Estimating the infection-fatality risk of SARS-CoV-2 in New York City during the spring 2020 pandemic wave: a model-based analysis.

Background: As the COVID-19 pandemic continues to unfold, the infection-fatality risk (ie, risk of death among all infected individuals including those with asymptomatic and mild infections) is crucial for gauging the burden of death due to COVID-19 in the coming months or years. Here, we estimate the infection-fatality risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in New York City, NY, USA, the first epidemic centre in the USA, where the infection-fatality risk remains unclear.

Methods: In this model-based analysis, we developed a meta-population network model-inference system to estimate the underlying SARS-CoV-2 infection rate in New York City during the 2020 spring pandemic wave using available case, mortality, and mobility data.

Estimation of Excess Deaths Associated With the COVID-19 Pandemic in the United States, March to May 2020.

Importance: Efforts to track the severity and public health impact of coronavirus disease 2019 (COVID-19) in the United States have been hampered by state-level differences in diagnostic test availability, differing strategies for prioritization of individuals for testing, and delays between testing and reporting. Evaluating unexplained increases in deaths due to all causes or attributed to nonspecific outcomes, such as pneumonia and influenza, can provide a more complete picture of the burden of COVID-19.

Objective: To estimate the burden of all deaths related to COVID-19 in the United States from March to May 2020.

Estimating the early death toll of COVID-19 in the United States.

Background: Efforts to track the severity and public health impact of the novel coronavirus, COVID-19, in the US have been hampered by testing issues, reporting lags, and inconsistency between states. Evaluating unexplained increases in deaths attributed to broad outcomes, such as pneumonia and influenza (P&I) or all causes, can provide a more complete and consistent picture of the burden caused by COVID-19.

Methods: We evaluated increases in the occurrence of deaths due to P&I above a seasonal baseline (adjusted for influenza activity) or due to any cause across the United States in February and March 2020.

A review of the 1918 herald pandemic wave: importance for contemporary pandemic response strategies.

Mounting epidemiological evidence supports the occurrence of a mild herald pandemic wave in the spring and summer of 1918 in North America and Europe, several months before the devastating autumn outbreak that killed an estimated 2% of the global population. These epidemiological findings corroborate the anecdotal observations of contemporary clinicians who reported widespread influenza outbreaks in spring and summer 1918, with sporadic occurrence of unusually severe clinical manifestations in young adults. Initially seen as controversial, these findings were eventually confirmed by retrospective identification of influenza specimens collected from U.

Evaluating and implementing temporal, spatial, and spatio-temporal methods for outbreak detection in a local syndromic surveillance system.

The New York City Department of Health and Mental Hygiene has operated an emergency department syndromic surveillance system since 2001, using temporal and spatial scan statistics run on a daily basis for cluster detection. Since the system was originally implemented, a number of new methods have been proposed for use in cluster detection. We evaluated six temporal and four spatial/spatio-temporal detection methods using syndromic surveillance data spiked with simulated injections.

Infectious Disease Surveillance in the Big Data Era: Towards Faster and Locally Relevant Systems.

While big data have proven immensely useful in fields such as marketing and earth sciences, public health is still relying on more traditional surveillance systems and awaiting the fruits of a big data revolution. A new generation of big data surveillance systems is needed to achieve rapid, flexible, and local tracking of infectious diseases, especially for emerging pathogens. In this opinion piece, we reflect on the long and distinguished history of disease surveillance and discuss recent developments related to use of big data.

A multicomponent nutrient bar promotes weight loss and improves dyslipidemia and insulin resistance in the overweight/obese: chronic inflammation blunts these improvements.

This study determined if twice-daily consumption of a nutrient-dense bar intended to fill gaps in Western diets, without other dietary/lifestyle requirements, favorably shifted metabolic/anthropometric indicators of dysregulation in a healthy direction. Three 8-wk clinical trials in 43 healthy lean and overweight/obese (OW/OB) adults, who served as their own controls, were pooled for analysis. In less inflamed OW/OB [high-sensitivity C-reactive protein (hsCRP) <1.

Visualizing the quality of partially accruing data for use in decision making.

Secondary use of clinical health data for near real-time public health surveillance presents challenges surrounding its utility due to data quality issues. Data used for real-time surveillance must be timely, accurate and complete if it is to be useful; if incomplete data are used for surveillance, understanding the structure of the incompleteness is necessary. Such data are commonly aggregated due to privacy concerns.

A nutrient-dense, high-fiber, fruit-based supplement bar increases HDL cholesterol, particularly large HDL, lowers homocysteine, and raises glutathione in a 2-wk trial.

Dietary intake modulates disease risk, but little is known how components within food mixtures affect pathophysiology. A low-calorie, high-fiber, fruit-based nutrient-dense bar of defined composition (e.g.

Chemiluminescence detection flow cells for flow injection analysis and high-performance liquid chromatography.

We have examined a range of new and previously described flow cells for chemiluminescence detection. The reactions of acidic potassium permanganate with morphine and amoxicillin were used as model systems representing the many fast chemiluminescence reactions between oxidising agents and organic analytes, and the preliminary partial reduction of the reagent was exploited to further increase the rates of reaction. The comparison was then extended to high-performance liquid chromatography separations of α- and β-adrenergic agonists, with permanganate chemiluminescence detection.

Chemiluminescence detectors for liquid chromatography.

In this tutorial we describe the construction of chemiluminescence detectors for high performance liquid chromatography (HPLC), comprising the components required to deliver the chemiluminescence reagent, a coiled-tubing flow cell, photomultiplier tube and detector housing, and various options for data acquisition. We also discuss two state-of-the-art commercially available chemiluminescence detectors for HPLC and other flow analysis methodology.

Solution mixing and the emission of light in flow-cells for chemiluminescence detection.

Constructing flow-through reactors for chemiluminescence detection by machining channels into polymer disks has enabled the exploration of new configurations and materials that can improve signal intensity beyond that attainable with the traditional coiled-tubing design. Several approaches to merge reactant solutions were examined: an intersection, chamber or deeper well in the centre of a serpentine configuration flow-cell (directly in front of a photomultiplier tube), or a confluence point outside the detection zone. For several analytically useful, rapid chemiluminescence reactions, the single-inlet flow-cell with external Y-piece was most suitable, but for others (such as KMnO(4)/Mn(II) with morphine, and [Ir(f-ppy)(2)BPS](-) with fluoroquinolones) the dual-inlet configuration provided greater signals.

Preliminary Estimates of Mortality and Years of Life Lost Associated with the 2009 A/H1N1 Pandemic in the US and Comparison with Past Influenza Seasons.

The on-going debate about the health burden of the 2009 influenza pandemic and discussions about the usefulness of vaccine recommendations has been hampered by an absence of directly comparable measures of mortality impact. Here we set out to generate an "apples-to-apples" metric to compare pandemic and epidemic mortality. We estimated the mortality burden of the pandemic in the US using a methodology similar to that used to generate excess mortality burden for inter-pandemic influenza seasons.

Autocatalytic nature of permanganate oxidations exploited for highly sensitive chemiluminescence detection.

Manganese(II) salts catalyze the chemiluminescent oxidation of organic compounds with acidic potassium permanganate. The formation of insoluble manganese(IV) species from the reaction between manganese(II) and permanganate can be prevented with sodium polyphosphate, and therefore, relatively high concentrations of the catalyst can be added to the reagent before the light-producing reaction is initiated. The rapid and intense emissions from these manganese(II) catalyzed chemiluminescence reactions provide highly sensitive detection and greater compatibility with liquid chromatography.

Chemiluminescence detector with a serpentine flow cell.

We present a new chemiluminescence detector, with solution channels that have been machined into a Teflon disk and sealed with a sapphire window. The configuration of the flow cell can be conveniently modified by replacing the Teflon disk. A comparison of some existing and novel designs, using the chemiluminescence reaction of morphine with acidic potassium permanganate and the bioluminescence reaction of ATP with the commercially available "BacTiter-Glo" reagent, has revealed that a serpentine channel allows greater quantities of light to be captured than a spiral channel, due to more efficient mixing of the analyte and reagent solutions within the cell.

Optimization of an axial flow heart pump with active and passive magnetic bearings.

Optimization of a magnetically suspended left ventricular assist device (LVAD) is crucial. We desire a totally implantable, long-life LVAD that delivers the necessary flow rate, pressure rise, and blood compatibility. By using a novel combination of passive and active magnetic bearings (AMBs), we have developed an axial flow LVAD prototype, the LEV-VAD, which provides an unobstructed blood flow path, preventing stagnation regions for the blood.

Measurement of unbound bilirubin by the peroxidase test using Zone Fluidics.

Background: Measuring plasma unbound bilirubin concentration by the peroxidase test is useful in the management of jaundiced newborns. However, the commercially available peroxidase technology is manual, and the unbound bilirubin may be seriously underestimated at the 42-fold sample dilution and single peroxidase concentration used. We investigated improving the test by adapting it to Zone Fluidics, which is a system for automating reactant handling that requires small sample volumes and dilution.