Molecular states during acute COVID-19 reveal distinct etiologies of long-term sequelae

Post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are debilitating, clinically heterogeneous and of unknown molecular etiology. A transcriptome-wide investigation was performed in 165 acutely infected hospitalized individuals who were followed clinically into the post-acute period. Distinct gene expression signatures of post-acute sequelae were already present in whole blood during acute infection, with innate and adaptive immune cells implicated in different symptoms. Two clusters of sequelae exhibited divergent plasma-cell-associated gene expression patterns. In one cluster, sequelae associated with higher expression of immunoglobulin-related genes in an anti-spike antibody titer-dependent manner. In the other, sequelae associated independently of these titers with lower expression of immunoglobulin-related genes, indicating lower non-specific antibody production in individuals with these sequelae. This relationship between lower total immunoglobulins and sequelae was validated in an external cohort. Altogether, multiple etiologies of post-acute sequelae were already detectable during SARS-CoV-2 infection, directly linking these sequelae with the acute host response to the virus and providing early insights into their development

Stoichiometric and catalytic C-C and C-H bond formation with B(C6F5)3 via cationic intermediates

This work showcases a new catalytic cyclization reaction using a highly Lewis acidic borane with concomitant C−H or C−C bond formation. The activation of alkyne‐containing substrates with B(C6F5)3 enabled the first catalytic intramolecular cyclizations of carboxylic acid substrates using this Lewis acid. In addition, intramolecular cyclizations of esters enable C−C bond formation as catalytic B(C6F5)3 can be used to effect formal 1,5‐alkyl migrations from the ester functional groups to unsaturated carbon–carbon frameworks. This metal‐free method was used for the catalytic formation of complex dihydropyrones and isocoumarins in very good yields under relatively mild conditions with excellent atom efficiency

Stöchiometrische und katalytische C-C- und C-H-Bindungsbildung mit B(C6 F5 )3 über kationische Zwischenstufen

Diese Arbeit beschreibt eine neuartige katalytische Cyclisierung unter Verwendung eines stark Lewis-sauren Borans mit einhergehender C-H- oder C-C-Bindungsbildung. Die Aktivierung von Molekülen mit C-C-Dreifachbindungen unter Verwendung von B(C6F5)3 ermöglicht erstmals eine entsprechende Lewis-Säure-katalysierte, intramolekulare Cyclisierung von Carbonsäuren. Darüber hinaus zeigen die Ester dieser Carbonsäuren mit katalytischen Mengen B(C6F5)3 eine formale 1,5-Migration der Estergruppen unter Knüpfung einer C-C-Bindung. Unter Verwendung dieser neuen metallfreien Methode konnten anspruchsvolle Dihydropyrone und Isocumarine in hohen Ausbeuten unter milden Bedingungen sowie mit hoher Atomökonomie synthetisiert werden

Ultrasonic plaque character and outcome after lower limb angioplasty

AbstractPurpose: The value of ultrasonic plaque characteristics in identifying patients at “high-risk” of restenosis after percutaneous transluminal angioplasty (PTA) was studied. Methods: Thirty-one arterial stenoses (6 common iliac, 2 external iliac, 1 profunda femoris, 21 superficial femoral, and 1 popliteal) in 17 patients who underwent angioplasty were studied by means of duplex scanning. With a computer-based program, B-mode images were digitized and normalized using 2 reference points, blood and adventitia. A grey level of 0 to 5 was allocated for the lumen (blood) and 180 to 190 for the adventitia on a linear gray scale of 0 to 255 (0 = absolutely black; 255 = absolutely white), and the overall plaque gray-scale median (GSM) of the pixels of the plaque was used as a measure of plaque echodensity. After PTA, follow-up of stenoses was done on day 1, weekly for 8 weeks, at 3 months, 6 months, and 1 year. The total plaque thickness (sum of anterior and posterior components), minimal luminal diameter (MLD), and peak systolic velocity ratio (PSVR) were measured for all stenoses. An increase of more than 2 in the PSVR was the duplex criterion used to signify restenosis. Results: The GSM of the stenoses before angioplasty ranged from 6 to 71 (mean, 31.3 ± 17.9); 17 stenoses had a GSM less than 25 (mean, 18.7 ± 5.3), and 14 had a GSM more than 25 (mean, 46.4 ± 15.8). When the GSM was less than 25, the absolute reduction in plaque thickness on day 1 post-PTA was 3.3 ± 1.8 mm, in contrast to 1.8 ± 1.6 mm when GSM was more than 25 (P < .03). The restenosis rate (PSVR more than 2) was 41% at 6 months and remained unchanged at 1 year. When the GSM was less than 25, restenosis occurred in 11% of lesions, in comparison with 78% when the GSM was more than 25 (P < .001). Conclusion: Plaque echodensity can be used to evaluate stenoses before PTA, to predict initial success and identify a subgroup that has a high prevalence of restenosis. The identification of a group at “high-risk” of restenosis can improve the selection of patients for the procedure and also be used in prospective studies on the prevention of restenosis. (J Vasc Surg 1999;29:110-21.

The role of 44-methylgambierone in ciguatera fish poisoning: Acute toxicity, production by marine microalgae and its potential as a biomarker for Gambierdiscus spp.

Ciguatera fish poisoning (CFP) is prevalent around the tropical and sub-tropical latitudes of the world and impacts many Pacific island communities intrinsically linked to the reef system for sustenance and trade. While the genus Gambierdiscus has been linked with CFP, it is commonly found on tropical reef systems in microalgal assemblages with other genera of toxin-producing, epiphytic and/or benthic dinoflagellates - Amphidinium, Coolia, Fukuyoa, Ostreopsis and Prorocentrum. Identifying a biomarker compound that can be used for the early detection of Gambierdiscus blooms, specifically in a mixed microalgal community, is paramount in enabling the development of management and mitigation strategies. Following on from the recent structural elucidation of 44-methylgambierone, its potential to contribute to CFP intoxication events and applicability as a biomarker compound for Gambierdiscus spp. was investigated. The acute toxicity of this secondary metabolite was determined by intraperitoneal injection using mice, which showed it to be of low toxicity, with an LD50 between 20 and 38 mg kg-1. The production of 44-methylgambierone by 252 marine microalgal isolates consisting of 90 species from 32 genera across seven classes, was assessed by liquid chromatography-tandem mass spectrometry. It was discovered that the production of this secondary metabolite was ubiquitous to the eight Gambierdiscus species tested, however not all isolates of G. carpenteri, and some species/isolates of Coolia and Fukuyoa

Does Gender Influence Colour Choice in the Treatment of Visual Stress?

Purpose Visual Stress (VS) is a condition in which words appear blurred, in motion, or otherwise distorted when reading. Some people diagnosed with VS find that viewing black text on white paper through coloured overlays or precision tinted lenses (PTLs) reduces symptoms attributed to VS. The aim of the present study is to determine whether the choice of colour of overlays or PTLs is influenced by a patient’s gender. Methods Records of all patients attending a VS assessment in two optometry practices between 2009 and 2014 were reviewed retrospectively. Patients who reported a significant and consistent reduction in symptoms with either overlay and or PTL were included in the analysis. Overlays and PTLs were categorized as stereotypical male, female or neutral colours based on gender preferences as described in the literature. Chi-square analysis was carried out to determine whether gender (across all ages or within age groups) was associated with overlay or PTL colour choice. Results 279 patients (133 males and 146 females, mean age 17 years) consistently showed a reduction in symptoms with an overlay and were included. Chi-square analysis revealed no significant association between the colour of overlay chosen and male or female gender (Chi-square 0.788, p = 0.674). 244 patients (120 males and 124 females, mean age 24.5 years) consistently showed a reduction in symptoms with PTLs and were included. Chi-square analysis revealed a significant association between stereotypical male/female/neutral colours of PTLs chosen and male/female gender (Chi-square 6.46, p = 0.040). More males preferred stereotypical male colour PTLs including blue and green while more females preferred stereotypical female colour PTLs including pink and purple. Conclusions For some VS patients, the choice of PTL colour is influenced not only by the alleviation of symptoms but also by other non-visual factors such as gender

The Experience of Quality in Higher Education in the United Arab Emirates: In Times of Rapid Change and Complexities

In less than five decades, from offering formal education only in a few schools to a small tribal community to providing a selection of three public and approximately 100 private higher education institutions to the citizens of seven emirates creates a unique context in the United Arab Emirates (UAE). It is an evolution that corresponds with its remarkable economic growth. Quality assurance of diverse higher educational institutions requires complex schemes to ensure their fitness for purpose, while perhaps development and enhancement aspects need time to mature. The quality of the education is especially important because the UAE yearns for the diversified and knowledge-based economy; one that is led by its own citizens whose contribution to the workforce is currently less than 10%. This chapter highlights contextual complexities in the UAE that might have direct and/or indirect impacts on the quality experiences in the higher education sector, with proposed recommendations

Wearable technology and the cardiovascular system: the future of patient assessment

The past decade has seen a dramatic rise in consumer technologies able to monitor a variety of cardiovascular parameters. Such devices initially recorded markers of exercise, but now include physiological and health-care focused measurements. The public are keen to adopt these devices in the belief that they are useful to identify and monitor cardiovascular disease. Clinicians are therefore often presented with health app data accompanied by a diverse range of concerns and queries. Herein, we assess whether these devices are accurate, their outputs validated, and whether they are suitable for professionals to make management decisions. We review underpinning methods and technologies and explore the evidence supporting the use of these devices as diagnostic and monitoring tools in hypertension, arrhythmia, heart failure, coronary artery disease, pulmonary hypertension, and valvular heart disease. Used correctly, they might improve health care and support research

A multi-analysis approach for estimating regional health impacts from the 2017 Northern California wildfires

Smoke impacts from large wildfires are mounting, and the projection is for more such events in the future as the one experienced October 2017 in Northern California, and subsequently in 2018 and 2020. Further, the evidence is growing about the health impacts from these events which are also difficult to simulate. Therefore, we simulated air quality conditions using a suite of remotely-sensed data, surface observational data, chemical transport modeling with WRF-CMAQ, one data fusion, and three machine learning methods to arrive at datasets useful to air quality and health impact analyses. To demonstrate these analyses, we estimated the health impacts from smoke impacts during wildfires in October 8–20, 2017, in Northern California, when over 7 million people were exposed to Unhealthy to Very Unhealthy air quality conditions. We investigated using the 5-min available GOES-16 fire detection data to simulate timing of fire activity to allocate emissions hourly for the WRF-CMAQ system. Interestingly, this approach did not necessarily improve overall results, however it was key to simulating the initial 12-hr explosive fire activity and smoke impacts. To improve these results, we applied one data fusion and three machine learning algorithms. We also had a unique opportunity to evaluate results with temporary monitors deployed specifically for wildfires, and performance was markedly different. For example, at the permanent monitoring locations, the WRF-CMAQ simulations had a Pearson correlation of 0.65, and the data fusion approach improved this (Pearson correlation = 0.95), while at the temporary monitor locations across all cases, the best Pearson correlation was 0.5. Overall, WRF-CMAQ simulations were biased high and the geostatistical methods were biased low. Finally, we applied the optimized PM2.5 exposure estimate in an exposure-response function. Estimated mortality attributable to PM2.5 exposure during the smoke episode was 83 (95% CI: 0, 196) with 47% attributable to wildland fire smoke. Implications: Large wildfires in the United States and in particular California are becoming increasingly common. Associated with these large wildfires are air quality and health impact to millions of people from the smoke. We simulated air quality conditions using a suite of remotely-sensed data, surface observational data, chemical transport modeling, one data fusion, and three machine learning methods to arrive at datasets useful to air quality and health impact analyses from the October 2017 Northern California wildfires. Temporary monitors deployed for the wildfires provided an important model evaluation dataset. Total estimated regional mortality attributable to PM2.5 exposure during the smoke episode was 83 (95% confidence interval: 0, 196) with 47% of these deaths attributable to the wildland fire smoke. This illustrates the profound effect that even a 12-day exposure to wildland fire smoke can have on human health