longitudinal trend
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Author(s):  
Elena Campello ◽  
Claudia Maria Radu ◽  
Chiara Simion ◽  
Luca Spiezia ◽  
Cristiana Bulato ◽  
...  

Plasma concentrations of extracellular vesicles (EVs) originating from cells involved in COVID-19-associated coagulopathy (CAC), their longitudinal trend and association with clinical outcomes were evaluated. Blood samples of consecutive COVID-19 patients admitted to a medical Unit were longitudinally collected within 48 h of admission, at discharge and 30 days post-discharge. EVs were analyzed using high sensitivity flow cytometry and phospholipid-dependent clotting time (PPL). The following EVs were measured: endothelium-, platelet-, leukocyte-derived, bearing tissue factor (TF)+, angiotensin-converting enzyme (ACE2)+, platelet-derived growth factor receptor-β (PDGF-β)+ and SARS-CoV-2-nucleoprotein (NP)+. 91 patients were recruited for baseline EV analysis (mean age 67 ± 14 years, 50.5% male) and 48 underwent the longitudinal evaluation. From baseline to 30-days post-discharge, we observed significantly decreased plasma concentrations of endothelium-derived EVs (E-Selectin+), endothelium-derived bearing TF (E-Selectin+ TF+), endothelium-derived bearing ACE2 (E-Selectin+ACE2+) and leukocyte-EVs bearing TF (CD45+TF+), p < 0.001, p = 0.03, p = 0.001, p = 0.001, respectively. Conversely, platelet-derived (P-Selectin+) and leukocyte-derived EVs (CD45+) increased from baseline to 30-days post-discharge (p = 0.038 and 0.032, respectively). EVs TF+, ACE2+, PDGF-β+, and SARS-CoV-2-NP+ did not significantly change during the monitoring. PPL increased from baseline to 30-days post-discharge (+ 6.3 s, p = 0.006). P-Selectin + EVs >1,054/µL were associated with thrombosis (p = 0.024), E-Selectin + EVs ≤531/µL with worsening/death (p 0.026) and 30-days P-Selectin+ and CD45 + EVs with persistent symptoms (p < 0.0001). We confirmed increased EVs originating from cells involved in CAC at admission and discharge. EVs derived from activated pericytes and expressing SARS-CoV-2-NP were also detected. 30-days post-discharge, endothelium-EVs decreased, while platelet- and leukocyte-EVs further increased, indicating that cellular activation persists long after the acute phase.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 483-483
Author(s):  
Peiyi Lu ◽  
Dexia Kong ◽  
Mack Shelley

Abstract Discrimination has been more prevalent since the pandemic. Black Lives Matter (BLM) movement flourished in the summer of 2020 as protests against police brutality and racial injustice. However, the extent to which individuals’ discrimination experiences and associated mental health outcomes change amid a global pandemic and a dramatic societal movement in American society remains unknown. This study examines the dynamic relationship of racism and/or Covid-19-related discrimination with changes in mental health in the context of BLM and Covid-19. Data were from U.S. adults (age ≥18) who completed the online Understanding Coronavirus in America survey in June and September of 2020 (n=3,502). Respondents were asked to attribute their discrimination experience to 8 main reasons: (1) Covid-19; (2) national origin/race/skin color; (3) gender/sexual orientation; (4) age; (5) physical feature; (6) education/income; (7) health condition; and (8) religion/other. Quasi-Poisson regression models examined the associations between discrimination and anxiety/depression/stress. Results indicated about 33% of respondents reported discrimination in June compared to 21% in September. Racism was significantly associated with more anxiety/depression/stress in June, but not in September or in the longitudinal trend. Covid-19-related discrimination was associated with elevated levels of anxiety/depression/stress in September and in the longitudinal trend, but not in June 2020. We concluded that individuals’ discrimination experiences are shaped by societal contexts. Specifically, racism was the dominant discrimination attribution in June 2020 when BLM was at its peak. However, Covid-19 discrimination overtook racism as the primary attribution and showed a significant relationship with poorer mental health over time.


2021 ◽  
Vol 8 ◽  
Author(s):  
Latthawan Monnamorn ◽  
Chutima Seree-aphinan ◽  
Piyatida Molika ◽  
Polathep Vichitkunakorn ◽  
Kovit Pattanapanyasat ◽  
...  

Septic shock represents a subset of sepsis with severe physiological aberrations and a higher mortality rate than sepsis alone. Currently, the laboratory tools which can be used to identify the state of septic shock are limited. In pre-clinical studies, extracellular vesicles (EVs), especially large EVs (lEVs), have been demonstrated a role as functional inflammatory mediators of sepsis. However, its longitudinal trend during the disease course has not been explored. In this study, the quantities and subtypes of plasma-derived lEVs were longitudinally compared between patients with septic shock (n = 21) and non-sepsis infection (n = 9), who presented within 48 h of their symptom onset. Blood specimens were collected for seven consecutive days after hospital admission. lEVs quantification and subtyping were performed using an imaging flow cytometer. The experiments revealed a higher lEVs concentration in septic shock patients than infected patients at the onset of the disease. In septic shock patients, lEVs concentration decreased over time as opposed to infected patients whose lEVs concentration is relatively static throughout the study period. The major contributors of lEVs in both septic shock and infected patients were of non-leukocyte origins; platelets, erythrocytes, and endothelial cells released approximately 40, 25, and 15% of lEVs, respectively. Among lEVs of leukocyte origins, neutrophils produced the highest number of EVs. Nevertheless, the proportion of each subtype of lEVs among the given amount of lEVs produced was similar between septic shock and infected patients. These findings raise the possibility of employing lEVs enumeration as a septic shock identifying tool, although larger studies with a more diverse group of participants are warranted to extrapolate the findings to a general population.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chiun-Ho Hou ◽  
Yu-Chin Lu ◽  
Christy Pu ◽  
Yin-Hsi Chang ◽  
Ken-Kuo Lin ◽  
...  

AbstractLongitudinal trends on traumatic cataract wound dehiscence are scant. In this study, we present the characteristics of traumatic cataract wound dehiscence using 15 years of longitudinal trend in one of the largest medical centers in Taiwan for a period when cataract surgeries were gradually shifting from extracapsular cataract extraction (ECCE) to phacoemulsification. All patients with a prior cataract surgery who suffered from blunt open globe trauma between 2001 and 2015 at a tertiary referral center in Taiwan were included. The number of cases per year; type of prior cataract surgery; visual acuity (VA); mechanism and place of injury were analyzed. The risk factors associated with final VA were investigated in patients followed up for ≥ 1 month. Seventy-six eyes of 75 patients were included and all of them were traumatic cataract wound dehiscence with a prior ECCE (65 eyes) or phacoemulsification. The most common mechanism and place of injury was fall and at home in both cataract surgical types. The mean log of the minimal angle resolution (logMAR) of final VA was 2.15 ± 0.88 (ECCE) and 1.61 ± 0.83 (phacoemulsification) (P = .026). The most significant risk factors associated with worse final VA were retinal detachment at the initial visit and low ocular trauma score (both P < .001). Long-term visual outcome of phacoemulsification wound dehiscence was better than that of ECCE wound after a blunt trauma.


2021 ◽  
Author(s):  
Samantha VanSchalkwyk ◽  
Daniel R. Jeske ◽  
Jane H. Kim ◽  
Manuela Martins‐Green

2021 ◽  
pp. 107755872110396
Author(s):  
Ge Bai ◽  
Hossein Zare ◽  
Matthew D. Eisenberg ◽  
Daniel Polsky ◽  
Gerard F. Anderson

Nonprofit hospitals provide charity care to financially disadvantaged patients according to their self-designed eligibility policies. The Affordable Care Act may have prompted nonprofit hospitals to adopt more generous eligibility policies, but no prior research has examined the longitudinal trend. The expansion of Medicaid coverage in many states has been found to reduce charity care provision, but it is unclear whether the change in charity care eligibility policies differed between Medicaid expansion and nonexpansion states. Using mandatory tax filings, we found that both hospitals in Medicaid expansion states and hospital in nonexpansion states adopted more generous eligibility policies in 2018 than in 2010, but the change was greater in the former for discounted charity care; while the former provided less charity care regardless of their policy changes, the latter provided more when their policies became more generous. This study has implications for policy discussions on the justification of nonprofit hospitals’ tax-exempt status.


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