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Claire C Davies,1 Dorothy Brockopp,2 Krista Moe2 1Baptist Health Rehabilitation, 2Research Department, Baptist Health Lexington, Lexington, KY, USA Abstract: Hypersensitive scar tissue formation along the incision line and drain site is a common side effect following mastectomy. If this scar tissue is not addressed, it can lead to decreased flexibility and function in the involved upper quadrant. Astym® treatment is a new approach to soft tissue injuries, and is evidenced in animal studies to promote the healing and regeneration of soft tissues. It has also been found to reduce pain and increase function in people with soft tissue dysfunction. The aim of Astym treatment is to engage the regenerative mechanisms of the body in order to resorb scar tissue, stimulate tissue turnover, and regenerate soft tissues. Handheld instrumentation is applied topically to locate and treat the underlying dysfunctional soft tissue through specific protocols for the application of particular pressures and shear forces. The purpose of this study was to examine the effects of Astym treatment on activities of daily living in women who had undergone a mastectomy following a diagnosis of breast cancer. A quasi-experiment involving 40 women, following a mastectomy, evaluated five outcome measures pre- and post-Astym treatment. All five measurement scores: Disabilities of the Arm, Shoulder, and Hand Outcome Measure; a clothing questionnaire on their ability to wear a bra; Patient-Specific Functional Scale; active range of motion of shoulder flexion; and active range of motion of abduction were also measured and all demonstrated significant changes. In this study, Astym treatment improved active range of motion in the involved quadrant and also improved function in patients following a mastectomy. Keywords: breast cancer, quality of life, scar tissue treatment, physical therapy

Human TPH2 (hTPH2) catalyzes the rate-limiting step in CNS serotonin biosynthesis. We characterized a single-nucleotide polymorphism (C2755A) in the hTPH2 gene that substitutes tyrosine for serine at position 41 in the regulatory domain of the enzyme. This polymorphism is associated with bipolar disorder and peripartum depression in a Chinese population. Recombinant h TPH2 human proteins were expressed in bacteria and also stably expressed in PC12 cells. Following bacterial expression and purification, the tyrosine for serine substitution at position 41 (S41Y) polymorphic enzyme displayed increased Vmax with unchanged Km values. By contrast, enzyme stability was decreased in vitro from 32 min to 4 min (37°C) for the S41Y enzyme (as compared to the wild-type enzyme). The S41Y polymorphism decreased cyclic AMP-dependent protein kinase A-mediated phosphorylation ~ 50% relative to wild-type hTPH2, suggesting that the S41Y mutation may disrupt the post-translational regulation of this enzyme. Transfected PC12 cells expressed hTPH2 mRNA, active protein, and synthesized and released serotonin. Paradoxically, while S41Y-transfected PC12 cells expressed higher levels of hTPH2 than wild type, they synthesized less serotonin. These findings suggest a modified regulation of the S41Y gene variant leading to altered regulation and reduced neurotransmitter synthesis that may contribute to association of the polymorphism with bipolar disorder and depression. © 2014 International Society for Neurochemistry.

Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is constantly evolving mutations in the Spike protein to evade humoral immunity. Respiratory tract antiviral IgA antibodies are superior to circulating IgG antibodies in preventing SARS-CoV-2 infection. However, the role of innate immune signals required for the induction of mucosal IgA against SARS-CoV-2 infection is unknown. Here we show that hamsters recovered from ancestral SARS-CoV-2 infection are cross-protected against heterologous SARS-CoV-2 alpha, gamma, delta, and omicron BA.1 variants. Intranasal vaccination with an inactivated whole virus vaccine completely protects hamsters against heterologous SARS-CoV-2 infection. In addition, we show that intranasal boost vaccination of mice recovered from SARS-CoV-2 infection with unadjuvanted Spike protein induces robust levels of respiratory anti-Spike IgA and protects the mice from a heterologous SARS-CoV-2 infection. Furthermore, our findings suggest that MyD88 and MAVS play a role in the induction of the memory IgA response following an intranasal booster with unadjuvanted Spike protein in mice recovered from the SARS-CoV-2 infection. These findings provide a useful basis for the development of cross-protective mucosal vaccines against heterologous SARS-CoV-2 infection.

We describe findings from a research partnership involving a global airline manufacturing company (The Boeing Company), and learning scientists and aeronautical engineers from the University of Washington. Our starting point for the partnership focused on an 8-hour introductory composites course that was designed for company employees. In phase one, learning scientists observed the company's course development activities and the course as taught by company experts. In phase two, we collaboratively designed and implemented a quasi-experimental study comparing two approaches to teaching. One involved lectures with PowerPoint slides. The second, a "challenge-based" learning approach, combined a set of composites-relevant challenges with individual, small-group, and large-group collaborative inquiry. Comparisons between these methods showed greater interaction among participants in the challenge-based group. In addition, the challenge-based group performed significantly better on posttest items requiring integration and synthesis of concepts. Increased interactivity in the challenge course provided opportunities for participants to articulate connections among concepts and may have contributed to the challenge participants' better synthesis of learned concepts. This work highlighted the benefits for learning scientists of collaborating with industry partners to explore learning in workplace settings, as these settings provide illuminating contrasts to the structures of teaching, learning, and assessment found in schools. (Contains 2 tables, 4 figures and 1 footnote.)

The Urban Data Space for Green Deal - USAGE - project is founded by the European Union (EU) to support the green transition of cities. Within USAGE, a series of geospatial, thematic and other datasets have been newly acquired or created to test and evaluate solutions (i) to better understand issues and trends on how our planet and its climate are changing and (ii) to address the role that humans play in these changes, e.g., with behaviour adaptation and mitigation actions. The paper aims to provide some relevant datasets collected in two urban areas, reporting processing methodologies and applications of analysis-ready and decision-ready geospatial data. The shared data are unique urban datasets due to their resolutions and sensors type and could boost progresses of geospatial procedures to create and use data useful for climate change adaptation, renewable energy monitoring and management, etc. [ABSTRACT FROM AUTHOR]

Abstract Background Hospitals should prepare for emerging diseases and protect healthcare workers (HCWs) from work-related infection. This study aims to assess public hospital preparedness for the coronavirus disease 2019 (COVID-19) a year after the Myanmar government began implementing COVID-19 prevention measures, and to identify factors associated with work-related COVID-19 infection among HCWs in Myanmar. Methods In January 2021, data were collected from 101 hospitals and 706 HCWs who had COVID-19 in Myanmar in 2020. Data from the hospitals included basic information, the status of infection prevention and control (IPC), the preparedness for COVID-19 (guidelines, checklists, fever screening, patient pathway, and training), handwashing facilities, and availability of personal protective equipment (PPE). Data of COVID-19 infected HCWs included age, occupation, workplace, severity and source of COVID-19 infection, knowledge and practice of handwashing, and working environment. Chi-square test was performed to compare the preparedness for COVID-19 among three hospital levels (primary, secondary and tertiary levels). Logistic regression analysis was performed to identify the associated factors of work-related infection of HCWs. Results The total number of beds, HCWs, and COVID-19 patients in 2020 at the 101 hospitals was 12,888, 14,421, and 19,835, respectively. The availability of PPE was high in hospitals at all levels. Approximately 80% of hospitals had functional status of IPC, set up fever screening and patient pathway, and provided training on IPC and COVID-19. However, only 39.6% of hospitals had developed COVID-19 guidelines and 55.4% had developed checklists. The percentage of hospitals that prepared each measurement was lowest at the primary level. The factors associated with work-related COVID-19 among HCWs were being 30–39 years old, working as a doctor, working at isolation wards, having disinfection technique training, and having enough PPE at the workplace. Conclusion The preparedness for COVID-19 at public hospitals in Myanmar in January 2021 was insufficient, especially in the availability of the guidelines and checklists and at primary hospitals. A support system for hospital pandemic preparedness and monitoring of IPC implementation is needed. The government should prepare for emerging diseases and provide appropriate and adequate PPE and additional training to all HCWs, especially HCWs who work for isolation wards.

Abstract Background Desulfovibrio desulfuricans (D. desulfuricans), a commensal anaerobic gram-negative rod endemic to the soil environment and human gastrointestinal tract, rarely causes bloodstream infections. We report two rare cases of bacteremia caused by D. desulfuricans in which the intestinal tract was the portal of entry. In addition, we summarize findings on D. desulfuricans. Case presentation Case 1: A 51-year-old man presented to the emergency department with the chief complaints of fever and right lower abdominal pain. He was admitted to the hospital with ascending colonic diverticulitis and received empirical antibacterial therapy with piperacillin/tazobactam. Blood culture revealed D. desulfuricans. The patient was discharged after 2 weeks of antimicrobial therapy. Case 2: A 95-year-old woman presented to our hospital with a chief complaint of fever. Owing to an elevated inflammatory response and pyuria, the patient was diagnosed with pyelonephritis and treated with ceftriaxone. Klebsiella pneumoniae was detected in her urine culture, while D. desulfuricans was detected in her blood culture. The patient was then treated with ampicillin/sulbactam for 14 days. The fecal occult blood test result was positive, suggesting a colonic mucosal lesion, such as a malignant tumor, may have been the portal of entry for D. desulfuricans bacteremia. Previous literature reviews indicate that D. desulfuricans bacteremia often results from liver or renal abscesses, intestinal lesions, among others, serving as the portal of entry. Although no specific underlying disease has been reported, it is more common in the older population. We encountered two cases of D. desulfuricans bacteremia and combined them with 15 cases from previous studies to explore the characteristics of the disease. The proportion of patients aged $$\:\ge\:$$ 60 years was 73.7%; overall, 73.7% had gastrointestinal complications, and 63.2% had abdominal symptoms at the time of presentation. Conclusions We encountered two rare cases of D. desulfurican bacteremia. This type of bacteremia is more common in elderly people over 60 years of age and is often associated with hepatobiliary and gastrointestinal diseases.

The advancement in depth-sensor technology increased the potential for the clinical use of markerless three-dimensional motion analysis (3DMA); however, the accurate quantification of depth-sensor-based 3DMA on gait characteristics deviating from normal patterns is unclear. This study investigated the concurrent validity of the measurements of compensatory movements measured by depth-sensor-based 3DMA compared to those measured by marker-based 3DMA. We induced swing-phase compensatory movements due to insufficient toe clearance by restricting unilateral ankle and knee joint movements in healthy individuals. Thirty-two healthy young adults (nineteen males, aged 20.4 ± 2.0 years, height 164.4 ± 9.8 cm, weight 60.0 ± 9.3 kg [average ± standard deviation]) walked the 6 m walkway in slow speed, very slow speed, and knee–ankle–foot orthosis (KAFO; participants wore KAFOs on the right leg) conditions. Gait kinematics were measured with marker-based and depth-sensor-based 3DMA systems. The intraclass correlation coefficient (ICC3,1) was used to measure the relative agreement between depth-sensor-based and marker-based 3DMA and demonstrated good or moderate validity for swing-phase compensatory movement measurement. Additionally, the ICC2,1 measured absolute agreement between the systems and showed lower validity than the ICC3,1. The measurement errors for contralateral vaulting, trunk lateral flexion, hip hiking, swing-side hip abduction, and circumduction between instruments were 0.01 m, 1.30°, 1.99°, 2.37°, and 1.53°, respectively. Depth-sensor-based 3DMA is useful for determining swing-phase compensatory movements, although the possibility of missing a slight measurement error of 1–2° must be considered.

Since most genetically modified mice are C57BL/6 background, a mouse-adapted SARS-CoV-2 that causes lethal infection in young C57BL/6 mice is useful for studying innate immune protection against SARS-CoV-2 infection. Here, we established two mouse-adapted SARS-CoV-2, ancestral and Delta variants, by serial passaging 80 times in C57BL/6 mice. Although young C57BL/6 mice were resistant to infection with the mouse-adapted ancestral SARS-CoV-2, the mouse-adapted SARS-CoV-2 Delta variant caused lethal infection in young C57BL/6 mice. In contrast, MyD88 and IFNAR1 KO mice exhibited resistance to lethal infection with the mouse-adapted SARS-CoV-2 Delta variant. Treatment with recombinant IFN-α/β at the time of infection protected mice from lethal infection with the mouse-adapted SARS-CoV-2 Delta variant, but intranasal administration of recombinant IFN-α/β at 2 days post infection exacerbated the disease severity following the mouse-adapted ancestral SARS-CoV-2 infection. Moreover, we showed that TNF-α amplified by type I IFN signals exacerbated the SARS-CoV-2 infection by stimulating CXCL1 production from macrophages and neutrophil recruitment into the lung tissue. Finally, we showed that intravenous administration to mice or hamsters with TNF protease inhibitor 2 alleviated the severity of SARS-CoV-2 and influenza virus infection. Our results uncover an unexpected mechanism by which type I interferon-mediated TNF-α signaling exacerbates the disease severity and will aid in the development of novel therapeutic strategies to treat respiratory virus infection and associated diseases such as influenza and COVID-19.

Objectives To investigate the details of disaster-related deaths due to the indirect health effects of the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident following the Great East-Japan Earthquake in 2011 and serve as a source of reference in the event of similar circumstances in the future.Design A retrospective observational study.Setting Minamisoma City, Fukushima Prefecture, Japan, which is located 13–38 km north of the FDNPP.Participants 520 residents of Minamisoma City, Fukushima Prefecture, who were certified as having died from disaster-related causes between September 2011 and February 2021.Results The most common cause of death was circulatory system diseases (27.7%), followed by respiratory system diseases (25.0%) and neoplasms (15.4%). The prevalence of circulatory and respiratory diseases is higher in older people, suggesting that they are more susceptible to indirect health effects due to the environmental changes related to evacuation. Malignant neoplasms accounted for the third and leading cause of death overall and for people in their 50s, respectively, implying the potential impact of evacuation on cancer diagnosis and treatment. Suicide is the leading cause of death among younger people and can occur even long after a disaster, which shows the psychological impact of environmental changes.Conclusion To prevent indirect disaster-related deaths in the future, it is important to consider appropriate intervention methods by age group and period since disaster occurrence. It is especially important to improve the environment of evacuation shelters and establish a healthcare system for evacuees, create a system for cancer screening and treatment during evacuation and expand long-term suicide prevention measures.

IntroductionRelocation after a disaster often has negative health effects on vulnerable people, particularly older adults. However, little is known about the number of repeated evacuations and relocations after disasters among those experienced disaster-related deaths. This case series aimed to summarize the secondary problems and mortality risks in patients involved in relocation after disasters.MethodsWe analyzed and summarized the data on 520 disaster-related deaths in Minamisoma City, a municipality near the Fukushima Daiichi Nuclear Power Plant, focusing on the number of relocations. Herein, we describe the cases of three individuals over 80 years old, who died after eight or more relocations, which were certified as disaster-related deaths.ResultsWe discuss following three cases, which are (1) a female patient in her 90s who had a stroke and was completely disabled, (2) a female patient in her 80s whose cancer was detected later due to her failing to see her family doctor, and (3) a male patient in his 80s whose regular postoperative treatment was disrupted following cancer recurrence.DiscussionOur findings indicate that evacuation led to the worsening of chronic diseases and eventually to post-disaster death. Prolonged wide-area evacuation and repeated relocation likely interrupted the continuum of care and led to the failure of adequate care provision. To reduce the loss of human life, it is necessary to review the number of wide-area evacuations and relocations over the medium to long term after large-scale disasters, including nuclear disasters, which may occur in the future. Simultaneously, it is important to establish a medical system at the evacuation site so that disaster victims can continue to receive medical care even after evacuation or relocation.

This paper reports a methodological exploration combining image network analysis and standardized practice analysis on social media data. Through applying the open source software Memespector to access the Clarifai API, the potential of an easy-at-hand image tagging tool as an instrument to manage larger data corpora is explored. Using the example of the German-speaking Twitter hashtag #systemrelevant, we relate image clusters to the results of standardized practice analysis of posts that contain images. The proposed method is intended for research that attempts to carve out the co-constituting of public discourse in social media by different groups of actors. The approach systematically differentiates the contributions of societal groups such as journalism, civil society, or private individuals, and the embedding of their tweets in selected anchoring practices and further modalities of participation. Altogether, the multistep analytical process offers a possible approach to process larger image corpora, while maintaining a sensitivity for the practice-theoretical demand of (re)contextualizing image use.

Improving the time resolution in microdialysis coupled to high performance liquid chromatography (HPLC) requires that the volume of the separation system be decreased. A low-volume separation permits smaller microdialysate volumes to be injected without suffering a sensitivity loss from dilution. Thus, improved time resolution can be achieved with offline analysis simply by decreasing the separations system volume. For online (near real-time) analysis, there is a further requirement. The separation speed must be at least as fast as the sampling time. Here, the combined use of high column pressures and temperatures, sub-2-[micro]m stationary phase particles, capillary columns, and sensitive, low dead-volume detection resulted in a retention time for the neurotransmitter sorotonin of less than 1 min in a 500 nL dialysate sample volume. Two sensitive detectors, photoluminescence following electron transfer (PFET) and electrochemical, were used for the detection of subnanomolar concentrations of sorotonin in brain microdialysate samples. The general principles developed are applicable to a wide range of separations with the additional advantages of increases in sample throughput and decreases in mobile phase usage. 10.1021/ac102200q

Following the Great East Japan Earthquake (GEJE) and the Fukushima Daiichi nuclear power plant accident in 2011, mandatory evacuation orders were issued to residents living near the nuclear power plant in Fukushima prefecture, including some patients receiving home oxygen therapy. Although the vulnerability of patients with home oxygen therapy (one of the population groups most vulnerable to disasters) has been noted, there is little information on the health effects of evacuation in the event of a radiation disaster. A 90-year-old man diagnosed with chronic obstructive pulmonary disease since the age of 70, and lived in a town located approximately 20 km south of the nuclear power plant, died 8 months after the disaster due to worsening health conditions. This case reveals the potential for both physical and psychological burdens experienced by vulnerable groups like patients undergoing home oxygen therapy during evacuations in times of disaster. Although it is only a case report and the information is limited, severe respiratory distress requiring home oxygen therapy may present a significant risk factor for disaster-related deaths, especially in cases where evacuations are prolonged, such as in nuclear disasters. Due to the challenge of obtaining prompt public support immediately after a disaster, home oxygen therapy patients may need to prioritize self-help and mutual assistance in their disaster preparedness efforts.

Abstract The medical situation during disasters often differs from that at usual times. Disasters can lead to significant mortality that can be difficult to monitor. The types of disaster-related deaths are largely unknown. In this study, we conducted a survey to categorize the disaster-related deaths caused by a radiation disaster. A total of 520 people living in Minamisoma City, Fukushima Prefecture, at the time of the Fukushima Daiichi Nuclear Power Plant accident, who were certified to have died due to disaster-related causes were surveyed. We divided the participants into those who were at home at the time of the earthquake and those who were in hospitals or facilities when the disaster struck and conducted a hierarchical cluster analysis of the two groups. Disaster-related deaths could be divided into seven groups for those who were at home at the time of the disaster and five groups for those who were in hospitals or facilities at the time of the disaster. Each group showed different characteristics, such as "the group with disabilities," "the group receiving care," and "the group with depression," and it became evident that not only uniform post-disaster support, but support tailored to the characteristics of each group is necessary.

Abstract Plasmodium falciparum erythrocyte binding antigen 175 (PfEBA-175) plays essential role in erythrocyte invasion by the parasite and is a leading vaccine candidate. However, its genetic diversity in global isolates is a concern in developing an universal vaccine incorporating this protein. This study aimed to investigate genetic polymorphisms and natural selection of pfeba-175 region II (RII) in Myanmar and Vietnam P. falciparum isolates. Vietnam pfeba-175 RII displayed a low genetic polymorphism, while Myanmar pfeba-175 RII showed high levels of genetic diversity across the region. Point mutations, deletion, and recombinations were main factors contributing to genetic diversities in P. falciparum populations. Global pfeba-175 RII revealed similar, but not identical, genetic polymorphisms and natural selection profiles. Despite profiles of amino acid substitutions differed among populations, five major amino acid changes (K279E, E403K, K481I, Q584K, and R664) were commonly detected in global pfeba-175 RII populations. Haplotype network and genetic differentiation analyses of global pfeba-175 RII populations demonstrated no geographical relationships. Non-neglectable level of genetic diversity was observed in global pfeba-175 RII populations, emphasizing the need to consider this when designing an effective vaccine based on this protein. This study underscores the importance of the continuous monitoring of genetic diversity of pfeba-175 RII in the global P. falciparum populations.

As we learned during the COVID-19 pandemic, vaccines are one of the most important tools in infectious disease control. To date, an unprecedentedly large volume of high-quality data on COVID-19 vaccinations have been accumulated. For preparedness in future pandemics beyond COVID-19, these valuable datasets should be analyzed to best shape an effective vaccination strategy. We are collecting longitudinal data from a community-based cohort in Fukushima, Japan, that consists of 2,407 individuals who underwent serum sampling two or three times after a two-dose vaccination with either BNT162b2 or mRNA-1273. Using the individually reconstructed time courses of the vaccine-elicited antibody response based on mathematical modeling, we first identified basic demographic and health information that contributed to the main features of the antibody dynamics, i.e., the peak, the duration, and the area under the curve. We showed that these three features of antibody dynamics were partially explained by underlying medical conditions, adverse reactions to vaccinations, and medications, consistent with the findings of previous studies. We then applied to these factors a recently proposed computational method to optimally fit an "antibody score", which resulted in an integer-based score that can be used as a basis for identifying individuals with higher or lower antibody titers from basic demographic and health information. The score can be easily calculated by individuals themselves or by medical practitioners. Although the sensitivity of this score is currently not very high, in the future, as more data become available, it has the potential to identify vulnerable populations and encourage them to get booster vaccinations. Our mathematical model can be extended to any kind of vaccination and therefore can form a basis for policy decisions regarding the distribution of booster vaccines to strengthen immunity in future pandemics.

Background: Refugees are among the most health-vulnerable members of society. Despite the importance of vaccination to mitigate the risks associated with COVID-19 infection, ensuring adequate access and uptake of the COVID-19 vaccine remains a pressing concern for refugee populations. Research has suggested that community-oriented approaches and open communication with trusted individuals are essential to address this challenge. Vaccine outreach efforts were performed in Syracuse, NY, by Community Health Workers (CHWs) as trusted refugee community members. This study explored CHWs’ experiences during vaccine outreach and perceptions about COVID-19 vaccine hesitancy and acceptance among refugees, including barriers and facilitators to vaccination. Methods: A qualitative study was performed using thematic analysis following six semi-structured interviews with CHWs. Results: Four main themes supported by 16 sub-themes were extracted. CHWs described the (1) diverse beliefs and attitudes of refugees by ethnic group, with most having low vaccine acceptance at first. (2) Barriers included contextual barriers, lack of awareness, misinformation, and withdrawal when forced from vaccine mandates. However, CHWs also identified numerous (3) facilitators to vaccination, including the internal processing and eventual vaccine acceptance, supported by external messaging by CHWs and time. Culturally sensitive intervention strategies occurred through (4) CHW team efforts and their provision of reliable information to refugee clients, with openness and over time. The team efforts of CHWs significantly contributed to refugee acceptance and uptake of the COVID-19 vaccine. Conclusions: This study revealed how the refugee population changed their belief towards the COVID-19 vaccine through trust, time, and reliable information provided by CHWs and describes culturally sensitive strategies for vaccine uptake by refugees. CHWs' reflection on COVID-19 vaccine hesitancy and acceptance among refugees during outreach efforts is an essential perspective when implementing future public health interventions.