Publications by authors named "Ahmed Ali"

908 Publications

Cardiovascular Safety of Hydroxychloroquine in Veterans with Rheumatoid Arthritis.

Arthritis Rheumatol 2021 May 10. Epub 2021 May 10.

Veterans Affairs Medical Center, Washington, DC, USA.

Objective: Hydroxychloroquine (HCQ) may prolong the QT interval, a risk factor for torsade de pointes, a potentially fatal ventricular arrhythmia. We examined the cardiovascular safety of HCQ in patients with rheumatoid arthritis (RA).

Methods: We conducted an active comparator safety study of HCQ in a propensity score-matched cohort of 8852 Veterans newly diagnosed with RA between October 1, 2001, and December 31, 2017. Patients were initiated on HCQ (n=4426) or another non-biologic disease-modifying antirheumatic drug (DMARD; n=4426) after RA diagnosis, up to December 31, 2018, and followed for 12 months after therapy initiation, up to December 31, 2019.

Results: Patients had a mean age of 64 (±12) years, 14% were women, 28% African American, and were balanced on 87 baseline characteristics. There were 3 (0.03%) long QT syndrome (LQTS) events, of which 2 belonged to the HCQ group. Of the 56 (0.63%) arrhythmia-related hospitalizations, 30 belonged to the HCQ group (hazard ratio associated with HCQ, 1.16; 95% CI, 0.68-1.95). All-cause mortality occurred in 144 (3.25%) and 136 (3.07%) patients in the HCQ and non-HCQ groups, respectively (hazard ratio associated with HCQ, 1.06; 95% CI, 0.84-1.34). During the first 30 days of follow-up, there was no LQTS event, 2 arrhythmia-related hospitalizations (none in the HCQ group), and 13 deaths (6 in the HCQ group).

Conclusions: The incidence of LQTS and arrhythmia-related hospitalization was low in patients with RA during the first year after the initiation of HCQ or another non-biologic DMARD. We found no evidence that HCQ therapy is associated with a higher risk of adverse cardiovascular events or death.
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http://dx.doi.org/10.1002/art.41803DOI Listing
May 2021

How Does Multiple Listing Affect Lung Transplantation? A Retrospective Analysis.

Semin Thorac Cardiovasc Surg 2021 May 7. Epub 2021 May 7.

Department of Surgery, Division of Cardio-thoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, USA; Department of Medicine, Pulmonology, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address:

The impact of multiple listing (ML) strategies on lung transplantation is unknown. Retrospective review of United Network for Organ Sharing (UNOS) registry for lung transplantation between May 1, 2005 and March 31, 2017 was performed. Characteristics of single (SL) and ML candidates were compared, and incidence density matching was used to select up to 10 controls for each case. Overall survival was evaluated using Cox regression stratified by matched sets. Nelson-Aalen estimators were used to estimate the cumulative incidence (CI) of transplant, death on the waiting list, and removal from wait-list as competing risks; Gray's test was used to compare wait list outcomes between groups. 23,445 subjects listed for lung transplant, of which 467 (2%) subjects listed at 2+ centers; 206 matched sets. There was no difference in overall survival of matched cases and controls at 1 year (ML 83.7%, SL 90.2%), 3 years (ML 63.9%, SL 68%), and 5 years (ML 51.9%, SL 49.3%) (p=0.24). The CIs of receiving a lung transplant at 2 years for ML and SL were 83.6% and 71%, respectively. Multi-listing increased the probability of receiving a transplant (p<0.001) but was not associated with waitlist mortality (p=0.13). There was no difference in post-transplant survival between ML and SL candidates (HR=0.82, p=0.32). ML was associated with a substantial increase in probability of lung transplantation, but there was no difference in overall survival, post-transplant, or wait-list mortality. Our study permits more informed decision-making for patients considering the ML strategy.
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http://dx.doi.org/10.1053/j.semtcvs.2021.03.041DOI Listing
May 2021

Barriers to accessing preventive health care among African-born individuals in King County, Washington: A qualitative study involving key informants.

PLoS One 2021 10;16(5):e0250800. Epub 2021 May 10.

Department of Medicine, University of Washington, Seattle, Washington, United States of America.

Studies of African immigrant health in the U.S. have traditionally focused on infectious diseases. However, the rising burden of non-communicable diseases (NCDs) indicates the increasing importance of general preventive health care. As part of a series of community health events designed for African-born individuals in King County, Washington, we administered key informant interviews (KIIs) with 16 health event participants, medical professionals, and community leaders to identify barriers and facilitators to use of preventive health care among African-born individuals. We used descriptive thematic analysis to organize barriers according to the socio-ecological model. Within the individual domain, KII participants identified lack of knowledge and awareness of preventive health benefits as barriers to engagement in care. Within the interpersonal domain, language and cultural differences frequently complicated relationships with health care providers. Within the societal and policy domains, healthcare costs, lack of insurance, and structural racism were also reported as major barriers. Participants identified community outreach with culturally competent and respectful providers as key elements of interventions to improve uptake. In conclusion, African immigrant communities face several barriers, ranging from individual to policy levels, to accessing health services, resulting in substantial unmet need for chronic disease prevention and treatment. Community-centered and -led care may help facilitate uptake and engagement in care.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250800PLOS
May 2021

The mystery of plummeting cases of measles during COVID-19 pandemic in Pakistan: Hidden impact of collateral damage.

J Med Virol 2021 May 3. Epub 2021 May 3.

College of Pharmacy, University of Manitoba, Winnipeg, Canada.

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http://dx.doi.org/10.1002/jmv.27045DOI Listing
May 2021

Unequal distribution of COVID-19 vaccine: A looming crisis.

J Med Virol 2021 May 3. Epub 2021 May 3.

School of Pharmacy, Monash University, Subang Jaya, Selangor, Malaysia.

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http://dx.doi.org/10.1002/jmv.27031DOI Listing
May 2021

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial.

Authors:

Lancet 2021 May;397(10285):1637-1645

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation.

Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg-800 mg (depending on weight) given intravenously. A second dose could be given 12-24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936).

Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76-0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12-1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77-0·92; p<0·0001).

Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids.

Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research.
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http://dx.doi.org/10.1016/S0140-6736(21)00676-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8084355PMC
May 2021

Harnessing the Rhizosphere of the Halophyte Grass for Halophilic Plant-Growth-Promoting Fungi and Evaluation of Their Biostimulant Activities.

Plants (Basel) 2021 Apr 16;10(4). Epub 2021 Apr 16.

Plant Production Department, College of Food and Agricultural Sciences, King Saud University, P.O. Box 2460, Riyadh 11451, Saudi Arabia.

Hydroponic systems have gained interest and are increasingly used in hot and dry desert areas. Numbers of benefits are offered by hydroponic systems such as the ability to save water, enhance nutrients use efficiency, easy environmental control, and prevention of soil-borne diseases. However, the high consumption of chemical fertilizers for nutrient solution and the sensitivity of closed hydroponic systems to salinity are issues that need solutions. Thus, the main goal of our research activities is to isolate plant growth promoting fungi in order to develop sustainable hydroponic systems. We are working on isolating and testing the possibility to incorporate the cell-free filtrate (CFF) of plant growth promoting fungi (PGPF) in the composition of the nutrient solution. In this work, we isolated six strains of PGPF from the rhizosphere of the halophyte grass . Phylogenetic analyses of DNA sequences amplified by ITS1 and ITS4 primers identified the isolated fungi as: , , , , , and . The promoting of vigor in tobacco seedlings was used as criteria to evaluate the biostimulant activity of these fungi by adding either their mycelia (DE: direct effect) or their cell-free filtrates (CFF: indirect effect) to the plant-growth media. The best significant growth stimulation was obtained with plants treated by . However, only the CFFs of (A5.1) and (A8) when added at a dilution factor of 1/50 to half-strength nutritive solution (0.5NS) resulted in significant improvement of all assessed growth parameters. Indeed, the A5.1CFF and A8CFF in 0.5NS induced a significant better increase in the biomass production when compared to NS or 0.5NS alone. All fungi produced indole acetic acid in the CFFs, which could be one of the key factors explaining their biostimulant activities. Furthermore, six genes involved in nitrogen-metabolism ( and ), auxin biosynthesis ( and ), and brassinosteroid biosynthesis ( and ) were shown to be induced in roots or leaves following treatment of plants with the all CFFs. This work opens up a prospect to study in deep the biostimulant activity of PGPFs and their applications to decrease the requirement of chemical fertilizers in the hydroponic growing systems.
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http://dx.doi.org/10.3390/plants10040784DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8073152PMC
April 2021

Enterocutaneous fistula closure using a balloon-assisted enteroscope preloaded with an over-the-scope clip - narrowing the gap.

Endoscopy 2021 Apr 28. Epub 2021 Apr 28.

The University of Alabama at Birmingham, Birmingham, Alabama, USA.

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http://dx.doi.org/10.1055/a-1471-2037DOI Listing
April 2021

Customer and Worker Discrimination against Gay and Lesbian Business Owners: A Web-Based Experiment among Students in Sweden.

J Homosex 2021 Apr 22:1-10. Epub 2021 Apr 22.

Department of Economics and Statistics, Linnæus University, Växjö, Sweden.

We examined customer and worker discrimination against gay and lesbian business owners using a web-based experiment conducted at a Swedish university campus. Participants ( = 1,406) were presented with a prospective restaurant establishment on the campus. They then stated whether they would be positive to such an establishment, whether they would be interested in working at the restaurant, and what their reservation wage would be if they were interested in the job. Owners' sexual orientation was randomized across participants. Results showed that participants were less positive to a restaurant opening if the owners were lesbians, and they were less interested in an available job if the owners were gay. The participants had higher reservation wages if the owners were lesbians. In fact, the participants increased their wage demands when the number of women among the owners increased. Our study underlines that gay and lesbian people face various inequalities in society.
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http://dx.doi.org/10.1080/00918369.2021.1919478DOI Listing
April 2021

Original Article--Outcomes of Pacing in Egyptian Pediatric Population.

J Saudi Heart Assoc 2021 15;33(1):61-70. Epub 2021 Apr 15.

Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Objectives: Permanent pacemakers are widely used in the pediatric population due to congenital and surgically acquired rhythm disturbances. The diversity and complexity of congenital heart diseases make device management a highly individualized procedure in pediatric pacing. We are also faced with special problems in pediatric age group as growth, children's activity and infection susceptibility. This study aimed to present our institute's experience in pediatric and adolescent pacemaker implantation and long-term outcomes.

Methods: This cross-sectional observational study included 100 pediatric patients who visited our outpatient clinics at Ain Shams University Hospitals for regular follow up of their previously implanted permanent pacemakers. All patients were subjected to history taking, clinical examination, ECG recording, echocardiography and elaborate device programming. Data about device types, device components' longevity, subsequent procedures, complications were collected, with comparison between epicardial and endocardial pacemakers.

Results: Our study population ranged in age from 8 months to 18 years (mean 13.12 ± 5.04 years), 51 were males and 53 patients had congenital heart disease. Epicardial pacing represented 26% of our total population using only VVIR pacemakers, while endocardial pacing represented 74% of our population with 58.1% of them being VVIR pacemakers. First battery longevity was higher in endocardial batteries (108 months vs. 60 months, p value: 0.007). First lead longevity was also higher in endocardial leads (105 moths vs. 58 months, p value: 0.006). Complication rate was 25%; 8 patients had early complications (one insulation break in endocardial group). Late complications occurred in 17 patients (10 patients had lead fracture; 9 of them were endocardial, 2 insulation breaks in endocardial leads, 3 patients from epicardial group had lead failure of capture). In total, 16 patients had lead-related complications. There was no statistically significant difference between different lead models regarding lead-related complications.

Conclusion: Pacemakers in children are generally safe, but still having high rates of lead-related complications. Lead failure of capture was more common in epicardial leads. These complications had no relation to the model of the leads. Endocardial pacemakers showed higher first lead and first battery longevity compared to epicardial pacemakers.
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http://dx.doi.org/10.37616/2212-5043.1244DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8051327PMC
April 2021

Artificial intelligence (AI) for medical imaging to combat coronavirus disease (COVID-19): a detailed review with direction for future research.

Artif Intell Rev 2021 Apr 15:1-31. Epub 2021 Apr 15.

Discipline of Business Analytics in Business School, The University of Sydney, Sydney, Australia.

Since early 2020, the whole world has been facing the deadly and highly contagious disease named coronavirus disease (COVID-19) and the World Health Organization declared the pandemic on 11 March 2020. Over 23 million positive cases of COVID-19 have been reported till late August 2020. Medical images such as chest X-rays and Computed Tomography scans are becoming one of the main leading clinical diagnosis tools in fighting against COVID-19, underpinned by Artificial Intelligence based techniques, resulting in rapid decision-making in saving lives. This article provides an extensive review of AI-based methods to assist medical practitioners with comprehensive knowledge of the efficient AI-based methods for efficient COVID-19 diagnosis. Nearly all the reported methods so far along with their pros and cons as well as recommendations for improvements are discussed, including image acquisition, segmentation, classification, and follow-up diagnosis phases developed between 2019 and 2020. AI and machine learning technologies have boosted the accuracy of Covid-19 diagnosis, and most of the widely used deep learning methods have been implemented and worked well with a small amount of data for COVID-19 diagnosis. This review presents a detailed mythological analysis for the evaluation of AI-based methods used in the process of detecting COVID-19 from medical images. However, due to the quick outbreak of Covid-19, there are not many ground-truth datasets available for the communities. It is necessary to combine clinical experts' observations and information from images to have a reliable and efficient COVID-19 diagnosis. This paper suggests that future research may focus on multi-modality based models as well as how to select the best model architecture where AI can introduce more intelligence to medical systems to capture the characteristics of diseases by learning from multi-modality data to obtain reliable results for COVID-19 diagnosis for timely treatment .
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http://dx.doi.org/10.1007/s10462-021-09985-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8047522PMC
April 2021

The crux of Pakistan's prolonged rabies vaccine shortage: A rising mortal threat in the COVID-19 pandemic.

J Med Virol 2021 Apr 14. Epub 2021 Apr 14.

Allama Iqbal Open University, Islamabad, Pakistan.

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http://dx.doi.org/10.1002/jmv.27024DOI Listing
April 2021

Suspended sediment load prediction using long short-term memory neural network.

Sci Rep 2021 Apr 9;11(1):7826. Epub 2021 Apr 9.

Department of Civil Engineering, Faculty of Engineering, University of Malaya (U.M.), 50603, Kuala Lumpur, Malaysia.

Rivers carry suspended sediments along with their flow. These sediments deposit at different places depending on the discharge and course of the river. However, the deposition of these sediments impacts environmental health, agricultural activities, and portable water sources. Deposition of suspended sediments reduces the flow area, thus affecting the movement of aquatic lives and ultimately leading to the change of river course. Thus, the data of suspended sediments and their variation is crucial information for various authorities. Various authorities require the forecasted data of suspended sediments in the river to operate various hydraulic structures properly. Usually, the prediction of suspended sediment concentration (SSC) is challenging due to various factors, including site-related data, site-related modelling, lack of multiple observed factors used for prediction, and pattern complexity.Therefore, to address previous problems, this study proposes a Long Short Term Memory model to predict suspended sediments in Malaysia's Johor River utilizing only one observed factor, including discharge data. The data was collected for the period of 1988-1998. Four different models were tested, in this study, for the prediction of suspended sediments, which are: ElasticNet Linear Regression (L.R.), Multi-Layer Perceptron (MLP) neural network, Extreme Gradient Boosting, and Long Short-Term Memory. Predictions were analysed based on four different scenarios such as daily, weekly, 10-daily, and monthly. Performance evaluation stated that Long Short-Term Memory outperformed other models with the regression values of 92.01%, 96.56%, 96.71%, and 99.45% daily, weekly, 10-days, and monthly scenarios, respectively.
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http://dx.doi.org/10.1038/s41598-021-87415-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035216PMC
April 2021

Cell-programmed nutrient partitioning in the tumour microenvironment.

Nature 2021 May 7;593(7858):282-288. Epub 2021 Apr 7.

Department of Radiology and Radiological Sciences, VUMC, Nashville, TN, USA.

Cancer cells characteristically consume glucose through Warburg metabolism, a process that forms the basis of tumour imaging by positron emission tomography (PET). Tumour-infiltrating immune cells also rely on glucose, and impaired immune cell metabolism in the tumour microenvironment (TME) contributes to immune evasion by tumour cells. However, whether the metabolism of immune cells is dysregulated in the TME by cell-intrinsic programs or by competition with cancer cells for limited nutrients remains unclear. Here we used PET tracers to measure the access to and uptake of glucose and glutamine by specific cell subsets in the TME. Notably, myeloid cells had the greatest capacity to take up intratumoral glucose, followed by T cells and cancer cells, across a range of cancer models. By contrast, cancer cells showed the highest uptake of glutamine. This distinct nutrient partitioning was programmed in a cell-intrinsic manner through mTORC1 signalling and the expression of genes related to the metabolism of glucose and glutamine. Inhibiting glutamine uptake enhanced glucose uptake across tumour-resident cell types, showing that glutamine metabolism suppresses glucose uptake without glucose being a limiting factor in the TME. Thus, cell-intrinsic programs drive the preferential acquisition of glucose and glutamine by immune and cancer cells, respectively. Cell-selective partitioning of these nutrients could be exploited to develop therapies and imaging strategies to enhance or monitor the metabolic programs and activities of specific cell populations in the TME.
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http://dx.doi.org/10.1038/s41586-021-03442-1DOI Listing
May 2021

Devastating urban flooding and dengue outbreak during the COVID-19 pandemic in Pakistan.

Med J Islam Repub Iran 2020 15;34:169. Epub 2020 Dec 15.

Department of Pharmacy, Quaid-I-Azam University, Islamabad, Pakistan.

Pakistan has recently been overwhelmed by extreme torrential rains, with its most populous city of Karachi experiencing its worst floods in almost a century. Poor flood control and water disposal facilities have led to an immense risk of another dengue outbreak, with multiple cases being reported recently. The enormous accumulation of stagnant water in urban areas is a major source of mosquito breeding and transmission. Historical data has shown the correlation between the number of dengue cases and average rainfall in the region. The monsoon rains have pounded at a time where health authorities are battling to contain the Coronavirus (COVID-19) pandemic. There is a need to implement centralized dengue control strategies to undertake large scale water drainage, sanitation, and disinfection drives in disaster-stricken areas alongside public health awareness programs to combat the after-effects of this natural calamity.
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http://dx.doi.org/10.47176/mjiri.34.169DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8004574PMC
December 2020

Paroxysmal narrow complex tachycardia secondary to hypokalaemic periodic paralysis.

Br J Hosp Med (Lond) 2021 Mar 13;82(3):1-3. Epub 2021 Mar 13.

Department of Diabetes and Endocrinology, Bassetlaw Hospital, Doncaster and Bassetlaw, Teaching Hospitals NHS Foundation Trust, Worksop, UK.

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http://dx.doi.org/10.12968/hmed.2020.0464DOI Listing
March 2021

Efficacy of topical versus intradermal injection of Tranexamic Acid In Egyptian melasma Patients: A randomised clinical trial.

Australas J Dermatol 2021 Mar 30. Epub 2021 Mar 30.

Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut, Egypt.

Background: Melasma is one of the common pigmentary problems affecting females in our community, owing to the frequent use of hormonal contraceptives as well as our sunny climate. A lot of treatment options are available but none of them is completely satisfactory. Many patients prefer the use of topical preparations and minimally invasive methods. Tranexamic acid (TA) is a potential treatment option for hyperpigmentation with different delivery routes.

Aim: We designed the study in order to evaluate the efficacy of TA in melasma using 2 different routes of delivery.

Patients And Methods: A randomised clinical trial was performed on 60 female patients with melasma, they randomly divided into three groups; A, B and C. Group (A) patients received TA (4 mg/mL) intradermal injections every 2 weeks with, group B received TA (10 mg/mL) intradermal injections every 2 weeks, group C received TA cream (10% concentration) twice daily, treatment continued for 12 weeks in all groups. Melasma Area and Severity Index (MASI) scores were measured for each patient before and after completion of treatment.

Results: The percentage of MASI score reduction was highest in group B (62.7%) versus (39.1%) in group A, while the percentage of MASI reduction was the lowest in group C (4.2%).

Conclusion: Tranexamic acid is a safe effective and well-tolerated treatment option for melasma patients. Intradermal injection of TA leads to better results than the topical application. Topical TA cream (even in a high concentration) produce fair improvement of melasma.
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http://dx.doi.org/10.1111/ajd.13575DOI Listing
March 2021

Comparative bursal cytokine gene expression and apoptosis in vaccinated chickens following virulent infectious bursal disease virus challenge.

Virology 2021 Jun 18;558:126-133. Epub 2021 Mar 18.

Poultry Diseases Department, Faculty of Veterinary Medicine, Beni-Suef University, Beni-Suef, 62511, Egypt. Electronic address:

The bursal cytokine gene expression and apoptosis were compared in vaccinated chickens with either live or immune-complex infectious bursal disease virus (IBDV) vaccines with or without virulent IBDV challenge. The cytokine gene expressions were evaluated at 5 and 12 day-post-challenge (DPC). The apoptotic marker Caspase-3 was determined by IHC on collected bursae, thymus, spleen, and kidneys at 12 DPC. A significantly decreased bursal cytokine levels were observed in the all-vaccinated birds except for IL-6 in the classic IBD vaccines at 5DPC. A significant upregulation of the IL-2 was observed in the live IBD vaccinated birds. No significant differences in the bursa and thymus Caspase-3 positive cells. However, splenic and renal apoptosis was significantly higher in the live IBD vaccine groups. Results indicate that both vaccine types reduce the IBDV-induced bursal proinflammatory cytokines and apoptosis. However, classic IBD vaccines failed to clear the challenge virus or reduce splenic and renal apoptosis.
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http://dx.doi.org/10.1016/j.virol.2021.03.004DOI Listing
June 2021

Authors' Response: Can a Three-Arm RCT With Two Active Drugs Have One Placebo? Yes, the Literature Contains Many.

J Pediatr Adolesc Gynecol 2021 Mar 21. Epub 2021 Mar 21.

Faculty of Medicine, Al Azhar University, Egypt.

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http://dx.doi.org/10.1016/j.jpag.2021.03.006DOI Listing
March 2021

Complete Genome Sequence of Mycobacteriophage Fulbright.

Microbiol Resour Announc 2021 Mar 18;10(11). Epub 2021 Mar 18.

Department of Biology, College of Science, Mustansiriyah University, Baghdad, Iraq.

Mycobacteriophage Fulbright was isolated from soil in central Oklahoma using mc115. The genome of phage Fulbright is 42,396 bp long and contains 70 open reading frames (ORFs), with 33 having predicted functions and 37 having hypothetical proteins. It belongs to cluster N and shares 99% nucleotide identity with mycobacteriophage Phloss.
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http://dx.doi.org/10.1128/MRA.00123-21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7975880PMC
March 2021

Myths and conspiracy theories on vaccines and COVID-19: Potential effect on global vaccine refusals.

Vacunas 2021 Mar 11. Epub 2021 Mar 11.

Medical Research Unit, School of Medicine, Syiah Kuala University, 23111, Indonesia.

The current coronavirus disease 2019 (COVID-19) pandemic is one of the international crises and researchers are working collaboratively to develop a safe and effective COVID-19 vaccine. The World Health Organization recognizes vaccine hesitancy as the world's top threat to public health safety, particularly in low middle-income countries. Vaccine hesitancy can be due to a lack of knowledge, false religious beliefs, or anti-vaccine misinformation. The current situation regarding anti-vaccine beliefs is pointing towards dreadful outcomes. It raises the concern that will people believe and accept the new COVID-19 vaccines despite all anti-vaccine movements and COVID-19-related myths and conspiracy theories. This review discusses the possible detrimental impact of myths and conspiracy theories related to COVID-19 and vaccine on COVID-19 vaccine refusals as well as other vaccine programs.
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http://dx.doi.org/10.1016/j.vacun.2021.01.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7951562PMC
March 2021

Understanding Demographic Risk Factors for Adverse Outcomes in COVID-19 Patients: Explanation of a Deep Learning Model.

J Healthc Inform Res 2021 Feb 27:1-20. Epub 2021 Feb 27.

Washington DC VA Medical Center, Washington, DC USA.

This study was to understand the impacts of three key demographic variables, age, gender, and race, on the adverse outcome of all-cause hospitalization or all-cause mortality in patients with COVID-19, using a deep neural network (DNN) analysis. We created a cohort of Veterans who were tested positive for COVID-19, extracted data on age, gender, and race, and clinical characteristics from their electronic health records, and trained a DNN model for predicting the adverse outcome. Then, we analyzed the association of the demographic variables with the risks of the adverse outcome using the impact scores and interaction scores for explaining DNN models. The results showed that, on average, older age and African American race were associated with higher risks while female gender was associated with lower risks. However, individual-level impact scores of age showed that age was a more impactful risk factor in younger patients and in older patients with fewer comorbidities. The individual-level impact scores of gender and race variables had a wide span covering both positive and negative values. The interaction scores between the demographic variables showed that the interaction effects were minimal compared to the impact scores associated with them. In conclusion, the DNN model is able to capture the non-linear relationship between the risk factors and the adverse outcome, and the impact scores and interaction scores can help explain the complicated non-linear effects between the demographic variables and the risk of the outcome.
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http://dx.doi.org/10.1007/s41666-021-00093-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914049PMC
February 2021

Prevalence and determinants of restless leg syndrome in type 2 diabetes mellitus (T2DM) in Pakistan.

Diabetes Metab Syndr 2021 Mar-Apr;15(2):525-528. Epub 2021 Feb 13.

Saulat Institute of Pharmaceutical Sciences & Drug Research, Quaid-i-Azam University, Islamabad, Pakistan.

Background And Aims: Restless legs syndromes (RLS) are intrinsic sleeping disorder and its prevalence rate is 10-15% in general population but it is observed that prevalence rate is different in diabetes patients. Current study aims to find prevalence and determinants of RLS in people living with type 2 diabetes mellitus in Pakistan.

Method: A multicenter cross-sectional observational study was conducted in 388 diabetes patients attending daily diabetes clinics and teaching hospitals in Pakistan's twin city between August 2019 and February 2020. The chi-square test and linear regression were used to detect RLS-related factors in type 2 diabetes mellitus.

Results: The prevalence of RLS found was; 3.1% patients with diabetes were suffering from very severe RLS, 23.5% from severe RLS, 34% from moderate RLS, 21.1% from mild RLS and 18.3% from non-RLS. Gender, age, education, blood glucose fasting (BSF), blood glucose random (BSR) and HBA1c were found to be significant predictors of RLS in patients with diabetes.

Conclusion: Policy makers can develop local interventions to curb the growing RLS prevalence by keeping in control the risk factors of RLS in people living with type 2 diabetes.
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http://dx.doi.org/10.1016/j.dsx.2021.02.013DOI Listing
February 2021

Association of KDR rs1870377 genotype with clopidogrel resistance in patients with post percutaneous coronary intervention.

Heliyon 2021 Feb 16;7(2):e06251. Epub 2021 Feb 16.

Department of Pharmacology and Therapeutics, College of Medicine, University of Kufa, Iraq.

Background: Clopidogrel is an antiplatelet therapy that is widely used in pre and post percutaneous (PCI) coronary intervention procedures to prevent platelet aggregation and stent restenosis. However, there is a wide inter-individual variation in clopidogrel response and some patients showed resistance against the activity of Clopidogrel. Kinase insert domain receptor ( gene is responsible for the transcription of vascular endothelial growth factor receptor 2 (VEGFR2) that plays a major role in the cardiovascular diseases (CVDs) and platelet aggregation. The aim of this study was to find out the association of genotype with clopidogrel resistance (CR) in CVD patients, of Iraqi Arabic origin, hospitalized for elective PCI.

Materials And Methods: This study was a case-control study with a total of 324 PCI patients. Those patients were classified into 213 patients with non-clopidogrel resistant and 111 patients with CR, depending on the analysis of platelet activity phenotype after clopidogrel administration. was genotyped for all patients using polymerase chain reaction-restriction fragment length polymorphism technique and confirmed by DNA Sänger sequencing through applying Biosystems Model (ABI3730x1).

Results: SNP is strongly associated (Chi-sqaure, vale <0.05) with CR under dominant, co-dominant and recessive models. Additionally, A allele in the SNP may have an impact on the serum levels of VEGFR2 and low density lipoprotein.

Conclusions: SNP is a potential genetic biomarker of CR among CVD patients of Iraqi Arabic origin. Further clinical studies, with larger sample, are required to confirm the findings of this study.
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http://dx.doi.org/10.1016/j.heliyon.2021.e06251DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900686PMC
February 2021

Alterations in skin microbiome mediated by radiotherapy and their potential roles in the prognosis of radiotherapy-induced dermatitis: a pilot study.

Sci Rep 2021 Mar 4;11(1):5179. Epub 2021 Mar 4.

Microbiology and Immunology Department, Faculty of Pharmacy Port, Said University, Port Said, 42526, Egypt.

Radiotherapy-induced dermatitis (RID) is an inflammatory cutaneous disorder that is acquired as an adverse effect of undergoing radiotherapy. Skin microbiome dysbiosis has been linked to the outcomes of several dermatological diseases. To explore the skin microbiota of RID and deduce their underlying impact on the outcome of RID, cutaneous microbiomes of 78 RID patients and 20 healthy subjects were characterized by sequencing V1-V3 regions of 16S rRNA gene. In total, a significantly apparent reduction in bacterial diversity was detected in microbiomes of RID in comparison to controls. Overall, the raised Proteobacteria/ Firmicutes ratio was significantly linked to delayed recovery or tendency toward the permanence of RID (Kruskal Wallis: P = 2.66 × 10). Moreover, applying enterotyping on our samples stratified microbiomes into A, B, and C dermotypes. Dermotype C included overrepresentation of Pseudomonas, Staphylococcus and Stenotrophomonas and was markedly associated with delayed healing of RID. Strikingly, coexistence of diabetes mellitus and RID was remarkably correlated with a significant overrepresentation of Klebsiella or Pseudomonas and Staphylococcus. Metabolic abilities of skin microbiome could support their potential roles in the pathogenesis of RID. Cutaneous microbiome profiling at the early stages of RID could be indicative of prospective clinical outcomes and maybe a helpful guide for personalized therapy.
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http://dx.doi.org/10.1038/s41598-021-84529-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7933139PMC
March 2021

Efficacy of core stability versus task oriented trainings on balance in ataxic persons with multiple sclerosis. A single blinded randomized controlled trial.

Mult Scler Relat Disord 2021 May 23;50:102866. Epub 2021 Feb 23.

Department of Physical Therapy for Neuromuscular Disorders - Faculty of Physical therapy - Cairo University - Egypt. Electronic address:

Background: Balance and ataxic symptoms are commonly encountered in people with multiple sclerosis (PwMS). Many intervention approaches have been proposed to address balance in PwMS. The purpose of this study was to investigate the efficacy of adding core stability versus task oriented trainings on traditional approaches on balance in ataxic PwMS.

Methods: Forty five ataxic relapsing-remitting PwMS from both sexes were randomly assigned into three identical groups. Control group (CG) treated with conventional balance exercise program; study groups I (GI) and II (GII) received respectively additional training using core stability exercises and task oriented trainings. Outcome measures recorded pre and post study period included stability index (SI), anterior posterior stability index (APSI), and mediolateral stability index (MLSI) using Biodex stability system in addition to the Berg balance scale (BBS).

Results: Post treatment, the results indicated significant improvement in (SI) and (APSI) (p<0.05), and non-significant improvement (p>0.05) in (MLSI) and BBS in CG. In GI and GII there was a significant improvement in all balance measures (p<0.05). Comparison of post treatment results between groups indicated a significant improvement of GII compared to CG in all study measures, GI showed non- significant difference in all balance measures compared to the CG(P>0.05).

Conclusion: In PwMS balance rehabilitation should be multimodal; core stability exercises and task-oriented training in addition to conventional balance training are effective to improve balance and should be considered as an essential part of the training program for balance rehabilitation in ataxic PwMS. Task-oriented training in addition to conventional balance rehabilitation seem to be a favorable approach.
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http://dx.doi.org/10.1016/j.msard.2021.102866DOI Listing
May 2021

University students under lockdown, the psychosocial effects and coping strategies during COVID-19 pandemic: A cross sectional study in Egypt.

J Am Coll Health 2021 Mar 2:1-12. Epub 2021 Mar 2.

Department of Pediatric Nursing, Faculty of Nursing, Beni-Suef University, Beni Suef, Egypt.

Objective: This study aimed to assess the psychosocial effects and coping strategies of university students during COVID-19 pandemic. Between 30 May and 6 June 2020, an online cross-sectional survey was fulfilled by 612 university students. The University of California Los Angeles (UCLA) Loneliness Scale, version 3, the Depression Anxiety Stress Scale (DASS-21), and the Brief COPE scale were used. Different degrees of depression, anxiety, and stress were reported by 74.5%, 47.1%, and 40.5% of the surveyed students, respectively. Dysfunctional coping strategies including venting, denial, and substance use had the lowest scores on Brief COPE while problem-focused coping strategies including planning and active coping strategies had the highest scores on Brief COPE. Undergraduate university students are very prone to experience psychosocial problems during the current pandemic. Educational institutions should work together with the authorities to promote measures to improve mental health and academic performance of their students.
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http://dx.doi.org/10.1080/07448481.2021.1891086DOI Listing
March 2021

Development and evaluation of an online continuing education course to increase healthcare provider self-efficacy to make strong HPV vaccine recommendations to East African immigrant families.

Tumour Virus Res 2021 Feb 27;11:200214. Epub 2021 Feb 27.

Department of Epidemiology, University of Washington School of Public Health, 3980 15th, Ave NE, Box 351619, Seattle, WA, 98195, USA. Electronic address:

Objective: To develop and evaluate an online continuing education (CE) course designed to improve healthcare provider self-efficacy to make strong adolescent HPV vaccine recommendations to East African immigrant families.

Methods: Focus groups with providers and East African immigrant mothers informed course development. Providers serving East African immigrant families were recruited to view the course and complete pre-/post-test and two-month follow-up surveys. Pre-/post differences were compared with paired t-tests.

Results: 202 providers completed the course and pre-/post-test; 158 (78%) completed two-month follow-up. Confidence to make strong HPV vaccine recommendations to East African families increased from 68% pre-test to 98% post-test. Confidence to address common parental concerns also increased: safety, 54% pre-test, 92% post-test; fertility, 55% pre-test, 90% post-test; child too young, 68% pre-test, 92% post-test; and pork gelatin in vaccine manufacturing, 38% pre-test, 90% post-test. Two-month follow-up scores remained high (97% for overall confidence, 94%-97% for addressing parental concerns). All pre-/post-test and pre-test/two-month follow-up comparisons were statistically significant (p < 0.05).

Conclusions: The online CE course focused on culturally appropriate strategies for making strong recommendations and addressing specific parental concerns was effective for increasing provider self-efficacy to recommend HPV vaccination to East African families. Similar courses could be tailored to other priority populations.
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http://dx.doi.org/10.1016/j.tvr.2021.200214DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7944093PMC
February 2021

A study of the possible factors affecting COVID-19 spread, severity and mortality and the effect of social distancing on these factors: Machine learning forecasting model.

Int J Clin Pract 2021 Feb 27:e14116. Epub 2021 Feb 27.

Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt.

Backgrounds: SARS-CoV-2 is affecting different countries all over the world, with significant variation in infection-rate and death-ratio. We have previously shown a presence of a possible relationship between different variables including the Bacillus Calmette-Guérin (BCG) vaccine, average age, gender, and malaria treatment, and the rate of spread, severity and mortality of COVID-19 disease. This paper focuses on developing machine learning models for this relationship.

Methods: We have used real-datasets collected from the Johns Hopkins University Center for Systems Science and Engineering and the European Centre for Disease Prevention and Control to develop a model from China data as the baseline country. From this model, we predicted and forecasted different countries' daily confirmed-cases and daily death-cases and examined if there was any possible effect of the variables mentioned above.

Results: The model was trained based on China data as a baseline model for daily confirmed-cases and daily death-cases. This machine learning application succeeded in modelling and forecasting daily confirmed-cases and daily death-cases. The modelling and forecasting of viral spread resulted in four different regions; these regions were dependent on the malarial treatments, BCG vaccination, weather conditions, and average age. However, the lack of social distancing resulted in variation in the effect of these factors, for example, double-humped spread and mortality cases curves and sudden increases in the spread and mortality cases in different countries. The process of machine learning for time-series prediction and forecasting, especially in the pandemic COVID-19 domain, proved usefulness in modelling and forecasting the end status of the virus spreading based on specific regional and health support variables.

Conclusion: From the experimental results, we confirm that COVID-19 has a very low spread in the African countries with all the four variables (average young age, hot weather, BCG vaccine and malaria treatment); a very high spread in European countries and the USA with no variable (old people, cold weather, no BCG vaccine and no malaria). The effect of the variables could be on the spread or the severity to the extent that the infected subject might not have symptoms or the case is mild and can be missed as a confirmed-case. Social distancing decreases the effect of these factors.
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http://dx.doi.org/10.1111/ijcp.14116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995223PMC
February 2021

SOM-LWL method for identification of COVID-19 on chest X-rays.

PLoS One 2021 24;16(2):e0247176. Epub 2021 Feb 24.

Department of Computer Science, Faculty of Computing and Information Technology, King Abdulaziz University, Rabigh, Saudi Arabia.

The outbreak of coronavirus disease 2019 (COVID-19) has had an immense impact on world health and daily life in many countries. Sturdy observing of the initial site of infection in patients is crucial to gain control in the struggle with COVID-19. The early automated detection of the recent coronavirus disease (COVID-19) will help to limit its dissemination worldwide. Many initial studies have focused on the identification of the genetic material of coronavirus and have a poor detection rate for long-term surgery. The first imaging procedure that played an important role in COVID-19 treatment was the chest X-ray. Radiological imaging is often used as a method that emphasizes the performance of chest X-rays. Recent findings indicate the presence of COVID-19 in patients with irregular findings on chest X-rays. There are many reports on this topic that include machine learning strategies for the identification of COVID-19 using chest X-rays. Other current studies have used non-public datasets and complex artificial intelligence (AI) systems. In our research, we suggested a new COVID-19 identification technique based on the locality-weighted learning and self-organization map (LWL-SOM) strategy for detecting and capturing COVID-19 cases. We first grouped images from chest X-ray datasets based on their similar features in different clusters using the SOM strategy in order to discriminate between the COVID-19 and non-COVID-19 cases. Then, we built our intelligent learning model based on the LWL algorithm to diagnose and detect COVID-19 cases. The proposed SOM-LWL model improved the correlation coefficient performance results between the Covid19, no-finding, and pneumonia cases; pneumonia and no-finding cases; Covid19 and pneumonia cases; and Covid19 and no-finding cases from 0.9613 to 0.9788, 0.6113 to 1 0.8783 to 0.9999, and 0.8894 to 1, respectively. The proposed LWL-SOM had better results for discriminating COVID-19 and non-COVID-19 patients than the current machine learning-based solutions using AI evaluation measures.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247176PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7904146PMC
March 2021