Oral manifestations in young adults infected with COVID-19 and impact of smoking:a multi-country cross-sectional study

Background: Oral manifestations and lesions could adversely impact the quality of people's lives. COVID-19 infection may interact with smoking and the impact on oral manifestations is yet to be discovered. Objectives: The aim of this study was to assess the self-reported presence of oral lesions by COVID-19-infected young adults and the differences in the association between oral lesions and COVID-19 infection in smokers and non-smokers. Methods: This cross-sectional multi-country study recruited 18-to-23-year-old adults. A validated questionnaire was used to collect data on COVID-19-infection status, smoking and the presence of oral lesions (dry mouth, change in taste, and others) using an online platform. Multi-level logistic regression was used to assess the associations between the oral lesions and COVID-19 infection; the modifying effect of smoking on the associations. Results: Data was available from 5,342 respondents from 43 countries. Of these, 8.1% reported COVID-19-infection, 42.7% had oral manifestations and 12.3% were smokers. A significantly greater percentage of participants with COVID-19-infection reported dry mouth and change in taste than non-infected participants. Dry mouth (AOR=, 9=xxx) and changed taste (AOR=, 9=xxx) were associated with COVID-19-infection. The association between COVID-19-infection and dry mouth was stronger among smokers than non-smokers (AOR = 1.26 and 1.03, p = 0.09) while the association with change in taste was stronger among non-smokers (AOR = 1.22 and 1.13, p = 0.86). Conclusion: Dry mouth and changed taste may be used as an indicator for COVID-19 infection in low COVID-19-testing environments. Smoking may modify the association between some oral lesions and COVID-19-infection

Cigarettes' use and capabilities-opportunities-motivation-for-behavior model:a multi-country survey of adolescents and young adults

The use of cigarettes among adolescents and young adults (AYA) is an important issue. This study assessed the association between regular and electronic-cigarettes use among AYA and factors of the Capability-Motivation-Opportunity-for-Behavior-change (COM-B) model. A multi-country survey was conducted between August-2020 and January-2021, Data was collected using the Global-Youth-Tobacco-Survey and Generalized-Anxiety-Disorder-7-item-scale. Multi-level logistic-regression-models were used. Use of regular and electronic-cigarettes were dependent variables. The explanatory variables were capability-factors (COVID-19 status, general anxiety), motivation-factors (attitude score) and opportunity-factors (country-level affordability scores, tobacco promotion-bans, and smoke free-zones) controlling for age and sex. Responses of 6,989-participants from 25-countries were used. Those who reported that they were infected with COVID-19 had significantly higher odds of electronic-cigarettes use (AOR = 1.81, P = 0.02). Normal or mild levels of general anxiety and negative attitudes toward smoking were associated with significantly lower odds of using regular-cigarettes (AOR = 0.34, 0.52, and 0.75, P < 0.001) and electronic-cigarettes (AOR = 0.28, 0.45, and 0.78, P < 0.001). Higher affordability-score was associated with lower odds of using electronic-cigarettes (AOR = 0.90, P = 0.004). Country-level-smoking-control policies and regulations need to focus on reducing cigarette affordability. Capability, motivation and opportunity factors of the COM-B model were associated with using regular or electronic cigarettes

Anxiety among adolescents and young adults during COVID-19 pandemic: A multi-country survey

(1) Background: Adolescents-and-young-adults (AYA) are prone to anxiety. This study assessed AYA's level of anxiety during the COVID-19 pandemic; and determined if anxiety levels were associated with country-income and region, socio-demographic profile and medical history of individuals. (2) Methods: A survey collected data from participants in 25 countries. Dependent-variables included general-anxiety level, and independent-variables included medical problems, COVID-19 infection, age, sex, education, and country-income-level and region. A multilevel-multinomial-logistic regression analysis was conducted to determine the association between dependent, and independent-variables. (3) Results: Of the 6989 respondents, 2964 (42.4%) had normal-anxiety, and 2621 (37.5%), 900 (12.9%) and 504 (7.2%) had mild, moderate and severe-anxiety, respectively. Participants from the African region (AFR) had lower odds of mild, moderate and severe than normal-anxiety compared to those from the Eastern-Mediterranean-region (EMR). Also, participants from lower-middle-income-countries (LMICs) had higher odds of mild and moderate than normal-anxiety compared to those from low-income-countries (LICs). Females, older-adolescents, with medical-problems, suspected-but-not-tested-for-COVID-19, and those with friends/family-infected with COVID-19 had significantly greater odds of different anxiety-levels. (4) Conclusions: One-in-five AYA had moderate to severe-anxiety during the COVID-19-pandemic. There were differences in anxiety-levels among AYAs by region and income-level, emphasizing the need for targeted public health interventions based on nationally-identified priorities

A multi-country study on the impact of sex and age on oral features of COVID-19 infection in adolescents and young adults

Background: Oral diseases are features of COVID-19 infection. There is, however, little known about oral diseases associated with COVID-19 in adolescents and young adults (AYA). Therefore, the aim of this study was to assess oral lesions’ association with COVID-19 infection in AYA; and to identify if sex and age will modify these associations. Methodology: Data was collected for this cross-sectional study between August 2020 and January 2021 from 11-to-23 years old participants in 43-countries using an electronic validated questionnaire developed in five languages. Data collected included information on the dependent variables (the presence of oral conditions- gingival inflammation, dry mouth, change in taste and oral ulcers), independent variable (COVID-19 infection) and confounders (age, sex, history of medical problems and parents’ educational level). Multilevel binary logistic regression was used for analysis. Results: Complete data were available for 7164 AYA, with 7.5% reporting a history of COVID-19 infection. A significantly higher percentage of participants with a history of COVID-19 infection than those without COVID-19 infection reported having dry mouth (10.6% vs 7.3%, AOR = 1.31) and taste changes (11.1% vs 2.7%, AOR = 4.11). There was a significant effect modification in the association between COVID-19 infection and the presence of dry mouth and change in taste by age and sex (P = 0.02 and < 0.001). Conclusion: COVID-19 infection was associated with dry mouth and change in taste among AYA and the strength of this association differed by age and sex. These oral conditions may help serve as an index for suspicion of COVID-19 infection in AYA

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Quantitative NMR spectroscopy applied to metabolism study using hyperpolarized 13C and to salt-matrix interactions in food

L’imagerie spectroscopique par résonance magnétique des noyaux X, tel que le 13C, offre des spectres plus simples qu’en 1H. De surcroit, ce noyau est notamment très utile pour l’étude du métabolisme pathologique, par exemple celui de la maladie de Parkinson. L’inconvénient principal est une sensibilité qui empêche toute application in vivo en RMN conventionnelle. L’hyperpolarisation est une solution potentielle à cette limite car elle permet d’augmenter le niveau de polarisation du 13C d’un facteur de 10000 environ, mais qui décroît rapidement durant les expériences. Afin de pouvoir profiter de signal amplifié momentanément, une méthode d’imagerie spectroscopique rapide a été développée qui s’applique aux précurseurs 13C hyperpolarisés, mais aussi à d’autres noyaux donnant lieu à des spectres clairsemés. En particulier, cette méthode peut être appliquée à l’imagerie quantitative du 23Na ayant un spectre simple et des temps de relaxation T2 très courts. Ce noyau quadripolaire est très sensible à son environnement. Cette sensibilité peut se manifester sous forme de plusieurs compartiments, chacun d’eux pouvant générer des cohérences à simple ou multiples quanta. Cette compartimentation est très peu étudiée dans les tissus biologiques et dans les aliments. C’est pourquoi, une étude de la relaxation du 23Na a été menée dans des aliments contrastés en termes de quantité de sel et de matrice. Elle montre que diverses populations de sodium coexistent dans la plupart des matrices: une population de sodium fortement liée à la matrice et une autre plus libre qui se distinguent par l’effet quadripolaire. Ce point observé pour la première fois est important pour la quantification du sel dans les aliments et le déterminisme de la sensation salée.13C magnetic resonance spectroscopic imaging (MRSI) allows studying metabolism flux and characterizing the difference between healthy and diseased conditions like in Parkinson disease. However, 13C nucleus suffers from a lack of sensitivity as both its gyromagnetic ratio and its natural abundance are low. To tackle this issue, it is possible to boost its NMR signal up to 4 order of magnitudes by hyperpolarizing it. Hyperpolarized nuclei are in a transient state which start to relax as soon as the polarization process is stopped. This excited state lasts for few tens of seconds in general. To exploit this boost in NMR signal, it is then critical to have a fast MRSI approach. I implemented and optimized a fast MRSI method which can be applied to hyperpolarized 13C but also to any nuclei having a sparse spectrum like 23Na. This quadrupolar nucleus is highly sensitive to its local environment leading to possible compartmentation. This phenomenon is poorly described in both the clinical and food science literature. I performed a 23Na relaxation study on contrasted food in term of salt quantity and food structure. I demonstrated that several sodium compartments existed in most of the food: one pool strongly bounded to the food matrix leading to quadrupolar interactions and a second pool for which sodium does not present strong interactions with the food and then no quadrupolar interactions. These observations are critical to both quantify locally the sodium and make a relationship between salt properties (concentration, interaction) and salty taste

Spectroscopie RMN quantitative appliquée à l’étude du métabolisme en 13C hyperpolarisé et aux interactions sel-matrice dans les aliments

13C magnetic resonance spectroscopic imaging (MRSI) allows studying metabolism flux and characterizing the difference between healthy and diseased conditions like in Parkinson disease. However, 13C nucleus suffers from a lack of sensitivity as both its gyromagnetic ratio and its natural abundance are low. To tackle this issue, it is possible to boost its NMR signal up to 4 order of magnitudes by hyperpolarizing it. Hyperpolarized nuclei are in a transient state which start to relax as soon as the polarization process is stopped. This excited state lasts for few tens of seconds in general. To exploit this boost in NMR signal, it is then critical to have a fast MRSI approach. I implemented and optimized a fast MRSI method which can be applied to hyperpolarized 13C but also to any nuclei having a sparse spectrum like 23Na. This quadrupolar nucleus is highly sensitive to its local environment leading to possible compartmentation. This phenomenon is poorly described in both the clinical and food science literature. I performed a 23Na relaxation study on contrasted food in term of salt quantity and food structure. I demonstrated that several sodium compartments existed in most of the food: one pool strongly bounded to the food matrix leading to quadrupolar interactions and a second pool for which sodium does not present strong interactions with the food and then no quadrupolar interactions. These observations are critical to both quantify locally the sodium and make a relationship between salt properties (concentration, interaction) and salty taste.L’imagerie spectroscopique par résonance magnétique des noyaux X, tel que le 13C, offre des spectres plus simples qu’en 1H. De surcroit, ce noyau est notamment très utile pour l’étude du métabolisme pathologique, par exemple celui de la maladie de Parkinson. L’inconvénient principal est une sensibilité qui empêche toute application in vivo en RMN conventionnelle. L’hyperpolarisation est une solution potentielle à cette limite car elle permet d’augmenter le niveau de polarisation du 13C d’un facteur de 10000 environ, mais qui décroît rapidement durant les expériences. Afin de pouvoir profiter de signal amplifié momentanément, une méthode d’imagerie spectroscopique rapide a été développée qui s’applique aux précurseurs 13C hyperpolarisés, mais aussi à d’autres noyaux donnant lieu à des spectres clairsemés. En particulier, cette méthode peut être appliquée à l’imagerie quantitative du 23Na ayant un spectre simple et des temps de relaxation T2 très courts. Ce noyau quadripolaire est très sensible à son environnement. Cette sensibilité peut se manifester sous forme de plusieurs compartiments, chacun d’eux pouvant générer des cohérences à simple ou multiples quanta. Cette compartimentation est très peu étudiée dans les tissus biologiques et dans les aliments. C’est pourquoi, une étude de la relaxation du 23Na a été menée dans des aliments contrastés en termes de quantité de sel et de matrice. Elle montre que diverses populations de sodium coexistent dans la plupart des matrices: une population de sodium fortement liée à la matrice et une autre plus libre qui se distinguent par l’effet quadripolaire. Ce point observé pour la première fois est important pour la quantification du sel dans les aliments et le déterminisme de la sensation salée

Spectroscopie RMN quantitative appliquée à l’étude du métabolisme en 13C hyperpolarisé et aux interactions sel-matrice dans les aliments

13C magnetic resonance spectroscopic imaging (MRSI) allows studying metabolism flux and characterizing the difference between healthy and diseased conditions like in Parkinson disease. However, 13C nucleus suffers from a lack of sensitivity as both its gyromagnetic ratio and its natural abundance are low. To tackle this issue, it is possible to boost its NMR signal up to 4 order of magnitudes by hyperpolarizing it. Hyperpolarized nuclei are in a transient state which start to relax as soon as the polarization process is stopped. This excited state lasts for few tens of seconds in general. To exploit this boost in NMR signal, it is then critical to have a fast MRSI approach. I implemented and optimized a fast MRSI method which can be applied to hyperpolarized 13C but also to any nuclei having a sparse spectrum like 23Na. This quadrupolar nucleus is highly sensitive to its local environment leading to possible compartmentation. This phenomenon is poorly described in both the clinical and food science literature. I performed a 23Na relaxation study on contrasted food in term of salt quantity and food structure. I demonstrated that several sodium compartments existed in most of the food: one pool strongly bounded to the food matrix leading to quadrupolar interactions and a second pool for which sodium does not present strong interactions with the food and then no quadrupolar interactions. These observations are critical to both quantify locally the sodium and make a relationship between salt properties (concentration, interaction) and salty taste.L’imagerie spectroscopique par résonance magnétique des noyaux X, tel que le 13C, offre des spectres plus simples qu’en 1H. De surcroit, ce noyau est notamment très utile pour l’étude du métabolisme pathologique, par exemple celui de la maladie de Parkinson. L’inconvénient principal est une sensibilité qui empêche toute application in vivo en RMN conventionnelle. L’hyperpolarisation est une solution potentielle à cette limite car elle permet d’augmenter le niveau de polarisation du 13C d’un facteur de 10000 environ, mais qui décroît rapidement durant les expériences. Afin de pouvoir profiter de signal amplifié momentanément, une méthode d’imagerie spectroscopique rapide a été développée qui s’applique aux précurseurs 13C hyperpolarisés, mais aussi à d’autres noyaux donnant lieu à des spectres clairsemés. En particulier, cette méthode peut être appliquée à l’imagerie quantitative du 23Na ayant un spectre simple et des temps de relaxation T2 très courts. Ce noyau quadripolaire est très sensible à son environnement. Cette sensibilité peut se manifester sous forme de plusieurs compartiments, chacun d’eux pouvant générer des cohérences à simple ou multiples quanta. Cette compartimentation est très peu étudiée dans les tissus biologiques et dans les aliments. C’est pourquoi, une étude de la relaxation du 23Na a été menée dans des aliments contrastés en termes de quantité de sel et de matrice. Elle montre que diverses populations de sodium coexistent dans la plupart des matrices: une population de sodium fortement liée à la matrice et une autre plus libre qui se distinguent par l’effet quadripolaire. Ce point observé pour la première fois est important pour la quantification du sel dans les aliments et le déterminisme de la sensation salée

Quantitative NMR spectroscopy applied to the study of hyperpolarized 13C metabolism and salt-matrix interactions in food

13C magnetic resonance spectroscopic imaging (MRSI) allows studying metabolism flux and characterizing the difference between healthy and diseased conditions like in Parkinson disease. However, 13C nucleus suffers from a lack of sensitivity as both its gyromagnetic ratio and its natural abundance are low. To tackle this issue, it is possible to boost its NMR signal up to 4 order of magnitudes by hyperpolarizing it. Hyperpolarized nuclei are in a transient state which start to relax as soon as the polarization process is stopped. This excited state lasts for few tens of seconds in general. To exploit this boost in NMR signal, it is then critical to have a fast MRSI approach. I implemented and optimized a fast MRSI method which can be applied to hyperpolarized 13C but also to any nuclei having a sparse spectrum like 23Na. This quadrupolar nucleus is highly sensitive to its local environment leading to possible compartmentation. This phenomenon is poorly described in both the clinical and food science literature. I performed a 23Na relaxation study on contrasted food in term of salt quantity and food structure. I demonstrated that several sodium compartments existed in most of the food: one pool strongly bounded to the food matrix leading to quadrupolar interactions and a second pool for which sodium does not present strong interactions with the food and then no quadrupolar interactions. These observations are critical to both quantify locally the sodium and make a relationship between salt properties (concentration, interaction) and salty taste.L’imagerie spectroscopique par résonance magnétique des noyaux X, tel que le 13C, offre des spectres plus simples qu’en 1H. De surcroit, ce noyau est notamment très utile pour l’étude du métabolisme pathologique, par exemple celui de la maladie de Parkinson. L’inconvénient principal est une sensibilité qui empêche toute application in vivo en RMN conventionnelle. L’hyperpolarisation est une solution potentielle à cette limite car elle permet d’augmenter le niveau de polarisation du 13C d’un facteur de 10000 environ, mais qui décroît rapidement durant les expériences. Afin de pouvoir profiter de signal amplifié momentanément, une méthode d’imagerie spectroscopique rapide a été développée qui s’applique aux précurseurs 13C hyperpolarisés, mais aussi à d’autres noyaux donnant lieu à des spectres clairsemés. En particulier, cette méthode peut être appliquée à l’imagerie quantitative du 23Na ayant un spectre simple et des temps de relaxation T2 très courts. Ce noyau quadripolaire est très sensible à son environnement. Cette sensibilité peut se manifester sous forme de plusieurs compartiments, chacun d’eux pouvant générer des cohérences à simple ou multiples quanta. Cette compartimentation est très peu étudiée dans les tissus biologiques et dans les aliments. C’est pourquoi, une étude de la relaxation du 23Na a été menée dans des aliments contrastés en termes de quantité de sel et de matrice. Elle montre que diverses populations de sodium coexistent dans la plupart des matrices: une population de sodium fortement liée à la matrice et une autre plus libre qui se distinguent par l’effet quadripolaire. Ce point observé pour la première fois est important pour la quantification du sel dans les aliments et le déterminisme de la sensation salée