Directed evolution, rational design and mechanistic studies of a phosphohydrolase from Enterobacter aerogenes

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Guttate leukoderma and acrokeratosis verruciformis of Hopf: a rare combination in Darier disease

A distinct Darier phenotype presenting with confetti-like hypopigmented macules was first described in 1965. Designated as "guttate leukoderma," this skin finding is a rarely-reported presentation of Darier disease. It has been theorized that the mutation in ATP2A2 causes defective E-cadherin, which in turn disrupts the adhesion of melanocytes to keratinocytes, thus leading to impaired dendrite formation, hindered melanin transfer, and ultimately to melanocyte apoptosis. Herein, we contribute a case of a 56-year old woman who presented with the rarely-described guttate leukoderma of Darier disease and acrokeratosis verruciformis of Hopf

Implementation of an early childhood obesity prevention intervention and physical activity- and screen time-related practices of Chinese-American parents of 6-month and 12-month old infants

BACKGROUND: Obesity is an understudied, but important issue for Chinese-American children. While overall rates of child obesity among Chinese-Americans are lower than in other racial/ethnic minority populations, about 1 in 4 low-income school-aged Chinese-American children are classified as overweight or obese, with the prevalence among male children as high as 40%. Despite the need to address obesity prevention, especially among younger, pre-school-aged Chinese-American children, strategies to prevent obesity early in life have not been well-studied for this population. OBJECTIVE: To examine activity and screen time related behaviors in a low-income Chinese-American population, before and after implementation of an early childhood obesity prevention intervention (Greenlight) in a primary care setting serving predominantly low income families. METHODS: This was a pre-, post-intervention analysis of physical activity- and screen time- related outcomes associated with the implementation of the Greenlight intervention, a health literacy-informed early child obesity prevention program, which was culturally adapted for low-income Chinese-Americans, and implemented in a federally qualified health center in New York City’s Chinatown. Greenlight consists of: 1) low literacy handouts and “tangible tools” (e.g. portion size bowls) given at each well-child check (WCC), 2) physician communication training (e.g. use of written handouts to support verbal counseling, teach-back, goal-setting), and 3) 1:1 health educator encounters in waiting room. Pre-implementation parent-child dyads were consecutively enrolled at their 6- or 12-month well-child check (WCC) (n=70 and n=74 respectively). The cohort of post-implementation parent-child dyads was consecutively enrolled between 0-3 months of age (n=200) and followed at their 6-month (n=159) and 12-month (n=146) WCCs. Inclusion criteria for the dyads included: parent spoke Cantonese, Mandarin or English; parent/child of Chinese descent; and child born full term (≥37 weeks gestation). Primary outcome variables were: 1) meeting physical activity recommendations (>30 minutes of tummy time at 6 months of age; >60 minutes of active time (crawling, scooting, active play) at 12 months of age; based on American Academy of Pediatrics (AAP) recommendations), 2) meeting screen time recommendations (0 minutes of screen time, based on AAP recommendations at 6 and 12 months of age). Multiple logistic regression analysis was performed, adjusting for child age, child gender, use of out of home daycare, parent age, primary language at home, and education. RESULTS: Six-month olds in the post-implementation period had a 5-fold increased odds of meeting the physical activity recommendation compared to pre-implementation (pre vs. post: 30.3 vs. 63.0%, p<0.001; AOR=5.0[2.5-10.1]. Twelve-month olds in the post-Greenlight implementation period had a nearly 20-fold increased odds of meeting the physical activity recommendation compared to pre-implementation (pre vs. post: 76.5 vs. 98.6%, p<0.001; AOR=19.4 [4.1-91.7]). Overall, screen time minutes were low in the pre- and post-implementation periods, with median television screen time <5 minutes at 6 months and <10-15 minutes at 12 months. There were no statistically significant differences by pre- vs. post-implementation status related to meeting the AAPs screen time recommendation of no screen time, in both unadjusted and adjusted analyses. CONCLUSION: At 6 and 12 months, implementation of Greenlight was associated with parent ability to meet physical activity-related recommendations. Overall use of screen time was low, and no differences were seen in parent ability to meet screen time recommendations. Further study is needed to identify additional strategies to address screen time use in infants

Paradigms of public-private partnerships in end-stage renal disease care: The National Kidney Foundation Singapore

Paradigms of public-private partnerships in end-stage renal disease care: The National Kidney Foundation Singapore. Novel forms of funding chronic renal replacement therapy and other chronic kidney disease programs are urgently required in order to address the increasing global burden of end-stage renal disease (ESRD). For areas of infectious disease control in less-developed countries, the formation of public-private partnerships has successfully yielded short-term improvement in clinical outcomes. This article reviews the concept of public-private partnerships and its various formats. We argue that similar partnerships play an important role in addressing the public health problem of chronic kidney disease. Through its establishment of numerous paradigms of partnerships with private for-profit corporations in building a nationwide chronic dialysis program and through partnerships with other non-governmental institutions and healthcare institutions in order to create a new entity characterized by a separate management structure, the NKFS has been able to provide chronic dialysis care to over 70% of the country's total ESRD population. This extensive network of partnerships is currently being applied as the NKFS continues to expand its programs to focus on the prevention of chronic kidney disease at a nationwide level

Relative risks of COVID-19 fatality between the first and second waves of the pandemic in Ontario, Canada

OBJECTIVES: To examine whether the case fatality rate (CFR) of COVID-19 decreased over time and whether the COVID-19 testing rate is a driving factor for the changes if the CFR decreased. METHODS: Analyzing COVID-19 cases, deaths and tests in Ontario, Canada, we compared the CFR between the first wave and the second wave across 26 public health units in Ontario. We also explored whether a high testing rate was associated with a large CFR decrease. RESULTS: The first wave CFR ranged from 0.004 to 0.146, whereas the second wave CFR ranged from 0.003 to 0.034. The pooled RR estimate of second wave COVID-19 case fatality, compared with first wave, was 0.24 (95% CI: 0.19-0.32). Additionally, COVID-19 testing percentages were not associated with the estimated relative risk (P=0.246). CONCLUSIONS: The COVID-19 CFR decreased significantly in Ontario during the second wave, and COVID-19 testing was not a driving factor for this decrease

Age-related changes in murine myometrial transcript profile are mediated by exposure to the female sex hormones.

In humans, the risk of operative first delivery increases linearly with maternal age. We previously hypothesized that prolonged, cyclical, prepregnancy exposure to estrogen and progesterone contributes to uterine aging. Here, we test this hypothesis. Myometrium was obtained from four groups of virgin mice: (i) 10- to 12-week- and 28- to 30-week-old mice; (ii) 10- to 12-week- and 38- to 40-week-old mice; (iii) 38-week-old mice that had an ovariectomy or sham operation early in life; (iv) 38-week-old mice that had been treated with progesterone or vehicle containing implants from 8 to 36 weeks. Transcript profiling was carried out using Affymetrix Gene ST 1.1 arrays, and data were normalized. We identified 60 differentially regulated transcripts associated with advancing age (group 1). We validated these changes in group 2 (P for overlap = 5.8 × 10(-46) ). Early ovariectomy prevented the age-related changes in myometrial transcript profile. Similarly, progesterone-mediated long-term ovarian suppression prevented the age-related changes in myometrial transcript profile. Interferon regulatory factor 7 (Irf7) mRNA was regulated by age and hormonal exposure, and was identified as a predicted regulator of the other differentially expressed transcripts by both promoter sequence and canonical pathway activation analysis (P = 8.47 × 10(-5) and P < 10(-10) , respectively). Immunohistochemistry demonstrated IRF7 in both mouse and human myometrium. We conclude the following: (i) Myometrial aging in mice is associated with reproducible changes in transcript profile; (ii) these changes can be prevented by interventions which inhibit cyclical changes in the female sex hormones; and (iii) IRF7 may be an important regulator of myometrial function and aging.This work was supported by the NIHR Cambridge Comprehensive Biomedical Research Centre, Addenbrooke's Charitable Trust and the Evelyn Trust.This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1111/acel.1240

An Unusual Presentation of Pigmented Purpuric Lichenoid Dermatitis

Pigmented purpuric lichenoid dermatitis (PPLD) is a rare subtype of pigmented purpuric dermatosis, which classically presents with a mixture of lichenoid papules and patches on the bilateral lower extremities. Herein, we describe an unusual case of a 47-year-old man with PPLD who presented with 1-3mm discrete papules without the presence of larger patches. The diagnosis of PPLD should be considered for patients presenting with bilateral symmetric discrete papules on the legs