New Isolation of Ponticelli III Virus (Bunyavirales: Phenuiviridae) in Emilia-Romagna Region, Italy

The number of newly described sandfly-borne phleboviruses has been steadily growing in recent years. Some phleboviruses are human pathogens, but their health relevance is largely uncharacterized. We aimed to investigate the circulation of these viruses in the Emilia-Romagna region where several have already been described. A total of 482 sandflies were collected in a site in Reggio Emilia in 2019 and 2020. Sandflies collected in 2020 were grouped in 21 pools with a maximum of 25 sandflies per pool, submitted to real time PCR, and isolated in Vero cell culture. Complete genome sequencing showed the isolation of a strain of a Ponticelli III virus. This virus, which belongs to the species Adana phlebovirus, differed in the M segment from the Ponticelli I and Ponticelli II viruses. Analysis performed on the genomic segments of the newly isolated virus compared with other phleboviruses highlighted a strong purifying selection in the L segments, and different substitution saturation, highest in the M segments. Future research should address the ecological processes driving the occurrence of these novel phleboviruses and their possible impact on public health.

Instrument-Assisted Soft Tissue Mobilization Increased Hamstring Mobility

CONTEXT

Limited research reveals that the use of different soft tissue mobilization techniques increases tissue mobility in different regions of the body.

OBJECTIVE

The purpose of this study was to determine whether there is a difference between administering instrument-assisted soft tissue mobilization (IASTM) and therapeutic cupping (TC) on hamstring tightness.

DESIGN

Subjects attended one session wherein treatment and leg order were randomized before attending the session. A statistical analysis was completed using a 2 (intervention) × 2 (time) repeated-measures analysis of variance at α level ≤ .05.

PARTICIPANTS

Thirty-three subjects between the age of 18-35 years old with bilateral hamstring tightness participated in this study.

INTERVENTIONS

The IASTM and TC were administered on different legs for 5 minutes and over the entire area of the hamstring muscles. One TC was moved over the entire treatment area in a similar fashion as the IASTM.

MAIN OUTCOME MEASURES

The intervention measurements included soreness numeric rating scale, Sit-n-Reach (single leg for side being tested), goniometric measurement for straight-leg hip-flexion motion, and superficial skin temperature. The timeline for data collection included: (1) intervention measurements for the first randomized leg, (2) 5-minute treatment with the first intervention treatment, (3) intervention measurements repeated for postintervention outcomes, and (4) repeat the same steps for 1 to 3 with the contralateral leg and the other intervention.

RESULTS

There was a main effect over time for Sit-n-Reach, measurement (pre-IASTM-29.50 [8.54], post-IASTM-32.11 [8.31] and pre-TC-29.67 [8.21], post-TC-32.05 [8.25]) and goniometric measurement (pre-IASTM-83.45 [13.86], post-IASTM-92.73 [13.20] and pre-TC-83.76 [11.97], post-TC-93.67 [12.15]; P < .05).

CONCLUSION

Both IASTM and TC impacted hamstring mobility during a single treatment using only an instrument-assisted soft tissue mobilization technique without any additional therapeutic intervention.

The emerging role of exosomes in innate immunity, diagnosis and therapy

Exosomes, which are nano-sized transport bio-vehicles, play a pivotal role in maintaining homeostasis by exchanging genetic or metabolic information between different cells. Exosomes can also play a vital role in transferring virulent factors between the host and parasite, thereby regulating host gene expression and the immune interphase. The association of inflammation with disease development and the potential of exosomes to enhance or mitigate inflammatory pathways support the notion that exosomes have the potential to alter the course of a disease. Clinical trials exploring the role of exosomes in cancer, osteoporosis, and renal, neurological, and pulmonary disorders are currently underway. Notably, the information available on the signatory efficacy of exosomes in immune-related disorders remains elusive and sporadic. In this review, we discuss immune cell-derived exosomes and their application in immunotherapy, including those against autoimmune connective tissue diseases. Further, we have elucidated our views on the major issues in immune-related pathophysiological processes. Therefore, the information presented in this review highlights the role of exosomes as promising strategies and clinical tools for immune regulation.

The Arctic Ocean's Beaufort Gyre

The Arctic Ocean's Beaufort Gyre is a dominant feature of the Arctic system, a prominent indicator of climate change, and possibly a control factor for high-latitude climate. The state of knowledge of the wind-driven Beaufort Gyre is reviewed here, including its forcing, relationship to sea-ice cover, source waters, circulation, and energetics. Recent decades have seen pronounced change in all elements of the Beaufort Gyre system. Sea-ice losses have accompanied an intensification of the gyre circulation and increasing heat and freshwater content. Present understanding of these changes is evaluated, and time series of heat and freshwater content are updated to include the most recent observations.

Nuclear Reprocessing Tracers Illuminate Flow Features and Connectivity Between the Arctic and Subpolar North Atlantic Oceans

Releases of anthropogenic radionuclides from European nuclear fuel reprocessing plants enter the surface circulation of the high-latitude North Atlantic and are transported northward into the Arctic Ocean and southward from the Nordic Seas into the deep North Atlantic, thereby providing tracers of water circulation, mixing, ventilation, and deep-water formation. Early tracer studies focused on ¹³⁷Cs, which revealed some of the first significant insights into the Arctic Ocean circulation, while more recent work has benefited from advances in accelerator mass spectrometry to enable the measurement of the conservative, long-lived radionuclide tracers ¹²⁹I and ²³⁶U. The latest studies of these tracers, supported by simulations using the North Atlantic-Arctic Ocean-Sea Ice Model (NAOSIM) and enhanced by the use of transit time distributions to more precisely accommodate mixing, have provided a rich inventory of transport data for circulation in the Arctic and North Atlantic Oceans that are of great importance to global thermohaline circulation and climate.

A New Perspective on the Co-Transmission of Plant Pathogens by Hemipterans

Co-infection of plants by pathogens is common in nature, and the interaction of the pathogens can affect the infection outcome. There are diverse ways in which viruses and bacteria are transmitted from infected to healthy plants, but insects are common vectors. The present review aims to highlight key findings of studies evaluating the co-transmission of plant pathogens by insects and identify challenges encountered in these studies. In this review, we evaluated whether similar pathogens might compete during co-transmission; whether the changes in the pathogen titer in the host, in particular associated with the co-infection, could influence its transmission; and finally, we discussed the pros and cons of the different approaches used to study co-transmission. At the end of the review, we highlighted areas of study that need to be addressed. This review shows that despite the recent development of techniques and methods to study the interactions between pathogens and their insect vectors, there are still gaps in the knowledge of pathogen transmission. Additional laboratory and field studies using different pathosystems will help elucidate the role of host co-infection and pathogen co-transmission in the ecology and evolution of infectious diseases.

The effects of cloth face masks on cardiorespiratory responses and VO2 during maximal incremental running protocol among apparently healthy men

We aimed to determine the effects of wearing a cloth face mask on cardiorespiratory response, peak oxygen uptake (Vo₂), respiratory muscle effort, and exercise tolerance during incremental exercise. The study had a randomized crossover design: 11 apparently healthy young men performed the Bruce protocol treadmill test in two conditions, wearing a cloth face mask (CFM) and without CFM (CON), in random order. Minute ventilation and oxygen uptake were measured using a mass spectrometry metabolic analyzer; cardiac output (CO) was measured using an impedance CO monitor; and mouth pressure (P_m) was measured and calculated as an integral P_m to assess respiratory muscle effort. Maximal minute ventilation was 13.4 ± 10.7% lower in the CFM condition than in the CON condition (P < 0.001). The peak Vo₂ (52.4 ± 5.6 and 55.0 ± 5.1 mL/kg/min in CFM and CON, respectively) and CO were not significantly different between the two conditions. However, the integral value of P_m was significantly higher (P = 0.02), and the running time to exhaustion was 2.6 ± 3.2% lower (P = 0.02) in the CFM condition than in the CON condition. Our results suggest that wearing a cloth face mask increased respiratory muscle effort and decreased ventilatory volume in healthy young men; however, Vo₂ remained unchanged. Exercise tolerance also decreased slightly.

Epizootic Haemorrhagic Disease Virus Serotype 8 in Tunisia, 2021

Epizootic haemorrhagic disease (EHD) is a Culicoides-borne viral disease caused by the epizootic haemorrhagic disease virus (EHDV) associated with clinical manifestations in domestic and wild ruminants, primarily white-tailed deer (Odocoileus virginianus) and cattle (Bos taurus). In late September 2021, EHDV was reported in cattle farms in central/western Tunisia. It rapidly spread throughout the country with more than 200 confirmed outbreaks. We applied a combination of classical and molecular techniques to characterize the causative virus as a member of the serotype EHDV-8. This is the first evidence of EHDV- 8 circulation since 1982 when the prototype EHDV-8 strain was isolated in Australia. This work highlights the urgent need for vaccines for a range of EHDV serotypes.

Associations of cardiorespiratory fitness, body composition, and blood pressure with arterial stiffness in adolescent, young adult, and middle-aged women

Few studies have investigated whether higher cardiorespiratory fitness (CRF) or favourable body composition are related to lower arterial stiffness in women. We therefore investigated the associations of CRF, body fat percentage (BF%), fat free mass index (FFMI), and mean arterial pressure (MAP) with arterial stiffness in 146 women aged 16-58 years. CRF was assessed by a maximal exercise test with respiratory gas analysis either on a cycle ergometer or a treadmill. Aortic pulse wave velocity (PWVao), augmentation index (AIx%), and MAP were assessed by a non-invasive oscillometric device and BF% and FFMI by a bioelectrical impedance or DXA device. CRF was inversely associated with PWVao (β =  - 0.004, 95% CI - 0.005 to - 0.002) and AIx% (β =  - 0.075, 95% CI - 0.102 to - 0.048) and these associations remained similar after adjustment for BF% or MAP, but not after the adjustment for age. FFMI was inversely associated with PWVao (β =  - 0.010, 95% CI - 0.019 to - 0.002) and MAP directly associated with PWVao (β = 0.005, 95% CI 0.003 to 0.006) and AIx% (β = 0.092, 95% CI 0.069 to 0.116) and the associations with PWVao also remained after further adjustments for BF% and age. In conclusion, a higher FFMI and a lower MAP were independently associated with lower arterial stiffness.

Advanced and Invasive Cardiopulmonary Resuscitation (CPR) Techniques as an Adjunct to Advanced Cardiac Life Support

BACKGROUND

Despite numerous promising innovations, the chance of survival from sudden cardiac arrest has remained virtually unchanged for decades. Recently, technological advances have been made, user-friendly portable devices have been developed, and advanced invasive procedures have been described that could improve this unsatisfactory situation.

METHODS

A selective literature search in the core databases with a focus on randomized controlled trials and guidelines.

RESULTS

Technical aids, such as feedback systems or automated mechanical cardiopulmonary resuscitation (CPR) devices, can improve chest compression quality. The latter, as well as extracorporeal CPR, might serve as a bridge to treatment (with extracorporeal CPR even as a bridge to recovery). Sonography may be used to improve thoracic compressions on the one hand and to rule out potentially reversible causes of cardiac arrest on the other. Resuscitative endovascular balloon occlusion of the aorta might enhance myocardial and cerebral perfusion. Minithoracostomy, pericardiocentesis, or clamshell thoracotomy might resolve reversible causes of cardiac arrest.

CONCLUSIONS

It is crucial to identify those patients who may benefit from an advanced or invasive procedure and make the decision to implement the intervention in a timely manner. As with all infrequently performed procedures, sound education and regular training are paramount.

Acquisition of optical coherence tomography angiography metrics during hemodialysis procedures: A pilot study

BACKGROUND AND AIMS

The observation of optical microcirculation gives us an extraordinary way to directly assess in vivo the responses of human circulation to stress stimuli. We run a pilot study to analyze optical coherence tomography angiography (OCT-A) metrics at determined time-points during a hemodialysis (HD) session to understand how these metrics gradually change and to evaluate possible correlations with patients' characteristics.

METHODS

After the eligibility screening, 15 patients (23 eyes) were included in the study. OCT-A parameters were collected at established time-points: Before treatment (t0), at first hour (t1), at second hour (t2), at third hour (t3), and finally at the end of HD treatment (t4). Patients were finally shared in hypotensive group if they occurred in a hypotensive episode during subsequent month methods or no hypotensive group. The instrument software automatically segmented OCT-A scans into four en-face slabs: The superficial capillary plexus (SCP), the deep capillary plexus (DCP), the outer retinal plexus and the choriocapillaris plexus. In this study we focus on SCP, DCP plexuses.

RESULTS

Overall, the majority of ophthalmic parameters remained unaffected and comparable at dialysis end; a significant reduction being observed at the end vs. starting of HD only for deep capillary plexus (DCP: Whole, fovea, and parafovea) and for central choroid thickness (CCT) (p < 0.05). An overall trend during the session showed in general a decrease with a significance in particular for DCP (whole, fovea, and parafovea) and for CCT (P = 0.006). In the hypotension group, Superficial capillary plexus (SCP: Fovea and parafovea) significantly increased comparing post vs. pre-dialysis values while CCT significantly decreased. Analyzing the trend during treatment only CCT maintained a significant trend (p for trend = 0.002). In the no-hypotension group, neither pre- vs. post-analysis and trend analysis showed a statistical significance.

CONCLUSION

Main achievement of our study was to measure, for the first time in literature, single parameters at different time-points of a HD session. As a result of this process we did not notice a brusque decreasing or increasing of OCT-A metrics but we can characterize the different effect of HD on the two distinct areas distinguishing ocular vessels: Retinal and choroidal circulation. As interesting sub-analysis, Hypotensive group showed for CCT a decreasing trend with a difference statistically significant respect to the group with no-hypotension maintaining a constant trend. In our opinion, these results suggest the role of autonomic system on vessel control in patients affected by uremia.

Post COVID-19 syndrome with impairment of flow-mediated epicardial vasodilation and flow reserve

AIMS

The aim of this study is to evaluate whether post-acute sequelae of COVID-19 cardiovascular syndrome (PASC-CVS) is associated with alterations in coronary circulatory function.

MATERIALS AND METHODS

In individuals with PASC-CVS but without known cardiovascular risk factors (n = 23) and in healthy controls (CON, n = 23), myocardial blood flow (MBF) was assessed with ¹³ N-ammonia and PET/CT in mL/g/min during regadenoson-stimulated hyperemia, at rest, and the global myocardial flow reserve (MFR) was calculated. MBF was also measured in the mid and mid-distal myocardium of the left ventricle (LV). The Δ longitudinal MBF gradient (hyperemia minus rest) as a reflection of an impairment of flow-mediated epicardial vasodilation, was calculated.

RESULTS

Resting MBF was significantly higher in PASC-CVS than in CON (1.29 ± 0.27 vs. 1.08 ± 0.20 ml/g/min, p ≤ .024), while hyperemic MBFs did not differ significantly among groups (2.46 ± 0.53 and 2.40 ± 0.34 ml/g/min, p = .621). The MFR was significantly less in PASC-CVS than in CON (1.97 ± 0.54 vs. 2.27 ± 0.43, p ≤ .031). In addition, there was a Δ longitudinal MBF gradient in PASC-CVS, not observed in CON (-0.17 ± 0.18 vs. 0.04 ± 0.11 ml/g/min, p < .0001).

CONCLUSIONS

Post-acute sequelae of COVID-19 cardiovascular syndrome may be associated with an impairment of flow-mediated epicardial vasodilation, while reductions in coronary vasodilator capacity appear predominantly related to increases in resting flow in women deserving further investigations.

A three-dimensional model of news recirculation: towards a unified understanding of news sharing

This paper responds to calls for theory-building about news sharing on social media, arguing for a unified understanding of sharing practices both online and off. Developing a theoretical understanding of news sharing requires broadening our gaze to include other communicative technologies, such as postal mail, email, voice calls, and in-person conversation. In a conceptual contribution based on reflections about my participation in long-term multi-method collaborative studies in the US, I argue that news sharing is an act of commitment at the core. I also propose a three-dimensional model of news recirculation. The first two dimensions, publicness and ephemerality, are ideological - although they widely misrecognized as properties of specific channels and platforms. People enact a third dimension of practice, voice, when they recirculate news.

Monitoring of Avian Influenza Viruses and Paramyxoviruses in Ponds of Moscow and the Moscow Region

The ponds of the Moscow region during the autumn migration of birds are a place with large concentrations of mallard ducks, which are the main hosts of avulaviruses (avian paramyxoviruses) and influenza A viruses (IAV). The purpose of this study was the determination of the biological diversity of IAV and avulaviruses isolated from mallards in Moscow's ponds. A phylogenetic analysis of IAV was performed based on complete genome sequencing, and virus genomic reassortment in nature was studied. Almost all IAV genome segments clustered with apathogenic duck viruses according to phylogenetic analysis. The origin of the genes of Moscow isolates were different; some of them belong to European evolutionary branches, some to Asian ones. The majority of closely related viruses have been isolated in the Western Eurasian region. Much less frequently, closely related viruses have been isolated in Siberia, China, and Korea. The quantity and diversity of isolated viruses varied considerably depending on the year and have decreased since 2014, perhaps due to the increasing proportion of nesting and wintering ducks in Moscow.

Increased biventricular hemodynamic forces in precapillary pulmonary hypertension

Precapillary pulmonary hypertension (PHprecap) is a condition with elevated pulmonary vascular pressure and resistance. Patients have a poor prognosis and understanding the underlying pathophysiological mechanisms is crucial to guide and improve treatment. Ventricular hemodynamic forces (HDF) are a potential early marker of cardiac dysfunction, which may improve evaluation of treatment effect. Therefore, we aimed to investigate if HDF differ in patients with PHprecap compared to healthy controls. Patients with PHprecap (n = 20) and age- and sex-matched healthy controls (n = 12) underwent cardiac magnetic resonance imaging including 4D flow. Biventricular HDF were computed in three spatial directions throughout the cardiac cycle using the Navier-Stokes equations. Biventricular HDF (N) indexed to stroke volume (l) were larger in patients than controls in all three directions. Data is presented as median N/l for patients vs controls. In the RV, systolic HDF diaphragm-outflow tract were 2.1 vs 1.4 (p = 0.003), and septum-free wall 0.64 vs 0.42 (p = 0.007). Diastolic RV HDF apex-base were 1.4 vs 0.87 (p < 0.0001), diaphragm-outflow tract 0.80 vs 0.47 (p = 0.005), and septum-free wall 0.60 vs 0.38 (p = 0.003). In the LV, systolic HDF apex-base were 2.1 vs 1.5 (p = 0.005), and lateral wall-septum 1.5 vs 1.2 (p = 0.02). Diastolic LV HDF apex-base were 1.6 vs 1.2 (p = 0.008), and inferior-anterior 0.46 vs 0.24 (p = 0.02). Hemodynamic force analysis conveys information of pathological cardiac pumping mechanisms complementary to more established volumetric and functional parameters in precapillary pulmonary hypertension. The right ventricle compensates for the increased afterload in part by augmenting transverse forces, and left ventricular hemodynamic abnormalities are mainly a result of underfilling rather than intrinsic ventricular dysfunction.

Virtualization of Cross-Border Labor Migration

Under virtual labor migration, or telemigration, in the expert community it is customary to understand remote work or the provision of services that are carried out in a cross-border format. The presence of the word migration in this term logically prompts us to consider the designated process in a migration context. From the standpoint of the concept of migration transition, the spread of virtual migration can be interpreted as a new link in the chain of mobility transformations generated by multifaceted digital transformations. With this kind of migration, a person crosses only virtual borders of states and, without leaving the country of residence, actually works outside it and performs the tasks of a foreign customer in a remote electronic mode. The short duration and rapid turnover of most jobs in cyberspace makes this process extremely circulatory, uncharacteristic of traditional labor relations. So far, this employment model has been limited in scope, but it is rapidly developing, having gained great momentum in the context of the COVID-19 pandemic, and may become significant in the future. While paying dividends to workers and employers interacting in global digitalized labor markets, virtual migration simultaneously exacerbates chronic imbalances and generates new sources of social tension. They are connected, among other things, with the global asymmetry of socioeconomic and digital development, the emergence of new factors and areas of competition for workers in the labor market, and insufficient social protection of the workers. Optimization of the development of virtual migration could be facilitated by comprehensive regulatory measures at the level of international organizations, states, and companies.

Selenocompounds and Sepsis-Redox Bypass Hypothesis: Part B-Selenocompounds in the Management of Early Sepsis

Significance: Endothelial barrier damage, which is in part caused by excess production of reactive oxygen, halogen and nitrogen species (ROHNS), especially peroxynitrite (ONOO^-), is a major event in early sepsis and, with leukocyte hyperactivation, part of the generalized dysregulated immune response to infection, which may even become a complex maladaptive state. Selenoenzymes have major antioxidant functions. Their synthesis is related to the need to limit deleterious oxidant redox cycling by small selenocompounds, which may be of therapeutic cytotoxic interest. Plasma selenoprotein-P is crucial for selenium transport from the liver to the tissues and for antioxidant endothelial protection, especially against ONOO^-. Above micromolar concentrations, sodium selenite (Na₂SeO₃) becomes cytotoxic, with a lower cytotoxicity threshold in activated cells, which has led to cancer research. Recent Advances: Plasma selenium (<2% of total body selenium) is mainly contained in selenoprotein-P, and concentrations decrease rapidly in the early phase of sepsis, because of increased selenoprotein-P binding and downregulation of hepatic synthesis and excretion. At low concentrations, Na₂SeO₃ acts as a selenium donor, favoring selenoprotein-P synthesis in physiology, but probably not in the acute phase of sepsis. Critical Issues: The cytotoxic effects of Na₂SeO₃ against hyperactivated leukocytes, especially the most immature forms that liberate ROHNS, may be beneficial, but they may also be harmful for activated endothelial cells. Endothelial protection against ROHNS by selenoprotein-P may reduce Na₂SeO₃ toxicity, which is increased in sepsis. Future Direction: The combination of selenoprotein-P for endothelial protection and the cytotoxic effects of Na₂SeO₃ against hyperactivated leukocytes may be a promising intervention for early sepsis. Antioxid. Redox Signal. 37, 998-1029.

Boosting the Bioaccessibility of Dietary Bioactives by Delivery as Protein-Polyphenol Aggregate Particles

Protein-polyphenol aggregate particles concurrently fortify a functional food product with healthy dietary proteins and concentrated polyphenols. However, what impact does ingestion of aggregate particles have on ultimate health relevance of either the polyphenolic molecules in the matrix or the protein molecules? Because human health benefits are contingent on bioavailability after ingestion, the fate of these molecules during transit in the gastrointestinal tract (GIT) will dictate their utility as functional food ingredients. This brief review explores diverse applications of protein-polyphenol particles in the food industry and the bioaccessibility of both bioactive polyphenolic compounds and edible proteins. Evidence to date suggests that complexation of phytoactive polyphenolics effectively enhances their health-relevant impacts, specifically because the phytoactives are protected in the protein matrix during transit in the GIT, allowing intact, non-degraded molecules to reach the colon for catabolism at the gut microbiome level, a prerequisite to realize the health benefits of these active compounds.

Change on the Circulation of Respiratory Viruses and Pediatric Healthcare Utilization during the COVID-19 Pandemic in Asturias, Northern Spain

(1) Background: The COVID-19 pandemic and the implementation of restrictions and nonpharmaceutical interventions (NPIs) changed the trends in respiratory viral circulation and the pattern in pediatric healthcare utilization; (2) Methods: A retrospective, multicenter observational study designed to analyze the impact of the pandemic on pediatric healthcare utilization and the viral circulation pattern in children in a region in Northern Spain was carried out. Viral diagnostics data from all nasal or pharyngeal swabs collected in children in Asturias during the periods of March 2018−September 2019 and March 2020−September 2021 were analyzed, as well as the number of pediatric hospitalizations and emergency visits; (3) Results: A total of 14,640 samples were collected during the pandemic period. Of these, at least one respiratory virus was detected in 2940 (20.1%) while 5568/10,298 samples were positive in the pre-pandemic period (54.1%); p < 0.001. The detection of both enveloped and non-enveloped viruses decreased among periods (p < 0.001). After week 14, 2020, enveloped viruses were no longer detected until one year later, while non-enveloped viruses continued to be detected in children. Overall, a mean of 4946.8 (95% CI 4519.1−5374.4) pediatric emergency visits per month during the period 2018−2019 as compared to 2496.5 (95% CI 2086.4−2906.5) for 2020−2021 occurred (p < 0.001). The mean of pediatric hospitalizations also significantly decreased between periods, as follows: 346.6 (95% CI 313−380.2) in 2018−2019 vs. 161.1 (95% CI 138.4−183.8); p < 0.001; (4) Conclusions: Our study showed a remarkably reduction in pediatric hospitalizations and emergency visits and a change in the pattern of viral circulation during the COVID-19 pandemic in Asturias. The usual seasonal respiratory viruses, namely influenza or RSV were nearly absent in the pediatric population during the pandemic.

Unidirectional Tactile Paving: Circulation for the Visually Impaired

The COVID-19 pandemic heightened inequalities of universal accessibility in the built environment. The visually impaired have been affected by the lack of mobility that resulted from social distancing and physical distancing. Numerous circulation networks, from small retail shops to large-scale public spaces, have been reorganized to limit the spread of COVID-19. By assigning an orientation to each lane, unidirectional circulation networks allow for physical distancing by limiting face-to-face interactions among most pedestrians. These unidirectional networks are communicated visually, by placing flat arrows on the floor, but not through the other senses and are thus inaccessible to the visually impaired. This demonstrates a lack of universally accessible design for unidirectional circulation. We propose two designs (asymmetrical blocks and cobblestone blocks) for a novel unidirectional tactile paving which allows the visually impaired to navigate through unidirectional circulation networks by feeling tiles with their feet and/or canes.

Pregnancy-specific responses to COVID-19 are revealed by high-throughput proteomics of human plasma

Pregnant women are at greater risk of adverse outcomes, including mortality, as well as obstetrical complications resulting from COVID-19. However, pregnancy-specific changes that underlie such worsened outcomes remain unclear. Herein, we profiled the plasma proteome of pregnant and non-pregnant COVID-19 patients and controls and showed alterations that display a dose-response relationship with disease severity; yet, such proteomic perturbations are dampened during pregnancy. In both pregnant and non-pregnant state, the proteome response induced by COVID-19 showed enrichment of mediators implicated in cytokine storm, endothelial dysfunction, and angiogenesis. Shared and pregnancy-specific proteomic changes were identified: pregnant women display a tailored response that may protect the conceptus from heightened inflammation, while non-pregnant individuals display a stronger response to repel infection. Furthermore, the plasma proteome can accurately identify COVID-19 patients, even when asymptomatic or with mild symptoms. This study represents the most comprehensive characterization of the plasma proteome of pregnant and non-pregnant COVID-19 patients.

Congestus Mode Invigoration by Convective Aggregation in Simulations of Radiative-Convective Equilibrium

This study examines how the congestus mode of tropical convection is expressed in numerical simulations of radiative-convective equilibrium (RCE). We draw insights from the ensemble of cloud-resolving models participating in the RCE Model Intercomparison Project (RCEMIP) and from a new ensemble of two-dimensional RCE simulations. About half of the RCEMIP models produce a congestus circulation that is distinct from the deep and shallow modes. In both ensembles, the congestus circulation strengthens with large-scale convective aggregation, and in the 2D ensemble this comes at the expense of the shallow circulation centered at the top of the boundary layer. Congestus invigoration occurs because aggregation dries out the upper troposphere, which allows moist congestus outflow to undergo strong radiative cooling. The cooling generates divergence that promotes continued congestus overturning (a positive feedback). This mechanism is fundamentally similar to the driving of shallow circulations by radiative cooling at the top of the surface boundary layer. Aggregation and congestus invigoration are also associated with enhanced static stability throughout the troposphere, but a modeling experiment shows that enhanced stability is not necessary for congestus invigoration; rather, invigoration itself contributes to the stability increase via its impact on the vertical profile of radiative cooling. Changes in entrainment cooling are also found to play an important role in stability enhancement, as has been suggested previously. When present, congestus circulations have a large impact on the mean RCE atmospheric state; for this reason, their inconsistent representation in models and their impact on the real tropical atmosphere warrant further scrutiny.

Current understanding of cardiac troponins metabolism: a narrative review

BACKGROUND AND AIMS

Current methods (highly sensitive and ultra-sensitive) of cardiospecific troponins detection have enabled early diagnosis of myocardial infarction (MI) and selection of optimal treatment tactics for patients early from admission. The use of these methods in real clinical practice helps to choose the most optimal treatment tactics for patients in the early stages after admission, and this significantly improved the further prognosis of patients suffering from MI. However, there are a number of problems that arise when using highly sensitive or ultra-sensitive methods for determining cardiospecific troponins: frequent and unexplained increase in serum levels of cardiospecific troponins in a number of pathological conditions unrelated to MI; insufficient knowledge and understanding of the mechanisms of release and increase in levels of cardiospecific troponins; poorly understood features and mechanisms of circulation and elimination of cardiospecific troponins; the presence of conflicting information about the influence of several factors (gender, age and circadian characteristics) on the levels of cardiospecific troponins in blood serum; undisclosed diagnostic potential of cardiospecific troponins in non-invasive human biological fluids. These problems cause great difficulties and increase the risk of errors in the differential diagnosis of MI, and also do not allow to fully unlock the diagnostic potential of cardiospecific troponins. In general, these problems are associated with a lack of understanding of the fundamental mechanisms of the metabolism of cardiospecific troponins. The main purpose of this narrative review is to summarize and provide detailed information about the metabolism of cardiospecific troponins and to discuss the potential impact of metabolic features on the diagnostic value of cardiospecific troponins and their diagnostic capabilities.

MATERIALS AND METHODS

This narrative review is based on the analysis of publications in the Medline, PubMed, and Embase databases. The terms "cardiac troponins," "troponin T," and "troponin I" in combination with "mechanisms of increase," "mechanisms of release," "circulation," "proteolytic cleavage," "elimination," "circadian rhythms," "saliva," and "urine" were used to search publications.

RESULTS

It has been reported that the metabolic features (mechanisms of release, circulation, and elimination) of cardiospecific troponins may have an important influence on the diagnostic value of cardiospecific troponins in a number of physiological and pathological conditions that cause cardiomyocyte damage. The main mechanisms of cardiac troponin release are: cardiomyocyte apoptosis; myocardial cell regeneration and renewal; increased cell membrane permeability; release of troponins by vesicular transport; increased proteolytic degradation of cardiospecific troponin molecules within the cell which may facilitate their release from intact myocardial cells or in the initial phase of those pathological conditions that increase the activity of enzymes that degrade cardiospecific troponins. Besides, the formation of small fragments (troponin molecules) may facilitate their penetration into other body fluids such as urine and/or oral fluid which may provide researchers and practitioners with a new diagnostic opportunity. It should be noted that in addition to release mechanisms, cardiospecific troponin elimination mechanisms may play an important diagnostic role. The contribution of release and elimination mechanisms in different pathologies may differ significantly. Circadian rhythms of cardiospecific troponins may be associated with fluctuations in the activity of those organ systems which influence the mechanisms of cardiospecific troponin release or elimination. Such major systems include: neuroendocrine, urinary, and hemostasis.

CONCLUSIONS

Cardiospecific troponins metabolism has an important influence on diagnostic value and diagnostic capabilities. Further study of the features of cardiac troponin metabolism (mechanisms of release, circulation and elimination) is required to improve diagnosis and differential diagnosis of diseases causing cardiomyocyte damage. The data on the influence of circadian rhythms of cardiospecific troponins on the diagnostic value and the possibility of determining cardiospecific troponins in body fluids that can be obtained by noninvasive methods are very interesting. However, so far this information and valuable capabilities have not been applied in clinical practice because of the paucity of studies conducted.

Examining the Regional Co-Variability of the Atmospheric Water and Energy Imbalances in Different Model Configurations-Linking Clouds and Circulation

Clouds are a key player in the global climate system, affecting the atmospheric water and energy budgets, and they are strongly coupled to the large-scale atmospheric circulation. Here, we examine the co-variability of the atmospheric energy and water budget imbalances in three different global model configurations-radiative-convective equilibrium, aqua-planet, and global simulations with land. The gradual increase in the level of complexity of the model configuration enables an investigation of the effects of rotation, meridional temperature gradient, land-sea contrast, and seasonal cycle on the co-variability of the water and energy imbalances. We demonstrate how this co-variability is linked to both the large-scale tropical atmospheric circulation and to cloud properties. Hence, we propose a co-variability-based framework that connects cloud properties to the large-scale tropical circulation and climate system and is directly linked to the top-down constrains on the system-the water and energy budgets. In addition, we examine how the water and energy budget imbalances co-variability depends on the temporal averaging scale, and explain its dependency on how stationary the circulation is in the different model configurations. Finally, we demonstrate the effect of an idealized global warming and convective aggregation on this co-variability.