Oxygen‐Mediated Reactions in Photopolymerizable Radical Thin Films: Application to Simultaneous Photocuring Under Air and Nanoparticle Formation

Titanium propoxide, titanium isopropoxide, and titanium (triethanolaminato) isopropoxide are proposed as high‐performance additives to overcome the oxygen inhibition effects in the free radical photopolymerization of a low‐viscosity monomer thin film, under air and upon a low‐intensity UV light activation. Indeed, when added to a Type I photoinitiator such as bis(2,4,6‐trimethylbenzoyl)‐phenylphosphine oxide (BAPO), noticeably higher conversions are achieved under air (48% vs. 30%). The in situ formation of Ti‐based nanoparticles is also observed. The photochemical properties of these types of Ti‐based compounds as well as their interaction with BAPO are investigated by steady‐state photolysis and electron spin resonance. Molecular orbital calculations give an interesting insight into the possible reactions. A chemical mechanism is also proposed.

     

Hidden Genetic Variation in LCA9‐Associated Congenital Blindness Explained by 5′UTR Mutations and Copy‐Number Variations of NMNAT1

Leber congenital amaurosis (LCA) is a severe autosomal‐recessive retinal dystrophy leading to congenital blindness. A recently identified LCA gene is NMNAT1, located in the LCA9 locus. Although most mutations in blindness genes are coding variations, there is accumulating evidence for hidden noncoding defects or structural variations (SVs). The starting point of this study was an LCA9‐associated consanguineous family in which no coding mutations were found in the LCA9 region. Exploring the untranslated regions of NMNAT1 revealed a novel homozygous 5′UTR variant, c.‐70A>T. Moreover, an adjacent 5′UTR variant, c.‐69C>T, was identified in a second consanguineous family displaying a similar phenotype. Both 5′UTR variants resulted in decreased NMNAT1 mRNA abundance in patients’ lymphocytes, and caused decreased luciferase activity in human retinal pigment epithelial RPE‐1 cells. Second, we unraveled pseudohomozygosity of a coding NMNAT1 mutation in two unrelated LCA patients by the identification of two distinct heterozygous partial NMNAT1 deletions. Molecular characterization of the breakpoint junctions revealed a complex Alu‐rich genomic architecture. Our study uncovered hidden genetic variation in NMNAT1‐associated LCA and emphasized a shift from coding to noncoding regulatory mutations and repeat‐mediated SVs in the molecular pathogenesis of heterogeneous recessive disorders such as hereditary blindness.     

Increase in Suicides Associated With Home Eviction and Foreclosure During the US Housing Crisis: Findings From 16 National Violent Death Reporting System States, 2005–2010

Objectives. We aimed to determine the frequency, characteristics, and precipitating circumstances of eviction- and foreclosure-related suicides during the US housing crisis, which resulted in historically high foreclosures and increased evictions beginning in 2006.Methods. We examined all eviction- and foreclosure-related suicides in the years 2005 to 2010 in 16 states in the National Violent Death Reporting System, a surveillance system for all violent deaths within participating states that abstracts information across multiple investigative sources (e.g., law enforcement, coroners, medical examiners).Results. We identified 929 eviction- or foreclosure-related suicides. Eviction- and foreclosure-related suicides doubled from 2005 to 2010 (n = 88 in 2005; n = 176 in 2010), mostly because of foreclosure-related suicides, which increased 253% from 2005 (n = 30) to 2010 (n = 106). Most suicides occurred before the actual housing loss (79%), and 37% of decedents experienced acute eviction or foreclosure crises within 2 weeks of the suicide.Conclusions. Housing loss is a significant crisis that can precipitate suicide. Prevention strategies include support for those projected to lose homes, intervention before move-out date, training financial professionals to recognize warning signs, and strengthening population-wide suicide prevention measures during economic crises.In 2010, 36 364 persons in the United States died by suicide (age-adjusted rate = 12.08 per 100 000 population), making it the second leading cause of death for US adults aged 25 to 34 years, and fourth for adults aged 35 to 54 years.1 Furthermore, the overall suicide rate in the United States has increased over the past decade,2 especially among adults aged 35 to 64 years.3 Suicide carries enormous costs to society, such as emotional trauma for friends and family members (including heightened risk of subsequently attempting suicide themselves), and medical and work loss costs estimated at $34.6 billion a year.Persons who engage in suicidal behavioral typically have multiple risk factors for suicide such as depression, substance abuse, or chronic or acute life stressors such as financial problems. In some instances, a precipitating event prompts an attempt in an already vulnerable person. Several studies of US and international economic cycles have found that suicides increase in step with adverse economic events.4,5 For example, a recent study examining the impact of austerity measures taken in England during the European financial crisis on unemployment and subsequent suicides attributed more than 1000 excess suicides to these economic conditions between 2008 and 2010.6 Another found that in Greece, one of the worst-hit economies in Europe, suicide mortality rates among men have increased by more than 22% since 2007.7 Similar trends were observed in several countries (e.g., Japan, Hong Kong, South Korea) following the Asian monetary crisis of 1997.8An analysis of US business cycles and suicide rates between 1928 and 2007 recently demonstrated that suicide rates in the United States have also generally increased and decreased along with economic conditions.4 The findings demonstrated that US suicide rates peaked during the Great Depression, and decreased during times of economic expansion and low unemployment. Working-age adults were most affected. One recent study attributed up to 25% of the US suicide rate increase seen over the past decade specifically to rising unemployment.9There were other important dimensions of the recent US economic downturn that may be associated with the observed increase in suicides. Beginning in late 2006, the US experienced a housing crisis characterized by historically high rates of home foreclosure10 and increased evictions.11 Media reports of suicides associated with eviction or foreclosure appeared in national news outlets during this time,12–14 although little information exists about the frequency or characteristics of these events. Although the full impact of the housing crisis on public health is not yet known, several studies have documented adverse effects associated with mortgage delinquency such as 2 or more times greater odds of major depression15,16 and 8 times greater odds of elevated depressive symptoms related to acute stress.17 In addition, a recent study found higher suicide rates in regions experiencing higher rates of foreclosure.18 These findings suggest that eviction or foreclosure may be related to elevated risk of suicide. However, to date, no study has described or directly investigated suicides associated with home eviction and foreclosure.We determined the frequency and circumstances of suicide deaths linked to eviction (i.e., renters evicted for financial reasons) and foreclosure (i.e., homeowners losing homes to foreclosure) in the years 2005 through 2010 with data from 16 states participating in the National Violent Death Reporting System (NVDRS). Within this sample, we also examined the extent to which eviction or foreclosure was perceived as a key stressor contributing to the decedent’s suicide versus acting in concert with other stressors. Furthermore, we calculated the frequency of eviction or foreclosure suicides relative to other suicides during this time period, and the percentage of all suicides associated with financial stressors that were eviction or foreclosure related.     

Clinical spectrum and short-term outcome of adult patients with purpura fulminans: a French multicenter retrospective cohort study

Purpose

Data on purpura fulminans (PF) in adult patients are scarce and mainly limited to meningococcal infections. Our aim has been to report the clinical features and outcomes of adult patients admitted in the intensive care unit (ICU) for an infectious PF, as well as the predictive factors for limb amputation and mortality.

Methods

A 17-year national multicenter retrospective cohort study in 55 ICUs in France from 2000 to 2016, including adult patients admitted for an infectious PF defined by a sudden and extensive purpura, together with the need for vasopressor support. Primary outcome variables included hospital mortality and amputation during the follow-up period (time between ICU admission and amputation, death or end of follow-up).

Results

Among the 306 included patients, 126 (41.2%; 95% CI 35.6–46.9) died and 180 (58.8%; 95% CI 53.3–64.3) survived during the follow-up period [13 (3–24) days], including 51/180 patients (28.3%, 95% CI 21.9–35.5) who eventually required limb amputations, with a median number of 3 (1–4) limbs amputated. The two predominantly identified microorganisms were Neisseria meningitidis (63.7%) and Streptococcus pneumoniae (21.9%). By multivariable Cox model, SAPS II [hazard-ratio (HR)?=?1.03 (1.02–1.04); p?<?0.001], lower leucocytes [HR 0.83 (0.69–0.99); p?=?0.034] and platelet counts [HR 0.77 (0.60–0.91); p?=?0.007], and arterial blood lactate levels [HR 2.71 (1.68–4.38); p?<?0.001] were independently associated with hospital death, while a neck stiffness [HR?0.51 (0.28–0.92); p?=?0.026] was a protective factor. Infection with Streptococcus pneumoniae [sub-hazard ratio 1.89 (1.06–3.38); p?=?0.032], together with arterial lactate levels and ICU admission temperature, was independently associated with amputation by a competing risks analysis.

Conclusion

Purpura fulminans carries a high mortality and morbidity. Pneumococcal PF leads to a higher risk of amputation.

Trials registration

NCT03216577.

     

Anti-Coxsackie antibodies and congestive cardiomyopathies

During a 4-years period 122 patients admitted to the cardiologic hospital in Lille presented a significative positivity of serological reaction against Coxsackievirus B. Among these patients 19 suffered from acute pericarditis, 4 from cardiac arrhythmias, 3 from Bornholm syndrome and 14 from apparently primary congestive cardiomyopathy. In most of these 14 patients representing 18.4% of congestive cardiomyopathies investigated at the same time, hemodynamic studies and heart scanning with radioactive gallium were performed. 7 of these patients had a chronic (group A) and 7 an acute evolution (group B). In group A the scans were negative 4 times out of 5, whereas in group B they were positive in 5 out of 5 examinations. The control group including 3247 patients coming from the Institut Pasteur exhibited serological positivity in 4.6% of cases. Comparison of this group with that of cardiomyopathies shows a significant difference (p less than 0.001). The authors draw the attention to the frequency of positive serodiagnosis in congestive cardiomyopathy and stress the importance of gallium scintiscanning.     

Mobile right heart thrombus with minimal pulmonary embolism. A case report

The generalisation of the use of transthoracic echocardiography in the investigation of pulmonary embolism leads to the diagnosis of mobile right heart thrombus in about 5% of cases. A review of the literature shows that this association is mainly observed in clinically severe pulmonary embolism. The presence of a mobile right heart thrombus is associated with a poor prognosis and emergency treatment is based on thrombolytic therapy or surgical embolectomy. In minimal or infraclinical pulmonary embolism, the finding of a mobile right heart thrombus is rare and there is no consensus about its treatment. The authors report the case of a 61 year old man admitted to hospital for bilateral deep vein thrombosis with no symptoms of pulmonary embolism in whom investigations revealed a mobile right heart thrombus with minimal pulmonary embolism. The outcome was favourable with progressive resolution of the right heart thrombus with oral anticoagulation after three weeks of heparin therapy.