Age, Gender, and Liver Enzyme Impact Hospital Stay in COVID-19 Minority Patient with Cancer in the USA: Does Race Matters in the Pandemic?

Patients with cancer are known to have a poor prognosis when infected with SARS-CoV-2 infection. We aimed in this study to assess health outcomes in COVID-19 patients with different cancers in comparison to non-cancer COVID-19 patients from different centers in the United States (US). We evaluated medical records of 1,943 COVID-19 Cancer patients from 3 hospitals admitted between December 2019 to October 2021 and compared them with non-cancer COVID-19 patients. Among 1,943 hospitalized COVID-19 patients, 18.7% (n=364) have an active or previous history of cancer. Among these 364 cancer patients, 222 were African Americans (61.7%) and 121 were Caucasians (33.2%). Cancer patients had significantly longer hospitalization compared to controls (8.24 vs 6.7 days). Overall, Lung cancer is associated with high mortality. Patients with a previous history of cancer were more prone to death (p=0.04) than active cancer patients. In univariate and multivariate analyses, predictors of death among cancer patients were male sex, older age, presence of dyspnea, elevated troponin, elevated AST (0.001) and ALT (0.05), low albumin (p=0.04) and mechanical ventilation (p=0.001). Patients with a previous history of cancer were more prone to death when compared to active cancer COVID-19 patients. Early recognition of cancer COVID-19 patients' death-associated risk factors can help determine appropriate treatment and management plans for better prognosis and outcome.

Utilization of wild Cressa cretica biomass for pectinase production from a halo-thermotolerant bacterium

Halophytes are the native inhabitants of saline environment. Their biomass can be considered as a potential substrate for the production of microbial enzymes. This study was intended at feasible utilization of a halophytic biomass, Cressia cretica, for pectinase production using a halo- and thermo-tolerant bacterium, Bacillus vallismortis MH 10. The data from fractionation of the C. cretica biomass revealed presence of 17% pectin in this wild biomass. Seven different factors (temperature, agitation, pH, inoculum size, peptone concentration, substrate concentration, and incubation time) affecting pectinase production using C. cretica were assessed through a statistical tool, Plackett-Burman design. Consequently, two significant factors (incubation time and peptone concentration) were optimized using the central composite design. The strain produced 20 IU mL-1 of pectinase after 24 h under optimized conditions. The enzyme production kinetics data also confirmed that 24 h is the most suitable cultivation period for pectinase production. Fourier transform infrared spectroscopy and scanning electron microscopy of C. cretica biomass ascertained utilization of pectin and structural changes after fermentation. The purification of pectinase by using DEAE column yielded specific activity and purification fold of 88.26 IU mg-1 and 3.2, respectively. The purified pectinase had a molecular weight of >65 kDa. This study offers prospects of large-scale production of pectinase by halotolerant strain in the presence of economical and locally grown substrate that makes the enzyme valuable for various industrial operations.

Unveiling the genomic potential of a novel thermostable glycoside hydrolases producing Neobacillus sedimentimangrovi UE25

Genetic and enzymatic potential of Neobacillus sedimentimangrovi has not been assembled to date. Here, we report a high-quality genome assembly of thermophilic bacterium Neobacillus sedimentimangrovi UE25 using Illumina Hi-seq 2500. The strain was isolated from a crocodile pond Manghopir, Karachi, Pakistan. QUAST quality parameters showed 37.75% GC content and exhibited the genome into 110 contigs, with a total size of 3,230,777 bases. Genome of N. sedimentimangrovi UE25 harbors phage mediated DNA through horizontal gene exchange from the phages, symbiotic and pathogenic bacteria. Most of the phage genome encodes for hypothetical proteins, protease, and phage assembly proteins. Gene clusters encoding the intrinsic resistance to glycopeptides, isoniazid, rifamycin, elfamycin, macrolide, aminoglycosides, tetracycline and fluoroquinolone were identified into the genome. Since, the strain has been reported for the production of many industrially important thermostable enzymes, therefore, the genomic data of thermostable enzymes might be helpful to employ this species in commercial sectors. Probing genes of multiple thermostable glycoside hydrolase enzymes especially xylanases of N. sedimentimangrovi UE25 showed genetic diversity among the genes and confer the industrial importance of this microorganism. Furthermore, the genome of N. sedimentimangrovi will greatly improve our understanding of its genetics and evolution.

Evaluation of Fecal Pancreatic Elastase-1 as a Measure of Pancreatic Exocrine Function in Children with Pancreatitis

Pancreatic exocrine insufficiency occurs as a clinical consequence of chronic pancreatitis leading to fat maldigestion, malabsorption and malnutrition. Fecal elastase-1 is a laboratory-based test used for the diagnosis or exclusion of pancreatic exocrine insufficiency. The aim of the study was to observe the value of fecal elastase-1 in children with pancreatitis as an indicator of pancreatic exocrine insufficiency. This was a cross-sectional descriptive study conducted from January 2017 through June 2018. Thirty children with pain abdomen as control and 36 patients with pancreatitis as cases were included. An ELISA technique which recognizes human pancreatic elastase-1 from spot stool sample was employed for the test. Fecal elastase-1 activity in spot stool samples in acute pancreatitis (AP) ranged from 198.2-500μg/g with a mean of 342.1±136.4μg/g, acute recurrent pancreatitis (ARP) ranged from 15-500μg/g with a mean of 332.8±194.5μg/g and chronic pancreatitis (CP) ranged from 15-492.8μg/g with a mean of 222.2±197.1μg/g was obtained. In controls, fecal elastase-1 ranged from 28.4-500μg/g with a mean of 398.8±114.9μg/g. Disease severity was classified as mild to moderate pancreatic insufficiency (fecal elastase-1 100 to 200μg/g stool) was found in AP (14.3%) and CP (6.7%) cases. The severe pancreatic insufficiency (fecal elastase-1<100μg/g stool) was observed in ARP (28.6%) and CP (46.7%) cases. Malnutrition was observed in severe pancreatic insufficiency cases. This study result showed that fecal elastase-1 can be used as a measure of pancreatic exocrine function in children with pancreatitis.

Synthesis of methylcellulose-polyvinyl alcohol composite, biopolymer film and thermostable enzymes from sugarcane bagasse

Agro-industrial wastes and by-products are the natural and abundant resources of biomaterials to obtain various value-added items such as biopolymer films, bio-composites and enzymes. This study presents a way to fractionate and to convert an agro-industrial residue, sugarcane bagasse (SB), into useful materials with potential applications. Initially cellulose was extracted from SB which was then converted into methylcellulose. The synthesized methylcellulose was characterized by scanning electron microscopy and FTIR. Biopolymer film was prepared by using methylcellulose, polyvinyl alcohol (PVA), glutaraldehyde, starch and glycerol. The biopolymer was characterized to exhibit 16.30 MPa tensile strength, 0.05 g/m² h of water vapor transmission rate, 366 % of water absorption to its original weight after 115 min of immersion, 59.08 % water solubility, 99.05 % moisture retention capability and 6.01 % of moisture absorption after 144 h. Furthermore, in vitro studies on absorption and dissolution of model drug by biopolymer showed 2.04 and 104.59 % of swelling ratio and equilibrium water content, respectively. Biocompatibility of the biopolymer was checked by using gelatin media and it was observed that swelling ratio was higher in initial 20 min of contact. The extracted hemicellulose and pectin from SB were fermented by a thermophilic bacterial strain, Neobacillus sedimentimangrovi UE25 that yielded 12.52 and 6.4 IU mL^-1 of xylanase and pectinase, respectively. These industrially important enzymes further augmented the utility of SB in this study. Therefore, this study emphasizes the possibility for industrial application of SB to form various products.

Investigation on structure, thermodynamic and multifunctional properties of Ni–Zn–Co ferrite for Gd3+ substitution

This study presents a modification of structure-dependent elastic, thermodynamic, magnetic, transport and magneto-dielectric properties of a Ni–Zn–Co ferrite tailored by Gd³⁺ substitution at the B-site replacing Fe³⁺ ions. The synthesized composition of Ni_0.7Zn_0.2Co_0.1Fe_2−xGd_xO₄ (0 ≤ x ≤ 0.12) crystallized with a single-phase cubic spinel structure that belongs to the Fd3̄m space group. The average particle size decreases due to Gd³⁺ substitution at Fe³⁺. Raman and IR spectroscopy studies illustrate phase purity, lattice dynamics with cation disorders and thermodynamic conditions inside the studied samples at room temperature (RT = 300 K). Ferromagnetic to paramagnetic phase transition was observed in all samples where Curie temperature (T_C) decreases from 731 to 711 K for Gd³⁺ substitution in Ni–Zn–Co ferrite. In addition, Gd³⁺ substitution reinforces to decrease the A-B exchange interaction. Temperature-dependent DC electrical resistivity (ρ_DC) and temperature coefficient of resistance (TCR) have been surveyed with the variation of the grain size. The frequency-dependent dielectric properties and electric modulus at RT for all samples were observed from 20 Hz to 100 MHz and the conduction relaxation processes were found to spread over an extensive range of frequencies with the increase in the amount of Gd³⁺ in the Ni–Zn–Co ferrite. The RLC behavior separates the zone of frequencies ranging from resistive to capacitive regions in all the studied samples. Finally, the matching impedance (Z/η₀) for all samples was evaluated over an extensive range of frequencies for the possible miniaturizing application.

This study presents a modification of structure-dependent elastic, thermodynamic, magnetic, transport and magneto-dielectric properties of a Ni–Zn–Co ferrite tailored by Gd³⁺ substitution at the B-site replacing Fe³⁺ ions.

Xylanolytic Bacillus species for xylooligosaccharides production: a critical review

The capacity of different Bacillus species to produce large amounts of extracellular enzymes and ability to ferment various substrates at a wide range of pH and temperature has placed them among the most promising hosts for the industrial production of many improved and novel products. The global interest in prebiotics, for example, xylooligosaccharides (XOs) is ever increasing, rousing the quest for various forms with expanded productivity. This article provides an overview of xylanase producing bacilli, with more emphasis on their capacity to be used in the production of the XOs, followed by the purification strategies, characteristics and application of XOs from bacilli. The large-scale production of XOs is carried out from a number of xylan-rich lignocellulosic materials by chemical or enzymatic hydrolysis followed by purification through chromatography, vacuum evaporation, solvent extraction or membrane separation methods. Utilization of XOs in the production of functional products as food ingredients brings well-being to individuals by improving defense system and eliminating pathogens. In addition to the effects related to health, a variety of other biological impacts have also been discussed.

Combined pretreatment of sugarcane bagasse using alkali and ionic liquid to increase hemicellulose content and xylanase production

BACKGROUND

Lignin in sugarcane bagasse (SB) hinders its utilization by microorganism, therefore, pretreatment methods are employed to make fermentable components accessible to the microbes. Multivariate analysis of different chemical pretreatment methods can aid to select the most appropriate strategy to valorize a particular biomass.

RESULTS

Amongst methods tested, the pretreatment by using sodium hydroxide in combination with methyltrioctylammonium chloride, an ionic liquid, (NaOH+IL) was the most significant for xylanase production by Bacillus aestuarii UE25. Investigation of optimal levels of five significant variables by adopting Box-Behnken design (BBD) predicted 20 IU mL^- 1 of xylanase and experimentally, a titer of 17.77 IU mL^- 1 was obtained which indicated the validity of the model. The production kinetics showed that volumetric productivity of xylanase was much higher after 24 h (833.33 IU L^- 1 h^- 1) than after 48 h (567.08 IU L^- 1 h^- 1). The extracted xylan from SB induced more xylanase in the fermentation medium than pretreated SB or commercially purified xylan. Nuclear Magnetic Resonance, Fourier transform infrared spectroscopy and scanning electron microscopy of SB indicated removal of lignin and changes in the structure of SB after NaOH+IL pretreatment and fermentation.

CONCLUSION

Combined pretreatment of SB with alkali and methyltrioctylammonium chloride appeared better than other chemical methods for bacterial xylanase production and for the extraction of xylan form SB.

Community-based Health Data Cooperatives Towards Improving the Immigrant Community Health: A Scoping Review to Inform Policy and Practice

Background

In the case of immigrant health and wellness, data are the key limiting factor, where comprehensive national knowledge on immigrant health and health service utilisation is limited. New data and data silos are an inherent response to the increase in technology in the collection and storage of data. The Health Data Cooperative (HDC) model allows members to contribute, store, and manage their health-related information, and members are the rightful data owners and decision-makers to data sharing (e g. research communities, commercial entities, government bodies).

Objective

This review attempts to scope the literature on HDC and fulfill the following objectives: 1) identify and describe the type of literature that is available on the HDC model; 2) describe the key themes related to HDCs; and 3) describe the benefits and challenges related to the HDC model.

Methods

We conducted a scoping review using the five-stage framework outlined by Arskey and O’Malley to systematically map literature on HDCs using two search streams: 1) a database and grey literature search; and 2) an internet search. We included all English records that discussed health data cooperative and related key terms. We used a thematic analysis to collate information into comprehensive themes.

Results

Through a comprehensive screening process, we found 22 database and grey literature records, and 13 Internet search records. Three major themes that are important to stakeholders include data ownership, data security, and data flow and infrastructure.

Conclusions

The results of this study are an informative first step to the study of the HDC model, or an establishment of a HDC in immigrant communities.

Key words

community health, health data, cooperative, and citizen data empowermen

Long-term health effects of chemical warfare agents on children following a single heavy exposure

In the 1980s, villages in the Kurdistan region of Iraq were exposed to chemical weapons (CWs), which killed and injured thousands of civilians. There has been no clinical assessment of the long-term effects of CWs exposure on those injured. We report the first such evaluation of CW effects on long-term health of children. Patients from the CW-exposed areas were interviewed to assess previous and current clinical history and underwent clinical examination. The status of organs known to be targets of CWs, including skin, eyes, respiratory and neuromuscular systems, was assessed. Children of similar age and social background, but with no history of CW exposure, were selected as a control population. Results showed that 70% of children in the CWs group had chronic health problems in contrast to 3.3% in the unexposed group ( p < 0.0001). Fifty-five per cent of the CW-exposed group had long-term visual impairment but none in the unexposed population. Thirty-six per cent of the CW-exposed group had chronic dermatological conditions compared with 0.8% of the unexposed group ( p < 0.0001), 31% of the CWs group had neurological sequelae compared with 0.4% of the unexposed group ( p < 0.0001) and 51% of the CWs group had long-term respiratory problems compared with 1.5% of the unexposed group ( p < 0.0001). Respiratory complaints including asthma, chronic bronchitis and bronchiectasis were particularly common. Our study suggests that CWs used were probably a combination of sulphur mustard and organophosphate nerve agents. Results also indicate that the prevalence of acute and chronic health problems following exposure to CW agents appear to be higher in children compared with reported data in adults.

Abstract P6-07-22: Association of Hedgehog signaling pathway with luminal B sub-type of breast cancer affected patients of Pakistan

Introduction

Hedgehog pathway dysregulation is observed in different types of cancers including breast. In the present study, expression profiles of hedgehog pathway molecules in breast cancer cohort of Pakistan and their probable association with molecular sub-types were explored.

Methods

The study was preceded with ethical approval and informed consent from respective institutions and participants. During 2013-2015, a total of 150 cancer biopsies along with adjacent normal tissues were prospectively collected immediately after surgery and processed for RNA isolation. Transcriptional profiles of salient members including SHH, DHH, IHH, PTCH-1, SMO and GLI-1 were quantified using qRT-PCR. Cohort was categorized into molecular sub-types following St. Gallen International Expert Consensus System. Association of expression levels of these aforementioned molecules with various clinico-pathological parameters was explored.

Result

Both SHH (p=0.01) and DHH (p&lt;0.001) showed elevated expression among tumors in comparison to their controls. Similarly, PTCH-1 (p&lt;0.001) and GLI-1 (p=0.002) were also significantly up regulated in the cohort. Interestingly, strong positive correlations were observed among the pathway molecules (r-value ranging from 0.45 to 0.81) which highlight their interdependence towards tumor progression. A significant correlation of SHH, DHH, PTCH-1 and GLI-1 was observed with advanced tumor sizes, stages, grades and nodal involvement (p&lt;0.05). Association of IHH, SMO and GLI-1 over expression with cancer metastasis was also established in the cohort. SHH, PTCH-1 and GLI-1 were significantly linked with laterality, age and menopausal status. Expression of SHH (p=0.002) was more related to younger age group (mean age &lt; 45 yrs) patients in comparison to elderly women.

Moreover all hedgehog molecules were strongly related to hormonal receptors (ER and PR) (r-value ranging from 0.51 to 0.86) while over-expression of HER-2 was not associated with any pathway component. Briefly, 53% (79) of the cohort was categorized as Luminal-B, 18% (27) triple negative, 15% (23) Luminal-A and 14% (21) HER-2 for sub-typing of breast cancer patients in the cohort. Expression of SHH was significantly associated with the molecular sub-types (p=0.02) and age (p=0.005) using Pearson Chi-Square test. Elevated expression of SHH was observed in 60% of the patients in Luminal B sub-type.

Conclusion

Hedgehog pathway plays a crucial role in breast cancer progression and is found to be activated in Luminal B sub-type in this cohort. As Luminal B is a more aggressive type of breast cancer having poor prognosis and early-onset, association of SHH with Luminal-B and younger age patients signify it importance as a biomarker for early diagnosis of young patient's. Hence therapeutic interventions for hedgehog pathway can improve the prognosis of patients categorized as Luminal B subtype of breast carcinogenesis.

Citation Format: Riaz SK, Rashid R, Shah STA, Wang F, Malik MFA. Association of Hedgehog signaling pathway with luminal B sub-type of breast cancer affected patients of Pakistan [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-07-22.

Reasons for underutilisation of drug therapy for smoking cessation among Malaysian aboriginal smokers

Introduction

The smoking rate among Malaysian aboriginal people is double the rate of other Malaysians. Smoking is a major cause of morbidity and mortality in aboriginal people but smoking cessation among this population is very low. At present, pharmacotherapy for smoking cessation is not subsidised in the health services.

Objective and aim

The study aimed to explore potential reasons for the underutilisation of drug therapy for smoking cessation among aboriginal and non-aboriginal smokers.

Methods

A cross-sectional study was conducted among aboriginal and non-aboriginal smokers in the state of Selangor between March 2010-August 2010. Participants were asked to complete a questionnaire on demographics, smoking behaviour, physician counselling on smoking cessation and perceptions about drug therapy for smoking cessation.

Results

The overall response rate was 85% (250 Aboriginal smokers and 105 non-aboriginal smokers). Majority of smokers reported smoking cessation or reduction in the previous 6 months (Aboriginal 62% vs non-aboriginal 68%). Aboriginal participants were less likely to seek physician services (p = 0.001) and less willing to use nicotine replacement therapy (p = 0.01) or varenicline (p = 0.001). Among all smokers, having to buy the medication and price of the medication was the most important factor associated with less willingness to use the drugs but advice from physician was associated with willingness to use the drugs.

Conclusions

Regardless of ethnic origin, smokers were interested to quit smoking, but cost of medication may explain their lower uptake of drug therapy. Malaysian policy makers should consider making the drugs for smoking cessation freely available in the Malaysian health services.

Expressional alterations and transcript isoforms of metastasis suppressor genes (KAI1 and KiSS1) in breast cancer patients

BACKGROUND

Metastasis suppressor genes are involved in the inhibition of a cancer cell's ability to metastasize. Down expression of such genes may contribute to pathogenesis of breast cancer. The aim of current study was firstly to evaluate expression of two examples, KAI1 and KISS1, and then to determine relationships with stages of breast cancer in a Pakistani population.

METHODOLOGY

Fresh biopsy tissues were collected from different hospitals and oncology research institutes. The semi quantitative reverse transcriptase polymerase chain reaction was used to investigate KAI1 and KISS1 expression in 25 breast tumor tissues and 25 normal tissues. Statistical analysis was performed to explore its association with breast cancer risk.

RESULTS

The present study revealed that KAI1 and KISS1 mRNA expression was markedly reduced in tissues of breast cancer compared to adjacent normal tissue. In present study a splice variant of KAI1 during a screen for its expression analysis was also observed. This splice variant has not been reported previously.

CONCLUSIONS

Metastasis suppressor genes demonstrate reduced expression in breast cancers in Pakistan.