COVID-19 pandemic led to wide-spread use of face-masks, respirators and other personal protective equipment (PPE) by healthcare workers. Various symptoms attributed to the use of PPE are believed to ...be, at least in part, due to elevated carbon-dioxide (CO2) levels. We evaluated concentrations of CO2 under various PPE.
In a prospective observational study on healthy volunteers, CO2 levels were measured during regular breathing while donning 1) no mask, 2) JustAir® powered air purifying respirator (PAPR), 3) KN95 respirator, and 4) valved-respirator. Serial CO2 measurements were taken with a nasal canula at a frequency of 1-Hz for 15-min for each PPE configuration to evaluate whether National Institute for Occupational Safety and Health (NIOSH) limits were breached.
The study included 11 healthy volunteers, median age 32 years (range 16-54) and 6 (55%) men. Percent mean (SD) changes in CO2 values for no mask, JustAir® PAPR, KN95 respirator and valve respirator were 0.26 (0.12), 0.59 (0.097), 2.6 (0.14) and 2.4 (0.59), respectively. Use of face masks (KN95 and valved-respirator) resulted in significant increases in CO2 concentrations, which exceeded the 8-h NIOSH exposure threshold limit value-weighted average (TLV-TWA). However, the increases in CO2 concentrations did not breach short-term (15-min) limits. Importantly, these levels were considerably lower than the long-term (8-h) NIOSH limits during donning JustAir® PAPR. There was a statistically significant difference between all pairs (p < 0.0001, except KN95 and valved-respirator (p = 0.25). However, whether increase in CO2 levels are clinically significant remains debatable.
Although, significant increase in CO2 concentrations are noted with routinely used face-masks, the levels still remain within the NIOSH limits for short-term use. Therefore, there should not be a concern in their regular day-to-day use for healthcare providers. The clinical implications of elevated CO2 levels with long-term use of face masks needs further studies. Use of PAPR prevents relative hypercapnoea. However, whether PAPR should be advocated for healthcare workers requiring PPE for extended hours needs to evaluated in further studies.
Abstract
Breast cancer is the commonest malignancy of women and with its incidence on the rise, the need to identify new targets for treatment is imperative. There is a growing interest in the role ...of lipid metabolism in cancer. Carnitine palmitoyl-transferase-1 (CPT-1); the rate limiting step in fatty acid oxidation, has been shown to be overexpressed in a range of tumours. There are three isoforms of CPT-1; A, B and C. It is CPT-1A that has been shown to be the predominant isoform which is overexpressed in breast cancer. We performed a bioinformatic analysis using readily available online platforms to establish the prognostic and predictive effects related to CPT-1A expression. These include the KM plotter, the Human Protein Atlas, the cBioPortal, the G2O, the MethSurvand the ROC plotter. A Network analysis was performed using the Oncomine platform and signalling pathways constituting the cancer hallmarks, including immune regulation as utilised by NanoString. The epigenetic pathways were obtained from the EpiFactor website. Spearman correlations (r) to determine the relationship between CPT-1A and the immune response were obtained using the TISIDB portal. Overexpression of CPT-1A largely confers a worse prognosis and CPT-1A progressively recruits a range of pathways as breast cancer progresses. CPT-1A’s interactions with cancer pathways is far wider than previously realised and includes associations with epigenetic regulation and immune evasion pathways, as well as wild-type moderate to high penetrant genes involved in hereditary breast cancer. Although CPT-1A genomic alterations are detected in 9% of breast carcinomas, both the alteration and the metagene associated with it, confers a poor prognosis. CPT-1A expression can be utilised as a biomarker of disease progression and as a potential therapeutic target.
Recurrent facial palsy and fissured tongue Sharma, Mansi; Sharma, Vijay K.
European journal of internal medicine,
July 2021, 2021-07-00, 20210701, Letnik:
89
Journal Article
Brassica juncea L. is a significant member of the Brassicaceae family, also known as Indian mustard. Water is a limiting factor in the successful production of this crop. Here, we tested the effect ...of water shortage in B. juncea plants supplemented with or without the application of silicon and arbuscular mycorrhizal fungi in total 8 different treatments compared under open filed conditions using a randomised complete block design (RCBD). The treatments under control conditions were control (C, T1); C+Silicon (Si, T2); C+My (Mycorrhiza; T3); and C+Si+My (T4). In contrast, treatments under stress conditions were S (Stress; T5); S+Si (T6); S+My (T7) and S+Si+My (T8), respectively. In total, we evaluated 16 traits, including plant response to stress by evaluating peroxidase (POD), superoxide dismutase (SOD), and catalase (CAT) activity. The fresh weight (g) increased only 7.47 percent with mycorrhiza (C+My) and 22.39 percent with silicon (C+Si) but increased 291.08 percent with both mycorrhiza and silicon (C+Si+My). Using mycorrhiza (S+My) or silicon (S+Si) alone produced a significant increase of 53.16 percent and 55.84 percent in fresh weight, respectively, while using both mycorrhiza and silicon (S+Si+My) together produced a dramatic increase of 380.71 percent under stress conditions. Superoxidase dismutase concentration (Ug-1 FW) was found to be increased by 29.48 percent, 6.71 percent, and 22.63 percent after applying C+My, C+Si and C+Si+My, but treatment under stress revealed some contrasting trends, with an increase of 11.21 percent and 19.77 percent for S+My, S+Si+My, but a decrease of 13.15 percent for S+Si. Finally, in the presence of stress, carotenoid content (mg/g FW) increased by 58.06 percent, 54.83 percent, 183.87 percent with C+My, and 23.81 percent with S+My and S+Si+My, but decreased by 22.22 percent with S+Si. Silicon application proved to be more effective than AMF treatment with Rhizophagus irregularis, and the best results were obtained with the combination of Si and AMF. This work will help to suggest the measures to overcome the water stress in B. juncea.
The standard test for the diagnosis of acute rejection in kidney transplants is the renal biopsy. Noninvasive tests would be preferable.
We prospectively collected 4300 urine specimens from 485 ...kidney-graft recipients from day 3 through month 12 after transplantation. Messenger RNA (mRNA) levels were measured in urinary cells and correlated with allograft-rejection status with the use of logistic regression.
A three-gene signature of 18S ribosomal (rRNA)-normalized measures of CD3ε mRNA and interferon-inducible protein 10 (IP-10) mRNA, and 18S rRNA discriminated between biopsy specimens showing acute cellular rejection and those not showing rejection (area under the curve AUC, 0.85; 95% confidence interval CI, 0.78 to 0.91; P<0.001 by receiver-operating-characteristic curve analysis). The cross-validation estimate of the AUC was 0.83 by bootstrap resampling, and the Hosmer-Lemeshow test indicated good fit (P=0.77). In an external-validation data set, the AUC was 0.74 (95% CI, 0.61 to 0.86; P<0.001) and did not differ significantly from the AUC in our primary data set (P=0.13). The signature distinguished acute cellular rejection from acute antibody-mediated rejection and borderline rejection (AUC, 0.78; 95% CI, 0.68 to 0.89; P<0.001). It also distinguished patients who received anti-interleukin-2 receptor antibodies from those who received T-cell-depleting antibodies (P<0.001) and was diagnostic of acute cellular rejection in both groups. Urinary tract infection did not affect the signature (P=0.69). The average trajectory of the signature in repeated urine samples remained below the diagnostic threshold for acute cellular rejection in the group of patients with no rejection, but in the group with rejection, there was a sharp rise during the weeks before the biopsy showing rejection (P<0.001).
A molecular signature of CD3ε mRNA, IP-10 mRNA, and 18S rRNA levels in urinary cells appears to be diagnostic and prognostic of acute cellular rejection in kidney allografts. (Funded by the National Institutes of Health and others.).
The widespread forest fires in Indonesia in June 2013 led to widespread haze to neighbouring countries. This is the first study in the medical literature reporting the acute physical and ...psychological symptoms of the general population during a haze crisis. We evaluated the factors that are associated with psychological stress of haze exposure.
This study was conducted between June 21 to June 26, 2013. Participants were recruited by an online recruitment post and snowball sampling techniques. Participants were required to complete an online survey which was composed of demographics questionnaire, physical symptom checklist, perceived dangerous Pollutant Standard Index (PSI) value and views on the N-95 mask and the Impact of Event Scale-Revised (IES-R).
A total of 298 participants returned the completed study questionnaire. The respondents reported a mean number of 4.03 physical symptoms (S.D. = 2.6). The five most common physical symptoms include mouth or throat discomfort (68.8%), nose discomfort (64.1%), eye discomfort (60.7%), headache (50.3%) and breathing difficulty (40.3%). The total IES-R score was 18.47 (S.D. = 11.69) which indicated that the study population experienced mild psychological stress but not to the extent of acute stress reaction syndrome. The perceived dangerous PSI level and number of physical symptoms were significantly associated with the mean intrusion score, mean hyper-arousal score, total mean IES-R score and total IES-R score (p < 0.05).
Our findings suggest that a haze crisis is associated with acute physical symptoms and mild psychological stress. The number of physical symptoms and the perceived dangerous PSI values are important factors associated with psychological stress.
Phytoremediation is a promising remediation method of heavy metal (HM)-contaminated soils. However, lower HM tolerance of metal accumulator inhibits its practical application and effects. The current ...study was aimed to illustrate the role of fungal seed endophyte (FZT214) in improving
Cd tolerance during different developmental stages under various Cd stresses (5, 15, 30 mg kg
) by pot experiments. The results showed that FZT214 significantly (
< 0.05) improved the host plant's growth at the flowering and fruiting stage in most of the treatment, while at the growing stage the increase was less (
> 0.05). The seed yield was also improved (
< 0.05) in the FZT214-inoculated plants (E+) and induced early flowering was observed. Moreover, the inoculation also positively affected total chlorophyll content, antioxidant process, and lipid peroxidation in most of the treatments throughout three developmental stages. Not all but in most cases, IAA and GA were more in E+ plants while JA was more in the E- plants (non-inoculated plants) during three developmental stages. The results suggested that the colonization of FZT214 to the
might trigger multiple and comprehensive protective strategies against Cd stress, which mainly include activation of the dilution effects, induced biochemical changes to overcome damage from Cd toxicity, and alteration of the endogenous phytohormones. FZT214 can find competent application in the future to improve the growth of other crop plants.
The COVID-19 pandemic evolved rapidly, overwhelming health care systems around the world. The cost to life and socioeconomic burden prompted a search for new treatments and vaccines. Several ...collaborations developed and could deliver state-of-the-art vaccines with acceptable efficacy and safety in record time. Recently, vaccination with Oxford-AstraZeneca and Johnson and Johnson vaccines was halted due to the reported adverse effects of vaccine-induced immune thrombotic thrombocytopenia (VITT) and cerebral venous sinus thrombosis (CVST). Although a detailed risk-benefit analysis led to their reinstitution, physicians across the world are still trying to understand the pathophysiology and mechanisms of these neurological adverse effects in order to better identify, diagnose, and treat them. One of the mechanisms that have been implicated is related to the adenovirus-based vector of these vaccines. COVISHIELD, which is the most widely administered vaccine in India, also shares the same vector. As India enters the next phase of vaccine distribution for younger adults, there are chances that such adverse effects may emerge. In this review, we analyze the temporary suspension of the administration of the vaccines due to VITT/CVST, summarize the existing guidelines about diagnosis and treatment of these neurological disorders as well as the need for increasing pharmacovigilance and awareness among physicians. Screening for potential risk factors, avoiding aggravating factors like dehydration, and providing choices in vaccinating the high-risk populations could help in avoiding these rare but potentially fatal adverse outcome.
Greater Auricular Neuropathy in Hansen’s Disease Sharma, Suryanarayana; Kulkarni, Amit; Sharma, Vijay K.
The American journal of tropical medicine and hygiene,
01/2019, Letnik:
101, Številka:
4
Journal Article
Recenzirano
Odprti dostop
A 28-year-old Indian man presented with painless and progressive swelling on the right side of his neck for the past 2 years. He denied a history of neck injury, prolonged fever, loss of appetite or ...weight, skin rashes, or diabetes mellitus. Examination revealed a cord-like, nontender swelling on the right neck, which could be moved side-to-side. Systemic examination was unremarkable. The GAN is a large sensory nerve in the posterior triangle of the neck, traversing upward and parallel to the external jugular vein. It is the commonest pure sensory cutaneous nerve affected in leprosy. Commonest differential diagnoses are thrombosed external jugular vein, enlarged cervical lymph nodes, cold abscess of the nerve in tuberculosis and other granulomatous diseases, traumatic neuromas, tumorous infiltrations, and Charcot-Marie-Tooth disease.
Immune rejection of organ transplants is a life-threatening complication and is exemplified by alterations in the expression of protein-encoding genes. Because microRNAs (miRNAs) regulate the ...expression of genes implicated in adaptive immunity, we investigated whether acute rejection (AR) is associated with alterations in miRNA expression within allografts and whether expression profiles are diagnostic of AR and predict allograft function. Seven of 33 renal allograft biopsies (12 AR and 21 normal) were profiled using microfluidic cards containing 365 mature human miRNAs (training set), and a subset of differentially expressed miRNAs were quantified in the remaining 26 allograft biopsies (validation set). We found a strong association between intragraft expression of miRNAs and messenger RNAs (mRNAs), and that AR, and renal allograft function, could be predicted with a high level of precision using intragraft levels of miRNAs. Our investigation of miRNA expression in normal human peripheral blood mononuclear cells (PBMCs) showed that miRNAs (miR-142-5p, -155, and -223) overexpressed in AR biopsies are highly expressed in PBMCs, and that stimulation with the mitogen phytohaemagglutinin results in an increase in the abundance of miR-155 and a decrease in miR-223 and let-7c. Quantification of miRNAs in primary cultures of human renal epithelial cells (HRECs) showed that miR-30a-3p, -10b, and let-7c are highly expressed in HRECs, and that stimulation results in a decreased expression of miR-30a-3p. Our studies, in addition to suggesting a cellular basis for the altered intragraft expression of miRNAs, propose that miRNA expression patterns may serve as biomarkers of human renal allograft status.
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