Exploring the Feasibility of Machine Learning to Predict Risk Stratification Within 3 Months in Chest Pain Patients with Suspected NSTE-ACS

Objective We aimed to assess the feasibility and superiority of machine learning(ML)methods to predict the risk of Major Adverse Cardiovascular Events(MACEs)in chest pain patients with NSTE-ACS.Methods Enrolled chest pain patients were from two centers,Beijing Anzhen Emergency Chest Pain Center Beijing Bo’ai Hospital,China Rehabilitation Research Center.Five classifiers were used to develop ML models.Accuracy,Precision,Recall,F-Measure and AUC were used to assess the model performance and prediction effect compared with HEART risk scoring system.Ultimately,ML model constructed by Naïve Bayes was employed to predict the occurrence of MACEs.Results According to learning metrics,ML models constructed by different classifiers were superior over HEART(History,ECG,Age,Risk factors,&Troponin)scoring system when predicting acute myocardial infarction(AMI)and all-cause death.However,according to ROC curves and AUC,ML model constructed by different classifiers performed better than HEART scoring system only in prediction for AMI.Among the five ML algorithms,Linear support vector machine(SVC),Naïve Bayes and Logistic regression classifiers stood out with all Accuracy,Precision,Recall and F-Measure from 0.8 to 1.0 for predicting any event,AMI,revascularization and all-cause death(vs.HEART≤0.78),with AUC from 0.88 to 0.98 for predicting any event,AMI and revascularization(vs.HEART≤0.85).ML model developed by Naïve Bayes predicted that suspected acute coronary syndrome(ACS),abnormal electrocardiogram(ECG),elevated hs-cTn I,sex and smoking were risk factors of MACEs.Conclusion Compared with HEART risk scoring system,the superiority of ML method was demonstrated when employing Linear SVC classifier,Naïve Bayes and Logistic.ML method could be a promising method to predict MACEs in chest pain patients with NSTE-ACS.

Role of lumbar puncture in clinical outcome of suspected acute bacterial meningitis

BACKGROUND Meningitis remains a significant source of mortality and morbidity,with an incidence of 1 per 100000 persons in the United States.Guidelines recommend obtaining blood cultures and cerebrospinal fluid(CSF)studies in patients presenting with acute meningitis syndrome,and beginning treatment with broad spectrum antibiotics based on the age and certain predisposing conditions.In some patients however,the diagnostic lumbar puncture(LP)is not performed due to a multitude of reasons,ranging from increased intracranial pressure to failed attempt.In such situations,appropriate therapy is initiated empirically and often continued without establishment of a definitive diagnosis.AIM To determine whether a diagnostic LP in acute meningitis syndrome was associated with a better outcome and less duration of antibiotic therapy,along with potential causes for deferral of procedure.METHODS A retrospective study was conducted amongst the patients presenting to a 360 bedded community hospital in central Massachusetts with a diagnosis of acute meningitis syndrome between January 2010-September 2022.The electronic health records were accessed to collect necessary demographic and clinical data,including etiology of meningitis,lumbar puncture results,reason for procedure deferral,duration of antibiotic therapy and clinical outcome.The patients were subsequently divided into two groups based on whether they received a LP or not,and data was analyzed.RESULTS A total of 169 patients admitted with acute meningitis syndrome between September 2010-2022 were included in the study.The mean age of the participants was 54.3 years(SD+/-19.2 years).LP was performed for 130(76.9%)participants,out of which,28(21.5%)showed some growth in CSF culture.The most commonly identified organism was streptococcus pneumoniae.Amongst the 39 patients in whom LP was deferred,the major reasons recorded were:Body habitus(n=6,15.4%),and unsuccessful attempt(n=4,10.3%).While 93(71.5%)patients with LP received antibiotic therapy,only 19(48.7%)patients without LP received the antibiotics,with the principal reason being spontaneous improvement in sensorium without any diagnosed source of infection.The mean duration of antibiotic use was 12.3 days(SD+/-5.6)in the LP group and 11.5 days(SD+/-7.0)in the non-LP group(P=0.56;statistically not significant).We observed higher long term sequalae in the non-LP group(n=6,15.4%)compared to the LP group(n=9,6.9%).Similarly,the death rate was higher in the non-LP group(n=7,18.0%)compared to the LP group(n=9,6.9%).CONCLUSION LP remains the cornerstone for diagnosing meningitis,but often CSF results are unavailable,leading to empiric treatment.Our study identified that body habitus and unsuccessful attempts were the most common reasons for LP not being performed,leading to empiric antibiotic coverage.There was no difference between the duration of antibiotics received by the two groups,but a lower proportion of patients without LP received antibiotics,attributed to a spontaneous improvement in sensorium.However,the residual neurological sequelae and death rates were higher in patients without LP,signifying a potential under-treatment.A LP remains crucial to diagnose meningitis,and a lack of CSF analysis predisposes to under-treatment,leading to higher neurological sequelae and increased chances of death.

Primary stratification and identification of suspected corona virus disease 2019(COVID-19) from clinical perspective by a simple scoring proposal

In this Commentary,we would like to comment on the article titled"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infected pneumonia(standard version)"as a featured article in Military Medical Research.In the guideline,except for"confirmed cases","suspected cases","close contact"and"suspicious exposure"were defined by clinical perspective based on epidemiological risk,clinical symptoms and auxiliary examination.Combined with our experience,we introduced a simple scoring proposal additionally based on not only CT imaging as strongly recommended by the guideline but also blood routine test,especially for primary screening of such patients in the out-patient department.

Comparison of diagnostic validity of two autism rating scales for suspected autism in a large Chinese sample

BACKGROUND Autism is the most common clinical developmental disorder in children.The childhood autism rating scale(CARS)and autistic autism behavior checklist(ABC)are the most commonly used assessment scales for diagnosing autism.However,the diagnostic validations and the corresponding cutoffs for CARS and ABC in individuals with suspected autism spectrum disorder(ASD)remain unclear.Furthermore,for suspected ASD in China,it remains unclear whether CARS is a better diagnostic tool than ABC.Also unclear is whether the current cutoff points for ABC and CARS are suitable for the accurate diagnosis of ASD.AIM To investigate the diagnostic validity of CARS and ABC based on a large Chinese sample.METHODS A total of 591 outpatient children from the ASD Unit at Beijing Children’s Hospital between June and November 2019 were identified.First,the Clancy autism behavior scale(CABS)was used to screen out suspected autism from these children.Then,each suspected ASD was evaluated by CARS and ABC.Receiver operating characteristic(ROC)curve analysis was used to compare diagnostic validations.We also calculated the area under the curve(AUC)for both CARS and ABC.RESULTS We found that the Cronbach alpha coefficients of CARS and ABC were 0.772 and 0.426,respectively.Therefore,the reliability of the CARS was higher than that of the ABC.In addition,we found that the correlation between CARS and CABS was 0.732.Next,we performed ROC curve analysis for CARS and ABC,which yielded AUC values of 0.846 and 0.768,respectively.The cutoff value,which is associated with the maximum Youden index,is usually applied as a decision threshold.We found that the cutoff values of CARS and ABC were 34 and 67,respectively.CONCLUSION This result indicated that CARS is superior to ABC in the Chinese population with suspected ASD.

Sensitivity of the suspected blood indicator:An experimental study

AIM： To investigate whether suspected blood indicator （SBI） in capsule endoscopy （CE） is affected by back- ground color and capsule passage velocity. METHODS： Experimental models of the small intestine constructed from paper in a variety of colors were used to simulate the background colors observed in CE im- ages. The background colors studied included very pale yellow, yellow, very pale magenta, light grayish pink, burnt sienna, and deep and dark brown, and red spots were attached inside them. An endoscopic capsule was manually passed through the models. The rate of detection of the red spots by the SBI was evaluated based on the colors of the models and the capsule pas- sage velocities （0.5 cm/s, 1 cm/s, and 2 cm/s）.RESULTS： The rate of detection of the red spots byground color of the model （P 〈 0.001）. Detection rates were highest for backgrounds of very pale magenta, burnt sienna, and yellow, in that order. They were lowest for backgrounds of dark brown and very pale yellow. The rate of detection of red spots by the SBI tended to decrease at rapid capsule passage velocities （1-2 cm/s） compared to slow velocities （0.5 cm/s） for backgrounds of very pale yellow （P = 0.042）, yellow （P = 0.001）, very pale magenta （P = 0.002）, and burnt sien- na （P = 0.001）. No significant differences in the rate of detection were observed according to velocity for light grayish pink （P = 0.643） or dark brown （P = 0.396）. CONCLUSION： SBI sensitivity was affected by back- ground color and capsule passage velocity in the models. These findings may facilitate the rapid detection of bleeding lesions by CE.

Suspected SARS-CoV-2 infection with fever and coronary heart disease:A case report

BACKGROUND The coronavirus disease 2019(COVID-19)is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Suspected cases accounted for a large proportion in the early stage of the COVID-19 outbreak.The deviation of the nucleic acid test by throat swab(the current gold standard of COVID-19)caused by variation in sampling techniques and reagent kits and coupled with nonspecific clinical manifestations make confirmation of the suspected cases difficult.Proper management of the suspected cases of COVID-19 is crucial for disease control.CASE SUMMARY A 65-year-old male presented with fever,lymphopenia,and chest computed tomography(CT)images similar to COVID-19 after percutaneous coronary intervention.The patient was diagnosed as having bacterial pneumonia with cardiogenic pulmonary edema instead of COVID-19.This was based on four negative results for throat swab detection of SARS-CoV-2 nucleic acid using reverse transcriptase-polymerase chain reaction assay and one negative result for serological antibody of SARS-CoV-2 with the serological assay.Additionally,the distribution of ground-glass opacities and thickened blood vessels from the CT images differed from COVID-19 features,which further supported the exclusion of COVID-19.CONCLUSION Distinguishing COVID-19 patients from those with bacterial pneumonia with cardiogenic pulmonary edema can be difficult.Therefore,it requires serious identification.

A substantial incidence of silent short segment endoscopically suspected esophageal metaplasia in an adult Japanese primary care practice

AIM: To determine the incidence and characteristics of endoscopically suspected esophageal metaplasia (ESEM) in a primary adult care institution. METHODS: Eight hundred and thirty two consecutive individuals (mean age, 67.6 years) undergoing upper gastrointestinal endoscopy between January 2009 and December 2010 were included in this study. The diagnosis of ESEM was based on the criteria proposed by the Japan Esophageal Society, and was classified as long segment ESEM (3 cm or more) or short segment ESEM (< 3cm). Short segment ESEM was further divided into circumferential and partial types. Age, gender, hiatus hernia, esophagitis, gastroesophageal reflux disease (GERD)-suggested symptoms, and antacid medications were recorded as background factors. Esophagitis was graded according to the Los Angeles classification. Hiatus hernia was divided into absent and at least partially present. RESULTS: Long and short segment ESEM were found in 0 and 184 (22.1%) patients, respectively (mean age of short segment ESEM patients, 68.3 years). Male gender and hiatus hernia were shown to be significant factors affecting short segment ESEM by both univariate (P = 0.03 and P = 9.9x10-18) and multivariate [Odds ratio (OR) = 1.45; P = 0.04, and OR = 43.3; P = 1.5x10-7)] analyses. Two thirds of patients with short segment ESEM did not have GERD-suggested symptoms. There was no correlation between short segment ESEM and GERD-suggested symptoms. CONCLUSION: The incidence of short segment ESEM in our community practice seems higher than assumed in Asian countries. As GERD-suggested symptoms are a poor predictor of ESEM, endoscopists should bear in mind that silent short segment ESEM does exist and, in fact, was found in the majority of our patients.

Application of the Modality of Multiple Disciplinary Team for a Perioperative Patient with Suspected Novel Coronavirus Pneumonia and Cervical Spine Fracture in Nursing

With the explosive spread of novel coronavirus pneumonia, a major public major public health emergency has been declared around the world. Our country has come to a crucial stage of “external defense input, internal defense rebound” and strict quarantine measures are taken in all ports of entry throughout the country. Operations on patients with cervical spine during the quarantine, which not only increases the risk of surgical treatment, but also increases the difficulty of perioperative nursing. The objective is to explore the result of application of the modality of multiple disciplinary team for a perioperative patient with suspected novel coronavirus pneumonia and cervical spine fracture in nursing. The patient’s condition and nursing measures are studied and discussed from various specialist angle through the multidisciplinary team established by the isolation ward, orthopedics department, emergency department, anesthesiology department, operating room, rehabilitation department, psychology department and so on, and the overall and personalized surgical and nursing planning is formed through interdisciplinary advice. The nursing experience is summarized in this paper.

Highly sensitive troponin I assay in the diagnosis of coronary artery disease in patients with suspected stable angina

BACKGROUND Evaluation of suspected stable angina patients with probable coronary artery disease(CAD)in the community is challenging.In the United Kingdom,patients with suspected stable angina are referred by community physicians to be assessed by specialists within the hospital system in rapid access chest pain clinics(RACPC).The role of a highly sensitive troponin I(uscTnI)assay in the diagnosis of suspected CAD in a RACPC in a“real-life”setting in a non-academic hospital has not been explored.AIM To examine the diagnostic value of uscTnI(detection limit 0.12 ng/L,upper reference range 8.15 ng/L,and detected uscTnI in 96.8%of the reference population),in the evaluation of stable CAD in a non-selected patient group,with several co-morbidities,who presented to the RACPC.METHODS One hundred and seventy two RACPC patients were assigned to either functional or anatomical testing according to the hospital protocol.RESULTS The investigations offered to patients were exercise tolerance test 7.6%,24 h ECG 1.2%,Echocardiogram 14.5%,stress echocardiogram 8.1%,coronary computed tomography angiography(CCTA)12.8%,coronary angiogram 13.4%,17.4%were diagnosed with non-cardiac chest pain,3.5%treated as stable angina,8.2%reviewed by cardiologists,electronic medical records were not available in 10.4%.Receiver operating characteristic curves for CAD used uscTnI values measured in patients who underwent functional testing,angiogram or CCTA.Values>0.52 ng/L showed 100%sensitivity and at>11.6 ng/L showed 100%specificity.In the range>0.52-11.6 ng/L,uscTnI may not have the same diagnostic potential.In patients assigned to coronary angiogram higher concentrations of uscTnI was associated with severe CAD.Low levels of uscTnI and low pre-test probability of CAD(QRISK3)may decrease patient numbers assigned to CCTA.CONCLUSION The uscTnI diagnostic cut-off values in a RACPC will depend on patient population and their presenting co-morbidity.In the presence of clinical comorbidities and previous CAD the uscTnI needs to be used in conjunction with clinical assessment.

Representativeness of suspected measles cases reported in a southern district of Nigeria

Objective:To compare the characteristics of suspected measles cases at the health facilities and to determine the representativeness of the data.Methods:We visited 25 hospitals in the Aniocha Local Government Area(LGA) of Delta State,Nigeria,from which information on reportable diseases was collected.In particular,the suspected measles cases in their registries between January 1,2007,and June 30,2008,were reviewed.We compared the characteristics,including age,sex,location,and month of reporting,of the suspected cases with the LGA surveillance records.Results:In the LGA records,10%cases involved individuals older than 14 years, compared with 20%in the same age group in the health facility records.Based on geographic location,53%of the measles cases among the hospital records came from a single location,in contrast to only 30%of the cases among the LGA records.An analysis considering time revealed that 30%of the cases in the LGA records occurred in August 2007,whereas 20%of hospital cases were reported in February and May 2008 combined.Conclusions:The two record types differed considerably in all of the characteristics used in this comparison.

Case report of a patient with suspected COVID-19 with depression and fever in an epidemic stress environment

During the COVID-19 pandemic,the number of suspected cases,confirmed cases and those who passed away from the virus has been reported in major media and the internet,and has caused a high degree of tension.In addition,people's outdoor activities have been limited,making it more difficult to find outlets for releasing stress.Under this situation,some people began to experience emotions of anxiety and depression.This article reports a case of depression with fever caused by the stress tension of the pandemic.The patient was highly suspected to have contracted COVID-19.The reported patient,who had a history of depression and had been to Wuhan to attend an exam,showed obvious pre-exam anxiety under the epidemic situation,which gradually increased the patient's pressure and then caused some adverse symptoms,such as insomnia,anxiety,sweating and a reoccurrent fever.Local community authorities paid close attention to him and later sent him to a general hospital in Jingmen for quarantine and treatment,as he was suspected of having COVID-19.After being hospitalised for half a month,he was ruled out from having‘COVID-19'and was cured of depression and discharged from the hospital.From this case,we can realise that,under the situation of the epidemic,people are easily prone to insomnia,anxiety and even depression.As clinicians in general hospitals,especially when encountering large emergencies,we must carefully inquire about the patient's medical history while strengthening our understanding of psychiatric knowledge to improve the recognition rate for depression.

Human Immunodeficiency Virus and Immunological Profiles among Suspected Tuberculosis Cases in Mombasa County, Kenya

Background: Human immunodeficiency virus (HIV) is a major public health concern and cause of death globally including Kenya. HIV infection is characterised by CD4+ lymphocyte depletion manifested through the loss of the immune response capacity. Aim: This study aimed to determine the prevalence of HIV infection and CD4+T cell counts among suspected tuberculosis (TB) cases seeking healthcare at TB clinics in Mombasa County, Kenya. Study Design: Hospital and laboratory based cross-sectional study was carried between May 2011 and November 2013 in Coast General Referral Hospital, Tudor, Port-Reitz, Mlaleo, Likoni and Mikandani districts and sub-districts hospitals. Methodology: A total of 500 suspected TB cases (271 males and 229 females) were screened for HIV infection using Trinity Biotech Uni-GoldTM test and positives confirmed with the enzyme- linked immunosorbent assay. CD4+ and CD8+T cells were analyzed using a BD FACS Count flow cytometer. A questionnaire was used to collect demographic data of the participants. Results: In total, 127 (25.4%) of the suspects were HIV infected 55.1% females and 44.9% males. Females were significantly affected than males (OR = 0.78;95% CI: 0.44 - 1.37;p = 0.042). The majority (36.2%) of the HIV cases were in the 25 - 34 years age group followed by the 35 - 44 (33.9%), 45 - 54 (16.5%) and 18 - 24 (7.1%) age groups, respectively. Widowed (AOR = 6.14;95% CI: 1.53 - 20.54;p < 0.033), alcohol (AOR = 2.83;95% CI: 1.71 - 4.87;p < 0.001) and condom use (AOR = 2.31;95% CI: 1.62 = 4.71;p < 0.002) were risk factors associated with HIV infection. The mean CD4 cell count was 333.27 ± 150.59 cells/mm3 and it was higher in males (343.05 ± 149.33 cells/mm3) than females (325.93 ± 152.92 cells). The mean values of white blood cells (5.9 ± 2.42) × 109/l), packed cell value (34.1% ± 4.3%), platelets (195.16 ± 88.7) × 109/l and erythrocyte sedimentation rate (102.0 ± 17.4 mm/hr) were significantly lower than the control group (p < 0.05). Conclusion: The prevalence of HIV infection among suspected TB cases was 25.4% which was higher than the current national average HIV prevalence of 6.9%. Lower CD4+ lymphocyte count was found to be the only predicting factor for HIV. There was a significant relationship between CD4/ESR and HIV infection.

Analysis of Clinical and Imaging Characteristics of Suspected and Confirmed COVID-19 Patients

Objective:To analyze the clinical characteristics and chest CT imaging characteristics of patients with confirmed COVID-19(COVID-19)and patients with suspected COVID-19.Methods:The study time span was from February 2020 to May 2020.The case samples were selected from 72 patients with confirmed covid-19 and suspected covid-19 diagnosed and treated by The First People’s Hospital of Yinchuan and Yinchuan Temporary Emergency Hospital,including 38 patients with confirmed covid-19 and 34 patients with suspected covid-19.All patients underwent laboratory examination and chest CT examination,and the specific examination results were compared and analyzed.Results:There were significant differences in number of white blood cell,percentage of lymphocytes,creatine kinase and erythrocyte sedimentation rate between confirmed and suspected COVID-19 patients(P<0.05).The CT imaging characteristics of COVID-19 patients were compared with those of suspected COVID-19 patients.The lesions of COVID-19 patients were mostly characterized by mixed ground glass density and pure ground glass density.There were vascular thickening and interstitial thickness increase,and accompanied by bronchiectasis or air bronchogram.The distribution of lesions was mostly subpleural without pleural effusion.The lesion area of suspected COVID-19 patients mostly showed solid density and mixed ground glass density.The lesion was distributed along bronchovascular and pleural effusion was observed.Conclusion:There are some differences in biochemical indexes and chest CT images between confirmed and suspected covid-19 patients,which can be used for differential diagnosis.

SEQUENTIAL INTRAOCULAR PRESSURE MEASUREMENTS IN SUSPECTED OPEN-ANGLE GLAUCOMA

Objective To evaluate the variations of intraocular pressure （lOP） in suspected open-angle glaucoma （OAG） patients. Methods The variations of lOP were measured in 216 eyes of suspected OAG patients at 4-hour intervals for 48 h. Based on the results of the serial lOP measurements, optic disc changed and visual field defected, the patients were diagnosed as primary OAG （ POAG ）, normal tension glaucoma （NTG）, ocular hypertension （ OHT） , or physiologic cup （PC）. Results After the serial lOP measurements, 16. 7% of the suspected OAG patients were diagnosed as POAG, 32. 4% as NTG, 24. 5% as OHT, and 26. 4% as PC. The highest percentages of the POAG group had peak lOP at 8 AM （19. 4% ） and their trough lOP at 10 PM （27. 8% ） ; the NTG group had peak lOP at 12 AM （18. 6% ） and their trough lOP at 12 PM （22. 9% ） ; the OHT group had peak lOP at 4 AM （22. 6% ） and their trough lOP at 10 PM （26. 4% ） ; and the PC group had peak lOP at 4 AM （ 21. 1% ） and their trough lOP at 12 PM （ 21. 1% ）. The percentages of peak lOP outside clinic （ 8 AM - 4 PM） in the POAG, NTG, OHT and PC groups were 55. 6%, 50. 0%, 58. 4% and 45. 7%, respectively. The mean magnitude of variance was 5. 1 - 6. 7 mmHg in those suspected OAG patients. There was a strong positive correlation in lOP between both eyes at each time point of measurement and the variation curves of the right and left eyes had parallel profiles in those suspected OAG patients. Conclusion Serial measurement of lOP is still needed, in order not to miss the peak and the trough lOP readings in suspected OAG patients, which helps in better management of glaucoma.

Clinical and genetic features of International Collaborative Group-hereditary nonpolyposis colorectal cancer families and suspected hereditary nonpolyposis colorectal cancer families

Background Hereditary nonpolyposis colorectal cancer (HNPPC) is one of the most common genetic syndrome related with mutation of human mismatch repair genes. This study was to evaluate the clinical significance of suspected hereditary nonpolyposis colorectal cancer (sHNPCC) criteria I and the clinical and genetic features of International Collaborative Group-HNPCC (ICG-HNPCC) and sHNPCC families Methods Twenty-nine ICG-HNPCC families fulfilling the Amsterdam criteria and 34 sHNPCC families fulfilling the sHNPCC criteria I were collected PCR-SSCP and DNA sequencing analysis were employed to screen the germline mutations of the hMLH1 and hMSH2 genes in these families Results The ICG group had more colorectal cancer (CRC) patients per family than did the suspected group ( P <0 05) No statistical difference was observed in Lynch classification and familial tumor spectrum In both groups of families, colorectal cancer was the most frequent malignancy, and carcinomas of the stomach, pancreas and uterus were the three most common extracolonic malignancies Mutation screening showed that ICG-HNPCC and sHNPCC families had a similar mutation rate (31 0% vs 29 4%, P >0 05), mutation type, and mutation distribution Comparison of the families with and without mutation showed no significant difference in CRC patients per family, Lynch classification, and tumor spectrum Conclusions ICG-HNPCC and sHNPCC families that have similar clinical manifestations and genetic basis indicate a similar nature for cancer development The application of sHNPCC criteria I will facilitate clinical diagnosis and treatment of small families

Repatriation Urged for Suspected Terrorists

Beijing has vigorously con- demned the United States’ recent transfer of suspected Uygur terrorists to Palau and called for their repatriation to China, according to the Chi- nese Foreign Ministry.

Expert Consensus by Qilu Hospital of Shandong University on the diagnosis,management,and treatment of suspected COVID-19 cases(English version)

We devised a protocol to establish a standardized method of screening,diagnosing,and managing suspected cases of coronavirus disease(COVID-19)and to enhance the management of COVID-19 suspected cases.The protocol that included diagnostic criteria,preventive measures,and control measures against COVID-19 was developed based on new evidence regarding the epidemiological and clinical characteristics of COVID-19.A consensus document was subsequently formulated.The consensus focused on the clinical management of patients with suspected fever and reviewed the procedure for undergoing severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)nucleic acid testing.This consensus will contribute to the ongoing efforts worldwide for the prevention and control of COVID-19.

Anatomic distribution of embolus at CT pulmonary angiography in patients suspected acute pulmonary embolism

Objective To summarize and analyze the morphology and distribution of embolus in patients suspected acute pulmonary embolism. Methods The CT pulmonary angiography(CTPA) imagings of 279 patients suspected acute pulmonary embolism were analyzed retrospectively

Mutations of hMLH1 and hMSH2 genes in suspected hereditary nonpolyposis colorectal cancer

Objective: To analyze the molecular characteristics of 29 ICG-HNPCC families and 34 suspected HNPCC families. Methods: Genomic DNAs were prepared from peripheral blood samples of probands for DNA test. PCR-SSCP and DNA se-

Suspected Close Contacts as the Pilot Indicator of the Growth Trend of Confirmed Population During the COVID-19 Pandemic: A Simulation Approach

Regarding to the actual situation of the new coronavirus disease 2019 epidemic,social factors should be taken into account and the increasing growth trend of confirmed populations needs to be explained.A proper model needs to be established,not only to simulate the epidemic,but also to evaluate the future epidemic situation and find a pilot indicator for the outbreak.The original susceptible-infectious-recover model is modified into the susceptible-infectious-quarantine-confirm-recover combined with social factors(SIDCRL)model,which combines the natural transmission with social factors such as external interventions and isolation.The numerical simulation method is used to imitate the change curve of the cumulative number of the confirmed cases and the number of cured patients.Furthermore,we investigate the relationship between the suspected close contacts(SCC)and the final outcome of the growth trend of confirmed cases with a simulation approach.This article selects four representative countries,that is,China,South Korea,Italy,and the United States,and gives separate numerical simulations.The simulation results of the model fit the actual situation of the epidemic development and reasonable predictions are made.In addition,it is analyzed that the increasing number of SCC contributes to the epidemic outbreak and the prediction of the United States based on the population of the SCC highlights the importance of external intervention and active prevention measures.The simulation of the model verifies its reliability and stresses that observable variable SCC can be taken as a pilot indicator of the coronavirus disease 2019 pandemic.