Pregnant Women’s Mental Health Status and its Related Factors Amidst COVID-19: A Cross- Sectional Study

Introduction: Since the emergence of COVID-19 pandemic, it has challenged the psychological aspect of everyone. Pregnant women being the vulnerable group are most likely to be at increased risk. This study aimed to assess the mental health status of the pregnant women residing in Nepal during COVID-19. Methods: A cross-sectional online study was carried out among 368 pregnant women during lockdown using Perceived stress scale-10, Generalized Anxiety Disorder-7 scale and Edinburg Perinatal Depression Scale. Data were analyzed using descriptive and inferential statistics. Results: The mean age of the participants was 27.06±4.64years. Getting infected with the virus (71.7%) was the major fear and inadequate antenatal checkup (61.1%) was the major effect experienced by the participants. The prevalence of stress, anxiety and depression was 41%, 28.5% and 33.2% respectively. Age, salary status of oneself and their husband, healthcare frontliner in the family and effect of social distancing were significantly associated with perceived stress. Age, education, employment, monthly income, trimester and effect of social distancing were significantly associated with anxiety. Salary status of husband, trimester, parity, being infected with COVID-19 and effect of social distancing were associated with depression. Conclusion: High prevalence of mental health disorders during COVID-19 outbreak suggests the importance of special attention on monitoring the maternal mental health status during such public health emergencies. Measures such as awareness program targeted to pregnant women and health education programs on how to cope during the pandemic situations should be made effective to rule down the mental health burden of COVID-19

Decreasing unnecessary laboratory testing in medical critical care

The overuse of laboratory testing is common in the intensive care unit (ICU) which leads to an increased cost of care and an increased potential for harm to the patient. There is no evidence that obtaining daily laboratory tests helps to reduce mortality or morbidity in critical care patients. We conduced a retrospective study where chart review was performed to assess the frequency of unnecessary laboratory testing followed by a quality improvement initiative. With our study we were successful at reducing the inappropriate laboratory testing and improving the appropriate laboratory testing through our study

‘The broker also told me that I will not have problems after selling because we have two and we can survive on one kidney’: findings from an ethnographic study of a village with one kidney in Central Nepal

Kidney selling is a global phenomenon engraved by poverty and governance in low-income countries with the higher-income countries functioning as recipients and the lower-income countries as donors. Over the years, an increasing number of residents in a village near the capital city of Nepal have sold their kidneys. This study aims to explore the drivers of kidney selling and its consequences using ethnographic methods and multi-stakeholder consultations. An ethnographic approach was used in which the researcher lived and observed the residents’ life and carried out formal and informal interactions including in-depth interviews with key informants, community members and kidney sellers in Hokse village, Kavrepalanchok district. Participants in the village were interacted by researchers who resided in the village. In addition, remote interviews were conducted with multiple relevant stakeholders at various levels that included legal workers, government officers, non-government organization (NGO) workers, medical professionals, and policymaker. All formal interviews were audio-recorded for transcription in addition to field notes and underwent thematic analysis. The study identified processes, mechanisms, and drivers of kidney selling. Historically, diversion of a major highway from the village to another village was found to impact the livelihood, economy and access to the urban centres, ultimately increasing poverty and vulnerability for kidney selling. Existing and augmented deprivation of employment opportunities were shown to foster emigration of villagers to India, where they ultimately succumbed to brokers associated with kidney selling. Population in the village also maintained social cohesion through commune living, social conformity (that had a high impact on decision making), including behaviours that deepened their poverty. Behaviours such as alcoholism, trusting and following brokers based on the persuasion and decision of their peers, relatives, and neighbours who became the new member of the kidney brokerage also contributed to kidney selling. The other reasons that may have influenced high kidney selling were perceived to be a poor level of education, high demands of kidneys in the market and an easy source of cash through selling. In Hokse village, kidney selling stemmed from the interaction between the brokers and community members’ vulnerability (poverty and ignorance), mainly as the brokers raised false hopes of palliating the vulnerability. The decision-making of the villagers was influenced heavily by fellow kidney sellers, some of whom later joined the network of kidney brokers. Although sustained support in livelihood, development, and education are essential, an expanding network and influence of kidney brokers require urgent restrictive actions by the legal authority

Dietary Plant Lectins Appear to Be Transported from the Gut to Gain Access to and Alter Dopaminergic Neurons of Caenorhabditis elegans, a Potential Etiology of Parkinson’s Disease

© Copyright © 2016 Zheng, Wang, Wei, Keller, Adhikari, King, King, Peng and Laine. Lectins from dietary plants have been shown to enhance drug absorption in the gastrointestinal tract of rats, be transported trans-synaptically as shown by tracing of axonal and dendritic paths, and enhance gene delivery. Other carbohydrate-binding protein toxins are known to traverse the gut intact in dogs. Post-feeding rhodamine- or TRITC-tagged dietary lectins, the lectins were tracked from gut to dopaminergic neurons (DAergic-N) in transgenic Caenorhabditis elegans (C. elegans) [egIs1(Pdat-1:GFP)] where the mutant has the green fluorescent protein (GFP) gene fused to a dopamine transport protein gene labeling DAergic-N. The lectins were supplemented along with the food organism Escherichia coli (OP50). Among nine tested rhodamine/TRITC-tagged lectins, four, including Phaseolus vulgaris erythroagglutinin (PHA-E), Bandeiraea simplicifolia (BS-I), Dolichos biflorus agglutinin (DBA), and Arachis hypogaea agglutinin (PNA), appeared to be transported from gut to the GFP-DAergic-N. Griffonia Simplicifolia and PHA-E, reduced the number of GFP-DAergic-N, suggesting a toxic activity. PHA-E, BS-I, Pisum sativum (PSA), and Triticum vulgaris agglutinin (Succinylated) reduced fluorescent intensity of GFP-DAergic-N. PHA-E, PSA, Concanavalin A, and Triticum vulgaris agglutinin decreased the size of GFP-DAergic-N, while BS-I increased neuron size. These observations suggest that dietary plant lectins are transported to and affect DAergic-N in C. elegans, which support Braak and Hawkes’ hypothesis, suggesting one alternate potential dietary etiology of Parkinson’s disease (PD). A recent Danish study showed that vagotomy resulted in 40% lower incidence of PD over 20 years. Differences in inherited sugar structures of gut and neuronal cell surfaces may make some individuals more susceptible in this conceptual disease etiology model

Molecular Docking and ADMET Prediction of Compounds from Piper longum L. Detected by GC-MS Analysis in Diabetes Management

Medicinal plants have been utilized traditionally for therapeutics against various diseases. This study focuses on identifying bioactive compounds present in the fruit of hexane, ethyl acetate, and methanol extract of Piper longum L. through GC-MS analysis. The molecular level computational exploration of its phytocompounds against diabetes through molecular docking and ADMET prediction was carried out. The results of the GC-MS analysis unveiled the presence of 33 different phytochemicals and the Molecular docking revealed that 5,6-dihydroergosterol, β-sitosterol, and piperine demonstrated better binding affinities of -9.7 kcal/mol, -9.5 kcal/mol, and -7.9 kcal/mol, respectively with α-amylase (PDB ID: 2QV4) and -9.1 kcal/mol, -9.4 kcal/mol and -8.1 kcal/mol respectively with α-glucosidase (PDB ID: 5ZCC). Most of the docked compounds exhibited significant binding with the receptor protein greater than that of the reference drugs (miglitol, voglibose, and metformin). Moreover, the ADMET predictions suggested that the compounds were comparative with the reference drugs. These phytochemicals may be considered promising candidates for addressing diabetes by interfering with the normal functioning of α-amylase and α-glucosidase. The study recommends additional in vitro and in vivo experiments to validate the preliminary in silico results

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

“Take a Walk in My Shoes”: A Qualitative Analysis of Participant Impressions

Take a Walk in My Shoes is an interactive, educational service-learning project for senior level nursing students that is designed to in-service health care employees at local hospitals and nursing homes. Through the use of simulation equipment, participants experienced the difficulties associated with activities of daily living experienced by geriatric clients. Results were generated through qualitative analysis of student journals and observations; major themes that were identified are nervous/ anxious , fun , teacher/educating , and empathy . Participants expressed an increase in empathy and understanding with regard to the elderly. In conclusion, this project has the potential to be implemented in additional health care settings

“Take a Walk in My Shoes”: A Qualitative Analysis of Participant Impressions

Take a Walk in My Shoes is an interactive, educational service-learning project for senior level nursing students that is designed to in-service health care employees at local hospitals and nursing homes. Through the use of simulation equipment, participants experienced the difficulties associated with activities of daily living experienced by geriatric clients. Results were generated through qualitative analysis of student journals and observations; major themes that were identified are nervous/ anxious , fun , teacher/educating , and empathy . Participants expressed an increase in empathy and understanding with regard to the elderly. In conclusion, this project has the potential to be implemented in additional health care settings

Enhanced lentiviral vectors : a comparison of enhancer driven expression of transgenes transferred by pronuclear injection or lentiviral vectors

The brain is a vast network of different types of neurons. Interactions between these different types of neurons underlie the different kinds of neural computations the brain performs. How the different types of neurons are connected and interact is largely unexplored. However, transgenic mice allow for investigation of individual cell types in this heterogeneous network. By expressing fluorescent proteins in transgenic mice, the morphology of individual cell types can be visualized. Furthermore modified rabies viruses allow for the identification of monosynaptic inputs of specific cell types. Finally, novel techniques such as optogenetics and pharmacogenetics give control over the activity of genetically labeled neurons. In short, novel transgenic methods allow for the exploration of the brain and behavior on a cellular level. However, these transgenic methods stand or fall by having genetic access to specific cell types. Current transgenic lines do not provide us with the specificity to get enough resolution. To increase resolution, we are using regulatory elements in the genome called enhancers to drive transgenes in specific brain regions. Transgenic lines created with enhancers have regional and cell type specificity. An alternative method to introduce the transgene to the brain is by viral vectors. In this thesis we investigate if enhancers transferred by lentiviral vectors may also show cell type specificity. The aim of this project is to compare the enhancer driven transgene expression in mice injected with lentivirus and in transgenic mice having same enhancer. To achieve this aim, 3 enhancers which drive expression in the medial entorhinal cortex (MEC) of transgenic mice were cloned into plasmids that allow for the production of lentiviral vectors. The lentiviral vectors were stereotactically injected to the MEC of adult mice. We investigated the expression of the virally transduced transgene in comparison to the transgene expression in the transgenic mice. We did this based on anatomical location of the expression and co-expression of molecular markers. We confirmed that in the transgenic mouse lines expression was confined to specific layers of the MEC. In contrast, in virus injected mice, the transgenes were expressed throughout layers. This suggests that enhancers did not have any specificity after gene transfer by lentiviral vectors. The molecular marker we investigated, calbindin, is not expressed in the transgene expressing cells of the transgenic lines. Neither did we find it in the cells that were transduced with the transgene by injection of viral vector. Though this may indicate specificity of the transgenic expression after transfection with the viral vector, it should be taken with care considering the unexpected staining for calbindin in the virus injected mice

Antioxidant, α-Glucosidase, and α-Amylase Inhibition Activities of Erythropalum scandens Blume

Diabetes is a major health problem worldwide, which is increasing day by day. Since ancient times, medicinal plants have been a key source of medicinal agents, and many of them have been authorized as strong medications or drug candidates. This study evaluated the antioxidant, α-glucosidase, and α-amylase inhibition activities of Erythropalum scandens Blume. The plant revealed the significant antioxidant and in vitro antidiabetic activity. The crude methanolic extract reported the highest antioxidant activity with an IC50 of 59.35 ± 5.47 μg/mL, followed by its dichloromethane (DCM) and ethyl acetate (EA) fractions with an IC50 of 66.45 ± 2.46 μg/mL and 80.46 ± 2.69 μg/mL, respectively, as compared to the standard quercetin’s IC50 value of 6.29 ± 1.02 μg/mL. Among the crude extract and its fractions, the EA fraction disclosed the significant inhibiting activity against α-glucosidase and α-amylase with an IC50 value of 17.92 ± 0.88 μg/mL and 44.51 ± 0.12 μg/mL, respectively. This research work has scientifically validated the traditional use of this plant