The “oral” history of COVID-19: Primary infection,salivary transmission,and post-acute implications

Severe acute respiratorysyndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, has led to more than 3.25 million recorded deaths worldwide as of May 2021. COVID-19 is known to be clinically heterogeneous, and whether the reported oral signs and symptoms in COVID-19 are related to the direct infection of oral tissues has remained unknown. Here, we review and summarize the evidence for the primary infection of the glands, oral mucosae, and saliva by SARS-CoV-2. Not only were the entry factors for SARS-CoV-2 found in all oral tissues, but these were also sites of SARS-CoV-2 infection and replication. Furthermore, saliva from asymptomatic individuals contained free virus and SARS-CoV-2-infected oral epithelial cells, both of which were found to transmit the virus. Collectively, these studies support an active role of the oral cavity in the spread and transmission of SARS-CoV-2 infection. In addition to maintaining the appropriate use of personal protective equipment and regimens to limit microbial spread via aerosol or droplet generation, the dental community will also be involved in co-managing COVID-19 “long haulers”—now termed Post-Acute COVID-19 Syndrome. Consequently, we propose that, as SARS-CoV-2 continues to spread and as new clinical challenges related to COVID-19 are documented, oral symptoms should be included in diagnostic and prognostic classifications as well as plans for multidisciplinary care.     

Hyperspectral imaging and spectral unmixing for improving whole-body fluorescence cryo-imaging

Whole-animal fluorescence cryo-imaging is an established technique that enables visualization of the biodistribution of labeled drugs, contrast agents, functional reporters and cells in detail. However, many tissues produce endogenous autofluorescence, which can confound interpretation of the cryo-imaging volumes. We describe a multi-channel, hyperspectral cryo-imaging system that acquires densely-sampled spectra at each pixel in the 3-dimensional stack. This information enables the use of spectral unmixing to isolate the fluorophore-of-interest from autofluorescence and/or other fluorescent reporters. In phantoms and a glioma xenograft model, we show that the approach improves detection limits, increases tumor contrast, and can dramatically alter image interpretation.     

Arm Position During Ambulatory Blood Pressure Monitoring: A Review of the Evidence and Clinical Guidelines

Ambulatory blood pressure monitoring (ABPM) offers advantages over clinic blood pressure measurement. Supporting the arm at the level of the right atrium has long been standard in clinic blood pressure measurement. In contrast, there is no consensus regarding arm position in the guidelines addressing ABPM. Research studies have used a variety of arm positions during ABPM. Discussed in this review are the merits of ABPM and a review of the several arm positions recommended in ABPM guidelines, suggested by cuff manufacturers, and used in research studies. To address this lack of standardization, a rationale for a clinically reasonable arm position during ABPM is offered. Specifically, the authors recommend advising the patient to keep the arm still and relaxed straight down at the side of the body when the cuff is going to inflate, when safe to do so.     

Azygous continuation of the inferior vena cava with anomalous hepatic vein drainage

A 62-year-old woman was referred for evaluation of hypoxemia. Despite a resting SaO(2) of 89%, she was otherwise asymptomatic. The arterial blood gas on room air demonstrated a pO(2) of 58 mm Hg. Two shunt studies confirmed a shunt fraction of 25%. Echocardiogram with agitated saline demonstrated bubbles in the left atrium. Nuclear perfusion study revealed no uptake over the kidneys or brain. Computed tomography of the chest and cardiac magnetic resonance imaging confirmed the presence of a large shunt (azygous continuation of the inferior vena cava [ACIVC] with anomalous hepatic vein drainage). A large shunt fraction dictates either significant cardiac septal defect or an extracardiac shunt. The finding of ACIVC should prompt consideration of other vascular or cardiac abnormalities. The true incidence of isolated ACIVC is not known, as limited ACIVC may remain asymptomatic. However, the spectrum of vascular, cardiac and somatic abnormalities that may accompany ACIVC is quite varied.     

HIV-related cognitive impairment shows bi-directional association with dopamine receptor DRD1 and DRD2 polymorphisms in substance-dependent and substance-independent populations

It has been postulated that drugs of abuse act synergistically with HIV, leading to increased neurotoxicity and neurocognitive impairment. The CNS impacts of HIV and drug use converge on the mesocorticolimbic dopamine (DA) system, which contains two main receptor subtypes: dopamine receptors 1 (DRD1) and 2 (DRD2). DRD1 and DRD2 have been linked to substance dependence; whether they predict HIV-associated neurocognitive disorder (HAND) is unclear. Using an advanced-stage HIV+ population, we sought to determine if drug dependence impacts the contribution of DA receptor polymorphisms on neurocognition. We observed that both DRD1 and DRD2 polymorphisms were associated with opiate and cocaine dependence (P?<?0.05) in Caucasian subjects, but not African-American individuals. Using linear regression analysis, we examined the polymorphisms for associations with neuropsychological performance in global and cognitive domain T-scores (Motor, Processing Speed, Verbal Fluency, Learning, Memory, Executive Functioning, Working Memory) while controlling for opiate and cocaine dependency. In the Motor domain, we observed an association for two DRD2 polymorphisms (P?<?0.05) in Caucasian subjects. The effects differed for substance dependence groups as the direction of the correlations with DRD2 were opposite to what was seen in subjects without these dependencies. In African-American subjects, associations were observed in nearly every domain, and again, the direction of the correlation differed between substance-dependent and substance-independent groups. We conclude that studies to examine genetic risk for HAND must carefully account for substance dependence patterns when assaying dopaminergic systems, as the neurobiological substrates of cognition in HIV populations may vary with tonic alterations secondary to chronic substance exposures.     

Profiles of ethnic-racial socialization from family,school, neighborhood,and the Internet: Relations to adolescent outcomes

Given that ecological models of development highlight the interacting influences of multiple environments, further research is needed that explores ethnic-racial socialization from multiple contexts. The current study explores how families, schools, neighborhoods, and the Internet jointly impact academic outcomes, critical consciousness, and psychological well-being in adolescents, both through socialization messages and experiences with racial discrimination. The research questions were: (a) What profiles of multiple contexts of socialization exist? and (b) How are the different profiles associated with academic outcomes, critical consciousness, and psychological well-being? The sample consisted of 1,084 U.S. adolescents aged 13–17 (M = 14.99, SD = 1.37; 49% girls) from four ethnic-racial groups: 25.6% Asian American, 26.3% Black/African American, 25.3% Latinx, and 22.9% White. The participants completed online surveys of socialization and discrimination from four contexts and three types of outcomes: academic outcomes, critical consciousness, and well-being. A latent profile analysis revealed three profiles: Average, High Discrimination, and Positive School. The Positive School class had the most positive academic outcomes and well-being. The High Discrimination class reported the highest critical consciousness. Their academic outcomes and well-being were similar to the Average group. The findings support complexity in perceptions of socialization from different contexts and the associations of socialization with youth outcomes.