Riviste scientifiche

[Correspondence] Electron microscopy of SARS-CoV-2: a challenging task – Authors' reply

The Lancet - Me, 20/05/2020 - 00:30
We thank Cynthia Goldsmith and colleagues for their interest in our recent Correspondence.1 We described autopsy findings from patients who had died from COVID-19 and showed a systemic endotheliitis with evidence of loss of integrity of the endothelial monolayer.1

[Correspondence] Electron microscopy of SARS-CoV-2: a challenging task

The Lancet - Me, 20/05/2020 - 00:30
We read with interest the Correspondence by Zsuzsanna Varga and colleagues1 on the possible infection of endothelial cells by SARS-CoV-2 using electron microscopic (EM) images as evidence. However, we believe the EM images in the Correspondence do not show coronavirus particles but instead show cross-sections of the rough endoplasmic reticulum (RER). These spherical structures are surrounded by dark dots, which might have been interpreted as spikes on coronavirus particles but are instead ribosomes.

Risk of severe maternal morbidity or death in relation to elevated hemoglobin A1c preconception, and in early pregnancy: A population-based cohort study

PLoS Medicine - Ma, 19/05/2020 - 23:00

by Alexander J. F. Davidson, Alison L. Park, Howard Berger, Kazuyoshi Aoyama, Ziv Harel, Jocelynn L. Cook, Joel G. Ray

Background

The relation between prepregnancy average glucose concentration and a woman’s risk of severe maternal morbidity (SMM) is unknown. The current study evaluated whether an elevated preconception hemoglobin A1c (A1c) is associated with SMM or maternal death among women with and without known prepregnancy diabetes mellitus (DM).

Methods and findings

A population-based cohort study was completed in Ontario, Canada, where there is universal healthcare. The main cohort included 31,225 women aged 16–50 years with a hospital live birth or stillbirth from 2007 to 2015, and who had an A1c measured within 90 days before conception, including 28,075 women (90%) without known prepregnancy DM. The main outcome was SMM or maternal mortality from 23 weeks’ gestation up to 42 days postpartum. Relative risks (RRs) were generated using modified Poisson regression, adjusting for the main covariates of maternal age, multifetal pregnancy, world region of origin, and tobacco/drug dependence. The mean maternal age was 31.1 years. Overall, SMM or death arose among 682 births (2.2%). The RR of SMM or death was 1.16 (95% CI 1.14–1.19; p < 0.001) per 0.5% increase in A1c and 1.16 (95% CI 1.13–1.18; p < 0.001) after adjusting for the main covariates. The adjusted relative risk (aRR) was increased among those with (1.11, 95% CI 1.07–1.14; p < 0.001) and without (1.15, 95% CI 1.02–1.29; p < 0.001) known prepregnancy diabetes, and upon further adjusting for body mass index (BMI) (1.15, 95% CI 1.11–1.20; p < 0.001), or chronic hypertension and prepregnancy serum creatinine (1.11, 95% CI 1.04–1.18; p = 0.002). The aRR of SMM or death was 1.31 (95% CI 1.06–1.62; p = 0.01) in those with a preconception A1c of 5.8%–6.4%, and 2.84 (95% CI 2.31–3.49; p < 0.001) at an A1c > 6.4%, each relative to an A1c < 5.8%. Among those without previously recognized prepregnancy diabetes and whose A1c was >6.4%, the aRR of SMM or death was 3.25 (95% CI 1.76–6.00; p < 0.001). Study limitations include that selection bias may have incorporated less healthy women tested for A1c, and BMI was unknown for many women.

Conclusions

Our findings indicate that women with an elevated A1c preconception may be at higher risk of SMM or death in pregnancy or postpartum, including those without known prepregnancy DM.

UK government advised to ‘urgently’ build up contact tracing capacity

New Scientist - Ma, 19/05/2020 - 20:30
The latest coronavirus news updated every day including coronavirus cases, the latest news, features and interviews from New Scientist and essential information about the covid-19 pandemic

Smoking probably puts you at greater risk of coronavirus, not less

New Scientist - Ma, 19/05/2020 - 19:05
Early data indicated that smokers may be less likely to be hospitalised with coronavirus, but broader analyses suggest smokers are actually at higher risk

Coronavirus set to cause biggest emissions fall since second world war

New Scientist - Ma, 19/05/2020 - 18:00
The coronavirus lockdown will see global carbon emissions fall by a fifth compared with last year, but this dramatic drop won't slow climate change

13 lockdown cooking projects and the science of how they work

New Scientist - Ma, 19/05/2020 - 13:43
While we're stuck indoors, it's a great time to get into cooking and baking. Our Science of Cooking series explains how to make foods such as sourdough bread, hand-pulled noodles and kimchi, and the theory behind the recipes

Medications for opioid use disorder among pregnant women referred by criminal justice agencies before and after Medicaid expansion: A retrospective study of admissions to treatment centers in the United States

PLoS Medicine - Lu, 18/05/2020 - 23:00

by Tyler N. A. Winkelman, Becky R. Ford, Rebecca J. Shlafer, Anna McWilliams, Lindsay K. Admon, Stephen W. Patrick

Background

Criminal justice involvement is common among pregnant women with opioid use disorder (OUD). Medications for OUD improve pregnancy-related outcomes, but trends in treatment data among justice-involved pregnant women are limited. We sought to examine trends in medications for OUD among pregnant women referred to treatment by criminal justice agencies and other sources before and after the Affordable Care Act’s Medicaid expansion.

Methods and findings

We conducted a serial, cross-sectional analysis using 1992–2017 data from pregnant women admitted to treatment facilities for OUD using a national survey of substance use treatment facilities in the United States (N = 131,838). We used multiple logistic regression and difference-in-differences methods to assess trends in medications for OUD by referral source. Women in the sample were predominantly aged 18–29 (63.3%), white non-Hispanic, high school graduates, and not employed. Over the study period, 26.3% (95% CI 25.7–27.0) of pregnant women referred by criminal justice agencies received medications for OUD, which was significantly less than those with individual referrals (adjusted rate ratio [ARR] 0.45, 95% CI 0.43–0.46; P < 0.001) or those referred from other sources (ARR 0.51, 95% CI 0.50–0.53; P < 0.001). Among pregnant women referred by criminal justice agencies, receipt of medications for OUD increased significantly more in states that expanded Medicaid (n = 32) compared with nonexpansion states (n = 18) (adjusted difference-in-differences: 12.0 percentage points, 95% CI 1.0–23.0; P = 0.03). Limitations of this study include encounters that are at treatment centers only and that do not encompass buprenorphine prescribed in ambulatory care settings, prisons, or jails.

Conclusions

Pregnant women with OUD referred by criminal justice agencies received evidence-based treatment at lower rates than women referred through other sources. Improving access to medications for OUD for pregnant women referred by criminal justice agencies could provide public health benefits to mothers, infants, and communities. Medicaid expansion is a potential mechanism for expanding access to evidence-based treatment for pregnant women in the US.

Tropical cyclones really are growing stronger as the world warms

New Scientist - Lu, 18/05/2020 - 22:00
Theory and models forecast stronger storms in a warmer world, and now this trend has been seen in the real world using satellite data stretching back 40 years

Covid-19 news: Mixed progress on coronavirus vaccine as US stocks rise

New Scientist - Lu, 18/05/2020 - 19:30
The latest coronavirus news updated every day including coronavirus cases, the latest news, features and interviews from New Scientist and essential information about the covid-19 pandemic

Beach water quality testing stops in England due to coronavirus crisis

New Scientist - Lu, 18/05/2020 - 18:46
People swimming at beaches and lakes across England this summer will probably never know if the water was dirty because routine sampling to test quality has stopped

Fidget spinner device can diagnose UTIs in under an hour without a lab

New Scientist - Lu, 18/05/2020 - 18:00
A device inspired by fidget spinner toys can be used to diagnose urinary tract infections quickly and easily outside of the laboratory

Mars may be covered in mud volcanoes disguised as lava flows

New Scientist - Lu, 18/05/2020 - 18:00
Mud on the surface of Mars probably flows like lava does on Earth, which makes it difficult to tell whether Martian volcanoes are spewing lava or just mud

Seven new coronaviruses have been found lurking in bats in Africa

New Scientist - Lu, 18/05/2020 - 15:27
By testing bats in Gabon, researchers found seven coronaviruses that are new to science, but we don’t yet know if they could jump to people and cause illness

Strange 'space cow' explosion may have been the birth of a black hole

New Scientist - Lu, 18/05/2020 - 12:00
A mysterious space explosion nicknamed “the Cow” was probably caused by the explosion of a massive star which may have resulted in the birth of a small black hole

Covid-19 pandemic risks worst global food crisis in decades

New Scientist - Lu, 18/05/2020 - 10:00
The covid-19 pandemic’s impact on hunger around the world could be worse than when food prices spiked calamitously in 2007 and 2008, a leading food security expert warns

[Correspondence] Use of herbal drugs to treat COVID-19 should be with caution

The Lancet - Sa, 16/05/2020 - 00:30
On April 14, 2020, a Chinese official announced at a press conference that indications of three patent herbal drugs were approved to be expanded to include COVID-19 symptoms.1 This included Lianhuaqingwen capsules and Jinhuaqinggan granules for mild conditions, and Xuebijing (injectable) for severe conditions.

[Correspondence] Steam inhalation and paediatric burns during the COVID-19 pandemic

The Lancet - Sa, 16/05/2020 - 00:30
Steam inhalation is traditionally used as a home remedy for common colds and upper respiratory tract infections. The evidence base of the practice is weak, with unproven theories that the steam loosens mucus, opens nasal passages, and reduces mucosal inflammation, or that the heat inhibits replication of viruses.1,2

[Public Health] Voluntary collective isolation as a best response to COVID-19 for indigenous populations? A case study and protocol from the Bolivian Amazon

The Lancet - Sa, 16/05/2020 - 00:30
Indigenous communities worldwide share common features that make them especially vulnerable to the complications of and mortality from COVID-19. They also possess resilient attributes that can be leveraged to promote prevention efforts. How can indigenous communities best mitigate potential devastating effects of COVID-19? In Bolivia, where nearly half of all citizens claim indigenous origins, no specific guidelines have been outlined for indigenous communities inhabiting native communal territories.

[Editorial] Reviving the US CDC

The Lancet - Sa, 16/05/2020 - 00:00
The COVID-19 pandemic continues to worsen in the USA with 1·3 million cases and an estimated death toll of 80 684 as of May 12. States that were initially the hardest hit, such as New York and New Jersey, have decelerated the rate of infections and deaths after the implementation of 2 months of lockdown. However, the emergence of new outbreaks in Minnesota, where the stay-at-home order is set to lift in mid-May, and Iowa, which did not enact any restrictions on movement or commerce, has prompted pointed new questions about the inconsistent and incoherent national response to the COVID-19 crisis.
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