Ocular manifestation as first sign of Coronavirus Disease 2019 (COVID-19): Interest of telemedicine during the pandemic context

We report here the case of a 27-year-old man who consulted by telemedicine during the Coronavirus disease 2019 (COVID-19) pandemic, due to foreign body sensation and left eye redness. Examination revealed unilateral eyelid edema and moderate conjunctival hyperemia. A few hours later, the patient experienced intense headache and developed fever, cough and severe dyspnea. A nasopharyngeal swab proved positive for SARS-CoV-2. This case demonstrates that conjunctivitis can be the inaugural manifestation of the COVID-19 infection. It illustrates the interest of telemedicine in ophthalmology during the COVID-19 pandemic, since moderate conjunctival hyperemia can be the first sign of a severe respiratory distress.

Body dysmorphic disorder in a sample of cosmetic surgery applicants

Body dysmorphic disorder (B.D.D.) consists of a preoccupation with an imagined or slight physical defect. This study is the first European report on prevalence and several clinical and functional characteristics of patients with B.D.D. in a cosmetic surgery setting. Comparisons with defect- and severity-matched subjects without B.D.D. were also performed.

Tariff Reductions and UK Imports of Manufactures: 1955-1971

Among the many factors that have contributed to the rapid growth of UK imports of manufactures over the last fifteen years or so, tariff reductions, both general and preferential, are usually mentioned as being one. Hitherto, however, the effect of all such reductions has not been quantified though some studies of the effect of EFTA membership on imports have been made. This article attempts to repair the omission by calculating the extent of the tariff cuts and by examining their effect on two broad groups of manufactures–semi-manufactures and finished goods.

High catalytic performance of laccase wired to naphthylated multiwall carbon nanotubes

The direct electrical connection of laccase on the electrode surface is a key feature in the design of efficient and stable biocathodes. However, laccase can perform a direct electron transfer only when it is in the preferred orientation toward the electrode. Here we report the investigation of the orientation of laccase from white rot fungus on multi-walled carbon nanotube surface modified with a naphthalene group. Naphthylated multi wall carbon nanotubes were synthesized and the kinetics of laccase from white rot fungus adsorption and its direct electro-catalytic activity toward oxygen reduction was investigated by QCM and electrochemical techniques. Compared to pristine multi-walled carbon nanotubes laccase shows a high affinity to be adsorbed onto the surface of naphthylated carbon nanotubes at a very fast rate. The subsequent wiring to the naphthylated multi-walled carbon nanotubes is accompanied by a reorientation and arrangement of adsorbed laccase to create a composite biocathode that exhibits a high-performance for oxygen reduction by direct electron transfer with maximum current densities of 3 mA cm^-2.

Fructans in Foods and Food Products, Ion-Exchange Chromatographic Method: Collaborative Study

Nine collaborating laboratories assayed 6 blind duplicate pairs of food samples containing the fructans inulin or oligofructose. The 6 sample pairs ranged from low (4%) to high levels (40%). Following the proposed method, the samples were treated with amyloglucosidase and inulinase enzymes and the released sugars were determined byion exchange chromatography. Repeatability standard deviation ranged from 2.9 to 5.8%; reproducibility standard deviation ranged from 4.7 to 11.1%. The ion-exchange chromatographic method for determinationof fructans in food and food products has been adopted first action by AOAC INTERNATIONAL (997.08)

Simultaneous Patient-Side Measurement of Hemoglobin, Glucose, and Cholesterol in Finger-Stick Blood

We describe a multianalyte assay system for patient-side use comprising single-use plastic cartridges and a small monitor. Hemoglobin, glucose, and cholesterol can be simultaneously measured in 3 min in an unmeasured volume of blood. The sample is drawn by capillary action into four channels for delivery to assay-specific stacks containing a set of closely apposed layers. The distal layer is a membrane that acts as the optical surface for reflectance optics. For glucose and cholesterol assays, erythrocytes are removed by a fibrous filter layer and oxidase-peroxidase chemical reactions contained in the optical membrane generate a colored product. For hemoglobin measurement, blood is lysed by detergent contained in a porous disk. The amount of color reaching the optical membrane is measured by fiber optics. To ensure fail-safe operation, sensors verify sample sufficiency and degree of hemolysis. The assays perform comparably with laboratory methods.

Determination of Nine Intense Sweeteners in Foodstuffs by High-Performance Liquid Chromatography and Evaporative Light-Scattering Detection: Interlaboratory Study

An interlaboratory trial was conducted to validate an analytical method based on high-performance liquid chromatographic analysis with evaporative light-scattering detection for the simultaneous determination of 9 intense sweeteners, i.e., acesulfame-K, alitame, aspartame, cyclamic acid, dulcin, neotame, neohesperidine dihydrochalcone, saccharin, and sucralose in carbonated and noncarbonated soft drinks and canned or bottled fruits. Seven laboratories participated in the validation study. The majority of the samples fortified with levels close to the limit of quantification had relative standard deviation for reproducibility (RSDR) values <15. In most cases, the recovery rates ranged between 90 and 105, demonstrating satisfactory performance of the method. For samples fortified at levels comparable to the prescribed legal limits stipulated in the current European Union legislation, the method produces acceptably accurate, repeatable, and reproducible results. Trueness, expressed in terms of recovery rates, was demonstrated in most cases by values ranging from 90 to 108. Comparability of results obtained by individual testing laboratories was good (RSDR values <10) for the majority of results. Moreover, HorRat values of <1.1 suggested good performance of the method for all sweeteners and matrixes tested.

Spontaneous non-traumatic splenic artery aneurysm rupture: a case report and review of the literature

The current case report is about spontaneous non-traumatic rupture of a splenic artery aneurysm (SAA) in a 53-year-old woman with no particular medical history. An emergent laparotomy with splenectomy was required, unfortunately without success as the patient died. SAA is the most common visceral artery aneurysm. Most of SAA remain asymptomatic and are discovered incidentally on imaging. The overall risk of rupture increases with the size of SAA, especially when above 2 cm. Initial presentation of SAA has been associated with acute rupture and hemodynamic instability leading to substantial perioperative morbidity and mortality.

A systematic review and computational modelling analysis of unilateral montages in electroconvulsive therapy

OBJECTIVE

To examine the clinical outcomes of ECT unilateral placements compared in prior studies and apply insights from computational modelling to understand differences between placements.

METHODS

PubMed, Embase, Scopus and PsycINFO and reference lists were systematically searched for studies of depressed patients where two unilateral placements were compared and clinical outcomes were reported. Computational modelling was done to generate electric field maps for each unilateral placement identified in the systematic review.

RESULTS

A total of 29 studies met criteria for inclusion. Eight studies reported efficacy outcomes and 23 studies reported cognitive outcomes. Most studies found no significant difference in efficacy between right unilateral (RUL) and left unilateral (LUL) ECT, and no difference was found between temporo-parietal and fronto-temporal ECT. For the majority of studies, RUL placements had better verbal anterograde memory outcomes compared with the LUL placements. There was some evidence suggestive of cognitive advantages for fronto-frontal and fronto-parietal placements relative to temporo-parietal ECT.

CONCLUSIONS

For efficacy, studies mainly focused on the comparison of right vs. left hemispheric stimulation, with the available evidence suggesting no substantive difference. RUL placements tended to have better verbal anterograde memory outcomes relative to LUL placements, though limited differences were found between the RUL placements.

Single-Cell RNA-seq Identifies Cell Diversity in Embryonic Salivary Glands

Branching organs, including the salivary and mammary glands, lung, and kidney, arise as epithelial buds that are morphologically very similar. However, the mesenchyme is known to guide epithelial morphogenesis and to help govern cell fate and eventual organ specificity. We performed single-cell transcriptome analyses of 14,441 cells from embryonic day 12 submandibular and parotid salivary glands to characterize their molecular identities during bud initiation. The mesenchymal cells were considerably more heterogeneous by clustering analysis than the epithelial cells. Nonetheless, distinct clusters were evident among even the epithelial cells, where unique molecular markers separated presumptive bud and duct cells. Mesenchymal cells formed separate, well-defined clusters specific to each gland. Neuronal and muscle cells of the 2 glands in particular showed different markers and localization patterns. Several gland-specific genes were characteristic of different rhombomeres. A muscle cluster was prominent in the parotid, which was not myoepithelial or vascular smooth muscle. Instead, the muscle cluster expressed genes that mediate skeletal muscle differentiation and function. Striated muscle was indeed found later in development surrounding the parotid gland. Distinct spatial localization patterns of neuronal and muscle cells in embryonic stages appear to foreshadow later differences in adult organ function. These findings demonstrate that the establishment of transcriptional identities emerges early in development, primarily in the mesenchyme of developing salivary glands. We present the first comprehensive description of molecular signatures that define specific cellular landmarks for the bud initiation stage, when the neural crest-derived ectomesenchyme predominates in the salivary mesenchyme that immediately surrounds the budding epithelium. We also provide the first transcriptome data for the largely understudied embryonic parotid gland as compared with the submandibular gland, focusing on the mesenchymal cell populations.

P2519Multiprofessional intervention for fostering self management capabilities for patients with chronic heart disease - development of a common curriculum (MIFeSCH)

Background

Chronic cardiovascular disease (CAD) still is the leading cause of death in industrialized countries in spite of substantial progress in diagnostics and therapy. Programs of lifestyle management are effective but insufficiently established in usual patient care. The authors provide multi professional educational courses to strengthen self management capabilities for cardiovascular patients in five different institutions in Europe since up to 20 years in modification of the program of Dr. Dean Ornish. Physicians, psychologists, dietitians and artistic and movement therapists work together in courses lasting from half a year to one year.

To implement their programs in daily care, an association of these five institutions will evaluate a common lifestyle management program in four phases: 1. development of a common curriculum, 2. pilot study, 3. interventional study, 4. implementation study.

Phase 1 is now completed. The evaluation will show, whether this lifestyle management program leads to improvement of health in patients and in the therapeutic team.

Purpose of phase 1: development of a common curriculum by the five active members of the association.

Methods

The five existing educational programs were assessed and differences between the programs themselves and other existing programs of patient education were defined. Distinctive and common features of the different institutions were recorded. Structured interviews with members of all institutions acquired content, methods and eductional goals of the interventions according to predefined criteria for patient education programs in the respective countries. The results were discussed, reflected and a common curriculum was consented.

Results

The consented multi professional curriculum, comprising the activities of five active heart education programs defines five different levels of competence which are key of their patient education goals: (1) reflective self-awareness (I-competence), (2) artistic competence, (3) competence of ensouled movement, (4) nutritional competence and (5) social competence.

The main difference between the already existing programs for patients with CAD and the newly developed curriculum is the emphasis on training the participants' self awareness and social competence, for example by biography work in an interdisciplinary approach.

Levels of competence

Conclusion

The process of generating a common curriculum of competence levels, educational goals and necessary methods comprising the work of five different but associated institutions was successful. A pilot study will now be performed to show the effects of this program on cardiovascular health and quality of live of study participants and the therapeutic team as well to show, whether this intervention reduces the risk of burn out for the therapists.

By this the authors hope to implement their education program according to the curriculum as an improvement of standard therapy for patients with cardiovascular disease.

Acknowledgement/Funding

Universität Witten-Herdecke

Data-informed targets for suicide prevention: a small-area analysis of high-risk suicide regions in Australia

PURPOSE

To investigate small-area variation in risks associated with suicide deaths across four regional communities in New South Wales, Australia, and to determine whether these areas have unique demographic and socioeconomic risk profiles that could inform targeted means restriction suicide prevention efforts.

METHODS

Archival data on suicide mortality for all deaths in New South Wales, Australia, over the period 2006-2015 were geospatially attributed to four high-risk priority regions. Deaths in the four regions were compared to each other, and to NSW, on demographic factors, indicators of economic deprivation, and suicide means.

RESULTS

Priority means restriction targets were identified for all sites. In Murrumbidgee, suicide deaths were significantly more likely to involve firearms and older males (p < 0.001). The Central Coast had a greater proportion of overdose deaths (p < 0.001), which were associated with being female and unemployed. Suicide deaths in Newcastle were associated with being younger (p = 0.001) and involving 'jumping from a height' (p < 0.001), while economic deprivation was a major risk for suicide death in Illawarra Shoalhaven (p < 0.001).

CONCLUSIONS

Local regions were significantly differentiated from each other, and from the State, in terms of priority populations and means of suicide, demonstrating the need for locally based, targeted interventions. There were, however, also some risk constancies across all sites (males, hanging, economic deprivation), suggesting that prevention initiatives should, optimally, be delivered within multilevel models that target risk commonalities and provide tailored initiatives that address risk specific to a region.

Influenza B virus infections in Western Saxony, Germany in three consecutive seasons between 2015 and 2018: Analysis of molecular and clinical features

BACKGROUND

The impact of annual influenza epidemics and prevailing strains varies worldwide and regional. The majority of vaccines used contained two influenza A strains and only one influenza B strain (trivalent vaccine).

AIM

The aim of the study was to compare laboratory confirmed influenza B cases during three consecutive years with respect to vaccination history, clinical symptoms and molecular virology.

METHODS

Partial HA gene sequences were analyzed for lineage determination and complete HA sequence in cases with reported vaccination and in fatal cases. Clinical data were retrieved from patient charts.

FINDINGS

During the 2015/16 season, 75 influenza B cases were retrieved; 11 in 2016/17, and 274 in 2017/18. The frequency of Yamagata-lineage strains increased from 7.6% to 100%. No difference was detected in the relative frequency of co-morbidities in season 2017/18. 37.7% of the adult patients and 4.5% of pediatric patients were vaccinated against influenza.

INTERPRETATION

Phylogenetically, Yamagata strains clustered similarly in 2017/2018 when compared to the previous two influenza seasons. While the relative frequency of influenza B cases differed, the clinical symptoms remained similar.

CONCLUSION

World Health Organization recommendations for the use of tetravalent vaccines that contain two influenza B strains (Yamagata and Victoria) in addition to the two influenza A strains (H1N1 and H3N2) should be implemented in national vaccination guidelines.

FUNDING

This research was partially supported by the Association of Sponsors and Friends of Leipzig University.