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The Existence of at Least Three Genomic Signature Patterns and at Least Seven Subtypes of COVID-19 and the End of the Disease
Full text linkHoping to find genomic clues linked to COVID-19 and end the pandemic has driven scientists’ tremendous efforts to try all kinds of research. Signs of progress have been achieved but are still limited. This paper intends to prove the existence of at least three genomic signature patterns and at least seven subtypes of COVID-19 driven by five critical genes (the smallest subset of genes) using three blood-sampled datasets. These signatures and subtypes provide crucial genomic information in COVID-19 diagnosis (including ICU patients), research focuses, and treatment methods. Unlike existing approaches focused on gene fold-changes and pathways, gene-gene nonlinear and competing interactions are the driving forces in finding the signature patterns and subtypes. Furthermore, the method leads to high accuracy with hospitalized patients, showing biological and mathematical equivalences between COVID-19 status and the signature patterns and a methodological advantage over other methods that cannot lead to high accuracy. As a result, as new biomarkers, the new findings and genomic clues can be much more informative than other findings for interpreting biological mechanisms, developing the second (third) generation of vaccines, antiviral drugs, and treatment methods, and eventually bringing new hopes of an end to the pandemic
Assessment of the Psychometric Properties of the Holland Sleep Disorders Questionnaire in the Iranian Population
Full text linkBackground. Assessing sleep disorders and understanding their causes are essential for the proper treatment and management of the disorders. The Holland Sleep Disorders Questionnaire (HSDQ) is a self-assessment questionnaire that measures sleep problems and symptoms based on the six categories of sleep disorders described in the International Classification of Sleep Disorders-2 (ICSD-2). The aim of this study was at validating and assessing the psychometric properties of the HSDQ in Iranian adults. Method. The study was carried out as a methodological and validation work. The guidelines for translation and cultural adaptation of patient-reported outcome measures were followed for the translation and the cultural validation of the tool. To examine construct validity, exploratory factor analysis (EFA) with 216 participants and confirmatory factor analysis (CFA) with 355 participants were used. As to the reliability, the test-retest method and, as to internal consistency, Cronbach’s alpha were employed. Data analyses were done in SPSS-25 and LISREL-8. Results. The CFA and EFA results confirmed the tool with six factors and 31 items. The index of the model was 0.99, which indicated that 99% of changes in the dependent variable (adults’ sleep problem) were attributed to the independent variable (the 31 items). In other words, 0.99 of the changes in the dependent variable were due to the independent variables. The main indices of CFA (, , , ) were acceptable. In addition, a correlation coefficient below 0.05 was considered as significant. Reliability of the tool based on internal correlation (Cronbach’s alpha) was in the 0.701–0.924 range for the subscales and equal to 0.789 for the whole tool. Conclusion. In general, the results showed that the Farsi version of HSDQ (six factors and 31 items) had acceptable and applicable indices and it can be used as a valid tool in the Iranian society. The tool can be used as a reliable tool in different fields of medical sciences.
1. Introduction
Sleep is a process that is essential for maintaining brain function, and the lack of it can lead to memory and attention impairments [1]. Sleep problems are hazardous for health and treating them is very expensive [2]. Sleep disorders are comorbid of other diseases such as an increased risk of obesity, diabetes, hypertension, tachycardia, and stroke [3]. Sleep disruptions have short-term health consequences (somatic pain, emotional distress, mood disorders, and cognitive, memory, and performance deficits) and also long-term health consequences (hypertension, dyslipidemia, cardiovascular disease, weight-related issues, and colorectal cancer) [4].
Through decreasing the quality of life, sleep deprivation imposes risks to physical, mental, social, and emotional health. In addition, low sleep quality has a relationship with an increase in stress, depression, irritation, and lower satisfaction with life [5]. Changes in sleep pattern are one of the earliest behavioral symptoms of psychophysical problems [6] such as somatic pain, emotional distress, and weight-related issues [4]. The lack of balance in sleep and rest process can create excessive fatigue and nervousness [7]
Characteristics of Obese Patients with Acute Hypercapnia Respiratory Failure Admitted in the Department of Pneumology: An Observational Study of a North African Population
Full text linkBackground. Acute hypercapnic respiratory failure (AHRF) is a common life-threatening event in patients with obesity hypoventilation syndrome (OHS). Objectives. To study the clinical pattern, noninvasive ventilatory support, as well as the short- and long-term outcomes of patients with OHS admitted in a ward because of AHRF. Methods. We conducted a retrospective cohort study including all adults with OHS , admitted in a 90-bed-ward for AHRF. Results. A total of 44 patients were included. Fifteen (34.1%) and 29 (65.9%) patients were diagnosed with malignant OHS (mOHS) and nonmalignant OHS (non-mOHS), respectively, while 36 (81.8%) had coexisting obstructive sleep apnea hypopnea syndrome (OSAHS). Patients with mOHS had a significantly higher rate of heart failure (100% vs. 31%; ), chronic renal insufficiency (CRI) (73.3% vs. 41.4%; ), and dyslipidemia (66.7% vs. 34.5%; ) than those with non-mOHS. The mean forced vital capacity (FVC) in our patients was of of the predicted value, lower than what is usually reported in stable patients with OHS. At hospital admission, more than two-thirds (, 77.3%) were misdiagnosed as having asthma exacerbation (, 4.9.1%), chronic obstructive pulmonary disease (COPD) exacerbation (, 27.3%) and/or heart failure (, 65.9%). Acute pulmonary oedema (ACPE) (, 36.4%) and acute viral bronchitis (, 27.3%) were the main identified causal factors, while no cause could be determined in 5 (11.4%) patients. Noninvasive positive pressure ventilation (NIPPV) using bilevel positive airway pressure (BIPAP) was very highly effective to treat AHRF, with only 2.27% of patients failing the modality. Median overall duration of ventilation was 9 hours per day (1.3–20) and was significantly longer in patients with mOHS than in those with non-mOHS (10 [6–18] vs. 8 [1.3–20], respectively; ). Forty two of the forty-three patients discharged alive were treated with BIPAP or continuous positive airway pressure (CPAP) in 26 and 16 patients, respectively. The probability of survival was 90% at 12 months, while the probability of readmission for a new episode of AHRF was 56% at 6 months and 22% at 12 months, respectively. Conclusion. AHRF in OHS patients is a life-threatening event which can be successfully and safely treated with BIPAP, with a low long-term mortality even in patients with mOHS
Cell Salvage in Oncological Surgery, Peripartum Haemorrhage and Trauma
Full text linkOncological surgery, obstetric haemorrhage and severe trauma are the most challenging conditions for establishing clinical recommendations for the use of cell salvage. When the likelihood of allogeneic transfusion is high, the intraoperative use of this blood-saving technique would be justified, but specific patient selection criteria are needed. The main concerns in the case of oncological surgery are the reinfusion of tumour cells, thereby increasing the risk of metastasis. This threat could be minimized, which may help to rationalize its indication. In severe peripartum haemorrhage, cell salvage has not proven cost-effective, damage control techniques have been developed, and, given the risk of fetomaternal alloimmunization and amniotic fluid embolism, it is increasingly out of use. In trauma, bleeding may originate from multiple sites, coagulopathy may develop, and it should be evaluated whether re-transfusion of autologous blood collected from uncontaminated organ cavities would be feasible. General safety measures include washing recovered blood and its passage through leukocyte depletion filters. To date, no well-defined indications for cell salvage have been established for these pathologies, but with accurate case selection and selective implementation, it could become safe and effective. Randomized clinical trials are urgently needed
Age-Dependent Dynamics of Maternally Derived Antibodies (MDAs) and Understanding MDA-Mediated Immune Tolerance in Foot-and-Mouth Disease-Vaccinated Pigs
Full text linkVaccine-induced active immunity in young animals may be compromised via interference caused by maternally derived antibodies (MDAs). Since the level, titer, and half-life of MDAs vary per individual, it is difficult to determine the appropriate timing of foot-and-mouth disease (FMD) vaccination in the field. In order to better understand the age-dependent characteristics of MDA in sows and piglets as well as the phenomenon of reduced vaccine-mediated active immunity due to MDAs, this study sought to determine antibody titers through structural protein (SP) O, A ELISA analyses, and virus-neutralizing (VN) antibody titers as well as their half-lives in the sera of sows and piglets derived from FMD-vaccinated mother. Furthermore, immunoglobulin (Ig) subtypes, such as IgG, IgM, and IgA, in serum were also evaluated. To understand the correlation between the inhibition of vaccine-mediated active immunity by MDA-mediated passive immunity and regulatory T (Treg) cells, Treg-related cytokine levels were explored. Our findings will help to predict the optimal timing of vaccination for overcoming MDAs and inducing a robust vaccine-mediated immune response in young individuals vaccinated against FMD. They also add to our understanding of MDA characteristics and interference, providing insight for the development of innovative strategies and novel FMD vaccine for overcoming such interference
Comparison of High-Performance Liquid Chromatography with Sucrose Density Gradient Ultracentrifugation for the Quantification of Foot-and-Mouth Disease Vaccine Antigens
Full text linkFoot-and-mouth disease (FMD) causes substantial economic losses in the livestock industry. The protective immunizing component of the FMD virus (FMDV) is a ribonucleoprotein particle with a sedimentation coefficient of 146S. Size-exclusion high-performance liquid chromatography (SE-HPLC) was introduced to replace sucrose density gradient ultracentrifugation (SDG), which is the gold standard for the quantification of FMDV 146S particles. SE-HPLC showed a pattern similar to that of SDG; however, the two methods resulted in different quantities for the same amount of 146S particles. This study aimed to identify the reason for this disparity and adjust the difference between the two methods by employing a standard material. While SE-HPLC displayed all the virus particles in the peak fraction by SDS-PAGE and Western blotting, the virus particles were widely dispersed in multiple fractions, including peak fractions in the SDG. To adjust the difference between the two methods, a stable surrogate virus, bovine enterovirus, was devised to draw a standard curve, and the gap was reduced to <10%. To our knowledge, this is the first report to provide experimental evidence on the difference between SDG and SE-HPLC for the quantification of FMDV particles
Learning-related congruent and incongruent changes of excitation and inhibition in distinct cortical areas
Full text linkExcitatory and inhibitory neurons in diverse cortical regions are likely to contribute differentially to the transformation of sensory information into goal-directed motor plans. Here, we investigate the relative changes across mouse sensorimotor cortex in the activity of putative excitatory and inhibitory neurons—categorized as regular spiking (RS) or fast spiking (FS) according to their action potential (AP) waveform—comparing before and after learning of a whisker detection task with delayed licking as perceptual report. Surprisingly, we found that the whisker-evoked activity of RS versus FS neurons changed in opposite directions after learning in primary and secondary whisker motor cortices, while it changed similarly in primary and secondary orofacial motor cortices. Our results suggest that changes in the balance of excitation and inhibition in local circuits concurrent with changes in the long-range synaptic inputs in distinct cortical regions might contribute to performance of delayed sensory-to-motor transformation
Bone Marrow Infiltration Is a Distinctive Risk Factor for Rituximab Infusion-Related Reactions in CD20-Positive B-Cell Non-Hodgkin Lymphoma
Full text linkBackground. Bone marrow infiltration of lymphoma cells is a candidate risk factor for infusion-related reactions (IRRs) in patients with CD20-positive B-cell non-Hodgkin lymphoma (B-NHL). However, despite with the lack of sufficient data, the effect of bone marrow infiltration of B-NHL cells on the incidence rate of grade 2 or higher IRRs with the administration of rituximab has been retrospectively studied in this paper. Methods. Patients with CD20-positive B-NHL who received the rituximab induction therapy for the first time were enrolled in this study. To evaluate the bone marrow infiltration of B-NHL cells, May–Giemsa stain of bone marrow films and flow cytometry examination of bone marrow aspiration samples were performed. IRR grade was determined using the IRR criteria in the Common Terminology Criteria for Adverse Events version 4.0. Results. A total of 127 patients were eligible for this study. Grade 2 or higher IRRs were observed in 43 (34%) patients. In univariate analysis, use of glucocorticoid before rituximab infusion was a strong risk-avoiding factor for grade 2 or higher IRRs. Advanced stage of disease (Ann Arbor: stages III and IV) or bone marrow infiltration of B-NHL cells revealed the risk factors, regardless of glucocorticoid premedication. Using multivariate analysis, bone marrow infiltration was found to be an independent risk factor for patients without prior glucocorticoid use. Conclusion. Bone marrow infiltration of B-NHL cells is a risk factor for grade 2 or higher IRRs at the first rituximab induction therapy without glucocorticoid premedication
Conceptualizing safer sex in a new era: Risk perception and decision-making process among highly sexually active men who have sex with men
Full text linkMen who have sex with men (MSM) are at the epicenter of the HIV epidemic. Efforts to prevent sexually transmitted infections (STIs) and HIV transmission have traditionally focused on condoms and abstinence from high risk sexual practices. Recently, additional methods such as pre-exposure prophylaxis (PrEP) and viral load sorting have been introduced. The aim of this study was to gain understanding about risk management and risk perception strategies for HIV among highly sexually active Swedish MSM with men in Berlin.
Methods
Eighteen sexually active Swedish MSM who travelled to or lived in Berlin were recruited and interviewed in this study. The data were analyzed using content analysis.
Results and discussion
These men represent a group of knowledgeable MSM in terms of HIV. They acknowledged that having sex with men in Berlin was linked to high sexual risk taking due to the higher prevalence of HIV/STIs than in Sweden, but reported that they nevertheless did not alter their risk management strategies. The analysis resulted in a conceptual model of risk assessment that allows for a deeper understanding of the complexity of the risk reduction decision-making process. Three ontological perceptions of risk were identified: accepting, minimizing and rejecting risk. Seven practiced risk reduction methods were described. Some informants applied their preferred method or set of methods to all settings and partners, while others faced complex decision-making processes.
Conclusion
HIV is integrated into the core of MSM’s sexuality, independently of how they ontologically related to the idea of risk. A constant navigation between pleasure, risk and safety, alongside having to relate to risk created a complex process. Efforts were made to remove HIV from their lives by rejecting the idea of risk, and thereby reject the idea of the homosexual body being a possible vessel for a virus and an epidemic
Evaluation of Crossover Sign in Pelvis Models Made with a Three-Dimensional Printer
Full text linkIntroduction. Investigation of the crossover sign (COS) in different degrees of tilt in pelvises made by three-dimensional printing of CT scans among patients with normal hip versions was carried out. Methods. Radiology CT scans of 8 normal pelvises reconstructed in 3D and the effect of sequential tilting on the presence of the false-positive COS in 48 radiographs were investigated. Results. The COS was seen in 77% of the AP radiographs during tilt changes. The average distance between the tip of the coccyx and the symphysis pubis was 32.06 ± 10.99 mm. Also, COSs were present in all radiographs from 6 degrees tilt and above. Conclusion. Minor tilting of the pelvis can result in a false-positive crossover sign on AP plain radiographs.
1. Introduction
The spatial orientation of the acetabulum, including its version and inclination, is an important anatomical feature of the hip joint [1]. Some of the major complications of hip arthroplasty include hip dislocation, impingement, and polyethylene abrasion and are related to improper position of acetabular hip prosthesis [2, 3]. In addition to the clinical significance of the acetabular position in joint replacement surgeries, acetabular version abnormalities can lead to hip pain and disability. Likewise, one of the most important causes of hip pain in young adults is the impingement between the head of the femur and the acetabulum. Furthermore, the retroversion of the acetabulum, which can be present globally or localized, can significantly increase the mentioned impingement [4, 5].
Normally, the anterior wall of the acetabulum is placed medially with regards to the posterior wall of the acetabulum, and the two walls meet at the top of the acetabulum [6, 7]. In a plain AP radiograph, if the anterior rim of the acetabulum intersects the posterior rim below the upper margin of the acetabulum, it is called a crossover sign (COS). Evaluation of femoral head coverage and acetabular orientation contributes to preoperative planning and decision-making of reorientation procedures [8]. Posterior and anterior femoral head coverage on an anteroposterior (AP) hip radiograph can be assessed by tracing the posterior and anterior rim contours. The increased risk for impingement followed by a retroverted acetabulum with excessive anterior coverage can be diagnosed in radiographs by the COS. Although the COS is the well-known radiographic sign for acetabular retroversion, there are controversial opinions about this sign’s clinical compliance and accuracy in the diagnosis of global or local retroversion [9, 10].
In this study, we aimed at investigating the crossover sign in different degrees of tilt in pelvises made by three-dimensional printing of CT scans among patients with normal hip versions