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Globally, COVID-19 has been shown to have had a wide ranging and significant impact on individuals’ daily living, and physical and mental health. However, there are some groups of individuals who may encounter unique challenges with regards to COVID-19 and whose experiences have not been investigated thus far. Therefore, this study aimed to understand the experiences of adults with a facial visible difference in relation to COVID-19 and lockdown. Semi-structured interviews were conducted with 21 adults with a variety of facial visible differences (e.g., cleft lip/palate, facial scars, skin conditions) and analyzed using inductive reflexive thematic analysis. This analysis generated three themes (Escaping the external gaze; Existing feelings manifesting in new challenges; COVID-19 taking priority). The results of this study suggest that the first U.K. lockdown from the COVID-19 pandemic created significant challenges for some individuals with a facial visible difference, and ongoing restrictions and social distancing measures might be particularly challenging for those who experience anxiety around social encounters. These findings highlight the importance of providing appropriate and accessible support for people with facial differences during lockdown and as restrictions ease.

Coronavirus disease 2019 (COVID-19) is associated with cardiovascular (CV) complications including myocardial injury, myocarditis, arrhythmias, and venous thromboembolism. The infection is more severe in patients with pre-existing cardiovascular disease (CVD), where systemic inflammation due to cytokine storm, hypercoagulation, as well as high hematocrit and platelet (PLT) count may contribute to an increased CV risk. The authors hypothesize that anticoagulants and antiplatelets prevent miocardial infarction (MI) in patients with pre-existing CVD.A cohort study enrolled patients with a confirmed diagnosis of COVID-19. Clinical and laboratory data, total and CV mortality, as well as MI incidence and treatment regimens were compared according to the time of hospitalization: 40-day period in April-May (Group 1) and in October-November (Group 2).A total of 195 patients were enrolled: 93 in Group 1, with 36.5%, and 102 in Group 2 with 38.2% pre-existing CVD. Group 1 was managed with infusion therapy; only 10.7% received anticoagulation. Group 2 received preventive anticoagulants, antiplatelets, and infusion therapy. In Group 1, seven cases of MI were recorded compared to only three in Group 2. No significant difference in overall mortality (4.3% vs 6.86%, p = 0.441) and MI incidence (7.5% vs 2.9%, p = 0.149) was found, but significant differences were seen in the incidence of severe and critically ill cases between the groups (69.9% and 7.5% vs 75.5% and 20.6%, p 0.001).Poorer outcomes in the early COVID-19 wave were associated with inadequate anticoagulation due to lack of knowledge about the new virus. Despite significantly more severe cases, there was no significant difference in overall mortality and MI incidence in patients with anticoagulation.HINTERGRUND: „Coronavirus disease 2019“ (COVID-19) ist mit kardiovaskulären (KV) Komplikationen, einschließlich Myokardinfarkt (MI), Myokarditis, Arrhythmien und venösen Thrombembolien, assoziiert. Die Infektion verläuft bei Menschen mit vorbestehenden KV-Erkrankungen schwerer, bei denen systemische Inflammation aufgrund der Hyperzytokinämie, Hyperkoagulation sowie erhöhte Hämatokrit- und Thrombozytenwerte zu einem erhöhten KV-Risiko beitragen könnten. Die Autoren stellen die Hypothese auf, dass ein Herzinfarkt bei Menschen mit präexistenten KV-Erkrankungen durch Antikoagulanzien und Thrombozytenaggregationshemmer verhindert werden kann.In die Kohortenstudie wurden Patienten mit bestätigter COVID-19-Diagnose aufgenommen. Deren klinische Parameter und Labordaten, Gesamtsterblichkeit und kardiovaskuläre Mortalität, MI-Inzidenz und die Behandlungsmodalitäten wurden, abhängig vom Zeitraum des Krankenhausaufenthalts (40-Tages-Zeitraum im April/Mai [Gruppe 1] bzw. Oktober/November [Gruppe 2]), verglichen.Insgesamt wurden 195 Patienten in die Studie aufgenommen: 93 in Gruppe 1 und 102 in Gruppe 2, davon 36,5 % (Gruppe 1) bzw. 38,2 % (Gruppe 2) mit vorbestehender KV-Erkrankung. Die Patienten in Gruppe 1 erhielten eine Infusionstherapie, nur 10,7 % wurden mit Antikoagulanzien behandelt. Bei Gruppe 2 kamen präventiv Antikoagulanzien und Thrombozytenaggregationshemmer zusätzlich zur Infusionstherapie zum Einsatz. In Gruppe 1 erlitten 7 Patienten einen MI, in Gruppe 2 nur 3. Keine signifikanten Unterschiede zwischen beiden Gruppen wurden bezüglich der Gesamtsterblichkeit (4,3 % vs. 6,86 %, p = 0,441) und MI-Inzidenz (7,5 % vs. 2,9 %, p = 0,149) festgestellt, jedoch hinsichtlich der Inzidenz schwerer und kritisch kranker Fälle (69,9 % und 7,5 % vs. 75,5 % und 20,6 %, p 0,001).Schlechtere Behandlungsresultate in der frühen COVID-19-Phase waren mit inadäquater Antikoagulation aufgrund fehlender Kenntnisse über das neue Virus assoziiert. Trotz der signifikant schwereren Verläufe ergaben sich keine signifikanten Unterschiede bezüglich der Gesamtsterblichkeit und der Herzinfarktinzidenz bei Patienten unter Antikoagulation.

Within-person studies of emotional disclosure have found evidence of a disclosure-discordance effect of depression, whereby the positive association between the intensity of one’s emotional experience and verbal disclosure of that experience weakens with increasing depression symptoms. Because these previous studies have exclusively been naturalistic ones, we examined the disclosure-discordance effect of depression in the lab. Participants (N = 115) completed a measure of depression symptoms and viewed a series of emotionally evocative photographs. Emotion-expressive behavior while viewing each photograph was rated by judges, subjective emotional experience was assessed via self-report, and emotional disclosure just after the photograph was viewed was rated by different judges. Multilevel analyses indicated that depression symptoms moderated the association between the behavioral (i.e., facial) expression of emotion intensity and disclosure of emotion. Moderation was not supported in analyses with self-reported emotional intensity as a predictor. These findings partly supported the disclosure-discordance effect, and they inform methods of empirically examining the effect of depression symptoms on the verbal disclosure of emotion.

Following the detection of the new coronavirus1 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its spread outside of China, Europe has experienced large epidemics of coronavirus disease 2019 (COVID-19). In response, many European countries have implemented non-pharmaceutical interventions, such as the closure of schools and national lockdowns. Here we study the effect of major interventions across 11 European countries for the period from the start of the COVID-19 epidemics in February 2020 until 4 May 2020, when lockdowns started to be lifted. Our model calculates backwards from observed deaths to estimate transmission that occurred several weeks previously, allowing for the time lag between infection and death. We use partial pooling of information between countries, with both individual and shared effects on the time-varying reproduction number (Rt). Pooling allows for more information to be used, helps to overcome idiosyncrasies in the data and enables more-timely estimates. Our model relies on fixed estimates of some epidemiological parameters (such as the infection fatality rate), does not include importation or subnational variation and assumes that changes in Rt are an immediate response to interventions rather than gradual changes in behaviour. Amidst the ongoing pandemic, we rely on death data that are incomplete, show systematic biases in reporting and are subject to future consolidation. We estimate that-for all of the countries we consider here-current interventions have been sufficient to drive Rt below 1 (probability Rt

The anti-angiogenic effects of bisphosphonates have been hypothesized as one of the major etiologic factors in the development of medication-related osteonecrosis of the jaw (MRONJ), a severe debilitating condition with limited treatment options. This study evaluated the potential of a gelatine-hyaluronic acid hydrogel loaded with the angiogenic growth factor, vascular endothelial growth factor (VEGF), as a local delivery system to aid in maintaining vascularization in a bisphosphonate-treated (Zoledronic Acid) rodent maxillary extraction defect. Healing was assessed four weeks after implantation of the VEGF-hydrogel into extraction sockets. Gross examination and histological assessment showed that total osteonecrosis and inflammatory infiltrate was significantly reduced in the presence of VEGF. Also, total vascularity and specifically neovascularization, was significantly improved in animals that received VEGF hydrogel. Gene expression of vascular, inflammatory and bone specific markers within the defect area were also significantly altered in the presence of VEGF. Furthermore, plasma cytokine levels were assessed to determine the systemic effect of locally delivered VEGF and showed similar outcomes. In conclusion, the use of locally delivered VEGF within healing extraction sockets assists bone healing and prevents MRONJ via a pro-angiogenic and immunomodulatory mechanism.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

The use of untrusted design tools, components, and designers, coupled with untrusted device fabrication, introduces the possibility of malicious modifications being made to integrated circuits (ICs) during their design and fabrication. These modifications are known as hardware trojans. The widespread use of commercially purchased 3rd party intellectual property (3PIP) and commercial design tools extends even into trusted design flows. Unfortunately, due to the theoretical result that there is no program that can decide whether any other program will eventually halt, we know that the properties of a program, or circuit, cannot be known in advance of running it. While we can design a circuit to meet some functional specification and generate a simulation or test suite to obtain at least probabilistic confidence that the circuit implements the intended functionality, we cannot test a circuit for unintended functionality due to the combinatorially large state space. To address these concerns, we have developed a design-time method for automatically and systematically modifying portions of a design that exhibit characteristics of hardware trojans. After each modification, the functionality of the design is verified against a comprehensive simulation suite to ensure that the intended circuit functionality has not been changed. This approach can be applied to any digital circuit and does not rely on secret keys or obfuscation.

The literature on emotion reactivity among people with major depressive disorder (MDD) indicates that people with MDD show diminished reactivity to negative events as compared to non-depressed controls. This diminished reactivity may only be at the highest levels of depression symptoms, suggesting a nonlinear association between depression symptoms and emotion reactivity. Unfortunately, depression has not been examined as a continuum in this line of research; moreover, the time course of reactivity during an emotional event has not been adequately examined. Participants (N = 100) completed a measure of depression symptoms and then viewed a sadness-inducing 11-min film clip while their facial expressions were video recorded and coded separately for each minute of the film clip. Growth-curve analyses indicated a quadratic effect of depression symptoms on curves for facial expressions of sadness and happiness, such that the change in growth/decay first increased and then decreased from low to high levels of depression symptoms. This result supports the idea that the negative mood inherent in depression potentiates reactivity at lower ends of the depression continuum but that reactivity is dampened at higher levels of depression. This suggests that researchers specify the specific range of depression symptoms under investigation (e.g., mild, moderate, dysphoric, severely depressed) when studying the role of depression on emotional reactivity.

Using an ensemble of 10 statistically downscaled global climate model (GCM) simulations, we project future climate change impacts on the state of Indiana (IN) for two scenarios of greenhouse gas concentrations (a medium scenario—RCP4.5 and a high scenario—RCP 8.5) for three future time periods (2020s, 2050s, 2080s). Relative to a 1971–2000 baseline, the projections show substantial changes in temperature (T) for IN, with a change in the annual ensemble mean T for the 2080s RCP8.5 scenario of about 5.6 °C (10.1 °F). Such changes also indicate major changes in T extremes. For southern IN, the number of days with daily maximum T above 35 °C (95 °F) is projected to be about 100 days per year for the 2080s RCP8.5 scenario, as opposed to an average of 5 days for the historical baseline climate. Locations in northern IN could experience 50 days per year above 35 °C (95 °F) for the same conditions. Energy demand for cooling, as measured by cooling degree days (CDD), is projected to increase nearly fourfold in response to this extreme warming, but heating demand as measured by heating degree days (HDD) is projected to decline by 30%, which would result in a net reduction in annual heating/cooling energy demand for consumers. The length of the growing season is projected to increase by about 30 to 50 days by the 2080s for the RCP8.5 scenario, and USDA hardiness zones are projected to shift by about one full zone throughout IN. By the 2080s, all GCM simulations for the RCP8.5 scenario show higher annual precipitation (P) over the Midwest and IN. Projected seasonal changes in P include a 25–30% increase in winter and spring by the 2080s for the RCP8.5 scenarios and a 1–7% decline in summer and fall P (although there is a low model agreement in the latter two seasons). Rising T is projected to cause systematic decreases in the snow-to-rain ratio from Nov-Mar. Snow is projected to become uncommon in southern IN by the 2080s for the RCP8.5 scenario, and snowfall is substantially reduced in other areas of the state. The combined effects of these changes in T, P, and snowfall will likely result in increased surface runoff and flooding during winter and spring.

Changes to water resources are critical to all sectors of the economy. Climate change will affect the timing and quantity of water available in the environment as well as have an adverse effect on the quality of that water. Floods, droughts, and changing patterns of water scarcity—when water is not available in sufficient enough quantities or of a suitable quality at the right time to fulfill demand—are all critical factors when considering how and where Indiana will be able to economically develop in the future. Management of water resources will become even more important as different sectors try to minimize the risk of water scarcity in the face of increasing climate variability. This paper focuses on observed changes to Indiana’s water resources and how the availability and quality of those resources are likely to change in the face of future climate. Generally, Indiana is becoming wetter but with the projected increase coming primarily in the winter and spring. Summer water use will increase the likelihood of water shortages and the need for improved water management. In particular, Indiana may benefit from investment in methods to increase short-term storage of water—retaining more of the overabundance from winter and spring to relieve summer shortages.

Background Biomaterial-based bone tissue engineering represents a promising solution to overcome reduced residual bone volume. It has been previously demonstrated that gradient and offset architectures of three-dimensional melt electrowritten poly-caprolactone (PCL) scaffolds could successfully direct osteoblast cells differentiation toward an osteogenic lineage, resulting in mineralization. The aim of this study was therefore to evaluate the in vivo osteoconductive capacity of PCL scaffolds with these different architectures. Methods Five different calcium phosphate (CaP) coated melt electrowritten PCL pore sized scaffolds: 250 μm and 500 μm, 500 μm with 50% fibre offset (offset.50.50), tri layer gradient 250–500-750 μm (grad.250top) and 750–500-250 μm (grad.750top) were implanted into rodent critical-sized calvarial defects. Empty defects were used as a control. After 4 and 8 weeks of healing, the new bone was assessed by micro-computed tomography and immunohistochemistry. Results Significantly more newly formed bone was shown in the grad.250top scaffold 8 weeks post-implantation. Histological investigation also showed that soft tissue was replaced with newly formed bone and fully covered the grad.250top scaffold. While, the bone healing did not happen completely in the 250 μm, offset.50.50 scaffolds and blank calvaria defects following 8 weeks of implantation. Immunohistochemical analysis showed the expression of osteogenic markers was present in all scaffold groups at both time points. The mineralization marker Osteocalcin was detected with the highest intensity in the grad.250top and 500 μm scaffolds. Moreover, the expression of the endothelial markers showed that robust angiogenesis was involved in the repair process. Conclusions These results suggest that the gradient pore size structure provides superior conditions for bone regeneration.

The burden of malaria is heavily concentrated in sub-Saharan Africa (SSA) where cases and deaths associated with COVID-19 are rising1. In response, countries are implementing societal measures aimed at curtailing transmission of SARS-CoV-22,3. Despite these measures, the COVID-19 epidemic could still result in millions of deaths as local health facilities become overwhelmed4. Advances in malaria control this century have been largely due to distribution of long-lasting insecticidal nets (LLINs)5, with many SSA countries having planned campaigns for 2020. In the present study, we use COVID-19 and malaria transmission models to estimate the impact of disruption of malaria prevention activities and other core health services under four different COVID-19 epidemic scenarios. If activities are halted, the malaria burden in 2020 could be more than double that of 2019. In Nigeria alone, reducing case management for 6 months and delaying LLIN campaigns could result in 81,000 (44,000–119,000) additional deaths. Mitigating these negative impacts is achievable, and LLIN distributions in particular should be prioritized alongside access to antimalarial treatments to prevent substantial malaria epidemics. Transmission dynamics models of COVID-19 and malaria reveal how different scenarios of COVID-19 spread and varying levels of interruption to antimalarial programs could result in increased deaths in sub-Saharan Africa.

On 21 February 2020, a resident of the municipality of Vo', a small town near Padua (Italy), died of pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection1. This was the first coronavirus disease 19 (COVID-19)-related death detected in Italy since the detection of SARS-CoV-2 in the Chinese city of Wuhan, Hubei province2. In response, the regional authorities imposed the lockdown of the whole municipality for 14 days3. Here we collected information on the demography, clinical presentation, hospitalization, contact network and the presence of SARS-CoV-2 infection in nasopharyngeal swabs for 85.9% and 71.5% of the population of Vo' at two consecutive time points. From the first survey, which was conducted around the time the town lockdown started, we found a prevalence of infection of 2.6% (95% confidence interval (CI): 2.1-3.3%). From the second survey, which was conducted at the end of the lockdown, we found a prevalence of 1.2% (95% CI: 0.8-1.8%). Notably, 42.5% (95% CI: 31.5-54.6%) of the confirmed SARS-CoV-2 infections detected across the two surveys were asymptomatic (that is, did not have symptoms at the time of swab testing and did not develop symptoms afterwards). The mean serial interval was 7.2 days (95% CI: 5.9-9.6). We found no statistically significant difference in the viral load of symptomatic versus asymptomatic infections (P = 0.62 and 0.74 for E and RdRp genes, respectively, exact Wilcoxon-Mann-Whitney test). This study sheds light on the frequency of asymptomatic SARS-CoV-2 infection, their infectivity (as measured by the viral load) and provides insights into its transmission dynamics and the efficacy of the implemented control measures.

The US National Institutes of Health convened a workshop on disease-promoting chronic inflammation to identify the challenges and needs in the development of clinically feasible strategies for monitoring a person's inflammation status before, during and after disease occurrence.

Microorganisms are part of the natural environments and reflect the effects of different physical factors of surrounding environment, such as gamma (γ) radiation. This work was devoted to the study of the influence of low doses of γ radiation with the intensity of 2.56 μW (m2 s)−1 (absorbed doses were 3.8 mGy for the radiation of 15 min and 7.2 mGy—for 30 min) on Escherichia coli M-17 and Pseudomonas aeruginosa GRP3 wild type cells. The changes of bacterial, growth, survival, morphology, and membrane activity had been studied after γ irradiation. Verified microbiological (specific growth rate, lag phase duration, colony-forming units (CFU) number, and light microscopy digital image analysis), biochemical (ATPase activity of bacterial membrane vesicles), and biophysical (H+ fluxes throughout cytoplasmic membrane of bacteria) methods were used for assessment of radiation implications on bacteria. It was shown that growth specific rate, lag phase duration and CFU number of these bacteria were lowered after irradiation, and average cell surface area was decreased too. Moreover ion fluxes of bacteria were changed: for P. aeruginosa they were decreased and for E. coli—increased. The N,N′-dicyclohexylcarbodiimide (DCCD) sensitive fluxes were also changed which were indicative for the membrane-associated F0F1-ATPase enzyme. ATPase activity of irradiated membrane vesicles was decreased for P. aeruginosa and stimulated for E. coli. Furthermore, DCCD sensitive ATPase activity was also changed. The results obtained suggest that these bacteria especially, P. aeruginosa are sensitive to γ radiation and might be used for developing new monitoring methods for estimating environmental changes after γ irradiation.

Plant biomass offers a renewable and environmentally favorable source of sugars that can be converted to different chemicals, second-generation ethanol, and other liquid fuels. Cellulose makes up approximately 45 % of the dry weight of lignocellulosic biomass. Prior to the enzymatic hydrolysis of cellulose, lignin and hemicellulose must be structurally altered or removed, at least in part, by chemical and/or physical pretreatments. However, the high cost and low efficiency of the enzymatic hydrolysis prevent the process from being economically competitive. For this reason, it is necessary to find enzymes suitable for this type of process, with higher specific activities and greater efficiency. Members of the Bacillus and Paenibacillus genera have been traditionally used for the production of many enzymes for industrial applications. Cellulases produced by both genera have shown activity on soluble and crystalline cellulose and high thermostability and/or activity over a wide pH spectrum. In this review, the most recent information about the characterization of cellulolytic enzymes obtained from new strains of the Bacillus and Paenibacillus genera are reviewed. We focused on the variety of isoenzymes produced by these cellulolytic strains, their optimal production and reaction conditions, and their kinetic parameters and biotechnological potential.

Microorganisms have a large number of tools to withstand different, and sometimes strong, environmental stresses, including irradiation, but this ability should be further evaluated for certain applications. Growth inhibition and morphological alterations of Escherichia coli M-17 and Pseudomonas aeruginosa GRP3 wild-type cells caused by UV-A irradiation have been detected in the present study. Comparative analysis was carried out using well-established microbiological methods (determination of specific growth rate, growth lag phase duration, and colony-forming unit number-CFU) and computational approaches, employing light microscopy and digital image analysis to evaluate bacterial cell morphology. Decreases in the specific growth rate, prolonged lag-phases, and lowered CFUs were observed after 5 and 10 min of UV irradiation (approx. 40 Gy) compared to the control (nonirradiated) cells. Accordingly, two computational parameters-the average bacterial cell surface area and the bacterial cell perimeter (i.e., of the 2D projection of bacterial cells in microscopy image)-were reduced. The ratio of bacterial cell surface area (S) to the square of the perimeter (p (2) ) was reduced after 5 min of irradiation, but after 10 min of irradiation the studied bacterial cells became flat cylinders. The revealed findings are concluded to be highly useful in developing new, rapid analysis methods to monitor environmental and UV irradiation effects on bacteria and to detect bacterial cell morphology alterations.

Background Cardiovascular magnetic resonance (CMR) feature tracking is increasingly used to quantify cardiac mechanics from cine CMR imaging, although validation against reference standard techniques has been limited. Furthermore, studies have suggested that commonly-derived metrics, such as peak global strain (reported in 63% of feature tracking studies), can be quantified using contours from just two frames – end-diastole (ED) and end-systole (ES) – without requiring tracking software. We hypothesized that mechanics derived from feature tracking would not agree with those derived from a reference standard (displacement-encoding with stimulated echoes (DENSE) imaging), and that peak strain from feature tracking would agree with that derived using simple processing of only ED and ES contours. Methods We retrospectively identified 88 participants with 186 pairs of DENSE and balanced steady state free precession (bSSFP) image slices acquired at the same locations across two institutions. Left ventricular (LV) strains, torsion, and dyssynchrony were quantified from both feature tracking (TomTec Imaging Systems, Circle Cardiovascular Imaging) and DENSE. Contour-based strains from bSSFP images were derived from ED and ES contours. Agreement was assessed with Bland-Altman analyses and coefficients of variation (CoV). All biases are reported in absolute percentage. Results Comparison results were similar for both vendor packages (TomTec and Circle), and thus only TomTec Imaging System data are reported in the abstract for simplicity. Compared to DENSE, mid-ventricular circumferential strain (Ecc) from feature tracking had acceptable agreement (bias: − 0.4%, p = 0.36, CoV: 11%). However, feature tracking significantly overestimated the magnitude of Ecc at the base (bias: − 4.0% absolute, p