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Background Pre-existing cardiovascular disease (CVD) or cardiovascular risk factors have been associated with an increased risk of complications following hospitalisation with COVID-19, but their impact on the rate of recovery following discharge is not known.Objectives To determine whether the rate of patient-perceived recovery following hospitalisation with COVID-19 was affected by the presence of CVD or cardiovascular risk factors.Methods In a multicentre prospective cohort study, patients were recruited following discharge from the hospital with COVID-19 undertaking two comprehensive assessments at 5 months and 12 months. Patients were stratified by the presence of either CVD or cardiovascular risk factors prior to hospitalisation with COVID-19 and compared with controls with neither. Full recovery was determined by the response to a patient-perceived evaluation of full recovery from COVID-19 in the context of physical, physiological and cognitive determinants of health.Results From a total population of 2545 patients (38.8% women), 472 (18.5%) and 1355 (53.2%) had CVD or cardiovascular risk factors, respectively. Compared with controls (n=718), patients with CVD and cardiovascular risk factors were older and more likely to have had severe COVID-19. Full recovery was significantly lower at 12 months in patients with CVD (adjusted OR (aOR) 0.62, 95% CI 0.43 to 0.89) and cardiovascular risk factors (aOR 0.66, 95% CI 0.50 to 0.86).Conclusion Patients with CVD or cardiovascular risk factors had a delayed recovery at 12 months following hospitalisation with COVID-19. Targeted interventions to reduce the impact of COVID-19 in patients with cardiovascular disease remain an unmet need.Trail registration number ISRCTN10980107.

Abstract Objectives The clinical activity score (CAS) and European severity scale (ESS) are established clinical tools to assess thyroid eye disease (TED) but are limited in terms of subjectivity and their reliability in non-Caucasian individuals, and can underestimate significant disease in the posterior orbit. Preliminary data from pilot studies have shown that diffusion-weighted imaging (DWI) using extraocular muscle (EOM) apparent diffusion coefficient (ADC) measurements may provide complementary information in TED. This study expands on previous research to assess for correlations between clinical scores and EOM-ADCs in stratifying disease activity and severity in a large patient cohort from an ethnically diverse population. Methods A retrospective review of TED clinics between 2011 and 2021 identified 96 patients with a documented CAS and ESS and an orbital MRI that included DWI. From regions of interest manually placed on EOM bellies, the highest ADC was computed for each patient and analysed for correlations and associations with CAS and ESS using Spearman Rank correlation and Mann–Whitney U tests, and any potential discriminatory cut-offs using Receiver Operator Curve analyses. A p-value

Our understanding of bird song, a model system for animal communication and the neurobiology of learning, depends critically on making reliable, validated comparisons between the complex multidimensional syllables that are used in songs. However, most assessments of song similarity are based on human inspection of spectrograms, or computational methods developed from human intuitions. Using a novel automated operant conditioning system, we collected a large corpus of zebra finches' (Taeniopygia guttata) decisions about song syllable similarity. We use this dataset to compare and externally validate similarity algorithms in widely-used publicly available software (Raven, Sound Analysis Pro, Luscinia). Although these methods all perform better than chance, they do not closely emulate the avian assessments. We then introduce a novel deep learning method that can produce perceptual similarity judgements trained on such avian decisions. We find that this new method outperforms the established methods in accuracy and more closely approaches the avian assessments. Inconsistent (hence ambiguous) decisions are a common occurrence in animal behavioural data; we show that a modification of the deep learning training that accommodates these leads to the strongest performance. We argue this approach is the best way to validate methods to compare song similarity, that our dataset can be used to validate novel methods, and that the general approach can easily be extended to other species.

ABSTRACT The Type VI secretion system (T6SS) is a multicomponent apparatus, present in many Gram-negative bacteria, which can inhibit bacterial prey in various ecological niches. Pseudomonas aeruginosa assembles one of its three T6SS (H1-T6SS) to respond to attacks from adjacent competing bacteria. Surprisingly, repeated assemblies of the H1-T6SS, termed dueling, were described in a monoculture in the absence of an attacker strain; however, the underlying mechanism was unknown. Here, we explored the role of H2-T6SS of P. aeruginosa in triggering H1-T6SS assembly. We show that H2-T6SS inactivation in P. aeruginosa causes a significant reduction in H1-T6SS dueling and that H2-T6SS activity directly triggers retaliation by the H1-T6SS. Intraspecific competition experiments revealed that elimination of H2-T6SS in non-immune prey cells conferred protection from H1-T6SS. Moreover, we show that the H1-T6SS response is triggered independently of the characterized lipase effectors of the H2-T6SS, as well as those of Acinetobacter baylyi and Vibrio cholerae. Our results suggest that H1-T6SS response to H2-T6SS in P. aeruginosa can impact intraspecific competition, particularly when the H1-T6SS effector-immunity pairs differ between strains, and could determine the outcome of multistrain colonization.IMPORTANCEThe opportunistic pathogen Pseudomonas aeruginosa harbors three different Type VI secretion systems (H1, H2, and H3-T6SS), which can translocate toxins that can inhibit bacterial competitors or inflict damage to eukaryotic host cells. Unlike the unregulated T6SS assembly in other Gram-negative bacteria, the H1-T6SS in P. aeruginosa is precisely assembled as a response to various cell damaging attacks from neighboring bacterial cells. Surprisingly, it was observed that neighboring P. aeruginosa cells repeatedly assemble their H1-T6SS toward each other. Mechanisms triggering this “dueling” behavior between sister cells were unknown. In this report, we used a combination of microscopy, genetic and intraspecific competition experiments to show that H2-T6SS initiates H1-T6SS dueling. Our study highlights the interplay between different T6SS clusters in P. aeruginosa, which may influence the outcomes of multistrain competition in various ecological settings such as biofilm formation and colonization of cystic fibrosis lungs.

COVID-19 vaccination effectively reduces disease severity, hospitalization, and mortality, particularly among individuals with chronic conditions who bear a disproportionate burden of disease complications. Vaccine confidence – belief in its safety, effectiveness, and importance – boosts uptake. However, limited data on vaccine confidence in this population hinders the development of targeted interventions. This study examined COVID-19 vaccine confidence and its impact on uptake among individuals with hypertension or diabetes mellitus in the Kilimanjaro region, Tanzania. A community-based cross-sectional study was conducted in March 2023 among 646 randomly selected adults aged ≥18 years with hypertension or diabetes mellitus in three districts of Kilimanjaro region, northern Tanzania. An interviewer-administered electronic questionnaire assessed confidence and uptake of COVID-19 vaccines in addition to related knowledge and demographic characteristics. Data analysis was done for 646 individuals who consented to participate. Multivariable logistic regression models determined the factors associated with COVID-19 vaccine confidence and its effect on vaccine uptake. The proportion of COVID-19 vaccine confidence among all 646 participants was 70% and was highest for perceived vaccine importance (80%), followed by perceived vaccine effectiveness (77%) and perceived vaccine safety (74%). Good knowledge of COVID-19 vaccines and living in the Mwanga municipal council (MC), a semi-urban district, was independently associated with confidence in the vaccines’ importance, safety, effectiveness, and overall COVID-19 vaccine confidence. Confidence in COVID-19 vaccines increased the odds of vaccine uptake. Targeted interventions to boost vaccine confidence are therefore essential to enhance vaccine uptake in this high-risk population.

Abstract Large cell lung cancer metastases to the testis are scarce, although it is the most common malignancy and the most common site of metastases for breast, colorectal and kidney cancers. We hereby report a 28‐year‐old male patient admitted to our hospital with a chief complaint of scrotal enlargement, accompanied by chest pain and progressive dyspnea. The definite diagnosis was malignant pleural mesothelioma with the synchronous occurrence of large cell lung cancer with testicular metastasis. Sophisticated clinical manifestation of symptoms led to a time‐consuming diagnosis, while the patient's condition deteriorated rapidly. Herein, we present this case to share our hard‐learnt experience to increase clinician awareness and contribute to the information in the literature.

Bullying is a worldwide concern and erroneous perceptions of the phenomenon could underscore unsustainable interventions. The purpose of this qualitative exploratory case study was to examine, in-depth, how some high school teachers from two schools in New Jersey perceived student bullying. The primary research question was: What perceptions do teachers have about student bullying? The main data were from face-to-face interviews with 14 teachers who answered semi-structured, open-ended questions. Secondary data originated from physical artefacts. The data analysis consisted of four phases. Inductive analysis allowed for the composition of individual cases. Cross-case analysis allowed data classification into three main areas of inquiry aligned with the three secondary research questions (a) bullying and victimisation dynamics as perceived by teachers, (b) adequacy of current interventions, and (c) adequacy of teachers' professional development for bullying mitigation. The data unveiled inconsistencies between causes of bullying and interventions. It culminated in recommendations for leadership and suggestions for future research.

The collapse of an abdominal aortic endograft is a rare event. We present the case of a 60-year-old man with an abdominal endograft who came to the emergency department with chest, back, abdominal, and lower extremity pain in addition to a cool left foot. On imaging, he was found to have a type B aortic dissection and a collapsed abdominal endograft. Subsequently, the patient was taken to the operating room and treated with a thoracic endovascular aortic repair, abdominal aortic cuff, and an iliac stent. Our study details this case and thoroughly reviews similar cases in the literature.

To enable chemical speciation, monitoring networks collect particulate matter (PM) on different filter media, each subjected to one or more analytical techniques to quantify PM composition present in the atmosphere. In this work, we propose an alternate approach that uses one filter type (teflon or polytetrafluoroethylene, PTFE, commonly used for aerosol sampling) and one analytical method, Fourier transform infrared (FT-IR) spectroscopy to measure almost all of the major constituents in the aerosol. In the proposed method, measurements using the typical multi-filter, multi-analytical techniques are retained at a limited number of sites and used as calibration standards. At all remaining sites, only sampling on PTFE and analysis by FT-IR is performed. This method takes advantage of the sensitivity of the mid-IR domain to various organic and inorganic functional groups and offers a fast and inexpensive way of exploring sample composition. As a proof of concept, multiple years of samples collected within the Interagency Monitoring of PROtected Visual Environment network (IMPROVE) are explored with the aim of retaining high quality predictions for a broad range of atmospheric compounds including mass, organic (OC), elemental (EC), and total (TC) carbon, sulfate, nitrate, and crustal elements. Findings suggest that models based on only 21 sites, covering spatial and seasonal trends in atmospheric composition, are stable over a 3 year period within the IMPROVE network with acceptable prediction accuracy (R2 > 0.9, median bias less than 3 %) for most constituents. The major limitation is measuring nitrate as it is known to volatilize off of PTFE filters. Incorporating additional sites at low cost, partially replacing existing, more time- and cost-intensive techniques, or using the FT-IR data for quality control or substitute for missing data, are among the potential benefits of the one-filter, one-method approach.

Megacities and other major population centres (MPCs) worldwide are major sources of air pollution, both locally as well as downwind. The overall assessment and prediction of the impact of MPC pollution on tropospheric chemistry are challenging. The present work provides an overview of the highlights of a major new contribution to the understanding of this issue based on the data and analysis of the EMeRGe (Effect of Megacities on the transport and transformation of pollutants on the Regional to Global scales) international project. EMeRGe focuses on atmospheric chemistry, dynamics, and transport of local and regional pollution originating in MPCs. Airborne measurements, taking advantage of the long range capabilities of the High Altitude and LOng Range Research Aircraft (HALO, https://www.halo-spp.de, last access: 22 March 2022), are a central part of the project. The synergistic use and consistent interpretation of observational data sets of different spatial and temporal resolution (e.g. from ground-based networks, airborne campaigns, and satellite measurements) supported by modelling within EMeRGe provide unique insight to test the current understanding of MPC pollution outflows. In order to obtain an adequate set of measurements at different spatial scales, two field experiments were positioned in time and space to contrast situations when the photochemical transformation of plumes emerging from MPCs is large. These experiments were conducted in summer 2017 over Europe and in the inter-monsoon period over Asia in spring 2018. The intensive observational periods (IOPs) involved HALO airborne measurements of ozone and its precursors, volatile organic compounds, aerosol particles, and related species as well as coordinated ground-based ancillary observations at different sites. Perfluorocarbon (PFC) tracer releases and model forecasts supported the flight planning, the identification of pollution plumes, and the analysis of chemical transformations during transport. This paper describes the experimental deployment and scientific questions of the IOP in Europe. The MPC targets – London (United Kingdom; UK), the Benelux/Ruhr area (Belgium, the Netherlands, Luxembourg and Germany), Paris (France), Rome and the Po Valley (Italy), and Madrid and Barcelona (Spain) – were investigated during seven HALO research flights with an aircraft base in Germany for a total of 53 flight hours. An in-flight comparison of HALO with the collaborating UK-airborne platform Facility for Airborne Atmospheric Measurements (FAAM) took place to assure accuracy and comparability of the instrumentation on board. Overall, EMeRGe unites measurements of near- and far-field emissions and hence deals with complex air masses of local and distant sources. Regional transport of several European MPC outflows was successfully identified and measured. Chemical processing of the MPC emissions was inferred from airborne observations of primary and secondary pollutants and the ratios between species having different chemical lifetimes. Photochemical processing of aerosol and secondary formation or organic acids was evident during the transport of MPC plumes. Urban plumes mix efficiently with natural sources as mineral dust and with biomass burning emissions from vegetation and forest fires. This confirms the importance of wildland fire emissions in Europe and indicates an important but discontinuous contribution to the European emission budget that might be of relevance in the design of efficient mitigation strategies. The present work provides an overview of the most salient results in the European context, with these being addressed in more detail within additional dedicated EMeRGe studies. The deployment and results obtained in Asia will be the subject of separate publications.

Abstract Background Cardiovascular disease is prevalent in idiopathic pulmonary fibrosis (IPF), yet the extent of left-sided heart failure (HF) burden, whether this has changed with time and whether HF impacts mortality risk in these patients are unknown. The aims of this study were therefore to determine the temporal trends in incidence and prevalence of left-sided HF in patients with IPF in England and compare these to published estimates in the general population and those with comparable chronic respiratory conditions such as chronic obstructive pulmonary disease (COPD), as well as determine the risk of all-cause and cause-specific mortality in patients with comorbid left-sided HF and IPF at population-level using electronic healthcare data. Methods Clinical Practice Research Datalink (CPRD) Aurum primary-care data linked to mortality and secondary-care data was used to identify IPF patients in England. Left-sided HF prevalence and incidence rates were calculated for each calendar year between 2010 and 2019, stratified by age and sex. Risk of all-cause, cardiovascular and IPF-specific mortality was calculated using multivariate Cox regression. Results From 40,577patients with an IPF code in CPRD Aurum, 25, 341 IPF patients met inclusion criteria. Left-sided HF prevalence decreased from 33.4% (95% CI 32.2–34.6) in 2010 to 20.9% (20.0–21.7) in 2019. Left-sided HF incidence rate per 100 person-years (95% CI) remained stable between 2010 and 2017 but decreased from 4.3 (3.9–4.8) in 2017 to 3.4 (3.0–3.9) in 2019. Throughout follow-up, prevalence and incidence were higher in men and with increasing age. Comorbid HF was associated with poorer survival (adjusted HR (95%CI) 1.08 (1.03–1.14) for all-cause mortality; 1.32 (1.09–1.59) for cardiovascular mortality). Conclusion Left-sided HF burden in IPF patients in England remains high, with incidence almost 4 times higher than in COPD, a comparable lung disease with similar cardiovascular risk factors. Comorbid left-sided HF is also a poor prognostic marker. More substantial reduction in left-sided HF prevalence than incidence suggests persistently high IPF mortality. Given rising IPF incidence in the UK, this calls for better management of comorbidities such as left-sided HF to help optimise IPF survival.

Paul George and colleagues developed a conductive polymer system to enable stem cell delivery and electrical modulation in vivo. Employing this system improved functional stroke recovery in rodents and identified important repair pathways.

Background: COVID-19 is an emerging infectious disease with a global outreach. Leptospirosis is a zoonotic disease mainly confined to tropical areas. In both cases, most of those affected are asymptomatic or have only mild respiratory disease. Those who turn critical develop acute respiratory distress syndrome (ARDS) and/or multiple-organ failure occurs rapidly, with high fatality. Methodology: This is a retrospective observational study from 2020 involving COVID-19 and leptospirosis patients. The data were collected using a semi-structured proforma, and analysis was performed using Easy R (EZR) software. Results: There were five patients with COVIDC-19 and four patients with leptospirosis; with pulmonary involvement. All the patients were males. There was no significant difference in age, the onset of pulmonary involvement, time of initiation of steroids, duration of steroids, and outcome between the two groups. However, in the case of COVID-19, it took a longer period for clearing of infiltrates. Conclusion: Though COVID-19 and leptospirosis are two different diseases, both of them show a similar life-saving response to steroids, the common factor in the pathogenesis being cytokine storm. Primary care physicians in tropical areas of the world should be aware of the similarities between these two diseases, especially the initial clinical presentation, the pathogenesis, and the response to steroids.

The patient was a 58-year-old man with a history of hypertension who had incidentally been found to have a 2.7-cm dissecting fusiform superior mesenteric artery aneurysm involving a long segment of a proximal to distal superior mesenteric artery. Double-lumen anatomy was present, with the true lumen perfusing the proximal and mid-small bowel and the false lumen perfusing the distal small bowel and the ileocolic artery. The patient elected to undergo endovascular repair using double-barrel stenting with self-expanding and balloon-expandable covered stents, as described. Computed tomography angiography after 1 year demonstrated patent stents.

الملخص: يعتبر فرط نشاط جارة الدرقية الأولي الناجم عن ورم غدد جارات الدرقية خارج مكانها المعتاد في منطقة المنصف اكتشافا نادرا. نقدم هنا حالة من فرط نشاط جارة الدرقية الأولي الناجم عن ورم غدد جارات الدرقية خارج مكانها المعتاد يقع في منطقة المنصف لرجل يبلغ من العمر ٧٥ عاما. بداية تمت إحالة هذا المريض إلى العيادة للتحقيق في ارتفاع نسبة الكالسيوم في الدم الذي تم تشخيصه صدفة. وأظهر تصويره الأولي غدتين مشبوهتين، واحدة مجاورة للغدة الدرقية والأخرى في منطقة المنصف. عند التحقق بدراسات متكررة وإضافية، تم تحديد الغدة المنصفية لوحدها فقط باعتبارها الغدة المشبوهة المحتملة لورم غدة جارة الدرقية وتم التأكيد على ذلك بعد اعتدال مستويات هرمون الغدة جارة الدرقية بعد الاستئصال الجراحي. يمكن أن يكون التشخيص الدقيق لمثل هذه الحالات أمرا صعبا؛ واستخدام دراسة أشعة واحدة مثل التصوير بالموجات فوق الصوتية أو التصوير المقطعي المحوسب أو التصوير النووي وحده قد لا يؤدي إلى نتائج قاطعة أو يمكن أن يعطي نتائج إيجابية خاطئة. توضح حالتنا أن طرق التصوير المتعددة المستخدمة مجتمعة يمكن أن تؤدي إلى تشخيص دقيق لسبب فرط نشاط جارات الدرقية الأولي. وبالتالي يؤدي ذلك إلى تجنيب المرضى إجراءات استئصال جراحية إضافية غير ضرورية أو من ناحية أخرى، تقليل فرص نسيان مصادر أخرى للإفراز خارج مكانها المعتاد. Abstract: Primary hyperparathyroidism caused by an ectopic parathyroid adenoma in the mediastinum is a rare clinical condition. We present a 75-year-old male with primary hyperparathyroidism caused by an ectopic parathyroid adenoma in the mediastinum. This patient was initially referred to the clinic for suspected incidental hypercalcemia. Initial imaging showed two suspicious lesions: one adjacent to the thyroid gland and another in the mediastinum. Further investigations identified a sole mediastinal adenoma. The diagnosis was confirmed by normalization of parathyroid hormone levels after its surgical resection. Thoroughly diagnosing such cases can prove challenging and using a single modality such as ultrasonography, computed tomography, or nuclear imaging alone may not yield conclusive findings or can give false positive results. Our case demonstrates that a combination of several imaging modalities can lead to accurate localization of the cause of primary hyperparathyroidism. This will obviate the performance of unnecessary surgical procedures. In addition, the possibility of missing additional sources of ectopic secretions of the parathyroid hormone will be reduced.

Abstract Historical records document medieval immigration from North Africa to Iberia to create Islamic al-Andalus. Here, we present a low-coverage genome of an eleventh century CE man buried in an Islamic necropolis in Segorbe, near Valencia, Spain. Uniparental lineages indicate North African ancestry, but at the autosomal level he displays a mosaic of North African and European-like ancestries, distinct from any present-day population. Altogether, the genome-wide evidence, stable isotope results and the age of the burial indicate that his ancestry was ultimately a result of admixture between recently arrived Amazigh people (Berbers) and the population inhabiting the Peninsula prior to the Islamic conquest. We detect differences between our sample and a previously published group of contemporary individuals from Valencia, exemplifying how detailed, small-scale aDNA studies can illuminate fine-grained regional and temporal differences. His genome demonstrates how ancient DNA studies can capture portraits of past genetic variation that have been erased by later demographic shifts—in this case, most likely the seventeenth century CE expulsion of formerly Islamic communities as tolerance dissipated following the Reconquista by the Catholic kingdoms of the north.

Abstract Purpose To compare updated prospective 5-year survival outcomes of cervical cancer patients living with and without human immunodeficiency virus (HIV) infection who initiated curative chemoradiation therapy (CRT) in a resource-limited setting. Methods & Materials Women in Botswana with locally advanced cervical cancer were enrolled in a prospective, observational, cohort study from July 2013 through January 2015. Survival outcomes were analyzed after 5 years of follow-up. Results This cohort included 143 women initiating curative CRT. Sixty-seven percent (n = 96) of cohort were women living with HIV (WLWH), all of whom were receiving antiretroviral therapy (ART) at the time of treatment initiation and boasted a median CD4 count of 481 cells/μL (IQR, 351-579 μL). The 5-year overall survival (OS) rates were 56.8% (95% CI, 40.0–70.5%) for patients without HIV infection and 55.1% (95% CI, 44.2–64.7%) for WLWH (p = 0.732). Factors associated with superior 5-year OS on multivariate analyses included baseline hemoglobin > 10 g/dL (hazard ratio (HR) 0.90, 95% CI, 0.83–0.98, p = 0.015), lower stage at diagnosis (stage I and II vs. III and IV) (HR 1.39, 95% CI 1.09–1.76, p = 0.007), and higher EQD2 (HR 0.98, 95% CI 0.97–0.99, p = 0.001). Conclusions Five-year OS was not impacted by HIV status in this population of WLWH with well-managed infection who initiated curative treatment for cervical cancer in Botswana. Regardless of HIV status, hemoglobin levels and stage at diagnosis were associated with survival. These findings suggest that treatment for cervical cancer in WLWH with well-controlled infection need not be altered solely due to HIV status.

For decades, avian endocrinology has been informed by male perspectives and male-focused research, leaving significant gaps in our understanding of female birds. Male birds have been favored as research subjects because their reproductive behaviors are considered more conspicuous and their reproductive physiology is presumably less complex than female birds. However, female birds should not be ignored, as female reproductive behavior and physiology are essential for the propagation of all avian species. Endocrine research in female birds has made much progress in the last 20 years, but a substantial disparity in knowledge between male and female endocrinology persists. In this perspective piece, we provide examples of why ornithology has neglected female endocrinology, and we propose considerations for field and laboratory techniques to facilitate future studies. We highlight recent advances that showcase the importance of female avian endocrinology, and we challenge historic applications of an oversimplified, male-biased lens. We further provide examples of species for which avian behavior differs from the stereotypically described behaviors of male and female birds, warning investigators of the pitfalls in approaching endocrinology with a binary bias. We hope this piece will inspire investigators to engage in more comprehensive studies with female birds, to close the knowledge gap between the sexes, and to look beyond the binary when drawing conclusions about what is ‘male’ versus ‘female’ biology.

Implementation strategies for pharmacogenetic testing have been largely limited to major academic medical centers and large health systems, threatening to exacerbate healthcare disparities for rural and tribal populations. There exists a need in Montana (United States)—a state where two-thirds of the population live in rural areas and with a large proportion of tribal residents—to develop novel strategies to make pharmacogenetic testing more broadly available. We established partnerships between University of Montana (UM) and three early adopter sites providing patient-centered care to historically neglected populations. We conducted 45 semi-structured interviews with key stakeholders at each site and solicited participant feedback on the utility of a centralized pharmacogenetic service at UM offering consultations to patients and providers statewide via telehealth. For settings serving rural patients—tribal and non-tribal—participants described healthcare facilities without adequate infrastructure, personnel, and funding to implement pharmacogenetic services. Participants serving tribal communities stressed the need for ethical practices for collecting biospecimens and returning genetic results to patients, largely due to historical and contemporary traumas experienced by tribal populations with regard to genetic research. Participants expressed that pharmacogenetic testing could benefit patients by achieving therapeutic benefit sooner, reducing the risk of side effects, and improving adherence outcomes for patients with limited access to follow-up services in remote areas. Others expressed concern that financial barriers to pharmacogenetic testing for patients of lower socioeconomic status would further exacerbate inequities in care. Participants valued the role of telehealth to deliver pharmacogenetic consults from a centralized service at UM, describing the ability to connect providers and patients to resources and expertise as imperative to driving successful pharmacogenetic implementation. Our results support strategies to improve access to pharmacogenetic testing for neglected patient populations and create opportunities to reduce existing healthcare inequities. By exploring critical challenges for pharmacogenetic implementation focused on serving underserved communities, this work can help guide equitable frameworks to serve as a model for other resource-limited settings looking to initiate pharmacogenetic testing.

Abstract Increasing the efficiency of current forage breeding programs through adoption of new technologies, such as genomic selection (GS) and phenomics (Ph), is challenging without proof of concept demonstrating cost effective genetic gain (∆G). This paper uses decision support software DeltaGen (tactical tool) and QU-GENE (strategic tool), to model and assess relative efficiency of five breeding methods. The effect on ∆G and cost ($) of integrating GS and Ph into an among half-sib (HS) family phenotypic selection breeding strategy was investigated. Deterministic and stochastic modelling were conducted using mock data sets of 200 and 1000 perennial ryegrass HS families using year-by-season-by-location dry matter (DM) yield data and in silico generated data, respectively. Results demonstrated short (deterministic)- and long-term (stochastic) impacts of breeding strategy and integration of key technologies, GS and Ph, on ∆G. These technologies offer substantial improvements in the rate of ∆G, and in some cases improved cost-efficiency. Applying 1% within HS family GS, predicted a 6.35 and 8.10% ∆G per cycle for DM yield from the 200 HS and 1000 HS, respectively. The application of GS in both among and within HS selection provided a significant boost to total annual ∆G, even at low GS accuracy rA of 0.12. Despite some reduction in ∆G, using Ph to assess seasonal DM yield clearly demonstrated its impact by reducing cost per percentage ∆G relative to standard DM cuts. Open-source software tools, DeltaGen and QuLinePlus/QU-GENE, offer ways to model the impact of breeding methodology and technology integration under a range of breeding scenarios.

Abstract Background Low socioeconomic status (SES) in early and late life has been associated with lower late-life cognition. Less is known about how changes in SES from childhood to late life are associated with late-life cognition, especially among diverse populations of older adults. Methods In a multi-ethnic sample (n = 1353) of older adults, we used linear regression to test associations of change in comprehensive measures of SES (financial, cultural, and social domains) from childhood to late life with semantic memory, episodic memory, and executive function. We tested whether the association between SES trajectory and late-life cognition differed by populations who resided in the U.S. during childhood or immigrated to the U.S. as adults. Results Participants with low childhood/high late-life financial capital had better semantic memory (β = 0.18; 95% CI: 0.04, 0.32) versus those with low financial capital in both childhood and late life, regardless of childhood residence. We observed a significant interaction in the association of verbal episodic memory and cultural capital by childhood residence (p = 0.08). Participants with a foreign childhood residence had higher verbal episodic memory if they had low childhood/high late-life cultural capital (β = 0.32; 95% CI: 0.01, 0.63), but lower verbal episodic memory if they had high childhood/low late-life cultural capital (β = − 0.40; 95% CI: − 0.94, 0.13). Having high lifecourse social capital was associated with better verbal episodic memory scores among those with a U.S. childhood (β = 0.34; 95% CI: 0.14, 0.55), but lower verbal episodic memory among those with a foreign childhood (β = − 0.10; 95% CI: − 0.51, 0.31). Conclusions High financial and cultural capital in late life is associated with better cognition, regardless of early childhood SES or childhood residence.

Abstract We examined cross-sectional associations between arm lymphedema symptoms and health-related quality of life (HRQoL) in the Health, Eating, Activity and Lifestyle (HEAL) Study. 499 women diagnosed with localized or regional breast cancer at ages 35–64 years completed a survey, on average 40 months after diagnosis, querying presence of lymphedema, nine lymphedema-related symptoms, e.g., tension, burning pain, mobility loss, and warmth/redness, and HRQoL. Analysis of covariance models were used to assess HRQoL scores in relation to presence of lymphedema and lymphedema-related symptoms. Lymphedema was self-reported by 137 women, of whom 98 were experiencing lymphedema at the time of the assessment. The most common symptoms were heaviness (52%), numbness (47%), and tightness (45%). Perceived physical health was worse for women reporting past or current lymphedema than those reporting no lymphedema (P-value

The Vip3 family proteins from Bacillus thuringiensis are thought to exert their insecticidal activity through pore formation. Here authors present cryo-EM structures of a Vip3 family toxin in both inactive and activated forms and show the activated Vip3Bc1 in its pore forming conformation on the membrane.

A population of Haemonchus contortus that was highly resistant to benzimidazoles and avermectin/milbemycins with a subpopulation that was resistant to levamisole, was replaced with a susceptible laboratory isolate of H. contortus in a flock of sheep. The anthelmintic susceptibility and population genetics of the newly established population were evaluated for 3.5 years using in vivo, in vitro, and molecular methods. Successful replacement of the resistant population with a susceptible population was confirmed using phenotypic and genotypic measurements; larval development assay indicated full anthelmintic susceptibility; albendazole treatment yielded 98.7% fecal egg count reduction; pyrosequence genotyping of single nucleotide polymorphisms in positions 167 and 200 of the isotype-1 beta tubulin gene were present at 0.0 and 1.7%, respectively; microsatellite genotyping indicated the background haplotype was similar to the susceptible isolate; and haplotypes of the isotype-1 beta tubulin gene were similar to the susceptible isolate. To sustain the susceptibility of the new population, targeted selective treatment was implemented using albendazole. Surprisingly, within 1.5 years post-replacement, the population reverted to a resistant phenotype. Resistance to albendazole, ivermectin, and moxidectin was confirmed via fecal egg count reduction test, larval development assay, and pyrosequencing-based genotyping. Targeted selective treatment was then carried out using levamisole. However, within one year, resistance was detected to levamisole. Population genetics demonstrated a gradual change in the genetic structure of the population until the final population was similar to the initial resistant population. Genetic analyses showed a lack of diversity in the susceptible isolate, suggesting the susceptible isolate had reduced environmental fitness compared to the resistant population, providing a possible explanation for the rapid reversion to resistance. This work demonstrates the power of combining molecular, in vitro, and in vivo assays to study phenotypic and genotypic changes in a field population of nematodes, enabling improved insights into the epidemiology of anthelmintic resistance.

Multicomponent efflux complexes constitute a primary mechanism for Gram-negative bacteria to expel toxic molecules for survival. As these complexes traverse the periplasm and link inner and outer membranes, it remains unclear how they operate efficiently without compromising periplasmic plasticity. Combining single-molecule superresolution imaging and genetic engineering, we study in living Escherichia coli cells the tripartite efflux complex CusCBA of the resistance-nodulation-division family that is essential for bacterial resistance to drugs and toxic metals. We find that CusCBA complexes are dynamic structures and shift toward the assembled form in response to metal stress. Unexpectedly, the periplasmic adaptor protein CusB is a key metal-sensing element that drives the assembly of the efflux complex ahead of the transcription activation of the cus operon for defending against metals. This adaptor protein-mediated dynamic pump assembly allows the bacterial cell for efficient efflux upon cellular demand while still maintaining periplasmic plasticity; this could be broadly relevant to other multicomponent efflux systems.

Forebrain development in vertebrates is regulated by transcription factors encoded by homeobox, bHLH and forkhead gene families throughout the progressive and overlapping stages of neural induction and patterning, regional specification and generation of neurons and glia from central nervous system (CNS) progenitor cells. Moreover, cell fate decisions, differentiation and migration of these committed CNS progenitors are controlled by the gene regulatory networks that are regulated by various homeodomain-containing transcription factors, including but not limited to those of the Pax (paired), Nkx, Otx (orthodenticle), Gsx/Gsh (genetic screened), and Dlx (distal-less) homeobox gene families. This comprehensive review outlines the integral role of key homeobox transcription factors and their target genes on forebrain development, focused primarily on the telencephalon. Furthermore, links of these transcription factors to human diseases, such as neurodevelopmental disorders and brain tumors are provided.

Eddy heat fluxes crucially affect large-scale oceanic currents but are challenging to monitor on a global scale. Here the authors develop a Deep Learning model to predict the eddy heat fluxes from sea surface height data only, bypassing the need for simultaneous observations of the deep ocean.

We report the occurrence of unilateral central retinal vein occlusion (CRVO) in a young yoga enthusiast who presented amidst the COVID-19 pandemic. Subtle signs of uveitis when systemically investigated revealed a multitude of causes, but ocular fluid polymerase chain reaction was positive for varicella zoster virus (VZV). The prompt initiation of antivirals resulted in a good visual outcome. Our case describes the rare presentation of VZV retinal vasculitis as CRVO in a young healthy individual and highlights the importance of early antiviral therapy for favorable outcomes.

Aim: The aim of this study is to review studies evaluating the role of genetics in skeletal class II malocclusion. Objective: To assess the scientific evidence associating the role of genes in skeletal class II malocclusion. Materials and Methods: A complete search across the electronic database through PubMed, Cochrane, LILACS, BMC and manual hand search of orthodontic journals were done till May 2019. The keywords for the search included: “Genetics”, “class II malocclusion”, “maxillary prognathism”, “mandibular retrognathism”. Data Collection and Analysis: Studies were selected based on PRISMA guidelines. Results: Articles were selected based on the inclusion and exclusion criteria. A total of 11 cross-sectional studies satisfied the inclusion criteria and were analyzed for the role of genes in skeletal class II malocclusion. Almost all the studies except for one revealed a positive correlation of genes with skeletal class II malocclusion. Conclusions: Out of the 11 studies included, a positive correlation of the genes with the skeletal II malocclusion was found in 10 studies. Genes FGFR2, MSX1, MATN1, MYOH1, ACTN3, GHR, KAT6B, HDAC4, AJUBA were found to be positively linked to skeletal class II malocclusion.

Abstract Background The clinical characteristics and outcomes of the 2019 novel coronavirus (COVID-19) pneumonia are different in Hubei compared to other regions in China. But there are few comparative studies on the differences between imported and local patients which may provide information of the different courses of the virus after transmission. Methods We investigated 169 cases of COVID-19 pneumonia in two centers in Hunan Province, and divided them into two groups according to epidemiological history, "imported patients" refers to patient with a clear history of travel in Wuhan within 14 days before onset, and " local patients” refers to local resident without a recent history of travel in Wuhan, aiming to analyze the difference in clinical characteristics and outcomes between the two groups. All the epidemiological, clinical, imaging, and laboratory data were analyzed and contrasted. Results The incidence of fever on admission in imported patients was significantly higher than local patients. There was a significantly higher proportion of abnormal pulmonary signs, hypokalemia, hyponatremia, prolonged PT, elevated D-dimer and elevated blood glucose in imported patients. Compared with local patients, the proportion using antibiotics, glucocorticoids and gamma globulin were significantly higher in imported patients. The moderate type was more common in local patients, and the severe type were more frequent in imported patients. In addition, the median duration of viral clearance was longer in imported patients. Conclusions In summary, we found that imported cases were more likely to develop into severe cases, compared with local patients and required more powerful treatments. Trial registration Registered 21st March 2020, and this study has been approved by the Medical Ethics Committee (Approved Number. 2020017).

We have analyzed TROPOspheric Monitoring Instrument (TROPOMI) carbon monoxide (CO) data acquired between November 2017 and March 2019 with respect to other satellite (MOPITT, Measurement Of Pollution In The Troposphere) and airborne (ATom, Atmospheric Tomography mission) datasets to better understand TROPOMI's contribution to the global tropospheric CO record (2000 to present). MOPITT and TROPOMI are two of only a few satellite instruments to ever derive CO from solar-reflected radiances. Therefore, it is particularly important to understand how these two datasets compare. Our results indicate that TROPOMI CO retrievals over land show excellent agreement with respect to MOPITT: relative biases and their SD (i.e., accuracy and precision) are on average -3.73%±11.51%, -2.24%±12.38%, and -3.22%±11.13% compared to the MOPITT TIR (thermal infrared), NIR (near infrared), and TIR + NIR (multispectral) products, respectively. TROPOMI and MOPITT data also show good agreement in terms of temporal and spatial patterns. Despite depending on solar-reflected radiances for its measurements, TROPOMI can also retrieve CO over bodies of water if clouds are present by approximating partial columns under cloud tops using scaled, model-based reference CO profiles. We quantify the bias of TROPOMI total column retrievals over bodies of water with respect to colocated in situ ATom CO profiles after smoothing the latter with the TROPOMI column averaging kernels (AKs), which account for signal attenuation under clouds (relative bias and its SD =3.25%±11.46 %). In addition, we quantify enull (the null-space error), which accounts for differences between the shape of the TROPOMI reference profile and that of the ATom true profile (enull=2.16%±2.23 %). For comparisons of TROPOMI and MOPITT retrievals over open water we compare TROPOMI total CO columns to their colocated MOPITT TIR counterparts. Relative bias and its SD are 2.98 %±15.71 % on average. We investigate the impact of discrepancies between the a priori and reference CO profiles (used by MOPITT and TROPOMI, respectively) on CO retrieval biases by applying a null-space adjustment (based on the MOPITT a priori) to the TROPOMI total column values. The effect of this adjustment on MOPITT and TROPOMI biases is minor, typically 1–2 percentage points.

Abstract Background Early initiation of breastfeeding offers nutritional and immunological benefits to the newborn, which is critical for health and survival. Understanding factors associated with timely initiation of breastfeeding is crucial for healthcare providers and policy-makers. This study aimed to assess the prevalence and factors associated with early initiation of breastfeeding among mothers with children

Abstract This study explores the utility of transmission electron microscopy (TEM) analysis of bone collagen for investigating prehistoric cooking. Approaches to cooking practices have relied principally on artefactual evidence, macroscopic bone modification, and organic residue analysis. However, direct evidence for cooking of bone has been limited. Richter and Koon successfully applied TEM analysis of collagen to determine heating to modern and medieval bones, but this method has yet to be experimentally tested using prehistoric remains. Collagen will denature at relatively low temperatures, such as during roasting, boiling, or baking. The denaturation of collagen causes predictable structural changes that can be viewed through TEM. Zooarchaeological remains of sheep and pig with minimal taphonomic modifications were analysed from four later prehistoric (c. 800–500BC) sites in Britain (n = 33). Humeri and phalanges were selected to compare elements with high and low meat yields. Samples were classified into ‘Heated’ and ‘Unheated’ groups consistent with previous studies, and variable patterns were observed between different sites and taxa. Analytical limitations have hindered the study of cooking in the past, but this study demonstrates the potential of this taphonomic method for exploring prehistoric cooking practices and provides a springboard for wider studies.

Biomass burning emissions are a major source of trace gases and aerosols. Wildfires being highly variable in time and space, calculating emissions requires a numerical tool able to estimate fluxes at the kilometer scale and with an hourly time step. Here, the APIFLAME model version 2.0 is presented. It is structured to be modular in terms of input databases and processing methods. The main evolution compared to version 1.0 is the possibility of merging burned area and fire radiative power (FRP) satellite observations to modulate the temporal variations of fire emissions and to integrate small fires that may not be detected in the burned area product. Accounting for possible missed detection due to small fire results in an increase in burned area ranging from ∼5 % in Africa and Australia to ∼30 % in North America on average over the 2013–2017 time period based on the Moderate-Resolution Imaging Spectroradiometer (MODIS) Collection 6 fire products. An illustration for the case of southwestern Europe during the summer of 2016, marked by large wildfires in Portugal, is presented. Emissions calculated using different possible configurations of APIFLAME show a dispersion of 80 % on average over the domain during the largest wildfires (8–14 August 2016), which can be considered as an estimate of uncertainty of emissions. The main sources of uncertainty studied, by order of importance, are the emission factors, the calculation of the burned area, and the vegetation attribution. The aerosol (PM10) and carbon monoxide (CO) concentrations simulated with the CHIMERE regional chemistry transport model (CTM) are consistent with observations (good timing for the beginning and end of the events, ±1 d for the timing of the peak values) but tend to be overestimated compared to observations at surface stations. On the contrary, vertically integrated concentrations tend to be underestimated compared to satellite observations of total column CO by the Infrared Atmospheric Sounding Interferometer (IASI) instrument and aerosol optical depth (AOD) by MODIS. This underestimate is lower close to the fire region (5 %–40 % for AOD depending on the configuration and 8 %–18 % for total CO) but rapidly increases downwind. For all comparisons, better agreement is achieved when emissions are injected higher into the free troposphere using a vertical profile as estimated from observations of aerosol plume height by the Multi-angle Imaging SpectroRadiometer (MISR) satellite instrument (injection up to 4 km). Comparisons of aerosol layer heights to observations by the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) show that some parts of the plume may still be transported at too low an altitude. The comparisons of the different CTM simulations to observations point to uncertainties not only on emissions (total mass and daily variability) but also on the simulation of their transport with the CTM and mixing with other sources. Considering the uncertainty of the emission injection profile and of the modeling of the transport of these dense plumes, it is difficult to fully validate emissions through comparisons between model simulations and atmospheric observations.

Abstract Soluble vascular endothelial growth factor receptor-1 (sFlt-1) is an anti-angiogenic protein which is secreted by numerous cell types and acts as a decoy receptor for the angiogenic protein vascular endothelial growth factor (VEGF). Despite its physiologic importance in maintaining angiogenic balance, excess sFlt-1 levels are associated with the pathogenesis of many diseases, especially those with angiogenic imbalance, endothelial dysfunction, and hypertension. Although sFlt-1 is a soluble protein, it contains a binding site for the extracellular matrix component heparan sulfate. This allows cells to retain and localize sFlt-1 in order to prevent excessive VEGF signaling. During pregnancy, placental syncytiotrophoblasts develop a large extracellular matrix which contains significant amounts of heparan sulfate. Consequently, the placenta becomes a potential storage site for large amounts of sFlt-1 bound to extracellular heparan sulfate. Additionally, it should be noted that sFlt-1 can bind to the anticoagulant unfractionated heparin due to its molecular mimicry to heparan sulfate. However, it remains unknown whether unfractionated heparin can compete with heparan sulfate for binding of localized sFlt-1. In this study, we hypothesized that administration of unfractionated heparin would displace and solubilize placental extracellular matrix(ECM)-bound sFlt-1. If unfractionated heparin can displace this large reservoir of sFlt-1 in the placenta and mobilized it into the maternal circulation, we should be able to observe its effects on maternal angiogenic balance and blood pressure. To test this hypothesis, we utilized in vitro, ex vivo, and in vivo methods. Using the BeWo placental trophoblast cell line, we observed increased sFlt-1 in the media of cells treated with unfractionated heparin compared to controls. The increase in media sFlt-1 was found in conjunction with decreased localized cellular Flt (sFlt-1 and Flt-1) as measured by total cell fluorescence. Similar results were observed using ex vivo placental villous explants treated with unfractionated heparin. Real-time quantitative PCR of the explants showed no change in sFlt-1 or heparanase-1 mRNA expression, eliminating increased production and enzymatic cleavage of heparan sulfate as causes for sFlt-1 media increase. Timed-pregnant rats given a continuous infusion of unfractionated heparin exhibited an increased mean arterial pressure as well as decreased bioavailable VEGF compared to vehicle-treated animals. These data demonstrate that chronic unfractionated heparin treatment is able to displace matrix-bound sFlt-1 into the maternal circulation to such a degree that mean arterial pressure is significantly affected. Here we have shown that the placental ECM is a storage site for large quantities of sFlt-1, and that it should be carefully considered in future studies concerning angiogenic balance in pregnancy.

Hydroperoxyl (HO2) and organic peroxy (RO2) radicals have an unpaired spin and are highly reactive free radicals. Measurements of the sum of HO2 and RO2 provide unique information about the chemical processing in an air mass. This paper describes the experimental features and capabilities of the Peroxy Radical Chemical Enhancement and Absorption Spectrometer (PeRCEAS). This is an instrument designed to make measurements on aircraft from the boundary layer to the lower stratosphere. PeRCEAS combines the amplified conversion of peroxy radicals to nitrogen dioxide (NO2) with the sensitive detection of NO2 using cavity ring-down spectroscopy (CRDS) at 408 nm. PeRCEAS is a dual-channel instrument, with two identical reactor–detector lines working out of phase with one another at a constant and defined pressure lower than ambient at the aircraft altitude. The suitability of PeRCEAS for airborne measurements in the free troposphere was evaluated by extensive characterisation and calibration under atmospherically representative conditions in the laboratory. The use of alternating modes of the two instrumental channels successfully captures short-term variations in the sum of peroxy radicals, defined as RO2∗ (RO2∗=HO2+∑RO2+OH+∑RO, with R being an organic chain) in ambient air. For a 60 s measurement, the RO2∗ detection limit is 2σ) NO2 detectable mixing ratio

Abstract Background Hydrogen peroxide has been widely used in Orthopaedics including Orthopaedic oncology, trauma and joint surgeries. However, we encountered an oxygen embolism and myoglobinuria after hydrogen peroxide was used to irrigate a septic hip arthroscopically. Case presentation A 61-year-old male patient with right hip septic arthritis underwent an arthroscopic hip washout and debridement. During the operation, the surgeon used 100 ml of 3% hydrogen peroxide to irrigate the joint cavity. Two minutes after irrigation, there was a transient decrease in oxygen saturation, heart rate and blood pressure, with significant subcutaneous emphysema around the wound. Concentrated urine was drained out 8 h after operation which resolved the following day. Post-operatively, the patient was managed in the intensive care unit for a pulmonary embolism and discharged without further complications. Conclusion Medical staff should be aware of the risk of oxygen embolism and be extremely careful when using hydrogen peroxide in patient care. Oxygen embolism following hydrogen peroxide use is rare, however, once encountered, it may bring serious consequences. Therefore, the use of hydrogen peroxide in closed spaces or arthroscopic procedures should be discontinued.

Background: National efforts to reduce maternal mortality with respect to community services have primarily focused on upgrading transportation infrastructure and formalizing training for care providers. There is, however, a paucity of baseline data on the profile and outcomes of pregnant women presenting to the Emergency Department (ED) in India. Methods: This retrospective study enrolled all pregnant women presenting to a large tertiary medical care center in India, between November 2016 and November 2017. Results: There were 696 ED visits by pregnant women during the study period. The mean age was 26.85 (SD: 4.88) years. Pregnant women in the first trimester contributed to 50.8% of all visits, and 54% being multigravida. The most common presenting complaints were bleeding/spotting per vaginum (PV) (38.2%) and abdominal pain (37.6%) followed by fever (21.6%) and vomiting (21.5%). Obstetric causes contributed to 53.2% of the ED visits, while nonobstetric causes amounted to 43.2%. Over a third (39.7%) required hospital admission. Of these patients, 73% delivered in CMC with live births amounting to 62.3% while 3.5% ended in fetal deaths. The miscarriages rate was as high as 28%. More than half (51.1%) of the deliveries were by normal vaginal delivery. There were no maternal deaths during the time of admission. Conclusions: Our study sheds new light on the profile of emergency visits among pregnant patients and their relationship to the outcome of pregnancy. First trimester visits were most common with complaints of bleeding PV and abdominal pain. This could explain the high rate of miscarriages among this population.

Abstract Background Over the past few decades, more and more articles about total hip arthroplasty have been published. We noticed, however, little is known about the characteristics and qualities of these studies. Methods The databases of Web of Science Core Collection, BIOSIS Citation Index, MEDLINE, etc. were utilized for the identification of articles published from 1990 to May 2019. Total hip arthroplasty–related articles were identified, and the 100 most cited articles were selected for subsequent analysis of citation count, citation density (citations/article age), authorship, theme, geographic distribution, time-related flux, level of evidence, and network analysis. Results The selected 100 articles were published mainly in the 1990s (46%) and 2000s (47%) with almost equal amount. Citations per article ranged from 994 to 191. Leading countries were the USA followed by Canada, England, and Sweden, all located in North America and Western Europe. The most highlighted study themes were postoperative thrombosis and surgical methods and materials. The most common level of evidence was level III (35%). The network analysis connoted that radiography, acetabulum, reoperation, and bone cement had a high degree of centrality in the 1990s, while cement had a high degree of centrality in the 2000s and 2010s. Conclusions The time, area, and theme distribution of the top 100 most cited articles in the total hip arthroplasty have been thoroughly analyzed. It is noticeable that postoperative thromboembolism currently plays a major role in the field of total hip arthroplasty researches. However, most of them focus on the effectiveness of different treatments and drugs; little is known about its underlying mechanisms and influencing factors.

Abstract Background Arsenic exposure through drinking water is an established lung carcinogen. Evidence on non-malignant lung outcomes is less conclusive and suggests arsenic is associated with lower lung function. Studies examining low-moderate arsenic (

In this paper, we introduce a novel time-averaged sampling method that can be used in a low-cost, camera-based, line-field, spectral domain optical coherence tomography (SD-OCT) device. We demonstrate that when used with an automated subtraction and magnitude based averaging scheme that is analogous to lock-in detection, this method can enhance the usually poor dynamic range and SNR. The technique is unique as it effectively eliminates arbitrarily located, arbitrarily strong autocorrelation artifacts, and is robust against blemishes in the camera or the reference mirror. We show through experiment, theory and simulations that a judicious choice of the Fourier transform window function, and one of the two proposed variants of the averaging scheme can enhance the final image. B-scan images of a variety of samples, and facile 3D tomograms, acquired with a device built from off-the-shelf components, demonstrate the potential of making OCT devices for niche applications, at much reduced costs.

The contagiousness of coronavirus disease-2019 (COVID-19) led to the imposition of historical lockdowns in various countries. No scientific mind could have made accurate projections of the tremendous impact that COVID-19 would have on nations, communities, and the global-wide economy. Meanwhile, millions of workers have lost their jobs, while healthcare workers are overwhelmed and are reaching a state of mental and physical exhaustion. With the uncontrollable spread, researchers have been working to identify factors associated with COVID-19. In this regard, race, ethnicity, industry, and occupation have been found to be predominant factors of interest. However, unfortunately, the unavailability of such information has been a difficult reality. Since race, ethnicity, and employment are essential social determinants of health and could serve as potential risk-factors for COVID-19, collecting such information may offer important context for prioritising vulnerable groups. Thus, this perspective aims to highlight the importance and need for collecting race, ethnicity, and occupation-related data to track and treat the racial/ethnic groups that have been most strongly affected by the COVID-19 pandemic. Collecting such data will provide valuable insights and help public health officials recognise workplace-related outbreaks and evaluate the odds of various ethnic groups and professions contracting COVID-19.

Introduction: Drug Related Problems (DRPs) frequently take place in modern medical practices, increasing the morbidity and mortality as well as the cost of patient care. Objective: The current study was undertaken to identify and evaluate various DRPs among the inpatients of the psychiatry department in a tertiary care teaching hospital using APS-Doc classification system and to identify the most recurrent drugs causing the DRPs. Method: ology: A prospective observational study was conducted forduration of six months among 198 patients using APS-Doc classification system. The data was statistically analysed and tabulated. Results: A total of 205 DRPs were identified in 102 patients, among which 115 (56.1%) were potential drug-drug interactions (pDDI) and 62 (30.2%) were adverse drug reactions (ADRs). 21 (10.2%) DRPs belonged to the category of incorrect spelling of the trade name and 3 (1.5%) among them belonged to unintended prescription of the same drug. Two out of 205 DRPs (1%) belonged to the class of prescription of an incorrect dosage form or no dosage prescribed. One DRP each were categorised under wrong dosage form prescribed and inadequate generic substitution respectively. Out of the total of 314 drugs, risperidone (n = 43, 13.7%) was found to be the drug associated with the most number of DRPs followed by olanzapine (n = 38, 12.1%) and lorazepam (n = 32, 10.2%). Conclusion: The study revealed that more than half (51.5%) of the patients presented with DRPs and the most commonly identified DRPs were pDDIs and ADRs.