Health effects and known pathology associated with the use of E-cigarettes.

In recent years, new nicotine delivery methods have emerged, and many users are choosing electronic cigarettes (e-cigarettes) over traditional tobacco cigarettes. E-cigarette use is very popular among adolescents, with more than 3.5 million currently using these products in the US. Despite the increased prevalence of e-cigarette use, there is limited knowledge regarding the health impact of e-cigarettes on the general population. Based on published findings by others, E-cigarette is associated with lung injury outbreak, which increased health and safety concerns related to consuming this product. Different components of e-cigarettes, including food-safe liquid solvents and flavorings, can cause health issues related to pneumonia, pulmonary injury, and bronchiolitis. In addition, e-cigarettes contain alarmingly high levels of carcinogens and toxicants that may have long-lasting effects on other organ systems, including the development of neurological manifestations, lung cancer, cardiovascular disorders, and tooth decay. Despite the well- documented potential for harm, e-cigarettes do not appear to increase susceptibility to SARS-CoV- 2 infection. Furthermore, some studies have found that e-cigarette users experience improvements in lung health and minimal adverse effects. Therefore, more studies are needed to provide a definitive conclusion on the long-term safety of e-cigarettes. The purpose of this review is to inform the readers about the possible health-risks associated with the use of e-cigarettes, especially among the group of young and young-adults, from a molecular biology point of view.

Depiction of possible solutions to improve the cold supply chain performance system

PurposeA poor performance of the cold supply chain (CSC) may increase the loss of quality and potency of perishables and temperature-sensitive products that deteriorate the financial and environmental aspects of the same. The purpose of the current research work is to identify the critical performance factors (criteria) and their co-factors (sub-criteria) that are responsible for the performance measurement of CSC and suggest the best possible solutions (alternatives) to improve the same.Design/methodology/approachTo achieve the objective of the research, a hierarchical model has been developed and analyzed using Analytic Hierarchy Process (AHP)-Fuzzy TOPSIS as a hybrid approach to obtain the severity weights of the identified criteria and prioritization toward their relative importance for the best possible alternatives.FindingsAnalysis reveals that the criteria “energy consumption” comes out to be the most critical criteria, and alternative “application of passive cold devices” is the most effective solution for improving the performance of CSC. Higher energy consumption leads to a higher rate of greenhouse gas (GHG) emissions increasing the global warming phenomenon, high operational cost and degradation of natural energy resources. The Application of Passive Cold Devices (PCDs) utilizes solar energy to operate the refrigeration units reducing the energy consumption, environmental and operating cost of CSC.Research limitations/implicationsThe research work provides several insights into the critical issues related to the CSC and suggests significant findings that enable the management and decision-makers to adopt these practices for performance evaluation and improvement of the same. The key findings of the work, such as “application of passive cold devices” and “application of IoT in cold chain logistics”, facilitate an improved platform to improve the CSC performance and proposed several directions that will enhance the merit of future research.Originality/valueThe presented study consolidates the various perspectives associated with CSC performance, explores the most critical criteria and proposes the best suitable cold chain practices for organizational growth. The work also provides an analytical analysis with the essence of practicalities and sensitivity analysis to support the robustness of the results. By enriching the literature and quantitative analysis of the new proposed model, this paper forms vast managerial and research implications in the field of CSC.

Crisis Standards of Care-More Than Just a Thought Experiment?

As described in two articles in the September-October 2021 issue of the Hastings Center Report, most crisis standards of care (CSC) plans include triage algorithms to guide the allocation of critical care resources to some patients and not others under conditions of extreme scarcity. The plans also include other important CSC strategies, but it is the notion of rationing scarce resources via triage that especially captured the imaginations of ethicists. Vigorous arguments have arisen over whether triage algorithms should be designed to prioritize patients based on predictions of short-, near-, or long-term survival. Additionally, there are ongoing debates about the ability of current algorithms to estimate patient survival accurately enough to be useful in triage and about the role of values like equity in triage protocols. Relatively few debates have noted, however, that while the development of CSC triage protocols has been based in medicine, public health, and ethics, the activation of CSC plans remains a political decision.

A Randomized Controlled Trial of the Efficacy of Systemic Enzymes and Probiotics in the Resolution of Post-COVID Fatigue.

Muscle fatigue and cognitive disturbances persist in patients after recovery from acute COVID-19 disease. However, there are no specific treatments for post-COVID fatigue. Objective: To evaluate the efficacy and safety of the health supplements ImmunoSEB (systemic enzyme complex) and ProbioSEB CSC3 (probiotic complex) in patients suffering from COVID-19 induced fatigue. A randomized, multicentric, double blind, placebo-controlled trial was conducted in 200 patients with a complaint of post-COVID fatigue. The test arm (n = 100) received the oral supplements for 14 days and the control arm (n = 100) received a placebo. Treatment efficacy was compared using the Chalder Fatigue scale (CFQ-11), at various time points from days 1 to 14. The supplemental treatment resulted in resolution of fatigue in a greater percentage of subjects in the test vs. the control arm (91% vs. 15%) on day 14. Subjects in the test arm showed a significantly greater reduction in total as well as physical and mental fatigue scores at all time points vs. the control arm. The supplements were well tolerated with no adverse events reported. This study demonstrates that a 14 days supplementation of ImmunoSEB + ProbioSEB CSC3 resolves post-COVID-19 fatigue and can improve patients' functional status and quality of life.

Recent Advances in Pathology: the 2021 Annual Review Issue of The Journal of Pathology.

The 2021 Annual Review Issue of The Journal of Pathology contains 14 invited reviews on current research areas of particular importance in pathology. The subjects included here reflect the broad range of interests covered by the journal, including both basic and applied research fields but always with the aim of improving our understanding of human disease. This year, our reviews encompass the huge impact of the COVID-19 pandemic, the development and application of biomarkers for immune checkpoint inhibitors, recent advances in multiplexing antigen/nucleic acid detection in situ, the use of genomics to aid drug discovery, organoid methodologies in research, the microbiome in cancer, the role of macrophage-stroma interactions in fibrosis, and TGF-ß as a driver of fibrosis in multiple pathologies. Other reviews revisit the p53 field and its lack of clinical impact to date, dissect the genetics of mitochondrial diseases, summarise the cells of origin and genetics of sarcomagenesis, provide new data on the role of TRIM28 in tumour predisposition, review our current understanding of cancer stem cell niches, and the function and regulation of p63. The reviews are authored by experts in their field from academia and industry, and provide comprehensive updates of the chosen areas, in which there has been considerable recent progress. © 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Evidence-based crisis standards of care for out-of-hospital cardiac arrests in a pandemic.

BACKGROUND & PURPOSE: Pandemics such as COVID-19 can lead to severe shortages in healthcare resources, requiring the development of evidence-based Crisis Standard of Care (CSC) protocols. A protocol that limits the resuscitation of out-of-hospital cardiac arrests (OHCA) to events that are more likely to result in a positive outcome can lower hospital burdens and reduce emergency medical services resources and infection risk, although it would come at the cost of lives lost that could otherwise be saved. Our primary objective was to evaluate candidate OHCA CSC protocols involving known predictors of survival and identify the protocol that results in the smallest resource burden, as measured by the number of hospitalizations required per favorable OHCA outcome achieved. Our secondary objective was to describe the effects of the CSC protocols in terms of health outcomes and other measures of resource burden. METHODS: We conducted a retrospective cohort study of adult patients in the Cardiac Arrest Registry to Enhance Survival (CARES) database. Non-traumatic OHCA events from 2018 were included (n = 79,533). Candidate CSC protocols involving combinations of known predictors of good survival for OHCA were applied to the existing dataset to measure the resulting numbers of resuscitation attempts, transportations to hospital, hospital admissions, and favorable neurological outcomes. These outcomes were also assessed under Standard Care, defined as no CSC protocol applied to the data. RESULTS: The CSC protocol with the smallest number of hospitalizations per survivor with a favorable neurological outcome was that an OHCA resuscitation should only be attempted if the arrest was witnessed by emergency medical services or the first monitored rhythm was shockable (number of hospitalizations: 2.26 [95% CI: 2.21-2.31] vs. 3.46 [95% CI: 3.39-3.53] under Standard Care). This rule resulted in significant reductions in resource utilization (46.1% of hospitalizations and 29.2% of resuscitation attempts compared to Standard Care) while still preserving 70.5% of the favorable neurological outcomes under Standard Care. For every favorable neurological outcome lost under this CSC protocol, 6.3 hospital beds were made free that could be used to treat other patients. CONCLUSION: In a pandemic scenario, pre-hospital CSC protocols that might not otherwise be considered have the potential to greatly improve overall survival, and this study provides an evidence-based approach towards selecting such a protocol. As this study was performed using data generated before the COVID-19 pandemic, future studies incorporating pandemic-era data will further help develop evidence-based CSC protocols.