Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Simultaneous Study of Cholesterol and GM1 Ganglioside by Specific Probes: Lipid Distribution during Maturation, Capacitation and the Acrosome Reaction

Lipid distribution has been extensively studied in the plasma membrane of the male gamete due to its relevant role in sperm physiology. However, there are controversial reports about their distribution. Because of different reports about this topic, the aim of this work was define cholesterol and GM1 ganglioside location by simultaneous detection during sperm maturation, capacitation and the acrosome reaction in CF1 mouse sperm. We observed that throughout the epididymis, cholesterol detected by filipin III or complex and GM1 ganglioside by cholera toxin, colocalized in the acrosomal domain of the head and midpiece of the flagellum. During sperm capacitation, a decrease of cholesterol can be observed like diffuse pattern on the whole head, while GM1 ganglioside was restricted to the apical acrosome. Capacitated sperm incubated with acrosome reaction inducers showed a diffuse location on the head with both probes after acrosomal exocytosis. Also, both probes did not show different locations on the flagellum. These findings indicate that cholesterol and GM1 ganglioside have a dynamic behaviour during the life of the sperm, which could indicate that a continuous assembly or disassembly of the lipid raft could be involved in the responsiveness of the sperm to different environments. Thus, during sperm capacitation and acrosome reaction there is a redistribution of the lipids. However, there are not apparent changes during sperm maturation. Cholesterol efflux, a characteristic event of sperm capacitation, could be analyzed through diffuse pattern described by filipin, and GM1 ganglioside patterns observed by the cholera toxin could be interesting when it is needed to evaluate sperm capacitation and the acrosome reaction in fixed spermFil: Boarelli, Paola Vanina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos. Universidad Nacional de Cuyo. Facultad de Cienicas Médicas. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos; ArgentinaFil: Monclus, Maria de Los Angeles. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos. Universidad Nacional de Cuyo. Facultad de Cienicas Médicas. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos; ArgentinaFil: Lancelotti, T. S.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos. Universidad Nacional de Cuyo. Facultad de Cienicas Médicas. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos; ArgentinaFil: Cabrillana, María Eugenia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos. Universidad Nacional de Cuyo. Facultad de Cienicas Médicas. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos; ArgentinaFil: Simón, Layla Yamila. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos. Universidad Nacional de Cuyo. Facultad de Cienicas Médicas. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos; ArgentinaFil: Funes, Abi Karenina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos. Universidad Nacional de Cuyo. Facultad de Cienicas Médicas. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos; ArgentinaFil: Fornes, Miguel Walter. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos. Universidad Nacional de Cuyo. Facultad de Cienicas Médicas. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos; Argentin

RBD and Spike DNA-Based Immunization in Rabbits Elicited IgG Avidity Maturation and High Neutralizing Antibody Responses against SARS-CoV-2

Neutralizing antibodies (nAbs) are a critical part of coronavirus disease 2019 (COVID-19) research as they are used to gain insight into the immune response to severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infections. Among the technologies available for generating nAbs, DNA-based immunization methods are an alternative to conventional protocols. In this pilot study, we investigated whether DNA-based immunization by needle injection in rabbits was a viable approach to produce a functional antibody response. We demonstrated that three doses of DNA plasmid carrying the gene encoding the full-length spike protein (S) or the receptor binding domain (RBD) of SARS-CoV-2 induced a time-dependent increase in IgG antibody avidity maturation. Moreover, the IgG antibodies displayed high cross neutralization by live SARS-CoV-2 and pseudoviruses neutralization assays. Thus, we established a simple, low cost and feasible DNA-based immunization protocol in rabbits that elicited high IgG avidity maturation and nAbs production against SARS-CoV-2, highlighting the importance of DNA-based platforms for developing new immunization strategies against SARS-CoV-2 and future emerging epidemics

On topological Morse theory

Starting from the concept of Morse critical point, introduced in [A. Ioffe and E. Schwartzman, J. Math. Pures Appl. (9), 75 (1996), 125-153], we propose a purely topological approach to Morse theory

Intra-site spatial analysis in ethnoarchaeology

The interpretative power of quantitative intra-site spatial analysis has long been recognised by archaeologists. On the contrary, very few ethnoarchaeological works have engaged with the statistical analysis of intra-site pattern of artefacts and ecofacts. Nonetheless, ethnoarchaeology is uniquely placed to guide and assist in the identification of sound techniques and in the development of the methodology of analysis. The possibility to directly connect the distribution of the proxies under study with the activity that generated such distribution, provide the means of fine-tuning the tools we use for identifying these patterns in the archaeological record. As a consequence, archaeological methodology and interpretation both benefit from the application of improved methodologies. In this paper we review some of the most common techniques used to analyse activity areas and we provide examples of the application of such techniques to ethnoarchaeological contexts. The aim is to assess how archaeology can benefit from the intra-site spatial analysis of ethnoarchaeological contexts