Background During the COVID-19 pandemic, the scarcity of resources has necessitated triage of critical care for patients with the disease. In patients aged 65 years and older, triage decisions are regularly based on degree of frailty measured by the Clinical Frailty Scale (CFS). However, the CFS could also be useful in patients younger than 65 years. We aimed to examine the association between CFS score and hospital mortality and between CFS score and admission to intensive care in adult patients of all ages with COVID-19 across Europe. Methods This analysis was part of the COVID Medication (COMET) study, an international, multicentre, retrospective observational cohort study in 63 hospitals in 11 countries in Europe. Eligible patients were aged 18 years and older, had been admitted to hospital, and either tested positive by PCR for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or were judged to have a high clinical likelihood of having SARS-CoV-2 infection by the local COVID-19 expert team. CFS was used to assess level of frailty: fit (CFS 1-3), mildly frail (CFS 4-5), or frail (CFS 6-9). The primary outcome was hospital mortality. The secondary outcome was admission to intensive care. Data were analysed using a multivariable binary logistic regression model adjusted for covariates (age, sex, number of drugs prescribed, and type of drug class as a proxy for comorbidities). Findings Between March 30 and July 15, 2020, 2434 patients (median age 68 years [IQR 55-77]; 1480 [61%] men, 954 [30%] women) had CFS scores available and were included in the analyses. In the total sample and in patients aged 65 years and older, frail patients and mildly frail patients had a significantly higher risk of hospital mortality than fit patients (total sample: CFS 6-9 vs CFS 1-3 odds ratio [OR] 2•71 [95% CI 2•04-3•60], p<0•0001 and CFS 4-5 vs CFS 1-3 OR 1•54 [1•16-2•06], p=0•0030; age ≥65 years: CFS 6-9 vs CFS 1-3 OR 2•90 [2•12-3•97], p<0•0001 and CFS 4-5 vs CFS 1-3 OR 1•64 [1•20-2•25], p=0•0020). In patients younger than 65 years, an increased hospital mortality risk was only observed in frail patients (CFS 6-9 vs CFS 1-3 OR 2•22 [1•08-4•57], p=0•030; CFS 4-5 vs CFS 1-3 OR 1•08 [0•48-2•39], p=0•86). Frail patients had a higher incidence of admission to intensive care than fit patients (CFS 6-9 vs CFS 1-3 OR 1•54 [1•21-1•97], p=0•0010), whereas mildly frail patients had a lower incidence than fit patients (CFS 4-5 vs CFS 1-3 OR 0•71 [0•55-0•92], p=0•0090). Among patients younger than 65 years, frail patients had an increased incidence of admission to intensive care (CFS 6-9 vs CFS 1-3 OR 2•96 [1•98-4•43], p<0•0001), whereas mildly frail patients had no significant difference in incidence compared with fit patients (CFS 4-5 vs CFS 1-3 OR 0•93 [0•63-1•38], p=0•72). Among patients aged 65 years and older, frail patients had no significant difference in the incidence of admission to intensive care compared with fit patients (CFS 6-9 vs CFS 1-3 OR 1•27 [0•92-1•75], p=0•14), whereas mildly frail patients had a lower incide...

Objective. The aim of this study was to introduce a novel methodology for classification of brain hemodynamic responses collected via functional near infrared spectroscopy (fNIRS) during rest, motor imagery (MI) and motor execution (ME) tasks which involves generating population-level training sets. Approach. A 48-channel fNIRS system was utilized to obtain hemodynamic signals from the frontal (FC), primary motor (PMC) and somatosensory cortex (SMC) of ten subjects during an experimental paradigm consisting of MI and ME of various right hand movements. Classification accuracies of random forest (RF), support vector machines (SVM), and artificial neural networks (ANN) were computed at the single subject level by training each classifier with subject specific features, and at the group level by training with features from all subjects for ME versus Rest, MI versus Rest and MI versus ME conditions. The performances were also computed for channel data restricted to FC, PMC and SMC regions separately to determine optimal probe location. Main results. RF, SVM and ANN had comparably high classification accuracies for ME versus Rest (%94, %96 and %98 respectively) and for MI versus Rest (%95, %95 and %98 respectively) when fed with group level feature sets. The accuracy performance of each algorithm in localized brain regions were comparable (>%93) to the accuracy performance obtained with whole brain channels (>%94) for both ME versus Rest and MI versus Rest conditions. Significance. By demonstrating the feasibility of generating a population level training set with a high classification performance for three different classification algorithms, the findings pave the path for removing the necessity to acquire subject specific training data and hold promise for a novel, real-time fNIRS based BCI system design which will be most effective for application to disease populations for whom obtaining data to train a classification algorithm is not possible.

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Background: To evaluate cervical length changes as predictors of preterm delivery. Methods: Two hundred and fifty-seven pregnant women underwent transvaginal ultrasound examination at 16 and 24 weeks of gestation. Cervical length was measured and the difference between the 2 measurements was calculated. The sensitivity, specificity, positive predictive value and negative predictive value of cervical length and cervical length changes were calculated and these methods were compared by receiver-operating characteristic (ROC) curve analysis. Results: Preterm delivery (before 37 weeks of gestation) occurred in 19 patients (7.4%). The mean cervical length was shorter in the preterm group, the area under the ROC curve for prediction of preterm delivery was 0.914, ultrasound had a sensitivity of 84.2% to predict preterm delivery with a false-positive rate of 18.5%, and the relative risk was 4.56 at the 34.3-mm cutoff value at 24 weeks of gestation. In contrast, a cervical length change on transvaginal ultrasound had a sensitivity of 73.3% to predict preterm delivery with a false-positive rate of 18.1%, and the relative risk was 4.08 at the 6.6-mm cutoff value. Conclusion: A single cervical length measurement obtained at 24 weeks of gestation can predict preterm delivery as accurately as cervical length change.

Corrective taping, although a form of conservative treatment for hallux valgus, has been insufficiently studied in terms of effects on balance. Our results show that taping, as an acute effect, may impair balance in middle-aged adults when walking or ascending and descending stairs.