients, those who had IDWG ≥ 4%, 81% had at least one hospital admission due to volume-overload or the need for extra HD-session(s). On the other hand, only 19% of those having IDWG < 4% had been admitted or got extra HD sessions (p < 0.001). Of those who were admitted (over 12 months) due to volume overload;74.1% had IDWG ≥ 4%, while 25.9% had IDWG < 4% (p < 0.001). Regarding IDH, 87% of patients having IDWG ≥ 4% had at least one episode of IDH/week. On the other hand, only 22.5% of those with IDWG < 4% had one episode of IDH/week (p < 0.001). When analyzing those who had at least one IDH episode/week;72.9% of them had IDWG ≥ 4%, while only 27.1% had IDWG < 4% (p < 0.001). Conclusion: In HD patients, the frequency of hospital admission due to volume-overload and the need for extra HD-sessions is strongly related to the amount of IDWG (>4% in our patients), the same stands for the frequency of IDH. Thus, control of IDWG in HD patients is of great importance, keeping in mind the importance of the nutrition status of HD patients that may also impact IDWG.

Monthly admissions for heart failure (HF)— Environmental links

In recent years the role of HF in the outcomes, cost of treatment in cardiology is raising. Concomitantly a number of studies were published demonstrating connections of many cardiac events with Space Weather Activity-Solar, Geomagnetic, Cosmic Ray (Neutron) activity levels. The aim of this study was to study links of timing of hospital admissions for HF with season and space weather components. Patients and Methods: monthly admissions of male and female patients for HF in two hospitals of Rabin Medical Center for years 2000-2012 were the subject of the study. 76,601 patient were included, 42,293 men, 34,308 woman. The cosmophysical data from USA, Russia and Finland were used. Results: Monthly average number of admissions for HF: 491.0 ± 82.4, 271.1 ± 46.75 for men and 219.9 ± 39.8 for woman. Gender admissions strongly correlated. Monthly admission for HF number differed by 2.2 - 2.5 times. Minimal admissions were in August, September;maximal—in January, February, December and March (according to numbers). It was a significant inverse correlation of monthly HF admissions with monthly solar activity and GMA indices and correlation with CRA (neutron) activity. Conclusion: Monthly admissions number for HF is fluctuated by season of the year, depending on gender and related to monthly solar and Cosmic Ray (Neutron) activity level. Gender differences in HF exacerbation may be a component explaining gender differences in longevity.

Diurnal Temperature Range and Daily Emergency Room Admissions among the Elderly in Beijing,China

In recent years, more attentions have been paid to the association between climate change and human health. Increasing and more variable global surface temperature is one of the key climatic change factors which have been consistently reported about the effect on human health. So far, more researches have revealed that temperature lead not only to direct deaths and illnesses but also to aggravation of cardiovascular and respiratory diseases. Typically, the relationship between temperature and mortality or morbidity is V-, U-, or J- shaped, with optimum temperature corresponding to the lowest point in the temperature mortality curve.

Prevalence of hyponatremia in acute medical admissions in tropical Asia Pacific Australia

Objective:To determine prevalence of hyponatremia in acute medical admissions in Northern Australasia.Methods:We studied 469 consecutive acute medical admissions to a hospital in Australia's Far North Queensland during the colder months of June and July 2012.Prevalence of hyponatremia and its relationship with gender,age,diagnosis and prognosis in acute medical admissions were investigated.Results:On admission,hyponatremia(plasma sodium<136 mmol/L)was present in 39.4%of patients,with mild(130—135 mmol/L),moderate(126-129 mmol/L)and severe?126 mmol/L)hyponatremia being present in 25.2%,10.7*and 3.6*respectively.Overall,adding together admission hyponatremia with that developing during admission,45.2%of patients were affected with 11.5%moderate hyponatremia cases and 4.1%severe ones.Hypokalemia and hyperkalemia were present in 17.0%and 18.1*,respectively.Overall,275/469 patients(58.6*)presented with an electrolyte abnormality.There were significant correlations of hyponatremia with age but not with gender and in-hospital mortality.Prevalence of hyponatremia was high across all diagnostic categories.Conclusions:The prevalence of hyponatremia appears to be high in the tropical North Australian population,being the highest prevalence reported amongst acute hospital admissions.The previously reported correlations with age and mortality do appear to hold good for this population with a high prevalence of electrolyte disorders.Further prospective analysis on a larger population in the area is needed to confirm our findings.

Elderly patients with non-cardiac admissions and elevated highsensitivity troponin:the prognostic value of renal function

BACKGROUND High-sensitivity cardiac troponin(hs-cTn)levels are frequently elevated in elderly patients presenting to the emergency department for non-cardiac events.However,most studies on the role of elevated hs-cTn in elderly populations have investigated the prognostic value of hs-cTn in patients with a specific diagnosis or have assessed the relationship between hs-cTn and comorbidities.AIM To investigate the in-hospital prognosis of consecutive elderly patients admitted to the Internal Medicine Department with acute non-cardiac events and increased hs-cTnI levels.METHODS In this retrospective study,we selected patients who were aged≥65 years and admitted to the Internal Medicine Department of our hospital between January 2019 and December 2019 for non-cardiac reasons.Eligible patients were those who had hs-cTnI concentrations≥100 ng/L.We investigated the independent predictors of in-hospital mortality by multivariable logistic regression analysis.RESULTS One hundred and forty-six patients(59%female)were selected with an age range from 65 to 100(mean±SD:85.4±7.61)years.The median hs-cTnI value was 284.2 ng/L.For 72(49%)patients the diagnosis of hospitalization was an infectious disease.The overall in-hospital mortality was 32%(47 patients).Individuals who died did not have higher hs-cTnI levels compared with those who were discharged alive(median:314.8 vs 282.5 ng/L;P=0.565).There was no difference in mortality in patients with infectious vs non-infectious disease(29%vs 35%).Multivariable analysis showed that age(OR 1.062 per 1 year increase,95%CI:1.000-1.127;P=0.048)and creatinine levels(OR 2.065 per 1 mg/dL increase,95%CI:1.383-3.085;P<0.001)were the only independent predictors of death.Mortality was 49%in patients with eGFR<30 mL/min/1.73 m2.CONCLUSION Myocardial injury is a malignant condition in elderly patients admitted to the hospital for non-cardiac reasons.The presence of severe renal impairment is a marker of extremely high in-hospital mortality.

The Burden of HIV-Related Admissions and Mortality at Princess Marina Hospital, Botswana in 2000: A Pre-Combination Antiretroviral Therapy Era

Background: human immune virus and acquired immunodeficiency syndrome (HIV/AIDS) have been recognized in Botswana for the last three decades, however, combination anti-retroviral therapy (cART) was only introduced after 2000. Facility-based historical data of the burden of HIV/AIDS- related conditions pre-cART have so far not been analyzed. Objective: To analyze the burden of HIV-related admissions and HIV-related deaths, and identify the socio-demographic factors associated with HIV/AIDS deaths at Princess Marina Hospital (PMH) in the year 2000. Methods: A retrospective review of medical files was carried out between May and June 2014. Nine thousand seven hundred and forty-six (9746) records were analyzed for the year for 2000. Cases were identified as documented HIV/AIDS as per medical notes and/or documentation of any of the conditions listed in sections B20-B24 of the International Classification of Diseases (ICD 10 B20-B24). Outcomes were the percentages of HIV-related admissions and HIV-related deaths out of all admissions and deaths. The in-hospital case fatality rate (CFR) was also calculated. Log-binomial regression models were used to determine the most significant factors associated with HIV-related admission and death. Results: The percentages of HIV-related admissions and HIV-related deaths were 4.1% (403/9746) and 11.3% (80/707), respectively. The in-hospital HIV-CFR was 19.9% (80/403). Adjusted log-binomial models identified the most significant protective factors for HIV-related admission were female sex and cART use while age >15 years old was the most significant risk factor. The se of cART was significant protective factor for HIV-associated death while age older than 15 years was the most significant risk factor. Conclusion: There was a significant burden of HIV-related admissions and deaths in PMH before wide-scale cART use in Botswana. This study highlights the increased risk of hospital admission for HIV-positive patients and underlines the need for cART to prevent deaths. Further studies evaluating the impact of wide-scale cART roll out are needed.

HIV Hospital Admissions Attributable to Specific Opportunistic Infections and Factors Associated with Them at a Botswana Referral Hospital

Hospital admissions among people living with HIV (PLWH) in Botswana are high. Opportunistic infections (OIs) are responsible for most of these admissions. Although leading OIs causing these admissions have been identified in the region, their correlates are poorly understood. This study aimed to: 1) evaluate major OIs responsible for admissions among HIV patients at Princess Marina Hospital (PMH) in Botswana;2) estimate the proportion and identify the most frequent admissions attributable to specific OIs;3) characterize major correlates of admissions attributable to each specific OIs and identify populations most at risk as a base for effective policy and resource orientation. HIV infected patients were randomly selected from hospital record lists. Biomedical, sociodemographic and economic data were collected from the records and from face-to-face patient interviews and analyzed. Tuberculosis was the most important OI responsible for 234.6 per 1000 HIV admissions. Cryptococcal meningitis accounted for 162.0 per 1000 admissions. Patients with a CD4-cell count < 350/μL and males were more likely to be admitted for both tuberculosis and cryptococcal meningitis compared to those with a CD4-cell count > 350/μL and females. The risk of admission due to cryptococcal meningitis was also high among patients with low socioeconomic status (SES). Females were more at risk for Cryptosporidium, Bacterial pneumonia (BP), Pneumocystis Carinii Pneumonia (PCP), Herpes and candidiasis-specific admissions than male and, patients not on co-trimoxazole were more likely to be admitted than those on co-trimoxazole. Comprehensive implementation strategies to address OIs among PLWH are needed. To be effective, such strategies should address not only biomedical factors but should also focus on PLWH’s SES.

Pattern of Mortalities among Orthopaedic and Trauma Admissions in Irrua

Background: There are many reports from different parts of the world addressing different aspects of surgical mortality. However, none has been done in this centre as it relates to orthopaedics and trauma admissions. Such data are invaluable to health planning and epidemiological monitoring. Objective: To retrospectively review all mortalities arising from orthopaedics and trauma admission as they present to Irrua specialist Teaching Hospital (ISTH) Irrua from Jan 2005-Dec 2014. Method: Medical records of case mortalities among orthopaedic and trauma admissions over ten years (Jan 2005-Dec 2014) were retrospectively reviewed. Results: Over this period, 2129 admissions and 45 deaths were recorded, with an overall crude mortality rate of 2.11%. No death was recorded among the paediatric age group. Thirty-four patients (75.56%) died from trauma (fracture) related diagnosis, majority of which were from head injury followed by infection 5 (11.11%), tumours 4, (8.89%) and disc herniation 2 (4.44%). Males were more affected 77.78% and median age at death was 44 years. Medical co-morbidities were found in 37.77% of the deceased patients. Conclusion: Patients with trauma related cases particularly head injuries, topped the list of mortalities. Young and middle aged adult males were most affected. Need for manpower development, investment in diagnostic and therapeutic facilities and preventive measures is emphasised.

Emergency Department Admissions for Dental &Oral Health Concerns in Rural Northwestern Pennsylvania

Background: Oral health emergency department (ED) visits are increasing nationally. This increase in ED admissions is an indicator that preventative dental and oral healthcare practices are not being utilized. Methods: Data was obtained from the Meadville Medical Center. Fourteen ICD-9 codes for dental and oral health admissions over 10 years were categorized and analyzed. Data was graphed to illustrate trends over time and the chi-square test of independence was used to determine associations between admissions types and demographic characteristics. Results: ED admissions for dental and oral health issues were most common among individuals age 19 - 38 years. Most individuals admitted to the ED for these concerns paid with private medical insurance or were uninsured. The categorization of ICD-9 codes allowed us to see that ED use for structural and soft-issues decreased at the end of the decade under study. However, admissions for infections and dental caries increased over time. Conclusions: The opening of a free dental clinic in 2011 might be associated with the decrease in overall admissions for dental and oral health concerns as well as soft tissue and structural admissions. The increase in ED admissions for dental caries and infections illustrates that more affordable and preventative dental and oral health care and education are need.

Outcome of the Post-Operative Patients’ Admissions in the Field of Resuscitation in Mali

Introduction: In spite of the use of the less and less invasive and the more and more effective techniques and the use of fast rehabilitation conditions of the patients in surgery, the post-operative complications (POC) stay the main reasons of admission in resuscitation service. Objective: To determine the post-operative outcome of the patients admitted in resuscitation. Patient and method: It was about a retrospective and transverse survey from June 2017 to May 2018 in the service of polyvalent resuscitation of the academic hospital center of Gabriel Touré. Have been included the patients operated for surgical or obstetric gynecology—pathologies admitted in resuscitation for post-operative complications established or potential precocious or late. The used statistical test was the Chi2 with p Results: During the period, 514 patients have been admitted in resuscitation of which 140 cases of post-operatively represented 27.2% of the admissions. Under hospitalization 35.7% of patients have presented a complication. The middle age of patients was 37.72 ± 20.9 years. The sex ratio was 0.70. The middle length of interventions was 122 ± 83 min with extremes going from 20 to 434 min. The predominant admission motive was hemodynamic instability. The delay of appearance intervening of the complications was 3 days in 94%. The predominant complications were: respiratory (32%), infectious (28%) and Cardiovascular (20%). The middle length of hospitalization was of 3.36 ± 2.90 days. The death rate was 15%. The complications were related age, the class of Alteme?er, the ASA, and the perioperative undesirable events with p Conclusion: The post-operative admissions in resuscitation are frequent including several factors of morbi-mortality. A better management per and postoperative of the patients operated would reduce the death rate. The profile mark is the one of a patient admitted for hemodynamic instability.

An Audit of Admissions to Intensive Care Unit at Kamuzu Central Hospital in Malawi

Results are presented of a retrospective audit of admissions to the Intensive Care Unit (ICU) of Kamuzu Central Hospital in Lilongwe, Malawi, which is a tertiary referral facility. The audit was conducted for a period of one year spanning from January to December, 2012. The objectives of the audit were to: describe the profile of admissions and treatment outcomes of the admissions and identify main causes of mortality in ICU of the facility. The admission book and patients’ records were reviewed retrospectively guided by a data extraction form which was specifically designed for this study. The extracted data included age, sex, referring unit, diagnosis, treatment outcome and length of stay. The data were analyzed using STATA version 10.0. A total of 253 patients were admitted to the ICU over the one year period of study. About a third of the patients (33.6% n = 85) were admitted due to postoperative surgery. There were 154 deaths representing an overall mortality of 60.9%. Sepsis was the commonest cause of death and accounted for 39.6%, n = 61 of the deaths. Younger age of less than 40 years and increased patients’ length of stay in the unit were significantly and positively associated with mortality (P < 0.05). The high mortality rates among patients admitted to ICU reflects numerous challenges at various levels of critical care service delivery in the country. There is therefore a need to strengthen critical care services to improve treatment outcomes for patients admitted to ICU of the facility.

Emergency department visits and hospital admissions in kidney transplant recipients during the COVID-19 pandemic:A hospitalbased study

BACKGROUND Several studies have demonstrated that the coronavirus disease 2019(COVID-19)has affected daily living and the healthcare system.No previous study has described the consequences of COVID-19 on emergency department(ED)visits and hospital admission among kidney transplant(KT)recipients.AIM To investigate the impact of the COVID-19 pandemic on ED visits and hospital admissions within 1 year in patients who underwent KT in Thailand.METHODS We conducted a retrospective study at a university hospital in Thailand.We reviewed the hospital records of KT patients who visited the ED during the outbreak of COVID-19(from January 2020 to December 2021).We used the previous 2 years as the control period in the analysis.We obtained baseline demographics and ED visit characteristics for each KT patient.The outcomes of interest were ED visits and ED visits leading to hospital admission within the 1^(st)year following a KT.The rate of ED visits and ED visits leading to hospital admissions between the two periods were compared using the stratified Cox proportional hazards model.RESULTS A total of 263 patients were included in this study:112 during the COVID-19 period and 151 during the control period.There were 34 and 41 ED visits after KT in the COVID-19 and control periods,respectively.The rate of first ED visit at 1 year was not significantly different in the COVID-19 period,compared with the control period[hazard ratio(HR)=1.02,95%confidence interval(CI):0.54-1.92;P=0.96].The hospital admission rate was similar between periods(HR=0.92,95%CI:0.50-1.69;P=0.78).CONCLUSION ED visits and hospital admissions within the 1st year in KT recipients were not affected by the COVID-19 pandemic.Despite these findings,we believe that communication between post-KT patients and healthcare providers is essential to highlight the importance of prompt ED visits for acute health conditions,particularly in post-KT patients.

Ambient Air Particulate Matter and Hospital Admissions for Chronic Kidney Disease in China:A Nationwide Case-Crossover Study

Incident chronic kidney disease(CKD)may be accelerated(could be indicated by repeated admissions to the hospital)by environmental triggers such as ambient particulate matter(PM).Additionally,hospital admission is a sensitive proxy reflecting the disease burden.However,the association of PM exposure with hospital admissions for CKD is still unknown,let alone the excess risks(ERs)in hospital admissions for CKD due to high PM level exposure.In this study,a two-stage time-stratified case-crossover study was conducted to investigate the association of ambient air PM exposure with hospital admission for CKD in 282 Chinese cities of prefecture-level or above during 2013–2017.City-specific associations of single and cumulative 0–3 days lagged exposure to fine particulate matter(PM_(2.5))and inhalable particles(PM_(10))with hospital admissions for total CKD and its subtypes were evaluated by the conditional logistic regression model,then were pooled using the random-effect model.A total of 3,490,416 hospital admissions for CKD were identified.We found that per interquartile range(IQR)increment in PM_(2.5) at lag02 and per IQR increment in PM_(10) at lag03 were associated with increases of 2.36%(95%CI:1.58%,3.14%)and 2.87%(95%CI:1.91%,3.85%)in hospital admissions for total CKD,respectively.Compared to control concentrations(PM_(2.5):35μg/m^(3);PM_(10):50μg/m^(3)),the largest ERs in hospital admissions for total CKD were 2.63%(95%CI:2.15%–3.11%)and 4.45%(95%CI:3.85%–5.06%)in association with exposure to heavily excessive PM_(2.5)(≥75μg/m^(3))and PM_(10)(≥150μg/m^(3)),respectively.Moreover,the attributable fractions(AFs)for CKD admissions were 2.83%for PM_(2.5) and 3.46%for PM_(10) during the study period.These findings suggested that exposure to PM_(2.5) and PM_(10) is associated with substantially increased risk and burden of CKD admissions.