Real-time impact of COVID-19 pandemic on cutaneous leishmaniasis case finding and strategic planning, preventive interventions, control and epidemiology in a region with a high burden of cutaneous leishmaniasis and COVID-19: A cross-sectional descriptive study based on registry data in Ilam-Iran

Background and Aims

Cutaneous leishmaniasis (CL) is a severe parasitic disease affecting people, mostly in underdeveloped nations. As a zoonotic infection yearly incidence of CL depends on several parameters such as demographic, epidemiological, and environmental factors as well as prevention and control measures. The sudden outbreak of pandemics such as SARS-Corona-Virus-2 pandemic, can probably affect the incidence or reporting of other diseases, especially infectious diseases, in various ways such as pressure on health systems, providing sanitary services and its components, lockdowns and changes in people's living habits.

Aim

This study aimed to evaluate the COVID-19 impact on the incidence and other epidemiological aspects as well as control measures of CL in Ilam Province-Iran.

Methods

Required data was extracted from the CL registration system in Ilam from 2014 to 2021 to demonstrate the trend of CL incidence before and after COVID-19 pandemic.

Results

Based on our results, a declining pattern of CL incidence was observed, accompanied by the advent and intensification of the viral pandemic in Iran and Ilam province. Although, this decreasing pattern was not integral in all areas, and even increase in CL detection was emphasized in some regions.

Conclusion

It may be inferred that the COVID-19 pandemic may disrupt treatment programs of CL cases, rodent nest destruction, and fighting vector insects.

Comorbidity of asthma in patients with attention-deficit/hyperactivity disorder (ADHD) aged 4-12 years in Iran: a cross-sectional study

Attention-deficit/hyperactivity disorder (ADHD) is defined as a stable pattern of attention deficits or impulsive hyperactivity that can interfere with the functioning, growth, and development of individuals. It is believed that both the type of asthma and the medications used to treat it exacerbate the symptoms of ADHD.

Methods and Materials

The present study was a cross-sectional analytical study conducted to investigate the incidence of asthma in ADHD patients aged 4-12 years who were referred to Urmia University of Medical Sciences clinics and hospitals. In this study, ADHD patients were diagnosed through a psychiatric interview and based on a paediatric asthma questionnaire (approved by asthma and allergy organizations and scientific institutions), and individuals with suspected asthma were selected. All 101 ADHD patients referred to these clinics during the specified period were examined. Five patients were excluded from the study because of lack of cooperation or incomplete information. Then, the selected subjects were divided into two age groups of less than 5 years and between 5 and 12 years. The final diagnosis of asthma was made by clinical findings and demographic questionnaire in subjects younger than 5 years, while it was made by spirometry in subjects between 5 and 12 years. Data analysis was conducted using SPSS software.

Results

The mean age of the 96 samples included in the study was 7.67 years with a standard deviation of 7.214. Sixteen of them (16.7%) were under 5 years of age and eighty of them (83.3%) were between 5 and 12 years of age. Asthma was diagnosed in 7 children under 5 years of age (7.3%) and in 14 children (14.6%) between 5 and 12 years of age. A total of 21 (21.9%) were diagnosed as having asthma after screening. On the basis of these results, the frequency of asthma according to classified age was significant (P=0.020). The frequency of asthma based on sex and birth rank was also examined, and none of these factors showed a significant association with asthma. Medications taken by the ADHD patients were also examined in this study. The most commonly used medications in both groups of patients with asthma and no asthmatic patients were a combination of risperidone and atomoxetine or risperidone alone. The prevalence of asthma in the target population was also assessed in terms of parental smoking.

Conclusions

According to the results of this study, the incidence of asthma in ADHD patients aged 4-12 years is high, and this case is more frequent in subjects younger than 5 years than in subjects aged 5-12 years. It should be noted that according to the results of the present study, there was no significant association between birth rank, parental smoking, ADHD medication, and the frequency of asthma.

Effects of emulsifier, betaine, and L-carnitine on growth performance, immune response, gut morphology, and nutrient digestibility in broiler chickens exposed to cyclic heat stress

1. This experiment investigated the efficacy of varying doses of an emulsifier blend (EB; 0 and 1 g/kg of diet), betaine (BT; 0 and 1 g/kg of diet) and L-carnitine (CT; 0 and 0.5 g/kg of diet) in broilers subjected to circular heat stress (HS) conditions. A total of 1080 one-day-old male broiler chickens (Ross 308) were randomly assigned to one of nine treatment groups (six pens/treatment with 20 birds/pen) according to a completely randomised design. The thermoneutral control broiler chickens were housed at a comfortable temperature and fed a standard diet (no additives). The other eight groups were exposed to cyclic HS conditions (34°C) for 8 h (10:00-18:00).2. There were EB × BT × CT interactions for body weight (BW) at 24 d (P = 0.038) and average daily gain (ADG) during the 10-24 d period (P = 0.049), with the greatest values found with concurrent supplementation of three supplements.3. Inclusion of EB resulted in greater (P < 0.05) BW, ADG, European performance index, uniformity rate, primary antibody titres against sheep red blood cells (SRBC), duodenal villus height (VH) and villus surface area, digestible energy (DE) and the coefficient of apparent ileal digestibility (CAID) of dry matter, crude protein, and fat However, feed conversion ratio, mortality rate and heterophile to lymphocyte ratio were lower (P < 0.05).4. Dietary BT supplementation improved (P < 0.05) all performance indicators, primary antibody titres against SRBC and Newcastle disease virus, serum total antioxidant capacity, duodenal VH, Jejunal VH/crypt depth and the CAID of dry matter and crude protein. The effect of dietary supplementation with CT was limited to an increase (P < 0.05) in ADG (d 10-24) and a decrease (P < 0.05) in serum malondialdehyde concentration (42 d) and jejunal crypt depth (42 d).5. In conclusion, dietary supplementation of either EB or BT alone or in combination ameliorated some of the detrimental effects of HS on growth performance, immunity and intestinal health in broilers, while a minor positive effect on performance and antioxidant status was observed with CT supplementation.

The Role of demand - control - support model in nursing musculoskeletal disorders:A systematic review

Introduction: Nursing is one of the high risk jobs in the world and its occupational hazards have a direct impact on the health of nurses. Work-based musculoskeletal disorders are prevalent among health care workers, particularly nursing staff.  The purpose of this study was to systematically review studies on the relationship between occupational stress based on demand-control-support model and nurses' musculoskeletal disorders. Materials and Methods: In this study, major international electronic databases including PubMed, ISI Web of Science, Scopus and ScienceDirect and Persian databases, including SID, Irandoc, Magiran and Medlib were studied. The keywords used were: social support, job stress, job control, job demand, and musculoskeletal disorder. The main criterion for inclusion was the survey of the top three variables in the nursing community. After evaluating the inclusion criteria and the quality of the articles, 6 studies were identified and included in the study. Results: According to the results of 6 studies, in 4 studies variables of job strain and in 5 studies psychological demands of job were related to the musculoskeletal disorders. The relationship between job control and supervisor support has also been confirmed in one study. Conclusion: Surveys clearly show that the greater the individual's perception of control over their work and the lower the level of psychological demands in their job, the health of the individual increases.

Effect of fennel essential oil on performance, serum biochemistry, immunity, ileum morphology and microbial population, and meat quality of broiler chickens fed corn or wheat-based diet

1. The effect of Foeniculi aetheroleum essential oil (EO) on growth performance, nutrient utilisation, serum biochemistry, immune response, ileum morphology, microbial population and meat quality of broiler chickens fed a corn- or wheat-based diet were determined.2. A total of 360 broiler chickens were arranged in a 2 × 2 factorial assay in a completely randomised design with six replicates and 15 birds per experimental unit. Birds were fed corn- or wheat-based diets supplemented with (200 mg/kg) or without fennel EO.3. Birds fed wheat-based diets had lower BWG and FCR during grower period and lower FI during finisher period as compared to those fed corn-based diet (P < 0.05) whereas addition of fennel EO decreased chickens BWG during finisher period and EPEF, both in wheat or in corn-based diets. Dietary treatments had no effect on serum glucose, triglyceride, cholesterol, LDL-cholesterol, AST, ALT, ALP, and MDA concentrations (P < 0.05).4. Antibody titres against avian influenza and sheep red blood cell antibody titres, crude protein and crude fat utilisation, villus height, crypt depth and epithelium thickness were not influenced by dietary treatments (P > 0.05). Inclusion of Fennel EO to the corn-based diet resulted in greater villus width and villus surface area while it reduced lamina propria thickness (P < 0.05). Fennel EO reduced ileal E. coli and Lactobacillus spp. populations (P < 0.05). Dietary treatments had no significant effect on meat pH, cooking loss, drip loss, crude protein, crude fat content and cholesterol concentration of breast and thigh meat, total phenolic and MDA concentrations, and breast meat sensory parameters (P > 0.05).5. These results showed that addition of fennel EO to wheat-based diets had a negative effect on chicken growth performance variables and decreased gut E. coli populations. However, immunity, meat quality and nutrient utilisation were not affected by dietary treatments.

Nanofibrous Poly(ε-Caprolactone)/Poly(Vinyl Alcohol)/Chitosan Hybrid Scaffolds for Bone Tissue Engineering using Mesenchymal Stem Cells

In the present study, based on a biomimetic approach, novel 3D nanofibrous hybrid scaffolds consisting of poly(ε-caprolactone), polyvinyl alcohol), and chitosan were developed via a multi-jet electrospinning method. The influence of chemical, physical, and structural properties of the scaffolds on the differentiation of mesenchymal stem cells into osteoblasts, and the proliferation of the differentiated cells were investigated. Osteogenically induced cultures revealed that cells were well-attached, penetrated into the construct and were uniformly distributed. The expression of early and late phenotypic markers of osteoblastic differentiation was upregulated in the constructs cultured in osteogenic medium.

Functional Hepatocyte-Like Cells Derived from Human Bone Marrow Mesenchymal Stem Cells on a Novel 3-Dimensional Biocompatible Nanofibrous Scaffold

Aim

To supporting growth and functional differentiation of adult stem cells into hepatocytes in a well-controlled manner, we performed differentiation of human bone marrow mesenchymal stem cells (hBMSCs) to hepatocytes-like cells on a constructed 3-dimensional (3D) nanofibrous biocompatible scaffold.

Methods

After characterization of the hBMSCs isolated from human bone marrow, the performance of the cells seeded and their proliferation on the scaffold was evaluated by scanning electron microscopy (SEM) and 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Different approaches such as immunocytochemistry, reverse transcriptase polymerase chain reaction (RT-PCR), and biochemical assays were used to estimate the ability of hBMSC-derived cells to express hepatocyte-specific markers.

Results

Scanning electron micrographs and MTT analysis revealed the cells were able to expand and remained biologically and metabolically active for 21 days. Immunocytochemical analysis of albumin and α-fetoprotein showing the accumulation of these markers in differentiated cells was confirmed by RT-PCR. Additional markers such as cytochrome P450 3A4, cytokeratin-18, and cytokeratin-19 detected by RT-PCR showed progressive expression during 3 weeks of differentiation on 3D scaffold. The hepatocyte-like cells displayed several characteristics of metabolic functions as judged by production of albumin, urea, transferrin, serum glutamic pyruvic transaminase (SGPT), and serum oxaloacetate aminotransferase (SGOT). Levels of above-mentioned markers, except SGOT in differentiated cells on scaffold, were found to be significantly greater than in the 2D culture system (p<0.05).

Conclusion

Overall data suggest that the engineered nanofibrous scaffold is a conductive matrix for functional hBMSC-derived hepatocyte-like cells and is promising for maintenance of hepatocytes suitable for implantation.

Use of germ-line single nucleotide polymorphisms (SNPs) in drug transporters (ABCG2/ABCB1) and tubulin (TUBB4) to predict survival in patients with metastatic castrate-resistant prostate cancer (CRPC) receiving docetaxel

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Background: Multiple treatment options now exist for metastatic CRPC patients (pts). Germ-line SNPs in docetaxel (D) transport, metabolism, binding site, and degradation genes may contribute to variability in outcomes observed in D treated CRPC pts.

Methods: Between 1/07 and 10/08, all PCa pts seen in the Indiana University Simon Cancer Center oncology clinics were approached for recruitment to the Prostate Cancer Genetic Risk Evaluation of SNPs Study (PROGRESS). Participants completed a demographic and clinical questionnaire and provided a blood sample. Only CRPC pts treated with D were included in this analysis. Germ-line DNA was analyzed for SNP genotyping on a 128-SNP chip using a TaqMan OpenArray GT Kit (Applied Biosystems). The chip included genes critical to D signaling, transport, and elimination with minor allele frequencies > 5%. Pts were followed for progression-free (PFS) and overall survival (OS). Univariable analyses were performed to identify significant associations between SNP genotype, clinical parameters, and PFS and OS outcomes.

Results: 60 pts with metastatic CRPC initiated on D enrolled. Demographics included: age (median) – 69 yrs, ECOG PS 0– 40%, prostate specific antigen (PSA) (median) – 129.9 ng/ml, PSA doubling time (median) – 1.8 months, visceral mets –25%. No clinical parameters were associated with PFS and OS. Significant SNP associations are summarized below.

Conclusions: Differences in germ-line ABCG2, ABCB1, and TUBB4 SNPs may contribute to variation in clinical outcomes in CRPC pts treated with D.

[Table: see text]

[Table: see text]

Germ-line single nucleotide polymorphism (SNP) predictors of progression-free survival and overall survival in patients with advanced prostate cancer treated with androgen-deprivation therapy (ADT)

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Background: Significant variation in response duration and overall survival exists among prostate cancer (PCa) patients treated with ADT. Germ-line SNPs affecting function of genes critical to hormone synthesis, transport, metabolism, binding sites, and degradation may contribute to variability in clinical outcomes observed in PCa patients treated with ADT.

Methods: Between 1/07 and 10/08, all PCa patients seen in the Indiana University Simon Cancer Center oncology clinics were approached for recruitment to the Prostate Cancer Genetic Risk Evaluation of SNPs Study (PROGRESS). Participants completed a demographic and clinical questionnaire and provided a peripheral blood sample. Only patients with confirmed ADT initiation dates were included in this analysis. Germ-line DNA was analyzed for SNP genotyping on a 128-SNP chip using a TaqMan OpenArray GT Kit (Applied Biosystems). The chip included genes critical to hormone signaling, transport, and elimination pathways with minor allele frequencies > 5%. Patients were followed for progression-free survival (PFS) and overall survival (OS) endpoints. Univariable analyses were performed to identify significant associations between SNP genotype, clinical parameters, and PFS and OS outcomes.

Results: 107 patients with PCa initiated on ADT enrolled. Demographics included: age (median)–69 yrs, prostate specific antigen (PSA) (median)–28.0 ng/ml, PSA doubling time (median)–4.9 months, biochemical/metastatic–25%/75%, concurrent anti-androgen therapy–44%. No clinical parameters were associated with PFS and OS. Significant SNP associations with PFS and OS are summarized in the Table.

Conclusions: Interpatient differences in hormone pathway germ-line SNPs may contribute to variability in clinical outcomes in patients treated with ADT.

[Table: see text]

[Table: see text]

Androgen pathway constitutional polymorphism predictors of progression-free and overall survivals in advanced castrate-resistant prostate cancer (CRPC) patients treated with ketoconazole (KC)

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Background: Recent trials have highlighted the clinical utility of second-line hormonal therapies for CRPC. KC, an oral inhibitor of CYP3A4 and CYP17, is commonly used in this setting. Germline SNPs in genes critical to hormone synthesis, transport, metabolism, binding sites, and degradation may contribute to variability in outcomes observed in KC treated CRPC pts.

Methods: Between 1/07 and 10/08, all PCa pts seen in the Indiana University Simon Cancer Center oncology clinics were approached for recruitment to the Prostate Cancer Genetic Risk Evaluation of SNPs Study (PROGRESS). Participants completed a demographic and clinical questionnaire and provided a peripheral blood sample. Only pts with initiated on KC were included in this analysis. Germline DNA was analyzed for SNP genotyping on a 128-SNP chip using a TaqMan OpenArray GT Kit. The chip included genes critical to hormone signaling, transport, and elimination pathways with minor allele frequencies > 5%. Pts were followed for progression-free survival (PFS) and overall survival (OS) endpoints. Univariable analyses were performed to identify significant associations between SNP genotype, clinical parameters, and PFS and OS outcomes.

Results: Between January 2007 and October 2008, 39 pts with CRPC initiated on KC therapy enrolled. Demographics included: age (median) – 70 yrs, prostate specific antigen (PSA) (median) – 13.0 ng/ml, PSA doubling time (median) – 2.9 months, metastatic –85%, ECOG PS 0– 74%. Age < 70 was associated with shorter PFS (p=0.010) and age > 70 was associated with shorter OS (p=0.030). SNPs significantly associated with PFS and OS are summarized in the table.

Conclusions: Interpatient differences in hormonal pathway germline SNPs may contribute to variability in clinical outcomes in pts treated with KC.

[Table: see text]

No significant financial relationships to disclose.

Antitumor activity of Ad-IU2, a prostate-specific replication-competent adenovirus encoding the apoptosis inducer, TRAIL

In this study, we investigated the preclinical utility and antitumor efficacy of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) delivered by Ad-IU2, a prostate-specific replication-competent adenovirus (PSRCA), against androgen-independent prostate cancer. Through transcriptional control of adenoviral early genes E1a, E1b and E4, as well as TRAIL by two bidirectional prostate-specific enhancing sequences (PSES), expression of TRAIL as well adenoviral replication was limited to prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA)-positive cells. Ad-IU2 induced 5-fold greater apoptosis selectively in PSA/PSMA-positive CWR22rv and C4-2 cells than an oncolytic adenoviral control. Furthermore, prolonged infection with Ad-IU2 reversed TRAIL resistance in LNCaP cells. Ad-IU2 exhibited superior killing efficiency in PSA/PSMA-positive prostate cancer cells at doses 5- to 8-fold lower than required by a PSRCA to produce a similar effect. This cytotoxic effect was not observed in non-prostatic cells, however. As an enhancement of its therapeutic efficacy, Ad-IU2 exerted a TRAIL-mediated bystander effect through direct cell-to-cell contact and soluble factors such as apoptotic bodies. In vivo, Ad-IU2 markedly suppressed the growth of subcutaneous androgen-independent CWR22rv xenografts compared to a PSRCA at six weeks post-treatment (3.1- vs. 17.1-fold growth of tumor). This study demonstrates the potential clinical utility of a PSRCA armed with an apoptosis-inducing ligand.