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The coronavirus disease 2019 (COVID-19) pandemic has catalyzed the rapid adoption of telemedicine which encompasses synchronous and asynchronous interactions between patients and providers. In order to facilitate this rapid deployment, there has been numerous regulatory changes to ensure caregivers can effectively communicate with patients during this time. We illustrate a model where people, processes, and technology work together to address the comprehensive needs of multiple sclerosis (MS) patients. We provide a template for how multidisciplinary, academic practices can implement a rapid shift to virtual management during the pandemic using existing infrastructure that can be widely adopted to care for patients with chronic diseases. Telemedicine was incorporated into our entire practice, which encompasses neurology, rehabilitation, advanced practice providers, fellows, social work, and behavioral medicine. Our patient satisfaction results remained stable across almost all domains when compared to survey results from our typical, in-office visits. Our experience demonstrates telemedicine’s transformative potential in successfully managing a multidisciplinary MS clinic during the time of a pandemic and outlines a potential path for other practices to follow.

PurposeTo better understand the pathophysiology of lichen sclerosus (LS) urethral stricture disease (USD), we aimed to investigate expression profiles of microRNAs (miRNAs) in tissue samples from men undergoing urethroplasty.MethodsUrethral stricture tissue was collected from 2005-2020. Histologic features diagnostic of LS were the basis of pathologic evaluation. Foci of areas diagnostic for LS or non-LS strictures were chosen for RNA evaluation. In an initial screening analysis, 13 LS urethral strictures and 13 non-LS strictures were profiled via miRNA RT-qPCR arrays for 752 unique miRNA. A validation analysis of 23 additional samples (9 LS and 14 non-LS) was performed for 15 miRNAs. Statistical analyses were performed using SPSS v25. Gene Ontology (GO) analysis was performed using DIANA-mirPath v. 3.0.ResultsIn the screening analysis 143 miRNAs were detected for all samples. 27 were differentially expressed between the groups (false discovery p-value 0.90 for distinguishing between between LS and non-LS strictures. 11-fold upregulation of MiR-155-5p specifically was found in LS vs. non-LS strictures (pConclusionsTo our knowledge this is the first study evaluating miRNA expression profiles in LS and non-LS USD. We identified several miRNAs that are differentially expressed in USD caused by LS vs other etiologies, which could potentially serve as biomarkers of LS USD. The top eight differentially expressed miRNAs have been linked to immune response processes as well as involvement in wound healing, primarily angiogenesis and fibrosis.

With the outbreak of COVID-19, patients and providers were forced to isolate and become innovative in ways to continue exceptional patient care. The Cleveland Clinic went from mostly in-person medical appointments to all virtual/telemedicine care in about 2 weeks’ time. In this piece, we show specifically the thought process and our conversion of the Mellen Center for Multiple Sclerosis Behavioral Medicine to ensure that our patients still receive exceptional care and patient experience. Additionally, we discuss the importance of innovating the training and supervision of postdoctoral trainees using telepsychology and virtual options.

Viruses play an important role in microbial communities but, due to limitations of available techniques, our understanding of viral diversity is limited. Here, the authors use SVGs and identify highly abundant viruses in marine communities that have been previously overlooked.

Although millions of distinct virus species likely exist, only approximately 9000 are catalogued in GenBank's RefSeq database. We selectively enriched for the genomes of circular DNA viruses in over 70 animal samples, ranging from nematodes to human tissue specimens. A bioinformatics pipeline, Cenote-Taker, was developed to automatically annotate over 2500 complete genomes in a GenBank-compliant format. The new genomes belong to dozens of established and emerging viral families. Some appear to be the result of previously undescribed recombination events between ssDNA and ssRNA viruses. In addition, hundreds of circular DNA elements that do not encode any discernable similarities to previously characterized sequences were identified. To characterize these ‘dark matter’ sequences, we used an artificial neural network to identify candidate viral capsid proteins, several of which formed virus-like particles when expressed in culture. These data further the understanding of viral sequence diversity and allow for high throughput documentation of the virosphere.

Advances in ocean observing technologies and modeling provide the capacity to revolutionize the management of living marine resources. While traditional fisheries management approaches like single-species stock assessments are still common, a global effort is underway to adopt ecosystem-based fisheries management (EBFM) approaches. These approaches consider changes in the physical environment and interactions between ecosystem elements, including human uses, holistically. For example, integrated ecosystem assessments aim to synthesize a suite of observations (physical, biological, socioeconomic) and modeling platforms [ocean circulation models, ecological models, short-term forecasts, management strategy evaluations (MSEs)] to assess the current status and recent and future trends of ecosystem components. This information provides guidance for better management strategies. A common thread in EBFM approaches is the need for high-quality observations of ocean conditions, at scales that resolve critical physical-biological processes and are timely for management needs. Here we explore options for a future observing system that meets the needs of EBFM by (i) identifying observing needs for different user groups, (ii) reviewing relevant datasets and existing technologies, (iii) showcasing regional case studies, and (iv) recommending observational approaches required to implement EBFM. We recommend linking ocean observing within the context of Global Ocean Observing System (GOOS) and other regional ocean observing efforts with fisheries observations, new forecasting methods, and capacity development, in a comprehensive ocean observing framework.

The heterogeneity in the behavioral presentation of autism spectrum disorder (ASD) may be surpassed only by the level of heterogeneity in its etiology. There are diverse pathways to the singular diagnostic outcome of ASD, and several etiological risk factors have been proposed in recent years. This review paper examines the role of inflammation as one possible etiologic factor in ASD, juxtaposed in the context of research on the role of inflammation in other psychiatric disorders. Human, animal, and postmortem studies of inflammation in ASD were surveyed, and their direct and indirect contributions to developing potential inflammation-based treatments, as well as potential preventative considerations, in ASD were reviewed. Although the mechanisms that link inflammation and ASD remain unknown, there exists a sizable multidisciplinary literature suggesting inflammation as a trans-etiological process.

Collective emotions experienced as existing objectively and widely shared challenge traditional views of emotions based on personal or private interests. This paper extends theories of group and crowd emotions focusing on social appraisal, social identity, emotional contagion, and ecstatic nationalism, and adds an interdisciplinary approach to research on international mega-sporting event impacts and legacies by examining the national-level collective emotions produced by a mega-sport event—the 2010 World Cup in South Africa. The novel case study approach triangulates ethnographic observations of life in downtown Johannesburg before and during the World Cup with a critical thematic analysis of qualitative interviews of 10 South Africans and the author’s and publicly posted videorecordings of individual and collective behavior. I explore how citizen support for efforts to pursue national projects combined with international attention to generate widespread and genuinely coordinated collective emotions of euphoria and pride. The social ontology-based analysis considers bottom–up and top–down mechanisms of emotional spread and influence along with important expressive-performative contributions of culture-specific forms of group-based and collective action tendencies. Moreover, the study shows how group agency in the form of coordinated ritualistic bases realized group affects spontaneously and normatively as South Africans desired, accepted and celebrated achieving team and host-related group goals. These results provide new insights into the emotions that occur in public events in two phases, (1) creation of collective normative commitment in practice related to group ethos and national interests and goals prior to the tournament start, and (2) during the tournament when dynamic relations between group-based and collective emotions also generated feelings of unity and solidarity. Together they highlight unique predisposing cultural and historical features of the emotional and affective-discursive practices associated with the World Cup for South Africans, limits to the spread of emotions of enthusiasm from urban cities to rural areas, forms of excitement and celebration in public spaces, instances of ambivalence about efforts to enact support for the nation’s World Cup team and host role, and indicate how collective emotional experiences are internalized, embodied and reproduced in accounts of national transformation, concerns about fragile intergroup solidarity, and instances of group-based hubristic pride.

Microbial communities are important for the health of mucosal tissues. Traditional culture and gene sequencing have demonstrated bacterial populations on the conjunctiva. However, it remains unclear if the cornea, a transparent tissue critical for vision, also hosts a microbiome. Corneas of wild-type, IL-1R (-/-) and MyD88 (-/-) C57BL/6 mice were imaged after labeling with alkyne-functionalized D-alanine (alkDala), a probe that only incorporates into the peptidoglycan of metabolically active bacteria. Fluorescence in situ hybridization (FISH) was also used to detect viable bacteria. AlkDala labeling was rarely observed on healthy corneas. In contrast, adjacent conjunctivae harbored filamentous alkDala-positive forms, that also labeled with DMN-Tre, a Corynebacterineae-specific probe. FISH confirmed the absence of viable bacteria on healthy corneas, which also cleared deliberately inoculated bacteria within 24 h. Differing from wild-type, both IL-1R (-/-) and MyD88 (-/-) corneas harbored numerous alkDala-labeled bacteria, a result abrogated by topical antibiotics. IL-1R (-/-) corneas were impermeable to fluorescein suggesting that bacterial colonization did not reflect decreased epithelial integrity. Thus, in contrast to the conjunctiva and other mucosal surfaces, healthy murine corneas host very few viable bacteria, and this constitutive state requires the IL-1R and MyD88. While this study cannot exclude the presence of fungi, viruses, or non-viable or dormant bacteria, the data suggest that healthy murine corneas do not host a resident viable bacterial community, or microbiome, the absence of which could have important implications for understanding the homeostasis of this tissue.