Insights from individuals with chronic conditions in the context of COVID-19

The objective of this prospective survey series was to evaluate knowledge and concerns related to the COVID-19 pandemic among individuals with one or more chronic conditions, including cardiometabolic, autoimmune, respiratory and cancer diagnoses. Two surveys were distributed consisting of up to 55 items (March; n=1069) and up to 71 items (April, n=1126), with 24 items repeated from the first survey. Questions focused on healthcare access, barriers and concerns related to the COVID-19 virus. Descriptive analysis evaluated central tendencies, spread, and frequencies of the demographic data, disease states, and survey results within and between the two survey timepoints. Results from 416 individuals (38.9%) on survey 1 and 425 (37.7%) on survey 2 were analyzed. Participants were predominantly female (85%) and white (67%) with 7% residing in rural areas and 69% employed. Respondents reported an average of 2 chronic conditions and 62% would be classified as “at risk” for COVID-19 complications by the CDC. Only 20% reported a conversation about COVID-19 with a healthcare provider, 9% reported anxiety, 35% indicated loneliness. Level of concern about COVID-19 contracting the disease, cost of treatment/complications, medical access, and process of being treated was associated with increased anxiety (p\u3c0.001) and wearing a facemask (p=0.01). Analysis suggests that analyzing concern and its association with health behaviors and anxiety should be a priority for innovative solutions. Insights into how the COVID-19 pandemic is impacting individuals with chronic conditions are imperative to inform tailored interventions to support individuals at higher risk of serious complications and death. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens

Analyses of expressed sequence tags from the maize foliar pathogen Cercospora zeae-maydis identify novel genes expressed during vegetative, infectious, and reproductive growth

<p>Abstract</p> <p>Background</p> <p>The ascomycete fungus <it>Cercospora zeae-maydis </it>is an aggressive foliar pathogen of maize that causes substantial losses annually throughout the Western Hemisphere. Despite its impact on maize production, little is known about the regulation of pathogenesis in <it>C. zeae-maydis </it>at the molecular level. The objectives of this study were to generate a collection of expressed sequence tags (ESTs) from <it>C. zeae-maydis </it>and evaluate their expression during vegetative, infectious, and reproductive growth.</p> <p>Results</p> <p>A total of 27,551 ESTs was obtained from five cDNA libraries constructed from vegetative and sporulating cultures of <it>C. zeae-maydis</it>. The ESTs, grouped into 4088 clusters and 531 singlets, represented 4619 putative unique genes. Of these, 36% encoded proteins similar (E value ≤ 10^-05) to characterized or annotated proteins from the NCBI non-redundant database representing diverse molecular functions and biological processes based on Gene Ontology (GO) classification. We identified numerous, previously undescribed genes with potential roles in photoreception, pathogenesis, and the regulation of development as well as <it>Zephyr</it>, a novel, actively transcribed transposable element. Differential expression of selected genes was demonstrated by real-time PCR, supporting their proposed roles in vegetative, infectious, and reproductive growth.</p> <p>Conclusion</p> <p>Novel genes that are potentially involved in regulating growth, development, and pathogenesis were identified in <it>C. zeae-maydis</it>, providing specific targets for characterization by molecular genetics and functional genomics. The EST data establish a foundation for future studies in evolutionary and comparative genomics among species of <it>Cercospora </it>and other groups of plant pathogenic fungi.</p

Analyses of expressed sequence tags from the maize foliar pathogen Cercospora zeae-maydis identify novel genes expressed during vegetative, infectious, and reproductive growth

<p>Abstract</p> <p>Background</p> <p>The ascomycete fungus <it>Cercospora zeae-maydis </it>is an aggressive foliar pathogen of maize that causes substantial losses annually throughout the Western Hemisphere. Despite its impact on maize production, little is known about the regulation of pathogenesis in <it>C. zeae-maydis </it>at the molecular level. The objectives of this study were to generate a collection of expressed sequence tags (ESTs) from <it>C. zeae-maydis </it>and evaluate their expression during vegetative, infectious, and reproductive growth.</p> <p>Results</p> <p>A total of 27,551 ESTs was obtained from five cDNA libraries constructed from vegetative and sporulating cultures of <it>C. zeae-maydis</it>. The ESTs, grouped into 4088 clusters and 531 singlets, represented 4619 putative unique genes. Of these, 36% encoded proteins similar (E value ≤ 10^-05) to characterized or annotated proteins from the NCBI non-redundant database representing diverse molecular functions and biological processes based on Gene Ontology (GO) classification. We identified numerous, previously undescribed genes with potential roles in photoreception, pathogenesis, and the regulation of development as well as <it>Zephyr</it>, a novel, actively transcribed transposable element. Differential expression of selected genes was demonstrated by real-time PCR, supporting their proposed roles in vegetative, infectious, and reproductive growth.</p> <p>Conclusion</p> <p>Novel genes that are potentially involved in regulating growth, development, and pathogenesis were identified in <it>C. zeae-maydis</it>, providing specific targets for characterization by molecular genetics and functional genomics. The EST data establish a foundation for future studies in evolutionary and comparative genomics among species of <it>Cercospora </it>and other groups of plant pathogenic fungi.</p

Trafficking of prion proteins through a caveolae-mediated endosomal pathway

To understand the posttranslational conversion of the cellular prion protein (PrPC) to its pathologic conformation, it is important to define the intracellular trafficking pathway of PrPC within the endomembrane system. We studied the localization and internalization of PrPC in CHO cells using cryoimmunogold electron microscopy. At steady state, PrPC was enriched in caveolae both at the TGN and plasma membrane and in interconnecting chains of endocytic caveolae. Protein A–gold particles bound specifically to PrPC on live cells. These complexes were delivered via caveolae to the pericentriolar region and via nonclassical, caveolae-containing early endocytic structures to late endosomes/lysosomes, thereby bypassing the internalization pathway mediated by clathrin-coated vesicles. Endocytosed PrPC-containing caveolae were not directed to the ER and Golgi complex. Uptake of caveolae and degradation of PrPC was slow and sensitive to filipin. This caveolae-dependent endocytic pathway was not observed for several other glycosylphosphatidyl inositol (GPI)-anchored proteins. We propose that this nonclassical endocytic pathway is likely to determine the subcellular location of PrPC conversion

Diagnosing perceptual distortion present in group stereoscopic viewing

Stereoscopic displays are an increasingly prevalent tool for experiencing virtual environments, and the inclusion of stereo has the potential to improve distance perception within the virtual environment. When multiple users simultaneously view the same stereoscopic display, only one user experiences the projectively correct view of the virtual environment, and all other users view the same stereoscopic images while standing at locations displaced from the center of projection (CoP). This study was designed to evaluate the perceptual distortions caused by displacement from the CoP when viewing virtual objects in the context of a virtual scene containing stereo depth cues. Judgments of angles were distorted after leftward and rightward displacement from the CoP. Judgments of object depth were distorted after forward and backward displacement from the CoP. However, perceptual distortions of angle and depth were smaller than predicted by a ray-intersection model based on stereo viewing geometry. Furthermore, perceptual distortions were asymmetric, leading to different patterns of distortion depending on the direction of displacement. This asymmetry also conflicts with the predictions of the ray-intersection model. The presence of monocular depth cues might account for departures from model predictions

Weyl's law and quantum ergodicity for maps with divided phase space

For a general class of unitary quantum maps, whose underlying classical phase space is divided into several invariant domains of positive measure, we establish analogues of Weyl's law for the distribution of eigenphases. If the map has one ergodic component, and is periodic on the remaining domains, we prove the Schnirelman-Zelditch-Colin de Verdiere Theorem on the equidistribution of eigenfunctions with respect to the ergodic component of the classical map (quantum ergodicity). We apply our main theorems to quantised linked twist maps on the torus. In the Appendix, S. Zelditch connects these studies to some earlier results on `pimpled spheres' in the setting of Riemannian manifolds. The common feature is a divided phase space with a periodic component.Comment: Colour figures. Black & white figures available at http://www2.maths.bris.ac.uk/~majm. Appendix by Steve Zelditc

Chandra X-ray observations of Young Clusters II. Orion Flanking Fields Data

We present results of Chandra observations of two flanking fields (FF) in Orion, outside the Orion Nebula Cluster (ONC). The observations were taken with the ACIS-I camera with an exposure time of about 48 ks each field. We present a catalog of 417 sources, which includes X-ray luminosity, optical and infrared photometry and X-ray variability information. We have found 91 variable sources, 33 of which have a flare-like light curve, and 11 of which have a pattern of a steady increase or decrease over a 10 hour period. The optical and infrared photometry for the stars identified as X-ray sources are consistent with most of these objects being pre-main sequence stars with ages younger than 10 Myr. We present evidence for an age difference among the X-ray selected samples of NGC 2264, Orion FF, and ONC, with NGC 2264 being the oldest, and ONC being the youngest.Comment: AJ in press, 32 pages, 13 figures in total, 5 figures available at http://spider.ipac.caltech.edu/staff/solange/ramirez07_figs.p

Cost-effectiveness of financial incentives to promote adherence to depot antipsychotic medication: economic evaluation of a cluster-randomised controlled trial

Background: Offering a modest financial incentive to people with psychosis can promote adherence to depot antipsychotic medication, but the cost-effectiveness of this approach has not been examined. Methods: Economic evaluation within a pragmatic cluster-randomised controlled trial. 141 patients under the care of 73 teams (clusters) were randomised to intervention or control; 138 patients with diagnoses of schizophrenia, schizo-affective disorder or bipolar disorder participated. Intervention participants received £15 per depot injection over 12 months, additional to usual acute, mental and community primary health services. The control group received usual health services. Main outcome measures: incremental cost per 20% increase in adherence to depot antipsychotic medication; incremental cost of ‘good’ adherence (defined as taking at least 95% of the prescribed number of depot medications over the intervention period). Findings: Economic and outcome data for baseline and 12-month follow-up were available for 117 participants. The adjusted difference in adherence between groups was 12.2% (73.4% control vs. 85.6% intervention); the adjusted costs difference was £598 (95% CI -£4 533, £5 730). The extra cost per patient to increase adherence to depot medications by 20% was £982 (95% CI -£8 020, £14 000). The extra cost per patient of achieving 'good' adherence was £2 950 (CI -£19 400, £27 800). Probability of cost-effectiveness exceeded 97.5%at willingness-to-pay values of £14 000 for a 20% increase in adherence and £27 800 for good adherence. Interpretation: Offering a modest financial incentive to people with psychosis is cost-effective in promoting adherence to depot antipsychotic medication. Direct healthcare costs (including costs of the financial incentive) are unlikely to be increased by this intervention. Trial Registration: ISRCTN.com 7776928

Unconditional care in academic emergency departments

Recent news stories have explicitly stated that patients with symptoms of COVID-19 were "turned away" from emergency departments. This commentary addresses these serious allegations, with an attempt to provide the perspective of academic emergency departments (EDs) around the Nation. The overarching point we wish to make is that academic EDs never deny emergency care to any person