Notes

Rosiglitazone account activation involving PPARγ-dependent signaling is neuroprotective inside mutant huntingtin expressing tissues.
Women are under-represented in many mid-career infectious diseases research fellowships, including a TDR fellowship for low- and middle-income country (LMIC) researchers. TDR solicited creative ideas as part of a challenge contest to increase the number of women fellowship applicants. The purpose of this study is to examine themes from submitted ideas and the impact of implementing the top three ideas on the number of women applicants.

We solicited ideas for modifying the TDR fellowship using a crowdsourcing challenge. Then we used a mixed methods approach to evaluate texts submitted in response to the challenge. The qualitative analysis identified themes from eligible submissions. The quantitative analysis examined the mean score (1-10 scale) assigned to submitted ideas and also the number of eligible women applicants before (2014-7) and after (2018) implementing the top three ideas.

We received 311 ideas on improving women's participation in this fellowship from 63 countries. Among all ideas, 282 (91% likely contributed to a greater number of women applicants to this mid-career fellowship. Further ways of enhancing women's participation in global health training are needed.
Despite reaching Millennium Development Goal (MDG) 3, the maternal mortality rate (MMR) is still high in Rwanda. Most deaths occur after transfer of patients with obstetric complications from district hospitals (DHs) to referral hospitals; timely detection and management may improve these outcomes. The RI and MEOWS tool has been designed to predict morbidity and decrease delay of transfer. Our study aimed 1) to determine if the use of the RI and MEOWS tool is feasible in DHs in Rwanda and 2) to determine the role of the RI and MEOWS tool in predicting morbidity.

A cross-sectional study enrolled parturient admitted to 4 district hospitals during the study period from April to July 2019. Data was collected on completeness rate (feasibility) to RI and MEOWS tool, and prediction of morbidity (hemorrhage, infection, and pre-eclampsia).

Among 478 RI and MEOWS forms used, 75.9% forms were fully completed suggesting adequate feasibility. In addition, the RI and MEOWS tool showed to predict morbidity with a sensitivity of 28.9%, a specificity of 93.5%, a PPV of 36.1%, a NPV of 91.1%, an accuracy of 86.2%, and a relative risk of 4.1 (95% Confidential Interval (CI), 2.4-7.1). When asked about challenges faced during use of the RI and MEOWS tool, most of the respondents reported that the tool was long, the staff to patient ratio was low, the English language was a barrier, and the printed forms were sometimes unavailable.

The RI and MEOWS tool is a feasible in the DHs of Rwanda. In addition, having moderate or high scores on the RI and MEOWS tool predict morbidity. After consideration of local context, this tool can be considered for scale up to other DHs in Rwanda or other low resources settings.

This is not a clinical trial rather a quality improvement project. It will be registered retrospectively.
This is not a clinical trial rather a quality improvement project. It will be registered retrospectively.
A healthy 25-year-old woman developed COVID-19 disease with clinical characteristics resembling Multisystem Inflammatory Syndrome in Children (MIS-C), a rare form of COVID-19 described primarily in children under 21 years of age.

The patient presented with 1 week of weakness, dyspnea, and low-grade fevers, followed by mild cough, sore throat, vomiting, diarrhea, and lymph node swelling. She was otherwise healthy, with no prior medical history. Her hospital course was notable for profound acute kidney injury, leukocytosis, hypotension, and cardiac dysfunction requiring ICU admission and vasopressor support. MIS-C-like illness secondary to COVID-19 was suspected due to physical exam findings of conjunctivitis, mucositis, and shock. She improved following IVIG, aspirin, and supportive care, and was discharged on hospital day 5.

MIS-C-like illness should be considered in adults presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG and aspirin in this patient population.
MIS-C-like illness should be considered in adults presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG and aspirin in this patient population.
Minimal change disease (MCD) is one of the causes of idiopathic nephrotic syndrome in adults. The pathogenesis of proteinuria in MCD has not been fully understood. Recently, it has been reported that the receptor activator of nuclear factor-kappa B (RANK)/RANK ligand (RANKL) may contribute to the podocyte biology in kidney diseases. Denosumab is a human anti-RANKL monoclonal antibody used to treat osteoporosis. Selleckchem mTOR inhibitor Here we report a case of MCD after denosumab administration.

A 59-year-old male without any episodes of proteinuria was given denosumab to treat osteoporosis. Two weeks after its administration, he noticed a foamy urine and bilateral pretibial edema. Laboratory tests revealed that he had severe proteinuria (15g/g Cr), hypoproteinemia (4.0g/dL), and hypoalbuminemia (1.5g/dL). Based on the results, he was diagnosed with nephrotic syndrome. The proteinuria selectivity index was 0.05, indicating selective proteinuria. Renal biopsy showed minor glomerular abnormality with less tubulointerstitial damage, and electron microscopy showed extensive foot process effacement, indicating MCD. With all these results, glucocorticoid therapy of 50mg/day prednisolone was started. After 4weeks of treatment, the urinary protein level remains high (3.1g/g Cr). Prednisolone therapy was continued, and the levels of proteinuria decreased gradually to the range of partial remission (1.2g/g Cr) with another 7weeks of prednisolone treatment, but complete remission was not achieved.

This might be a case wherein RANKL inhibition is associated with the pathogenesis of MCD. Further studies will be needed to elucidate the causal relationship of RANK-RANKL signaling to the pathogenesis of MCD.
This might be a case wherein RANKL inhibition is associated with the pathogenesis of MCD. Further studies will be needed to elucidate the causal relationship of RANK-RANKL signaling to the pathogenesis of MCD.
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