Rat leukocyte population dynamics predicts a window for intervention in aging.

Age-associated changes in human hematopoiesis have been mostly recapitulated in mouse models; but not much has been explored in rats, a physiologically closer model to humans. To establish whether rat hematopoiesis closely mirrors humans’, we examined the peripheral blood of rats throughout their lifespan. Significant age-associated changes showed distinctive population shifts predictive of age. A divergence between predicted versus chronological age changes was indicative of fragility; thus, these data may be a valuable tool to identify underlying diseases or as a surrogate predictor for intervention efficacy. Notably, several blood parameters and DNA methylation alterations defined specific leverage points during aging, supporting non-linear aging effects and highlighting a roadmap for interventions at these junctures. Overall, we present a simple set of rat blood metrics that can provide a window into their health and inform the implementation of interventions in a model system physiologically relevant for humans.

Respiratory Syncytial Virus (RSV) Diseases

The respiratory syncytial virus (RSV) is an RNA virus that causes annual ARI outbreaks during winter with mild URTI in the general population, but with severe LRTI particularly among young children (bronchiolitis), patients with underlying diseases and people >65 years of age. RSV does not induce a long-lasting protective immunity and repeated infections throughout life are the norm. Basically, all children have been infected by 2 years of age and of those hospitalized, >50% are <3 months and 75% are <6 months of age. The overall CFR is 1/500. For adults ≥65 years, RSV hospitalization rates are 90–250/105. There is no specific therapy, general preventive measures include general hygiene and isolation/separation of patients. A monoclonal anti-F-protein antibody is available for passive immunization of selected high-risk children. It requires monthly injections, comes at a high cost and has limited efficacy (50% against RSV hospitalization). Active immunization failed in the past, probably as the post-fusion conformation of the F-protein was used. Long-acting monoclonal antibodies (for infants) as well as stabilized pre-fusion F-protein vaccines (for immunization of pregnant women, children, older adults) produced on various platforms are in late stages of clinical development.

A New Rapid Approach for Predicting Death in Coronavirus Patients: The Development and Validation of the COVID-19 Risk-Score in Fars Province (CRSF)

Background:Patients who are identified to be at a higher risk of mortality from COVID-19 should receive better treatment and monitoring. This study aimed to propose a simple yet accurate risk assessment tool to help decision-making in the management of the COVID-19 pandemic. Methods: From Jul to Nov 2020, 5454 patients from Fars Province, Iran, diagnosed with COVID-19 were enrolled. A multiple logistic regression model was trained on one dataset (training set: n=4183) and its prediction performance was assessed on another dataset (testing set: n=1271). This model was utilized to develop the COVID-19 risk-score in Fars (CRSF). Results: Five final independent risk factors including gender (male: OR=1.37), age (60-80: OR=2.67 and >80: OR=3.91), SpO2 (≤85%: OR=7.02), underlying diseases (yes: OR=1.25), and pulse rate (<60: OR=2.01 and >120: OR=1.60) were significantly associated with in-hospital mortality. The CRSF formula was obtained using the estimated regression coefficient values of the aforementioned factors. The point values for the risk factors varied from 2 to 19 and the total CRSF varied from 0 to 45. The ROC analysis showed that the CRSF values of ≥15 (high-risk patients) had a specificity of 73.5%, sensitivity of 76.5%, positive predictive value of 23.2%, and negative predictive value (NPV) of 96.8% for the prediction of death (AUC=0.824, P<0.0001). Conclusion:This simple CRSF system, which has a high NPV,can be useful for predicting the risk of mortality in COVID-19 patients. It can also be used as a disease severity indicator to determine triage level for hospitalization.

Craniofacial measurements in children with sella turcica shape’s anomalies

Objectives: The objective of the study is to evaluate the cephalometric measurements of Tunisian children who presented sella turcica’s (ST) shape anomalies. Materials and Methods: This cross-sectional study was conducted between January and June 2019 in the Department of Pediatric Dentistry of Monastir and Faculty of Dentistry of Tunisia. Radiographs were gathered from patients aged between 7 and 12 years old (n = 104) who had consulted for a malocclusion. The inclusion criteria were considered as follows: Good visibility of anatomic structures and absence of congenital craniofacial deformities. We excluded bad radiographs with errors and discrepancies: Double limits, deformities as well as children having hereditary craniofacial anomalies and underlying diseases. The cephalometric analysis was conducted according to Segner and Hassund’s method. ST’s shape was identified according to Axelsson’s classification modified by Becktor. The sample size was divided into groups: Group 1 with normal ST’s shape and Group 2 with sella’s anomaly. Statistics were performed using IBM SPSS STATISTICS 22. Data normality has been tested using Shapiro–Wilk test. The normality of variance was investigated too with Levene’s test, and comparison of means between groups was performed with t-test. Results: The prevalence of aberrations of ST’s form in Tunisian children is about 59.6%. The inclination of upper incisors to the maxilla differed in children with ST’s anomaly compared to normal kids. Children with sella aberration are characterized by retroclination of upper incisors to the maxilla. The variables which showed a statistically significant relationship between abnormalities of ST and cephalometric measurements were 1+NA with P = 0.03 and NL-NSL with P = 0.04. Conclusion: The prevalence of ST’s shape anomalies in Tunisian children is about two-thirds. It seems that the anomaly of ST influences the position of the maxilla to the cranial base and the position of upper incisors to the maxilla.

Clinical and Laboratory Findings of Viral Influenza among Children Hospitalized in Qazvin Pediatric Hospital in Iran, 2015-2020

Background: Children are one of the most important groups at risk of catching the influenza infection. The consequences of influenza in some children, especially children with chronic and underlying diseases, can be very severe and lead to hospitalization. Objective: Purpose of this research was to determine children with influenza and their clinical and laboratory findings in Qazvin children hospital between 2015 to 2020 years. Methods: In this descriptive cross-sectional study, epidemiological and clinical finding of children hospitalized due to confirmed influenza were considered. A total of 1468 children with a suspected diagnosis to influenza were included in this study. Then, based on the Real-time Polymerase Chain Reaction (PCR) a total of 229 were confirmed positive to influenza. Statistical analysis was done using software SPSS 23.0, Analysis Of Variance (ANOVA) and t-test (p≤0.05). Results: Most of patients (53.7%) were infected with influenza H1N1 type. Most comorbidity was observed with Central Nervous System (CNS) disease and febrile seizure (each one 3.10%). Highest clinical feature was fever (83.4%). Significant relationship was observed between the season (p=0.001), sore in throat (p=0.001), febrile seizure (p=0.051), muscle and joint pain (p=0.059), rhinorrhea (p=0.006) and shiver (p=0.051) and occurrence of influenza. Also 4 children had died from influenza during hospitalization. Conclusion: Children with influenza disease were found in this study. Influenza has some side effects on children health. Due to the irreversible and dangerous effects of the influenza, early diagnosis and appropriate treatment in children is important.

Out-Patient Attitude towards Hospitals during COVID-19 in India

COVID-19, one of the worst pandemics in recent years, have changed the face of our world. Every sector has been experiencing a tug in unexpected directions than anticipated. Often it is said that the healthcare sector is facing a boom in this COVID-19 episode, nevertheless there has been a decline of out-patient segment in hospitals. An out-patient is one who visits a hospital for treatment without staying overnight. Through this time of uncertainty where a new normal is being burgeoned, the people’s attitude towards healthcare has shifted a great deal. Predominantly out-patients are hesitant to continue with their regular physician visits by delaying or avoiding unneeded visits. People with underlying diseases, both which are at low risk or at high risk, find themselves at higher caution due to the COVID-19. This study focuses to understand the attitude of out-patients and of out-patient’s with risk during this COVID-19 pandemic towards hospitals in India. Online or Tele medical consultation has picked up momentum among out-patients during the COVID-19 Unlock phase which shines a possibility as a new normal in the healthcare industry.

Incidence, prevalence, and outcome of moderate to severe neurotrophic keratopathy in a German tertiary referral center from 2013 to 2017

Background Neurotrophic keratopathy (NK) is an orphan disease, with an estimated prevalence of 1–5/10,000. No data regarding the incidence exists. The primary aim was to evaluate incidence and prevalence of NK at a tertiary referral center in Germany, and the secondary aim was to analyze demographic parameters, etiology, and clinical features and therapeutic outcomes. Methods and material All patients treated for NK with serum eye drops (SED), amnionic membrane transplantation (AMT), or penetrating keratoplasty (PK) in 2013–2017 were identified. Age, sex, etiology of NK, visual acuity, disease stage, treatment, and visual acuity were analyzed. Incidence and prevalence of NK in our hospital and the overall population of the city were calculated. Results In 63 eyes of 60 patients (56.7% male; 68 ± 16 years), the most common underlying diseases were herpetic infections (23.8%), neurological causes (19%), and diabetes mellitus (14.3%). The annual incidence of NK in our tertiary referral center ranges between 5/10,000 and 3/10,000, the prevalence between 9/10,00 and 22/10,000. In all patients treated with corneal ulcers, the prevalence was up to 27% (2706/10,000). The incidence in the overall population is estimated at 0.1–0.3/10,000, the prevalence at 0.2–0.5/10,000 to 0.5/10,000. Conclusion Based on our assessment, the prevalence of NK in the overall population is lower than estimated before. However, in patients with corneal ulcers, the percentage of NK is comparably high. The disease may still be underdiagnosed due to the variety of underlying disorders and unknown comorbidities. Thus, in cases of therapy-refractive superficial keratopathy or ulcerations, NK should be considered more frequently.

Evaluation of 86 Patients Whom Death While Being Followed up with Pre-Diagnosis of Covid-19

The Coronavirus-19 pandemic continues at full speed, and the number of patients who die from Covıd-19 is increasing. It was aimed to evaluate the demographic information and laboratory findings of 86 patients who died while being followed up in our hospital with a pre-diagnosis of Covıd-19. Identifying these characteristics of deceased patients will be essential to guide clinicians in identifying critically ill patients. Data on demographic information, comorbidities, time from hospitalization to death, molecular test results, thorax CT findings, biochemical findings, culture, antibiotic susceptibility, and the given treatments of the cases were collected from the electronic system Kastamonu Training and Research Hospital. While the RT-PCR test of 21 of the cases was positive, in 9 of the cases, control PCR tests were negative after a while. The CT results of 18 of the 21 initially RT-PCR positive cases were compatible with Covid-19, and the CT result of 3 could not be reached. When the blood test results of the cases were examined, neutrophil increase, white blood cell increase, lymphocyte reduction, and inflammatory markers increase were determined. A total of 43 bacterial growths were found in 21 cases. It has been observed that deaths in patients who were followed up with the pre-diagnosis of Covıd-19 generally occur in older people, males, and those with underlying diseases. It was thought that the cause of death could be underlying diseases, pathologies caused by inflammation, and secondary bacterial infections in addition to viral infection. Clinicians should be more careful about elderly patients, patients with secondary bacterial infections, or patients with neutrophilia, lymphopenia.

Perception and preventive behavior during COVID-19 pandemic among urban residents in Banda Aceh, Indonesia: a cross-sectional study

BACKGROUND It is critical to evaluate the perception and preventive behavior of COVID-19 to formulate the optimal public health strategies for tackling the ongoing pandemic. This study aimed to enhance knowledge on the perception and preventive behavior toward COVID-19 among urban residents in Banda Aceh, Indonesia. METHODS A cross-sectional population-based survey was conducted from September to October 2020 using a structured questionnaire for the attendants of the six public health centers in Banda Aceh. Information about sociodemographic, perception, and preventive behavior toward COVID-19 were collected. The data were analyzed to find the association between the level of preventive behavior and covariates. RESULTS Among 1,067 respondents, 71.1% were female, 52.5% were aged between 40 and 60 years, 31.2% were university graduates, and >60% were unemployed with underlying diseases such as diabetes, hypertension, and cardiopulmonary diseases. The responses of each statement toward COVID-19 were varied. The multivariable model of covariates showed that females had good preventive behavior toward COVID-19 (adjusted OR: 1.849, 95% CI: 1.359–2.515). Urban residents in Banda Aceh with the underlying diseases had poor preventive behavior, while those with higher educational level and perception scores were more inclined to engage in good preventive behavior. CONCLUSIONS Most urban residents in Banda Aceh showed positive perception and propensity for adopting preventive measures. Health education is necessary for susceptible residents, such as males, less educated people, and people with underlying diseases. It should be stressed on specific practices and knowledge.

Study on PD-L1 Expression in NSCLC Patients and Related Influencing Factors in the Real World

PD-L1 is one of the current biomarkers for immune checkpoint inhibitor (ICI) therapy in patients with non-small-cell lung cancer. However, the expression of PD-L1 in the real world and its related influencing factors remain unclear. We want to observe the expression of PD-L1 in the real world and study the related influencing factors through the collection and analysis of clinical data. R software (version 4.0) was used to perform data analysis and the “corplot” package for correlation analysis. A total of 296 individuals (mean [SD] age, 67 [9] years; 23%female) were assessed. According to the expression amount of PD-L1, the cohort was divided into low nonexpression group ( PD ‐ L 1 < 1 % , 26.7%), low-expression group ( 1 % ≤ PD ‐ L 1 < 50 % , 49.3%), and high-expression group ( PD ‐ L 1 ≥ 50 % , 23.5%). Age, gender, underlying diseases, smoking status, and PD-L1 expression level were not statistically significant. We found that the expression of PD-L1 was correlated with serum albumin ( P < 0.05 ) and pathological type ( P < 0.05 ) and had a negative correlation with EGFR mutation but did not correlate with gender, age, smoking status, combined with underlying diseases, tumor stage, whether it was initially treated or not, sampling site, specimen type, specimen storage time, R-IFN, CD4, CD8, NLR, CRP, and LDH. The present findings indicated that serum albumin, pathological type, and EGFR mutations are associated with PD-L1 expression in patients with NSCLC, which may provide a new basis for individualized immunotherapy and need further study to confirm. The results of this study help to further reveal the actual expression of PD-L1 in non-small-cell lung cancer patients with real events.