Prevalence Of Micro Research Articles

Apolipoprotein-CIII O-Glycosylation Is Associated with Micro- and Macrovascular Complications of Type 2 Diabetes.

Apolipoprotein-CIII (apo-CIII) inhibits the clearance of triglycerides from circulation and is associated with an increased risk of diabetes complications. It exists in four main proteoforms: O-glycosylated variants containing either zero, one, or two sialic acids and a non-glycosylated variant. O-glycosylation may affect the metabolic functions of apo-CIII. We investigated the associations of apo-CIII glycosylation in blood plasma, measured by mass spectrometry of the intact protein, and genetic variants with micro- and macrovascular complications (retinopathy, nephropathy, neuropathy, cardiovascular disease) of type 2 diabetes in a DiaGene study (n = 1571) and the Hoorn DCS cohort (n = 5409). Mono-sialylated apolipoprotein-CIII (apo-CIII1) was associated with a reduced risk of retinopathy (β = -7.215, 95% CI -11.137 to -3.294) whereas disialylated apolipoprotein-CIII (apo-CIII2) was associated with an increased risk (β = 5.309, 95% CI 2.279 to 8.339). A variant of the GALNT2-gene (rs4846913), previously linked to lower apo-CIII0a, was associated with a decreased prevalence of retinopathy (OR = 0.739, 95% CI 0.575 to 0.951). Higher apo-CIII1 levels were associated with neuropathy (β = 7.706, 95% CI 2.317 to 13.095) and lower apo-CIII0a with macrovascular complications (β = -9.195, 95% CI -15.847 to -2.543). In conclusion, apo-CIII glycosylation was associated with the prevalence of micro- and macrovascular complications of diabetes. Moreover, a variant in the GALNT2-gene was associated with apo-CIII glycosylation and retinopathy, suggesting a causal effect. The findings facilitate a molecular understanding of the pathophysiology of diabetes complications and warrant consideration of apo-CIII glycosylation as a potential target in the prevention of diabetes complications.

Spatial Interactions between Planned Settlements and Small Businesses: Evidence from the Jakarta Metropolitan Area, Indonesia

Rapid urban growth is reshaping cities and promoting economic development in low and middle-income countries throughout Southeast Asia, with the prevalence of Micro-, Small-, and Medium-sized Enterprises (MSME) emerging as a crucial factor. This study explores the complex relationship between MSMEs and planned settlements within the Jakarta Metropolitan Area (JMA), Indonesia. Utilizing official government data and extensive GIS sources analyzed using a Spatial Lag Model, the research assessed the spatial interactions between MSMEs and sixteen variables, revealing the statistical significance of eight of these variables. Notably, the study identified a negative correlation between the prevalence of planned settlements and the number of MSMEs, indicating that areas with a higher proportion of planned settlement land use tend to have fewer MSMEs. Emphasizing the importance of land use and built environment policies, the findings underscore MSMEs’ preference for locations with a greater share of commercial land uses. Moreover, the research highlights the localized nature of MSMEs, suggesting a tendency to cluster in specific areas. As Indonesia and other Global South countries experience rapid urbanization and potential increases in planned settlements, the study underscores the need for policymakers to develop strategies that foster a synergistic relationship between planned settlement development and MSME growth to support sustainable urban development.

A pilot study: Drug utilization pattern and prevalence of micro and macrovascular complication in type 2 diabetes patient

Background: Diabetes mellitus is a chronic metabolic disorder resulting from the deficiency of insulin secretion and insulin resistance. Currently, there is a death of nationwide data regarding the prevalence of micro and macro complications and drug utilization patterns. This study will help health-care professionals approach management more aggressively to prevent complications. Objectives: To assess the risk factors associated with complications in diabetes patients, and to determine the pattern of drug prescription among type-2 DM patients patterns at Virudhunagar Medical College & Hospital. Methods: This is a Prospective, prescription-based, and observational study. A sample size of 50 was selected systematically. Data were collected from patient case records and Prescriptions. The obtained data were entered in the structured patient profile form, and the filled forms were analyzed. Results: Out of the total 50 cases evaluated, 60 (60%) were males and 20(40%) were females. The 28 patients (56%) had a family history of diabetes. The prevalence of the associated diabetic complications was as follows viz. Hypertension (17.65%), IHD (1.47%), retinopathy (17.65%), nephropathy (7.35%), Neuropathy (47.06%), Stroke (5.88%) and CHF (2.94%). The overall utilization pattern of drugs were as follows viz. anti-diabetics (28%), anti-hypertensive (9%), antiplatelets (4%), lipid lowering agents (7%), vitamins and minerals (17%),GI drugs (14%), antimicrobials(6%). Among anti-diabetic drugs 48(96%) biguanides and 44(88%) of sulfonylureas classes of antidiabetic drugs were utilized. Likewise, preferred drugs for the management of hypertension, IHD, dyslipidemia, and neuropathy were Diuretics (25.93%), Clopidogrel (66.66%), Atorvastatin (100%), and Acetominophine (67.74%) respectively. Conclusion: The prevalence of micro and macro complications among type 2 diabetic patients was found to be high. Although polypharmacy was observed, drug utilization patterns can be rational owing to the higher prevalence of complications. Patient are not aware of the severity of the disease so complication makes the therapeutic more challenging. Patient education on disease severity and healthcare professionals need more focus on disease complications and severity to treat the disease earlier to improve patient health outcomes.

Spatial-Temporal Determinants of Income Inequality in the Cantons of Ecuador between 2010 and 2019: a Spatial Panel Econometric Analysis

Inequality is a problem that remains latent throughout generations, despite the growth of countries and the mechanisms that were implemented to mitigate it. Understanding the structure of spillovers from a spatial point of view would allow for the management of current resources, with the aim of improving the distribution among individuals at the cantonal level for Ecuador. In this context, this study aims to estimate the effect of the determinants of income inequality at the cantonal level, through the use of spatial models during the period 2010–2019, for 213 cantons in Ecuador. The Kuznets inverted-U theory is applied, which allows us to understand the changes that economic growth produces on income inequality levels. The approach indicates that the current average rate of growth of production per capita has made inequality levels decrease. In addition, human capital has the opposite effect to that expected, increasing inequality levels as a result of a concentration of this resource in certain cantons. On the other hand, the entrepreneurial structure of micro and small enterprises allows to mitigate the inequality levels between cantons. In this sense, among the policy objectives is to prioritize a more homogeneous growth of the cantons of Ecuador, likewise, generate policies that allow reducing the concentration of human capital in certain regions, as well as financial development. On the other hand, it is important to strengthen the prevalence of Micro, small and medium-sized enterprises in the long term, with the aim of improving family income levels and reducing inequality.

Albuminuria as a marker of systemic congestion in patients with heart failure.

Albuminuria is common in patients with heart failure and associated with worse outcomes. The underlying pathophysiological mechanism of albuminuria in heart failure is still incompletely understood. The association of clinical characteristics and biomarker profile with albuminuria in patients with heart failure with both reduced and preserved ejection fractions were evaluated. Two thousand three hundred and fifteen patients included in the index cohort of BIOSTAT-CHF were evaluated and findings were validated in the independent BIOSTAT-CHF validation cohort (1431 patients). Micro-albuminuria and macro-albuminuria were defined as urinary albumincreatinine ratio (UACR) 30 mg/gCr and 300 mg/gCr in spot urines, respectively. The prevalence of micro- and macro-albuminuria was 35.4 and 10.0, respectively. Patients with albuminuria had more severe heart failure, as indicated by inclusion during admission, higher New York Heart Association functional class, more clinical signs and symptoms of congestion, and higher concentrations of biomarkers related to congestion, such as biologically active adrenomedullin, cancer antigen 125, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) (all P 0.001). The presence of albuminuria was associated with increased risk of mortality and heart failure (re)hospitalization in both cohorts. The strongest independent association with log UACR was found for log NT-proBNP (standardized regression coefficient 0.438, 95 confidence interval 0.350.53, P 0.001). Hierarchical clustering analysis demonstrated that UACR clusters with markers of congestion and less with indices of renal function. The validation cohort yielded similar findings. In patients with new-onset or worsening heart failure, albuminuria is consistently associated with clinical, echocardiographic, and circulating biomarkers of congestion.

Prevalence of microvascular and macrovascular complications of diabetes in newly diagnosed type 2 diabetes in low-and-middle-income countries: A systematic review and meta-analysis.

There is an excessive burden of diabetes complications in low-resource settings. We conducted a systematic review to determine the nature and frequency of diabetes complications in newly diagnosed with type 2 diabetes. A systematic search was performed using Medline, CINAHL and Global Health online databases from inception to July 2020. Articles reporting prevalence of microvascular or macrovascular complications within six months of type 2 diabetes diagnosis and published in English or French from low- and middle-income countries (LMICs) were eligible for analysis. Data were extracted using a standardized data extraction tool. Descriptive statistics were used to describe the prevalence of micro and macrovascular complications in newly diagnosed type 2 diabetes. Assessment of heterogeneity was conducted using the inconsistency index (I2) and Cochran-Q chi2 statistical tests. Publication bias was assessed by the Funnel plot and Egger test. A total of 3 292 records underwent title or abstract screening and 95 articles underwent full text review. Thirty-three studies describing 13 283 participants (aged 20 years and older) met the inclusion criteria. The eligible studies were from Asia (n = 24), Africa (n = 4), Oceania (n = 2), South America (n = 2) and the Caribbean (n = 1). For microvascular complications, the median prevalence (interquartile range) of retinopathy, nephropathy and neuropathy were 12% (6%-15%), 15% (7%-35%) and 16% (10%25%) respectively. For macrovascular complications, the median prevalence (interquartile range) was 10% (7%-17%) for ischaemic heart disease, 6% (1%-20%) for peripheral arterial disease and 2% (1%-4%) for stroke. There was evidence of substantial heterogeneity between studies for all outcomes (I2 > 90%. We found a high prevalence of complications in newly diagnosed type 2 diabetes in LMICs. Findings suggest that many people live with diabetes and are only diagnosed when they present with complications in LMICs. Research is needed to guide timely and effective identification of people living with diabetes in these settings.

Use of Continuous Glucose Monitoring in the Assessment and Management of Patients With Diabetes and Chronic Kidney Disease.

In developed countries, diabetes is the leading cause of chronic kidney disease (CKD) and accounts for 50% of incidence of end stage kidney disease. Despite declining prevalence of micro- and macrovascular complications, there are rising trends in renal replacement therapy in diabetes. Optimal glycemic control may reduce risk of progression of CKD and related death. However, assessing glycemic control in patients with advanced CKD and on dialysis (G4-5) can be challenging. Laboratory biomarkers, such as glycated haemoglobin (HbA1c), may be biased by abnormalities in blood haemoglobin, use of iron therapy and erythropoiesis-stimulating agents and chronic inflammation due to uraemia. Similarly, glycated albumin and fructosamine may be biased by abnormal protein turnover. Patients with advanced CKD exhibited heterogeneity in glycemic control ranging from severe insulin resistance to ‘burnt-out’ beta-cell function. They also had high risk of hypoglycaemia due to reduced renal gluconeogenesis, frequent use of insulin and dysregulation of counterregulatory hormones. Continuous glucose monitoring (CGM) systems measure glucose in interstitial fluid every few minutes and provide an alternative and more reliable method of glycemic assessment, including asymptomatic hypoglycaemia and hyperglycaemic excursions. Recent international guidelines recommended use of CGM-derived Glucose Management Index (GMI) in patients with advanced CKD although data are scarce in this population. Using CGM, patients with CKD were found to experience marked glycemic fluctuations with hypoglycemia due to loss of glucose and insulin during haemodialysis (HD) followed by hyperglycemia in the post-HD period. On the other hand, during peritoneal dialysis, patients may experience glycemic excursions with influx of glucose from dialysate solutions. These undesirable glucose exposure and variability may accelerate decline of residual renal function. Although CGM may improve the quality of glycemic monitoring and control in populations with CKD, further studies are needed to confirm the accuracy, optimal mode and frequency of CGM as well as their cost-effectiveness and user-acceptability in patients with advanced CKD and dialysis.

Micro(nano)plastics Prevalence, Food Web Interactions, and Toxicity Assessment in Aquatic Organisms: A Review

Plastic pollution is a fast-rising environmental catastrophe. Microplastics and nanoplastics (MNPs) are ubiquitous components of most aquatic environments, and their burgeoning prevalence is endangering aquatic organisms. Recent studies have documented the entanglement of marine and freshwater biota by plastic litters, particularly ghost fishing gear, resulting in suffocation, drowning, or starving to death. Numerous reports have shown that aquatic organisms readily ingest and accumulate these emerging contaminants in their digestive systems. Given experimental evidence that contaminants-laden MNPs can persist in the gastrointestinal tract for considerable durations, investigations have documented a high probability of lethal and sublethal toxicological effects associated with direct and indirect MNPs ingestions. These include chronic protein modulation, DNA damage, embryotoxicity, gastrointestinal toxicity, genotoxicity, growth inhibition toxicity, histopathotoxicity, liver toxicity, neurotoxicity, oxidative stress, reproductive toxicity, and tissue damage. Today, reports have proven the transfer of MNPs across the aquatic food web to humans. However, the mechanisms of multiple contaminants-laden MNPs-induced toxicities, size-dependent toxicity, and the comprehensive mode-of-action and alterations of digestive, reproductive, and neurological systems’ functionality in marine organisms are still unclear. Thus, this review mainly addresses the prevalence, food web interactions, and toxicity assessment of micro(nano) plastics in marine and freshwater organisms. It summarizes documented studies based on the following broad objectives: (1) the occurrence and prevalence of micro(nano) plastic particles in marine and freshwater environments; (2) the ingestion of MNPs by aquatic biota and the food web exposure routes and bioaccumulation of contaminated MNPs by higher trophic entities; (3) the adsorption and desorption of persistent organic pollutants, metals, and chemical additives on/from micro(nano)plastics; and (4) the probable ecotoxicological effects of micro(nano)plastics ingestion on aquatic biota.

Stress myocardial blood flow reduced after severe COVID-19, not related to symptoms

Abstract Introduction Persistent cardiopulmonary symptoms after COVID-19 are reported in a large number of patients and the underlying pathology is still poorly understood. (1) Histopathologic studies revealed myocardial macrophage infiltrates in deceased patients, likely an unspecific finding of severe illness, and increased prevalence of micro- and macrovascular thrombi. (2) We examined whether microvascular perfusion, measured by quantitative cardiac magnetic resonance under vasodilator stress, was altered post COVID-19. Methods Our population consisted of 12 patients from the Pa-COVID-19-Study of the Charité Berlin, which received a cardiac MRI as part of a systematic follow up post discharge, 10 patients that presented at the German Heart Center Berlin with persistent cardiac symptoms post COVID-19 and 12 patients from the Kings College London referred for stress MRI and previous COVID-19. The scan protocol included standard functional, edema and scar imaging and quantitative stress and rest perfusion to assess both macro- and microvascular coronary artery disease. The pharmacological stress agent was regadenosone in 20 and adenosine in 13 of the patients. To control for the higher heart rate increase under regadenosone compared to adenosine, we calculated the myocardial blood flow per heartbeat (MBF_HRi) under stress. Results The median time between first positive PCR for COVID-19 and the CMR exam was 2 months (Range 0 to 12). None of the 33 patients exhibited signs of myocardial edema. One patient with a previous history of myocarditis had focal fibrosis. Three patients with known coronary artery disease showed ischemic Late Enhancement. Five patients had a small pericardial effusion; one of these four patients showed slight focal pericardial edema and LGE, consistent with mild focal pericarditis. Five Patients had a stress-induced focal perfusion deficit. Mean Stress MBF_HRi was 32.5±6.5 μl/beat/g. Stress MBF_HRi was negatively correlated with COVID-19 severity (rho=−0.361, P=0.039) and age (r=−0.452, P=0.009). The correlation with COVID-19 severity remained significant after controlling for age (rho=−0.390, P=0.027). There was no apparent difference in stress MBF_HRi between patients with and without persistent chest pain (34.5 vs. 31.5 μl/beat/g, P=0.229) Conclusion While vasodilator-stress myocardial blood flow after COVID-19 was negatively correlated to COVID-19 severity, it was not correlated to the presence of chest pain. The etiology of persistent cardiac symptoms after COVID-19 remains unclear. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Philips Figure 1. A) Quantitative regadenosone stress myocardial blood flow (MBF) map, medial short axis slice, in a patient with persistent cardiac symptoms after COVID-19. B) Boxplot of stress MBF per heart beat by COVID-19 severity, showing decreasing MBF with increasing COVID-19 severity.

Comment on: Prevalence of micro and macro vascular complications and their risk factors in type 2 diabetes in Saudi Arabian population: an analysis from SHIS.

Comment on: Prevalence of micro and macro vascular complications and their risk factors in type 2 diabetes in Saudi Arabian population: an analysis from SHIS.

Prevalence of Micro and Macrovascular Complications and Assessment of Risk Factors in Diabetic patients: a Prospective Observational Study

Diabetes is a chronic metabolic disorder of heterogenous type. Diabetic complications are mostly associated with condition of vascular penetrability that affects different tissues & kidneys, retina, nerves which involve the body organs.The aim of study was to assess the prevalence of micro and macro diabetic complications and risk factors of diabetic patients. The prospective observational study was conducted in Raghu Diabetes and general clinic, Chittoor, Andhra Pradesh. A sample size of 200 subjects was recruited for the study. The study was conducted from December 2020 to May 2021. Patients with age group of 30-90 years and diabetic complications were included in the study. Patients below 30 years of age were excluded from study. The patient details were collected using questionnaire form. It contains sociodemographic data and medical history including smoking, alcohol, family history of diabetes mellitus, and treatment and management of diabetes. The statistical analysis was carried out using SPSS version 25.0. The study results showed 1.5% of patients had more than two co-morbidities, which was significantly higher among elderly (5.04%), females (5.2%) and urban residence (6.31%), physical inactivity (3.15%) and house wife (2.1%). The statins prescribed patients were 160 (80%) whereas patients on other medications, insulin in combination with OHA 38 (19%), and multivitamins prescribed patients 181 (90.5%). The study showed the patient’s age of 51- 70 years was mostly affected by diabetes. Regular exercise, intake of more vegetables and fruits and adopting a healthier life-style can reduce the prevalence of diabetes. Keywords: Diabetic complications; physical inactivity; smoking; alcohol; statins; Insulin

Uptake, translocation, and biological impacts of micro(nano)plastics in terrestrial plants: Progress and prospects

Micro(nano)plastics are emerging environmental contaminants of concern. The prevalence of micro(nano)plastics in soils has aroused increasing interest regarding their potential effects on soil biota including terrestrial plants. With the rapid increase in published studies on plant uptake and impacts of micro(nano)plastics, a review summarizing the current research progress and highlighting future needs is warranted. A growing body of evidence indicates that many terrestrial plants can potentially take up micro(nano)plastics via roots and translocate them to aboveground portions via the vascular system, primarily driven by the transpiration stream. Exposure to micro(nano)plastics can cause a variety of effects on the biometrical, biochemical, and physiological parameters of terrestrial plants, but the specific effects vary considerably as a function of plastic properties, plant species, and experimental conditions. The presence of micro(nano)plastics can also affect the bioavailability of other associated toxicants to terrestrial plants. Based on analysis of the available literature, this review identifies current knowledge gaps and suggests prospective lines for further research.

Prevalence of micro and macro vascular complications and their risk factors in type 2 diabetes in Saudi Arabian population: an analysis from SHIS.

Diabetes mellitus is a non-communicable disease (NCD) with metabolic dysfunction that has attained epidemic proportions worldwide. Vascular complications account for the mortality and morbidity associated with diabetes. Hence, the study aimed to estimate the prevalence and risk factors for vascular complications in patients with type 2 diabetes mellitus (T2DM). A cross-sectional national multistage survey, the Saudi Health Interview Survey (SHIS), was used in this study, which surveyed individuals aged 15 years or older. After inclusion and exclusion criteria, 1240 diabetic patients' data were analyzed for sociodemographic data, risk factors, and prevalence of micro and macrovascular complications. Binary logistic regression with stepwise backward elimination was performed to build the optimal model to assess the determinants of macrovascular complications in diabetic patients. The strength of the associations was examined by estimating adjusted odds ratios (aOR) with their 95% CI. p-value < 0.05 was considered statistically significant. R Studio Version 1.2.1093 was used for statistical analysis RESULTS: Prevalence of micro and macrovascular complications in the diabetic patients was 6.05%, in which 3.5% had myocardial infarction, 1.2% had stroke and 1.9% had renal failure. The optimal model showed that for each year increase in age (aOR=1.05, 95%CI 1.02-1.07; p-value=0.000), smoking history (aOR=4.02, 95%CI 2.23-7.26; p-value=0.000), hypertensive patients (aOR=2.71, 95%CI 1.47-4.99; p-value=0.001), patients with low physical activity (aOR=4.32, 95%CI 1.26-14.82; p-value=0.001) were more likely to develop macro and microvascular complications in diabetic patients. The high prevalence of microvascular and macrovascular complications in diabetic patients poses a serious threat to public health in Saudi Arabia. A multisectoral approach needs to be undertaken to properly control and modify common risk factors at the community level.

Clinical significance of anti-Ro52 (TRIM21) antibodies in adult patients with connective tissue diseases

ObjectivesClinical significance of anti-Ro52 antibodies in connective tissue diseases (CTD) is controversial. Anti-Ro52 antibodies might be associated with a more severe CTD phenotype, especially interstitial lung disease (ILD). The aims of this study were to evaluate ILD prevalence and severity, the prevalence of micro- or macroangiopathy and CTD-associated cancers in CTD with anti-Ro52 antibodies. MethodsCTD patients with anti-Ro52 antibody screening by immunoblot at diagnosis were enrolled. Two groups were retrospectively formed according to the presence of anti-Ro52 antibodies with an unbiased 1:1 matching on CTD types. Unsupervised multiple correspondence analysis and hierarchical clustering analysis were used to aggregate anti-Ro52 positive patients in subgroups. Results408 CTD patients were included. Anti-Ro52 antibodies were detected in 33 % of CTD patients. Anti-Ro52 antibodies were associated with ILD at CTD diagnosis (47.8% vs. 23.0%, OR 3.3 95% IC 1.4 to 8.0, p = 0.008), even after adjusting for the presence of anti-Ro60 antibodies, especially in patients with antisynthetase syndrome, primary Sjögren syndrome and systemic sclerosis. Micro- or macroangiopathy was more frequent in anti-Ro52 positive CTD patients (18.6% vs. 9.7%, p = 0.02) and CTD patients with anti-Ro52 antibodies experienced more frequent relapses and required more immunosuppressive drugs. Clusters 4 and 5 identified anti-Ro52 positive CTD patients with severe ILD and with clinical features of systemic sclerosis or antisynthetase syndrome respectively. ConclusionsWe found that anti-Ro52 antibodies were independently associated with ILD in CTD patients irrespective of CTD type. Anti-Ro52 antibodies could be associated with severity and a more relapsing disease course in CTD patients.

Anti-cancer Therapy Leads to Increased Cardiovascular Susceptibility to COVID-19.

Anti-cancer treatment regimens can lead to both acute- and long-term myocardial injury due to off-target effects. Besides, cancer patients and survivors are severely immunocompromised due to the harsh effect of anti-cancer therapy targeting the bone marrow cells. Cancer patients and survivors can therefore be potentially extremely clinically vulnerable and at risk from infectious diseases. The recent global outbreak of the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its infection called coronavirus disease 2019 (COVID-19) has rapidly become a worldwide health emergency, and on March 11, 2020, COVID-19 was declared a global pandemic by the World Health Organization (WHO). A high fatality rate has been reported in COVID-19 patients suffering from underlying cardiovascular diseases. This highlights the critical and crucial aspect of monitoring cancer patients and survivors for potential cardiovascular complications during this unprecedented health crisis involving the progressive worldwide spread of COVID-19. COVID-19 is primarily a respiratory disease; however, COVID-19 has shown cardiac injury symptoms similar to the cardiotoxicity associated with anti-cancer therapy, including arrhythmia, myocardial injury and infarction, and heart failure. Due to the significant prevalence of micro- and macro-emboli and damaged vessels, clinicians worldwide have begun to consider whether COVID-19 may in fact be as much a vascular disease as a respiratory disease. However, the underlying mechanisms and pathways facilitating the COVID-19-induced cardiac injury in cancer and non-cancer patients remain unclear. Investigations into whether COVID-19 cardiac injury and anti-cancer drug-induced cardiac injury in cancer patients and survivors might synergistically increase the cardiovascular complications and comorbidity risk through a “two-hit” model are needed. Identification of cardiac injury mechanisms and pathways associated with COVID-19 development overlapping with anti-cancer therapy could help clinicians to allow a more optimized prognosis and treatment of cancer survivors suffering from COVID-19. The following review will focus on summarizing the harmful cardiovascular risk of COVID-19 in cancer patients and survivors treated with an anti-cancer drug. This review will improve the knowledge of COVID-19 impact in the field of cardio-oncology and potentially improve the outcome of patients.

Business vulnerability assessment: a firm-level analysis of micro- and small businesses in China

Micro- and small businesses are more vulnerable to natural hazards than the larger ones. However, there are few attempts to systematically assess their vulnerabilities. Existing business vulnerability assessments use aggregate-level data, which poorly account for the prevalence of micro- and informal businesses in some areas. Also, they focus on business sensitivity and have not incorporated key elements of adaptive capacity into analysis. This study explores a firm-level assessment approach that would work better under resource and data constraints, which are common challenges to developing-country researchers. Surveys were conducted in four jurisdictions of China: Sanya, Zhuhai, Macao and Hong Kong. A total of 596 urban and rural businesses were involved. Indicators of business sensitivity, exposure and adaptive capacity were built into a structured questionnaire. The results were turned into a set of metrics for cross-location comparison. Aggregated scores suggest that business vulnerabilities increase from Sanya, Zhuhai, Hong Kong to Macao. Additional tests show that the integrated vulnerability scores are geographically differentiated and demonstrate compatibility with theoretical expectations. The value of this approach lies in its appropriate and realistic requirements for conducting business vulnerability assessments in small, isolated or less developed communities. Future applications need to overcome some uncertainties in the assessment.

1q21.1 distal copy number variants are associated with cerebral and cognitive alterations in humans

Low-frequency 1q21.1 distal deletion and duplication copy number variant (CNV) carriers are predisposed to multiple neurodevelopmental disorders, including schizophrenia, autism and intellectual disability. Human carriers display a high prevalence of micro- and macrocephaly in deletion and duplication carriers, respectively. The underlying brain structural diversity remains largely unknown. We systematically called CNVs in 38 cohorts from the large-scale ENIGMA-CNV collaboration and the UK Biobank and identified 28 1q21.1 distal deletion and 22 duplication carriers and 37,088 non-carriers (48% male) derived from 15 distinct magnetic resonance imaging scanner sites. With standardized methods, we compared subcortical and cortical brain measures (all) and cognitive performance (UK Biobank only) between carrier groups also testing for mediation of brain structure on cognition. We identified positive dosage effects of copy number on intracranial volume (ICV) and total cortical surface area, with the largest effects in frontal and cingulate cortices, and negative dosage effects on caudate and hippocampal volumes. The carriers displayed distinct cognitive deficit profiles in cognitive tasks from the UK Biobank with intermediate decreases in duplication carriers and somewhat larger in deletion carriers—the latter potentially mediated by ICV or cortical surface area. These results shed light on pathobiological mechanisms of neurodevelopmental disorders, by demonstrating gene dose effect on specific brain structures and effect on cognitive function.

The risk of micro and macrovascular disease in Egyptian patients with diabetes and peripheral arterial disease

ABSTRACT Aim: The aim of this study was to assess the prevalence of micro- and macrovascular disease in Egyptian patients with diabetes mellitus (DM) and peripheral arterial disease (PAD). Methods: The study included 161 Egyptian patients with DM and PAD (91.3% had type 2 DM and 67.1% were females). Mean diabetes duration was 14.2 ± 5.2 years. Full history, clinical and fundus examination as well as laboratory investigations were done. PAD was diagnosed through assessment of ankle/brachial index (ABI) by Doppler ultrasonography. Results: ABI was <0.9 in 33.5% and >1.3 in 66.5% of patients. A significant positive correlation was found between abnormal ABI and diabetes duration, ischemic heart disease (IHD), diabetic retinopathy and neuropathy, foot ulcers, elevated blood pressure (BP), creatinine, urine albumin/creatinine ratio (ACR) and triglycerides and a significant negative correlation with HDL. Multivariate regression analysis revealed that the independent predictors for PAD in patients with ABI< 0.9 were neuropathy, creatinine, triglyceride, LDL, urine ACR and low HDL, and in patients with ABI >1.3 were IHD, neuropathy, elevated diastolic BP and triglyceride. Conclusion: The risk of micro- and macrovascular disease is high in Egyptian patients with diabetes and PAD. Early diagnosis and good control of risk factors could reduce PAD progression.

Coastal hazards vulnerability assessment for micro and small businesses in China

Micro and small businesses are more vulnerable to natural hazards than the larger ones. However, there are few attempts to systematically assess their vulnerabilities. Existing business vulnerability assessments use aggregate-level data, which poorly account for the prevalence of micro and informal businesses in some areas. Also, they focus on business sensitivity and have not incorporated key elements of adaptive capacity into analysis. This study explores a firm-level assessment approach that would work better under resource and data constraints, which are common challenges to developing-country researchers. Surveys were conducted in four jurisdictions of China: Sanya, Zhuhai, Macao and Hong Kong. A total of 596 urban and rural businesses were involved. Indicators of business sensitivity, exposure and adaptive capacity were built into a structured questionnaire. The results were turned into a set of metrics for cross-location comparison. Aggregated scores suggest that business vulnerabilities increase from Sanya, Zhuhai, Hong Kong to Macao. Additional tests show that the integrated vulnerability scores are geographically differentiated and demonstrate compatibility with theoretical expectations. The value of this approach lies in its appropriate and realistic requirements for conducting business vulnerability assessments in small, isolated or less developed communities. Future applications need to overcome some uncertainties in the assessment.

A rare splice site mutation in the gene encoding glucokinase/hexokinase 4 in a patient with MODY type 2

The article presents a variant of maturity onset diabetes of the young type 2, caused by a rare mutation in the GCK gene. Maturity onset diabetes of the young (MODY) is a hereditary form of diabetes with an autosomal dominant type of inheritance, an onset at a young age, and a primary defect in pancreatic β-cell function. This type of diabetes is different from classical types of diabetes mellitus (DM1 and DM2) in its clinical course, treatment strategies, and prognosis. Clinical manifestations of MODY are heterogeneous and may vary even among members of the same family, i. e., carriers of identical mutations. This phenotypic variation is due to the interaction of mutations with different genetic backgrounds and the influence of environmental factors (e. g., lifestyle). Using next-generation sequencing technology, the c.580–1G>A substitution (IVS5 –1G>A, rs1554335421) located in an acceptor splice site of intron 5 of the GCK gene was found in a proband. The identified variant cosegregated with a pathological phenotype in the examined family members. The GCK gene encodes glucokinase (hexokinase 4), which catalyzes the first step in a large number of glucose metabolic pathways such as glycolysis. Mutations in this gene are the cause of MODY2. The illness is characterized by an insignificant increase in the fasting glucose level, is a well-controlled disease without medication, and has a low prevalence of micro- and macrovascular complications of diabetes. The presented case of MODY2 reveals the clinical significance of a mutation in the splice site of the GCK gene. When nonclassical diabetes mellitus is being diagnosed in young people and pregnant women, genetic testing is needed to verify the diagnosis and to select the optimal treatment method. Key words: human; maturity onset diabetes of the young; MODY2; glucokinase gene; next-generation sequencing; genetic analysis; bioinformatics.