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Edward Goldstein

Publications and source records attributed to Edward Goldstein.

At least 19 recordsLinked to original sources
arXiv2020

Detectability of the novel coronavirus (SARS-CoV-2) infection and rates of mortality from the novel coronavirus infection in different regions of the Russian Federation

Relevance: Laboratory diagnosis of the novel coronavirus (SARS-CoV-2) infection combined with quarantine for contacts of infected individuals affects the spread of SARS-CoV-2 infection and levels of related mortality. Practices for testing for SARS-CoV-2 infection vary geographically in Russia. For example, in the city of St. Petersburg, where mortality rate for COVID-19 is the highest in the Russian Federation on Oct. 25, 2020, every death for COVID-19 corresponds to 15.7 detected cases of COVID-19 in the population, while the corresponding number for the whole of Russia is 58.1, suggesting limited detection of mild/moderate cases of COVID-19 in St. Petersburg. Methods: More active testing for SARS-CoV-2 results in lower case-fatality ratio (i.e. the proportion of detected COVID-19 cases among all cases of SARS-CoV-2 infection in the population). We used data on COVID-19 cases and deaths to examine the correlation between case-fatality ratios and rates of mortality for COVID-19 in different regions of the Russian Federation. Results: The correlation between case-fatality ratios and rates of mortality for COVID-19 in different regions of the Russian Federation on Oct. 25, 2020 is 0.64 (0.50,0.75). For several regions of the Russian Federation, detectability of SARS-CoV-2 infection is relatively low, while rates of mortality for COVID-19 are relatively high. Conclusions: Detectability of the SARS-CoV-2 infection is one of the factors that affects the levels of mortality from COVID-19. To increase detectability, one ought to test all individuals with respiratory symptoms seeking medical care for SARS-CoV-2 infection, and to undertake additional measures to increase the volume of testing for SARS-CoV-2. Such measures, in combination with quarantine for infected cases and their close contacts help to mitigate the spread of the SARS-CoV-2 infection and diminish the related mortality.

q-bio.PE↗
arXiv2020

Temporal rise in the proportion of younger adults and older adolescents among COVID-19 cases in Germany: evidence of lesser adherence to social distancing practices?

Background: There is uncertainty about the role of different age groups in propagating the SARS-CoV-2 epidemics in different countries. Methods: We used the Koch Institute data on COVID-19 cases in Germany. To minimize the effect of changes in healthcare seeking behavior and testing practices, we included the following 5-year age groups in the analyses: 10-14y through 45-49y. For each age group g, we considered the proportion PL(g) of individuals in age group g among all detected cases aged 10-49y during weeks 13-14, 2020 (later period), as well as corresponding proportion PE(g) for weeks 10-11, 2020 (early period), and the relative risk RR(g)=PL(g)/PE(g). For each pair of age groups g1,g2, a higher value of RR(g1) compared to RR(g2) is interpreted as the relative increase in the population incidence of SARS-Cov-2 for g1 compared to g2 for the later vs. early period. Results: The relative risk was highest for individuals aged 20-24y (RR=1.4(95% CI (1.27,1.55))), followed by individuals aged 15-19y (RR=1.14(0.99,1.32)), aged 30-34y (RR= 1.07(0.99,1.16)), aged 25-29y (RR= 1.06(0.98,1.15)), aged 35-39y (RR=0.95(0.87,1.03)), aged 40-44y (RR=0.9(0.83,0.98)), aged 45-49y (RR=0.83(0.77,0.89)) and aged 10-14y (RR=0.78(0.64,0.95)). Conclusions: The observed relative increase with time in the prevalence of individuals aged 15-34y (particularly those aged 20-24y) among COVID-19 cases is unlikely to be explained by increases in the likelihood of seeking medical care/being tested for individuals in those age groups compared to individuals aged 35-49y or 10-14y, suggesting an actual increase in the prevalence of individuals aged 15-34y among SARS-CoV-2 infections in the German population. That increase likely reflects elevated mixing among individuals aged 15-34y (particularly those aged 20-24y) compared to other age groups, possibly due to lesser adherence to social distancing practices.

q-bio.PE↗
arXiv2020

Reduction in respiratory mortality not associated with influenza in Russia: effect of the introduction of pneumococcal vaccination (PCV13), or improvement in care?

Background. Pneumococcal vaccination (PCV13) for children (as well as older adults) in Russia was introduced in 2014, with no prior PCV7 use. While pneumonia hospitalization rates, both in children and adults did not decrease in the following years, respiratory mortality rates did decline with time. Moreover, there is a strong association between antibiotic, including multidrug resistance and PCV13 vaccine serotypes for S. pneumoniae in children in Russia, and presence of S. pneumoniae among sepsis cases in Russia during the recent years has been very low. Annual variability in influenza circulation may affect some of the changes in respiratory mortality rates. Methods. We applied the inference method from our recent study of influenza-associated mortality in Russia to relate monthly respiratory mortality rates between 09/2010 and 08/2019 to monthly indices of influenza circulation and baseline rates of mortality not associated with influenza, allowing for a potential trend in the baseline rates starting 2015. Results. Baseline rates of respiratory mortality not associated with influenza decreased with time starting from the 2014/15 season (with each season running from September to August), with the 2018/19 baseline rates of respiratory mortality per 100,000 individuals being lower by 12.41 (95% CI (10.6,14.2)) compared to the 2010-2014 period. Conclusions. While improvement in care might have contributed to the reduction in the rates of respiratory mortality not associated with influenza in Russia, the above temporally consistent reduction is compatible with the gradual replacement of vaccine serotypes in the transmission and carriage of S. pneumoniae following the introduction of PCV13. Further work is needed to better understand the impact of PCV13 on the epidemiology of respiratory infections and related mortality in Russia.

q-bio.PE↗
arXiv2019

Mortality for circulatory and respiratory causes associated with influenza circulation in Russia during the 2013/14 through the 2018/19 seasons

Background: Information on influenza-associated mortality in Russia is limited. Methods: Using previously developed methodology (Goldstein et al., Epidemiology 2012), we regressed the monthly rates of mortality for respiratory causes, as well as circulatory causes linearly against the monthly proxies for the incidence of influenza A/H3N2, A/H1N1 and B (obtained using data from the Smorodintsev Research Institute of Influenza (RII)), adjusting for the baseline rates of mortality not associated with influenza circulation and temporal trends. Results: For the 2013/14 through the 2018/19 seasons, influenza circulation was associated with an average annual 17636 (95% CI (9482,25790)) deaths for circulatory causes and 4179 (3250,5109) deaths for respiratory causes, with the largest number of deaths (32298 (18071,46525) for circulatory causes and 6689 (5019,8359) for respiratory causes) estimated during the 2014/15 influenza season. The biggest contributor to both circulatory and respiratory influenza-associated deaths was influenza A/H3N2, followed by influenza B and A/H1N1. Compared to the 2013/14 through the 2015/16 seasons, during the 2016/17 through the 2018/19 seasons (when levels of influenza vaccination were significantly higher), the number of influenza-associated deaths declined by about 16.1%, or 3809 annual respiratory and circulatory deaths. Conclusions: Influenza circulation is associated with a substantial mortality burden in Russia, particularly for circulatory deaths, with some reduction observed following the major increase in vaccination coverage. Those results support the potential utility of further extending the levels of influenza vaccination, the use of quadrivalent influenza vaccines, and extra efforts for protecting individuals with circulatory disease in Russia, including vaccination and the use of antiviral medications.

q-bio.PE↗
arXiv2019

Influenza-associated mortality for circulatory and respiratory causes during the 2013-2014 through the 2018-2019 influenza seasons in Russia

Background: Information on influenza-associated mortality in Russia is limited. Methods: Using previously developed methodology (Goldstein et al., Epidemiology 2012), we regressed the monthly rates of mortality for respiratory causes, as well as circulatory causes linearly against the monthly proxies for the incidence of influenza A/H3N2, A/H1N1 and B (obtained using data from the Smorodintsev Research Institute of Influenza (RII)), adjusting for the baseline rates of mortality not associated with influenza circulation and temporal trends. Results: For the 2013/14 through the 2018/19 seasons, influenza circulation was associated with an average annual 17636 (95% CI (9482,25790)) deaths for circulatory causes and 4179 (3250,5109) deaths for respiratory causes, with the largest number of deaths (32298 (18071,46525) for circulatory causes and 6689 (5019,8359) for respiratory causes) estimated during the 2014/15 influenza season. The biggest contributor to both circulatory and respiratory influenza-associated deaths was influenza A/H3N2, followed by influenza B and A/H1N1. Compared to the 2013/14 through the 2015/16 seasons, during the 2016/17 through the 2018/19 seasons (when levels of influenza vaccination were significantly higher), the volume of influenza-associated mortality declined by about 16.1%, or 3809 annual respiratory and circulatory deaths. Conclusions: Influenza circulation is associated with a substantial mortality burden in Russia, particularly for circulatory deaths, with some reduction observed following the major increase in vaccination coverage. Those results support the potential utility of further extending the levels of influenza vaccination, the use of quadrivalent influenza vaccines, and extra efforts for protecting individuals with circulatory disease in Russia, including vaccination and the use of antiviral medications.

q-bio.PE↗
arXiv2019

Influenza-associated mortality for different causes of death during the 2010-2011 through the 2014-2015 influenza seasons in Russia

Background: There is limited information on the volume of influenza-associated mortality in Russia. Methods: Using previously developed methodology (Goldstein et al., Epidemiology 2012), we regressed the monthly rates of mortality for respiratory causes, circulatory causes, and for certain infectious and parasitic diseases (available from the Russian Federal State Statistics Service (Rosstat)) linearly against the monthly proxies for the incidence of influenza A/H3N2, A/H1N1 and B (obtained using data from the Smorodintsev Research Institute of Influenza (RII) on levels of ILI/ARI consultations and the percent of respiratory specimens testing positive for influenza A/H3N2, A/H1N1 and B), adjusting for the baseline rates of mortality not associated with influenza circulation and temporal trends. Results: For the 2010/11 through the 2014/15 seasons, influenza circulation was associated with an average annual 11106 (95% CI (4321,17892)) deaths for circulatory causes, 4552 (3744,5360) deaths for respiratory causes, and 343 (63,624) deaths for certain infectious and parasitic diseases, with influenza A/H3N2 being responsible for the majority of influenza-associated respiratory deaths and influenza B making a substantial contribution to influenza-associated mortality for circulatory causes. Conclusions: Influenza circulation is associated with a substantial mortality burden in Russia, particularly for circulatory deaths. Those results support the potential utility of influenza vaccination (with the role played by influenza B in circulatory mortality pointing to the benefit of quadrivalent influenza vaccines), as well as of administration of antiviral drugs for high-risk individuals during periods of active influenza circulation.

q-bio.PE↗
arXiv2018

Antimicrobial resistance and use, and rates of hospitalization associated with bacterial infections, including sepsis

While the mechanisms and quantitative details are complex, few analysts would doubt that antibiotic use increases the prevalence of drug-resistant bacterial pathogens among all bacteria causing disease in a population. The causal connection between antibiotic use and the total incidence of severe bacterial infections, possibly mediated by antibiotic resistance, is less clearly established. The increasing burden of severe bacterial infections and their sequelae, particularly sepsis, in the United States and other countries, calls out for an explanation. In this Perspective we consider the evidence bearing on the hypothesis that prevalence of antibiotic resistance and levels of antibiotic use are important contributors to the rates of sepsis hospitalizations and other outcomes with bacterial etiology. In the process, we discuss the consequences of resistance to/use of commonly prescribed antibiotics, including fluoroquinolones, and provide a comparison of the epidemiology of antibiotic use/resistance and severe outcomes associated with infections with bacterial pathogens, particularly Escherichia coli, methicillin-resistant Staphylococcus aureus (MRSA), and Clostridium Difficile in the UK vs. US.

q-bio.PE↗
arXiv2017

On the relative role of different age groups during epidemics associated with the respiratory syncytial virus

Background: While RSV circulation results in high burden of hospitalization, particularly among infants, young children and the elderly, little is known about the role of different age groups in propagating annual RSV epidemics in the community. Methods: During a communicable disease outbreak, some subpopulations may play a disproportionate role during the outbreak's ascent due to increased susceptibility and/or contact rates. Such subpopulations can be identified by considering the proportion that cases in a subpopulation represent among all cases in the population occurring before (Bp) and after the epidemic peak (Ap) to calculate the subpopulation's relative risk, RR=Bp/Ap. We estimated RR for several age groups using data on RSV hospitalizations in the US between 2001-2012 from the Healthcare Cost and Utilization Project (HCUP). Results: Children aged 3-4y and 5-6y each had the highest RR estimate for 5/11 seasons in the data, with RSV hospitalization rates in infants being generally higher during seasons when children aged 5-6y had the highest RR estimates. Children aged 2y had the highest RR estimate during one season. RR estimates in infants and individuals aged 11y and older were mostly lower than in children aged 1-10y. Conclusions: The RR estimates suggest that preschool and young school-age children have the leading relative roles during RSV epidemics. We hope that those results will aid in the design of RSV vaccination policies.

q-bio.PE↗
arXiv2017

Pediatric hospitalizations associated with respiratory syncytial virus (RSV) and influenza, and the frequency of asthma as a secondary diagnosis

Background: There is uncertainty about the burden of severe outcomes associated with RSV and influenza in children. Methods: We have applied previously developed methodology to estimate the rates of influenza and RSV-associated hospitalizations with different diagnoses in different age subgroups of US children between the 2003-04 through the 2009-10 seasons. Results: The average annual rates (per 100,000) of influenza and RSV-associated hospitalizations for any cause excluding asthma (ICD-9 code 493) in the principal diagnosis with a respiratory cause (ICD-9 codes 460-519) in the diagnosis (either principal or secondary) were 173.1(95%CI (134.3,212.6)) (influenza) vs. 2336(2209,2463) (RSV) (age <1y); 77.9(51.1,105.2) vs. 625.7(540,711.5) (age 1y); 56.3(40.9,72.2) vs. 324.2(275.1,375) (age 2y); 44.6(32.9,56.6) vs. 172.2(134.2,211) (age 3y); 36.4(27.7,45.3) vs. 89.7(60.6,117.8) (age 4y); 36.6(29.3,43.9) vs. 62.3(38.8,86.4) (ages 5-6y); 20.5(16.3,24.6) vs. 30.2(16.1,43.9) (ages 7-11y); and 16.1(10.6,21.7) vs. 36.9(17.8,55.9) (ages 12-17y). The rates of RSV-associated hospitalizations with asthma as a secondary (non-principal) diagnosis were 162.6(143.6,181.6) (age <1y), 144.7(120.8,168.2) (age 1y), 99.5(82.3,116.8) (age 2y), 60.9(46.4,75.3) (age 3y), 23.5(10.7,36.4) (age 4y), 16.1(5.1,27) (ages 5-6y), 11.4(4.7,18.3) (ages 7-11y), and 15.8(4.9,26.7) (ages 12-17y). Conclusions: The estimated rates of RSV-associated hospitalizations in young children are high, with those rates declining rapidly with age. Additionally, the estimated rates of RSV-associated hospitalizations with asthma as a secondary diagnosis in young children, combined with data on the prevalence of asthma in those age groups suggest very high rates of RSV-associated hospitalizations in young children with asthma. Those children may be considered as potential target groups for RSV-related mitigation efforts.

q-bio.PE↗
arXiv2017

On the relative role of different age groups during influenza A epidemics in Germany, 2002-2017

Background: There is limited information about the role of different age groups, particularly subgroups of school-age children and younger adults in propagating influenza epidemics. Methods: For a communicable disease outbreak, some subpopulations may play a disproportionate role during the ascent of the outbreak due to increased susceptibility and/or contact rates. Such subpopulations can be identified by considering the proportion that cases in a subpopulation represent among all cases in the population occurring before the epidemic peak (Bp), the corresponding proportion after the epidemic peak (Ap), to calculate the relative risk for a subpopulation, RR=Bp/Ap. We estimated RR for several age groups using data on reported influenza A cases in Germany between 2002-2017. Results: Children aged 14-17y had the highest RR estimates for 7 out of 15 influenza A epidemics in the data, including the 2009 pandemic, and the large 2016/17, 2008/09, and 2006/07 seasons. Children aged 10-13y had the highest RR estimates during 3 epidemics, including the large 2014/15 and 2004/05 seasons. Children aged 6-9y had the highest RR estimates during two epidemics, including the large 2012/13 season. Children aged 2-5y had the highest RR estimate during the moderate 2015/16 season; adults aged 18-24y had the highest RR estimate during the small 2005/06 season; adults aged 25-34y had the highest RR estimate during the large, 2002/03 season. Conclusions: Our results support the prominent role of all school-age children, particularly the oldest ones, in propagating influenza epidemics in the community. We note that national vaccination coverage levels among older school-age children were lower than among younger school-age children during the recent influenza seasons in the US, and influenza vaccination program in England has not been phased in yet for secondary school students.

q-bio.PE↗
arXiv2006

Area comparison results for isotropic surfaces

Consider a 2-plane $P \subset \mathbb{C}^n$ and let $D$ be a bounded region in $P$ with a piecewise-smooth boundary. Let $I(D)$ be the infimum of areas of all piecewise-smooth isotropic surfaces in $\mathbb{C}^n$ with the same boundary as $D$. Then $I(D)= λ_P^n \cdot Area(D)$. If $P$ is not complex, $λ_P^n < \frac{3π}{2\sqrt{2}}$. For a complex plane $\mathbb{C} \subset \mathbb{C}^n$, $λ_{\mathbb{C}}^n \geq 2$, $λ_{\mathbb{C}}^2 \geq 3$ and also $\frac{3π^2}{2\sqrt{2}}$ is the area of an explicit Hamiltonian stationary isotropic Mobius band embedded in $\mathbb{C}^n$ whose boundary is a unit circle in $\mathbb{C}$. As a corollary, a compact surface $Σ$ (possibly with boundary) in a symplectic manifold can be approximated by isotropic surfaces of area $\leq \frac{3π}{2\sqrt{2}} Area(Σ)$. Another corollary is that a closed curve of length $l$ in $\mathbb{C}^n$ bounds an isotropic surface of area $\leq \frac{3l^2}{8\sqrt{2}}$. A related result is the following: consider $\mathbb{C}P^1 \subset \mathbb{C}P^n$ and let $D$ be a region in $\mathbb{C}P^1$. Let $I(D)$ be the infimum of areas of all isotropic surfaces in $\mathbb{C}P^n$ with the same boundary as $D$ representing the same relative homology class mod 2 as $D$. Then $ 2 \cdot Area(D) \leq I(D) \leq λ_{\mathbb{C}}^n \cdot Area(D)$. Moreover the first inequality becomes an equality for $D=\mathbb{C}P^1$.

math.DG↗
arXiv2004

Volume minimization and estimates for certain isotropic submanifolds in complex projective spaces

In this note we show the following result using the integral-geometric formula of R. Howard: Consider the totally geodesic $\mathbb{R}P^{2m}$ in $\mathbb{C}P^n$. Then it minimizes volume among the isotropic submanifolds in the same $\mathbb{Z}/2$ homology class in $\mathbb{C}P^n$ (but not among all submanifolds in this $\mathbb{Z}/2$ homology class). Also the totally geodesic $\mathbb{R}P^{2m-1}$ minimizes volume in its Hamiltonian deformation class in $\mathbb{C}P^n$. As a corollary we'll give estimates for volumes of Lagrangian submanifolds in complete intersections in $\mathbb{C}P^n$.

math.DG↗
arXiv2004

Volume minimization for Lagrangian submanifolds in complex manifolds with negative first Chern class

It is classically known that closed geodesics on a compact Riemann surface with a metric of negative curvature strictly minimize length in their free homotopy class. We'd like to generalize this to Lagrangian submanifolds in Kähler manifolds of negative Ricci curvature. The only known result in this direction is a theorem on Y.I. Lee for certain Lagrangian submanifolds in a product of two Riemann surfaces of constant negative curvature. We develop an approach to study this problem in higher dimensions. Along the way we prove some weak results (volume-minimization outside of a divisor) and give a counterexample to global volume-minimization for an immersed minimal Lagrangian submanifold.

math.DG↗
arXiv2004

Geometric Model for Complex Non-Kaehler Manifolds with SU(3) Structure

For a given complex n-fold M we present an explicit construction of all complex (n+1)-folds which are principal holomorphic T2-fibrations over M. For physical applications we consider the case of M being a Calabi-Yau 2-fold. We show that for such M, there is a subclass of the 3-folds that we construct, which has natural families of non-Kaehler SU(3)-structures satisfying the conditions for N = 1 supersymmetry in the heterotic string theory compactified on the 3-folds. We present examples in the aforementioned subclass with M being a K3-surface and a 4-torus.

hep-th↗
arXiv2003

Some estimates related to Oh's conjecture for the Clifford tori in CP^n

This note is motivated by Y.G. Oh's conjecture that the Clifford torus $L_n$ in $\mathbb{C}P^n$ minimizes volume in its Hamiltonian deformation class. We show that there exist explicit positive constants $a_n$ depending on the dimension with $a_2=3/π$ such that for any Lagrangian torus $L$ in the Hamiltonian class of $L_n$ we have $vol(L) \geq a_n vol (L_n)$. The proof uses the recent work of C.H. Cho on Floer homology of the Clifford tori. A formula from integral geometry enables us to derive the estimate. We wish to point out that a general lower bound on the volume of $L$ exists from the work of C. Viterbo. Our lower bound $a_2= 3/π$ is the best one we know.

math.DG↗
arXiv2000

Holomorphic vector fields and minimal Lagrangian submanifolds

The purpose of this note is to establish the following theorem: Let N be a Kahler manifold, L be a compact oriented immersed minimal Lagrangian submanifold in N and V be a holomorphic vector field in a neighbourhood of L in N. Let div(V) be the (complex) divergence of V. Then the integral of div(V) over L is 0. Vice versa let N^2n be Kahler-Einstein with non-zero scalar curvature and L^n be a totally real oriented embedded n-dimensional real-analytic submanifold of N s.t. the divergence of any holomorphic vector field defined in a neighbourhood of L in N integrates to 0 on L. Then L is a minimal Lagrangian submanifold of N.

math.DG↗
arXiv2000

Calibrated Fibrations

In this paper we investigate the geometry of Calibrated submanifolds and study relations between their moduli-space and geometry of the ambient manifold. In particular for a Calabi-Yau manifold we define Special Lagrangian submanifolds for any Kahler metric on it. We show that for a choice of Kahler metric the Borcea-Voisin threefold has a fibration structure with generic fiber being a Special Lagrangian torus. Moreover we construct a mirror to this fibration. Also for any closed G_2 form on a 7-manifold we study coassociative submanifolds and we show that one example of a G_2 manifold constructed by Joyce in [10] is a fibration with generic fiber being a coassociative 4-torus. Similarly we construct a mirror to this fibration.

math.DG↗