Howardchappell3185

ole of Hajj in facilitating transmission of pneumococci and inform vaccination policy. © International Society of Travel Medicine 2020. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail journals.permissions@oup.com.Despite their essential role in chromosome segregation in most eukaryotes, centromeric histones (CenH3s) evolve rapidly and are subject to gene turnover. We previously identified four instances of gene duplication and specialization of Cid, which encodes for the centromeric histone in Drosophila. We hypothesized that retention of specialized Cid paralogs could be selectively advantageous to resolve the intralocus conflict that occurs on essential genes like Cid, which are subject to divergent selective pressures to perform multiple functions. We proposed that intralocus conflict could be a widespread phenomenon that drives evolutionary innovation in centromeric proteins. If this were the case, we might expect to find other instances of co-retention and specialization of centromeric proteins during animal evolution. Consistent with this hypothesis, we find that most mosquito species encode two CenH3 (mosqCid) genes, mosqCid1 and mosqCid2, which have been co-retained for over 150 million years. In addition, Aedes species encode a third mosqCid3 gene, which arose from an independent gene duplication of mosqCid1. Like Drosophila Cid paralogs, mosqCid paralogs evolve under different selective constraints and show tissue-specific expression patterns. Analysis of mosqCid N-terminal protein motifs further supports the model that mosqCid paralogs have functionally diverged. Extending our survey to other centromeric proteins, we find that all Anopheles mosquitos encode two CAL1 paralogs, which are the chaperones that deposit CenH3 proteins at centromeres in Diptera, but a single CENP-C paralog. The ancient co-retention of paralogs of centromeric proteins adds further support to the hypothesis that intralocus conflict can drive their co-retention and functional specialization. © The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.OBJECTIVES Vision complications and a stroke represent severe cranial ischaemic complications (sCIC) associated with increased morbidity and mortality in GCA. We aimed to determine the risk factors for sCIC in GCA. METHODS We analysed the medical records of prospectively enrolled GCA patients diagnosed between September 2011 and August 2019, and compared the clinical and laboratory characteristics of patients with and without sCIC defined as either severe vision complications (diplopia, transient vision loss, permanent partial vision field/acuity defect and permanent visual loss) or stroke. RESULTS During the 96-month observation period, we identified 295 new GCA patients [65.4% female, median (interquartile range) age 74.7 (67.3-80.0) years]. Sixty-one (20.7%) patients developed sCIC (52 isolated severe vision complications, 5 isolated ischaemic strokes and 4 patients with both complications). In a multivariable logistic regression model jaw claudication [odds ratio (OR) 3.43 (95% CI 1.84, 6.42), P  less then  0.001], smoking [OR 1.92 (95% CI 1.01, 3.65), P = 0.046] and increasing age [OR 1.08 (95% CI 1.04, 1.13), P  less then  0.001] were significantly associated with sCIC. Higher CRP [OR 0.99 (0.99-1.00), P = 0.011] decreased the risk of sCIC. When considered separately, the odds for severe vision complications increased with age and jaw claudication, and decreased with polymyalgia rheumatica, constitutional symptoms and higher CRP. Atrial fibrillation emerged as the sole independent predictor of ischaemic stroke. CONCLUSION Increasing age, jaw claudication and smoking predicted sCIC, while higher CRP decreased the risk of sCIC in our GCA cohort. © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email journals.permissions@oup.com.BACKGROUND It has been long hypothesized that emotional factors and depression may play role in the development of cardiovascular diseases. AIM The aim of this study was to examine the association between depression, arterial stiffness and atheromatic burden in carotid arteries. DESIGN AND METHODS Corinthia study is a cross-sectional epidemiological study conducted in subjects aged 40-99years, inhabitants of the homonym region of Greece. Intima media thickness (IMT) was measured in the left and right common carotid artery, carotid bulb and internal carotid artery. The average of the measurements (mean IMT) and the maximum IMT were determined as the representative value of carotid atherosclerosis burden. Pulse wave velocity (PWV) was used to evaluate arterial stiffness. The Zung self-rating depression scale was used to evaluate depressive symptoms in subjects 65 years), maximum IMT was significantly increased in subjects with depression compared to those without (1.57±0.97mm vs. 1.74±1.05mm, p = 0.04). Similarly, the prevalence of atheromatic plaques was higher in subjects with depression (46% vs. 34%, p = 0.005). In the younger subgroup ( less then 65years) there was no difference in mean and maximum IMT. PWV was found higher in the presence of depression (8.35±2.36m/sec vs. 7.88±1.77m/sec, p = 0.007). No differences emerged for the rest of the variables assessed in the individual subgroups. CONCLUSIONS There is an age-dependent association between depression, arterial stiffness and carotid atheromatic burden highlighting the interplay between cardiovascular diseases and emotional status. © The Author(s) 2020. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email journals.permissions@oup.com.Importance A shift in the setting of care delivery for children with a new diagnosis of type 1 diabetes led to a reorganization of treatment. ubiquitin-Proteasome system Objective To determine whether a new diagnosis of pediatric diabetes can be successfully managed in a day hospital model. Design, Setting, and Participants This quality improvement study used retrospectively collected data on pediatric patients with a new diagnosis of diabetes who completed an inpatient program for education and insulin titration prospectively compared with patients completing a diabetes day hospital program. Baseline data were collected over 12 months (January-December 2015) and intervention data collected over 14 months (March 2016-May 2017). The study was conducted at a single institution and judged as a nonhuman participant project. The referral local base included a 100-mile radius. Patient inclusion was a new diagnosis of diabetes, age 5 years or older, and no biochemical evidence of diabetic ketoacidosis. Ninety-six patients completed the day hospital program and 192 patients completed an inpatient program.