The immune system cell populations were increased in salt-induced hypertensive rats without an increase in the serum testosterone level (Short communication)

The consumption of dietary salt has significantly increased globally, especially in the developed countries. High dietary salt intake has been linked to onset and complications in hypertension with a dimorphism tendency. There is scanty information about the influence of high salt diet on the immune cell population and androgen level in circulation. Male Sprague–Dawley rats of 8 weeks old were used for this study. They were divided into control (fed 0.1% salted feed) and salt-loaded groups (fed 8% salted feed) for 8 weeks. All experimental rats were allowed access to clean drinking water; daily feed consumption was measured in addition to weekly weight. On confirmation of hypertension using PowerLab® data acquisitions system, the rats were sacrificed and blood samples were collected into EDTA and sterile sample bottles. EDTA-blood samples were used for white blood cell and CD4 counts while the serum was used for hormonal assays. All salt-loaded rats became hypertensive, with a significant increase in total white blood cell, lymphocyte, neutrophil, monocyte, and CD4 cell counts. However, the eosinophil count was significantly decreased in salt-loaded rats. This study showed no change in the serum testosterone in salt-loaded male rats compared with control. In summary, dietary salt loading while precipitating hypertension also activated increased production of white blood cells and CD4 cells without any change in the serum testosterone level

Evaluating assumptions of scales for subjective assessment of thermal environments – Do laypersons perceive them the way, we researchers believe?

International audienc

A limited-size ensemble of homogeneous CNN/LSTMs for high-performance word classification

The strength of long short-term memory neural networks (LSTMs) that have been applied is more located in handling sequences of variable length than in handling geometric variability of the image patterns. In this paper, an end-to-end convolutional LSTM neural network is used to handle both geometric variation and sequence variability. The best results for LSTMs are often based on large-scale training of an ensemble of network instances. We show that high performances can be reached on a common benchmark set by using proper data augmentation for just five such networks using a proper coding scheme and a proper voting scheme. The networks have similar architectures (convolutional neural network (CNN): five layers, bidirectional LSTM (BiLSTM): three layers followed by a connectionist temporal classification (CTC) processing step). The approach assumes differently scaled input images and different feature map sizes. Three datasets are used: the standard benchmark RIMES dataset (French); a historical handwritten dataset KdK (Dutch); the standard benchmark George Washington (GW) dataset (English). Final performance obtained for the word-recognition test of RIMES was 96.6%, a clear improvement over other state-of-the-art approaches which did not use a pre-trained network. On the KdK and GW datasets, our approach also shows good results. The proposed approach is deployed in the Monk search engine for historical-handwriting collections

Mu2e Technical Design Report

The Mu2e experiment at Fermilab will search for charged lepton flavor violation via the coherent conversion process mu- N --> e- N with a sensitivity approximately four orders of magnitude better than the current world's best limits for this process. The experiment's sensitivity offers discovery potential over a wide array of new physics models and probes mass scales well beyond the reach of the LHC. We describe herein the preliminary design of the proposed Mu2e experiment. This document was created in partial fulfillment of the requirements necessary to obtain DOE CD-2 approval.Comment: compressed file, 888 pages, 621 figures, 126 tables; full resolution available at http://mu2e.fnal.gov; corrected typo in background summary, Table 3.

Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p<00001), age 70 years or older versus younger than 70 years (230 [165-322], p<00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p<00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Macroeconomic costs and benefits of a common currency for the second West African Monetary Zone (WAMZ)

Against the background and mixed results on the implications of adopting a common monetary policy framework, this study examined the macroeconomic costs and benefits of a common currency for the second West African Monetary Zone (WAMZ). Macroeconometric models based on a hybrid theoretical framework of the Optimum Currency Area and the Endogenous Optimum Currency Area theories were developed to estimate the elements of costs and benefits of monetary union. It revealed that the costs due to loss of monetary policy autonomy and fiscal policy distortion were significantly higher than the expected trade creation and policy coordination gains. To benefit from economic and monetary integration, the region needed to deal with the sources of fiscal policy distortion through better management of their economies.Keywords: Behavioural models, Monetary policy autonomy, Fiscal policy distortion and Asymmetric shocks.JEL Classification: E60, E61, E63, F41 and F4

Improving Care Pathway Access and Utilization in an HIV/AIDS Skilled Nursing Center in New Haven, CT

Background: Individuals living with HIV/AIDS are at greater risk for developing chronic conditions, such as diabetes, cardiovascular diseases, hypertension, and cognitive impairment. These individuals are also more likely to present with complex social and mental health needs. Unstable housing, lack of transportation, unemployment, substance abuse, depression, anxiety, and other psychiatric disorders are disproportionately experienced by HIV/AIDS patients. The confluence of these conditions result in high usage of Emergency Department (ED) services for non-urgent needs. Methods: We conducted a preliminary landscape analysis to explore factors that influence patient access and adherence to care pathways. Medical records of 28 Leeway Residential Care Home (RCH) residents up to May 2021 were extracted and analyzed. Of these 28 residents, 12 were selected for participation in semi-structured, in-depth qualitative interviews. Additionally, 6 RCH staff members participated in qualitative interviews. Results: Staff support, barriers to care utilization, substance use treatment and management, community-building at Leeway, building resident self-efficacy, and navigating mental health and social needs were major themes that emerged from Leeway RCH staff and resident interviews. 89.3% of residents had at least one mental health condition diagnosis and 64.3% of residents had a history of substance use. The most common comorbidities among residents were neurological disorders (82.1%), complications of the lungs (64.3%), and cardiovascular disease (60.7%). The most common mental health conditions among residents were depression (46.4%), suicide (32.1%), and schizophrenia/schizoaffective disorder (28.6%). The highest number of ER visits per year among RCH residents was 22. The most common ER diagnoses were other, pain, and lung issues. Conclusion: Residents reported having medical and basic needs met through services at Leeway. Residents’ complex psychosocial and emotional needs as well as difficulties managing substance use could contribute to poor utilization of care pathways. Identifying and leveraging community assets to meet residents’ psychosocial and emotional needs and implementing peer-support and/or community health worker models to build resident self-efficacy could improve care pathway utilization.https://elischolar.library.yale.edu/ysph_pbchrr/1053/thumbnail.jp

Staying or moving: Results of a latent transition analysis examining intra-individual stability of recreational substance use among MSM in the Multicenter AIDS Cohort Study from 2004 to 2016

BackgroundStudies have examined patterns of substance use among Men who have Sex with Men (MSM), but few have examined factors predicting transitioning from one substance use pattern to another. We investigated transitioning from one substance use pattern to another over a 12-year period (2004-2016) among the Multicenter AIDS Cohort Study participants.MethodAlcohol, marijuana, heroin, cocaine, poppers, uppers (e.g., methamphetamines) and erectile dysfunction(ED) medications use in the last 6 months from 3568 US MSM was dichotomized (no/yes) to classify participants into substance use classes at each follow up visit. We fit latent transition models to calculate transition probabilities of moving from one substance use class to another over a 3, 4 and 6-year time period. Then fit regression models to identify factors associated with the probability of each participant staying in or moving from the same substance use class.ResultsOverall, cocaine and ED medication use declined but marijuana and heroin use increased over 2004-2016. We observed most participants (84.6 %-100 %) stayed in the same class. Increased age was associated with transition from the Minimal-use class to the Alcohol-only class (aOR = 1.06,95 %CI:1.01-1.13;p < 0.01) and non-White MSM reported lower odds of moving from the Alcohol-only class to the Alcohol-Popper class (aOR = 0.50,95 %CI:0.30-0.82;p <0.01). There were no difference in the transition probabilities by HIV-status.ConclusionDespite decline in substance use in general, participants are highly stable in their choice of substances. However, treating MSM as a homogeneous group can lead to an under-appreciation of the diversity of prevention needs and treatment of substance using MSM