Purpose Many studies revealed that stress, anxiety and depressive symptoms are increased during the pandemic in both healthcare workers and the general public. In our study, we aimed to evaluate anxiety levels in patients who applied to an Ophthalmology outpatient clinic during the COVID-19) pandemic. We thought that close contact requirement in eye examination might lead to the anxiety of COVID-19. Methods This is a cross-sectional descriptive study conducted in Dicle University Ophthalmology department outpatient clinic. Data were collected for COVID-19 fear and safety measurements and all the patients were applied Hamilton Anxiety Scale (HAM-A). Results A total of 223 voluntary participants were recruited. Of the participants, 101 were female and 122 were male. HAM-A total score mean was found 9.28 ± 8.717 and approximately half of the patients (51.6%) had a score of higher than 6 which means clinical significance. Women and single participants had higher anxiety levels compared with men and married/partnership respectively. Age, educational level and fear of COVID-19 when visiting the hospital were found to be related to HAM-A levels. 41.7% of the patients had postponed the hospital admission because of the pandemic and this was also significantly associated with the anxiety levels. Conclusions This is the first study that investigates anxiety specifically in an eye clinic specifically during the COVID-19 outbreak. This study, apart from supporting the increased anxiety levels in the pandemic, highlights that anxiety must have caused a problem of proper access to health services. Key words: COVID-19, anxiety, pandemic, ophthalmology

In this paper, we first obtain an identity for twice partially differentiable mappings involving some parameters. Moreover, by utilizing this identity and functions whose twice partially derivatives in absolute value are co-ordinated convex, we establish some inequalities which generalize several inequalities, such as trapezoid, midpoint and Simpson's inequalities.

Primary squamous cell carcinoma (PSCC) of the stomach is a rare type of gastric malignancies. Diagnosis crireria are well defined but diagnosis is generally late made at an advanced stage with metastases explaining it’s poor diagnosis. We report a case of gastric PSCC with a bilio-gastric fistula and Krukenberg sydrome.

Infective endocarditis still has significant morbimortality, despite diagnostic and therapeutic improvements. We describe a case of a 67-year-old man with recurrent prosthetic aortic valve infective endocarditis complicated by massive local tissue damage, making valve replacement unfeasible. Although rarely performed in this setting, heart transplantation was a needed salvage strategy, highlighting the need to make bold decisions for complex clinical scenarios.

Background: The main aim of this research is to provide a literature of the Ocimum plant, to know the significance of the Ocimum species carried out by pharmacognostical study and experimental design for GC-MS.Ocimum are very important for their therapeutic potentials. among the most important aromatic herbs for its enormous medicinal properties. Methods: An extreme Attention has been put on those literature reports wherein the utilization of Tulsi and their pharmacognostical study has been done by performing morphological and microscopic leaf and experimental design by using essential oil by GC-MS instrumentation method Results: The utilization of these characteristics would be important for the drug discovery scientist to develop a specific formulation of the crude drug, which will be a magical therapeutic agent in the future, with the many advantageous. GC-MS chromatogram of the Ocimum sanctum, Ocimum canum and Ocimum gratissimum oil showed major peaks and has been identified after comparison of the mass spectra with NIST library, indicating the presence of three phytocomponents. From the results GC-MS study suggested that anethole which is well reported antimicrobial compound is more in O. canum (2.66%) in comparison to O. sanctum (1,28%) but absent in O. Gratissimum. The results indicated that the antimicrobial activity is more in O. canum due to presence high amount of anethole in comparison to O.Gratissimum, and O. Sanctum. The GC-MS study suggested that anethole which is well reported antimicrobial compound is more in O. canum (2.66%) in comparison to O. sanctum (1,28%) but absent in O. Gratissimum. Conculsion: The result showed that microscopic character of O. canum, with the characteristic GC MS analysis of the extracts, to identify different species of the ocimum plant. Ocimum sanctum L. and further experiments are required for better exploitation of essential oil for its commercial purposes.

DiGeorge syndrome, an immunodeficiency disorder due to long arm microdeletion of chromosome 22. Isolated hemolysis is rarely seen in DiGeorge syndrome and is usually reported in conjunction with idiopathic thrombocytopenic purpura. We report a case of DiGeorge syndrome with AIHA, which was successfully managed by intravenous steroids and intravenous immunoglobulins.

Obstetric anal sphincter injury is a common complication of vaginal delivery. Such injuries are more likely to result in postpartum fecal incontinence and thus diagnosis and restoration of perineal injuries at the time of vaginal delivery is of paramount importance.

Millette et al. (Ecology Letters, 2020, 23:55-67) reported no consistent worldwide anthropogenic effects on animal genetic diversity using repurposed mitochondrial sequences. We describe limitations to this study, some of which are common to other macrogenetic studies, that may lead to misinterpretations and unintended consequences for conservation.

Fibroblast growth factor 21 (FGF21) is a human metabolic hormone that is being pursued in early stage clinical trials as pharmacological target to treat a range of metabolic diseases. In animal models, increased FGF21 signalling has been shown to have beneficial effects on cardiometabolic outcomes, Alzheimer’s disease risk and lifespan. However, studies investigating the effect of FGF21 signalling on these clinical outcomes in humans have been inconclusive. In this study, a genetic variant associated with higher circulating FGF21 levels was leveraged to investigate its clinical effects in humans. Higher genetically proxied circulating FGF21 levels were associated favourably with lipid levels, blood pressure traits, waist-to-hip ratio, chronic inflammation, cardiovascular outcomes, Alzheimer’s disease risk and lifespan. These findings may be used to anticipate the effects of pharmacologically increasing FGF21 signalling and inform the design of further clinical trials.

Background and Purpose: Acute lung injury (ALI), acute respiratory distress syndrome (ARDS) and pulmonary fibrosis remain major causes of morbidity, mortality and healthcare burden in the critically ill patient. There is an urgent medical need for identifying factors of susceptibility and prognosis and for designing new therapeutic tools for treating these disorders. Here, we evaluate the capacity of the immunomodulatory neuropeptide cortistatin to regulate pulmonary inflammation and fibrosis in vivo. Experimental Approach: ALI/ARDS and pulmonary fibrosis were induced experimentally in wild-type and cortistatin-deficient mice by pulmonary infusion of the bacterial endotoxin LPS or the chemotherapeutic drug bleomycin, and the histopathological signs, pulmonary leukocyte infiltration and cytokines and fibrotic markers were evaluated. Key Results: Partially-deficient mice in cortistatin showed exacerbated pulmonary damage, pulmonary inflammation, alveolar oedema and fibrosis, and subsequent increased respiratory failure and mortality when challenged to LPS or bleomycin, even at low doses. Treatment with cortistatin reversed these aggravated phenotypes and protected from progression to severe ARDS and fibrosis after high-exposition to both injury agents. Moreover, cortistatin-deficient pulmonary macrophages and fibroblasts showed exaggerated ex vivo inflammatory and fibrotic responses. The anti-fibrotic protective effect of cortistatin was also observed in experimental scleroderma, in which lack of cortistatin predisposes to develop more severe dermal lesions and associated pulmonary fibrosis. Conclusion and Implications: We identify to cortistatin as an endogenous break of pulmonary inflammation and fibrosis. Deficiency in cortistatin could be a marker of poor-prognosis in inflammatory/fibrotic pulmonary disorders. Cortistatin-based therapies emerge as attractive candidates to treat severe ALI/ARDS, including SARS-Cov-2-associated ARDS.

Nick K. Jones1,2*, Lucy Rivett1,2*, Chris Workman3, Mark Ferris3, Ashley Shaw1, Cambridge COVID-19 Collaboration1,4, Paul J. Lehner1,4, Rob Howes5, Giles Wright3, Nicholas J. Matheson1,4,6¶, Michael P. Weekes1,7¶1 Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK2 Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK3 Occupational Health and Wellbeing, Cambridge Biomedical Campus, Cambridge, UK4 Cambridge Institute of Therapeutic Immunology & Infectious Disease, University of Cambridge, Cambridge, UK5 Cambridge COVID-19 Testing Centre and AstraZeneca, Anne Mclaren Building, Cambridge, UK6 NHS Blood and Transplant, Cambridge, UK7 Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK*Joint first authorship¶Joint last authorshipCorrespondence: mpw1001@cam.ac.ukThe UK has initiated mass COVID-19 immunisation, with healthcare workers (HCWs) given early priority because of the potential for workplace exposure and risk of onward transmission to patients. The UK’s Joint Committee on Vaccination and Immunisation has recommended maximising the number of people vaccinated with first doses at the expense of early booster vaccinations, based on single dose efficacy against symptomatic COVID-19 disease.1-3At the time of writing, three COVID-19 vaccines have been granted emergency use authorisation in the UK, including the BNT162b2 mRNA COVID-19 vaccine (Pfizer-BioNTech). A vital outstanding question is whether this vaccine prevents or promotes asymptomatic SARS-CoV-2 infection, rather than symptomatic COVID-19 disease, because sub-clinical infection following vaccination could continue to drive transmission. This is especially important because many UK HCWs have received this vaccine, and nosocomial COVID-19 infection has been a persistent problem.Through the implementation of a 24 h-turnaround PCR-based comprehensive HCW screening programme at Cambridge University Hospitals NHS Foundation Trust (CUHNFT), we previously demonstrated the frequent presence of pauci- and asymptomatic infection amongst HCWs during the UK’s first wave of the COVID-19 pandemic.4 Here, we evaluate the effect of first-dose BNT162b2 vaccination on test positivity rates and cycle threshold (Ct) values in the asymptomatic arm of our programme, which now offers weekly screening to all staff.Vaccination of HCWs at CUHNFT began on 8th December 2020, with mass vaccination from 8th January 2021. Here, we analyse data from the two weeks spanning 18thto 31st January 2021, during which: (a) the prevalence of COVID-19 amongst HCWs remained approximately constant; and (b) we screened comparable numbers of vaccinated and unvaccinated HCWs. Over this period, 4,408 (week 1) and 4,411 (week 2) PCR tests were performed from individuals reporting well to work. We stratified HCWs <12 days or > 12 days post-vaccination because this was the point at which protection against symptomatic infection began to appear in phase III clinical trial.226/3,252 (0·80%) tests from unvaccinated HCWs were positive (Ct<36), compared to 13/3,535 (0·37%) from HCWs <12 days post-vaccination and 4/1,989 (0·20%) tests from HCWs ≥12 days post-vaccination (p=0·023 and p=0·004, respectively; Fisher’s exact test, Figure). This suggests a four-fold decrease in the risk of asymptomatic SARS-CoV-2 infection amongst HCWs ≥12 days post-vaccination, compared to unvaccinated HCWs, with an intermediate effect amongst HCWs <12 days post-vaccination.A marked reduction in infections was also seen when analyses were repeated with: (a) inclusion of HCWs testing positive through both the symptomatic and asymptomatic arms of the programme (56/3,282 (1·71%) unvaccinated vs 8/1,997 (0·40%) ≥12 days post-vaccination, 4·3-fold reduction, p=0·00001); (b) inclusion of PCR tests which were positive at the limit of detection (Ct>36, 42/3,268 (1·29%) vs 15/2,000 (0·75%), 1·7-fold reduction, p=0·075); and (c) extension of the period of analysis to include six weeks from December 28th to February 7th 2021 (113/14,083 (0·80%) vs 5/4,872 (0·10%), 7·8-fold reduction, p=1x10-9). In addition, the median Ct value of positive tests showed a non-significant trend towards increase between unvaccinated HCWs and HCWs > 12 days post-vaccination (23·3 to 30·3, Figure), suggesting that samples from vaccinated individuals had lower viral loads.We therefore provide real-world evidence for a high level of protection against asymptomatic SARS-CoV-2 infection after a single dose of BNT162b2 vaccine, at a time of predominant transmission of the UK COVID-19 variant of concern 202012/01 (lineage B.1.1.7), and amongst a population with a relatively low frequency of prior infection (7.2% antibody positive).5This work was funded by a Wellcome Senior Clinical Research Fellowship to MPW (108070/Z/15/Z), a Wellcome Principal Research Fellowship to PJL (210688/Z/18/Z), and an MRC Clinician Scientist Fellowship (MR/P008801/1) and NHSBT workpackage (WPA15-02) to NJM. Funding was also received from Addenbrooke’s Charitable Trust and the Cambridge Biomedical Research Centre. We also acknowledge contributions from all staff at CUHNFT Occupational Health and Wellbeing and the Cambridge COVID-19 Testing Centre.

Objective: To determine if the racial and ethnic compositions of the participants in Obstetrics and Gynecology randomized controlled trials (RCTs) conducted in the U.S. match that of the general U.S. population. Design: Retrospective analysis of U.S. RCTs. Setting: United States. Population: Women enrolled in U.S. RCTs. Methods: Racial and ethnic composition of RCT participants published in two premier US journals, Obstetrics and Gynecology and American Journal of Obstetrics and Gynecology, from January 2010 to April 2020 were collected and analyzed. Main outcome measures: Comparison of the racial and ethnic composition of the U.S. RCTs to U.S. General population. Results: Chi-square analysis showed significant deviations from the U.S. general population in both Obstetrics (p<0.001) and Gynecology (p<0.05). We observed an overrepresentation of Black race and an underrepresentation of White and Asian races overall Obstetrics and in most subcategories. We observed an overrepresentation of Black race and an underrepresentation of Asian race in Gynecology overall and in most subcategories. White race representation was similar to the general population on average, but with wide variation across studies especially among the subcategories. Hispanic ethnicity was overall underrepresented. Conclusions: RCTs in the field of Obstetrics and Gynecology conducted in the U.S. deviate from the general population with regard to racial and ethnic distributions. Funding: NC,YW, CP, JG and SL received stipend from University of Chicago Metcalf summer internship program and Odyssey and Empower summer program. Keywords: U.S. Randomized Controlled Trials, Racial and Ethnic Backgrounds, Obstetrics and Gynecology

Northern range margin populations of the European fire-bellied toad (Bombina bombina) have rapidly declined during recent decades. Extensive agricultural land use has fragmented the landscape, leading to habitat disruption and loss, as well as eutrophication of ponds. In Northern Germany (Schleswig-Holstein) and Southern Sweden, this decline resulted in decreased gene flow from surrounding populations, low genetic diversity, and a putative reduction in adaptive potential, leaving populations vulnerable to future environmental and climatic changes. Previous studies using mitochondrial control region and nuclear transcriptome-wide SNP data detected introgressive hybridization in multiple northern B. bombina populations after presumed illegal release of toads from Austria. Here, we determine the impact of this introgression by comparing the body conditions (as a proxy for fitness) of introgressed and non-introgressed populations, and the genetic consequences in two candidate genes for putative local adaptation (the MHC II gene as part of the adaptive immune system and the stress response gene HSP70 kDa). We detected regional differences in body condition. We observed significantly elevated levels of within individual MHC allele counts in introgressed Swedish populations, associated with a tendency towards higher body weight, relative to regional non-introgressed populations. These differences were not observed among introgressed and non-introgressed German populations. Genetic diversity in both MHC and HSP was generally lower in northern than southern populations. Our study sheds light on the potential benefits of translocations of more distantly related conspecifics as a means to increase adaptive genetic variability and fitness of struggling range margin populations without distortion of local adaptation.

Accurate assessment of right ventricular (RV) function is drawing a growing attention. Pressure-volume (PV) loop analysis is the gold standard method for evaluating RV function; however, it is not widely employed due to its invasive nature and complexity. The present report is the first to have drawn a RV PV loop in a patient with pulmonary hypertension, with a simultaneous recording of RV pressure and volume using high fidelity micromanometry and 3D echocardiography. This allows for less invasive and simple assessment of RV function, potentially promoting better understanding and management of pulmonary hypertension and other cardiovascular diseases.

Background: Tracheobronchial foreign body aspiration (TFBA) is a major cause of death in children. There are few reports about lower respiratory tract infection (LRTI) caused by TFBA. This study collected the TFBA in our hospital to analyze the LRTI and to determine its risk factors. Methods: A total of 194 children who were performed TFBA extraction in The Children’s Hospital of Zhejiang University School of Medicine between June 2019 and April 2020 were enrolled. The clinical data, cervicothoracic CT and operation records were collected. Chi-square test, rank sum test and multivariate logistics regression analysis were applied. Results: The incidence of LRTI was 46.6%, 68.6% and 68.6% respectively when retention time was within 24 hours, 1 week and more than 1 week. Cervicothoracic CT showed embedding site in and above trachea in 24 cases, in main bronchus in 134 cases, in segmental bronchus and below in 36 cases. Cervicothoracic CT showed no obvious abnormality in 60 cases, obstructive emphysema or atelectasis in 77 cases, obstructive pneumonia in 50 cases, and the rest in 7 cases. Cervicothoracic CT diagnosis and retention time of TFBA were different between LRTI group and non-LRTI group in univariate analysis. There was a correlation between the retention time of TFBA and LRTI in multivariate logistics regression analysis. Conclusionss: The incidence of LRTI caused by TFBA is high. There was no difference in the incidence of LRTI between organic and inorganic TFBA. The retention time of TFBA is an independent risk factor for LRTI.

Le emissioni odorigene generate da impianti industriali e di tutela ambientale sono spesso causa di potenziali fenomeni di molestia olfattiva in grado di generare malcontento nei cittadini che vi risiedono in prossimità e, per tale ragione, vanno monitorate per contenerle entro determinate soglie tramite azioni di controllo e mitigazione. La caratterizzazione quantitativa e qualitativa dei composti di tipo odorigeno risulta, tuttavia, ancora di complessa esecuzione, sia a causa della soggettività intrinseca della percezione olfattiva sia per effetto dell’influenza delle condizioni meteoclimatiche sui fenomeni di dispersione odorigena e, dunque, sui livelli di fastidio percepiti. Fra le tecniche di misura generalmente impiegate per il monitoraggio degli odori, quelle senso-strumentali con applicazione dei nasi elettronici, più recentemente definiti IOMS (Instrumental Odour Monitoring Systems), rappresentano attualmente la soluzione più efficace per consentire l’investigazione della classe odorigena e dell’intensità di odore e sono in grado di monitorare gli odori in maniera continua ed in tempo reale, coniugando i vantaggi delle convenzionali tecniche di misura strumentali e sensoriali. Gli IOMS rappresentano la tecnologia con il più alto potenziale di sviluppo futuro e quindi risultano essere dei sistemi ulteriormente migliorabili. La mancanza di riferimenti tecnico-normativi in materia di emissioni odorigene rappresenta ancora un fattore limitante per l’impiego di tali dispositivi. Il quadro normativo in materia di odori, tuttavia, è in evoluzione, con l’emanazione di norme e regolamenti in materia sia in ambito nazionale che comunitario ed internazionale. La Norma UNI 11761:2019, in fase di revisione, definisce i requisiti tecnici e di gestione degli IOMS per la misurazione degli odori in aria ambiente, alle emissioni e indoor.

In current work, we have firstly synthesized 4-(2-chlorobenzyl)-1-(4-hydroxy-3- ((4-hydroxypiperidin-1-yl)methyl)-5-methoxyphenyl)-[1,2,4]triazolo[4,3-a]quinazolin-5(4H)-one (1) by ring-opening, cyclization, substitution, doamine condensation and Mannich reactions. The structural properties of the title compound 1 were explored using spectroscopy (1H NMR, 13C NMR, MS and FT-IR) and X-ray crystallography method. The single-crystal structure confirmed by X-ray diffraction was consistent with the molecular structure optimized by density functional theory (DFT) calculation at B3LYP/6-311G (2d, p) level of theory. The geometrical parameters, molecular electrostatic potential (MEP) and frontier molecular orbital (FMO) analysis were performed by DFT using the B3LYP/6-311G (2d, p) method. Molecular docking has shown favorable interaction between the title compound 1 and SHP2 protein. The inhibitory activity of target compound 1 on SHP2 protein at 10 μM is better than the reference compound (SHP244).

Systemic mastocytosis is a life-threatening disease in which mast cell mediator release can lead to general symptoms. The most common triggers are stress and pain during labor and delivery. We report the management of labor and delivery in a case with severe systemic mastocytosis by epidural analgesia.

Background: Atrial fibrillation (AF) and venous thromboembolism (VTE) share several risk factors related to arterial thromboembolism. No study has reported the differential contribution to arterial thromboembolic events and mortality between these two conditions in the same population. Methods: We included AF and VTE national cohorts derived from Taiwan National Health Insurance Research Database between 2001 and 2013. The eligible population was 314,861 patients in the AF cohort and 41,102 patients in the VTE cohort. The primary outcome was arterial thromboembolic events, including ischemic stroke, extracranial arterial thromboembolism (ECATE) and myocardial infarction (MI). Secondary outcomes were all-cause mortality and cardiovascular death. Results: After a 1:1 propensity matching, 32,688 patients in either group were analyzed. The risk of arterial thromboembolic events was lower in the VTE cohort than that in the AF cohort (subdistribution hazard ratio [SHR], 0.60; 95% confidence interval [CI], 0.57–0.62)). The risk of ischemic stroke (SHR, 0.44; 95% CI, 0.42–0.46) and MI (SHR, 0.80; 95% CI, 0.72–0.89) were lower in the VTE cohort, while the risk of ECATE (SHR, 1.23; 95% CI, 1.14–1.33; particularly lower extremities) was higher in the VTE cohort. All-cause mortality rate was higher in the VTE cohort (HR, 1.18; 95% CI, 1.15–1.21) while the risk of cardiovascular death was lower in the VTE cohort (HR, 0.96; 95% CI, 0.93–0.995). Conclusions: Patients with AF had higher risks of arterial thromboembolic events compared to patients with VTE, despite having risk factors in common. The VTE cohort had higher risks of all-cause mortality and ECATE, particularly lower extremity events, compared to AF patients. These differential manifestations of thromboembolism sequelae in AF and VTE merit further investigation.

Background: Cardiac injury is common and associated with worse clinical outcomes in COVID-19. Data are lacking whether high-dose intravenous vitamin C (HIVC) could help to improve cardiac injury in the pandemic. Methods: The study included severe and critically ill COVID-19 with cardiac injury. Troponin I and inflammatory markers were collected at admission and 14 days after treatment with HIVC along with symptomatic supportive treatment from the electronic medical records. Results: The patients (n = 113) were categorized into the improved cardiac injury (ICI) group (n = 70) and the non-improved cardiac injury (NICI) group (n = 43). Overall, 51 (45.1%) patients were administrated with HIVC, the percentages of patients with HIVC were higher in the ICI group than those in the NICI group. Logistic regression analysis revealed that HIVC was independently associated with improved cardiac injury. Further analysis showed that inflammatory markers levels significantly decreased at 14 days after treatment with HIVC compared to those without HIVC. Meanwhile, similar results were also observed regarding changes in inflammatory markers levels from baseline to 14 days after treatment with HIVC. Conclusions: HIVC can improve cardiac injury through attenuating hyperinflammation in severe and critically ill patients with COVID-19.

Background: Severe coronavirus disease 2019 (COVID-19) is associated with pathological elevations of tumor necrosis factor-alpha (TNF-ɑ) and interleukin 6 (IL-6). These cause extreme elevations of the acute phase reactant fibrinogen and plasma viscosity. Severe COVID-19 is also associated with poorly understood complications including a high incidence of arterial and venous thrombosis despite prophylactic anticoagulation, silent hypoxemia, pulmonary microvascular thrombosis, excess neutrophil extracellular trap formation, encephalopathy, and cardiac dysfunction. Aims: To investigate the cause of this pathological inflammatory response, the authors determined the number of purine-uridine-uridine-purine-uridine (purUUpurU) motifs in the genomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other RNA viruses. This motif is the precursor to the oligonucleotide which is the minimal motif required to activate inflammation via toll-like receptor 8 (TLR8). A genome containing the same nucleotides in SARS-CoV-2 in random order was used as a control. Result: PurUUpurU occurred 2.8 times more often in the actual SARS-CoV-2 genome than the randomized genome. The number of purUUpurU motifs correlates with the severity of the acute illnesses caused by the RNA viruses examined, except for influenza A. Conclusion: Hyperactivation of TLR8 mediated inflammation by purUUpurU may cause pathological inflammation in COVID-19. Marked elevations of TNF-ɑ, IL-6, and fibrinogen will cause erythrocyte aggregation and increase blood viscosity. This promotes thrombosis and decreases tissue perfusion. Therapeutic plasmapheresis reduces blood hyperviscosity and should be used in severe COVID-19. To date, use of this therapy has only been reported in COVID-19 associated thrombosis.

Background The elderly multi-morbid patient is at high risk of adverse outcomes with COVID-19 complications, and in the general population, the development of incident AF is associated with worse outcomes in such patients. We therefore investigated incident AF risks in a large prospective population of elderly patients with/without incident COVID-19 cases and baseline cardiovascular/non-cardiovascular multi-morbidities. We used two approaches: main-effect modeling and secondly, a machine-learning (ML) approach accounting for complex dynamic relationships. Methods We studied a prospective elderly US cohort of 280592 patients from medical databases in a 8-month investigation of new COVID19 cases. Incident AF outcomes were examined in relationship to diverse multi-morbid conditions, COVID-19 status and demographic variables, with ML accounting for the dynamic nature of changing multimorbidity risk factors. Results Multi-morbidity contributed to the onset of confirmed COVID-19 cases with cognitive impairment (OR 1.69; 95%CI 1.52-1.88), anemia (OR 1.41; 95%CI 1.32-1.50), diabetes mellitus (OR 1.35; 95%CI 1.27-1.44) and vascular disease (OR 1.30; 95%CI 1.21-1.39) having the highest associations. A main effect model (C-index value 0.718) showed that COVID-19 had the highest association with incident AF cases (OR 3.12; 95%CI 2.61-3.710, followed by congestive heart failure (1.72; 95%CI 1.50-1.96), then coronary artery disease (OR 1.43; 95%CI 1.27-1.60) and valvular disease (1.42; 95%CI 1.26-1.60). The ML algorithm demonstrated improved discriminatory validity incrementally over the statistical main effect model (training: C-index 0.729, 95%CI 0.718-0.740; validation: C-index 0.704, 95%CI 0.687-0.72). Calibration of ML based formulation was satisfactory and better than the main-effect model. Decision curve analysis demonstrated that the clinical utility for the ML based formulation was better than the ‘treat all’ strategy and the main effect model. Conclusion COVID-19 status has major implications for incident AF in a cohort with diverse cardiovascular/non-cardiovascular multi-morbidities. Our approach accounting for dynamic multimorbidity changes had good prediction for incident AF amongst incident COVID19 cases.

Introduction: The opinion that latent T. gondii infection is having a broadly asymptomatic projection has now been interrogated, in specific due to the echoed association between the latent infection and an elevated incidence of schizophrenia or even suicide attempts. Notwithstanding conducted studies aimed to understand this feasible link are restricted. Methods: In the present case-control study, we focused to illuminate the relationship between the serological and molecular presence of T. gondii and schizophrenia with or without the suicide attempts by comparing it with healthy individuals. A total of 237 participants (117 in schizophrenia; 120 in healthy control) were included in this study. Results: Overall, latent T. gondii infections were found statistically higher in 63 (53.8%) of the 117 patients with schizophrenia and in 33 (27.5%) of the 120 controls (p < 0.001). In schizophrenia patients, seroprevalence T. gondii was again found to be statistically higher in suicide attempters (59.6%), compared to no history of suicide attempts (48.3%) (p < 0.05). The molecular positivity rate of T. gondii DNA was higher in the schizophrenia group, compared to the healthy control group (p < 0.05), whereas the history of suicide attempts was not statistically associated (p = 0.831) with T. gondii DNA positivity by PCR. Conclusion: This case-control study enlightens additional demonstration to the belief that T. gondii infection would be an underlying component for the pathophysiology of schizophrenia. Regardless of the clarity results of this study, this supposition warrants further endorsement.

Phytoplasmas (Mollicutes, Acholeplasmataceae), vector-borne obligate bacterial plant-parasites, infect nearly 1,000 plant species and unknown numbers of insects, mainly leafhoppers (Hemiptera, Deltocephalinae), which play a key role in transmission and epidemiology. Although the plant-phytoplasma-insect association has been evolving for >300 million years, nearly all known phytoplasmas have been discovered as a result of the damage inflicted by phytoplasma diseases on crops. Few efforts have been made to study phytoplasmas occurring in non-economically important plants in natural habitats. In this study, a sub-sample of leafhopper specimens preserved in a large museum biorepository was analyzed to unveil potential new associations. PCR screening for phytoplasmas performed on 227 phloem-feeding leafhoppers collected worldwide from natural habitats revealed the presence of 6 different previously unknown phytoplasma strains. This indicates that museum collections of herbivorous insects represent a rich and largely untapped resource for discovery of new plant pathogens, that natural areas worldwide harbor a diverse but largely undiscovered diversity of phytoplasmas and potential insect vectors, and that independent epidemiological cycles occur in such habitats, posing a potential threat of disease spillover into agricultural systems. Larger-scale future investigations will contribute to a better understanding of phytoplasma genetic diversity, insect host range, and insect-borne phytoplasma transmission and provide an early warning for the emergence of new phytoplasma diseases across global agroecosystems.