Health Status, Persistent Symptoms, and Effort Intolerance One Year After Acute COVID-19 Infection.

BACKGROUND: The long-term prevalence and risk factors for post-acute COVID-19 sequelae (PASC) are not well described and may have important implications for unvaccinated populations and policy makers. OBJECTIVE: To assess health status, persistent symptoms, and effort tolerance approximately 1 year after COVID-19 infection DESIGN: Retrospective observational cohort study using surveys and clinical data PARTICIPANTS: Survey respondents who were survivors of acute COVID-19 infection requiring Emergency Department presentation or hospitalization between March 3 and May 15, 2020. MAIN MEASURE(S): Self-reported health status, persistent symptoms, and effort tolerance KEY RESULTS: The 530 respondents (median time between hospital presentation and survey 332 days [IQR 325-344]) had mean age 59.2±16.3 years, 44.5% were female and 70.8% were non-White. Of these, 41.5% reported worse health compared to a year prior, 44.2% reported persistent symptoms, 36.2% reported limitations in lifting/carrying groceries, 35.5% reported limitations climbing one flight of stairs, 38.1% reported limitations bending/kneeling/stooping, and 22.1% reported limitations walking one block. Even those without high-risk comorbid conditions and those seen only in the Emergency Department (but not hospitalized) experienced significant deterioration in health, persistent symptoms, and limitations in effort tolerance. Women (adjusted relative risk ratio [aRRR] 1.26, 95% CI 1.01-1.56), those requiring mechanical ventilation (aRRR 1.48, 1.02-2.14), and people with HIV (aRRR 1.75, 1.14-2.69) were significantly more likely to report persistent symptoms. Age and other risk factors for more severe COVID-19 illness were not associated with increased risk of PASC. CONCLUSIONS: PASC may be extraordinarily common 1 year after COVID-19, and these symptoms are sufficiently severe to impact the daily exercise tolerance of patients. PASC symptoms are broadly distributed, are not limited to one specific patient group, and appear to be unrelated to age. These data have implications for vaccine hesitant individuals, policy makers, and physicians managing the emerging longer-term yet unknown impact of the COVID-19 pandemic.

Quantitative focused laser differential interferometry with hypersonic turbulent boundary layers.

The effect of turbulent wind-tunnel-wall boundary layers on density change measurements obtained with focused laser differential interferometry (FLDI) was studied using a detailed direct numerical simulation (DNS) of the wall from the Boeing/AFOSR Mach-6 Quiet Tunnel run in its noisy configuration. The DNS was probed with an FLDI model that is capable of reading in three-dimensional time-varying density fields and computing the FLDI response. Simulated FLDI measurements smooth the boundary-layer root-mean-square (RMS) profile relative to true values obtained by directly extracting the data from the DNS. The peak of the density change RMS measured by the FLDI falls within 20% of the true density change RMS. A relationship between local spatial density change and temporal density fluctuations was determined and successfully used to estimate density fluctuations from the FLDI measurements. FLDI measurements of the freestream fluctuations are found to be dominated by the off-axis tunnel-wall boundary layers for lower frequencies despite spatial suppression provided by the technique. However, low-amplitude (0.05%-5% of the mean density) target signals placed along the tunnel centerline were successfully measured over the noise of the boundary layers (which have RMS values of about 12% of the mean). Overall, FLDI was shown to be a useful technique for making quantitative turbulence measurements and to measure finite-width sinusoidal signals through turbulent boundary layers, but may not provide enough off-focus suppression to provide accurate freestream noise measurements, particularly at lower frequencies.

William H. G. Logan and His Bow.

The Logan Bow is an external device comprising a curved bow-shaped metal bar, with spikes attached to its cross bars, and is widely used as part of a cleft lip management to maintain postoperative apposition and to avoid excessive strain after cheiloplasty for a cleft lip. Since its first description by William Hoffman Gardiner Logan, in the early 20th century, no significant modifications have been made to its original design. Even though this external device continues to be commonly used by cleft care providers, there is a paucity of objective evidence regarding its potential benefits and adverse effects even after almost 100 years since its original description. The goal of the current historical manuscript is to provide the reader an engaging study on the life of the man who invented this device, W. H. G. Logan, his initial description of the bow that bears his name, and how this external device is being used.

Global and Local Manipulation of DNA Repair Mechanisms to Alter Site-Specific Gene Editing Outcomes in Hematopoietic Stem Cells.

Monogenic disorders of the blood system have the potential to be treated by autologous stem cell transplantation of ex vivo genetically modified hematopoietic stem and progenitor cells (HSPCs). The sgRNA/Cas9 system allows for precise modification of the genome at single nucleotide resolution. However, the system is reliant on endogenous cellular DNA repair mechanisms to mend a Cas9-induced double stranded break (DSB), either by the non-homologous end joining (NHEJ) pathway or by the cell-cycle regulated homology-directed repair (HDR) pathway. Here, we describe a panel of ectopically expressed DNA repair factors and Cas9 variants assessed for their ability to promote gene correction by HDR or inhibit gene disruption by NHEJ at the HBB locus. Although transient global overexpression of DNA repair factors did not improve the frequency of gene correction in primary HSPCs, localization of factors to the DSB by fusion to the Cas9 protein did alter repair outcomes toward microhomology-mediated end joining (MMEJ) repair, an HDR event. This strategy may be useful when predictable gene editing outcomes are imperative for therapeutic success.

Liver steatosis and nonalcoholic steatohepatitis: from pathogenesis to therapy. / Hígado graso y esteatohepatitis no alcohólica: patogénesis y tratamiento.

Non-alcoholic fatty liver disease refers to a disease spectrum that ranges from steatosis to non-alcoholic steatohepatitis, which leads to fibrosis, cirrhosis and hepatocellular carcinoma. Given the increasing prevalence of obesity worldwide, the incidence of non-alcoholic fatty liver disease has become a world health problem. Non-alcoholic fatty liver disease is considered to be the hepatic manifestation of metabolic syndrome associated with insulin resistance, central obesity, and type 2 diabetes mellitus. Allegedly, insulin resistance plays a pivotal role in its pathogenesis. Here we highlight non-alcoholic fatty liver disease epidemiology and pathophysiology, its progression towards steatohepatitis with particular emphasis in liver fibrosis and participation of advanced glycation end products. The different treatments reported are described here as well. We conducted a search in PubMed with the terms steatohepatitis, steatosis advanced glycation end products, liver fibrosis and adipocytokines. Articles were selected according to their relevance.

La enfermedad hepática no alcohólica se refiere a un espectro de enfermedades que va desde hígado graso, hasta esteatohepatitis y que puede cursar por fibrosis, cirrosis y hepatocarcinoma. Dado que a nivel mundial se ha incrementado la prevalencia de la obesidad, los cambios en el estilo de vida y la alimentación desbalanceada, la enfermedad hepática no alcohólica se ha convertido en un problema de salud pública. Se le considera como la manifestación hepática del síndrome metabólico, asociada a resistencia a la insulina, obesidad central, diabetes mellitus tipo 2, e hipertrigliceridemia. Se estima que la resistencia a la insulina, juega un papel detonador en la patogénesis de la enfermedad hepática no alcohólica. En este artículo se describen diferentes aspectos de la enfermedad hepática no alcohólica: la epidemiología, la patofisiología, su progresión hacia esteatohepatitis con particular énfasis en la fibrosis hepática, la participación de los productos finales de glicación avanzada, y los diferentes tratamientos reportados. Se realizó una búsqueda de artículos en la base de datos de PubMed con los términos esteatohepatitis, esteatosis, productos finales de glicación avanzada, fibrosis hepática y adipocinas. Los artículos fueron seleccionados por su relevancia en el tema.

Cost of intensive routine control and incremental cost of insecticide-treated curtain deployment in a setting with low Aedes aegypti infestation.

INTRODUCTION: Information regarding the cost of implementing insecticide-treated curtains (ITCs) is scarce. Therefore, we evaluated the ITC implementation cost, in addition to the costs of intensive conventional routine activities of the Aedes control program in the city of Guantanamo, Cuba. METHODS: A cost-analysis study was conducted from the perspective of the Aedes control program, nested in an ITC effectiveness trial, during 2009-2010. Data for this study were obtained from bookkeeping records and activity registers of the Provincial Aedes Control Programme Unit and the account records of the ITC trial. RESULTS: The annual cost of the routine Aedes control program activities was US$16.80 per household (p.h). Among 3,015 households, 6,714 ITCs were distributed. The total average cost per ITC distributed was US$3.42, and 74.3% of this cost was attributed to the cost of purchasing the ITCs. The annualized costs p.h. of ITC implementation was US$3.80. The additional annualized cost for deploying ITCs represented 19% and 48.4% of the total cost of the routine Aedes control and adult-stage Aedes control programs, respectively. The trial did not lead to further reductions in the already relatively low Aedes infestation levels. CONCLUSIONS: At current curtain prices, ITC deployment can hardly be considered an efficient option in Guantanamo and other comparable environments.

Cost of intensive routine control and incremental cost of insecticide-treated curtain deployment in a setting with low Aedes aegypti infestation

Abstract: INTRODUCTION Information regarding the cost of implementing insecticide-treated curtains (ITCs) is scarce. Therefore, we evaluated the ITC implementation cost, in addition to the costs of intensive conventional routine activities of the Aedes control program in the city of Guantanamo, Cuba. METHODS A cost-analysis study was conducted from the perspective of the Aedes control program, nested in an ITC effectiveness trial, during 2009-2010. Data for this study were obtained from bookkeeping records and activity registers of the Provincial Aedes Control Programme Unit and the account records of the ITC trial. RESULTS The annual cost of the routine Aedes control program activities was US$16.80 per household (p.h). Among 3,015 households, 6,714 ITCs were distributed. The total average cost per ITC distributed was US$3.42, and 74.3% of this cost was attributed to the cost of purchasing the ITCs. The annualized costs p.h. of ITC implementation was US$3.80. The additional annualized cost for deploying ITCs represented 19% and 48.4% of the total cost of the routine Aedes control and adult-stage Aedes control programs, respectively. The trial did not lead to further reductions in the already relatively low Aedes infestation levels. CONCLUSIONS At current curtain prices, ITC deployment can hardly be considered an efficient option in Guantanamo and other comparable environments.

Characterization of a type O foot-and-mouth disease virus re-emerging in the year 2011 in free areas of the Southern Cone of South America and cross-protection studies with the vaccine strain in use in the region.

Molecular, antigenic and vaccine matching studies, including protective response in vivo, were conducted with a foot-and-mouth disease type O virus isolated during the outbreak in September 2011 in San Pedro, Paraguay, country internationally recognized as free with vaccination in 1997. The phylogenetic tree derived from complete VP(1) sequences as well as monoclonal antibody profiling indicated that this isolate was related to viruses responsible for previous emergencies in free areas of the Southern Cone of South America occurring sporadically between the years 2000 and 2006. Marked differences with the vaccine strain O(1)/Campos, including the loss of reactivity with neutralizing MAbs, were recognized. Levels of protective antibodies induced by the vaccine containing the O(1)/Campos strain against the San Pedro virus and the virus responsible for the previous emergency in 2006 in the Southern Cone assessed by in vitro vaccine matching studies pointed to an insufficient protective response 30 days after vaccination (DPV), which was properly attained at 79 DPV or after revaccination. In agreement with the in vitro assessment, the in vivo challenge in the Protection against Podal Generalization test in cattle indicated appropriate protection for the San Pedro strain at 79 DPV or after revaccination. The complementary conclusions that can be derived from vaccine matching tests designed differently to fit the various objectives intended: prophylaxis, emergency vaccination or incorporation of new field strains into antigen banks, is evaluated. This is the first report of the antigenic and immunogenic characterization of the variants responsible for emergencies in the Southern Cone of South America and the putative impact of the changes on the cross protection conferred by the vaccine strain.

Regulation of glycogen metabolism in hepatocytes through adenosine receptors. Role of Ca2+ and cAMP.

The objective of this work is to identify the adenosine receptor subtype and the triggered events involved in the regulation of hepatic glycogen metabolism. Glycogenolysis, gluconeogenesis, cAMP, and cytosolic Ca2+ ([Ca2+](cyt)) were measured in isolated hepatocytes challenged with adenosine A1, A2A, and A3 receptor-selective agonists. Stimulation of adenosine receptor subtypes with selective agonists in Ca2+ media produced a dose-dependent increase in [Ca2+]cyt with A1>A2=A3, cAMP with A2A, glycogenolysis with A1>A2A>A3, and gluconeogenesis with A2A>A1>A3, in addition, a decrease in cAMP was observed with A1=A3. Comparatively, in Ca2+-free media or with a cell membrane-permeant Ca2+ chelator, activation of these adenosine receptors with the same selective agonists produced a smaller and transient rise in [Ca2+]cyt with A1=A3>A2, no rise in glycogenolysis and gluconeogenesis with A3>A1, but a full rise with A2A. Thus, in isolated rat hepatocytes activation of the adenosine A1 receptor triggered Ca2+-mediated glycogenolysis, activation of the adenosine A2A receptor stimulated cAMP-mediated gluconeogenesis, and activation of the adenosine A3 receptor increased [Ca2+]cyt and decreased cAMP with minor changes in glycogen metabolism.