The Effect of Covid-19 on Cardiac Health Investigated by Electrocardiogram in Collegiate Athletes

Covid-19 has emerged as a global pandemic and affected almost every organ of the body. There is limited data on cardiovascular involvement in athletes with covid-19 infection. PURPOSE: The purpose of the study is to determine the effect of covid-19 on cardiac health in collegiate athletes by electrocardiogram. METHODS: Prior to testing, all subjects signed an Informed Consent approved by the university Institutional Review Board (IRB). Screening electrocardiograms were performed in 45 Covid-19 infected basketball, football and soccer playing athletes (39 males and 6 females) of 18-25 years of age and have since shown to be negative following two successive tests. The data were then compared to ECG values in non-infected basketball, football, and soccer athletes, obtained by conducting meta-analyses with having same age and sport criteria. Descriptive statistics were means and standard deviation (SD). Additional statistical analyses utilized a Factorial ANOVA with main effect, post hoc Tukey and effect size calculations. Statistical significance is set a priori at P \u3c 0.05. RESULTS: The total number of subjects in experimental group were 12 male basketball players, 23 male football players, 4 male soccer players and 6 female Soccer players. The total number of subjects in control group obtained through meta-analyses were 591 male basketball athletes, 176 male footballers, 588 male soccer athletes and 154 female soccer athletes. The baseline characteristics of mean (SD) BMI (kg/m2) for experimental group was as follows: male basketball: 23.4 (1.77), male football: 31.5 (6.53), male soccer: 23.9 (1.55), and female soccer: 24.5 (4.52). For control groups, BMI were as follows: male basketball: 25, male football: 22.6 (7), male soccer: 23.1 (0.8), and female soccer: 21.8 (0.3). The factorial ANOVA shows that there is a significant difference in ECG parameters between male and females (p=0.001) and between sports (p= 0.000034) but not between experimental and control group (p=0.18). The post hoc Tukey analysis indicated the following: PR interval and QRS duration were significantly (p=0.006, p=0.017) higher in males compared to females, respectively; PR interval was significantly (p=0.04) lower in Soccer players compared to other sports. The resting heart rate (RHR) was significantly (p=0.01) higher in the experimental group compared to controls, yet was within normal range of heart rate. While there was not a significant difference between the two groups in the ECG parameters, there was a small to huge effect size in ECG parameters in male and female soccer players. In male soccer players between the groups, the value of Cohen D for RHR was 0.16 (very small effect size), 0.92 (large effect size) for QRS duration and 0.72 (medium effect size) for QTc interval. For the female soccer players, the value of Cohen D for RHR was 1.70 (very large effect size), and 0.67 (medium effect size) for QRS duration. There is a huge effect size in RHR in male football athletes with a Cohen D value of 2.1. CONCLUSION: The effect of Covid-19 on ECG parameters is more profound in male athletes compared to female counterparts, primarily in RHR, PR interval and QRS duration. In terms of sports, the male and female soccer players have changes in ECG parameters when compared to male football and basketball athletes

The Role of Personalized Choice in Decision Support: A Randomized Controlled Trial of an Online Decision Aid for Prostate Cancer Screening

Importance Decision support tools can assist people to apply population-based evidence on benefits and harms to individual health decisions. A key question is whether “personalising” choice within decisions aids leads to better decision quality. Objective To assess the effect of personalising the content of a decision aid for prostate cancer screening using the Prostate Specific Antigen (PSA) test. Design Randomized controlled trial. Setting Australia. Participants 1,970 men aged 40–69 years were approached to participate in the trial. Intervention 1,447 men were randomly allocated to either a standard decision aid with a fixed set of five attributes or a personalised decision aid with choice over the inclusion of up to 10 attributes. Outcome Measures To determine whether there was a difference between the two groups in terms of: 1) the emergent opinion (generated by the decision aid) to have a PSA test or not; 2) self-rated decision quality after completing the online decision aid; 3) their intention to undergo screening in the next 12 months. We also wanted to determine whether men in the personalised choice group made use of the extra decision attributes. Results 5% of men in the fixed attribute group scored ‘Have a PSA test’ as the opinion generated by the aid, as compared to 62% of men in the personalised choice group (χ2 = 569.38, 2df, p< 0001). Those men who used the personalised decision aid had slightly higher decision quality (t = 2.157, df = 1444, p = 0.031). The men in the personalised choice group made extensive use of the additional decision attributes. There was no difference between the two groups in terms of their stated intention to undergo screening in the next 12 months. Conclusions Together, these findings suggest that personalised decision support systems could be an important development in shared decision-making and patient-centered care.funded by the National Health and Medical Research Council of Australia under Program Grant number 6633003

Impact of the introduction of falls risk assessment toolkit on falls prevention and psychotropic medicines' utilisation in Walsall: an interrupted time series analysis.

OBJECTIVE: To determine the impact of the introduction of a falls risk assessment toolkit (FRAT) in a UK medical centre on the number and cost of non-elective admissions for falls and psychotropic medication utilisation. DESIGN: Interrupted time series analysis quantifying the number and cost of non-elective admissions for falls and primary care use data for Rushall Medical Centre before and after the implementation of FRAT at July 2017. SETTING: Data on the monthly number and cost of non-elective admissions for falls and number of referrals and assessment to the falls service were provided by Walsall Clinical Commissioning Group. Primary care prescribing cost and volume data for Rushall Medical Centre was derived from the Openprescribing.net website for prescriptions dispensed between April 2015 and November 2018. PRIMARY AND SECONDARY OUTCOME MEASURES: The number and cost of non-elective admissions for falls and number of referrals and assessment to the falls service, and the volume of utilisation of psychotropic medicines. RESULTS: Following the implementation of FRAT at Rushall Medical Centre in July 2017, the number of non-elective admissions for falls decreased at a rate of 0.414 admissions per month (p<0.033, 95% CI -0.796 to -0.032). The utilisation of psychotropic medications (alimemazine, citalopram, escitalopram, fluoxetine, mirtazapine, olanzapine and risperidone) decreased. The expenditure on psychotropic medications prescribed/used at Rushall Medical Centre decreased by at least £986 per month (p<0.001, 95% CI -2067 to -986). CONCLUSIONS: The implementation of FRAT at Rushall Medical Centre was associated with a reduction in the number of non-elective admissions for falls. Assessment of these patients together with deprescribing of psychotropic medications resulted in a reduction in the number of non-elective admissions for falls and associated costs

MicroRNA-148a controls epidermal and hair follicle stem/progenitor cells by modulating the activities of Rock1 and Elf5

Skin and hair development is regulated by complex programs of gene activation and silencing and microRNA-dependent modulation of gene expression to maintain normal skin and hair follicle development, homeostasis, and cycling. In this study, we show that miR-148a, through its gene targets, plays an important role in regulating skin homeostasis and hair follicle cycling. RNA and protein analysis of miR-148a and its gene targets were analyzed using a combination of in vitro and in vivo experiments. We show that the expression of miR-148a markedly increases during telogen (bulge and hair germ stem cell compartments). Administration of antisense miR-148a inhibitor into mouse skin during the telogen phases of the postnatal hair cycle results in accelerated anagen development and altered stem cell activity in the skin. We also show that miR-148a can regulate colony-forming abilities of hair follicle bulge stem cells as well as control keratinocyte proliferation/differentiation processes. RNA and protein analysis revealed that miR-148a may control these processes by regulating the expression of Rock1 and Elf5 in vitro and in vivo. These data provide an important foundation for further analyses of miR-148a as a crucial regulator of these genes target in the skin and hair follicles and its importance in maintaining stem/progenitor cell functions during normal tissue homeostasis and regeneration

Predicting the Need for Ventilation in Term and Near-Term Neonates

To determine whether the need for respiratory support can be predicted by oxygen requirement within the first 72 h in term and near-term infants. Methods: To mimic the population of infants that would often be delivered outside a tertiary centre we studied a retrospective cohort of infants greater than or equal to 32 weeks requiring oxygen, divided into three groups: cot oxygen only, nasal continuous positive airway pressure (NCPAP) only, or intermittent positive pressure ventilation (IPPV). We recorded each infant's peak fraction of inspired oxygen (FiO2) - i.e. FiO 2 in the first 72 h in the cot oxygen only group or maximum FiO2 prior to commencing the highest level of respiratory support. The peak FiO2 was used as a diagnostic test to predict any respiratory support or IPPV-sensitivity and specificity were calculated and receiver operating characteristic (ROC) curves plotted (FiO2 0.21-1.00) to identify the best balance point for prediction. Results: The cohort included 592 infants: 516 cot oxygen only, 46 NCPAP only and 30 IPPV. The proportion ventilated increased with increasing peak FiO2 - above 0.45 the proportion of infants ventilated exceeded 50%. To predict any respiratory support, the cut-point balancing sensitivity and specificity was a FiO2 greater than or equal to 0.35-58/136 required respiratory support (sensitivity = 0.76, specificity = 0.85, positive predictive value (PPV) = 43%, negative predictive value (NPV) = 96%). To predict IPPV the cut-point was a FiO2 greater than or equal to 0.5-28/47 treated with IPPV (sensitivity = 0.93, specificity = 0.97, PPV = 60%, NPV = 100%). Conclusion: The need for respiratory support can be predicted by oxygen requirement within the first 72 h in term and near-term infants with reasonable sensitivity and excellent specificity

Inhibitory effect of HIV-specific neutralizing IgA on mucosal transmission of HIV in humanized mice

HIV-1 infections are generally initiated at mucosal sites. Thus, IgA antibody, which plays pivotal roles in mucosal immunity, might efficiently prevent HIV infection. However, mounting a highly effective HIV-specific mucosal IgA response by conventional immunization has been challenging and the potency of HIV-specific IgA against infection needs to be addressed in vivo. Here we show that the polymeric IgA form of anti-HIV antibody inhibits HIV mucosal transmission more effectively than the monomeric IgA or IgG1 form in a comparable range of concentrations in humanized mice. To deliver anti-HIV IgA in a continual manner, we devised a hematopoietic stem/progenitor cell (HSPC)–based genetic approach using an IgA gene. We transplanted human HSPCs transduced with a lentiviral construct encoding a class-switched anti-HIV IgA (b12-IgA) into the humanized bone marrow-liver-thymus (BLT) mice. The transgene was expressed specifically in B cells and plasma cells in lymphoid organs and mucosal sites. After vaginal HIV-1 challenge, mucosal CD4^+ T cells in the b12-IgA–producing mice were protected from virus-mediated depletion. Similar results were also obtained in a second humanized model, “human immune system mice.” Our study demonstrates the potential of anti-HIV IgA in immunoprophylaxis in vivo, emphasizing the importance of the mucosal IgA response in defense against HIV/AIDS

Antibodies against six human herpesviruses in relation to seven cancers in black South Africans: A case control study

BACKGROUND: Infections with certain human herpesviruses have been established as risk factors for some cancer types. For example, Epstein-Barr Virus is considered a cause of Burkitt's lymphoma and other immunosuppression related lymphomas, Hodgkin lymphoma, and nasopharyngeal cancer. Several other human herpesviruses have been linked to cancers but the totality of evidence is inconclusive. METHODS: We conducted a systematic sub-study from within an ongoing case control study of adult black South Africans to investigate the relationship between antibodies to six human herpesviruses and seven cancer groups that may be caused by infectious agents. Subjects had incident cancers of the oral cavity(n = 88), the cervix(n = 53), the prostate(n = 66), Hodgkin lymphoma(n = 83), non-Hodgkin lymphoma(n = 80), multiple myeloma(n = 94) or leukaemia(n = 203). For comparison, patients with other cancers(n = 95) or cardiovascular disease(n = 101) were randomly selected from within the study. Patients were interviewed and their blood was tested for IgG antibodies against HSV-1, HSV-2, VZV, EBV-EBNA, CMV and HHV-6 using enzyme linked immunosorbent assays. Because these viruses are highly prevalent in this population, optical density results from the assays were used as an indirect, quantitative measure of antibody level. RESULTS: There was significant variation in the mean log antibody measures for HSV-2, VZV, CMV and HHV-6 between the disease groups. However, none of the specific cancer groups had significantly higher mean log antibody measures for any of the viruses compared to either control group. In a more detailed examination of seven associations between cancers and herpesviruses for which there had been prior reports, two statistically significant associations were found: a decreasing risk of myeloid leukaemia and an increasing risk of oral cancer with increasing tertiles of antibodies against HHV-6 compared to all other patients (p-trend = 0.03 and 0.02, respectively). Odds ratios for the top tertile compared to the bottom tertile were 0.58 (95%CI 0.3 – 1.0) for myeloid leukaemia and 2.21 (95% CI 1.1 – 4.3) for oral cancer. CONCLUSION: In this population, using these tests for IgG, neither mean antibody measure nor high antibody measure against human herpesviruses 1–6 was strongly associated with any of the seven cancer groups. However, we may not have had sufficient power to detect weak associations or associations with a sub-type of cancer if they were present

Fabrication of FeSe1-x superconducting films with bulk properties

We have fabricated high-quality FeSe1-x superconducting films with a bulk Tc of 11-12 K on different substrates, Al2O3(0001), SrTiO3(100), MgO(100), and LaAlO3(100), by using a pulsed laser deposition technique. All the films were grown at a high substrate temperature of 610 oC, and were preferentially oriented along the (101) direction, the latter being to be a key to fabricating of FeSe1-x superconducting thin films with high Tc. According to the energy dispersive spectroscopy data, the Fe:Se composition ratio was 1:0.90+-0.02. The FeSe1-x film grown on a SrTiO3 substrate showed the best quality with a high upper critical magnetic field [Hc2(0)] of 56 T

Mid-Upper Arm Circumference based Nutrition Programming: evidence for a new approach in regions with high burden of Acute Malnutrition

In therapeutic feeding programs (TFP), mid-upper arm circumference (MUAC) shows advantages over weight-for-height Z score (WHZ) and is recommended by the World Health Organization (WHO) as an independent criterion for screening children 6-59 months old. Here we report outcomes and treatment response from a TFP using MUAC ≤118 mm or oedema as sole admission criteria for severe acute malnutrition (SAM)