Decreased peripheral health service utilisation during an outbreak of Marburg haemorrhagic fever, Uíge, Angola, 2005.

In 2005, a Marburg haemorrhagic fever (MHF) outbreak occurred in Uíge province, Angola, which had its epicentre in Uíge municipality. Concurrently, a health facility located a considerable distance from the outbreak's epicentre reported a drastic reduction in attendance, possibly due to a remote effect of the ongoing MHF outbreak. Health officials should devise strategies to ensure that communities far from a filovirus haemorrhagic fever epicentre are not adversely affected by interventions at the epicentre and, to the greatest extent possible, ensure that these peripheral communities receive essential medical care during an epidemic

Modulating the polarization of broadband terahertz pulses from a spintronic emitter at rates up to 10 kHz

Reliable modulation of terahertz electromagnetic waveforms is important for many applications. Here, we rapidly modulate the direction of the electric field of linearly polarized terahertz electromagnetic pulses with 1–30 THz bandwidth by applying time-dependent magnetic fields to a spintronic terahertz emitter. Polarity modulation of the terahertz field with more than 99% contrast at a rate of 10 kHz is achieved using a harmonic magnetic field. By adding a static magnetic field, we modulate the direction of the terahertz field between angles of, for instance, −53° and 53° at kilohertz rates. We believe our approach makes spintronic terahertz emitters a promising source for low-noise modulation spectroscopy and polarization-sensitive techniques such as ellipsometry at 1–30 THz

Impact of Hospital Teaching Status on Healthcare Utilization, Length of Stay (LOS), and Cost of Hospitalization of Radiation Cystitis (RC) in the United States

Background: Limited data exist regarding in-hospital use of resources, LOS, and cost of RC-associated admissions in teaching hospital (TH) versus nonteaching hospital (NTH) settings. The goal of this study was to address the above void in literature. Methods:We focused on 13,272 admissions for RC between 2008-2014 within the National Inpatient Sample. Patients with concurrent diagnosis of other bladder conditions (n=914) were excluded. ICD-9 diagnosis and procedure codes were used to study inpatient procedures performed during admission. Type of admissions, receipt of a procedure, type of procedures performed, LOS, and total inflation-adjusted cost were then compared between TH and NTH. Complex survey chi-squared test and analysis of variance procedures were used to account for the NIS sampling design. Results: Of the 12,358 assessable records, 49% were at THs. Patients were more commonly admitted to emergency department at NTH (85%) compared to TH (80%; p\u3c0.001). Weekend admissions were more common at NTH (24%) compared to TH (21%) (p=0.004). Receipt of a procedure during admission was higher in TH (65%) compared to NTH (60%; p\u3c0.001). Number of procedure codes recorded was higher in TH (\u3e= 2 codes; 28.9% in TH vs 24.5% in NTH; p \u3c0.001. More complex procedures like cystectomy were almost exclusively performed at TH (cystectomy 2.4% in TH vs 0.4% in NTH admissions; p \u3c0.001), whereas there was no difference in procedures like blood transfusion (TH 34%; NTH 33%; p=0.3), suprapubic cystostomy (TH 1.3%; NTH 1.4%; p=0.8), and transurethral procedures (TH 14%; NTH 16%; p=0.06). Despite statistically significant difference in LOS between the two groups (Median days (IQR): TH 5 (3-9); NTH 5 (3-8); p\u3c0.001) the difference was not clinically significant. Cost of admission was higher in TH (10,377$TH; 8504$ NTH; p\u3c0.001). Conclusions: In the United States, patients with RC are more frequently admitted to the emergency department in NTH. Patients admitted to TH receive a procedure more often, receive a higher number of procedures, and more complex procedures, compared to NTH. This explains higher cost of admission in TH. Further research is needed to study the readmission rates and outcomes of patients treated in both types of health systems to know the best practices that can reduce morbidity and readmissions.https://scholarlycommons.henryford.com/merf2019qi/1021/thumbnail.jp

Admission Rates, Healthcare Utilization, and Economic Burden of Radiation Cystitis (RC) in the United States

INTRODUCTION AND OBJECTIVES: Radiation cystitis (RC) is a major cause of morbidity after radiotherapy for pelvic cancers. In the absence of a definite cure, patients may require repeated admissions, undergoing multiple - often morbid - urological procedures. Our aim was to study the inpatient economic burden and healthcare utilization associated with RC in the United States (US). METHODS: We focused on 13,272 records of adult (age \u3e= 18) patients with a diagnosis of RC within the National Inpatient Sample (NIS) from 2008- 2014. Patients with a concurrent diagnosis of other bladder conditions (n=914) were excluded. Due to a change in NIS sampling methodology in 2012, trend of RC-associated admissions was analyzed for 2012-2014. ICD-9 diagnosis and procedure codes were used to study inpatient procedures performed during admission. Complex survey procedures were used to study the descriptive characteristics of RC patients and the procedures received during admission. Inflation- adjusted cost for each admission and cumulative annual cost of RC-associated admissions were calculated for the study period. RESULTS: The 12,358 assessable patients represented 61,346 admissions for RC nationally per NIS survey weights. The number of admissions increased gradually from 1681 (weighted 8405) in 2012 to 1803 (weighted 9015) in 2014. Overall 84% of all RC-associated admissions were non-elective. 74% of the patients were males. A vast majority (82%) of the patients had Medicare/Medicaid insurance. The admissions were equally distributed between teaching (49%) and non-teaching (51%) hospitals, however, 90% of the admissions were in hospitals located in urban areas. Any RC-directed procedure code was recorded in 62% admissions. Of these, 3,331 (43%) admissions recorded more than one procedure code. Blood transfusion was the most frequently recorded code (33%), followed by transurethral procedures (28%) and cystoscopy (12.6%). Radical cystectomy was done in 1.3% of the admissions. The median length of stay was 4.4 days (IQR 2.2-8.4).The inflation-adjusted cost per admission was 9207 US dollars (IQR 5275 -17,573) overall, being higher in teaching hospitals (median 9802 vs 8463 US dollars in non-teaching hospitals. The cumulative cost of inpatient treatment of radiation cystitis was 63.5 million US dollars per year, amounting to a total of 952.2 million over the study period. CONCLUSIONS: The incidence of RC-associated admissions is rising in the US. This disease is a major burden to US healthcare. The awareness of the inpatient economic burden and healthcare utilization associated with RC may have funding implications.https://scholarlycommons.henryford.com/merf2019qi/1020/thumbnail.jp

Managing Urology Consultations During COVID-19 Pandemic: Application of a Structured Care Pathway

OBJECTIVE: To describe and evaluate a risk-stratified triage pathway for inpatient urology consultations during the SARS-CoV-2 (COVID-19) pandemic. This pathway seeks to outline a urology patient care strategy that reduces the transmission risk to both healthcare providers and patients, reduces the healthcare burden, and maintains appropriate patient care. MATERIALS AND METHODS: Consultations to the urology service during a 3-week period (March 16 to April 2, 2020) were triaged and managed via one of 3 pathways: Standard, Telemedicine, or High-Risk. Standard consults were in-person consults with non COVID-19 patients, High-Risk consults were in-person consults with COVID-19 positive/suspected patients, and Telemedicine consults were telephonic consults for low-acuity urologic issues in either group of patients. Patient demographics, consultation parameters and consultation outcomes were compared to consultations from the month of March 2019. Categorical variables were compared using Chi-square test and continuous variables using Mann-Whitney U test. A P value \u3c.05 was considered significant. RESULTS: Between March 16 and April 2, 2020, 53 inpatient consultations were performed. By following our triage pathway, a total of 19/53 consultations (35.8%) were performed via Telemedicine with no in-person exposure, 10/53 consultations (18.9%) were High-Risk, in which we strictly controlled the urology team member in-person contact, and the remainder, 24/53 consultations (45.2%), were performed as Standard in-person encounters. COVID-19 associated consultations represented 18/53 (34.0%) of all consultations during this period, and of these, 8/18 (44.4%) were managed successfully via Telemedicine alone. No team member developed COVID-19 infection. CONCLUSION: During the COVID-19 pandemic, most urology consultations can be managed in a patient and physician safety-conscious manner, by implementing a novel triage pathway

Features of mammalian microRNA promoters emerge from polymerase II chromatin immunoprecipitation data

Background: MicroRNAs (miRNAs) are short, non-coding RNA regulators of protein coding genes. miRNAs play a very important role in diverse biological processes and various diseases. Many algorithms are able to predict miRNA genes and their targets, but their transcription regulation is still under investigation. It is generally believed that intragenic miRNAs (located in introns or exons of protein coding genes) are co-transcribed with their host genes and most intergenic miRNAs transcribed from their own RNA polymerase II (Pol II) promoter. However, the length of the primary transcripts and promoter organization is currently unknown. Methodology: We performed Pol II chromatin immunoprecipitation (ChIP)-chip using a custom array surrounding regions of known miRNA genes. To identify the true core transcription start sites of the miRNA genes we developed a new tool (CPPP). We showed that miRNA genes can be transcribed from promoters located several kilobases away and that their promoters share the same general features as those of protein coding genes. Finally, we found evidence that as many as 26% of the intragenic miRNAs may be transcribed from their own unique promoters. Conclusion: miRNA promoters have similar features to those of protein coding genes, but miRNA transcript organization is more complex. © 2009 Corcoran et al

Markedly Divergent Tree Assemblage Responses to Tropical Forest Loss and Fragmentation across a Strong Seasonality Gradient

We examine the effects of forest fragmentation on the structure and composition of tree assemblages within three seasonal and aseasonal forest types of southern Brazil, including evergreen, Araucaria, and deciduous forests. We sampled three southernmost Atlantic Forest landscapes, including the largest continuous forest protected areas within each forest type. Tree assemblages in each forest type were sampled within 10 plots of 0.1 ha in both continuous forests and 10 adjacent forest fragments. All trees within each plot were assigned to trait categories describing their regeneration strategy, vertical stratification, seed-dispersal mode, seed size, and wood density. We detected differences among both forest types and landscape contexts in terms of overall tree species richness, and the density and species richness of different functional groups in terms of regeneration strategy, seed dispersal mode and woody density. Overall, evergreen forest fragments exhibited the largest deviations from continuous forest plots in assemblage structure. Evergreen, Araucaria and deciduous forests diverge in the functional composition of tree floras, particularly in relation to regeneration strategy and stress tolerance. By supporting a more diversified light-demanding and stress-tolerant flora with reduced richness and abundance of shade-tolerant, old-growth species, both deciduous and Araucaria forest tree assemblages are more intrinsically resilient to contemporary human-disturbances, including fragmentation-induced edge effects, in terms of species erosion and functional shifts. We suggest that these intrinsic differences in the direction and magnitude of responses to changes in landscape structure between forest types should guide a wide range of conservation strategies in restoring fragmented tropical forest landscapes worldwide

La journée du souvenir André Prud'homme

The marine genus Pseudoalteromonas is known for its versatile biotechnological potential with respect to the production of antimicrobials and enzymes of industrial interest. We have sequenced the genomes of three Pseudoalteromonas sp. strains isolated from different deep sea sponges on the Illumina MiSeq platform. The isolates have been screened for various industrially important enzymes and comparative genomics has been applied to investigate potential relationships between the isolates and their host organisms, while comparing them to free-living Pseudoalteromonas spp. from shallow and deep sea environments. The genomes of the sponge associated Pseudoalteromonas strains contained much lower levels of potential eukaryotic-like proteins which are known to be enriched in symbiotic sponge associated microorganisms, than might be expected for true sponge symbionts. While all the Pseudoalteromonas shared a large distinct subset of genes, nonetheless the number of unique and accessory genes is quite large and defines the pan-genome as open. Enzymatic screens indicate that a vast array of enzyme activities is expressed by the isolates, including -galactosidase, -glucosidase, and protease activities. A -glucosidase gene from one of the Pseudoalteromonas isolates, strain EB27 was heterologously expressed in Escherichia coli and, following biochemical characterization, the recombinant enzyme was found to be cold-adapted, thermolabile, halotolerant, and alkaline active

Unique and conserved MicroRNAs in wheat chromosome 5D revealed by next-generation sequencing

MicroRNAs are a class of short, non-coding, single-stranded RNAs that act as post-transcriptional regulators in gene expression. miRNA analysis of Triticum aestivum chromosome 5D was performed on 454 GS FLX Titanium sequences of flow sorted chromosome 5D with a total of 3,208,630 good quality reads representing 1.34x and 1.61x coverage of the short (5DS) and long (5DL) arms of the chromosome respectively. In silico and structural analyses revealed a total of 55 miRNAs; 48 and 42 miRNAs were found to be present on 5DL and 5DS respectively, of which 35 were common to both chromosome arms, while 13 miRNAs were specific to 5DL and 7 miRNAs were specific to 5DS. In total, 14 of the predicted miRNAs were identified in wheat for the first time. Representation (the copy number of each miRNA) was also found to be higher in 5DL (1,949) compared to 5DS (1,191). Targets were predicted for each miRNA, while expression analysis gave evidence of expression for 6 out of 55 miRNAs. Occurrences of the same miRNAs were also found in Brachypodium distachyon and Oryza sativa genome sequences to identify syntenic miRNA coding sequences. Based on this analysis, two other miRNAs: miR1133 and miR167 were detected in B. distachyon syntenic region of wheat 5DS. Five of the predicted miRNA coding regions (miR6220, miR5070, miR169, miR5085, miR2118) were experimentally verified to be located to the 5D chromosome and three of them : miR2118, miR169 and miR5085, were shown to be 5D specific. Furthermore miR2118 was shown to be expressed in Chinese Spring adult leaves. miRNA genes identified in this study will expand our understanding of gene regulation in bread wheat