Urban health — What it is and Why We Should Care

Urban health is a field of study that draws upon multiple disciplines including sociology, public health, epidemiology, and geography among others. This piece argues for the further development and prioritization of urban health as an area of research. This is discussed with respect to structural health inequalities, urbanization and urbanicity, and demographic change. Urban health is inherently complex and needs a multifaceted approach to tackle unique public health problems. This complexity, alongside its potential to inform emerging areas of scientific research such as neurourbanism, makes developing urban health of utmost priority.

Selective Targeting of Unique Metabolic Properties of Leukemic Stem Cells in Acute Myeloid Leukemia

Current therapeutic options in the treatment of acute myeloid leukemia often succumb to high instances of relapse and subsequent mortality. Chemotherapy and radiotherapy have long been used as the standard treatment for this disease, remaining stagnant over the past few decades. Recently, a small self-renewing population of leukemic stem cells have been identified as drivers of cancer relapse and progression due to their increased resistance to anticancer therapeutics. This enables these cells to maintain a minimal residual disease and results in downstream differentiation, leading to relapse. Targeting these cells may lead to effective therapies that reduce relapse and mortality. Recently, the metabolic properties of leukemic stem cells have begun to be elucidated. Here, we discuss recent discoveries regarding the metabolism of leukemic stem cells and approaches to targeting their unique metabolic properties.

role of stathmin microtubule-destabilizing activity in Shigella flexneri motility and tunneling

The infection of the intestinal mucosa by Shigella bacteria is a global health issue resulting in a variety of potentially life-threatening gastrointestinal complications. Their unique method of intracellular motility depends on microtubule destabilization to clear the dense host cytoskeletal network in a process called tunneling. It is hypothesized that the host protein stathmin may play a role in this process, due to its tubulin-sequestering capability. This proposal aims to provide potential methodologies to elucidate the function of stathmin with respect to Shigella flexneri motility. Three experiments are proposed, involving comparisons between human intestinal epithelial cell strains under varying levels of stathmin expression, each infected with S. flexneri. Respectively, the experiments examine tunnel widths via electron microscopy, microtubule densities via imaging fluorescence correlation spectroscopy, and bacterial movement patterns via live fluorescence microscopy. If microtubule destabilization and movement is impaired in null stathmin strains, as predicted, such findings may inform a novel therapeutic target for Shigellosis by preventing internal spreading. This is particularly significant in our current landscape, as antibiotic-resistant strains of Shigella are growing increasingly prevalent.

Role of Electrical Source Imaging in Pediatric Epilepsy and Pre-Surgical Evaluation

Children with drug-resistant epilepsy undergo an extensive pre-surgical evaluation to determine the part of the brain thought to be the cause of seizures. The employment of non-invasive diagnostic imaging tools plays an important role in establishing surgical candidacy, preventing the need for invasive procedures. Electrical source imaging (ESI) has been explored as a modern alternative to traditional diagnostic techniques in pre-surgical workup. Through computational analysis of recorded electric potentials and individualized head scans, ESI provides a non-invasive method of obtaining more accurate localizations. However, its use within the clinical setting is limited. The following review looks to examine the literature surrounding ESI and advocates for its inclusion within the pre-surgical workup of children.

Evaluating the use of biomarkers for the diagnosis of myocardial injury in neonates

Myocardial infarction is defined as the obstruction of blood flow to the heart, resulting in oxygen deprivation. While myocardial infarction in adults is common and has sufficient diagnostic strategies, there remain gaps in the diagnostic strategies for myocardial infarction in neonates. Presently, biomarkers such as creatine-kinase MB, brain natriuretic peptide, myoglobin, and troponin are believed to be potential diagnostic tools for neonatal myocardial infarction. This literature review explores the efficacy of biomarkers for early diagnosis of neonatal myocardial infarction. The review concludes that creatine-kinase MB, brain natriuretic peptide, and myoglobin do not serve as accurate biomarkers for myocardial infarction in neonates. However, cardiac troponins, in particular cardiac troponin I, have high sensitivity and specificity for diagnosing myocardial injury. Cardiac troponins experience rapid elevation upon myocardial injury, and they remain unaffected by gestational age and birth weight. In addition, they do not cross the placenta and are therefore intrinsic to the neonate. Future research should be conducted to verify the accuracy, sensitivity, and specificity of cardiac troponins as myocardial infarction biomarkers.

Sex Differences in the Association Between Obesity and Hypertension: A Systematic Review

Introduction: Obesity is associated with multiple health-related complications, which together can decrease quality of life, disability-adjusted life years and life expectancy.1 Systematic reviews and meta-analyses have demonstrated that sex can influence the association between obesity and health complications, such as rheumatoid arthritis and many types of cancer.2-4 However, no systematic review or meta-analysis has been conducted to review the effect of sex on the association between obesity and hypertension, thus far. Knowing whether or not sex influences this relationship can help tailor the prevention, prediction, and care of this condition towards each sex. Objectives: To evaluate current studies on the association between sex, obesity, and hypertension, so as to obtain an overall estimate of the effect of sex on the prevalence of hypertension in obese individuals. Methods: A systematic search of EMBASE, MEDLINE, and PubMed was conducted. Search terms, such as “obesity,” “sex differences,” and “hypertension,” were used to filter results. After reviewing 406 articles, eight articles were included. Results: Four articles showed that obese women were at a greater risk of developing hypertension than obese men.5-8 Conversely, the results of two studies found that obese men are at a greater risk of developing hypertension.9,10 The remaining two studies showed that the difference between the sexes was insignificant.11,12 Discussion/Limitations: Stronger evidence shows that obese women are at a greater risk of developing hypertension than obese men. The two studies that had contradictory conclusions had small sample sizes relative to the other studies. Additionally, the two studies that concluded that both sexes are at a similar risk highlighted that most other studies have determined that obese women are at a greater risk and that their limitations may have caused this discrepancy. Limitations of this review include the limited ethnicity of participants and the use of BMI to classify obesity, which can sometimes lead to misclassification due to varying muscle to fat ratios. These factors limit the generalizability of the results. Conclusion: Obese women are seemingly at a greater risk of developing hypertension than obese men. However, this conclusion remains statistically inconclusive. Therefore, it would be beneficial to complete a meta-analysis in order to conclusively determine which sex is statistically more at risk of developing hypertension, when obese.

COVID-19 vs. History’s Pandemics

The spread of a new virus has caused a worldwide effort to combat the COVID-19 pandemic. Humans, however, have experienced many viral outbreaks in the past. Historical data can help inform current analyses and decisions. Thus, this infographic compares COVID-19 with past pandemics and outbreaks to showcase similarities and differences. This can allow for a better understanding of COVID-19 in the context of past events and changing perspectives.

Implications of Vitamin D Levels in COVID-19 Morbidity and Mortality

Vitamin D is a steroid hormone known for maintaining bone health. Vitamin D deficiency is a 25-hydroxyvitamin D (25(OH)D) serum concentration below 25 nmol/L. In contrast, vitamin D insufficiency occurs at levels below 75 nmol/L. Vitamin D insufficiency and deficiency affect 70% and 30% of the US population, respectively. Emerging evidence associates optimal vitamin D levels with better clinical outcomes in COVID-19. This literature review analyzed three preliminary articles that explored associations between vitamin D levels, COVID-19 mortality, and risk of adverse clinical outcomes in adult hospitalized patients. Google Scholar was used to find studies that diagnosed COVID-19 with reverse transcription (RT-PCR). In a cross-sectional analysis, Maghbooli et al. (2020) reported that vitamin D sufficient patients had a significantly lower chance (9.7%, n=77, p=0.01) of severe COVID-19 complications than deficient patients (32.8%, n=158, p=0.01). This study is under review for diagnosis accuracy and sample size. A retrospective cohort study by Raharusun et al. (2020), which included active and expired cases (n=780), found that 98.9% (p<0.001) of vitamin D deficient COVID-19 patients and 88% (p<0.001) with insufficiency died, but only 4% of sufficient individuals died. Lastly, a retroactive cohort study by Meltzer et al. (2020) reported higher rates of COVID-19 infection, 21.6% (95% CI, 14.0-29.2%), in vitamin D deficient groups (n=172), compared to 12.2% (95% CI, 8.5-15.4%) in sufficient groups (n=327). The 25(OH)D levels were measured within one year of COVID-19 testing. All studies controlled for age, sex, and comorbidities, while the first controlled for BMI and smoking, and the third controlled for race. Vitamin D sufficiency may activate the innate and adaptive immune systems, leading to an antiviral response. Receptor binding of vitamin D on neutrophils and macrophages stimulates cathelicidin expression, an antibacterial peptide. Macrophage and T-regulatory cell quantities also increase. These results reveal the need for randomized controlled studies of vitamin D sufficiency as a potential mitigator in COVID-19 outcomes.