Analysis of Presentation and Outcomes in Acute Limb Ischemia Patients During COVID-19 State of Emergency.

Background: During the COVID-19 pandemic, cardiovascular patients were found to be presenting to hospitals with myocardial infarctions and cerebrovascular accidents at progressed disease states. We noticed a parallel in acute limb ischemia (ALI) patients presenting during Massachusetts' COVID-19 State of Emergency declaration. We question whether patients developed a hesitancy to seek medical attention at hospitals due to fear of COVID-19.

Plasmapheresis as an Early Treatment for Severe Hypertriglyceridemia, Acute Pancreatitis, and Diabetic Ketoacidosis.

Objective: Severe hypertriglyceridemia (SHTG; plasma triglycerides >1000 mg/dL) is a rare but serious complication in children who develop diabetic ketoacidosis (DKA) from uncontrolled or new-onset type 1 diabetes.

Methods: We present the case of a severely malnourished 16-year-old with a 10-month history of presumed type 2 diabetes managed with lifestyle modifications and metformin, who presented with SHTG, acute pancreatitis, and DKA. On examination, there was no evidence of lipemia retinalis, cutaneous xanthomas, or xanthelasma.

The seventh pandemic of cholera in Europe revisited by microbial genomics.

In 1970, the seventh pandemic of cholera (7 P) reached both Africa and Europe. Between 1970 and 2011, several European countries reported cholera outbreaks of a few to more than 2,000 cases. We report here a whole-genome analysis of 1,324 7 P V.

Identifying incident dementia by applying machine learning to a very large administrative claims dataset.

Alzheimer's disease and related dementias (ADRD) are highly prevalent conditions, and prior efforts to develop predictive models have relied on demographic and clinical risk factors using traditional logistical regression methods. We hypothesized that machine-learning algorithms using administrative claims data may represent a novel approach to predicting ADRD. Using a national de-identified dataset of more than 125 million patients including over 10,000 clinical, pharmaceutical, and demographic variables, we developed a cohort to train a machine learning model to predict ADRD 4-5 years in advance.

Incident Hearing Loss and Comorbidity: A Longitudinal Administrative Claims Study.

Importance: Because hearing loss is highly prevalent and treatable, determining its association with morbidity has major public health implications for disease prevention and the maintenance of health in adults with hearing loss.

Objective: To investigate the association between the diagnosis of incident hearing loss and medical comorbidities in adults 50 years or older.

Design, Setting, And Participants: Retrospective, propensity-matched cohort study using administrative claims data from commercially insured and Medicare Advantage members in a geographically diverse US health plan.

Trends in Health Care Costs and Utilization Associated With Untreated Hearing Loss Over 10 Years.

Importance: Nearly 38 million individuals in the United States have untreated hearing loss, which is associated with cognitive and functional decline. National initiatives to address hearing loss are currently under way.

Objective: To determine whether untreated hearing loss is associated with increased health care cost and utilization on the basis of data from a claims database.

Blunt traumatic celiac artery avulsion managed with celiac artery ligation and open aorto-celiac bypass.

Traumatic celiac artery injuries are rare and highly lethal with reported mortality rates of 38-62%. The vast majority are caused by penetrating trauma with only 11 reported cases due to blunt trauma (Graham et al., 1978; Asensio et al.

Numerical Context and Time Perception: Contrast Effects and the Perceived Duration of Numbers.

In the current study, we examined how the contextual repetition of magnitude information presented in either symbolic (Arabic digits) or nonsymbolic (numerosities) formats impacted on the perceived duration of a later occurring target number. The results of the current study demonstrated a time-magnitude bias in which, on average, large magnitude target numbers were judged to last for longer durations relative to small magnitude target numbers, regardless of notation (symbolic number and numerosity). Furthermore, context effects were found, in which a greater discrepancy in the target's magnitude from the initial context led to longer perceived duration ratings.

Cost-of-Illness Studies: An Updated Review of Current Methods.

Introduction: Cost-of-illness (COI) studies provide policy-relevant information for cross-country, longitudinal, and other cost comparisons. Prior studies have called for standardization in COI methods. We investigated trends, identified factors associated with variation in COI estimation methods, and characterized reporting of heterogeneity in COI estimates.

Patient misunderstanding of the academic hierarchy is prevalent and predictable.

Background: Medical personnel introduce themselves to patients using titles that reflect their level of training, although these titles may not be inherently obvious to the patient. This study explored patient understanding of commonly used physician and student titles.

Materials And Methods: A survey was developed asking patients to match six mutually exclusive medical titles to six levels of training.

A comparative study of handsewn versus stapled gastrojejunal anastomosis in laparoscopic Roux-en-Y gastric bypass.

Background: The two basic techniques available in which to perform the gastrojejunal (GJ) anastomosis during a laparoscopic Roux-en-Y gastric bypass (LRYGBP) are stapled and handsewn. Few outcomes differences have been noted between the two to recommend one as a superior approach. We present our findings in comparison of the two methods.

The learning curve with single-port cholecystectomy.

Objectives: Single-port surgery is a rapidly advancing technique in laparoscopic surgery. Currently, there is limited evidence on the learning curve and practicality of performing single-port laparoscopic cholecystectomy.

Methods: Single-port cholecystectomy was performed on 20 consecutive patients for biliary dyskinesia, symptomatic cholelithiasis, or acute cholecystitis.

Muscle-specific BCL2 expression ameliorates muscle disease in laminin {alpha}2-deficient, but not in dystrophin-deficient, mice.

To examine the role of apoptosis in neuromuscular disease progression, we have determined whether pathogenesis in dystrophin-deficient (mdx) and laminin alpha2-deficient (Lama2-null) mice is ameliorated by overexpression of the anti-apoptosis protein BCL2 in diseased muscles. The mdx mice are a model for the human disease, Duchenne muscular dystrophy (DMD), and the Lama2-null mice are a model for human congenital muscular dystrophy type 1A (MDC1A). For these studies, we generated transgenic mice that overexpressed human BCL2 under control of muscle-specific MyoD or MRF4 promoter fragments.

Immortalization of mouse myogenic cells can occur without loss of p16INK4a, p19ARF, or p53 and is accelerated by inactivation of Bax.

Background: Upon serial passaging of mouse skeletal muscle cells, a small number of cells will spontaneously develop the ability to proliferate indefinitely while retaining the ability to differentiate into multinucleate myotubes. Possible gene changes that could underlie myogenic cell immortalization and their possible effects on myogenesis had not been examined.

Results: We found that immortalization occurred earlier and more frequently when the myogenic cells lacked the pro-apoptotic protein Bax.

Investigation of the 1994-5 Ukrainian Vibrio cholerae epidemic using molecular methods.

Thirty-seven Vibrio cholerae and four non-cholera Vibrio isolates from Ukraine, including strains from the epidemic of 1994-5, were analysed by molecular methods. Results from PFGE and ribotyping indicated that all Ukrainian toxigenic V. cholerae were closely related to each other and to an isolate from a patient from Pakistan.

Microbiological and epidemiological investigation of cholera epidemic in Ukraine during 1994 and 1995.

The Ukraine cholera epidemic of 1994 and 1995 was caused by Vibrio cholerae O1, serotype Ogawa, biotype El Tor. This epidemic was centred in the area around Respublika Krim (Crimea) and Mykolajiv, and spread to include parts of southern Ukraine. Cases of cholera occurred between September and November of 1994 and between June and October of 1995.

Complete nucleotide sequence of the Hsd plasmid pECO29 and identification of its functional regions.

The complete nucleotide sequence of the Hsd plasmid pECO29 has been determined. The plasmid DNA consists of 3895 base pairs. These include 4 genes and 5 sites.

Cloning and sequence analysis of the plasmid-borne genes encoding the Eco29kI restriction and modification enzymes.

The Eco29kI restriction-modification system (RMS2) has been found to be localized on the plasmid pECO29 occurring naturally in the Escherichia coli strain 29k (Pertzev, A.V., Ruban, N.

Isolation of a strain overproducing endonuclease Eco29kI: purification and characterization of the homogeneous enzyme.

The physical map of the plasmid pSACII1 carrying the genes of restriction-modification system Eco29kI (isoschizomer of SacII) was determined. The cloning of the Eco29kI endonuclease and methylase genes into the plasmid vector pUC129 produced recombinant strain Escherichia coli K802[pECO29A15] with Eco29kI synthesis level about 100 times higher than in the parent strain. The restriction endonuclease was purified from Escherichia coli K802 [pECO29A15] cells to near homogeneity using column chromatography sequentially on phosphocellulose, hydroxyapatite, and heparin-Sepharose and rechromatography on phosphocellulose.

Heterogeneity of diphtheria toxin gene, tox, and its regulatory element, dtxR, in Corynebacterium diphtheriae strains causing epidemic diphtheria in Russia and Ukraine.

Diphtheria toxin (tox) and its regulatory element (dtxR) from 72 Corynebacterium diphtheriae strains isolated in Russia and Ukraine before and during the current diphtheria epidemic were studied by PCR-single-strand conformation polymorphism analysis (PCR-SSCP). Twelve sets of primers were constructed (eight for tox and four for dtxR), and three regions within tox and all four regions of dtxR showed significant variations in the number and/or sizes of the amplicons. Two to four different SSCP patterns were identified in each of the variable regions; subsequently, tox and dtxR could be classified into 6 and 12 different types, respectively.

Cloning and sequences of the genes encoding the CfrBI restriction-modification system from Citrobacter freundii.

The genes encoding the CfrBI restriction and modification (R-M) systems from Citrobacter freundii and recognizing the sequence 5'-CCWWGG-3' (W = A or T) were cloned in Escherichia coli McrBC- cells. The nucleotide (nt) sequences of the genes were determined. Two large open reading frames were found.

The cleavage sites and localization of genes encoding the restriction endonucleases Eco1831I and EcoHI.

The restriction endonucleases Eco1831I and EcoHI cleave before the first 5'-cytosine in the recognition sequence 5'-decreases CCSGG--3'/3'--GGSCC increases-5' (where S = G or C), generate 5-base 5' cohesive ends, and are encoded by homologous plasmids that are restricted in McrA+ hosts. Thus, they differ in their cleavage specificity from that of the BcnI isoschizomer, which cleaves after the second 5' cytosine.