Study Subjects Research Articles

Occurrence of gangrenous mastitis and its associated risk factors in dairy goats

Gangrenous mastitis is one among the major economically important health constraint faced by goat farmers. Occurrence of gangrenous mastitis is a result of combination of host, agent and environmental factors. Alteration in any of the host, agent and environmental factors can lead to an increase in bacterial concentration and the expression of virulence factors resulting in gangrenous mastitis. The present study was conducted over a period of two years from September 2021 to September 2023. The study subjects included 30 goats affected with gangrenous mastitis, managed under semi- intensive and intensive system. The selected animals included Malabari, Jamnapari and Malabari crossbreds with age group ranging from one to eight years, parity number ranging from one to six and stage of lactation ranging from peri-parturient period, early lactation and late lactation. Information regarding the host associated and environmental risk factors were collected by a prepared proforma. Disease diagnosis was made based on clinical examination, examination of udder and milk changes. Epidemiological analysis revealed a higher occurrence of gangrenous mastitis in crossbred goats. The occurrence was also higher in the age group of 3-4 yrs, during periparturient period and in herd without proper management practices. Absence of herd and management practices like proper disinfection and isolation of animals to new shed during parturition significantly caused occurrence of gangrenous mastitis. Proper awareness regarding the epidemiological factors leading to gangrenous mastitis can help in future control strategies of caprine gangrenous mastitis. Keywords: Goat, gangrenous mastitis, epidemiology

The correlation between mental health and arterial stiffness in Chinese population

This study aimed to evaluate the correlation between mental health status and arterial stiffness. A Symptom Checklist 90 (SCL-90) score was conducted for 10,688 employees of Kailuan Group Co., Ltd., of which 4936 participants received baPWV measurement. Of these, 4424 met the inclusion criteria. Based on the SCL-90 score, the study subjects were divided into normal mental health group (SCL-90 score < 160, 3993 cases) and abnormal mental health group (SCL-90 score ≥ 160, 431 cases). Statistical indicators include: General information, including levels of brachial-ankle pulse wave velocity (baPWV), age, gender, systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), body mass index (BMI), smoking and alcohol consumption, daily activity levels, nature of work and educational qualifications. The proportion of males, baPWV value, and abnormal proportion of baPWV in normal mental health group were higher than those in abnormal mental health group (P < 0.05). The Hs-CRP in normal mental health group were lower than that in abnormal mental health group (P < 0.05). There were significant differences in activity level and educational attainment between the two groups (P < 0.05). After adjusting for confounders, the results of the multiple linear regression analysis showed that, Age, MAP, HR, FBG, TG were positively correlated with baPWV; SCL-90 score, gender, BMI, educational qualification were negatively correlated with baPWV. When the SCL-90 score of the general population increased by one point, baPWV decreased by 0.246 cm/s. Each such increase corresponded with a decrease in baPWV of 0.299 cm/s for male participants in general (β = − 0.299, P = 0.007) and 0.412 cm/s for the male participants in the older-age group (β = − 0.412, P = 0.017). Although adverse psychological factors have a certain impact on arterial stiffness, it does not constitute an independent risk factor.

The aromatic amino acid phenylalanine: a versatile tool for binding transition metal ions.

The human body contains many different types of transition metal ions, such as Zn2+, Cu2+, which are involved in many physiological processes. An excess or deficiency of these ions can cause diseases, such as Alzheimer's disease, which is closely related to the levels of these ions in the body. In-depth understanding of various physiological and pathological mechanisms related to metal ions requires understanding the interaction between metal ions and nearby amino acids at the atomic level. This article selected four transition metal ions: Zn2+, Cu2+, Fe2+, and Mn2+ and the aromatic amino acid Phe, known for its strong coordination capability, as study subjects, comprehensively examining their binding situations. The results show that there are multiple binding modes between them and Phe, and most of the binding modes involve benzene ring coordination. The coordination strength order of the four metal ions with benzene ring, carbonyl O, hydroxyl O and amino N is different. For the lowest energy structure formed by each ion with Phe, all four ions are bound to N, carbonyl O, and benzene ring. Zn2+ is combined with two C's of the benzene ring, Cu2+ with four C's of the benzene ring, and Fe2+ and Mn2+ with the benzene ring as a whole. Part of the reason for this phenomenon may be derived from the tendency of transition metal ions to reach 18e stable structures when bound to ligands. There is a strong binding force between the four ions and Phe, and the binding trend is Cu2+(-294.9kcal/mol) > Zn2+(-261.3kcal/mol) > Fe2+(-247.5kcal/mol) > Mn2+(-220.2kcal/mol). Mayer bond order analysis and molecular orbital localization analysis found that there are very strong chemical interactions between transition metal ions and surrounding atoms, especially with N and carbonyl O. Several initial structures with different coordination modes to Phe were created according to chemical intuition for each divalent cation. Then semiempirical MD simulations at GFN2 level were run on these structures. The numerous generated structures were classified according to some criteria, then representative geometries were preliminarily optimized by TPSSh/6-31G*/LanL2DZ. To get more accurate electronic energies, high-precision quantum chemistry calculations at the level of TPSSh/def2TZVPP//TPSSh/def2QZVPP were carried out on the selected low-lying structures. All the optimized structures were confirmed to be minima without imaginary frequency by performing frequency analyses. Further electronic structure analyses such as IRI, Mayer bond order, IBSI etc. were performed to get more insights into the binding between the transition metal ions and Phe.

Increasing Burden of Antibiotic Resistance in Children Suffering from Septicemia in Tertiary Care Hospitals

Abstract Introduction/Objective Invasion of the bloodstream by microorganisms constitutes one of the most serious situations in infectious disease. Children are the most susceptible groups to contract diseases specifically Blood Stream Infections (BSIs). BSIs have been considered to be the main cause of morbidity and mortality in children. It is associated with a high mortality rate of 20%–50%. The emerging causative agents and resistance to various antimicrobial agents are increasing from time to time. Methods/Case Report The present study was carried out to confirm the causative agents and their antibacterial susceptibility pattern in children with septicemia at Tertiary Care Hospitals, Peshawar, KP, Pakistan. This cross- sectional study involved about 873 pediatric patients (≤ 13 years). BACTEC BD 9050 system was used to identify the causative organism, and sub-cultures were done on MacConkey Agar and Blood Agar. The antibiotic susceptibility test was done using the Kirby Bauer Disk diffusion method as per CLSI guidelines. Results (if a Case Study enter NA) Among 873 study subjects 568 (65.06 %) were males followed by 305 (34.93 %) females. Out of the 873 tested blood samples, blood cultures were positive in 83 (9.51%) followed by 122 (13.98%) skin contaminants, and no growth was observed in 668 (76.51%) cases. The majority 43 (51.80 %) of them were neonates (≤ 28 days). Gram-positive and Gram-negative bacteria constituted 58 (69.87%) and 25 (30.13%), respectively. The most frequent pathogen found was Staphylococcus aureus 54 (65.06 %), followed by Klebsiella spp., E. coli, and Pseudomonas aeruginosa 6 (7.22 %), Salmonella spp. 5 (6.02 %) Enterococcus faecalis 3 (3.61 %), Acinetobacter baumannii 2 (2.40 %) and Staphylococcus epidermidis 1 (1.20 %). In Staphylococcus aureus about 6 (11.11) were MRSA. The majority of bacterial isolates showed high resistance to Ciprofloxacin, Ceftazidime, Cefuroxime, Co-trimoxazole, Cefepime, Cefotaxime, Minocycline, Tobramycin, Cefoxitin and Cephradine that are commonly used in the study area. Conclusion The majority of the isolates were multidrug resistant. These higher percentages of multi-drug resistant emerged isolates urge us to take infection prevention measures and to conduct other large studies for appropriate empiric antibiotic choice.

Differential methylation of circulating free DNA assessed through cfMeDiP as a new tool for breast cancer diagnosis and detection of BRCA1/2 mutation

BackgroundRecent studies have highlighted the importance of the cell-free DNA (cfDNA) methylation profile in detecting breast cancer (BC) and its different subtypes. We investigated whether plasma cfDNA methylation, using cell-free Methylated DNA Immunoprecipitation and High-Throughput Sequencing (cfMeDIP-seq), may be informative in characterizing breast cancer in patients with BRCA1/2 germline mutations for early cancer detection and response to therapy.MethodsWe enrolled 23 BC patients with germline mutation of BRCA1 and BRCA2 genes, 19 healthy controls without BRCA1/2 mutation, and two healthy individuals who carried BRCA1/2 mutations. Blood samples were collected for all study subjects at the diagnosis, and plasma was isolated by centrifugation. Cell-free DNA was extracted from 1 mL of plasma, and cfMeDIP-seq was performed for each sample. Shallow whole genome sequencing was performed on the immuno-precipitated samples. Then, the differentially methylated 300-bp regions (DMRs) between 25 BRCA germline mutation carriers and 19 non-carriers were identified. DMRs were compared with tumor-specific regions from public datasets to perform an unbiased analysis. Finally, two statistical classifiers were trained based on the GLMnet and random forest model to evaluate if the identified DMRs could discriminate BRCA-positive from healthy samples.ResultsWe identified 7,095 hypermethylated and 212 hypomethylated regions in 25 BRCA germline mutation carriers compared to 19 controls. These regions discriminate tumors from healthy samples with high accuracy and sensitivity. We show that the circulating tumor DNA of BRCA1/2 mutant breast cancers is characterized by the hypomethylation of genes involved in DNA repair and cell cycle. We uncovered the TFs associated with these DRMs and identified that proteins of the Erythroblast Transformation Specific (ETS) family are particularly active in the hypermethylated regions. Finally, we assessed that these regions could discriminate between BRCA positives from healthy samples with an AUC of 0.95, a sensitivity of 88%, and a specificity of 94.74%.ConclusionsOur study emphasizes the importance of tumor cell-derived DNA methylation in BC, reporting a different methylation profile between patients carrying mutations in BRCA1, BRCA2, and wild-type controls. Our minimally invasive approach could allow early cancer diagnosis, assessment of minimal residual disease, and monitoring of response to therapy.

Analysis of Factors Influencing Exercise Benefits and Barriers in Cardiovascular Disease Patients Visiting the Emergency Department Based on Machine Learning

Objective: To investigate the exercise benefits/barriers and influencing factors among cardiovascular disease (CVD) patients seeking emergency care. Methods: A convenience sampling method was used to select CVD patients who visited the emergency department of a tertiary hospital in Chengdu from December 2023 to July 2024 as the study subjects. The investigation was conducted through medical record review and on-site questionnaire surveys. The research tools included a general information questionnaire, the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the Exercise Benefits/Barriers Scale (EBBS), the Exercise Self-Efficacy Scale, the Patient Health Questionnaire-9 (PHQ-9), and the Social Support Rating Scale (SSRS). Data were entered into Excel and statistically analyzed using SPSS 26.0. Results: Among the 1080 patients, 62.9% did not meet physical activity standards. Depression and social support explained 48.0% of the total variance in exercise benefits/barriers. The random forest algorithm performed best in predicting influencing factors. Conclusion: CVD patients seeking emergency care are generally insufficiently active, with depression and social support significantly impacting exercise benefits/barriers.

Knowledge and practices of interventional radiology staff regarding radiation protection

Interventional radiology (IR) has become a widespread medical imaging technique, offering minimally invasive treatment options. However, IR procedures can expose patients and staff to substantial radiation risks, necessitating enhanced radiation protection practices. This study aimed to survey the knowledge and practices of interventional radiology staff regarding radiation protection. A cross-sectional study with a descriptive aim, based on a questionnaire was done. The study subjects were all healthcare personnel of all specialties having practiced in interventional radiology between 2019 and 2022 at the University Hospital Center of Rabat. The statistical processing was carried out using Microsoft Excel 2013® and the IBM SPSS Statistical program version 20 (IBM Inc. NY, USA). The results indicated that 59.4% of participants had not received any specific training in radiation protection, and 45% were unaware of the radiation-induced risks associated with interventional radiology procedures. Regarding safety practices, 75% of participants maintained a distance of at least 1 meter from the x-ray source, while only 6% used the lowest possible exposure settings. Concerning the use of radiation protection devices, 87.5% of participants wore a lead apron, 75% used a thyroid shield, 6.3% wore lead glasses, and 37.5% utilized suspended mobile screens, whereas 12.5% did not use any radiation protection devices. Additionally, 84% of participants wore their personal dosimeter, though not consistently. The knowledge and practices of most interventional radiology personnel are inadequate for effective radiation protection. Regular, ongoing training in radiation safety is essential to improve adherence to protection standards and enhance overall safety in clinical practice.

Comparison of fetal growth patterns from Western India with Intergrowth-21st.

To generate longitudinal fetal growth data in an Indian population and compare it with Intergrowth-21st. Fetal biometry data was collected in a prospective longitudinal observational study (REVAMP: Research Exploring Various Aspects and Mechanisms in Preeclampsia) from 2017 to 2022. Fetal crown-rump length (CRL) was measured at 11-14 weeks gestation, and biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), and femur length (FL) at 18-22 and 32-35 weeks, and converted into Z-scores using the Intergrowth standard. Generalized Additive Models for Location, Scale and Shape (GAMLSS) models were used to construct fetal growth centile curves compared against Intergrowth centiles. Out of 1096 singleton pregnancies in REVAMP, this analysis included 655 'healthy' pregnancies (uncomplicated by pre-eclampsia, diabetes, pre-term delivery or low birth weight) and a sub-set of 106 'low-risk' pregnancies defined using Intergrowth criteria. The 'healthy' study subjects showed lower mean CRL Z-score [-0.45 SD (95% CI:-0.54,-0.37)] at 11-14 weeks, and BPD Z-score [-1.2 SD (-1.28,-1.11) and -1.17 SD (-1.23,-1.1)] at 18-22 and 32-35 weeks respectively. Mean HC Z-score was comparable to the Intergrowth standard at 18-22 weeks [-0.08 SD (-0.16, 0.02)] but smaller at 32-35 weeks [-0.25 SD (-0.32,-0.19)]. Mean AC Z-score was lower at 18-22 weeks [-0.32 SD (-0.41,-0.23)] but comparable at 32-35 weeks [0.004 SD (-0.07, 0.07)]. FL was comparable to or larger than the Intergrowth standard at both time points [0.05 SD (-0.05, 0.14); 0.82 SD (0.75, 0.89), respectively]. These findings were similar, though measurements were slightly larger, in the 'low-risk' sample. This data from healthy and low-risk pregnant women in urban western India indicates that some fetal dimensions and growth trajectories differ significantly from the Intergrowth-21st. Our data suggest the need for a larger representative study to define a population-specific fetal growth reference for India, for identification of fetal growth restriction.

Patterns of upper gastrointestinal diseases among patients undergoing esophagogastroduodenoscopy at three hospitals in Asella town, Southeast Ethiopia

Upper gastrointestinal (UGI) symptoms are among the common complaints among patients visiting health facilities. Because of the scarcity of gastrointestinal endoscopy services and gastroenterologists, the pattern of common upper gastrointestinal diseases has not been well studied in the study setting. This study aimed to determine the pattern of upper gastrointestinal diseases among patients undergoing esophagogastroduodenoscopy (EGD). An institution-based cross-sectional study was conducted at three hospitals in Asella town, southeast Ethiopia. A total of 279 study subjects were included in the study. Three-fourths (74%) of the study participants had abnormal endoscopic findings. The clinical indications for endoscopic examination were dyspepsia (32.6%), peptic ulcer disease (PUD) (27.2%), suspicion of gastric cancer (13.3%), and suspicion of esophageal cancer (11.5%). The abnormal endoscopic findings were esophageal cancer (10.4%), gastric cancer (10%), duodenal ulcer (DU) (9.3%), and gastritis (8.6%). The abnormal biopsy findings were esophageal cancer (7.5%), gastric adenocarcinoma (6.4%), and gastritis (3.9%). Dyspepsia, peptic ulcer disease, and suspicion of UGI malignancies were the most common clinical indications for endoscopic examination, while esophageal cancer and gastric cancer were the most common abnormal endoscopic findings. The most common abnormal biopsy results were esophageal squamous cell carcinoma and gastric adenocarcinoma. It is advised to have a high index of suspicion for esophageal cancer and gastric cancer for patients who present with alarming upper gastrointestinal symptoms in the study setting.

Corneal Clarity after Phacoemulsification: Nuclear Management by Stop and Chop vs Divide and Conquer Methods

Background: Restoration of effective vision is the principal aim of all modalities of cataract surgery including Phacoemulsification. Energy level of ultrasonic power in Phacoemulsification and turbulence of fluid in the anterior chamber plays an important role in corneal endothelial cell loss influencing post-operative corneal clarity. Objectives: To compare post-operative corneal clarity after Phacoemulsification by two techniques of nuclear divisions: stop and chop with divide and conquer. Methodology: This prospective observational study was conducted at Shaheed Monsur Ali Medical College and Hospital, Uttara, Dhaka from January, 2023 to June, 2023. The study was carried out on 30 outdoor patients undergoing Phacoemulsification at SMAMCH and Mirpur Eye Hospital, Dhaka. The selected patients underwent detailed ocular and systemic examinations with relevant investigations and divided equally into two groups comprising of 15 in group A (stop and chop) and 15 in group B (divide and conquer). Phacoemulsification was done in all patients by a single expert surgeon. Patients were followed up after 1 week, 4 weeks and 12 weeks of surgery. Corneal endothelial cell count and central corneal thickness were assessed in each visit. Mean value of these mentioned parameters in follow-up periods were compared between two groups. Unpaired t test was done to assess the level of significance. Results: The mean age + standard deviation (SD) of the study subjects was 61.5+2 years, out of which 13(43.33%) were males and other 17(56.67%) females. Pre-operative value of mean endothelial cell count was 2620+70.20/mm2 in group A and 2625+71.10/mm2 in group B. Postoperative mean value + SD of endothelial cell count was 2420+68.90/mm2, 2345+66.64/mm2, 2310+66.04/mm2 respectively after 1 week, 4 weeks and 12 weeks of surgery in group A and 2410+69.54/mm2, 2340 +6587/mm2, 2310+64.45/mm2 in group B respectively. Mean value + SD of central corneal thickness was 545+40.50 micrometer, 535+40.02 micrometer and 532+39.85 micrometer respectively after 1 week, 4 weeks and 12 weeks after surgery in group A and 547+43.98 micrometer, 537+41.23 micrometer and 533+40.63 micrometer respectively in group B. Conclusion: Quantitative assessment and comparison of endothelial cell count and central corneal thickness shows that at end of the study, there was no remarkable difference in mean values of endothelial cell count and central corneal thickness between two methods. Journal of Monno Medical College December, 2023; 9 (2):37-40

Knowledge and Experiences of Diseases with Associated Factors among Agricultural Workers in Manikganj District

Background: Farmers are generally the people of poor segment of the society and agricultural workers are prone to develop different types of health problems. Objectives: The study was conducted with a view to finding out the pattern of health problems of the agricultural workers in a rural area of Manikganj district. Methodology: This was a descriptive type of cross-sectional study carried out in Koshunda village of Manikganj district during the period of November, 2021 to April, 2022 in the Department of Community Medicine, Monno Medical College, Manikganj. For finding out pattern of diseases, knowledge and practice of the study subjects were determined by using pretested questionnaire. Results: Among the 300 cases, majority (124, 41.33%) of the respondents belonged to the age group 36-50 years. Most of the respondents (239, 79.67%) were male, being literate (195, 65.00%) had monthly family income of 10,001 or more BDT (139, 46.33%). Regarding cultivators’ knowledge of health problems during cultivation, majority (230, 76.67%) expressed occurring cut injury, followed by 206(68.67%) temperature injury, 85(24.08%) insect bite and others. Responding to question regarding injuries caused by tools and machineries of or animals involved in cultivation, majority (134, 44.67%) told that they are injured by handtools, followed by 51(17.00%) due to cattle’s kick, 46(15.33%) due to tractors and other machineries, and otherswhereas, majority of them (199, 66.33%) also reported that the injuries occur in hands, followed by 192(64.00%) in legs and others. Diseases experienced by the respondents during agricultural works included temperature-related injury (165, 55.00%), cut injury (96, 32.00%), skin problems (34, 11.33%) and others. Regarding the knowledge of the respondents’ choice of physician, majority (125, 41.67%) preferred MBBS Doctors, followed by rural medical practitioners (121, 40.33%), homeopathic doctors (67, 22.33%) and others. Conclusion: Most of the farmers shared their knowledge of suffering from different types of diseases with choice of treatment by MBBS doctors. Journal of Monno Medical College December, 2023; 9 (2):73-77

Short-term Clinical Outcomes of COVID-19 Patients Hospitalized with Chronic Obstructive Pulmonary Disease and Asthma in Three Tertiary Level Hospitals in Bangladesh

Background: Several comorbidities including chronic obstructive pulmonary disease (COPD) or bronchial asthma have been found associated with COVID-19 cases. But it remains unclear which of the comorbidities are associated with worse outcomes of the patients. Objectives: This study was carried out to determine the clinical outcomes of hospitalized COVID-19 patients with COPD or asthma. Methodology: This prospective study was carried out at Respiratory Medicine unit of Monno Medical College and Hospital, Manikganj, from April 2020 to December 2022. Admitted COVID-19 patients, suffering from COPD or bronchial asthma, were enrolled purposively upon fulfilling the inclusion and exclusion criteria. The patients were divided into two groups with associated comorbidities: Group A suffering from COPD and Group B suffering from Asthma. Data were collected from the patients on variables of interest using a semi-structured questionnaire. Results: Among the 144 enrolled patients, 96(66.67%) in group A were suffering from COPD and the other 48 (33.33%) in group B had bronchial asthma. In this study, 41(42.7%) patients in Group A exhibited &gt;25% lung field involvement in the high-resolution computed tomography (CT) chest imaging, compared to only 10(20.8%) in COVID-19 patients in Group B, and this difference in distribution was statistically significant (p=0.026). The COVID-19 patients in Group A were more severe to critically ill (45, 46.9%), compared to patients in Group B (12, 25.0%) with a p value of 0.011. Group A study subjects required intensive care unit (ICU) admission (49, 51.0%) more than the group B participants (16, 33.3%), which was also found statistically significant (p&lt;0.05). Nearly one-fifth (17, 17.7%) of the patients died among the Group A, compared to only 2(4.2%) mortality observed in Group B (p=0.024). The COVID-19 patients with COPD were found significantly associated with the risk of &gt;25% lung field involvement, severe to critical illness, ICU admission, invasive mechanical ventilation, and death (all p values &lt;0.05). Conclusion: The comorbidity of COPD was found to increase the risk of disease severity and adverse outcomes in COVID-19patients significantly. It also heightened the risk of lung field involvement, exceeding 25% more severe disease and increased mortality rates compared to individuals with bronchial asthma. Journal of Monno Medical College December, 2023; 9 (2):47-52

CLINICAL AND EPIDEMIOLOGICAL FEATURES OF THE COURSE OF CORONAVIRUS INFECTION DEPENDING ON THE PERIOD OF ILLNESS

After the COVID-19 pandemic, the persistence of Long COVID symptoms is of particular concern, which significantly affects the quality of life and ability to work. The aim of the study is to establish the peculiarities of clinical and epidemiological data in patients infected with SARS-CoV-2 depending on the period of illness. Patients and methods. We examined 108 patients divided into three groups: those with confirmed COVID-19, those with Long COVID, and practically healthy persons. The epidemiological and clinical features of the course were determined based on the analysis of medical records and the developed questionnaire. Results. Women predominated among the study subjects (56 %) with an average age of 41.44 years. The main symptoms that characterized the clinical picture of COVID-19 were generalized weakness/fatigue (94 %), headache (74 %), fever/body aches and cough in 71 % of patients (p&lt;0.05). In the Long COVID group, compared to the COVID-19 group, generalized weakness/fatigue (40 %), headache (29 %), fever/body aches (3 %), and cough (9 %) were significantly less common, sleep disorders / insomnia (17 %), muscle pain (11 %), shortness of breath (17 %), runny nose / sneezing (6 %), loss (worsening) of appetite (3 %), sore throat (6 %), difficulty concentrating (6 %), abdominal pain (3 %) (p&lt;0.05). Conclusions. Reduced access to healthcare services leads to delayed hospitalization, prolonged treatment, and complications. The level of vaccination does not affect the risk of Long COVID. Clinical signs of Long COVID: generalized weakness/fatigue, anxiety, mood disturbance, headache are detected in one third of patients and cause a decrease in overall quality of life. The most persistent are general weakness/fatigue, headache, shortness of breath, sleep disorders/insomnia and persist in 34-42 % of patients from the moment COVID-19 is confirmed.

Ex vivo and in vitro methods as a platform for studying anthropogenic effects on marine mammals: four challenges and how to meet them

Marine mammals are integral to global biodiversity and marine health through their roles in coastal, benthic, and pelagic ecosystems. Marine mammals face escalating threats from climate change, pollution, and human activities, which perturb their oceanic environment. The diverse biology and extreme adaptations evolved by marine mammals make them important study subjects for understanding anthropogenic pressures on marine ecosystems. However, ethical and logistical constraints restrict the tractability of experimental research with live marine mammals. Additionally, studies on the effects of changing ocean environments are further complicated by intricate gene-environment interactions across populations and species. These obstacles can be overcome with a comprehensive strategy that involves a systems-level approach integrating genotype to phenotype using rigorously defined experimental conditions in vitro and ex vivo. A thorough analysis of the interactions between the genetics of marine mammals and their exposure to anthropogenic pressures will enable robust predictions about how global environmental changes will affect their health and populations. In this perspective, we discuss four challenges of implementing such non-invasive approaches across scientific fields and international borders: 1) practical and ethical limitations of in vivo experimentation with marine mammals, 2) accessibility to relevant tissue samples and cell cultures; 3) open access to harmonized methods and datasets and 4) ethical and equitable research practices. Successful implementation of the proposed approach has the potential impact to inspire new solutions and strategies for marine conservation.

Application of triplet-primer PCR technology for the genetic testing and prenatal diagnosis of patients with Myotonic dystrophy type 1

To explore the application of triplet-primer PCR (TP-PCR) for the genetic testing and prenatal diagnosis in patients with Myotonic dystrophy type 1 (DM1). A total of 60 individuals from 48 pedigrees undergoing genetic testing at the Genetic and Prenatal Diagnosis Center of the First Affiliated Hospital of Zhengzhou University from May 2018 to October 2022 were selected as the study subjects. TP-PCR combined with capillary electrophoresis was applied to determine the number of CTG repeats of the DMPK gene, and prenatal testing was provided to four DM1 pedigrees. This study was approved by the First Affiliated Hospital of Zhengzhou University (Ethics No. KS-2018-KY-36). A total of 52 DM1 patients were detected, mostly with muscle weakness, muscular atrophy and myotonia as the initial symptoms, along with typical myotonic potentials. Some patients also had abnormalities of other systems. The number of abnormal CTG repeats of the DMPK gene was > 50, whilst the number of CTG repeats on the normal allele had ranged from 5 to 18. The number of the most common normal CAG repeats was 6 (30.77%, 16/52). Among the four DM1 pedigrees undergoing prenatal diagnosis, one fetus was healthy, whilst three fetuses were found to have abnormal CTG repeats (> 50 times) and diagnosed with DM1. TP-PCR can diagnose DM1 patients with speed and accuracy. However, this method cannot accurately determine the number of CTG repeats when it exceeds 50.

Development of a prediction model for the incidence of type 2 diabetic kidney disease and its application based on a regional health data platform

Objective: To construct a risk prediction model for diabetes kidney disease (DKD). Methods: Patients newly diagnosed with type 2 diabetes mellitus (T2DM) between January 1, 2015, and December 31, 2022, were selected as study subjects from the Yinzhou Regional Health Information Platform in Ningbo City. The Lasso method was used to screen the risk factors, and the DKD risk prediction model was established using Cox proportional hazard regression models. Bootstrap 500 resampling was applied for internal validation. Results: The study included 49 706 subjects, with an median (Q1, Q3) age of 60.00 (50.00, 68.00) years old, and 55% were male. A total of 4 405 subjects eventually developed DKD. Age at first diagnosis of T2DM, BMI, education level, fasting plasma glucose, glycated hemoglobin A1c, urinary albumin, past medical history (hyperuricemia, rheumatic diseases), triglycerides, and estimated glomerular filtration rate were included in the final model. The final model's C-index was 0.653, with an average of 0.654 after Bootstrap correction. The final model's area under the receiver operating characteristic curve for predicting 4-year, 5-year, and 6-year was 0.657, 0.659, and 0.664, respectively. The calibration curve was closely aligned with the ideal curve. Conclusions: This study constructed a DKD risk prediction model for newly diagnosed T2DM patients based on real-world data that is simple, easy to use, and highly practical. It provides a reliable basis for screening high-risk groups for DKD.

A screening study of high-risk groups for liver fibrosis in patients with metabolic dysfunction-associated fatty liver disease

The purpose of this study was to explore the correlation between Hashimoto’s thyroiditis and Metabolic dysfunction-associated fatty liver disease (MAFLD), and at the same time to screen high-risk groups for liver fibrosis in MAFLD, find out the high-risk related indicators. The physical examination population was included as the study subjects and was grouped according to the diagnostic criteria for MAFLD. APRI > 1 or NFS > 0.676 or FIB-4 > 2.67were used to assess people at high risk of liver fibrosis, and logistic regression analysis was used to identify risk factors associated with high risk of liver fibrosis in MAFLD. ROC curves are used to look for indicators of diagnostic value. The proportion of people with Hashimoto’s thyroiditis was lower in the MAFLD group. The MAFLD high-risk group for liver fibrosis had higher TSH levels, lower FT3 and FT4 levels, higher TGAB levels, and differences in biochemical markers. Age, BMI, FBG, and AST are risk factors for the high risk of liver fibrosis in MAFLD patients. ROC curve analysis showed that the AUC of age was 0.741 (0.721–0.761), and the optimal stage value was 57.5 years, while the AUC of AST was 0.729 (0.707–0.751), and the optimal cut-off value was 39.5 U/L. Age, BMI, FBG, and AST are risk factors for the high risk of liver fibrosis in MAFLD patients.The age is greater than or equal to 57.5 years, or the AST is greater than or equal to 39.5 U/L, indicating that the MAFLD patients are at high risk of liver fibrosis.

Clinical characteristics and genetics functional analysis of two children with Spinal muscular atrophy

To explore the characteristics of SMN1 gene variants and carry out functional verification for two children with Spinal muscular atrophy (SMA). Two male children with complicated SMA diagnosed at the Children's Hospital Affiliated to Capital Institute of Pediatrics respectively in July 2021 and April 2022 due to delayed or retrograde motor development were selected as the study subjects. Clinical data of the children were collected. Primary culture of skin fibroblasts was carried out, and peripheral blood samples were collected from both children and their parents. Multiplex ligation-dependent probe amplification, combined long-range PCR and nested PCR, and Sanger sequencing were carried out to detect the copy number and variants of the SMN1 gene. Absolute quantitative real-time PCR, Western blotting and immunofluorescence were used to determine the transcriptional level of the SMN gene, expression of the SMN protein, and the number of functional SMN protein complexes (gems body), respectively. This study was approved by the Children's Hospital Affiliated to Capital Institute of Pediatrics (Ethics No. SHERLLM2021009). Child 1, a 1-year-old boy, was clinically diagnosed with type 1 SMA. Child 2, a 2-and-a-half-year-old boy, was clinically diagnosed with type 3 SMA. Both children were found to harbor a paternally derived SMN1 deletion and a maternally derived SMN1 gene variant, namely c.824G>T (p.Gly275Val) and c.884A>T (p.*295Leu). Compared with the normal controls and carriers, the levels of full-length SMN1 transcripts in their peripheral blood and skin fibroblast cell lines were significantly decreased (P < 0.05), and the levels of SMN protein normalized to that of β-actin, and the numbers of gems bodies in the primary fibroblast cells were also significantly lower (P < 0.05). Based on the guidelines from the American College of Medical Genetics and Genomics, both variants were classified as likely pathogenic (PS3+PM3+PM5+PP3; PS3+PM3+PM4+PP3). Following the diagnosis, both children had received nusinersen treatment. Although their motor function was improved, child 1 still died at the age of 2 due to severe pulmonary infection. The walking ability of child 2 was significantly improved, and his prognosis appeared to be good. Two cases of clinically complicated SMA have been confirmed by genetic testing and experimental studies, which has provided a reference for their accurate treatment.

Demographic Influences on Suicide Attempts: A Study of Age, Gender, Socioeconomic Status and Profession

Introduction: Suicide remains a significant public health concern globally, with its prevalence reflecting complex interactions among various factors such as age, gender, socio-economic status, and profession. This study aimed to assess the patterns of suicide attempts, focusing on age, gender, socio-economic status, and profession. Methods: This descriptive cross-sectional study was carried out at Department of psychiatry, Sheikh Hasina Medical college, Jamalpur, Bangladesh during the period from January 2018 to December 2018. All patients with suicide attempts admitted in the different wards of Community-Based Medical College, Mymensingh, and fulfilling the inclusion and exclusion criteria were selected as a sample for the study. A total of 90 patients were selected as study subjects by purposive sampling technique. Data analysis was done by SPSS (Statistical Package for Social Sciences) version 20. Result: The study revealed that the majority of suicide attempts occurred in the 21-30 years age group (52%), with middle-class individuals contributing the highest number (47.8%) of attempts. Unmarried individuals, particularly females, had the most attempts (58%), while students accounted for the largest percentage of suicide attempts by profession (38%), primarily in the 11-21 years age group. Rural residents had more attempts (70%) compared to urban residents (30%), and individuals from joint families (66%) were more likely to attempt suicide than those from nuclear families (34%). Conclusion: Young adults (21-30 years) and adolescents (11-21 years) are the most vulnerable age groups, with suicide attempts being notably higher among unmarried individuals and those from middle socio-economic backgrounds. Females exhibit a higher rate of attempts than males, especially among the unmarried. Professionally, students and unemployed individuals are particularly at risk.

Retrospective analysis of 62 cases who received clinical application of artificial temporomandibular joint

Objective: To conduct a retrospective study on the treatment outcomes of patients who underwent artificial temporomandibular joint (TMJ) replacement surgery and to evaluate the effectiveness of artificial TMJ treatment. Methods: This study selected 62 patients who received standard Biomet artificial TMJ treatment at Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University from May 2010 to September 2023 as the study subjects. Among them, there were 15 male patients and 47 female patients. The average age was 33.5 years old(ranging from 18 to 67 years). This study statistically analyzed postoperative indicators, including maximum mouth opening, forward jaw movement, lateral movement, postoperative pain scores, and patient satisfaction. Results: This study included a total of 62 patients with 99 TMJ joints. No infections occurred postoperatively. The average follow-up period was 33.7 months (ranging from 7 to 170 months). At 6 months postoperatively, the mean mouth opening was (36.1±6.2) mm, lateral movement was (2.1±0.9) mm, and forward jaw movement was (1.0±0.9) mm. The pain visual analog scale score at 6 months postoperatively was (2.8±0.6), and patient satisfaction with the surgery was (8.8±1.1). Spiral CT scans conducted after surgery showed no joint dislocation or migration, and the artificial joint remained stable during the follow-up period. Conclusions: Artificial TMJ replacement is a valuable method for effectively restoring TMJ structure and essential functions related to mouth opening and chewing. It is worthy of promotion as a reconstructive approach for the temporomandibular joint.