Search

Background and Objective: Coronavirus disease 2019 (COVID-19) characterized by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created serious concerns about its potential adverse effects. There are limited data on clinical, radiological, and neonatal outcomes of pregnant women with COVID-19 pneumonia. This study aimed to assess clinical manifestations and neonatal outcomes of pregnant women with COVID-19.Methods: We conducted a systematic article search of PubMed, EMBASE, Scopus, Google Scholar, and Web of Science for studies that discussed pregnant patients with confirmed COVID-19 between January 1, 2020, and April 20, 2020, with no restriction on language. Articles were independently evaluated by two expert authors. We included all retrospective studies that reported the clinical features and outcomes of pregnant patients with COVID-19.Results: Forty-seven articles were assessed for eligibility; 13 articles met the inclusion criteria for the systematic review. Data is reported for 235 pregnant women with COVID-19. The age range of patients was 25–40 years, and the gestational age ranged from 8 to 40 weeks plus 6 days. Clinical characteristics were fever [138/235 (58.72%)], cough [111/235 (47.23%)], and sore throat [21/235 (8.93%)]. One hundred fifty six out of 235 (66.38%) pregnant women had cesarean section, and 79 (33.62%) had a vaginal delivery. All the patients showed lung abnormalities in CT scan images, and none of the patients died. Neutrophil cell count, C-reactive protein (CRP) concentration, ALT, and AST were increased but lymphocyte count and albumin levels were decreased. Amniotic fluid, neonatal throat swab, and breastmilk samples were taken to test for SARS-CoV-2 but all found negativ results. Recent published evidence showed the possibility of vertical transmission up to 30%, and neonatal death up to 2.5%. Pre-eclampsia, fetal distress, PROM, pre-mature delivery were the major complications of pregnant women with COVID-19.Conclusions: Our study findings show that the clinical, laboratory and radiological characteristics of pregnant women with COVID-19 were similar to those of the general populations. The possibility of vertical transmission cannot be ignored but C-section should not be routinely recommended anymore according to latest evidences and, in any case, decisions should be taken after proper discussion with the family. Future studies are needed to confirm or refute these findings with a larger number of sample sizes and a long-term follow-up period.

Simple Summary Gastric cancer (GC) is one of the most newly diagnosed cancers and the fifth leading cause of death globally. Previous studies reported that the detection rate of gastric cancer (EGC) at an earlier stage is low, and the overall false-negative rate with esophagogastroduodenoscopy (EGD) is up to 25.8%, which often leads to inappropriate treatment. Accurate diagnosis of EGC can reduce unnecessary interventions and benefits treatment planning. Convolutional neural network (CNN) models have recently shown promising performance in analyzing medical images, including endoscopy. This study shows that an automated tool based on the CNN model could improve EGC diagnosis and treatment decision. Abstract Gastric cancer (GC) is one of the most newly diagnosed cancers and the fifth leading cause of death globally. Identification of early gastric cancer (EGC) can ensure quick treatment and reduce significant mortality. Therefore, we aimed to conduct a systematic review with a meta-analysis of current literature to evaluate the performance of the CNN model in detecting EGC. We conducted a systematic search in the online databases (e.g., PubMed, Embase, and Web of Science) for all relevant original studies on the subject of CNN in EGC published between 1 January 2010, and 26 March 2021. The Quality Assessment of Diagnostic Accuracy Studies-2 was used to assess the risk of bias. Pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were calculated. Moreover, a summary receiver operating characteristic curve (SROC) was plotted. Of the 171 studies retrieved, 15 studies met inclusion criteria. The application of the CNN model in the diagnosis of EGC achieved a SROC of 0.95, with corresponding sensitivity of 0.89 (0.88–0.89), and specificity of 0.89 (0.89–0.90). Pooled sensitivity and specificity for experts endoscopists were 0.77 (0.76–0.78), and 0.92 (0.91–0.93), respectively. However, the overall SROC for the CNN model and expert endoscopists was 0.95 and 0.90. The findings of this comprehensive study show that CNN model exhibited comparable performance to endoscopists in the diagnosis of EGC using digital endoscopy images. Given its scalability, the CNN model could enhance the performance of endoscopists to correctly stratify EGC patients and reduce work load.

Background: A potential evidence from previous epidemiological studies remains conflicting findings regarding the association between atrial fibrillation (AF) and dementia risk. We, therefore, carried out a meta-analysis of relevant studies to investigate the magnitude of the association between AF and dementia risk. Methods: We performed a systematic literature search of PubMed, EMBASE, and Google Scholar for potential studies between January 1, 1990, and December 31, 2018, with no restriction on the publication language. All potential studies were independently assessed by two reviewers. We only included observational studies that calculated the odds ratio (OR)/hazards ratio (HR) for dementia associated with atrial fibrillation. We first assessed the heterogeneity among study-specific HRs using the Q statistic and I2 statistic. We then used the random-effects model to obtain the overall HR and its 95% CI for all studies. We also tested and corrected for publication bias by funnel plot–based methods. The quality of each study was assessed with the Newcastle Ottawa Scale. Results: A total of 16 studies with 2,415,356 individuals, and approximately 200,653 cases of incidence dementia were included in this study. Patients with AF had a greater risk of incidence dementia than those without AF (random-effect hazard ratio HR: 1.36, 95% CI: 1.23–1.51, p < 0.0001; I2 = 83.58). Funnel plot and Egger test did not reveal significant publication bias. However, limitations of the study included high heterogeneity and varying degrees of confounder adjustment across individual studies. Conclusion: This study serves as added evidence supporting the hypothesis that AF is associated with an increased risk of dementia. More studies are needed to establish whether optimal treatment of AF can reduce or mitigate the risk of dementia.

The Anthropocene causes many massive and novel impacts, e.g., on migratory birds and their habitats. Many species of migratory birds have been declining on the Palearctic-African flyway in recent decades. To investigate possible impacts on a continental scale, we used 18 predictors extracted from 16 publicly available GIS layers in combination with machine learning methods on the sub-Saharan distributions of 64 passerine migrant species. These bird species were categorized as having experienced a ‘Large Decline’ (n = 12), a ‘Moderate Decline’ (n = 6) or ‘No Decline’ (n = 46) based on European census data from 1970 to 1990. Therefore, we present the first study for these species which uses publically available Open Access GIS-data and a multivariate (n = 18) and multi-species (n = 64) machine learning approach to deduce possible past impacts. We furthermore modelled likely future human population change and climate change impacts. We identified three predictor themes related to the distributions and declines of these migratory birds: (I) locations, represented by African ecosystems, countries, and soil types; (II) human population pressures and land-use intensities, the latter represented by land-use categories, habitat area, and cropland proportion; and (III) climatic predictors. This is the first study to relate migratory bird declines to human population pressures and land-use intensities using this type of analysis. We also identified areas of conservation concern, such as the Sahel region. Our models also predict that the declining trends of migratory birds will continue into the foreseeable future across much of Africa. We then briefly discuss some wider conservation implications in the light of the increasing drivers of biodiversity change associated with the Anthropocene as well as some possible solutions. We argue that only comprehensive systemic change can mitigate the impacts on the migratory birds and their habitats.

SummaryThe Corncrake Crex crex breeds in the Palearctic but overwinters in central and southern Africa. While some information had previously been gathered about the Corncrake’s African wintering distribution, we here analyse a much more comprehensive database of 1,284 records based on a five-year desk study completed in January 2011 and use those records selected for spatio-temporal accuracy to build a continental distribution model. Our model was based mostly on climatic variables and predicts a high suitability for most eastern Africa countries south of the equator, but none of the western African countries with the exception of Angola and Namibia. Both the actual number of records as well as the distribution model thus indicates that the vast majority of Corncrakes migrate through and overwinter in the eastern parts of Africa. Because large parts of Angola, Mozambique, north-eastern Namibia, and Tanzania are predicted as suitable but have yielded very few actual records so far, they should be targeted for future field work. A very small number of Corncrakes may oversummer in Africa but such individuals are possibly unable to migrate due to sickness or injury, or may be first-year birds that are not ready to breed. An analysis of habitat and population density data indicates that, within the continental distribution, Corncrakes are mostly concentrated within grass-dominated habitats, mirroring their habitat preferences in the breeding areas. Corncrakes reach their wintering distribution mostly through an eastern migration route, but some individuals or subpopulations from the Western breeding population also use a western migration route. We also document the food choices, weights, and causes of injury and death within Africa. Because habitat conversion is accelerating all across Africa, we recommend constant monitoring of habitat availability and population densities within the Corncrake’s wintering distribution.