The novel coronavirus SARS-CoV-2, responsible for the 2019–2020 global (COVID-19) pandemic, is a respiratory virus associated with the development of thromboembolic complications and respiratory ...failure in severe cases. Increased risk of pulmonary embolism and thrombosis has been identified in COVID-19 patients, alongside accompanying elevations in potential prognostic biomarkers, including D-dimer, IL-6 and cardiac specific troponins. Our aim was to provide a scoping review of the available literature regarding thrombosis risk, other cardiovascular implications, and their biomarkers in COVID-19 to highlight potential disease mechanisms.
Authors conducted a literature search in PubMed using MeSH headings “disseminated intravascular coagulation”, “pulmonary embolism”, “thromb*”, “stroke”, “myocardial infarction” and “acute lung injury”, as well as terms “COVID-19”, “SARS-CoV-2”, “2019 novel coronavirus” and “2019-nCoV”.
COVID-19 disease is characterised by the interactions between hyperactive coagulation and complement systems – induced by hyper-inflammatory conditions, resulting in a pro-thrombotic state and diffuse tissue injury. There are several promising prognostic markers of disease severity, with D-dimer the most significant. The presence of thrombocytopenia appears to be a key indicator of patient deterioration.
Further research is required to understand the underlying pathophysiology in COVID-19 and its implications in disease progression and patient management. Randomised trials are urgently needed to determine the safety of proposed therapeutic anticoagulation with heparin and the role for anti-platelet agents, such as Ticagrelor, in patient management.
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•COVID-19 is associated with an increased risk of thrombotic complications.•COVID-19 phenotype results from inflammation, complement and coagulation interplay.•D-dimer, thrombocytopenia and IL-6 are promising markers of COVID-19 severity.•Anticoagulative therapy in COVID-19 needs further study.
A long-standing prediction of nuclear models is the emergence of a region of long-lived, or even stable, superheavy elements beyond the actinides. These nuclei owe their enhanced stability to closed ...shells in the structure of both protons and neutrons. However, theoretical approaches to date do not yield consistent predictions of the precise limits of the 'island of stability'; experimental studies are therefore crucial. The bulk of experimental effort so far has been focused on the direct creation of superheavy elements in heavy ion fusion reactions, leading to the production of elements up to proton number Z = 118 (refs 4, 5). Recently, it has become possible to make detailed spectroscopic studies of nuclei beyond fermium (Z = 100), with the aim of understanding the underlying single-particle structure of superheavy elements. Here we report such a study of the nobelium isotope 254No, with 102 protons and 152 neutrons-the heaviest nucleus studied in this manner to date. We find three excited structures, two of which are isomeric (metastable). One of these structures is firmly assigned to a two-proton excitation. These states are highly significant as their location is sensitive to single-particle levels above the gap in shell energies predicted at Z = 114, and thus provide a microscopic benchmark for nuclear models of the superheavy elements.
Background
Laser therapy is now being proposed for the treatment of pelvic organ prolapse (POP) and urinary incontinence (UI).
Objectives
To systematically review the available literature on laser ...therapy for POP and UI.
Search strategy
PubMed, Web Of Science and Embase were searched for relevant articles, using a three‐concept (POP, UI, laser therapy) search engine composed as (concept 1 OR concept 2) AND concept 3.
Selection criteria
Only full‐text clinical studies in English.
Data collection and analysis
Data on patient characteristics, laser setting, treatment outcome and adverse events were independently collected by two researchers. There was a lack of methodological uniformity so meta‐analysis was not possible and the results are presented narratively.
Main results
Thirty‐one studies recruiting 1530 adult women met the inclusion criteria. All studies showed significant improvement either on UI, POP or both; however the heterogeneity of laser settings, application and outcome measures was huge. Only one study was a randomised controlled trial, two studies were controlled cohort studies. All three were on UI and used standardised validated tools. The risk of bias in the randomised controlled trial was low on all seven domains; the controlled studies had a serious risk of bias. No major adverse events were reported, mild pain and burning sensation were the most commonly described adverse events.
Conclusions
All studies on vaginal and/or urethral laser application for POP and UI report improvement, but the quality of studies needs to be improved.
Tweetable
There is weak evidence that laser therapy is effective for urinary incontinence and pelvic organ prolapse #LASER#UI#POP.
Tweetable
There is weak evidence that laser therapy is effective for urinary incontinence and pelvic organ prolapse #LASER#UI#POP.
We report our identification of the optical afterglow and host galaxy of the short-duration gamma-ray burst sGRB 160821B. The spectroscopic redshift of the host is z = 0.162, making it one of the ...lowest redshift short-duration gamma-ray bursts (sGRBs) identified by Swift. Our intensive follow-up campaign using a range of ground-based facilities as well as Hubble Space Telescope, XMM-Newton, and Swift, shows evidence for a late-time excess of optical and near-infrared emission in addition to a complex afterglow. The afterglow light curve at X-ray frequencies reveals a narrow jet, deg, that is refreshed at >1 day post-burst by a slower outflow with significantly more energy than the initial outflow that produced the main GRB. Observations of the 5 GHz radio afterglow shows a reverse shock into a mildly magnetized shell. The optical and near-infrared excess is fainter than AT2017gfo associated with GW170817, and is well explained by a kilonova with dynamic ejecta mass Mdyn = (1.0 0.6) × 10−3 M and a secular (post-merger) ejecta mass with Mpm = (1.0 0.6) × 10−2 M , consistent with a binary neutron star merger resulting in a short-lived massive neutron star. This optical and near-infrared data set provides the best-sampled kilonova light curve without a gravitational wave trigger to date.
TRPV1 receptors have classically been defined as heat-sensitive, ligand-gated, nonselective cation channels that integrate nociceptive stimuli in sensory neurons. TRPV1 receptors have also been ...identified in the brain, but their physiological role is poorly understood. Here we report that TRPV1 channel activation is necessary and sufficient to trigger long-term synaptic depression (LTD). Excitatory synapses onto hippocampal interneurons were depressed by either capsaicin, a potent TRPV1 channel activator, or the endogenously released eicosanoid, 12-(S)-HPETE, whereas neighboring excitatory synapses onto CA1 pyramidal cells were unaffected. TRPV1 receptor antagonists also prevented interneuron LTD. In brain slices from
TRPV1
−/− mice, LTD was absent, and neither capsaicin nor 12-(S)-HPETE elicited synaptic depression. Our results suggest that, in the hippocampus, TRPV1 receptor activation selectively modifies synapses onto interneurons. Like other forms of hippocampal synaptic plasticity, TRPV1-mediated LTD may have a role in long-term changes in physiological and pathological circuit behavior during learning and epileptic activity.
The majority of short gamma-ray bursts (SGRBs) are thought to originate from the merger of compact binary systems collapsing directly to form a black hole. However, it has been proposed that both ...SGRBs and long gamma-ray bursts (LGRBs) may, on rare occasions, form an unstable millisecond pulsar (magnetar) prior to final collapse. GRB 090515, detected by the Swift satellite was extremely short, with a T90 of 0.036 ± 0.016 s, and had a very low fluence of 2 × 10−8 erg cm−2 and faint optical afterglow. Despite this, the 0.3–10 keV flux in the first 200 s was the highest observed for an SGRB by the Swift X-ray Telescope (XRT). The X-ray light curve showed an unusual plateau and steep decay, becoming undetectable after ∼500 s. This behaviour is similar to that observed in some long bursts proposed to have magnetars contributing to their emission. In this paper, we present the Swift observations of GRB 090515 and compare it to other gamma-ray bursts (GRBs) in the Swift sample. Additionally, we present optical observations from Gemini, which detected an afterglow of magnitude 26.4 ± 0.1 at T+ 1.7 h after the burst. We discuss potential causes of the unusual 0.3–10 keV emission and suggest it might be energy injection from an unstable millisecond pulsar. Using the duration and flux of the plateau of GRB 090515, we place constraints on the millisecond pulsar spin period and magnetic field.
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