The coronavirus disease 2019 (COVID-19) pandemic has changed health care delivery worldwide. Although decreases in hospitalization for acute myocardial infarction (AMI) have been reported during the ...pandemic, the implication for in-hospital outcomes is not well understood.
To define changes in AMI case rates, patient demographics, cardiovascular comorbidities, treatment approaches, and in-hospital outcomes during the pandemic.
This cross-sectional study retrospectively analyzed AMI hospitalizations that occurred between December 30, 2018, and May 16, 2020, in 1 of the 49 hospitals in the Providence St Joseph Health system located in 6 states (Alaska, Washington, Montana, Oregon, California, and Texas). The cohort included patients aged 18 years or older who had a principal discharge diagnosis of AMI (ST-segment elevation myocardial infarction STEMI or non-ST-segment elevation myocardial infarction NSTEMI). Segmented regression analysis was performed to assess changes in weekly case volumes. Cases were grouped into 1 of 3 periods: before COVID-19 (December 30, 2018, to February 22, 2020), early COVID-19 (February 23, 2020, to March 28, 2020), and later COVID-19 (March 29, 2020, to May 16, 2020). In-hospital mortality was risk-adjusted using an observed to expected (O/E) ratio and covariate-adjusted multivariable model.
Date of hospitalization.
The primary outcome was the weekly rate of AMI (STEMI or NSTEMI) hospitalizations. The secondary outcomes were patient characteristics, treatment approaches, and in-hospital outcomes of this patient population.
The cohort included 15 244 AMI hospitalizations (of which 4955 were for STEMI 33% and 10 289 for NSTEMI 67%) involving 14 724 patients (mean SD age of 68 13 years and 10 019 men 66%). Beginning February 23, 2020, AMI-associated hospitalizations decreased at a rate of -19.0 (95% CI, -29.0 to -9.0) cases per week for 5 weeks (early COVID-19 period). Thereafter, AMI-associated hospitalizations increased at a rate of +10.5 (95% CI, +4.6 to +16.5) cases per week (later COVID-19 period). No appreciable differences in patient demographics, cardiovascular comorbidities, and treatment approaches were observed across periods. The O/E mortality ratio for AMI increased during the early period (1.27; 95% CI, 1.07-1.48), which was disproportionately associated with patients with STEMI (1.96; 95% CI, 1.22-2.70). Although the O/E mortality ratio for AMI was not statistically different during the later period (1.23; 95% CI, 0.98-1.47), increases in the O/E mortality ratio were noted for patients with STEMI (2.40; 95% CI, 1.65-3.16) and after risk adjustment (odds ratio, 1.52; 95% CI, 1.02-2.26).
This cross-sectional study found important changes in AMI hospitalization rates and worse outcomes during the early and later COVID-19 periods. Future studies are needed to identify contributors to the increased mortality rate among patients with STEMI.
A new MgII‐based version of the porous coordination polymer CUK‐1 with one‐dimensional pore structure was prepared by microwave synthesis in water. Mg‐CUK‐1 is moisture‐stable, thermally stable up to ...500 °C, and shows unusual reversible soft‐crystal behavior: dehydrated single crystals of the material selectively adsorb a range of organic molecules at ambient temperature and pressure. Both polar and apolar aromatic compounds, including pyridine, benzene, p‐xylene, and p‐divinylbenzene (p‐DVB), are all readily adsorbed, while other isomers from complex mixtures of xylenes or DVBs are selectively excluded. The solvent‐loaded structures have been studied by single‐crystal X‐ray diffraction. Time‐dependent liquid sorption experiments using commercially available DVB demonstrate a high and rapid selective adsorption of p‐DVB and exclusion of m‐DVB and ethylvinylbenzene isomers.
From complex to simple: The porous material Mg‐CUK‐1 has been prepared using an aqueous microwave‐assisted synthetic method. This material contains infinite one‐dimensional pores that show highly selective, room‐temperature adsorption of p‐divinylbenzene (p‐DVB) and other organic compounds from complex mixtures of isomers.
Purpose
This retrospective cohort observational study evaluated marginal integrity, gingival health and aesthetics of zirconia crowns (ZC) placed on primary maxillary anterior teeth at 6- to over ...30-month follow-up visits.
Methods
Two independent raters evaluated radiographic and photographic findings in 131 ZC placed in 36 children aged 24.8–62.2 months (median = 40.6) who had at least one recall visit 6 months after placement. Follow-up periods were stratified into three levels: long, intermediate and short. Associations between crown performance and crown brands, follow-up periods, treatment performed under general anaesthesia or sedation and previous pulpotomy were investigated by ordinal logistic regression
.
Results
Follow-up ranged from 6 to 33.8 months (average: 13.5 months). Marginal integrity was highly rated in 82.4% of the teeth. No gingivitis was found in 35% of the teeth, 58% showed mild gingivitis and 7% showed moderate gingivitis (
p
= 0.06).
Colour match and crown contour were rated very high in 55% of the cases. Marginal integrity and periodontal health differed between cases performed under general anaesthesia and those performed under sedation (
p
= 0.03 and
p
= 0.003, respectively). Pulpotomized teeth showed worse colour matching with the adjacent teeth than non-pulpotomized teeth (
p
= 0.03).
Conclusions
Our findings suggest that ZC comprise a satisfactory treatment option for carious primary maxillary incisors, presenting good overall marginal integrity, gingival health, and aesthetics.
Purified lipopolysaccharide (LPS) infusion in cattle induces clinical and metabolic responses similar to gram-negative bacterial infection. Effects of LPS and dietary protein on rectal temperature, ...serum hormones, haptoglobin, plasma urea N and AA, and N balance were evaluated in 24 steers (250 ± 2.8 kg of BW). Treatments were a 2 x 3 factorial of LPS (0 vs. 1.5 μg/kg of BW; -LPS vs. +LPS) and diets containing (DM basis) 1) 14.5% CP, 11.6% ruminally degradable protein (RDP), and 2.9% ruminally undegradable protein (RUP; CP14.5CON); 2) 16.3% CP, 13.4% RDP, and 2.9% RUP (CP16RDP); and 3) 16.1% CP, 11.2% RDP, and 4.9% RUP (CP16RUP). Diet RDP and RUP were altered using casein, fish meal, and corn gluten meal. Steers were adapted to diets (1.1 Mcal/kg of NEg; DM fed at 1.8% BW) for 14 d and were infused (intravenously 1 mL/min) with LPS (in 100 mL of saline) on d 15. Rectal temperature and serum cortisol, prolactin, haptoglobin, and insulin increased, glucose initially increased and then declined, and serum thyroxine and triiodothyronine decreased for +LPS vs. -LPS steers (LPS x hour; P < 0.01). Serum IGF-I was less (P < 0.01) for +LPS vs. -LPS steers. Plasma urea N increased in response to LPS (LPS x hour; P = 0.02) and was greater for +LPS steers fed CP16RDP and CP16RUP vs. CP14.5CON, but greater in -LPS steers fed CP16RUP vs. CP16RDP and CP14.5CON (LPS x diet; P = 0.04). Plasma Met, Thr, Leu, Ile, Phe, Trp, Gly, Ser, Asn, and Tyr decreased, and plasma Ala increased in response to LPS (LPS x hour; P < 0.01). Plasma Orn initially increased and then decreased in +LPS vs. -LPS steers (LPS x hour; P < 0.01). No LPS x diet interactions (P greater-than-or-equal 0.15) occurred for DM, OM, NDF and N intake, fecal excretion, or apparent digestibility. Dietary DM, OM, NDF, and N intake, and retained N were less (P < 0.01) for +LPS than -LPS steers. Total N intake, apparent N digestibility, and retained N were greater (P less-than or equal to 0.05) for steers fed CP16RDP and CP16RUP vs. CP14.5CON. An LPS x diet interaction (P = 0.05) occurred for N retention (% N intake) because N retention was less for +LPS than -LPS steers when fed CP14.5CON, but not different between +LPS and -LPS steers when fed CP16RDP and CP16RUP. These results demonstrate that LPS infusion alters serum hormones, plasma AA, and N balance in cattle and imply that growing steers exposed to LPS may require greater dietary protein concentrations to account for altered intake and metabolic AA demand.
Bovine respiratory disease (BRD) is a frequent beef cattle syndrome. Improved understanding of the timing of BRD events, including subsequent deleterious outcomes, promotes efficient resource ...allocation. This study's objective was to determine differences in timing distributions of initial BRD treatments (Tx1), days to death after initial treatment (DTD), and days after arrival to fatal disease onset (FDO). Individual animal records for the first BRD treatment (
= 301,721) or BRD mortality (
= 19,332) were received from 25 feed yards. A subset of data (318-363 kg; steers/heifers) was created and Wasserstein distances were used to compare temporal distributions of Tx1, FDO, and DTD across genders (steers/heifers) and the quarter of arrival. Disease frequency varied by quarter with the greatest Wasserstein distances observed between Q2 and Q3 and between Q2 and Q4. Cattle arriving in Q3 and Q4 had earlier Tx1 events than in Q2. Evaluating FDO and DTD revealed the greatest Wasserstein distance between cattle arriving in Q2 and Q4, with cattle arriving in Q2 having later events. Distributions of FDO varied by gender and quarter and typically had wide distributions with the largest 25-75% quartiles ranging from 20 to 80 days (heifers arriving in Q2). The DTD had right-skewed distributions with 25% of cases occurring by days 3-4 post-treatment. Results illustrate temporal disease and outcome patterns are largely right-skewed and may not be well represented by simple arithmetic means. Knowledge of typical temporal patterns allows cattle health managers to focus disease control efforts on the correct groups of cattle at the appropriate time.
Estimates of the prevalence of the polycystic ovary syndrome (PCOS) in the general population have ranged from 2-20%. The vast majority of these reports have studied White populations in Europe, used ...limited definitions of the disorder, and/or used bias populations, such as those seeking medical care. To estimate the prevalence of this disorder in the United States and address these limitations, we prospectively determined the prevalence of PCOS in a reproductive-aged population of 369 consecutive women (174 White and 195 Black; aged 18-45 yr), examined at the time of their preemployment physical. Body measures were obtained, and body hair was quantified by a modified Ferriman-Gallwey (F-G) method. All exams were initially performed by 2 trained nurses, and any subject with an F-G score above 3 was reexamined by a physician, the same for all patients. Of the 369 women, 277 (75.1%) also agreed to complete a questionnaire and have additional blood drawn. Subjects were studied regardless of current estrogen/progestin hormonal use (28.5%). PCOS was defined as 1) oligoovulation, 2) clinical hyperandrogenism (i.e. hirsutism) and/or hyperandrogenemia, and 3) exclusion of other related disorders, such as hyperprolactinemia, thyroid abnormalities, and non-classic adrenal hyperplasia. Hirsutism was defined by a F-G score of 6 or more, and hyperandrogenemia was defined as a total or free testosterone, androstenedione, and/or dehydroepiandrosterone sulfate level above the 95th percentile of control values i.e. all eumenorrheic women in the study, who had no hirsutism (F-G < or = 5) or acne and were receiving no hormonal therapy; n = 98. Considering all 369 women studied, White and Black women had similar mean ages (29.4 +/- 7.1 and 31.1 +/- 7.8 yr, respectively), although White women had a lesser body mass than Black women (24.9 +/- 6.1 vs. 29.2 +/- 8.1 kg/m2, respectively; P < 0.001). Of these 7.6%, 4.6%, and 1.9% demonstrated a F-G score of 6 or more, 8 or 10, respectively, and there was no significant racial difference, with hirsutism prevalences of 8.0%, 2.8%, and 1.6% in Whites, and 7.1%, 6.1%, and 2.1% in Blacks, respectively. Of the 277 women consenting to a history and hormonal evaluation, 4.0% had PCOS as defined, 4.7% (6 of 129) of Whites and 3.4% (5 of 148) of Blacks. In conclusion, in our consecutive population of unselected women the prevalence of hirsutism varied from 2-8% depending on the chosen cut-off F-G score, with no significant difference between White and Black women. Using an F-G score of 6 or more as indicative of hirsutism, 3.4% of Blacks and 4.7% of Whites had PCOS as defined. These data suggest that PCOS may be one of most common reproductive endocrinological disorders of women.
A tetra(carboxylated) PCP pincer ligand has been synthesized as a building block for porous coordination polymers (PCPs). The air‐ and moisture‐stable PCP metalloligands are rigid tetratopic linkers ...that are geometrically akin to ligands used in the synthesis of robust metal–organic frameworks (MOFs). Here, the design principle is demonstrated by cyclometalation with PdIICl and subsequent use of the metalloligand to prepare a crystalline 3D MOF by direct reaction with CoII ions and structural resolution by single crystal X‐ray diffraction. The Pd−Cl groups inside the pores are accessible to post‐synthetic modifications that facilitate chemical reactions previously unobserved in MOFs: a Pd−CH3 activated material undergoes rapid insertion of CO2 gas to give Pd−OC(O)CH3 at 1 atm and 298 K. However, since the material is highly selective for the adsorption of CO2 over CO, a Pd−N3 modified version resists CO insertion under the same conditions.
Poly‐PCP‐pincers: A new synthetic strategy for the formation of crystalline, porous versions of PCP‐pincer complexes is presented. These complexes can selectively activate gas molecules, such as CO2 over CO, in the solid state. PCP=Porous Coordination Polymer
MuLK, a Eukaryotic Multi-substrate Lipid Kinase Waggoner, David W.; Johnson, Laura Beth; Mann, Philip C. ...
The Journal of biological chemistry,
09/2004, Letnik:
279, Številka:
37
Journal Article
Recenzirano
Odprti dostop
We report the identification and characterization of a novel lipid kinase that phosphorylates multiple substrates. This enzyme, which we term MuLK for multi-substrate lipid kinase, does not belong to ...a previously described lipid kinase family. MuLK has orthologs in many organisms and is broadly expressed in human tissues. Although predicted to be a soluble protein, MuLK co-fractionates with membranes and localizes to an internal membrane compartment. Recombinant MuLK phosphorylates diacylglycerol, ceramide, and 1-acylglycerol but not sphingosine. Although its affinity for diacylglycerol and ceramide are similar, MuLK exhibits a higher Vmax toward diacylglycerol in vitro, consistent with it acting primarily as a diacylglycerol kinase. MuLK activity was inhibited by sphingosine and enhanced by cardiolipin. It was stimulated by calcium when magnesium concentrations were low and inhibited by calcium when magnesium concentrations were high. The effects of charged lipids and cations on MuLK activity in vitro suggest that its activity in vivo is tightly regulated by cellular conditions.
Metabolic demand for sulfur-containing AA increases during inflammation in nonruminants. Therefore, Met supplementation may alleviate the negative effects of infection on N balance. Effects of ...gram-negative bacterial lipopolysaccharide (LPS) and supplemental dietary Met on N balance, serum hormones and haptoglobin, and plasma urea-N and AA were evaluated in 20 Angus-cross steers (BW = 262 ± 6.3 kg). Treatments (2 x 2 factorial) were infusion of no LPS (-LPS) or a prolonged low dose of LPS (+LPS) and dietary supplementation of no (-MET) or 14 g/d (+MET) of rumen-protected Met (providing 7.9 g/d of DL-Met). Steers were adapted to a roughage-based diet (DMI = 1.4% of BW daily) and supplemental Met for 14 d, and were then infused (1 mL/min via intravenous catheter) with LPS on d 1 (2 μg/kg of BW) and 3 (1 μg/kg of BW) of a 5-d collection period. Blood was collected on d 1, before LPS infusion, and at 2, 4, 6, 8, 10, 12, and 24 h after LPS challenge. Diet samples, feed refusals, feces, and urine were collected daily for 5 d. Rectal temperature and serum concentrations of cortisol, prolactin, tumor necrosis factor-α, and haptoglobin increased, whereas thyroxine and triiodothyronine decreased for +LPS vs. -LPS steers (LPS x h; P < 0.01). Plasma urea-N was greater for +LPS than -LPS steers (LPS; P = 0.03), and serum IGF-1 was not affected (P greater-than-or-equal 0.26) by LPS or Met. Plasma concentrations of Thr, Lys, Leu, Ile, Phe, Trp, Asn, Glu, and Orn decreased, plasma Ala increased, and Gly and Ser initially increased, then declined in +LPS vs. -LPS steers (LPS x h; P less-than or equal to 0.04). Plasma Met was greater for +MET than -MET steers before LPS infusion, but declined in +MET steers after LPS infusion (LPS x Met x h; P < 0.01). By design, DMI was not different, but DM digested was less (P = 0.04) for +LPS than -LPS steers. Infusion of LPS did not affect (P greater-than-or-equal 0.24) N intake, fecal N excretion, or N digested, but resulted in greater (P < 0.01) urinary N excretion and less (P < 0.01) N retention. The absence of an LPS x Met interaction (P = 0.26) for N retention indicates that supplemental Met does not improve the N utilization of growing beef steers exposed to a gram-negative bacterial endotoxin. Decreases in plasma concentrations of several essential AA in +LPS steers suggest that metabolic demand for these AA likely increased in steers exposed to endotoxin.
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