Pattern of seat belt use by drivers in Trinidad and Tobago, West Indies

<p>Abstract</p> <p>Background</p> <p>In Trinidad and Tobago, the law on the mandatory use of seat belts was passed in 1995, but this law is hardly enforced. The objective of this study was to determine the frequency and predictors of seat belt use by motor vehicle drivers in the country.</p> <p>Findings</p> <p>A cross-sectional study of 959 motor vehicle drivers using a self-administered questionnaire. Data analysis included Pearson Chi square test and multinomial logistic regression analysis in order to determine the possible predictors of seat belt use by the drivers in Trinidad and Tobago. A majority of the drivers sometimes (51.8%) or always (31.6%) use a seat belt. About 16.7%, 29% and 54.2% of the drivers perceived that the other drivers use their seat belts more frequently, with the same frequency and less frequently respectively compared to themselves. The main reason for not using seat belt by the drivers was given as frequent stops (40.7%) and the main motivation to use seat belt by the drivers was given as stiffer penalties for non-compliance with the seat belt law (44.5%). The predictors of seat belt use were male driver, no formal or lower level of education, driving for less than 10 years, and the perception that the other drivers use seat belts with the same or higher frequency compared to the respondents.</p> <p>Conclusion</p> <p>Only a small proportion of the drivers in Trinidad and Tobago always use a seat belt when driving. There is the need to enforce the seat belt legislation in the country.</p

Severe leukocytoclastic vasculitis secondary to the use of a naproxen and requiring amputation: a case report

<p>Abstract</p> <p>Introduction</p> <p>Leukocytoclastic vasculitis (also known as hypersensitivity vasculitis and cutaneous necrotizing vasculitis) can present with various manifestations, which often delays the diagnosis and treatment. In order to show the importance of the early recognition of leukocytoclastic vasculitis, we present a case which occurred secondary to the use of a common pharmaceutical, naproxen. We were unable to find a case of leukocytoclastic vasculitis secondary to naproxen in the literature.</p> <p>Case presentation</p> <p>We present the case of a 33-year-old African American woman with below the knee and bilateral digital gangrene from hypersensitivity vasculitis secondary to the non-steroidal anti-inflammatory medication naproxen.</p> <p>Conclusion</p> <p>This is an original case report focusing on the rheumatologic management of leukocytoclastic vasculitis. However, other specialties, such as internal medicine, dermatology, infectious disease, general surgery and pathology, can gain valuable information by reviewing this case report. Reporting a case of leukocytoclastic vasculitis secondary to treatment with naproxen will advance our understanding of this disease etiology by adding yet another non-steroidal anti-inflammatory drug to the list of potential causes of leukocytoclastic vasculitis.</p

Homozygous Deletion of Six Olfactory Receptor Genes in a Subset of Individuals with Beta-Thalassemia

Progress in the functional studies of human olfactory receptors has been largely hampered by the lack of a reliable experimental model system. Although transgenic approaches in mice could characterize the function of individual olfactory receptors, the presence of over 300 functional genes in the human genome becomes a daunting task. Thus, the characterization of individuals with a genetic susceptibility to altered olfaction coupled with the absence of particular olfactory receptor genes will allow phenotype/genotype correlations and vindicate the function of specific olfactory receptors with their cognate ligands. We characterized a 118 kb β-globin deletion and found that its 3′ end breakpoint extends to the neighboring olfactory receptor region downstream of the β-globin gene cluster. This deletion encompasses six contiguous olfactory receptor genes (OR51V1, OR52Z1, OR51A1P, OR52A1, OR52A5, and OR52A4) all of which are expressed in the brain. Topology analysis of the encoded proteins from these olfactory receptor genes revealed that OR52Z1, OR52A1, OR52A5, and OR52A4 are predicted to be functional receptors as they display integral characteristics of G-proteins coupled receptors. Individuals homozygous for the 118 kb β-globin deletion are afflicted with β-thalassemia due to a homozygous deletion of the β-globin gene and have no alleles for the above mentioned olfactory receptors genes. This is the first example of a homozygous deletion of olfactory receptor genes in human. Although altered olfaction remains to be ascertained in these individuals, such a study can be carried out in β-thalassemia patients from Malaysia, Indonesia and the Philippines where this mutation is common. Furthermore, OR52A1 contains a γ-globin enhancer, which was previously shown to confer continuous expression of the fetal γ-globin genes. Thus, the hypothesis that β-thalassemia individuals, who are homozygous for the 118 kb deletion, may also have an exacerbation of their anemia due to the deletion of two copies of the γ-globin enhancer element is worthy of consideration

Adsorption of fluoride on a green adsorbent derived from wastepaper: Kinetic, isotherm and characterisation study

The excessive concentration of fluoride (F−) in water represents a grave problem for several countries, especially those that depend on groundwater as a main source of drinking water. Therefore, many treatment methods, such as chemical precipitation and membrane, were practised to remove F− from water. However, the traditional methods suffer from many limitations, such as the high cost and the slowness. Hence, many studies have been directed towards developing novel and effective water defluoridation methods. In this context, the current study investigates the development of an eco-friendly adsorbent by extracting Ca, Al, and Fe from industrial by-products, precipitating them on sand particles, and using this new adsorbent to remove F− from water. The removal experiments were commenced under different pH levels (3-10), contact times (0–240 minutes) and concentrations of F− (7.5–37.5 mg/L). X-ray fluorescence (XRF), X-ray diffraction Investigator (XRD), Fourier Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectroscopy (EDX) methods were used to characterise the green adsorbent. Adsorption isotherm and kinetic studies were also conducted to define the adsorption type. The results confirmed that the new adsorbent could remove as high as 86% of F− at pH, contact time, agitation speed and adsorbent dose of 10, 180 minutes, 200 rpm and 15 mg/L, respectively. The characterisation studies prove the occurrence of the sorption process and the suitability of the morphology of the adsorbent for F− removal. Adsorption kinetics follow better with a pseudo-first-order model that indicates the predominance of physisorption, which agrees with the FTIR results. The isotherm study indicated that Langmuir isotherm is more suitable for representing data with an R2 value of 0.992, which means the adsorption of F− occurs as monolayer adsorption on homogeneous sites on the surface of the new adsorbent. In summary, it can be concluded that the developed adsorbent in this study could be a promising alternative to the traditional F− removal methods

Th17-Related Genes and Celiac Disease Susceptibility

Th17 cells are known to be involved in several autoimmune or inflammatory diseases. In celiac disease (CD), recent studies suggest an implication of those cells in disease pathogenesis. We aimed at studying the role of genes relevant for the Th17 immune response in CD susceptibility. A total of 101 single nucleotide polymorphisms (SNPs), mainly selected to cover most of the variability present in 16 Th17-related genes (IL23R, RORC, IL6R, IL17A, IL17F, CCR6, IL6, JAK2, TNFSF15, IL23A, IL22, STAT3, TBX21, SOCS3, IL12RB1 and IL17RA), were genotyped in 735 CD patients and 549 ethnically matched healthy controls. Case-control comparisons for each SNP and for the haplotypes resulting from the SNPs studied in each gene were performed using chi-square tests. Gene-gene interactions were also evaluated following different methodological approaches. No significant results emerged after performing the appropriate statistical corrections. Our results seem to discard a relevant role of Th17 cells on CD risk

A phase 1 trial of the safety, tolerability and biological effects of intravenous Enadenotucirev, a novel oncolytic virus, in combination with chemoradiotherapy in locally advanced rectal cancer (CEDAR)

Background: Chemoradiotherapy remains the standard of care for locally advanced rectal cancer. Efforts to intensify treatment and increase response rates have yet to yield practice changing results due to increased toxicity and/or absence of increased radiosensitization. Enadenotucirev (EnAd) is a tumour selective, oncolytic adenovirus which can be given intravenously. Pre-clinical evidence of synergy with radiation warrants further clinical testing and assessment of safety with radiation. Methods: Eligibility include histology confirmed locally advanced rectal cancer that require chemoradiation. The trial will use a Time-to-Event Continual Reassessment Model-based (TiTE-CRM) approach using toxicity and efficacy as co-primary endpoints to recommend the optimal dose and treatment schedule 30 patients will be recruited. Secondary endpoints include pathological complete response the neoadjuvant rectal score. A translational program will be based on a mandatory biopsy during the second week of treatment for ‘proof-of-concept’ and exploration of mechanism. The trial opened to recruitment in July 2019, at an expected rate of 1 per month for up to 4 years. Discussion: Chemoradiation with Enadenotucirev as a radiosensitiser in locally Advanced Rectal cancer (CEDAR) is a prospective multicentre study testing a new paradigm in radiosensitization in rectal cancer. The unique ability of EnAd to selectively infect tumour cells following intravenous delivery is an exciting opportunity with a clear translational goal. The novel statistical design will make efficient use of both toxicity and efficacy data to inform subsequent studies. Trial registration: ClinicalTrial.gov, NCT03916510. Registered 16th April 2019