Radiation Protection Measures in Radio-Diagnostic Centers in Gaza Hospitals, Palestine

Whereas radio-diagnostic centers have potential to present hazardous effects due of ionizing radiation. Radio-diagnostic workers awareness, practices regarding radiation protection issues, availability of radiation protection devices and effective personal radiation exposure monitoring process has an important role to safe working in these places. We carried out this study in nine governmental Gaza governorates hospitals. The study instrument was close-ended structured questionnaire consists of five parts. 182 radio-diagnostic workers participated in the work. Based on the obtained data, the participants reported that 35.2% of personal radiation protection devices are available in the radio-diagnostic centers at governmental Gaza governorates hospitals. In spite the fact that 74.8% of participants have awareness about radiation protection issues, but it is only about 53.4% of participants follows the radiation protection practices. There is an obvious poor of personal radiation exposure monitoring process. Conclusively, the results represented in this work reflect that majority of participants believe there is no radiation safety officer to provide the service. Therefore, there is a desperate need for rules, regulations and radiation protection act in the field of radiation in medical field

Ionizing Radiation Leakage in Radio-Diagnostic Centers at Gaza Strip Hospitals, Palestine

The fact of using radiation in medicine has led to major improvements in the diagnostic and treatment of human diseases. However, it carries some risks of health problems. In Gaza governorates hospitals, there is tremendous development has taken place in the radio-diagnostic field and there is no clear radiation protection program, lack of clear information about radiation protection measures and guidelines. The objective of this study was an assessment whether yearly equivalent radiation dose received by the radio-diagnostic workers and public in governmental Gaza governorates hospitals are within the dose limits recommended by ICRP or not. The study was carried out in nine governmental hospitals. The hospitals were selected because of their large and diverse of their radio-diagnostic services. The radiation survey meter (OD-01) was used to measure radiation leakage. Data sheet was also used to elicit information about the radio-diagnostic rooms and machines specifications. The results indicate that the fluoroscopy and CT scan rooms were not efficiently lead lined and the radiation protection is not well organized. The measured values of radiation dose rate at different locations in basic X-ray and mammography rooms are found within a permissible limits for occupational stuff and public. However, the recommended distance between the X-ray machine and control panel have not been achieved in some rooms. Therefore, there is a desperate need for rules, regulations and radiation protection act in the field of radiation in medical field

Erratum: Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

The interstitium in cardiac repair: role of the immune-stromal cell interplay

Cardiac regeneration, that is, restoration of the original structure and function in a damaged heart, differs from tissue repair, in which collagen deposition and scar formation often lead to functional impairment. In both scenarios, the early-onset inflammatory response is essential to clear damaged cardiac cells and initiate organ repair, but the quality and extent of the immune response vary. Immune cells embedded in the damaged heart tissue sense and modulate inflammation through a dynamic interplay with stromal cells in the cardiac interstitium, which either leads to recapitulation of cardiac morphology by rebuilding functional scaffolds to support muscle regrowth in regenerative organisms or fails to resolve the inflammatory response and produces fibrotic scar tissue in adult mammals. Current investigation into the mechanistic basis of homeostasis and restoration of cardiac function has increasingly shifted focus away from stem cell-mediated cardiac repair towards a dynamic interplay of cells composing the less-studied interstitial compartment of the heart, offering unexpected insights into the immunoregulatory functions of cardiac interstitial components and the complex network of cell interactions that must be considered for clinical intervention in heart diseases

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

Foliar Application of Chitosan and Phosphorus Alleviate the <i>Potato virus Y</i>-Induced Resistance by Modulation of the Reactive Oxygen Species, Antioxidant Defense System Activity and Gene Expression in Potato

Viruses pose a serious threat to the sustainable production of economically important crops around the world. In the past 20 years, potato virus Y (PVY) emerged as a relatively new and very serious problem in potatoes, even though it is the oldest known plant virus. Multiple strains of the virus cause various symptoms on the leaves and tubers of potatoes, resulting in yield reduction and poor-quality tubers. Consequently, it would be very interesting to learn what causes systemic PVY resistance in plants. Natural compounds such as chitosan (CHT) and phosphorus have been developed as alternatives to chemical pesticides to manage crop diseases in recent years. In the current study, potato leaves were foliar-sprayed with chitosan and phosphorus to assess their ability to induce PVY resistance. Compared to untreated plants, the findings demonstrated a significant decrease in disease severity and PVY accumulation in plants for which CHT and P were applied. Every treatment includes significantly increased growth parameters, chlorophyll content, photosynthetic characteristics, osmoprotectants (glycine betaine, proline, and soluble sugar), non-enzymatic antioxidants (glutathione, phenols, and ascorbic acid), enzymatic antioxidants (peroxidase, superoxide dismutase, lipoxygenase, glutathione reductase, catalase, β-1,3 glucanase, and ascorbate peroxidase), phytohormones (gibberellic acid, indole acetic acid, jasmonic acid, and salicylic acid), and mineral content (phosphorus, nitrogen, and potassium), compared to infected plants. However, compared to PVY infection values, CHT and P treatments showed a significant decrease in malondialdehyde, DPPH, H2O2, O2, OH, and abscisic acid levels. In addition, increased expression levels of some regulatory defense genes, including superoxide dismutase (SOD), ascorbic acid peroxidase (APX), relative pathogenesis-related 1 basic (PR-1b), and relative phenylalanine ammonia-lyase (PAL), were found in all treated plants, compared to PVY-infected plants. Conclusion: Phosphorus is the most effective treatment for alleviating virus infections