Elderberry Extracts: Characterization of the Polyphenolic Chemical Composition, Quality Consistency, Safety, Adulteration, and Attenuation of Oxidative Stress- and Inflammation-Induced Health Disorders.

Elderberry is highly reputed for its health-improving effects. Multiple pieces of evidence indicate that the consumption of berries is linked to enhancing human health and preventing or delaying the onset of chronic medical conditions. Compared with other fruit, elderberry is a very rich source of anthocyanins (approximately 80% of the polyphenol content). These polyphenols are the principals that essentially contribute to the high antioxidant and anti-inflammatory capacities and the health benefits of elderberry fruit extract. These health effects include attenuation of cardiovascular, neurodegenerative, and inflammatory disorders, as well as anti-diabetic, anticancer, antiviral, and immuno-stimulatory effects. Sales of elderberry supplements skyrocketed to $320 million over the year 2020, according to an American Botanical Council (ABC) report, which is attributable to the purported immune-enhancing effects of elderberry. In the current review, the chemical composition of the polyphenolic content of the European elderberry (Sambucus nigra) and the American elderberry (Sambucus canadensis), as well as the analytical techniques employed to analyze, characterize, and ascertain the chemical consistency will be addressed. Further, the factors that influence the consistency of the polyphenolic chemical composition, and hence, the consistency of the health benefits of elderberry extracts will be presented. Additionally, adulteration and safety as factors contributing to consistency will be covered. The role of elderberry in enhancing human health alone with the pharmacological basis, the cellular pathways, and the molecular mechanisms underlying the observed health benefits of elderberry fruit extracts will be also reviewed.

From complexity to evolution: Mapping resilience management practices in the hospitality industry during the COVID-19 crisis

The COVID-19 pandemic has severely affected the hospitality industry. Many have treated the crisis as a temporary shock. However, there are those who see it as a turning point. Treating the hospitality industry as a complex adaptive system, this research uses the organizational resilience framework to investigate how hospitality organizations responded to the crisis. A mixed methods approach was employed, and two studies were conducted. A sample of managers from Omani hotels were interviewed and a content analysis was performed on the websites and annual reports of a sample of international hotel brands. The results revealed that the Omani industry's response was mostly limited to coping, whereas the international industry was active in anticipating, coping, and adapting to the pandemic. Strong support is provided for the notion of the pandemic as a turning point. An action framework has been developed to support firms in keeping pace with the industry's evolution.

Strategies to save energy in the context of the energy crisis: a review.

New technologies, systems, societal organization and policies for energy saving are urgently needed in the context of accelerated climate change, the Ukraine conflict and the past coronavirus disease 2019 pandemic. For instance, concerns about market and policy responses that could lead to new lock-ins, such as investing in liquefied natural gas infrastructure and using all available fossil fuels to compensate for Russian gas supply cuts, may hinder decarbonization efforts. Here we review energy-saving solutions with a focus on the actual energy crisis, green alternatives to fossil fuel heating, energy saving in buildings and transportation, artificial intelligence for sustainable energy, and implications for the environment and society. Green alternatives include biomass boilers and stoves, hybrid heat pumps, geothermal heating, solar thermal systems, solar photovoltaics systems into electric boilers, compressed natural gas and hydrogen. We also detail case studies in Germany which is planning a 100% renewable energy switch by 2050 and developing the storage of compressed air in China, with emphasis on technical and economic aspects. The global energy consumption in 2020 was 30.01% for the industry, 26.18% for transport, and 22.08% for residential sectors. 10-40% of energy consumption can be reduced using renewable energy sources, passive design strategies, smart grid analytics, energy-efficient building systems, and intelligent energy monitoring. Electric vehicles offer the highest cost-per-kilometer reduction of 75% and the lowest energy loss of 33%, yet battery-related issues, cost, and weight are challenging. 5-30% of energy can be saved using automated and networked vehicles. Artificial intelligence shows a huge potential in energy saving by improving weather forecasting and machine maintenance and enabling connectivity across homes, workplaces, and transportation. For instance, 18.97-42.60% of energy consumption can be reduced in buildings through deep neural networking. In the electricity sector, artificial intelligence can automate power generation, distribution, and transmission operations, balance the grid without human intervention, enable lightning-speed trading and arbitrage decisions at scale, and eliminate the need for manual adjustments by end-users.

Atypical Presentation of Burkitt Lymphoma With Isolated Peritoneal Involvement and Association With Refractory Type B Lactic Acidosis and Hypoglycemia Secondary to the Warburg Effect.

Lactic acidosis is considered to be one of the most common causes of high anion gap metabolic acidosis in hospitalized patients. Warburg effect can present with type B lactic acidosis and is considered to be a rare but well-known complication of hematological malignancies. Here, we present the case of a 39-year-old male who had type B lactic acidosis and recurrent hypoglycemia secondary to newly diagnosed Burkitt lymphoma. This case highlights the importance of considering malignancy workup in any case of unexplained type B lactic acidosis with vague clinical presentation, which can aid in early diagnosis and management.

From complexity to evolution: Mapping resilience management practices in the hospitality industry during the COVID-19 crisis.

The COVID-19 pandemic has severely affected the hospitality industry. Many have treated the crisis as a temporary shock. However, there are those who see it as a turning point. Treating the hospitality industry as a complex adaptive system, this research uses the organizational resilience framework to investigate how hospitality organizations responded to the crisis. A mixed methods approach was employed, and two studies were conducted. A sample of managers from Omani hotels were interviewed and a content analysis was performed on the websites and annual reports of a sample of international hotel brands. The results revealed that the Omani industry's response was mostly limited to coping, whereas the international industry was active in anticipating, coping, and adapting to the pandemic. Strong support is provided for the notion of the pandemic as a turning point. An action framework has been developed to support firms in keeping pace with the industry's evolution.

Sever erythema multiforme post-COVID-19 moderna vaccine: Case report and literature review.

Introduction: Although the COVID-19 Vaccine usually causes a few non-serious side effects, serious ones such as Erythema multiforme recently has been linked to it. Case presentation: Our patient presented with severe skin reaction one day post-Covid-19 Moderna vaccine diagnosed as erythema multiforme proven by skin biopsy that responded well to steroids. Discussion: Erythema multiform major, an immune-mediated cutaneous reaction to infections or drugs involving the oral cavity, should be considered a possible adverse effect of numerous vaccinations, including SARSCoV2. Correct patient history gathering enables early detection and successful medical therapy with oral corticosteroids.Furthermore, the disease's rarity makes establishing a causative link difficult. However, because we are still learning about the innovative antiSARSCoV2 vaccines, it is crucial to be cautious of the potential cutaneous adverse responses. Conclusion: Despite being rare, life-threatening adverse reactions can occur post-COVID-19 Vaccination.

In-house protocol: spin-based viral RNA purification.

A worldwide shortage of molecular biology consumables is in surge. This includes filter tips, nucleic acid purification kits, polymerases, reverse-transcriptase, and different types of reagents which are included in viral diagnostic kits. In developing countries, the problem is even worse, since there is few capital enterprise to adopt this kind of industry. So, our aim is to develop a suitable, functional, comparable to commercial ones, and affordable in-house protocol to purify viral RNA. We sought some published and commercial RNA purification solutions to set-up an in-house protocol for viral RNA extraction. Solution was prepared accordingly. Also, LPA (linearized polyacrylamide) carrier was evaluated. The whole setting of in-house solutions with addition of LPA carrier was compared to QIAamp viral RNA minikit solutions. Our results showed that linearized polyacrylamide (LPA) carrier in homemade solutions is comparable to poly A carrier which is used in the most commercial kit. In addition, the whole setting of RNA purification solutions did achieve the purpose of viral RNA purification. Also, the result was confirmed using sputum of a Sars-Cov2 infected patient. Our experiments did end up with an affordable homemade solutions for viral RNA purification.

Ukraine - Russia crisis and its impacts on the mental health of Ukrainian young people during the COVID-19 pandemic.

The Russia-Ukraine crisis has been at the center of international talks since early 2022. This conflict, bursting after the sanitary crisis of the covid 19 pandemic, creates an atmosphere of uncertainty and instability, which negatively impacts many aspects, including mental health. Young Ukrainians have been suffering from socio-political instability for decades, and the current war, together with the Covid 19 pandemic, shatters hopes of brighter days. This commentary covers the challenges facing the younger generation in Ukraine and the impact of this situation on their mental health.

The SARS-CoV-2 receptor ACE2 is expressed in mouse pericytes but not endothelial cells: Implications for COVID-19 vascular research.

Humanized mouse models and mouse-adapted SARS-CoV-2 virus are increasingly used to study COVID-19 pathogenesis, so it is important to learn where the SARS-CoV-2 receptor ACE2 is expressed. Here we mapped ACE2 expression during mouse postnatal development and in adulthood. Pericytes in the CNS, heart, and pancreas express ACE2 strongly, as do perineurial and adrenal fibroblasts, whereas endothelial cells do not at any location analyzed. In a number of other organs, pericytes do not express ACE2, including in the lung where ACE2 instead is expressed in bronchial epithelium and alveolar type II cells. The onset of ACE2 expression is organ specific: in bronchial epithelium already at birth, in brain pericytes before, and in heart pericytes after postnatal day 10.5. Establishing the vascular localization of ACE2 expression is central to correctly interpret data from modeling COVID-19 in the mouse and may shed light on the cause of vascular COVID-19 complications.

Clinical and Epidemiological Characteristics of COVID-19 Patients with SARS-CoV-2 Re-Detected on PCR Test after Discharge from Isolation.

There have been multiple reports of patients with coronavirus disease (COVID-19) testing positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after discharge; however, information on the characteristics of such cases is limited. In this case report, we aimed to identify clinical and epidemiological characteristics of patients who had a repeat positive polymerase chain reaction (PCR) test for SARS-CoV-2. We analyzed data of 22 COVID-19 patients who tested positive for SARS-CoV-2 on polymerase chain reaction (PCR) testing after two consecutive negative PCR results following discharge from hospitals. The interval between the two positive tests in the episodes of COVID-19 ranged from 4 to 117 days. More than one-third of the cases were healthcare workers (HCWs) and one-third of them had comorbidities. The main symptoms were cough and fever, and we noticed that males experienced more symptoms and signs of COVID-19 than females. Individuals with repeat SARS-CoV-2 positivity tend to experience milder illness during the second episode than the first episode. To confirm the reinfection of SARS-CoV-2, the results of other tests, such as viral culture and immunological assays of immunoglobulin G (IgG) and immunoglobulin M (IgM), need to be considered. Recovered COVID-19 patients should continue social distancing, using face masks, and practicing hand hygiene, especially HCWs who are more likely to be exposed to SARS-CoV-2.

Pilot Social Network Weight Loss Intervention With Two Immigrant Populations During the COVID-19 Pandemic.

PURPOSE: To examine the feasibility and acceptability of a social network weight loss intervention delivered by lay health promoters (HPs) to immigrant populations. DESIGN: Single-arm, non-randomized, pilot study of a social network weight loss intervention developed by a community-based participatory research partnership and delivered by HPs. SETTING: Community-based setting in Southeastern Minnesota, United States. SAMPLE: Somali and Hispanic immigrants to the United States: 4 social networks of adults (2 Hispanic and 2 Somali) with 39 network participants. INTERVENTION: Twelve-week behavioral weight loss intervention delivered by HPs (4 weeks in-person and then 8 weeks virtual). MEASURES: Feasibility was assessed by recruitment and retention rates. Acceptability was assessed by surveys and focus groups with HPs and participants. Behavioral measures included servings of fruits and vegetables, drinking soda, and physical activity. Physiologic measures included weight, blood pressure, glucose, cholesterol, and triglycerides. ANALYSIS: Paired t-tests of pre- to post-intervention changes at the end of 12 weeks of treatment. RESULTS: Recruitment was feasible and post-intervention was 100%. Participants highly rated the intervention on satisfaction, motivation, and confidence to eat a healthy diet, be physically active, and lose weight. Participants were motivated by group social support and cohesion of their social networks. On average, participants lost weight (91.6 ± 15.9 to 89.7 ± 16.6 kg, P < .0001), lowered their systolic blood pressure (133.9±16.9 to 127.2 ± 15.8 mm Hg; P < .001), lowered their diastolic blood pressure (81 ± 9.5 to 75.8 ± 9.6 mm Hg; P < .0001), had more servings of vegetables per day (1.9 ± 1.2 to 2.6 ± 1.4; P < .001), and increased their physical activity (2690 ± 3231 to 6595 ± 7322 MET-minutes per week; P = .02). CONCLUSION: This pilot study of 2 immigrant communities who participated in a peer-led weight loss social network intervention delivered during the COVID-19 pandemic demonstrated high feasibility and acceptability. Participants lost weight, improved their health status, and improved their health behaviors.

Community-Engaged Bidirectional Crisis and Emergency Risk Communication With Immigrant and Refugee Populations During the COVID-19 Pandemic.

OBJECTIVES: This study was conducted to assess an intervention that was created by a community-academic partnership to address COVID-19 health inequities. We evaluated a community-engaged bidirectional pandemic crisis and emergency risk communication (CERC) framework with immigrant and refugee populations during the COVID-19 pandemic. METHODS: A 17-year community-engaged research partnership adopted a CERC framework in March 2020 to address COVID-19 prevention, testing, and socioeconomic impacts with immigrant and refugee groups in southeast Minnesota. The partnership used bidirectional communication between communication leaders and their social networks to refine messages, leverage resources, and advise policy makers. We conducted a mixed-methods evaluation for intervention acceptability, feasibility, reach, adaptation, and sustainability through multisource data, including email communications, work group notes, semistructured interviews, and focus groups. RESULTS: The intervention reached at least 39 000 people in 9 months. It was implemented as intended and perceived efficacy was high. Frequent communication between community and academic partners allowed the team to respond rapidly to concerns and facilitated connection of community members to resources. Framework implementation also led to systems and policy changes to meet the needs of immigrant and refugee populations. CONCLUSIONS: Community-engaged CERC is feasible and sustainable and can reduce COVID-19 disparities through shared creation and dissemination of public health messages, enhanced connection to existing resources, and incorporation of community perspectives in regional pandemic mitigation policies.

Knowledge and Practice Regarding Coronavirus Disease Prevention (COVID-19) Among Internally Displaced Persons in Camps in Central Darfur Region, Sudan

AJOL Abstract: Background: The lacking healthcare system services in conflict areas and the emergence of infection with a pandemic of coronavirus  disease may exacerbate the humanitarian crisis among the camp residents in the central Dafur region of Sudan. Adequate knowledge and practices are vital to prevent coronavirus disease 2019 (COVID-19). Therefore, this study aimed to investigate the knowledge and practiceregarding COVID-19 among internally displaced persons in Sudan. Methods: In this cross-sectional study, data were collected through an online survey using a self-administered questionnaire. Convenience sampling method was used for the internally displaced persons in two camps of Zalingei town, central Darfur region, Sudan. Results: In total, 143 participants responded;75 (52.4%) of them were female, while 68 (47.6%) were male;49 (34.3%) were between the age of 50 and 60 years;78 (54.5%) were formally uneducated;126 (88.1%) did not have a chronic disease;and 56 (39.2%) knew about COVID-19 from their relatives and friends. The overall mean of participants’ knowledge toward COVID-19 was 3.68 (SD ± 0.60(, denoting good with a rate of 73.6% and that of the practice was 2.65 (SD ±1.08), denoting moderate with a rate of 53%. A positive correlation was seen between knowledge and practice (r = 0.700, p < 0.000). Statistically significant differences were observed between the mean score of knowledge and practice with age, education, and information sources (p < 0.0001). While graduates showed a higher knowledge (116.29, p = 0.000), secondary respondents showed a higher practice (115.04, p = 0.000) than others. Conclusion: This study suggests educational intervention and awareness programs for uneducated and older people

Clinical Characteristics And Analysis Of Risk Factors For Disease Progression Of COVID-19 Among Patients Within Wad Medani Isolation Centers, Gezira State: A Retrospective Cohort Study From Sudan (preprint)

Background: (COVID-19) had a great impact on the world’s health systems since December 2019. A little is known about the clinical characteristics and risk factors associated with COVID-19 severity in Sudanese Patients; therefor it is necessary to summarize the clinical characteristics of patients with COVID-19 and to explore the risk factors associated with COVID-19 severity. Methods : A one-year retrospective cohort study (May 2020- May2021) was done at three isolation centers in Wad Medani. Sample contained all COVID-19 patients who are over 18 years old and were confirmed to be COVID-19 by nucleic acid testing or features Suggestive of Covid19 on Chest CT scan. Results : This study included 418 patients confirmed COVID-19 cases with a median age of 66.3±13years. 179 (64.2%) patients were men. Hypertension (n=195; 46.7%) and diabetes (n=187; 44.7%) were the most common comorbidities. The most common symptoms at COVID-19 onset were fever (n=303; 72.5%), cough (n=278; 66.5%) and dyspnea (n= 256; 61.2%). the overall mortality rate was 35.4% (n=148). The morality rate was 42.3% (n=118) among patients with severe disease. The Chi-square test and ANOVA analysis revealed that older age, anemia, neutrophilia and lymphcytopenia, higher glucose levels, HbA1c levels and creatinine levels were variables associated with severe COVID-19. In inflammatory markers, the levels of CRP and d-dimer were elevated in severe infection more than moderate and mild infections. Conclusion : Patients with these factors are more likely to deteriorate into severe infection and have higher mortality rate than those without these factors.

30-Day Morbidity and Mortality of Bariatric Surgery During the COVID-19 Pandemic: a Multinational Cohort Study of 7704 Patients from 42 Countries.

BACKGROUND: There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates. METHODS: We conducted an international cohort study to determine all-cause and COVID-19-specific 30-day morbidity and mortality of BS performed between 01/05/2020 and 31/10/2020. RESULTS: Four hundred ninety-nine surgeons from 185 centres in 42 countries provided data on 7704 patients. Elective primary BS (n = 7084) was associated with a 30-day morbidity of 6.76% (n = 479) and a 30-day mortality of 0.14% (n = 10). Emergency BS, revisional BS, insulin-treated type 2 diabetes, and untreated obstructive sleep apnoea were associated with increased complications on multivariable analysis. Forty-three patients developed symptomatic COVID-19 postoperatively, with a higher risk in non-whites. Preoperative self-isolation, preoperative testing for SARS-CoV-2, and surgery in institutions not concurrently treating COVID-19 patients did not reduce the incidence of postoperative COVID-19. Postoperative symptomatic COVID-19 was more likely if the surgery was performed during a COVID-19 peak in that country. CONCLUSIONS: BS can be performed safely during the COVID-19 pandemic with appropriate perioperative protocols. There was no relationship between preoperative testing for COVID-19 and self-isolation with symptomatic postoperative COVID-19. The risk of postoperative COVID-19 risk was greater in non-whites or if BS was performed during a local peak.

Clinical Course and Outcomes of COVID‐19 in Hematopoietic Cell Transplant Patients: A Regional Report from the Middle East (preprint)

Background: The coronavirus disease‐2019 (COVID‐19) caused by SARS Coronavirus 2 (SARS‐CoV‐2) is a potentially lethal infection. Cancer patients, and specifically hematopoietic cell transplant (HCT) recipients are severely immunocompromised and may be at a higher risk of a complicated course with this infection. We aimed to study the COVID-19 outcomes and severity in post HCT patients.Methods: We retrospectively reviewed post-HCT patients diagnosed with COVID-19 between March 15, 2020, and December 1, 2020 at 10 transplant centers across the Middle East. Results: We identified 91 patients with confirmed SARS-CoV-2 infection across 10 transplant centers. 52 patients were post allo-HCT while the remaining 39 patients were post auto-HCT. The median time from transplant was 14.9 months. Mortality rate was 4.4%. Hospital admission rate was 53%. ICU admission rate was 14%. Mechanical ventilation rate was 10%. Oxygen supplementation rate was 18%. Time from HCT to COVID-19 > 6 months was associated with lower admission rates and lower rates of the “severity” composite endpoint. Antibody responses was seen 67% of evaluable patients.Conclusion: In this series of HCT recipients, we report overall favorable clinical outcomes for patients with COVID-19 and provide preliminary insights into the clinical course of this disease in this specific population.Funding Statement: NoneDeclaration of Interests: None.Ethics Approval Statement: The hospitals’ Institutional Review Board approved the study.

COVID-19. An update for orthopedic surgeons.

The COVID-19 pandemic has affected our world in a short period of time, and the orthopedic surgery practice was not an exclusion. Elective care was deferred in most health care facilities and emergency care was continued with strict precautions. With rapid progression of the pandemic, the response of the medical community is also rapidly changing in all aspects of delivering care. This led to a large number of publications with reports, guidelines, measures, ways to react to the crisis, and post-pandemic predictions and speculations. In this review we aimed at summarizing all the relevant information to the orthopedic surgery community. To do this, a comprehensive search was performed with all related terms on two scientific search engines, PubMed and SCOPUS, and the results were filtered by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. The result was 72 articles that were further reduced to 33 articles after full text reading. The resultant information was organized under 5 main headings; the impact of pandemic on the orthopedic practice, COVID-19 and the trauma patient, elective and emergency surgeries during the pandemic, peri-operative management of the patient with COVID-19, Miscellaneous effects of the pandemic such as those on training programs and the evolution of telemedicine. This review represents the most up to date information published in the literature that is a must-know to every orthopedic surgeon.