Discrepant data were reported about hospital admissions for ST-segment elevation myocardial infarction (STEMI) during COVID-19 pandemic. We reviewed studies reporting STEMI hospitalizations during ...COVID-19 pandemic, investigating whether differences in COVID-19 epidemiology or public health-related factors could explain discrepant findings in different countries.
Search through MedLine, Embase, Scopus, Web-of-Science, Cochrane Register of Controlled Trials, of studies comparing STEMI admissions during COVID-19 pandemic with a reference period, without language restrictions, as registered in PROSPERO International Prospective Register of Systematic Reviews. Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed. Data independently extracted by multiple investigators were pooled using a random-effects model. Health-related metrics were from publicly-available sources.
We included 79 articles (111,557 STEMI cases, from 57 countries). During peak COVID-19 pandemic, overall incidence rate-ratio (IRR) of STEMI hospitalizations over reference period decreased (0.80; 95% CI 0.76–0.84; p < 0.05). Although wide variations and significant heterogeneity were detected among studies (I2 = 89%; p < 0.0001), no significant differences were observed by report methodology (survey vs registry), or observation/reference period. However, large differences emerged at country level not explained by COVID-related epidemiological data, nor by public health strategies. Instead, IRRs for STEMI admissions were inversely related to hospital bed availability in each country (p < 0.05).
During COVID-19 pandemic hospitalization for STEMI significantly decreased, although to a smaller extent than initially reported. Large variability emerged across countries, unrelated to COVID-related epidemiology or social containment measures. Disparities in healthcare organization likely contributed, indicating that proper organization of emergency medicine should be preserved during pandemics.
•STEMI admissions during COVID-19 pandemic decreased substantially less that initially reported•Wide differences exist across countries with respect to the decrease in STEMI admissions•Differences were unrelated to COVID-19 diffusion, or to lockdown measures or stay-at-home orders•Instead, decreased STEMI admissions were related to country availability of hospital beds•These findings highlight the importance of proper health organization during a pandemic
Backward-angle meson electroproduction above the resonance region, which was previously ignored, is anticipated to offer unique access to the three quark plus sea component of the nucleon wave ...function. In this Letter, we present the first complete separation of the four electromagnetic structure functions above the resonance region in exclusive ω electroproduction off the proton, ep→e′pω, at central Q2 values of 1.60, 2.45 GeV2, at W=2.21 GeV. The results of our pioneering −u≈−umin study demonstrate the existence of a unanticipated backward-angle cross section peak and the feasibility of full L/T/LT/TT separations in this never explored kinematic territory. At Q2=2.45 GeV2, the observed dominance of σT over σL, is qualitatively consistent with the collinear QCD description in the near-backward regime, in which the scattering amplitude factorizes into a hard subprocess amplitude and baryon to meson transition distribution amplitudes: universal nonperturbative objects only accessible through backward-angle kinematics.
Objective
Focusing on low‐ and middle‐income countries (LMICs), this article uses data from the Global Burden of Disease (GBD) database to highlight the burden of morbidity due to benign ...gynecological conditions (BGCs).
Methods
We analyzed 2019 morbidity data for all BGCs, measured as years lost to disability (YLDs). Disease burden was calculated for individual conditions, BGCs overall, and percentages of overall disease burden from all conditions. The same data extraction was performed for malaria, tuberculosis, and HIV/AIDS for comparison. The data were subcategorized by age and World Bank income level.
Results
BGCs are major causes of disease morbidity worldwide. For women aged 15 years and over in high‐income countries (HICs), 3 588 157 YLDs (3.94% of all YLDs) were due to BGC. In LMICs, 18 242 989 YLDs (5.35% of all YLDs) were due to BGCs. The highest burden of BGCs is seen during the reproductive years where conditions driven or exacerbated by reproductive hormones are the major causes of morbidity. In LMICs, for women aged 15–49, 14 574 100 YLDs (7.75% of all YLDs) were due to BGCs, declining to 3 152 313 YLDs (3.04%) in women aged 50–69 and 529 399 YLDs (1.06%) in women age 70+.
Conclusion
These data demonstrate a huge burden of morbidity due to BGCs. There is an urgent need for international stakeholders to prioritize the treatment and prevention of BGCs.
Synopsis
The burden of disease due to benign gynecological conditions measured is greater than that from malaria, tuberculosis, and HIV/AIDS with most of the disease burden borne by women in LMICs.
The lack of reproducibility of animal experimental results between laboratories, particularly in studies investigating the microbiota, has raised concern among the scientific community. Factors such ...as environment, stress and sex have been identified as contributors, whereas dietary composition has received less attention. This study firstly evaluated the use of commercially available rodent diets across research institutions, with 28 different diets reported by 45 survey respondents. Secondly, highly variable ingredient, FODMAP (Fermentable Oligo-, Di-, Mono-saccharides And Polyols) and gluten content was found between different commercially available rodent diets. Finally, 40 mice were randomized to four groups, each receiving a different commercially available rodent diet, and the dietary impact on cecal microbiota, short- and branched-chain fatty acid profiles was evaluated. The gut microbiota composition differed significantly between diets and sexes, with significantly different clusters in β-diversity. Total BCFA were highest (p = 0.01) and SCFA were lowest (p = 0.03) in mice fed a diet lower in FODMAPs and gluten. These results suggest that nutritional composition of commercially available rodent diets impact gut microbiota profiles and fermentation patterns, with major implications for the reproducibility of results across laboratories. However, further studies are required to elucidate the specific dietary factors driving these changes.
Abstract
Background
Echinococcus multilocularis is one of the most severe and lethal parasitic diseases of humans, most often reported in Europe and Asia. Only 1 previous case has been documented in ...the contiguous United States from Minnesota in 1977. European haplotypes have been identified in carnivores and domestic dogs as well as recently in patients in western and central Canada.
Methods
We used immunohistochemical testing with the monoclonal antibody Em2G11 and a species-specific enzyme-linked immunosorbent assay affinity-purified antigen Em2, as well as COX1 gene sequencing.
Results
Using pathology, immunohistochemical staining, specific immunodiagnostic testing, and COX1 gene sequencing, we were able to definitively identify E. multilocularis as the causative agent of our patient’s liver and lung lesions, which clustered most closely with the European haplotype.
Conclusions
We have identified the first case of a European haplotype E. multilocularis in the United States and the first case of this parasitic infection east of the Mississippi River. Given the identification of this haplotype in Canada, this appears to be an emerging infectious disease in North America.
We have identified the first case of a European haplotype Echinococcus multilocularis in the United States. Given the recent identification of this haplotype in Canada, this may be an emerging infectious disease in North America.
The COVID-19 pandemic has heavily impacted elective and emergency surgery around the world. We aimed to confirm the incidence of perioperative severe acute respiratory syndrome coronavirus 2 ...(SARS-CoV-2) infection and associated mortality after surgery.
Analysis of routine electronic health record data from NHS hospitals in England. We extracted data from Hospital Episode Statistics in England describing adult patients undergoing surgery between January 1, 2020 and February 28, 2021. The exposure was SARS-CoV-2 infection defined by International Classification of Diseases (ICD)-10 codes. The primary outcome measure was 90 day in-hospital mortality. Data were analysed using multivariable logistic regression adjusted for age, sex, Charlson Comorbidity Index, Index of Multiple Deprivation, presence of cancer, surgical procedure type and admission acuity. Results are presented as n (%) and odds ratios (OR) with 95% confidence intervals (CI).
We identified 2 666 978 patients undergoing surgery of whom 28 777 (1.1%) had SARS-CoV-2 infection. In total, 26 364 (1.0%) patients died in hospital. SARS-CoV-2 infection was associated with a much greater risk of death (SARS-CoV-2: 6153/28 777 21.4% vs no SARS-CoV-2: 20 211/2 638 201 0.8%; OR=5.7 95% CI, 5.5–5.9; P<0.001). Amongst patients undergoing elective surgery, 2412/1 857 586 (0.1%) had SARS-CoV-2, of whom 172/2412 (7.1%) died, compared with 1414/1 857 586 (0.1%) patients without SARS-CoV-2 (OR=25.8 95% CI, 21.7–30.9; P<0.001). Amongst patients undergoing emergency surgery, 22 918/582 292 (3.9%) patients had SARS-CoV-2, of whom 5752/22 918 (25.1%) died, compared with 18 060/559 374 (3.4%) patients without SARS-CoV-2 (OR=5.5 95% CI, 5.3–5.7; P<0.001).
The low incidence of SARS-CoV-2 infection in NHS surgical pathways suggests current infection prevention and control policies are highly effective. However, the high mortality amongst patients with SARS-CoV-2 suggests these precautions cannot be safely relaxed.
We explore the chemical distribution of stars in a simulated galaxy. Using simulations of the same initial conditions but with two different feedback schemes (McMaster Unbiased Galaxy Simulations -- ...MUGS -- and Making Galaxies in a Cosmological Context - MaGICC), we examine the features of the age-metallicity relation (AMR), and the three-dimensional age-Fe/H-O/Fe distribution, both for the galaxy as a whole and decomposed into disc, bulge, halo and satellites. The MUGS simulation, which uses traditional supernova feedback, is replete with chemical substructure. This substructure is absent from the MaGICC simulation, which includes early feedback from stellar winds, a modified initial mass function and more efficient feedback. The reduced amount of substructure is due to the almost complete lack of satellites in MaGICC. We identify a significant separation between the bulge and disc AMRs, where the bulge is considerably more metal-rich with a smaller spread in metallicity at any given time than the disc. Our results suggest, however, that identifying the substructure in observations will require exquisite age resolution, of the order of 0.25 Gyr. Certain satellites show exotic features in the AMR, even forming a 'sawtooth' shape of increasing metallicity followed by sharp declines which correspond to pericentric passages. This fact, along with the large spread in stellar age at a given metallicity, compromises the use of metallicity as an age indicator, although alpha abundance provides a more robust clock at early times. This may also impact algorithms that are used to reconstruct star formation histories from resolved stellar populations, which frequently assume a monotonically increasing AMR.
This report describes the identification of a more virulent European haplotype of
Echinococcus multilocularis
in both humans and animals (foxes) in the United States, suggesting the zoonotic spread ...of this parasite.
PDF
