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Relationship between COVID-19 and Alzheimer's disease
Rim Harfouch

Rim Harfouch

June 06, 2023
Rim M. HarfouchDepartment of Microbiology and Biochemistry, Faculty of Pharmacy, Tishreen University, Latakia, Syria.Corresponding author’s Email: rimharfouch@tishreen.edu.syAbstract :Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a life-threatening disease, especially in elderly individuals and those with comorbidities. The predominant clinical manifestation of COVID-19 is respiratory dysfunction, while neurological presentations are increasingly being recognized. SARS-CoV-2 invades host cells primarily via attachment of the spike protein to the angiotensin-converting enzyme 2 (ACE2) receptor expressed on cell membranes. Patients with Alzheimer’s disease (AD) are more susceptible to SARS-CoV-2 infection and prone to severe clinical outcomes. Recent studies have revealed some common risk factors for AD and COVID-19. An understanding of the association between COVID-19 and AD and the potential related mechanisms may lead to the development of novel approaches to treating both diseases. It is important to understand the mechanisms by which SARS-CoV-2 invades the central nervous system (CNS) and the associations and potential shared factors between COVID-19 and AD.Keywords: COVID-19, Alzheimer’s disease, correlation, mechanism of action
The eco-evolutionary risks of not changing seed provenancing practices in changing en...
Rebecca Jordan
Peter Harrison

Rebecca Jordan

and 2 more

June 02, 2023
Rapidly changing environments combined with increasing global restoration initiatives require improved seed sourcing strategies for native revegetation. Sourcing seed from local populations (local provenancing) has been the long-standing default for native revegetation for numerous eco-evolutionary reasons including local adaptation and species co-evolution. However, the evidence-base has shifted, revealing risks for both non-local and local provenancing in changing environments. As alternative strategies gain interest, we argue for effective decision-making that weighs the risks of changing and not changing seed sourcing strategies in a changing environment that transcends a default position and the polarising local vs. non-local debate.
Tackling EEG test-retest reliability with a pre-processing pipeline based on ICA and...
Veronica Henao Isaza
Valeria Cadavid Castro

Veronica Henao Isaza

and 6 more

June 02, 2023
The reliability of Electroencephalography (EEG) measurements on normal human neurophysiology can be used to determine whether changes in brain electrical activity in subjects with neurological diseases have potential in the diagnosis or follow-up of the patients, being more crucial in neurodegenerative diseases where reliable measures across time might be needed. The objective of this study is to report the reliability of relative band powers extracted from a two-year four-session resting-EEG longitudinal study conditioned by an automated pipeline that leverages state of the art EEG signal-processing approaches involving ICA, wavelet-ICA, and normalization by a recording-specific constant. The Intraclass Correlation Coefficient (ICC) was used as a measure of reliability. Similarly, to assess the association between age and relative performance. The results of the ICC for EEG data acquisition and preprocessing process showed high significant reliability, where an average ICC of 0.91 ± 0.04 was obtained for neural related Independent Components (ICs) and 0.92 ± 0.03 for ROIs (p-value < 5% for all data). This study shows that after performing four EEG recording sessions for 43-subject, the recorded measurements were replicable, and the correlation of relative power with the age of healthy subjects is consistent with the literature. These results suggest that relative power measured from EEGs preprocessed with the automated pipeline is a replicable metric across sessions, and, consequently, is useful for the study of relative power changes caused by the progression of neurodegenerative pathologies such as Alzheimer’s disease.
Cross-diffusion effects on the double-diffusive convection in a rotating vertical por...
Osman Noreldin
Smah Ali

Osman Noreldin

and 4 more

June 02, 2023
The impacts of vertical throughflow, rotation, cross-diffusion, and vertical heterogeneous permeability on the double-diffusive convection in a finite rotating vertical porous cylinder have been studied. The fluid in the cylinder is warmed and salted from beneath, and its top and lower walls are taken to be isothermal, isosolutal and permeable. In the model formulation, the Brinkman model was adopted, coupled with the Boussinesq approximation. The normal mode technique is used to perform linear stability analysis and single term Galerkin technique is employed to solve the eigenvalue problem. Further, the influence of vertical heterogeneity, vertical throughflow, thermal and solute Rayleigh, Taylor, and the Soret and Dufour numbers on the fluid system instability has been investigated. We found, among other results, that vertical heterogeneity may either stabilize or destabilize the fluid system. The Dufour number delays both the stationary and oscillatory convection onsets. The positive Soret number is found to have a stabilizing effect on the stationary convection case, with a destabilizing effect on the oscillatory convection case.
Privacy-preserving Authentication Protocols in VANET: A Review
Himun Jyoti Nath
Hiten Choudhury

Himun Jyoti Nath

and 1 more

June 02, 2023
Vehicular Ad hoc Network (VANET) is a versatile and ad hoc network, where the vehicles must be authenticated before sharing any critical information. During authentication, privacy of the users must be preserved. There are several surveys on privacy-preserving authentication schemes in VANET. However, none of them are focused on the ability of the schemes to address different security issues and their robustness against security attacks. In this paper, we present a review on various privacy-preserving authentication schemes in VANET. These schemes may be categorized into several types like symmetric/asymmetric key cryptography based schemes, digital signature based schemes, ID cryptography based schemes, pseudonym based schemes, homomorphic encryption based schemes and blockchain based schemes. A comprehensive study of the prominent schemes, with regards to their effectiveness in addressing different security issues and their robustness against possible attacks, has been performed. Open issues and scope for future work are also highlighted.
A rapidly selected 4.3kb transposon-containing structural variation is driving a P450...
Mugenzi Leon
Theofelix Tekoh

Mugenzi Leon

and 11 more

June 02, 2023
Deciphering the evolutionary forces controlling insecticide resistance in malaria vectors remains a prerequisite to designing molecular tools to detect and assess resistance impact on control tools. Here, we demonstrate that a 4.3kb transposon-containing structural variation drives pyrethroid resistance in central/eastern African populations of the malaria vector Anopheles funestus. In this study, we analysed Pooled template sequencing data and direct sequencing to identify an insertion of 4.3kb containing putative transposons in the intergenic region of two P450s CYP6P5-CYP6P9b in mosquitoes of the malaria vector Anopheles funestus from Uganda. We then designed a PCR assay to track its spread temporally and regionally and decipher its role in insecticide resistance. The insertion originates in or near Uganda in East Africa, where it is fixed and has spread to high frequencies in the Central African nation of Cameroon but is still at low frequency in West Africa and absent in Southern Africa. A strong association was established between this SV and pyrethroid resistance in field populations (SV+ vs SV-; OR=29, P< 0.0001) and is reducing pyrethroid-only nets’ efficacy. Genetic crosses and qRT-PCR revealed that this SV enhances the overexpression of CYP6P9a/b but not CYP6P5. A marked and rapid selection was observed with the 4.3kb-SV frequency increasing from 3% in 2014 to 98 % in 2021 in Cameroon. Our findings highlight the underexplored role and rapid spread of SVs in the evolution of insecticide resistance and provide additional tools for molecular surveillance of insecticide resistance.
T-LCP Fixation of a cranial mid-body fracture of the axis in an adult horse
Ariane Campos Schweitzer
Gustaf  Croon

Ariane Campos Schweitzer

and 2 more

June 02, 2023
Cranial mid-body fractures of the axis in horses result from hyperflexion of the neck and are most commonly associated with lateral bending falls over showjumping or steeple chase fences. In the authors' experience, conservative treatment of mild to moderately displaced cranial mid-body axis fractures has been unsuccessful. This case report describes surgical management of a cranial mid-body fracture of the axis in an eight-year-old warmblood gelding that sustained the injury during a showjumping course. Following reduction, a five hole 4.5mm equine compression T-plate was contoured to fit the ventral aspect of the axis and used as an internal fixator. The horse was turned out starting 2 months after surgery and training was gradually resumed. No lameness, ataxia or decrease in cervical range motion were reported after surgery. Check-up radiographs at 5 months post-op showed complete healing of the fracture. T-LCP fixation is a promising treatment option for cranial mid-body fractures of the axis with a good prognosis for athletic function.
Genetic connectivity of little penguin colonies in Australia
Sandra Vardeh
Jennifer Sinclair

Sandra Vardeh

and 5 more

June 02, 2023
The Australian range of little penguins, Eudyptula minor, extends around southern Australia, with range-edge sites near the large cities of Perth (west) and Sydney (east). Both range-edges are closer to the equator than the range-core, being likely to experience similar heating with climate change. As a result, movement to one range-edge is not an option for little penguins, unlike in many other species. Therefore, adaptation at the range edge might be very important for little penguins. Capacity for future adaptation depends upon the variability each site holds, and the amount of exchange between sites. In peripheral sites, incoming dispersal might either forestall demographic collapse and replenish genetic variation (good), or overcome local adaptation and increase disease transmission (bad). We aimed to establish the genetic variability in each site, and the exchange (dispersal) of individuals between sites. Genetic markers included biparentally-inherited microsatellites, and maternally-inherited mitochondrial DNA sequence. For microsatellites, no site appeared to have critically low variation, including the peripheral sites, however there was a significant but slight trend of increased variation from east to west. In contrast, mitochondrial DNA showed a pattern of significantly reduced variation at the two range-edges, possibly indicating differential dispersal patterns in males and females. There appear to be two main genetically distinct groups, in the west and the east, but analysis of lifetime dispersal patterns across the Australian range also suggests complex dispersal, sometimes with high dispersal or similarity between locations that are not adjacent. Our work suggests that despite some differentiation, little penguin sites are interdependent due to complex dispersal patterns, and all have valuable genetic variation. In particular, the peripheral sites are not depauperate of variation, and are moderately connected to the remainder of the distribution, so possibly may be able to adapt in response to climate warming.
An integrated and person-centred care model in a Belgian reference hospital, a journe...
Louis Van Slambrouck
Bram Claeys

Louis Van Slambrouck

and 7 more

June 02, 2023
Healthcare worldwide has undergone a tremendous evolution in recent decades. Due to the evolution of medicine and the explosion of various ingenious and more expensive examination and treatment options. This ensures that patients are treated more and more efficiently, and admission times are drastically reduced. Not only medicine is creating new challenges, but social developments are also setting the scene for a renewed healthcare organisation. The healthcare sector and governments face enormous challenges. The changing landscape is shifting the focus from episodic acute care to chronic continuous care. Consider the participation needs of patients, the documentation and accountability of quality of care, the ageing of the population, evolution towards supra-regional hospital networks in Belgium and the alignment with-and substitution of-care to primary care. The nursing profession must evolve along with it, but the amount of knowledge we expect from nurses both in terms of knowledge of pathology but also broader knowledge of informatics, technology makes it particularly complex. In response to these challenges, AZ Groeninge Belgium has developed a new model of care in recent years.
Settlement Patterns and Environmental Adaptation in Traditional Villages of Taihu Lak...
HE TIAN
JIANWU MA

HE TIAN

and 1 more

June 02, 2023
This study investigates the influence of geography and socio-cultural aspects on traditional villages in the Taihu Lake region. It examines how topography, water resources, and climate conditions affect village development, architecture, infrastructure, and agricultural practices. The research also explores the socio-cultural characteristics including religious beliefs, clan culture, and commercial activities that shape community dynamics. The findings highlight the adaptive strategies employed by villages to manage water resources, cope with environmental challenges, and maintain strong community relationships. This study emphasizes the importance of understanding the interplay between geography and socio-cultural factors in preserving and revitalizing traditional villages for sustainable development.
Leveraging whole genome sequencing to estimate telomere length in plants
Michelle Zavala Paez
Jason Holliday

Michelle Zavala Paez

and 2 more

June 02, 2023
Changes in telomere length are increasingly used to indicate species’ response to environmental stress across diverse taxa. Despite this broad use, few studies have explored telomere length in plants. However, rapid advances in sequencing approaches and bioinformatic tools now allow estimation of telomere length using whole genome sequencing (WGS) data. Thus, evaluation of new approaches for measuring telomere length in plants are needed. Traditionally, telomere length has been quantified using quantitative polymerase chain reaction (qPCR). While WGS has been extensively used in humans, no study to date has compared the effectiveness of WGS in estimating telomere length in plants relative to traditional qPCR approaches. In this study, we use one hundred Populus clones re-sequenced using short-read Illumina sequencing to quantify telomere length using three different bioinformatic approaches, Computel, K-seek, and TRIP, in addition to qPCR. Overall, telomere length estimates varied across different bioinformatic approaches, but were highly correlated across methods for individual genotypes. A positive correlation was observed between WGS estimates and qPCR, however, Computel estimates exhibited the greatest correlation. Computel incorporates genome coverage into telomere length calculations, suggesting that genome coverage is likely important to telomere length quantification when using WGS data. Overall, telomere estimates from WGS provided greater precision and accuracy of telomere length estimates relative to qPCR. The findings suggest WGS is a promising approach for assessing telomere length, and as the field of telomere ecology evolves may provide added value to assaying response to biotic and abiotic environments for plants needed to accelerate plant breeding and conservation management.
Organic Semiconductor Interfaces and Their Effects in Organic Solar Cells
Chuanfei Wang
Qi Zeng

Chuanfei Wang

and 4 more

June 02, 2023
Energy levels and energy level alignment at interfaces play a decisive role in designing efficient and stable organic solar cells (OSCs). In this review two usually used technologies in organic photovoltaic communities for measuring energy levels of organic semiconductors, photoelectron spectroscopy and electrochemical methods, are introduced, and the relationships between the values obtained from the corresponding techniques are compared. The energy level and energy level alignment across the interfaces involved in solution processed organic photovoltaics are described, and the corresponding integer charge transfer model for predicting and explaining energy level alignment are presented. The effects of the interface properties in designing efficient binary and ternary OSCs were discussed. The effects of environmental factors mainly including water vapor, oxygen gas and thermal annealing on energy levels and energy level alignment involved in photoactive layers, and the subsequent effects on the corresponding OSC properties are given.
Cypsela morphology and its significance for the taxonomic delimitation of the genus S...
Rubina Abid
M. Qaiser

Rubina Abid

and 2 more

June 02, 2023
Cypsela macro and micromorphological features of 28 taxa belonging to 7 genera namely Saussurea DC. s.str., Lipschitziella Kamelin , Himalaiella Raab-Straube, Dolomiaea DC, Aucklandia Falconer, Frolovia (DC.) Lipsch. and Shangwua Yu J. Wang of the tribe Cardueae (Asteraceae) were studied through light and scanning electron microscope to assess their taxonomic significance. Various cypsela features like pappus series, cypsela shape and surface patterns were found most significant characters for the taxonomic delimitation of Saussurea (s.l.). The genus Saussurea s.str. was delined from its allied genera by having biseriate pappus. While, in remaining genera pappus were either uniseriate or multiseriate and among these genera, Dolomiaea was characterized due to multiseriate pappus. While, remaining genera such as, Lipschitziella, Himalaiella, Aucklandia, Shangwa and Frolovia had uniseriate pappus. Furthermore, these genera could be delimited on the basis of cypsela shape and surface patterns. Similar to the generic delimitation, cypsela micro and macromorphological characters were also found to be useful for specific delimitation within studied genera. Most of the cypsela morphological variables when analyzed numerically, also proved the taxonomic affiliation within all the taxa of the genus Saussurea and its allied genera. Similarly, these cypsela features could be well correlated with the gross morphological and molecular decisions at generic and partially for specific delimitation of Saussurea (s.l.) from Pakistan and Kashmir.
Critical issues in family peer support in a youth mental health service
Sarah Whitson
Zsofi de Haan

Sarah Whitson

and 8 more

June 02, 2023
Background: Family peer workers form connections with family/carers and can offer emotional support, psychoeducation and referrals based on their own lived experience. Although an increasing number of family peer support programs exist in the youth mental health sector, they are rarely described or reported on. There is a need for greater documentation of the experiences of family peer workers operating in the healthcare sector, in order to raise awareness of issues currently facing the workforce and support organisations to make positive changes. Methods: We present a detailed description of the family peer support program at Orygen in Victoria, Australia. In doing so, we highlight factors that impact effective program implementation and delivery from the perspectives of four family peer workers and two supervisors. Findings/Conclusions: Organisations should encourage self-care and social connections between family peer workers to reduce impacts of ongoing mental-ill health and workplace burnout and isolation. Staff should be educated about the field of family peer support to improve role clarity and foster a positive team environment. It is vital to develop a comprehensive position description, training program, and onboarding procedures to ensure new employees are adequately equipped. To improve staff retention and compensate those with further education, experience and skills, organisations may consider offering increased remuneration, negotiate longer-term contracts with a potential for a greater number of workdays, and should promote/hire senior lived experience positions. Further research is needed to formally investigate barriers and facilitating factors of program implementation in mental health settings.
Exploring the associations between cognition, social functioning, and tobacco use in...
Geoffrey Carney-Knisely
Nicholas Breitborde

Geoffrey Carney-Knisely

and 1 more

June 02, 2023
Aim: Tobacco use in persons with psychotic disorders is a leading cause of death and disability. We sought to explore the associations between tobacco use and both cognition and social functioning among patients with first-episode psychosis. Methods: Participants were eighty persons with first-episode psychosis enrolled in EPICENTER with documented tobacco-use status at baseline. In this group, we compared mean differences in social and cognitive functioning at enrollment in EPICENTER. Results: Most measures of cognition and social functioning were similar between smokers and non-smokers. Smokers had greater scores than non-smokers on measures related to problem solving and interpersonal communication. Conclusions: There are few differences in cognitive and social functioning among persons with first-episode psychosis who smoke tobacco products versus those who do not. Further research into cognitive and social functioning as putative targets for smoking-cessation interventions for persons with first-episode psychosis is warranted.
A novel approach for pollen identification and quantification using hybrid capture-ba...
Dona Kireta
Kor-jent Dijk

Dona Kireta

and 6 more

June 02, 2023
Efforts to explore optimal molecular methods for identifying plant mixtures, particularly pollen, are increasing. Pollen identification (ID) and quantification is important in many fields, including pollination ecology and agricultural sciences, but quantifying mixture proportions remains challenging. Traditional pollen ID using microscopy is time-consuming, requires expertise, and has limited accuracy and throughput. Molecular barcoding approaches being explored offer improved accuracy and throughput. The common approach, amplicon sequencing, employs PCR amplification to isolate DNA barcodes, but introduces significant bias, impairing downstream quantification. We apply a novel molecular hybridisation capture approach to artificial pollen mixtures, to improve upon current taxon ID and quantification methods. The method randomly fragments DNA, and uses RNA baits to capture DNA barcodes, which allows for PCR duplicate removal, reducing downstream quantification bias. Metabarcoding was tested using two reference libraries constructed from publicly available sequences; the matK plastid barcode, and RefSeq complete chloroplast references. Single barcode-based taxon ID did not consistently resolve to species or genus level. The RefSeq chloroplast database performed better qualitatively but had limited taxon coverage (relative to species used here) and introduced ID issues. At family level, both databases yielded comparable qualitative results, but the RefSeq database performed better quantitatively. A restricted matK database containing only mixture species yielded sequence proportions highly correlated with input pollen proportions, demonstrating that hybridization capture usefulness for metabarcoding and quantifying pollen mixtures. The choice of reference database remains one of the most important factors affecting qualitative and quantitative accuracy.
Population assignment from genotype likelihoods for low-coverage whole-genome sequenc...
Matthew DeSaix
Marina Rodriguez

Matthew DeSaix

and 3 more

June 02, 2023
Low-coverage whole genome sequencing (WGS) is increasingly used for the study of evolution and ecology in both model and non-model organisms; however, effective application of low-coverage WGS data requires the implementation of probabilistic frameworks to account for the uncertainties in genotype likelihood data. Here, we present a probabilistic framework for using genotype likelihood data for standard population assignment applications. Additionally, we derive the Fisher information for allele frequency from genotype likelihood data and use that to describe a novel metric, the effective sample size, which figures heavily in assignment accuracy. We make these developments available for application through WGSassign, an open-source software package that is computationally efficient for working with whole genome data. Using simulated and empirical data sets, we demonstrate the behavior of our assignment method across a range of population structures, sample sizes, and read depths. Through these results, we show that WGSassign can provide highly accurate assignment, even for samples with low average read depths (< 0.01X) and among weakly differentiated populations. Our simulation results highlight the importance of equalizing the effective sample sizes among source populations in order to achieve accurate population assignment with low-coverage WGS data. We further provide study design recommendations for population-assignment studies and discuss the broad utility of effective sample size for studies using low-coverage WGS data.
Cell-based homologous expression system for in-vitro characterization of environmenta...
Pazit Con
Jens  Hamar

Pazit Con

and 4 more

June 02, 2023
All organisms encounter environmental changes that lead to physiological adjustments and drive evolutionary adaptations. These, in turn, induce behavioral, physiological and molecular changes that affect each other. Deciphering the role of molecular adjustments in physiological changes will help to understand how multiple levels of biological organization are synchronized during adaptations. Transmembrane transporters are prime targets for molecular studies of environmental effects, as they facilitate the ability of cells to interact with the external surrounding. Fish are subjected to fluctuations of environmental factors of their aquatic surrounding and exhibit different coping mechanisms. To study the molecular adjustments of fish proteins to their unique external surrounding, suitable experimental systems must be established. Mozambique tilapia (Oreochromis mossambicus) is an excellent model for environmental stress studies due to its extreme osmotolerance. We established a homologues cellular-based expression system, and an uptake assay, that allowed us to study effects of environmental conditions on transmembrane transport. We applied it to study the effects of environmental conditions on the activity of PepT2, a widely studied transporter due to its importance in absorption of dietary peptides and drugs. We created a stable, modified fish cell-line, exogenously expressing the tilapia PepT2 and tested the effects of temperature and water salinity on the uptake of fluorescent di-peptide, β-Ala-Lys-AMCA. While temperature affected the Vmax of the transport, salinity affected both the Vmax and the Km. These assays demonstrate the importance of suitable experimental systems for fish ecophysiology studies. The presented tools and methods can be adapted to study other transporters in-vitro.
A Tangled Web: Dual Diagnosis of Hereditary Hemorrhagic Telangiectasia and Familial C...
Manjusha Kumar
Carla Fleck

Manjusha Kumar

and 2 more

June 02, 2023
A Tangled Web: Dual Diagnosis of Hereditary Hemorrhagic Telangiectasia and Familial Cerebral Cavernous Malformation
Eating Behaviors Associated with Suicidal Behaviors and Overall Risk
David McCord
Terran Sutphin

David McCord

and 2 more

June 02, 2023
Maladaptive eating behaviors remain prevalent in the U.S. population, and a significant percentage of U.S. college students acknowledge engaging in maladaptive eating. Formally defined eating disorders (EDs) have the highest mortality rate of any other mental illness. Suicide risk is substantially elevated among individuals diagnosed with EDs, and even subclinical levels of maladaptive eating behaviors are associated with suicidality. The current study examined associations between specific problematic eating behaviors measured dimensionally (e.g., purging, binging, laxative use) and specific suicide-related constructs and behaviors as well as overall suicide risk. College students (n=188; 62% women) completed the EDE-Q, a well-established measure of dysfunctional eating, as well as several self-report measures of theoretical components of suicidality, and, finally, a semi-structured clinical interview. Results showed a general pattern of moderate and strong associations between the subscales and overall score of the EDE-Q and core suicide constructs of the interpersonal-psychological theory of suicide (IPTS). Many substantive correlations were found between specific eating behaviors and specific suicide-related behaviors; for example, purging was the highest correlate of overall suicide risk ( ρ = .36). These results are discussed in terms of consistency with the IPTS as well as practical implications for intervention.
Anesthesia using remimazolam during coronary artery bypass surgery in a patient with...
Shingo Narumi
Yusuke Ishida

Shingo Narumi

and 5 more

June 02, 2023
Anesthesia using remimazolam during coronary artery bypass surgery in a patient with decreased left ventricular functionShingo Narumi, Yusuke Ishida, Sae Igarashi, Shunya Sekiguchi, Aya Kawachi, and Mikiko TominoDepartment of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, JapanCorresponding author: Yusuke IshidaDepartment of AnesthesiologyTokyo Medical University6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, JapanTel.: +81-03-3342-6111; Fax: +81-03-5381-6650Email: yishida14anes@gmail.com
The spectrum of myocardial stress: Concurrent spontaneous coronary artery dissection...
Subash Nepal
Kamala Ojha

Subash Nepal

and 2 more

June 02, 2023
A 72-year-old lady without any conventional cardiovascular risk factors presented to the emergency room with severe anginal chest pain. ECG showed lateral wall ST-elevation and serial serum troponins were elevated. Emergent cardiac catheterization showed spontaneous coronary artery dissection involving the first diagonal artery with angiographically normal other epicardial coronary arteries. Left ventriculogram and echocardiogram showed a moderately reduced left ventricular systolic function with akinetic mid to distal myocardial segments and normal basal contraction suggestive of stress-induced cardiomyopathy. Spontaneous coronary artery dissection presenting with ST-elevation myocardial infarction and stress-induced cardiomyopathy is very rare.
SoK: Decentralized Finance (DeFi)-Fundamentals, Taxonomy and Risks
KRZYSZTOF GOGOL
CHRISTIAN KILLER

KRZYSZTOF GOGOL

and 4 more

June 02, 2023
Financial services that are not only related to crypto-currencies but rely on blockchain for security and integrity are jointly referred to as Decentralized Fiance (DeFi) and are evolving rapidly. Given their novel applications of DLT and sophistical economical designs, the distinction between DeFi services and understanding the involved risk are often complex. This paper systematically studies the major classes of DeFi protocols, including risk and security. The selection of DeFi categories is based on a quantitative approach, covering over 80% of total value locked (TVL) in DeFi. Further, a structured methodology is provided to differentiate between DeFi protocols based on the algorithmic design and blockchain-network architecture. The findings indicate that every DeFi protocol falls into one of the three classes of DeFi algorithms: liquidity pool, synthetic asset or aggregator protocol. This work concludes with the risk analysis that is derived from the DeFi protocol, underlying tokens and agents. Certain DeFi assets, such as crypto-backed stablecoins, liquid staking tokens, and wrapped tokens of bridges, are synthetic assets, similar to derivatives in traditional finance, and bore similar risk exposure.
A pilot prospective longitudinal study comparing dupilumab to surgery in CRSwNP
Eugene Chang
Nirushan H. Narendran

Eugene Chang

and 6 more

June 02, 2023
Background: To date, there have not been any direct comparative studies assessing clinical outcomes in CRSwNP between biologic and surgical therapies. Objective: To directly compare the effect of dupilumab to FESS using subjective and objective outcomes of CRSwNP patients in a prospective longitudinal study. Methods: We prospectively enrolled 20 CRSwNP patients and counseled them on both biologic and surgical options. Patients were able to decide on either therapy, and data collected at baseline and 3-, 6-, 9-, and 12-months with subjective outcomes including the nasal congestion score (NCS) and SNOT-22 questionnaires, and objectively by degree of smell (UPSIT-40) and nasal polyp score (NPS). Results: All subjects met criteria for either biologic therapy or surgery, with NPS >5, Lund-Mackay score (LMK-CT)>16, SNOT-22>54, and were graded as anosmic/hyposmic. There were no significant differences in age, sex, comorbid asthma/Aspirin Exacerbated Respiratory Disease, or prior FESS between groups. Both dupilumab and FESS significantly improved outcomes by one year in patients with severe CRSwNP when compared to baseline. At one-year, patients on dupilumab had greater improvement in NCS, UPSIT and asthma control relative to one year post FESS. In a subgroup of patients with a history of prior sinus surgery and asthma, dupilumab had lower polyp recurrence rate compared to one year post FESS. Conclusions: Both dupilumab and FESS can significantly improve outcomes by one year in CRSwNP patients. However, in those with a history of asthma and prior surgery, dupilumab is more effective in reducing polyp recurrence and improving sinonasal outcomes than FESS.
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