Status of the Endangered Indian Knob Mountainbalm Eriodictyon altissimum (Namaceae) in Central Coastal California

Indian Knob Mountainbalm Eriodictyon altissimum (Namaceae) is a shrub endemic to western San Luis Obispo County in central coastal California, and little has been published regarding it. The species was listed as endangered under the California Endangered Species Act in 1979 and the U.S. Endangered Species Act in 1995. At Federal listing in 1995, Indian Knob mountainbalm was known from six occurrences, two of which were in protected areas, with a total population estimate of 2018, Indian Knob mountainbalm is known from seven occurrences, six of which are in protected areas and one (the largest) mostly in a protected area, with a total population count of 6,489+ individuals in 2016. Two occurrences are likely extirpated. Indian Knob mountainbalm is considered a fire-adapted chaparral plant. Reproduction is reported to be primarily vegetative by underground rhizomes, and it is specialized for substrates with physical disturbances, including: steep rocky slopes, cliff faces, fallen rock debris, sand dunes (shifting sand), roadsides, old graded substrates such as dirt/rock roads, the talus of graded substrates, and trails. We report the species grows up to 5.5 m tall and at 98 to 263 m elevation. In consideration of the life history traits used by Anacker et al. (2013) for rare plants in California, Indian Knob mountainbalm would be considered highly vulnerable to climate change. Using the international standards of IUCN, Indian Knob mountainbalm meets the criteria for classification as critically endangered including the following: geographic range, severely fragmented; extent of occurrence, 34 km2 (km2); area of occupancy, 2 (km2); and quality of habitat, continuing to decline (dense vegetation, lack of recent fire). Coordinated conservation and research are needed to further understand the species, and to restore and maintain the five extant occurrences

The relationship between frailty and delirium: Insights from the 2017 Delirium Day study

Background: Although frailty and delirium are among the most frequent and burdensome geriatric syndromes, little is known about their association and impact on short-term mortality. Objective: To examine, in hospitalized older persons, whether frailty is associated with delirium, and whether these two conditions, alone or in combination, affect these patients' 30-day survival. Design: Observational study nested in the Delirium Day project, with 30-day follow-up. Setting: Acute medical wards (n = 118) and rehabilitation wards (n = 46) in Italy. Subjects: A total of 2,065 individuals aged 65+ years hospitalized in acute medical (1,484 patients, 71.9%) or rehabilitation (581 patients, 28.1%) wards. Methods: A 25-item Frailty Index (FI) was created. Delirium was assessed using the 4AT test. Vital status was ascertained at 30 days. Results: Overall, 469 (22.7%) patients experienced delirium on the index day and 82 (4.0%) died during follow-up. After adjustment for potential confounders, each FI score increase of 0.1 significantly increased the odds of delirium (odds ratio, OR: 1.66 [95% CI: 1.45-1.90]), with no difference between the acute (OR: 1.65 [95% CI: 1.41-1.93]) and rehabilitation ward patients (OR: 1.71 [95% CI: 1.27-2.30]). The risk of dying during follow-up also increased significantly for every FI increase of 0.1 in the overall population (OR: 1.65 [95% CI: 1.33-2.05]) and in the acute medical ward patients (OR: 1.61 [95% CI: 1.28-2.04]), but not in the rehabilitation patients. Delirium was not significantly associated with 30-day mortality in either hospital setting. Conclusions: In hospitalized older patients, frailty is associated with delirium and with an increased risk of short-term mortality

Describing the epidemic trends of covid-19 in the area covered by agency for health protection of the metropolitan area of Milan = Descrizione dell’andamento dell’epidemia di covid-19 nell’ats di Milano

OBIETTIVI: descrivere l’andamento temporale e spaziale dell’epidemia di COVID-19 nel territorio dell’ATS di Milano nel periodo febbraio-maggio 2020. DISEGNO: studio descrittivo dei casi di COVID-19 SETTING E PARTECIPANTI: un sistema informativo dedicato ha permesso di registrare i casi di COVID-19, con positività del tampone nasofaringeo residenti nel territorio dell’ATS-MI. Sono inclusi i casi con data di insorgenza dei sintomi compresa tra febbraio e maggio 2020. I dati sono stati analizzati in base agli intervalli di tempo caratterizzati dalle diverse misure di conteni- mento dell’epidemia intraprese a livello regionale e nazionale. PRINCIPALI MISURE DI OUTCOME: percentuale di letali- tà tra i casi con tampone positivo, tasso di incidenza e indice di riproduzione del COVID-19 nei diversi periodi epidemici e suddivisioni territoriali dell’ATS-MI. RISULTATI: sono stati registrati 27.017 casi COVID-19 posi- tivi al tampone. I maschi sono il 45% e l’età media è di 65 anni. L’incidenza sul territorio dell’ATS-MI è stata di 776 per 100.000 abitanti. I deceduti sono 4.660, il tasso grezzo di le- talità del 17,3%, superiore nei maschi (21,2%) rispetto alle femmine (14,0%). Il numero di riproduzione dei casi nel tem- po è massimo nei periodi iniziali dell’epidemia (3,0) e poi de- cresce successivamente. Si rileva la presenza di diverse inten- sità di contagio nel territorio dell’ATS-MI con il territorio del Lodigiano maggiormente colpito rispetto al resto dell’ATS-MI. CONCLUSIONI: le stime di incidenza e mortalità sono supe- riori a quanto riportato per il territorio italiano. Sul territorio dell’ATS-MI vengono evidenziati diversi pattern di andamen- to dell’epidemia.OBJECTIVES: to describe the epidemic trends of COVID-19 over time and by area in the territory covered by Milan’s Agen- cy for Health Protection (ATS-MI) from February to May 2020. DESIGN: descriptive study of COVID-19 cases. SETTING AND PARTICIPANTS: a new information system was developed to record COVID-19 cases with positive na- sopharyngeal swab. Patients resident in the area covered by ATS-MI with symptom onset between February and May 2020 were selected. Different epidemic periods were consid- ered based on the timeline of the various regional and na- tional containment measures. MAIN OUTCOME MEASURES: case fatality ratios, inci- dence rates, and reproduction number by epidemic period and sub-area of ATS-MI. RESULTS: a total of 27,017 swab-positive COVID-19 cases were included. Mean age was 65 years and males were 45%. Incidence in the ATS-MI area was 776 per 100,000 popula- tion. The number of deaths was 4,660, the crude case fatali- ty ratio was 17.3%, higher in males (21.2%) than in females (14.0%). The estimated reproduction number registered its peak (3.0) in the early stages of the epidemic and subse- quently decreased. Territorial differences were observed in the epidemic spread, with a higher incidence in the Lodi area. CONCLUSIONS: estimated incidence and case fatality ratios were higher than national estimates for Italy. Each ATS-MI area had different epidemic spread patterns

Reporting of rehabilitation intervention for low back pain in randomized controlled trials : Is the treatment fully replicable?

Study Design. Methodological review of randomized controlled trials (RCTs). Objective. To assess the quality of reporting of rehabilitation interventions for mechanical low back pain (LBP) in published RCTs. Summary of Background Data. Reporting of interventions in RCTs often focused on the outcome value and failed to describe interventions adequately. Methods. We systematically searched for all RCTs in Cochrane systematic reviews on LBP published in the Cochrane Database of Systematic Reviews until December 2013. The description of rehabilitation interventions of each RCT was evaluated independently by 2 of the investigators, using an ad hoc checklist of 7 items. The primary outcome was the number of items reported in sufficient details to be replicable in a new RCT or in everyday practice. Results. We found 11 systematic reviews, including 220 eligible RCTs, on LBP. Of those, 185 RCTs were included. The median publication year was 1998 (I-III quartiles, 1990 to 2004). The most reported items were the characteristics of participants (91.3%; 95% confidence interval [CI], 87.3-95.4), the intervention providers (81.1%; 95% CI, 75.4-86.7), and the intervention schedule (69.7%; 95% CI, 63-76). Based on the description of the intervention, less than one fifth would be replicable clinically. The proportion of trials providing all essential information about the participants and interventions increased from 14% (n=7) in 1971 to 1980 to 20% (n=75) in 2001 to 2010. Conclusion. Despite the remarkable amount of energy spent producing RCTs in LBP rehabilitation, the majority of RCTs failed to report sufficient information that would allow the intervention to be replicated in clinical practice. Improving the quality of intervention description is urgently needed to better transfer research into rehabilitation practices

Polysulfates block SARS‐CoV‐2 uptake through electrostatic interactions

Here we report that negatively charged polysulfates can bind to the spike protein of SARS-CoV-2 via electrostatic interactions. Using a plaque reduction assay, we compare inhibition of SARS-CoV-2 by heparin, pentosan sulfate, linear polyglycerol sulfate (LPGS) and hyperbranched polyglycerol sulfate (HPGS). Highly sulfated LPGS is the optimal inhibitor, with a half-maximal inhibitory concentration (IC50) of 67 μg/mL (approx. 1.6 μM). This synthetic polysulfates exhibit more than 60-fold higher virus inhibitory activity than heparin (IC50: 4084 μg/mL), along with much lower anticoagulant activity. Furthermore, in molecular dynamics simulations, we verified that LPGS can bind stronger to the spike protein than heparin, and that LPGS can interact even more with the spike protein of the new N501Y and E484K variants. Our study demonstrates that the entry of SARS-CoV-2 into host cells can be blocked via electrostatic interaction, therefore LPGS can serve as a blueprint for the design of novel viral inhibitors of SARS-CoV-2

SARS-CoV-2 variants, spike mutations and immune escape.

Although most mutations in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome are expected to be either deleterious and swiftly purged or relatively neutral, a small proportion will affect functional properties and may alter infectivity, disease severity or interactions with host immunity. The emergence of SARS-CoV-2 in late 2019 was followed by a period of relative evolutionary stasis lasting about 11 months. Since late 2020, however, SARS-CoV-2 evolution has been characterized by the emergence of sets of mutations, in the context of 'variants of concern', that impact virus characteristics, including transmissibility and antigenicity, probably in response to the changing immune profile of the human population. There is emerging evidence of reduced neutralization of some SARS-CoV-2 variants by postvaccination serum; however, a greater understanding of correlates of protection is required to evaluate how this may impact vaccine effectiveness. Nonetheless, manufacturers are preparing platforms for a possible update of vaccine sequences, and it is crucial that surveillance of genetic and antigenic changes in the global virus population is done alongside experiments to elucidate the phenotypic impacts of mutations. In this Review, we summarize the literature on mutations of the SARS-CoV-2 spike protein, the primary antigen, focusing on their impacts on antigenicity and contextualizing them in the protein structure, and discuss them in the context of observed mutation frequencies in global sequence datasets

Endometrial cancer

Endometrial cancer is the most common gynecological malignancy in well-developed countries. Biologically and clinicopathologically, endometrial carcinomas are divided into two types: type 1 or estrogen-dependent carcinomas and type 2 or estrogen-independent carcinomas. Type 1 cancers correspond mainly to endometrioid carcinomas and account for approximately 90 % of endometrial cancers, whereas type 2 cancers correspond to the majority of the other histopathological subtypes. The vast majority of endometrial cancers present as abnormal vaginal bleedings in postmenopausal women. Therefore, 75 % of cancers are diagnosed at an early stage, which makes the overall prognosis favorable. The first diagnostic step to evaluate women with an abnormal vaginal bleeding is the measurement of the endometrial thickness with transvaginal ultrasound. If endometrial thickening or heterogeneity is confirmed, a biopsy should be performed to establish a definite histopathological diagnosis. Magnetic resonance imaging is not considered in the International Federation of Gynaecology and Obstetrics staging system. Nonetheless it plays a relevant role in the preoperative staging of endometrial carcinoma, helping to define the best therapeutic management. Moreover, it is important in the diagnosis of treatment complications, in the surveillance of therapy response, and in the assessment of recurrent disease.info:eu-repo/semantics/publishedVersio

Men and Women Exhibit a Differential Bias for Processing Movement versus Objects

Sex differences in many spatial and verbal tasks appear to reflect an inherent low-level processing bias for movement in males and objects in females. We explored this potential movement/object bias in men and women using a computer task that measured targeting performance and/or color recognition. The targeting task showed a ball moving vertically towards a horizontal line. Before reaching the line, the ball disappeared behind a masking screen, requiring the participant to imagine the movement vector and identify the intersection point. For the color recognition task, the ball briefly changed color before disappearing beneath the mask and participants were required only to identify the color shade. Results showed that targeting accuracy for slow and fast moving balls was significantly better in males compared to females. No sex difference was observed for color shade recognition. We also studied a third, dual attention task comprised of the first two, where the moving ball briefly changed color randomly just before passing beneath the masking screen. When the ball changed color, participants were required only to identify the color shade. If the ball didn't change color, participants estimated the intersection point. Participants in this dual attention condition were first tested with the targeting and color tasks alone and showed results that were similar to the previous groups tested on a single task. However, under the dual attention condition, male accuracy in targeting, as well as color shade recognition, declined significantly compared to their performance when the tasks were tested alone. No significant changes were found in female performance. Finally, reaction times for targeting and color choices in both sexes correlated highly with ball speed, but not accuracy. Overall, these results provide evidence of a sex-related bias in processing objects versus movement, which may reflect sex differences in bottom up versus top-down analytical strategies