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1.
Cell ; 2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39255801

RESUMEN

The family of Ras-like GTPases consists of over 150 different members, regulated by an even larger number of guanine exchange factors (GEFs) and GTPase-activating proteins (GAPs) that comprise cellular switch networks that govern cell motility, growth, polarity, protein trafficking, and gene expression. Efforts to develop selective small molecule probes and drugs for these proteins have been hampered by the high affinity of guanosine triphosphate (GTP) and lack of allosteric regulatory sites. This paradigm was recently challenged by the discovery of a cryptic allosteric pocket in the switch II region of K-Ras. Here, we ask whether similar pockets are present in GTPases beyond K-Ras. We systematically surveyed members of the Ras, Rho, and Rab family of GTPases and found that many GTPases exhibit targetable switch II pockets. Notable differences in the composition and conservation of key residues offer potential for the development of optimized inhibitors for many members of this previously undruggable family.

2.
Mil Med ; 2024 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-39240695

RESUMEN

INTRODUCTION: After an anterior cruciate ligament (ACL) injury, service members often undergo ACL reconstruction (ACLR) to restore knee stability, which is critical for performing physically demanding and unconventional military-specific tasks. Despite advancements in surgical techniques and rehabilitation protocols, a large portion of service members will not fully return to duty (RTD) post-ACLR and will receive a permanent profile restriction (PP) or undergo a medical evaluation board (MEB). The timing of ACLR is a modifiable factor that can potentially impact RTD and remains underexplored in this population. This study aimed to assess the relationship between the timing of ACLR and its impact on RTD and meniscal procedures performed at index ACLR. METHODS: This retrospective observational study was conducted among active duty military personnel who underwent primary ACLR at Madigan Army Medical Center between October 1, 2016, and December 31, 2022. The primary outcome was the number of RTD, PP, or MEB outcomes. Secondary outcomes included the incidence and type of meniscal procedure performed at index ACLR. Kruskal-Wallis analyses were employed to assess the relationships between time to ACLR and RTD, as well as the incidence and type of meniscal procedure performed. After separating time to ACLR into four distinct time-based groups (0-3 months, 3-6 months, 6-12 months, and >12 months), a chi-squared test with post hoc analysis via Dunn's test with Bonferroni correction was conducted to identify a time interval from injury to ACLR that impacted RTD. RESULTS: Initial analysis to assess the relationship between time to ACLR and outcome (RTD, PP, or MEB) were significant (P = .02). Subsequent analyses performed between 4 distinct time-based groups (0-3 months, 3-6 months, 6-12 months, and >12 months) were also significant (P = .03). Pairwise comparisons revealed an 80% rate of RTD in the 0-3 month group compared to a 53% RTD rate in 3-6 month group (P = .006). However, comparisons between the 3-6 month and 6-12 month group (P = .68) and between the 6-12 month and greater than 12 month groups were not significant (P = .80).Additionally, time to ACLR significantly differed between service members who did not undergo any concurrent meniscal procedure to those who had a meniscal debridement (P = .002), and to those who underwent meniscal repair (P = .02). There was no significant difference in time to ACLR between those who underwent debridement versus repair (P = .22). Patients without any meniscal procedure had an average surgery time of 175 days, compared to 240 days for those undergoing meniscal repair and 295 days for those with meniscal debridement. CONCLUSION: The findings from this novel study suggest that ACLR within 3 months after injury can improve the likelihood of RTD without limitations. The timing of ACLR can also impact the incidence and type of meniscal procedures, as patients who did not undergo any concomitant meniscal procedures underwent ACLR within 6 months after injury. This study offers valuable insight into the importance of earlier ACLR among service members to improve RTD rates and decrease additional concomitant meniscal procedures.

3.
Nat Commun ; 15(1): 5589, 2024 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-38961063

RESUMEN

As the new SARS-CoV-2 Omicron variants and subvariants emerge, there is an urgency to develop intranasal, broadly protective vaccines. Here, we developed highly efficacious, intranasal trivalent SARS-CoV-2 vaccine candidates (TVC) based on three components of the MMR vaccine: measles virus (MeV), mumps virus (MuV) Jeryl Lynn (JL1) strain, and MuV JL2 strain. Specifically, MeV, MuV-JL1, and MuV-JL2 vaccine strains, each expressing prefusion spike (preS-6P) from a different variant of concern (VoC), were combined to generate TVCs. Intranasal immunization of IFNAR1-/- mice and female hamsters with TVCs generated high levels of S-specific serum IgG antibodies, broad neutralizing antibodies, and mucosal IgA antibodies as well as tissue-resident memory T cells in the lungs. The immunized female hamsters were protected from challenge with SARS-CoV-2 original WA1, B.1.617.2, and B.1.1.529 strains. The preexisting MeV and MuV immunity does not significantly interfere with the efficacy of TVC. Thus, the trivalent platform is a promising next-generation SARS-CoV-2 vaccine candidate.


Asunto(s)
Administración Intranasal , Anticuerpos Neutralizantes , Anticuerpos Antivirales , Vacunas contra la COVID-19 , COVID-19 , SARS-CoV-2 , Glicoproteína de la Espiga del Coronavirus , Animales , Glicoproteína de la Espiga del Coronavirus/inmunología , Glicoproteína de la Espiga del Coronavirus/genética , Femenino , SARS-CoV-2/inmunología , SARS-CoV-2/genética , COVID-19/prevención & control , COVID-19/inmunología , COVID-19/virología , Anticuerpos Antivirales/inmunología , Anticuerpos Antivirales/sangre , Anticuerpos Neutralizantes/inmunología , Anticuerpos Neutralizantes/sangre , Ratones , Vacunas contra la COVID-19/inmunología , Vacunas contra la COVID-19/administración & dosificación , Cricetinae , Humanos , Vacuna contra el Sarampión-Parotiditis-Rubéola/inmunología , Vacuna contra el Sarampión-Parotiditis-Rubéola/administración & dosificación , Virus del Sarampión/inmunología , Virus del Sarampión/genética , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Virus de la Parotiditis/inmunología , Virus de la Parotiditis/genética , Ratones Noqueados , Mesocricetus , Inmunoglobulina A/inmunología , Inmunoglobulina A/sangre
4.
HeartRhythm Case Rep ; 10(6): 442-444, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38983884
5.
Chem Mater ; 36(11): 5796-5804, 2024 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-38883430

RESUMEN

We use a combination of X-ray pair distribution function (PDF) measurements, lattice dynamical calculations, and ab initio density functional theory (DFT) calculations to study the local structure and dynamics in various MPt(CN)6 Prussian blue analogues. In order to link directly the local distortions captured by the PDF with the lattice dynamics of this family, we develop and apply a new "interaction-space" PDF refinement approach. This approach yields effective harmonic force constants, from which the (experiment-derived) low-energy phonon dispersion relations can be approximated. Calculation of the corresponding Grüneisen parameters allows us to identify the key modes responsible for negative thermal expansion (NTE) as arising from correlated tilts of coordination octahedra. We compare our results against the phonon dispersion relations determined using DFT calculations, which identify the same NTE mechanism.

6.
Ethics Hum Res ; 46(4): 47-51, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38944881

RESUMEN

In an earlier essay, I advocated that translational bioethics uses the public's values, determined through social science, in its analysis of translational science technologies. It may be unclear what those values might be, and whether such a translational ethics would necessarily conclude that cutting edge technologies should not be developed. In this essay, I show the public's values relevant to human brain organoids and argue that a translational bioethics analysis using these values would support continued organoid research.


Asunto(s)
Encéfalo , Organoides , Investigación Biomédica Traslacional , Humanos , Investigación Biomédica Traslacional/ética , Toma de Decisiones/ética , Bioética , Valores Sociales
7.
Circulation ; 149(24): e1313-e1410, 2024 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-38743805

RESUMEN

AIM: The "2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease" provides recommendations to guide clinicians in the treatment of patients with lower extremity peripheral artery disease across its multiple clinical presentation subsets (ie, asymptomatic, chronic symptomatic, chronic limb-threatening ischemia, and acute limb ischemia). METHODS: A comprehensive literature search was conducted from October 2020 to June 2022, encompassing studies, reviews, and other evidence conducted on human subjects that was published in English from PubMed, EMBASE, the Cochrane Library, CINHL Complete, and other selected databases relevant to this guideline. Additional relevant studies, published through May 2023 during the peer review process, were also considered by the writing committee and added to the evidence tables where appropriate. STRUCTURE: Recommendations from the "2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease" have been updated with new evidence to guide clinicians. In addition, new recommendations addressing comprehensive care for patients with peripheral artery disease have been developed.


Asunto(s)
American Heart Association , Extremidad Inferior , Enfermedad Arterial Periférica , Humanos , Enfermedad Arterial Periférica/terapia , Enfermedad Arterial Periférica/diagnóstico , Extremidad Inferior/irrigación sanguínea , Estados Unidos , Cardiología/normas
8.
J Am Coll Cardiol ; 83(24): 2497-2604, 2024 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-38752899

RESUMEN

AIM: The "2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS Guideline for the Management of Lower Extremity Peripheral Artery Disease" provides recommendations to guide clinicians in the treatment of patients with lower extremity peripheral artery disease across its multiple clinical presentation subsets (ie, asymptomatic, chronic symptomatic, chronic limb-threatening ischemia, and acute limb ischemia). METHODS: A comprehensive literature search was conducted from October 2020 to June 2022, encompassing studies, reviews, and other evidence conducted on human subjects that was published in English from PubMed, EMBASE, the Cochrane Library, CINHL Complete, and other selected databases relevant to this guideline. Additional relevant studies, published through May 2023 during the peer review process, were also considered by the writing committee and added to the evidence tables where appropriate. STRUCTURE: Recommendations from the "2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease" have been updated with new evidence to guide clinicians. In addition, new recommendations addressing comprehensive care for patients with peripheral artery disease have been developed.


Asunto(s)
American Heart Association , Extremidad Inferior , Enfermedad Arterial Periférica , Humanos , Enfermedad Arterial Periférica/terapia , Enfermedad Arterial Periférica/diagnóstico , Extremidad Inferior/irrigación sanguínea , Estados Unidos , Cardiología/normas , Sociedades Médicas/normas
9.
Public Underst Sci ; : 9636625241229196, 2024 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-38469856

RESUMEN

Gene drive could be a powerful tool for addressing problems of conservation, agriculture, and human health caused by insect and animal pests but is likely to be controversial as it involves the release of genetically modified organisms. This study examined the social determinants of opinion of gene drive. We asked a representative sample of the U.S. public to respond to a description of a hypothetical application of a gene-drive mosquito to the problem of malaria and examined the relationship of these responses with demographic and ideological beliefs. We found strong general approval for the use of gene-drive mosquitos to address malaria, coinciding with the concern about a possible environmental impact of modified mosquitos and that gene drives represent "too much power over nature." Among the determinants we measured, respondent acceptance of scientism and trust that scientists are advancing the public's interest were the greatest predictors of views of gene drive.

11.
Am J Bioeth ; 24(1): 49-51, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38236859
12.
Plant Cell Environ ; 47(5): 1701-1715, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38294051

RESUMEN

Leaf gas exchange measurements are an important tool for inferring a plant's photosynthetic biochemistry. In most cases, the responses of photosynthetic CO2 assimilation to variable intercellular CO2 concentrations (A/Ci response curves) are used to model the maximum (potential) rate of carboxylation by ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco, Vcmax) and the rate of photosynthetic electron transport at a given incident photosynthetically active radiation flux density (PAR; JPAR). The standard Farquhar-von Caemmerer-Berry model is often used with default parameters of Rubisco kinetic values and mesophyll conductance to CO2 (gm) derived from tobacco that may be inapplicable across species. To study the significance of using such parameters for other species, here we measured the temperature responses of key in vitro Rubisco catalytic properties and gm in cotton (Gossypium hirsutum cv. Sicot 71) and derived Vcmax and J2000 (JPAR at 2000 µmol m-2 s-1 PAR) from cotton A/Ci curves incrementally measured at 15°C-40°C using cotton and other species-specific sets of input parameters with our new automated fitting R package 'OptiFitACi'. Notably, parameterisation by a set of tobacco parameters produced unrealistic J2000:Vcmax ratio of <1 at 25°C, two- to three-fold higher estimates of Vcmax above 15°C, up to 2.3-fold higher estimates of J2000 and more variable estimates of Vcmax and J2000, for our cotton data compared to model parameterisation with cotton-derived values. We determined that errors arise when using a gm,25 of 2.3 mol m-2 s-1 MPa-1 or less and Rubisco CO2-affinities in 21% O2 (KC 21%O2) at 25°C outside the range of 46-63 Pa to model A/Ci responses in cotton. We show how the A/Ci modelling capabilities of 'OptiFitACi' serves as a robust, user-friendly, and flexible extension of 'plantecophys' by providing simplified temperature-sensitivity and species-specificity parameterisation capabilities to reduce variability when modelling Vcmax and J2000.


Asunto(s)
Gossypium , Ribulosa-Bifosfato Carboxilasa , Gossypium/metabolismo , Ribulosa-Bifosfato Carboxilasa/metabolismo , Dióxido de Carbono , Temperatura , Fotosíntesis/fisiología , Hojas de la Planta/metabolismo
13.
Health Promot J Austr ; 35(1): 225-234, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36961054

RESUMEN

ISSUE ADDRESSED: Aboriginal and Torres Strait Islander child ear health is complex and multiple. We examined relationships between parent-reported sociodemographic, child health, health service access factors and ear symptoms among Aboriginal and Torres Strait Islander children aged 3 to 7 years. METHODS: The Longitudinal Study of Indigenous Children is a large child cohort study with annual parent-reported data collection. Generalised linear mixed model analyses examined Wave 1 (1309 children 0-5 years; 2008) predictors of being free of parent-reported ear symptoms in both Waves 2 and 3. RESULTS: A total of 1030 (78.7%) had no reported ear symptoms in either Wave 2 or 3. In the fully adjusted model, children who had been hospitalised in the past year (aOR = 2.16; 95% CI 1.19-3.93) and those with no ear symptoms (aOR = 2.94; 95% CI, 1.59-5.46) at Wave 1 had higher odds of no ear symptoms in both the subsequent waves. There were also relationships between parent main source of income-government pension or allowance as well as parents who reported no history of their own ear symptoms and higher odds of no ear symptoms in Waves 2 and 3 after partial adjustment for sociodemographic factors. CONCLUSION: These findings suggest relationships between different sociodemographic and health factors and parent-reported ear symptoms among Aboriginal and Torres Strait Islander children that warrant further investigation. So what? Children with parent-reported ear symptoms during the early years need holistic support to prevent future ear symptoms that impact health, social and educational life trajectories.


Asunto(s)
Aborigenas Australianos e Isleños del Estrecho de Torres , Enfermedades del Oído , Servicios de Salud del Indígena , Niño , Humanos , Estudios de Cohortes , Recolección de Datos , Estudios Longitudinales , Padres , Enfermedades del Oído/epidemiología
15.
Artículo en Inglés | MEDLINE | ID: mdl-37942837

RESUMEN

BACKGROUND: There is a need for causally stronger research on the association between child mental health and school exclusion and truancy. This study examines school exclusion and truancy in relation to both conduct and emotional problems and considers these problems both as predictors and as outcomes of school exclusion and truancy. METHOD: The sample included 15,236 individuals from the Millennium Cohort Study, a UK longitudinal birth cohort study. Conduct and emotional problems were assessed from childhood to adolescence (age 7, 11, 14 and 17 years), and reports of school exclusion and truancy were collected at age 11 and 14. Fixed effect analyses were used. RESULTS: Increases in conduct problems and emotional symptoms were associated with subsequent exclusion (OR 1.22, [95% CI 1.08-1.37] and OR 1.16, [1.05-1.29], respectively). Emotional symptoms, but not conduct problems, predicted truancy (OR 1.17, [1.07-1.29]). These estimates were similar for males and females. Exclusion was associated with an increase in conduct problems at age 14 (0.50, [0.30-0.69]), and for males, it was associated with an increase in emotional symptoms both at age 14 (0.39, [0.12-0.65]) and 17 (0.43, [0.14-0.72]). Truancy was associated with an increase in conduct problems at age 14 (0.41, [0.28-0.55]), and for females also at age 17 (0.22, [0.03-0.42]), and it was associated with increased emotional symptoms at age 14 (0.43, [0.25-0.62]) and 17 (0.44, [0.21-0.66]), which was similar for males and females. CONCLUSION: Results indicate a bidirectional association between emotional symptoms and school exclusion and truancy, as an increase in these symptoms was associated with later truancy and exclusion, and emotional symptoms increased following both school events. For conduct problems, the association was bidirectional for school exclusion, but unidirectional for truancy as these symptoms did not lead to truancy, but an increase in conduct problems was observed after both exclusion and truancy.

16.
J Immunol ; 211(10): 1459-1467, 2023 11 15.
Artículo en Inglés | MEDLINE | ID: mdl-37931210

RESUMEN

The impacts of the COVID-19 pandemic led to the development of several effective SARS-CoV-2 vaccines. However, waning vaccine efficacy as well as the antigenic drift of SARS-CoV-2 variants has diminished vaccine efficacy against SARS-CoV-2 infection and may threaten public health. Increasing interest has been given to the development of a next generation of SARS-CoV-2 vaccines with increased breadth and effectiveness against SARS-CoV-2 infection. In this Brief Review, we discuss recent work on the development of these next-generation vaccines and on the nature of the immune response to SARS-CoV-2. We examine recent work to develop pan-coronavirus vaccines as well as to develop mucosal vaccines. We further discuss challenges associated with the development of novel vaccines including the need to overcome "original antigenic sin" and highlight areas requiring further investigation. We place this work in the context of SARS-CoV-2 evolution to inform how the implementation of future vaccine platforms may impact human health.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Humanos , Anticuerpos ampliamente neutralizantes , Pandemias , SARS-CoV-2 , Anticuerpos Antivirales , Anticuerpos Neutralizantes
17.
RSC Chem Biol ; 4(12): 1111-1122, 2023 Nov 29.
Artículo en Inglés | MEDLINE | ID: mdl-38033723

RESUMEN

The synthesis and characterisation of fluorosulfate covalent inhibitors of the lipid kinase PI4KIIIß is described. The conserved lysine residue located within the ATP binding site was targeted, and optimised compounds based upon reversible inhibitors with good activity and physicochemical profile showed strong reversible interactions and slow onset times for the covalent inhibition, resulting in an excellent selectivity profile for the lipid kinase target. X-Ray crystallography demonstrated a distal tyrosine residue could also be targeted using a fluorosulfate strategy. Combination of this knowledge showed that a dual covalent inhibitor could be developed which reveals potential in addressing the challenges associated with drug resistant mutations.

18.
Life (Basel) ; 13(11)2023 Nov 17.
Artículo en Inglés | MEDLINE | ID: mdl-38004357

RESUMEN

The introduction of plasmids into Agrobacterium cells is one of the key steps in the Agrobacterium-mediated transformation of plants for gene editing applications. Depending on chromosomal background, some Agrobacterium strains exhibit a very low transformation efficiency, which results in a low number of colonies for subsequent screening and thus limits the potential for automated high-throughput transformation processes, especially with low copy or large plasmids. This study demonstrates improvements of transformation frequency by modifying the competent cell preparation process and optimizing electroporation parameters for two Agrobacterium strains. The competent cell preparation process was modified by prolonging bacterial growth in the log phase and optimizing the endpoint cell density for cell harvest which resulted in a significant cell yield increase and transformation frequency improvement. Optimization of electroporation by fine-tuning the parameters not only resulted in a 30-fold transformation frequency increase but also revealed a strain-dependent requirement for field strength and electric pulse length. To further improve transformation of a recalcitrant strain, different concentrations of dimethyl sulfoxide (DMSO) in recovery medium were examined. The study revealed an important role of DMSO in transformed cell recovery, with 5% DMSO resulting in the highest transformation frequency. The significant improvements in Agrobacterium transformation frequency addressed a critical bottleneck towards establishing a high throughput process.

19.
Proc Natl Acad Sci U S A ; 120(41): e2220403120, 2023 10 10.
Artículo en Inglés | MEDLINE | ID: mdl-37796985

RESUMEN

As SARS-CoV-2 variants of concern (VoCs) that evade immunity continue to emerge, next-generation adaptable COVID-19 vaccines which protect the respiratory tract and provide broader, more effective, and durable protection are urgently needed. Here, we have developed one such approach, a highly efficacious, intranasally delivered, trivalent measles-mumps-SARS-CoV-2 spike (S) protein (MMS) vaccine candidate that induces robust systemic and mucosal immunity with broad protection. This vaccine candidate is based on three components of the MMR vaccine, a measles virus Edmonston and the two mumps virus strains [Jeryl Lynn 1 (JL1) and JL2] that are known to provide safe, effective, and long-lasting protective immunity. The six proline-stabilized prefusion S protein (preS-6P) genes for ancestral SARS-CoV-2 WA1 and two important SARS-CoV-2 VoCs (Delta and Omicron BA.1) were each inserted into one of these three viruses which were then combined into a trivalent "MMS" candidate vaccine. Intranasal immunization of MMS in IFNAR1-/- mice induced a strong SARS-CoV-2-specific serum IgG response, cross-variant neutralizing antibodies, mucosal IgA, and systemic and tissue-resident T cells. Immunization of golden Syrian hamsters with MMS vaccine induced similarly high levels of antibodies that efficiently neutralized SARS-CoV-2 VoCs and provided broad and complete protection against challenge with any of these VoCs. This MMS vaccine is an efficacious, broadly protective next-generation COVID-19 vaccine candidate, which is readily adaptable to new variants, built on a platform with a 50-y safety record that also protects against measles and mumps.


Asunto(s)
COVID-19 , Sarampión , Paperas , Cricetinae , Animales , Humanos , Ratones , SARS-CoV-2/genética , Vacunas contra la COVID-19 , COVID-19/prevención & control , Vacuna contra el Sarampión-Parotiditis-Rubéola , Anticuerpos Antivirales , Anticuerpos ampliamente neutralizantes , Inmunoglobulina G , Mesocricetus , Anticuerpos Neutralizantes , Glicoproteína de la Espiga del Coronavirus/genética
20.
Environ Res ; 237(Pt 2): 117070, 2023 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-37666316

RESUMEN

Many epidemiologic studies concerned with acute exposure to ambient PM2.5 have reported positive associations for respiratory disease hospitalization. However, few studies have investigated this relationship in Kuwait and extrapolating results from other regions may involve considerable uncertainty due to variations in concentration levels, particle sources and composition, and population characteristics. Local studies can provide evidence for strategies to reduce risks from episodic exposures to high levels of ambient PM2.5 and generating hypotheses for evaluating health risks from chronic exposures. Therefore, using speciated PM2.5 data from local samplers, we analyzed the impact of daily total and source-specific PM2.5 exposure on respiratory hospitalizations in Kuwait using a case-crossover design with conditional quasi-Poisson regression. Total and source-specific ambient PM2.5 were modeled using 0-5-day cumulative distributed lags. For total PM2.5, we observed a 0.16% (95% confidence interval [CI] = 0.05, 0.27%) increase in risk for respiratory hospitalization per 1 µg/m3 increase in concentration. Of the source factors assessed, dust demonstrated a statistically significant increase in risk (0.16%, 95% CI = 0.04, 0.29%), and the central estimate for regional PM2.5 was positive (0.11%) but not statistically significant (95% CI = -0.11, 0.33%). No effect was observed from traffic emissions and 'other' source factors. When hospitalizations were stratified by sex, nationality, and age, we found that female, Kuwaiti national, and adult groups had higher effect estimates. These results suggest that exposure to ambient PM2.5 is harmful in Kuwait and provide some evidence of differential toxicity and effect modification depending on the PM2.5 source and population affected.

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