The Spartacus Rebellion, More Than a Slave Revolt

The Spartacus Revolt is commonly known for its titular leader, whose deeds have been romanticized in movies and other media. While Hollywood has led many to believe Spartacus was a revolutionary leader working to end slavery in the Roman Empire, this is not an accurate characterization. However, that does not mean that the Spartacus Revolt was nothing more than a historical footnote, although not for its leader. In fact, the revolt should be seen as a revolt of a middle class of veterans in the Roman Empire who wanted greater social standing than the end of the Social War had afforded them, rather than a revolt merely by slaves

Life-Threatening Adenovirus Infections in the Setting of the Immunocompromised Allogeneic Stem Cell Transplant Patients

A single institution case series of adenovirus infections after allogeneic hematopoietic stem cell transplantation is presented to highlight the consideration for adenovirus infections as an etiology in patients with rapid hepatic or other sudden organ deterioration in the setting of apparent GVHD stabilization. The series also highlights that survival is limited with these infections often due in part to concomitant opportunistic infections. In addition, the pathophysiological events, such as GVHD and hepatic dysfunction, may complicate the clinical picture and delay therapy of an opportunistic infection. This is particularly true for adenoviral infections as they also have a distinct clinical picture in immunocompromised patients when compared to immune competent patients. Adenovirus infections also have the additional challenge that its treatment, cidofovir, has associated toxicities that can delay its administration. Recent developments has yielded an assay that can be used in the early detection and for serial determinations of adenovirus in patients with advanced GVHD, as well as a new therapeutic agent currently undergoing clinical trials

The Glucagon Receptor Is Required for the Adaptive Metabolic Response to Fasting

SummaryGlucagon receptor (Gcgr) signaling maintains hepatic glucose production during the fasting state; however, the importance of the Gcgr for lipid metabolism is unclear. We show here that fasted Gcgr−/− mice exhibit a significant increase in hepatic triglyceride secretion and fasting increases fatty acid oxidation (FAO) in wild-type (WT) but not in Gcgr−/− mice. Moreover fasting upregulated the expression of FAO-related hepatic mRNA transcripts in Gcgr+/+ but not in Gcgr−/− mice. Exogenous glucagon administration reduced plasma triglycerides in WT mice, inhibited TG synthesis and secretion, and stimulated FA beta oxidation in Gcgr+/+ hepatocytes. The actions of glucagon on TG synthesis and FAO were abolished in PPARα−/− hepatocytes. These findings demonstrate that the Gcgr receptor is required for control of lipid metabolism during the adaptive metabolic response to fasting

The transcriptomic evolution of mammalian pregnancy:gene expression innovations in endometrial stromal fibroblasts

The endometrial stromal fibroblast (ESF) is a cell type present in the uterine lining of therian mammals. In the stem lineage of eutherian mammals, ESF acquired the ability to differentiate into decidual cells in order to allow embryo implantation. We call the latter cell type “neo-ESF” in contrast to “paleo-ESF” which is homologous to eutherian ESF but is not able to decidualize. In this study, we compare the transcriptomes of ESF from six therian species: Opossum (Monodelphis domestica; paleo-ESF), mink, rat, rabbit, human (all neo-ESF), and cow (secondarily nondecidualizing neo-ESF). We find evidence for strong stabilizing selection on transcriptome composition suggesting that the expression of approximately 5,600 genes is maintained by natural selection. The evolution of neo-ESF from paleo-ESF involved the following gene expression changes: Loss of expression of genes related to inflammation and immune response, lower expression of genes opposing tissue invasion, increased markers for proliferation as well as the recruitment of FOXM1, a key gene transiently expressed during decidualization. Signaling pathways also evolve rapidly and continue to evolve within eutherian lineages. In the bovine lineage, where invasiveness and decidualization were secondarily lost, we see a re-expression of genes found in opossum, most prominently WISP2, and a loss of gene expression related to angiogenesis. The data from this and previous studies support a scenario, where the proinflammatory paleo-ESF was reprogrammed to express anti-inflammatory genes in response to the inflammatory stimulus coming from the implanting conceptus and thus paving the way for extended, trans-cyclic gestation

Filter life span in postoperative cardiovascular surgery patients requiring continuous renal replacement therapy, using a post dilution regional citrate anticoagulation continuous hemofiltration circuit

Background: Regional citrate anticoagulation (RCA) is the recommended standard for continuous renal replacement therapy (CRRT). This study assesses its efficacy in patients admitted to critical care following cardiovascular surgery and the influence of standard antithrombotic agents routinely used in this specific group. Methods: Consecutive cardiovascular surgery patients treated with post-dilution hemofiltration with RCA were included in this prospective observational study. The primary outcome of the study was CRRT circuit life-span adjusted for reasons other than clotting. The secondary outcome evaluated the influence of standard antithrombotic agents (acetylsalicylic acid [ASA], low molecular weight heparin [LMWH] or fondaparinux as thromboprophylaxis or treatment dose with or without ASA) on filter life. Results: Fifty-two patients underwent 193 sessions of CVVH, after exclusion of 15 sessions where unfractionated heparin was administered. The median filter life span was 58 hours. Filter life span was significantly longer in patients receiving therapeutic dose of LMWH or fondaparinux (79 h [2–110]), in comparison to patients treated with prophylactic dose of LMWH or fondaparinux (51 h [7–117], p < 0.001), and patients without antithrombotic prophylaxis (42 h [2–91], p < 0.0001). 12 bleeding episodes were observed; 8 occurred in patients receiving treatment dose anticoagulation, 3 in patients receiving prophylactic dose anticoagulation and 1 in a patient with no antithrombotic prophylaxis. Conclusions: A post dilution hemofiltration with RCA provides prolonged filter life span when adjusted for reasons other than clotting. Patients receiving treatment dose anticoagulation had a significantly longer filter life span than those who were on prophylactic doses or ASA alone

Factors Impacting COVID-19 Vaccine Hesitancy and Resistance Among College Students in Northwest Ohio

Background: Vaccination is a critical strategy for controlling the transmission of COVID-19 and for returning to normalcy on college campuses; however, vaccine hesitancy and resistance persist as a significant barrier. This study utilized the integrated behavior model (IBM) and the precaution adoption process model (PAPM) to identify factors predictive of COVID-19 vaccine willingness (receptive, hesitant, and resistant) among college students. Methods: A sample of 1248 students at 2 universities in northwest Ohio were surveyed online in 2021. Stata/SE, version 17 (StataCorp) software was used to conduct stepwise logistic regression to investigate the association of theoretical constructs with vaccine willingness, after controlling for COVID-19 related factors and sociodemographic factors. Results: Most students (82.5%) were vaccine receptive, 6.9% were vaccine hesitant, and 10.6% were vaccine resistant. Vaccine hesitancy was higher among students aged 18 to 22 years (9.3%), undergraduates (16.5%), and students who identified as Black (13%) or Middle Eastern (14.3%). Lower vaccine hesitance was significantly predicted by IBM constructs of positive attitudes, high self-efficacy, and high salience. Not getting an influenza vaccine in the past 3 years and viewing vaccination as a personal choice were significantly associated with higher vaccine hesitancy. Lower odds of vaccine resistance were predicted by higher subjective norms. Descriptive norms, not getting an influenza vaccine in the past 3 years, agreeing with conspiracies, and viewing vaccination as a personal choice were strongly predictive of higher vaccine resistance. Conclusion: Identifying the factors that predict vaccine hesitancy and resistance among college students is critical for college administrators, and for those who are designing health communication campaigns, to increase vaccination among this priority population

Pre-existing invasive fungal infection is not a contraindication for allogeneic HSCT for patients with hematologic malignancies: a CIBMTR study.

Patients with prior invasive fungal infection (IFI) increasingly proceed to allogeneic hematopoietic cell transplantation (HSCT). However, little is known about the impact of prior IFI on survival. Patients with pre-transplant IFI (cases; n=825) were compared with controls (n=10247). A subset analysis assessed outcomes in leukemia patients pre- and post 2001. Cases were older with lower performance status (KPS), more advanced disease, higher likelihood of AML and having received cord blood, reduced intensity conditioning, mold-active fungal prophylaxis and more recently transplanted. Aspergillus spp. and Candida spp. were the most commonly identified pathogens. 68% of patients had primarily pulmonary involvement. Univariate and multivariable analysis demonstrated inferior PFS and overall survival (OS) for cases. At 2 years, cases had higher mortality and shorter PFS with significant increases in non-relapse mortality (NRM) but no difference in relapse. One year probability of post-HSCT IFI was 24% (cases) and 17% (control, P<0.001). The predominant cause of death was underlying malignancy; infectious death was higher in cases (13% vs 9%). In the subset analysis, patients transplanted before 2001 had increased NRM with inferior OS and PFS compared with later cases. Pre-transplant IFI is associated with lower PFS and OS after allogeneic HSCT but significant survivorship was observed. Consequently, pre-transplant IFI should not be a contraindication to allogeneic HSCT in otherwise suitable candidates. Documented pre-transplant IFI is associated with lower PFS and OS after allogeneic HSCT. However, mortality post transplant is more influenced by advanced disease status than previous IFI. Pre-transplant IFI does not appear to be a contraindication to allogeneic HSCT

Martensitic transformation, magnetic entropy, and adiabatic temperature changes in bulk and ribbon Ni48Mn39.5Sn12.5−xInx (x = 2, 4, 6) metamagnetic shape memory alloys

Martensitic transformation, magnetic entropy, and direct adiabatic temperature changes in Ni48Mn39.5Sn12.5− xInx (x = 2, 4, 6) metamagnetic Heusler bulk and grain-constrained ribbon alloys were studied. All alloys showed a typical L21 structure in austenite and the 4O structure in martensite. Their relative volume contributions changed depending on In content. With increasing In concentration, the martensitic transformation temperature increased, whereas the Curie temperature of austenite decreased. The magnetic entropy change under magnetic field of 5 T attained maximum of 20 J/kgK in the bulk and 14.4 J/kgK in the ribbon alloys with the Ni48Mn39.5Sn8.5In4 nominal composition. The corresponding adiabatic temperature change under 1.7 T yielded 1.3 K for the Ni48Mn39.5Sn8.5In4 bulk alloy. Despite grain confinement, melt spinning was found to stabilize martensite phase. Changes observed were discussed with relation to strengthened covalency imposed by In substitution