COVID-19 infection outcome in African American Renal Transplant recipients: Detroit Medical Center

Background: Transplant recipients are more vulnerable to infections including COVID-19, given their comorbidities and chronic immunosuppression. Most preliminary care series report rapid clinical progression and higher mortality compared to the general population. Methods: Retrospective study at Harper University Hospital - Detroit Medical Center. Twenty-five renal transplant recipients (RTR) presenting consecutively with COVID-19 symptoms and positive NP swab PCR for SARS-CoV2 between 03/01/2020 - 05/01/2020 were included. Data on demographics, clinical presentation, laboratory findings, management and outcomes were collected. Results: Patients had a median age of 56, all African American and deceased donor transplant recipients. Most had hypertension (96%), about half (52%) had diabetes, 64% had pulmonary disease including obstructive sleep apnea, COPD and pulmonary hypertension. Most common presenting symptom was dyspnea (64%), followed by fever and cough (56%) and diarrhea (56%). Half of patients had multifocal opacities on initial chest x-ray (52%). Immunosuppression with tacrolimus and low dose prednisone was continued, while mycophenolate mofetil was held on admission. Following institution guidelines, hydroxychloroquine was given to 32% who met criteria for risk of severe disease, while 48% received both hydroxychloroquine and steroids. Prophylactic anticoagulation was given to 80% of patients, while therapeutic coagulation to 8%. Oxygen supplementation given to 60% of patients and one patient required intubation. Three patients (12%) were admitted to intensive care, of which one expired. Treatment with mycophenolate was reintroduced based on resolution of symptoms and laboratory parameters. Conclusion: COVID-19 infected RTR in this cohort had lower mortality of 4% (n=1) compared to State-wide mortality of 10%. Clinical presentation was similar to non-immunocompromised hosts, but diarrhea was common. Despite multiple co-morbidities and chronic immunosuppression, our patient cohort had favorable outcome and lower mortality compared to other series. Exact reasons for this optimal outcome are unclear

Microservice Transition and its Granularity Problem: A Systematic Mapping Study

Microservices have gained wide recognition and acceptance in software industries as an emerging architectural style for autonomic, scalable, and more reliable computing. The transition to microservices has been highly motivated by the need for better alignment of technical design decisions with improving value potentials of architectures. Despite microservices' popularity, research still lacks disciplined understanding of transition and consensus on the principles and activities underlying "micro-ing" architectures. In this paper, we report on a systematic mapping study that consolidates various views, approaches and activities that commonly assist in the transition to microservices. The study aims to provide a better understanding of the transition; it also contributes a working definition of the transition and technical activities underlying it. We term the transition and technical activities leading to microservice architectures as microservitization. We then shed light on a fundamental problem of microservitization: microservice granularity and reasoning about its adaptation as first-class entities. This study reviews state-of-the-art and -practice related to reasoning about microservice granularity; it reviews modelling approaches, aspects considered, guidelines and processes used to reason about microservice granularity. This study identifies opportunities for future research and development related to reasoning about microservice granularity.Comment: 36 pages including references, 6 figures, and 3 table

Cellular Radiosensitivity: How much better do we understand it?

Purpose: Ionizing radiation exposure gives rise to a variety of lesions in DNA that result in genetic instability and potentially tumorigenesis or cell death. Radiation extends its effects on DNA by direct interaction or by radiolysis of H2O that generates free radicals or aqueous electrons capable of interacting with and causing indirect damage to DNA. While the various lesions arising in DNA after radiation exposure can contribute to the mutagenising effects of this agent, the potentially most damaging lesion is the DNA double strand break (DSB) that contributes to genome instability and/or cell death. Thus in many cases failure to recognise and/or repair this lesion determines the radiosensitivity status of the cell. DNA repair mechanisms including homologous recombination (HR) and non-homologous end-joining (NHEJ) have evolved to protect cells against DNA DSB. Mutations in proteins that constitute these repair pathways are characterised by radiosensitivity and genome instability. Defects in a number of these proteins also give rise to genetic disorders that feature not only genetic instability but also immunodeficiency, cancer predisposition, neurodegeneration and other pathologies. Conclusions: In the past fifty years our understanding of the cellular response to radiation damage has advanced enormously with insight being gained from a wide range of approaches extending from more basic early studies to the sophisticated approaches used today. In this review we discuss our current understanding of the impact of radiation on the cell and the organism gained from the array of past and present studies and attempt to provide an explanation for what it is that determines the response to radiation

Inter-population variations in concentrations, determinants of and correlations between 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (p,p'-DDE): a cross-sectional study of 3161 men and women from Inuit and European populations

BACKGROUND: The study is part of a collaborative project (Inuendo), aiming to assess the impact of dietary persistent organochlorine pollutants (POPs) on human fertility. The aims with the present study are to analyze inter-population variations in serum concentrations of 2,2',4,4',5,5'-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis (p-chlorophenyl)-ethylene (p,p'-DDE), to assess inter-population variations in biomarker correlations, and to evaluate the relative impact of different determinants for the inter-individual variations in POP-biomarkers. METHOD: In study populations of 3161 adults, comprising Greenlandic Inuits, Swedish fishermen and their wives, and inhabitants from Warsaw, Poland and Kharkiv, Ukraine, serum concentrations of CB-153 and p,p'-DDE, were analysed by gas chromatography-mass spectrometry. RESULTS: The median serum concentrations of CB-153 were for male and female Inuits 200 and 110, for Swedish fishermen 190 and their wives 84, for Kharkiv men and women 44 and 27, and for Warsaw men and women 17 and 11 ng/g lipids, respectively. The median serum concentrations of p,p'-DDE were for Kharkiv men and women 930 and 650, for male and female Inuits 560 and 300, for Warsaw men and women 530 and 380, and for Swedish fishermen 240 and their wives 140 ng/g lipids, respectively. The correlation coefficients between CB-153 and p,p'-DDE varied between 0.19 and 0.92, with the highest correlation among Inuits and the lowest among men from Warsaw. Men had averagely higher serum concentrations of CB-153 and p,p'-DDE, and there were positive associations between age and the POP-biomarkers, whereas the associations with BMI and smoking were inconsistent. Dietary seafood was of importance only in the Inuit and Swedish populations. CONCLUSION: CB-153 concentrations were much higher in Inuits and Swedish fishermen's populations than in the populations from Eastern Europe, whereas the pattern was different for p,p'-DDE showing highest concentrations in the Kharkiv population. The correlations between the POP-biomarkers varied considerably between the populations, underlining that exposure sources differ and that the choice of representative biomarkers of overall POP exposure has to be based on an analysis of the specific exposure situation for each population. Age and gender were consistent determinants of serum POPs; seafood was of importance only in the Inuit and Swedish populations

The peculiar debris disk of HD 111520 as resolved by the Gemini Planet Imager

This is the author accepted manuscript. The final version is available from American Astronomical Society / IOP Publishing via the DOI in this record.Using the Gemini Planet Imager, we have resolved the circumstellar debris disk around HD 111520 at a projected range of ∼30-100 AU in both total and polarized H-band intensity. The disk is seen edge-on at a position angle of 165° along the spine of emission. A slight inclination and asymmetric warp are covariant and alter the interpretation of the observed disk emission. We employ three point-spread function subtraction methods to reduce the stellar glare and instrumental artifacts to confirm that there is a roughly 2:1 brightness asymmetry between the NW and SE extension. This specific feature makes HD 111520 the most extreme example of asymmetric debris disks observed in scattered light among similar highly inclined systems, such as HD 15115 and HD 106906. We further identify a tentative localized brightness enhancement and scale height enhancement associated with the disk at ∼40 AU away from the star on the SE extension. We also find that the fractional polarization rises from 10% to 40% from 0.″5 to 0.″8 from the star. The combination of large brightness asymmetry and symmetric polarization fraction leads us to believe that an azimuthal dust density variation is causing the observed asymmetry.Z.H.D. and B.C.M. acknowledge a Discovery Grant and Accelerator Supplement from the Natural Science and Engineering Research Council of Canada. Supported by NSF grants AST-0909188, AST-1313718 (J.R.G., J.J.W., P.G.K.), AST-141378 (G.D., M.F.), and AST-1411868 (K.F., J.L.P., A.R., K.W.D.). Supported by NASA grants NNX15AD95G/NEXSS, NNX14AJ80G, and NNX11AD21G (J.R.G., J.J.W., P.G.K.)

The peculiar debris disk of HD 111520 as resolved by the Gemini Planet Imager

This is the author accepted manuscript. The final version is available from American Astronomical Society / IOP Publishing via the DOI in this record.Using the Gemini Planet Imager, we have resolved the circumstellar debris disk around HD 111520 at a projected range of ∼30-100 AU in both total and polarized H-band intensity. The disk is seen edge-on at a position angle of 165° along the spine of emission. A slight inclination and asymmetric warp are covariant and alter the interpretation of the observed disk emission. We employ three point-spread function subtraction methods to reduce the stellar glare and instrumental artifacts to confirm that there is a roughly 2:1 brightness asymmetry between the NW and SE extension. This specific feature makes HD 111520 the most extreme example of asymmetric debris disks observed in scattered light among similar highly inclined systems, such as HD 15115 and HD 106906. We further identify a tentative localized brightness enhancement and scale height enhancement associated with the disk at ∼40 AU away from the star on the SE extension. We also find that the fractional polarization rises from 10% to 40% from 0.″5 to 0.″8 from the star. The combination of large brightness asymmetry and symmetric polarization fraction leads us to believe that an azimuthal dust density variation is causing the observed asymmetry.Z.H.D. and B.C.M. acknowledge a Discovery Grant and Accelerator Supplement from the Natural Science and Engineering Research Council of Canada. Supported by NSF grants AST-0909188, AST-1313718 (J.R.G., J.J.W., P.G.K.), AST-141378 (G.D., M.F.), and AST-1411868 (K.F., J.L.P., A.R., K.W.D.). Supported by NASA grants NNX15AD95G/NEXSS, NNX14AJ80G, and NNX11AD21G (J.R.G., J.J.W., P.G.K.)

A Comparison of Scent Marking between a Monogamous and Promiscuous Species of Peromyscus: Pair Bonded Males Do Not Advertise to Novel Females

Scent marking can provide behavioral and physiological information including territory ownership and mate advertisement. It is unknown how mating status and pair cohabitation influence marking by males from different social systems. We compared the highly territorial and monogamous California mouse (Peromyscus californicus) to the less territorial and promiscuous white-footed mouse (P. leucopus). Single and mated males of both species were assigned to one of the following arenas lined with filter paper: control (unscented arena), male scented (previously scent-marked by a male conspecific), or females present (containing females in small cages). As expected, the territorial P. californicus scent marked and overmarked an unfamiliar male conspecific's scent marks more frequently than P. leucopus. Species differences in responses to novel females were also found based on mating status. The presence of unfamiliar females failed to induce changes in scent marking in pair bonded P. californicus even though virgin males increased marking behavior. Pair bonding appears to reduce male advertisement for novel females. This is in contrast to P. leucopus males that continue to advertise regardless of mating status. Our data suggest that communication through scent-marking can diverge significantly between species based on mating system and that there are physiological mechanisms that can inhibit responsiveness of males to female cues

Are pediatric Open Access journals promoting good publication practice? An analysis of author instructions

<p>Abstract</p> <p>Background</p> <p>Several studies analyzed whether conventional journals in general medicine or specialties such as pediatrics endorse recommendations aiming to improve publication practice. Despite evidence showing benefits of these recommendations, the proportion of endorsing journals has been moderate to low and varied considerably for different recommendations. About half of pediatric journals indexed in the Journal Citation Report referred to the Uniform Requirements for Manuscripts of the International Committee of Medical Journal Editors (ICMJE) but only about a quarter recommended registration of trials. We aimed to investigate to what extent pediatric open-access (OA) journals endorse these recommendations. We hypothesized that a high proportion of these journals have adopted recommendations on good publication practice since OA electronic publishing has been associated with a number of editorial innovations aiming at improved access and transparency.</p> <p>Methods</p> <p>We identified 41 journals publishing original research in the subject category "Health Sciences, Medicine (General), Pediatrics" of the Directory of Open Access Journals <url>http://www.doaj.org</url>. From the journals' online author instructions we extracted information regarding endorsement of four domains of editorial policy: the Uniform Requirements for Manuscripts, trial registration, disclosure of conflicts of interest and five major reporting guidelines such as the CONSORT (Consolidated Standards of Reporting Trials) statement. Two investigators collected data independently.</p> <p>Results</p> <p>The Uniform Requirements were mentioned by 27 (66%) pediatric OA journals. Thirteen (32%) required or recommended trial registration prior to publication of a trial report. Conflict of interest policies were stated by 25 journals (61%). Advice about reporting guidelines was less frequent: CONSORT was referred to by 12 journals (29%) followed by other reporting guidelines (MOOSE, PRISMA or STARD) (8 journals, 20%) and STROBE (3 journals, 7%). The EQUATOR network, a platform of several guideline initiatives, was acknowledged by 4 journals (10%).</p> <p>Journals published by OA publishing houses gave more guidance than journals published by professional societies or other publishers.</p> <p>Conclusions</p> <p>Pediatric OA journals mentioned certain recommendations such as the Uniform Requirements or trial registration more frequently than conventional journals; however, endorsement is still only moderate. Further research should confirm these exploratory findings in other medical fields and should clarify what the motivations and barriers are in implementing such policies.</p

Exposure to phthalates among premenstrual girls from rural and urban Gharbiah, Egypt: A pilot exposure assessment study

<p>Abstract</p> <p>Background</p> <p>Phthalates have been identified as endocrine active compounds associated with developmental and reproductive toxicity. The exposure to phthalates in premenstrual Egyptian females remains unknown. The objective of this study was to characterize phthalate exposure of a potentially vulnerable population of premenstrual girls from urban and rural Egypt.</p> <p>Materials and methods</p> <p>We collected one spot urine sample from 60 10-13 year old females, 30 from rural Egypt, and 30 from urban Egypt from July to October 2009. Samples were analyzed for 11 phthalate metabolites. Additionally, we collected anthropometrics as well as questionnaire data concerning food storage behaviors, cooking practices, and cosmetic use. Phthalate metabolite concentrations were compared between urban and rural Egyptians as well as to age and gender matched Americans.</p> <p>Results</p> <p>Monoethyl phthalate (MEP), was detected at the highest concentration in urine of Egyptian girls (median: 43.2 ng/mL in rural, 98.8 ng/mL in urban). Concentrations of urinary metabolites of di-(2-ethylhexyl) phthalate and dibutyl phthalate were comparable between Egyptians and age matched US girls. Storage of food in plastic containers was a statistically significant predictor of urinary mono-isobutyl phthalate (MiBP) concentrations when comparing covariate adjusted means.</p> <p>Conclusions</p> <p>Urinary concentrations of phthalate metabolites were similar in Egyptian and US populations, suggesting that phthalate exposure also occurs in developing nations. Dietary intake is likely an important route of exposure to phthalates in both urban and rural populations.</p