Purpose Throughout the SARS-CoV2 pandemic, multiple reports show higher percentages of hospitalization, morbidity, and mortality among men than women, indicating that men are more affected by COVID-19. The pathophysiology of this difference is yet not established, but recent studies suggest that sex hormones may influence the viral infectivity process. Here, we review the current evidence of androgen sensitivity as a decisive factor for COVID-19 disease severity. Methods Relevant literature investigating the role of androgens in COVID-19 was assessed. Further, we describe several drugs suggested as beneficial for COVID-19 treatment related to androgen pathways. Lastly, we looked at androgen sensitivity as a predictor for COVID-19 progression and ongoing clinical trials on androgen suppression therapies as a line of treatment. Results SARS-COV2 virus spike proteins utilize Transmembrane protease serine 2 (TMPRSS2) for host entry. Androgen receptors are transcription promoters for TMPRSS2 and can, therefore, facilitate SARS-COV2 entry. Variants in the androgen receptor gene correlate with androgen sensitivity and are implicated in diseases like androgenetic alopecia and prostate cancer, conditions that have been associated with worse COVID-19 outcomes and hospitalization. Conclusion Androgen’s TMPRSS2-mediated actions might explain both the low fatalities observed in prepubertal children and the differences between sexes regarding SARS-COV2 infection. Androgen sensitivity may be a critical factor in determining COVID-19 disease severity, and sensitivity tests can, therefore, help in predicting patient outcomes.

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This paper presents a novel plane-stress continuum damage mechanics (CDM) model for the prediction of the different shapes of forming limit diagrams (FLCs) for aluminium alloys under hot stamping conditions. Firstly, a set of uniaxial viscoplastic damage constitutive equations is determined from tensile experimental data of AA5754 at a temperature range of 350-550 C and strain rates of 0.1, 1.0 and 10 s À1 . The tests were carried out on Gleeble materials simulator (3800). Based on the analysis of features of FLCs for different materials forming at different temperatures, a plane-stress damage equation is proposed to take account the failure of materials at different stress-state sheet metal forming conditions. In this way, a set of multiaxial viscoplastic damage constitutive equations is formulated. The model is calibrated from the FLC data at temperature of 350 C and strain rate of 1.0 s À1 for AA5754. A good agreement has been achieved between the experimental and numerical data. The effect of the maximum principal stress, effective stress and hydrostatic stress on the materials failure features and on the shape of FLCs is studied individually and in combination. Using the newly developed plane-stress unified viscoplastic damage constitutive equations, the FLC of materials can be predicted at different temperatures and strain rate forming conditions.

BackgroundCompliance with the clinical practice guidelines of sepsis management has been low. The objective of our study was to describe the results of implementing a multifaceted intervention including an electronic alert (e-alert) with a sepsis response team (SRT) on the outcome of patients with sepsis and septic shock presenting to the emergency department.MethodsThis was a pre–post two-phased implementation study that consisted of a pre-intervention phase (January 01, 2011–September 24, 2012), intervention phase I (multifaceted intervention including e-alert, from September 25, 2012–March 03, 2013) and intervention phase II when SRT was added (March 04, 2013–October 30, 2013) in a 900-bed tertiary-care academic hospital. We recorded baseline characteristics and processes of care in adult patients presenting with sepsis or septic shock. The primary outcome measures were hospital mortality. Secondary outcomes were the need for mechanical ventilation and length of stay in the intensive unit and in the hospital.ResultsAfter implementing the multifaceted intervention including e-alert and SRT, cases were identified with less severe clinical and laboratory abnormalities and the processes of care improved. When adjusted to propensity score, the interventions were associated with reduction in hospital mortality [for intervention phase II compared to pre-intervention: adjusted odds ratio (aOR) 0.71, 95% CI 0.58–0.85, p = 0.003], reduction in the need for mechanical ventilation (aOR 0.45, 95% CI 0.37–0.55, p < 0.0001) and reduction in ICU LOS and hospital LOS for all patients as well as ICU LOS for survivors.ConclusionsImplementing a multifaceted intervention including sepsis e-alert with SRT was associated with earlier identification of sepsis, increase in compliance with sepsis resuscitation bundle and reduction in the need for mechanical ventilation and reduction in hospital mortality and LOS.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-017-0280-7) contains supplementary material, which is available to authorized users.

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The fractional derivatives in the sense of Caputo and the homotopy analysis method are used to construct an approximate solution for the nonlinear space-time fractional derivatives Klein-Gordon equation. The numerical results show that the approaches are easy to implement and accurate when applied to the nonlinear space-time fractional derivatives Klein-Gordon equation. This method introduces a promising tool for solving many space-time fractional partial differential equations. This method is efficient and powerful in solving wide classes of nonlinear evolution fractional order equations.

Hepatitis C and hepatitis B virus infections constitute an important public health problem in prisons. Public health strategies to prevent morbidity and mortality from these infections should include hepatitis B vaccination, HCV testing, counseling and medical management of infected prisoners.

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