An alternative mechanism for skeletal muscle dysfunction in long-term post-viral lung disease (preprint)

ABSTRACT Chronic lung disease is often accompanied by disabling extrapulmonary symptoms, notably skeletal muscle dysfunction and atrophy. Moreover, the severity of respiratory symptoms correlates with decreased muscle mass and in turn lowered physical activity and survival rates. Previous models of muscle atrophy in chronic lung disease often modeled COPD and relied on cigarette smoke exposure and LPS-stimulation, but these conditions independently affect skeletal muscle even without accompanying lung disease. Moreover, there is an emerging and pressing need to understand the extrapulmonary manifestations of long-term post-viral lung disease (PVLD) as found in Covid-19. Here, we examine the development of skeletal muscle dysfunction in the setting of chronic pulmonary disease using a mouse model of PVLD caused by infection due to the natural pathogen Sendai virus. We identify a significant decrease in myofiber size when PVLD is maximal at 49 d after infection. We find no change in the relative types of myofibers, but the greatest decrease in fiber size is localized to fast-twitch type IIB myofibers based on myosin heavy chain immunostaining. Remarkably, all biomarkers of myocyte protein synthesis and degradation (total RNA, ribosomal abundance, and ubiquitin-proteasome expression) were stable throughout the acute infectious illness and chronic post-viral disease process. Together, the results demonstrate a distinct pattern of skeletal muscle dysfunction in a mouse model of long-term PVLD. The findings thereby provide new insight into prolonged limitations in exercise capacity in patients with chronic lung disease after viral infections and perhaps other types of lung injury.

Colorectal Cancer Screening with Mailed Fecal Immunochemical Tests and Telephone Outreach at a Community Health Center during the COVID-19 Pandemic.

Colorectal cancer (CRC) is a common cause of cancer death and disproportionately affects non-Hispanic Black patients. Routine screening with the fecal immunochemical test (FIT) decreases CRC incidence and mortality, and previous literature suggests pairing FIT with live outreach. Screening delays due to the COVID-19 pandemic will likely increase CRC incidence and mortality, especially in underserved communities. We implemented a quality improvement (QI) project at an urban community health center (CHC) in which FIT was paired with live telephone outreach. The intervention increased CRC screening at the CHC by five percentage points. Fecal immunochemical test completion rates significantly increased with successful contact (24.6% for at least one vs. 3.0% for none, p < .0001) and ordering a FIT kit during a patient interaction (28.4% vs. 15.7%, p < .001). This intervention addressed disparities in CRC screening, and the report may have general implications for addressing systemic racism in preventive medicine.

Insights into Gastrointestinal Virome: Etiology and Public Exposure

Recycled wastewater is widely used owing to the potential shortage of water resources for drinking purposes, recreational activities, and irrigation. However, gut microbiomes of both human beings and animals negatively affect this water quality. Wastewater contamination is continuously monitored, using fecal contamination indicators or microbial source tracking approaches, to oppose arising enteric infections. Viral gastroenteritis is considered a principal manifestation of waterborne pathogenic virome-mediated infections, which are mainly transmitted via the fecal-oral route. Furthermore, acquired enteric viromes are the common cause of infantile acute diarrhea. Moreover, public exposure to wastewater via wastewater discharge or treated wastewater reuse has led to a significant surge of public health concerns. In this review, we discussed the etiology of waterborne enteric viromes, notably gastrointestinal virus infections, and public exposure to municipal wastewater. Conclusively, the early human virome is affected mainly by birth mode, dietary behavior, and maternal health, and could provide a signature of disease incidence, however, more virome diversification is acquired in adulthood. A multi-phase treatment approach offered an effective means for the elimination of wastewater reuse mediated public risks. The insights highlighted in this paper offer essential information for defining probable etiologies and assessing risks related to exposure to discharged or reused wastewater.