Age related diffusion and tractography changes in typically developing pediatric cervical and thoracic spinal cord

Background and objective: Diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) are two techniques that can measure white matter integrity of the spinal cord. Recently, DTI indices have been shown to change with age. The purpose of this study is (a) to evaluate the maturational states of the entire pediatric spinal cord using DTI and DTT indices including fractional anisotropy (FA), mean diffusivity (MD), mean length of white matter fiber tracts and tract density and (b) to analyze the DTI and DTT parameters along the entire spinal cord as a function of spinal cord levels and age. Method: A total of 23 typically developing (TD) pediatric subjects ranging in age from 6 to 16 years old (11.94 ± 3.26 (mean ± standard deviation), 13 females and 10 males) were recruited, and scanned using 3.0 T MR scanner. Reduced FOV diffusion tensor images were acquired axially in the same anatomical location prescribed for the T2-weighted images to cover the entire spinal cord (C1-mid L1 levels). To mitigate motion induced artifacts, diffusion directional images were aligned with the reference image (b0) using a rigid body registration algorithm performed by in-house software developed in Matlab (MathWorks, Natick, Massachusetts). Diffusion tensor maps (FA and MD) and streamline deterministic tractography were then generated from the motion corrected DTI dataset. DTI and DTT parameters were calculated by using ROIs drawn to encapsulate the whole cord along the entire spinal cord by an independent board certified neuroradiologist. These indices then were compared between two age groups (age group A = 6–11 years (n = 11) and age group B = 12–16 years (n = 12)) based on similar standards and age definitions used for reporting spinal cord injury in the pediatric population. Standard least squared linear regression based on a restricted maximum likelihood (REML) method was used to evaluate the relationship between age and DTI and DTT parameters. Results: An increase in FA (group A = 0.42 ± 0.097, group B = 0.49 ± 0.116), white matter tract density (group A = 368.01 ± 236.88, group B = 440.13 ± 245.24) and mean length of fiber tracts (group A = 48.16 ± 20.48 mm, group B = 60.28 ± 23.87 mm) and a decrease in MD (group A = 1.06 ± 0.23 × 10−3 mm2/s, group B = 0.82 ± 0.24 × 10−3 mm2/s) were observed with age along the entire spinal cord. Statistically significant increases have been shown in FA (p = 0.004, R2 = 0.57), tract density (p = 0.0004, R2 = 0.58), mean length of fiber tracts (p \u3c 0.001, R2 = 0.5) and a significant decrease has been shown in MD (p = 0.002, R2 = 0.59) between group A and group B. Also, it has been shown DTI and DTT parameters vary along the spinal cord as a function of intervertebral disk and mid-vertebral body level. Conclusion: This study provides an initial understanding of age related changes of DTI values as well as DTT metrics of the spinal cord. The results show significant differences in DTI and DTT parameters which may result from decreasing water content, myelination of fiber tracts, and the thickening diameter of fiber tracts during the maturation process. Consequently, when quantitative DTI and DTT of the spinal cord is undertaken in the pediatric population an age and level matched normative dataset should be used to accurately interpret the quantitative results. © 201

Inhibition of Human α7 Nicotinic Acetylcholine Receptors by Cyclic Monoterpene Carveol

Cyclic monoterpenes are a group of phytochemicals with antinociceptive, local anesthetic, and anti-inflammatory actions. Effects of cyclic monoterpenes including vanilin, pulegone, eugenole, carvone, carvacrol, carveol, thymol, thymoquinone, menthone, and limonene were investigated on the functional properties of the cloned α7 subunit of the human nicotinic acetylcholine receptor expressed in Xenopus oocytes. Monoterpenes inhibited the α7 nicotinic acetylcholine receptor in the order carveol\u3ethymoquinone\u3ecarvacrol\u3ementhone\u3ethymol\u3elimonene\u3eeugenole\u3epulegone≥carvone≥vanilin. Among the monoterpenes, carveol showed the highest potency on acetylcholine-induced responses, with IC50 of 8.3 µM. Carveol-induced inhibition was independent of the membrane potential and could not be reversed by increasing the concentration of acetylcholine. In line with functional experiments, docking studies indicated that cyclic monoterpenes such as carveol may interact with an allosteric site located in the α7 transmembrane domain. Our results indicate that cyclic monoterpenes inhibit the function of human α7 nicotinic acetylcholine receptors, with varying potencies

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life Years for 29 Cancer Groups From 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019.

The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.Funding/Support: The Institute for Health Metrics and Evaluation received funding from the Bill & Melinda Gates Foundation and the American Lebanese Syrian Associated Charities. Dr Aljunid acknowledges the Department of Health Policy and Management of Kuwait University and the International Centre for Casemix and Clinical Coding, National University of Malaysia for the approval and support to participate in this research project. Dr Bhaskar acknowledges institutional support from the NSW Ministry of Health and NSW Health Pathology. Dr Bärnighausen was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, which is funded by the German Federal Ministry of Education and Research. Dr Braithwaite acknowledges funding from the National Institutes of Health/ National Cancer Institute. Dr Conde acknowledges financial support from the European Research Council ERC Starting Grant agreement No 848325. Dr Costa acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia, IP under the Norma Transitória grant DL57/2016/CP1334/CT0006. Dr Ghith acknowledges support from a grant from Novo Nordisk Foundation (NNF16OC0021856). Dr Glasbey is supported by a National Institute of Health Research Doctoral Research Fellowship. Dr Vivek Kumar Gupta acknowledges funding support from National Health and Medical Research Council Australia. Dr Haque thanks Jazan University, Saudi Arabia for providing access to the Saudi Digital Library for this research study. Drs Herteliu, Pana, and Ausloos are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084. Dr Hugo received support from the Higher Education Improvement Coordination of the Brazilian Ministry of Education for a sabbatical period at the Institute for Health Metrics and Evaluation, between September 2019 and August 2020. Dr Sheikh Mohammed Shariful Islam acknowledges funding by a National Heart Foundation of Australia Fellowship and National Health and Medical Research Council Emerging Leadership Fellowship. Dr Jakovljevic acknowledges support through grant OI 175014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. Dr Katikireddi acknowledges funding from a NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_00022/2), and the Scottish Government Chief Scientist Office (SPHSU17). Dr Md Nuruzzaman Khan acknowledges the support of Jatiya Kabi Kazi Nazrul Islam University, Bangladesh. Dr Yun Jin Kim was supported by the Research Management Centre, Xiamen University Malaysia (XMUMRF/2020-C6/ITCM/0004). Dr Koulmane Laxminarayana acknowledges institutional support from Manipal Academy of Higher Education. Dr Landires is a member of the Sistema Nacional de Investigación, which is supported by Panama’s Secretaría Nacional de Ciencia, Tecnología e Innovación. Dr Loureiro was supported by national funds through Fundação para a Ciência e Tecnologia under the Scientific Employment Stimulus–Institutional Call (CEECINST/00049/2018). Dr Molokhia is supported by the National Institute for Health Research Biomedical Research Center at Guy’s and St Thomas’ National Health Service Foundation Trust and King’s College London. Dr Moosavi appreciates NIGEB's support. Dr Pati acknowledges support from the SIAN Institute, Association for Biodiversity Conservation & Research. Dr Rakovac acknowledges a grant from the government of the Russian Federation in the context of World Health Organization Noncommunicable Diseases Office. Dr Samy was supported by a fellowship from the Egyptian Fulbright Mission Program. Dr Sheikh acknowledges support from Health Data Research UK. Drs Adithi Shetty and Unnikrishnan acknowledge support given by Kasturba Medical College, Mangalore, Manipal Academy of Higher Education. Dr Pavanchand H. Shetty acknowledges Manipal Academy of Higher Education for their research support. Dr Diego Augusto Santos Silva was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil Finance Code 001 and is supported in part by CNPq (302028/2018-8). Dr Zhu acknowledges the Cancer Prevention and Research Institute of Texas grant RP210042

Effect of Moringa Oleifera leaves powder on hemoglobin level in second-trimester pregnant women of Karachi, Pakistan.

Abstract Background: Anemia, particularly iron-deficiency anemia during pregnancy, has substantial implications for maternal health and fetal growth. Moringa leaves are known to be rich in iron and may offer a dietary solution to combat anemia in pregnant women. However, evidence on the association between fresh Moringa leaf consumption and maternal hemoglobin levels during pregnancy is lacking. Hence, this study aims to assess the impact of Moringa Oleifera leaf powder supplementation on hemoglobin levels during the second trimester of pregnancy in Karachi, Pakistan. Methodology: A community-based comparative cross-sectional study was conducted at Koohi Goth Women's Hospital, Karachi, Pakistan, from November 2021 to May 2023. The study involved 200 pregnant women who consumed fresh Moringa leaves and 200 non-consumers. Data were collected through an interviewer-administered structured questionnaire, and hemoglobin levels were measured using HemoCue Hb 301. Results: The demographic characteristics of the study participants were analyzed, revealing that most participants in both groups were between 20 and 30 years old. Additionally, most participants in both groups were pregnant for the first time. Hemoglobin (Hb) levels were measured across trimesters, with the Moringa leaf extract group showing levels of 9.43 ± 0.62 g/dL in the first trimester, 8.98 ± 1.12 g/dL in the second trimester, and 9.09 ± 1.04 g/dL in the third trimester. The folic iron group exhibited a higher increase in hemoglobin concentration (10.14 ± 0.91 g/dL) compared to the Moringa leaf extract group (8.98 ± 1.12 g/dL), but the difference between the two groups was not statistically significant. Conclusion: In conclusion, iron-rich foods such as Moringa leaves and iron tablets are recommended to enhance hemoglobin levels in pregnant women

A Descriptive Study of the Types and Survival Patterns of Saudi Patients with Multiple Primary Solid Malignancies: A 30-Year Tertiary Care Center Experience

Background and Objective: Cancer survival has improved significantly, which reflects the achievements in screening, diagnosis, and treatment. As a consequence, multiple primary malignancies are diagnosed more frequently, with an incidence ranging from 0.52–11.7%. The types of malignancy that coexist and survival patterns vary notably in different countries and geographical areas. Due to the limited literature in Saudi Arabia, a baseline of prevalent malignancy combinations and their survival patterns would support early detection and disease management. Method: This was a retrospective descriptive study conducted from 1993–2022 at King Abdulaziz Medical City, Department of Medical Oncology, Riyadh, Saudi Arabia. Patients with at least two biopsy-proven solid malignancies were included. Patients with hematological malignancies, missing data, or an uncertain or indecisive pathology report were excluded. Result: In total, 321 patients were analyzed. More than half (57.3%) of the patients were female. A third (33%) of the cases were synchronous, and 67% were metachronous. The most frequent site of the first primary malignancy was breast cancer, followed by colorectal, skin, and thyroid cancers. The most frequent site of the second primary malignancy was colorectal cancer, followed by thyroid, breast, and liver cancers. Only 4% of the cases had a third primary malignancy, with colorectal and appendiceal cancers being the most frequent. The most frequently observed histopathology in the synchronous and metachronous malignancies was adenocarcinoma. Breast–colorectal, breast–thyroid, and kidney–colorectal were the most frequently observed malignancy combinations. Conclusion: The current study offers a baseline of multiple primary malignancies in Saudi Arabia and provides supporting evidence that the pattern of multiple primary malignancies varies among different countries and ethnicities. The possibility of developing another primary malignancy should be considered when treating and monitoring cancer patients

Transmission dynamics, responses, and clinical features for the first 1100 COVID-19 cases in South Batinah, Oman: Major lessons from a provincial perspective

الملخص: أهداف البحث: هدفت هذه الدراسة إلى استكشاف وتحليل الملامح الوبائية ورصد واستجابة كوفيد-19، وديناميكيات انتقالها وتشكل المجموعات. طرق البحث: تحليل استرجاعي لبيانات الرصد، بما في ذلك تتبع الاتصال، وعوامل الخطر، والمعلومات السريرية. أجريت تحليلات الانحدار اللوجستية الثنائية لتقييم احتمالات القبول، وتشكل المجموعات، وكونه حالة رئيسية. تم توضيح المجموعات باستخدام أنظمة البيانات الجغرافية وتحليل الشبكات وبرامج التصور. النتائج: تم تشخيص ١١٠٠ حالة إصابة بفيروس كوفيد-١٩ في الفترة من ٢٠ مارس إلى ٧ يونيو ٢٠٢٠، وكانت ١٤٤ حالة منها (١٣,١٪) بدون أعراض. كانت المدة المتوسطة من بدء الأعراض حتى القبول في المستشفى ٧ أيام (٤,٥ - ١٠)، ومدة الأعراض نفسها كانت ٥ أيام (٣ - ٩). تم تحديد 89 مجموعة تحتوي على ٧٣٦ مريضا. وتم تمييز ثلاث مراحل توضح إجراءات الرصد والسيطرة. بدأت المجموعات في المرحلة الثانية وزادت وضوحا في المرحلة الثالثة. المرضى الذين تجاوزوا سن ٥٠ عاما وأولئك الذين يعانون من الحمى لديهم فرصة أكبر للقبول في المستشفى، بنسبة ١٢,٨٥ (٩٥٪ م.م. ٥,١٣ – ٣٢,١٩) و ٢,٥٣ (٩٥٪ م.م. ١,٢٤ – ٥,١٧) على التوالي. وقد لوحظ تشكل المجموعات بين الإناث والمرضى الذين لم يظهروا أعراضا وبين سكان ولاية عوابي، بنسب ٢,٣ (٩٥٪ م.م. ١,٧ – ٣,١) و ٦,٣٩ (٩٥٪ م.م. ٢,٣٣ – ١٧,٢) و ٣,٥٤ (٩٥٪ م.م. ٢,٠٦ – ٦,٠٧) على التوالي. وكان لدى المرضى العاملين في قطاعات الشرطة والدفاع فرصة أعلى لكونهم حالة رئيسية، بنسبة ٧,٨٨ (٩٥٪ م.م. ٣,٣٥ – ١٨,٥٢). الاستنتاجات: يجب دعم التدخلات القائمة على الحالات من خلال التدابير الموسعة على مستوى السكان - خاصة قيود الحركة. يعد إنشاء فرق الوقاية أو وحدات المنطقة، أو من خلال الرعاية الأولية أمرا حاسما للسيطرة على الأوبئة المستقبلية. يجب أن تكون الوقاية دائما أولوية للفئات السكانية الضعيفة. Abstract: Objectives: This study was aimed at exploring and analyzing the epidemiological profile, surveillance, and response to COVID-19, including transmission dynamics and cluster formation. Methodology: This was a retrospective analysis of surveillance data, including contact tracing, risk factors, and clinical information. Binary logistic regressions were used to assess the likelihood of admission, cluster formation, and of each individual being an index patient. Clusters were demonstrated through geographic data systems, network analysis, and visualization software. Results: A total of 1100 COVID-19 cases were diagnosed from 20 March to 7 June 2020, of which 144 (13.1%) were asymptomatic. The median time from symptom onset to admission was 7 days (IQR, 4.5–10), and the median symptom duration was 5 days (IQR, 3–9). Eighty-nine clusters containing 736 patients were identified. The surveillance and control actions were divided into three phases. Clusters began to form in phase 2 and became more pronounced in phase 3. Patients ≥50 years of age and patients presenting with fever had relatively higher odds of admission: OR = 12.85 (95% CI 5.13–32.19) and 2.53 (95% CI 1.24–5.17), respectively. Cluster formation was observed among females, asymptomatic patients, and people living in Awabi: OR = 2.3 (95% CI 1.7–3.1), 6.39 (95% CI 2.33–17.2), and 3.54 (95% CI 2.06–6.07), respectively. Patients working in the police and defense sectors had higher odds of being an index patient: OR = 7.88 (95% CI 3.35–18.52). Conclusion: Case-based interventions should be supported by population-wide measures, particularly movement restrictions. Establishing prevention teams or district units, or primary care will be crucial for the control of future pandemics. Prevention should always be prioritized for vulnerable populations