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The proceedings contain 238 papers. The topics discussed include: treatment with tofacitinib attenuates muscle loss through Myogenin activation in collagen-induced arthritis;plasma cytokine levels in a group of Colombian patients with moderate systemic lupus erythematosus and rheumatoid arthritis;prevalence of neoplastic disease in patients with systemic sclerosis in a south American cohort;characterization of rheumatic manifestations in patients with HIV infection from a south American hospital;anthropometric measures of central adiposity in the evaluation of metabolic syndrome in patients with idiopathic inflammatory myopathies;anti RO 52/60 antibodies and their clinical serological correlation. single center descriptive study;safety and immunogenicity of CoronaVac and CHADOX1 vaccines against SARS-COV-2 in patients with rheumatoid arthritis: Brazilian multicentric study;and effect of ABO and RH blood type on SARS-COV-2 infection severity in patients with rheumatic diseases: data from the national SAR-COVID registry.
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Background: Indirect calorimetry (IC) is the gold-standard procedure for measuring resting energy expenditure (REE) in hospitalized patients. Predictive energy equations commonly use static variables and rarely account for changes in REE throughout hospitalization. We hypothesize that predictive equations are typically inaccurate in surgical intensive care unit (ICU) patients. More specifically, we hypothesize that predictive equations often overpredict measured resting energy expenditure (mREE) in early-stage critical illness and underpredict needs later in surgical ICU stay, leading to over-/under-feeding and associated complications. Method(s): This prospective observational trial enrolled surgical ICU patients who underwent emergent or urgent operations for abdominal trauma, perforated viscus, or ischemic bowel within 72 hours of their surgical procedure. Metabolic assessments were performed using the COSMED Q-NRG + Metabolic Monitor ventilator, mask, and canopy at regular intervals during and post ICU admission until hospital discharge. Measurements were categorized by post-surgical intervention ICU admission days 0-3, 4-7, 8-14, 15-21, and 22-28. Patients with multiple measurements taken during the same time interval were averaged. mREE reported in calories (kcal) per kilogram (kg) of admission body weight per day were compared in obese (BMI > 30 kg/m2) and non-obese (BMI < 30 kg/m2) subgroups. Compared to IC, the Mifflin St Jeor (MSJ) equation determined predicted REE using ICU admission anthropometrics. Data are reported as mean+/-standard error of the mean (SEM) and median (interquartile range), and a two-sided p-value of <0.05 was determined significant. Result(s): In total, 18 surgical ICU patients who contributed 47 IC measurements were included in the analysis (Table 1). Most measures were obtained within the first 7 days of post-surgical ICU admission (72%). mREE peaked between days 8-14 in obese and non-obese subgroups (20.6 vs 28.5 kcal/kg;p = 0.02) and was lowest during 0-3 days of post-surgical ICU admission in both groups. Across all 5-time intervals, average kcal/ kg ranged from 14.7-20.6 among obese patients and from 20.1-28.5 in non-obese counterparts (Table 2). Non-obese patients had higher mREE per kg of body weight than obese patients at all time points (Figure 1). MSJ over-predicted mREE during the first 7 days post ICU admission in non-obese patients and within the first 3 days in obese patients and underpredicted mREE in both groups thereafter. Conclusion(s): Equations such as MSJ over- and under-predict mREE in post-operative surgical ICU patients depending on the days elapsed since post-surgical ICU admission. ASPEN's current guideline recommendation of 12-25 kcal/kg may also underfeed post-surgical populations while 25 kcal/kg may not support hypermetabolism among non-obese patients seen in week 2 following post-surgical ICU admission. Alternatively, MSJ multiplied by a 1.2 activity factor may account for hypermetabolism during this time. Notably, non-obese patients experienced greater hypermetabolism than obese patients during week 2 which is consistent with our previously published data in mechanically ventilated COVID- 19 patients. Additionally, the striking dichotomy between the mREE of obese and non-obese patients at all post-surgical time points should be considered in the clinical care of patients. Ultimately, IC remains the gold-standard means of measuring REE and is a critical tool to capture the dynamic nature of energy requirements in post-surgical populations as weight-based and predictive equations continually fall short. (Table Presented).
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Background: Fitness is a marker of physiological and mental health. The purpose of this pilot study was to assess the feasibility of processes to recruit women with polycystic ovary syndrome (PCOS) during the Covid pandemic and collect their health and fitness data. Additionally, the data was used to explore possible associations between anthropometrics, PCOS biomarkers, health-related quality-of-life (HRQoL), and depressive symptoms with that of fitness and self-reported physical activity levels among women with PCOS. Method(s): A convenience sample of women with PCOS (n = 15) were recruited via flyers and the snowball method. Participants completed surveys, anthropometrics, a dual energy x-ray absorptiometry scan, blood work, and a fitness assessment. Data were statistically analyzed using Spearman correlations. Result(s): Feasibility measures of recruitment and retention rates were 83% and 100%, respectively. Fidelity measurement for process averaged 97%. Participants (age 25.9 (+/- 6.2), mostly White (80%), single (60%), and employed full-time (67%)) were categorized as obese (body mass index (BMI) 32.2 kg/m2 +/- 8.3, percent bodyfat 41.1% +/- 8.1) with <=1 comorbidity. Most participants were not regularly physically active and had high free testosterone levels (7.6 pg/mL+/-4.3), elevated high-density lipoprotein (63.2 mg/dL+/-12.9), fair cardiovascular capacity, and below average muscular strength/endurance. The following statistically significant and strong associations were found: (1) VO2 max with percent bodyfat (-0.59;p = 0.02), sex hormone binding globulin (0.73;p = 0.00), HRQoL (0.72;p = 0.00), and depressive symptoms (-0.67;p = 0.00), (2) abdominal strength with BMI (-0.66;p = 0.01) and high density lipoprotein (HDL) (0.59;p = 0.02), (3) physical activity level with percent bodyfat (-0.72;p = 0.00), and (4) resistance training with low density lipoprotein (LDL) (-0.52;p = 0.05). Conclusion(s): Collecting health and fitness data from women with PCOS is a feasible research approach. Randomized controlled trials in which health and fitness data are collected from women with PCOS are needed to confirm possible associations between fitness and PCOS clinical features and is in the planning process. Copyright: Copyright © 2023 The Author(s).
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Objective: In this study, we aimed to retrospectively assess the change in weight before and after the COVID-19 mandatory lockdown in Colombia among adults who received nutritional and healthy lifestyle recommendations at weight loss and wellness clinics by telehealth. The primary objective was to describe and compare the mean weight reduction measured at the baseline and by the end of the lockdown. Secondary objectives include describing and comparing body fat percentage, muscle mass percentage, and BMI measured at the baseline and by the end of the lockdown. Method(s): One hundred and seventy-two middle-aged (18-68 years old) women and men received online nutritional and healthy lifestyle advice during the COVID-19 lockdown in Colombia. Weight, fat (%), muscle mass (%), and BMI were assessed before and after the lockdown. We included baseline measurements taken before the lockdown from March 1st to June 20th, 2020, and post-lockdown measurements from August 31st to October 20th, 2020. Exclusion criteria included pregnancy or breastfeeding women, acutely decompensated diabetes, hypertension, CKD, Hypothyroidism or taking any of the obesity treatment medications approved in Colombia, including liraglutide, semaglutide or orlistat. A retrospective analysis was completed to compare the change in mean body anthropometrics. Shapiro Wilk test was used to assess for normality. Paired T Test and Wilcoxon sign test were used to compare the distribution of body anthropometrics before and after the lockdown. IRB approval was obtained before exporting and analyzing the collection of data. Result(s): Out of 205 subjects and after a review of exclusion criteria, 172 subjects were included in the data analysis. 90.1% (155) were women. 52.3% (135) had overweight or obesity. After the COVID-19 lockdown, the mean weight loss reduction was 8.79 kg (SD +/- 5.45, p<0.0001), corresponding to an 11.4% weight loss reduction. The mean fat mass percentage loss was 2.89 % (SD +/- 2.64, p<0.0001), and the mean BMI presented a reduction of 3.16 (SD +/- 1.96, p <0.0001). The mean muscle percentage loss was 0.10% (SD +/- 2.67, p 0.482). Discussion/Conclusion: Subjects receiving telehealth nutritional advice in Colombia during the COVID-19 lockdown had significant clinical and statistical weight, BMI, and fat loss reduction. Muscle mass was preserved;however, this mean change was not statistically significant. Physical inactivity during the lockdown period was a potential contributor to a nonsignificant mean muscle mass change. The subjects in this study were highly motivated to virtually attend weight loss and wellness clinics and to improve body anthropometrics by optimizing lifestyle changes. Telehealth weight loss strategies should always be considered when in-person patient interaction is not available.Copyright © 2023
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Introduction: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) exhibits 25-30% mortality in hospitalized patients with heart failure (HF). Cardiovascular disease is the most significant comorbidity associated with increased mortality in COVID-19 patients with data suggesting local and systemic inflammation play a critical role in cardiac functional abnormalities. SARS-CoV-2 vaccination reportedly reduces severity of infection. We sought to characterize if vaccination had any protective effect on patients with HF hospitalized for acute COVID-19. Hypothesis: Baseline cardiac biomarkers including CRP, ferritin, high sensitivity cardiac troponin I (hs-cTnI), and pro-brain natriuretic peptide (pBNP) may be lower in vaccinated COVID-19 HF patients revealing the impact of vaccination on reducing inflammation by SARS-CoV-2 infection. Method(s): Electronic health records underwent IRB exempted extraction of demographics, anthropometrics, vital signs, laboratory tests, and ICD-10-CM-based Elixhauser comorbidity categories. Continuous data summarized with median [IQR] were compared using Kruskal-Wallis test and discrete data with chi-squared test. Result(s): Among HF patients with a recorded vaccine status admitted between July 3, 2021 and March 17, 2022, 206 underwent acute COVID-19 hospitalization. Vaccinated (n=91, 44%) and unvaccinated (115, 56%) patients exhibited statistically similar distribution of males (56%), aged 78[69-86] years with comorbidities 5[4-7] distributed across Whites (88%), Blacks (8%), and other races (4%). There were no intergroup differences with most prevalent comorbidities at admission including hypertension (99%), diabetes (41%), chronic pulmonary disease (37%), obesity (36%), deficiency anemia (31%), and renal failure (25%). There were no intergroup differences in initiation of COVID-19 directed treatments. Baseline biomarkers in vaccinated versus unvaccinated were CRP 6.0[1.3-9.5] vs. 6.9[2.7-11.3] mg/dL (p=.25), ferritin 171[76-552] vs. 432[79-876] ng/mL (p=.13), LDH 245[192-317] vs. 338[260-439] U/L (p=.003), D-dimer 0.89[0.53-1.73] vs. 1.36[0.95-2.80] mg/L FEU (p=.06), hs-cTnI 27[14-67] vs. 28[16-81] ng/L (p=.39), and pro-BNP 3487[1516-7162] vs. 3278[1549 vs. 9001] pg/mL (p=.90). Clinical visit criteria respectively were hospital LOS 4.9[2.9-10.3] vs. 5.4[3.4-10.3] days (p=.27), ICU admission 10% vs. 17% (p=.15), and discharge disposition expired or Hospice 15% vs. 16% (p=.48). Rehospitalization occurred similarly between groups and was not significant. Conclusion(s): Acute and chronic inflammation are pathogenic drivers of HF. Inflammatory biomarkers lower among vaccinated patients with HF included CRP, ferritin, D-dimer, and hs-cTnI, although not significant. LDH, however, was significantly lower suggesting improved host widespread tissue perfusion as one mechanism of reduced severity in patients with HF undergoing SARS-CoV-2 vaccine breakthrough infection. One study caveat is that despite inclusion of all patients, these preliminary findings are likely not sufficiently powered to validate our hypothesis.Copyright © 2022
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Background: Spirulina may protect individuals against viral infections and promote health in obese subjects. This study is designed to investigate the impacts of spirulina on obesity to find a hope to protect this population against COVID-19. Material(s) and Method(s): In a double-blinded randomized placebo-controlled trial, 24 obese subjects (Mean age: 44.83+/-3.04 years;mean weight: 111.95+/-22.55kg;body mass index (BMI): 40.31+/-6.03kg/m2) were randomly allocated to spirulina (n=12) or control (Co, n=12) groups. Spirulina was administered 2 gr/day for 8 weeks and the Co group received a placebo for a similar period. Before and after the administration of spirulina, the anthropometric measurements were calculated for each subject. Furthermore, ACE2, NLRP3, and FNDC5 gene expression were examined in adults with obesity. Result(s): Our findings demonstrated that spirulina could not effective in normalizing body weight (BW), BMI, and waist-hip ratio (WHR). Spirulina administration significantly upregulated the gene expression of FNDC5 and significantly reduced NLRP3 and ACE2 gene expression in obese subjects compared with the Co-group. Furthermore, by increasing FNDC5 the gene expression of NLRP3 and ACE2 was significantly reduced. Conclusion(s): While administration of spirulina for eight weeks could not affect the anthropometric measurements, it showed the greatest impact on the gene expression of NLRP3, ACE2, and FNDC5, emplacing its potential in the protection of obese cases against COVID-19.Copyright © 2023 Journal of Cellular & Molecular Anesthesia. All rights reserved.
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Background: The COVID-19 pandemic has been associated with weight gain among adults and children, and obesity is a risk factor and disease modifier for asthma. The objective of this study was to determine if there was a change in the body mass index (BMI) in pediatric patients with respiratory and allergic diseases, comparing their BMI in 2021 with the one in 2019. Method(s): A retrospective cohort study was performed using the database of the Hospital's Information System, including children under 15 years old from the Pediatric Pneumology and Allergy Unit in the year 2021 who had at least one anthropometric measurement done before March 2020, when lockdown and social distancing measures were enacted in Spain. The main variable was the variation of the BMI, weight, and height of patients before and after lockdown. To prove if the trend was higher or lower than the one detected before the pandemic, these measurements were compared with those obtained during the 5 years prior to 2019 in the same population. Subsequently, a secondary outcome was to evaluate the relationship between the different allergic diseases with weight gain. Result(s): A total of 291 patients were recruited, 37.46% female. 54.98% suffered from asthma, and the most frequent diagnosis was allergic rhinitis. The mean age at the start of the pandemic was 8.67 years old (DT 3.15). The percentage of patients with obesity grew significantly during the pandemic: 10.31% versus 16.15%. Therefore, significant increases of BMI were observed with p < 0.05 in patients with obesity, compared to patients with normal weight and overweight. Nevertheless, no differences were found with the increases of BMI that were already detected before the start of the pandemic: previous DELTABMI percentile 1.86 (DT 16.32) -DELTA BMI percentile during pandemic 2.71 (DT 15.89), p = 0.477. Children between 5 and 11 years were the most affected group, with an increase of BMI percentile from -2.25 (DT 19.86) to 1.27 (DT 5.43), p = 0.003 after de lockdown. With the Fisher's non-parametric independent test, the relationship between allergic diseases and BMI increase was studied, finding a relationship with the presence of asthma (DELTABMI p = 0.026). Conclusion(s): The pandemic has caused an increase of the obesity rates, especially among children between 5 to 11 years old, and those with asthma. Nevertheless, the BMI increase in the pediatric population was already a reality taking place before the pandemic, without finding changes in this trend in the study.
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Alcohol use disorder (AUD) is highly prevalent in Australia.(1) However, best practice management of AUD in the community post discharge from hospital is not well articulated in the literature. In particular, given the harmful effects excessive alcohol consumption has on nutritional status there is a need to identify what approaches are being utilised in managing this vulnerable group.(2) Hence the aim of this scoping review was to identify the current approaches and outcomes with respect to nutritional care as identified by the Nutrition Care Process Model (NCPM) for patients discharged from hospital post alcohol withdrawal. This scoping review was registered with OpenScience Framework (words: PubMed, CINAHL, Web of Science and Scopus. Articles included were published between January 1995 and April 2022 Eligible articles were screened independently by pairs of reviewers, and consensus was reached across pairs to provide inter-rater and inter-consensus reliability. Screening and data extraction was conducted using Covidence by reviewers HM, ATM, CM, SG Fourteen articles were eligible for inclusion. Approaches to nutritional care was identified based on the intervention utilised and in comparison to the NCPM.(3) Key findings were screening for nutrition related problems and anthropometry measures were the most evaluated (n = 10), whereas practices of referral providing continuum of care were highlighted in only a minority of studies (n = 3). Education interventions included Motivational Interviewing and cognitive behavioural therapy sessions (4) (n = 7). Few studies (n = 4) which combined harm-reduction counselling with nutritional approaches and education interventions showed significant improvement (p < 0.05) in outcome measures of nutritional care. This was measured through the improvement in nutritional status (positive eating habits, decrease in nutrition-related impact symptoms, and WHO Quality of Life (QoL) health and physical domains) Limitations include varying aims of analysis and a paucity of information in this area. There is a need for further studies to be completed in this area to understand the nature of this complex issue and recommend effective strategies to improve health outcomes for individuals and populations.
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Background: Infections during pregnancy can increase the risk for neurodevelopmental disorders in offspring. This study aimed to prospectively monitor children exposed in utero to SARS-CoV-2 from birth to 15 years of age with a secondary aim to identify biomarkers of neurodevelopmental impairments. Method(s): Women infected with SARS-CoV-2 during pregnancy and sociodemographic and age matched non-exposed women were recruited from Monash Health, Australia (N=112 mother-infant dyads). Demographics, biospecimens and clinical data are collected at multiple time points from birth-15 years using standardised sample collection and neurological and behavioural scales. We present here the birth data. Result(s): Mother-infant dyads are classified as;non-exposed, mild SARS-CoV-2 (limitation of activities) and severe SARS-CoV-2 (hospitalised). Edinburgh postnatal depression scale scores were significantly higher in severe SARS-CoV-2 vs. non-exposed mothers (p<0.05). Maternal attachment scores were unchanged. Hammersmith neonatal neurological assessment scores were unchanged across groups, as were anthropometric measures. Severe SARS-CoV-2 exposed infants had lower scores on the sensory profile 2 questionnaire auditory domain than non-exposed infants (p<0.05). Analysis of infant buccal DNA (Illumina MethylationEPIC BeadChip >850,000 CpGs, N=8) showed hypomethylation of the gene AFAP-1 (q value<0.0008), and hypermethylation of neurodevelopmental pathways;'dendrite morphology' and 'axogenesis' in SARS-CoV-2 infants vs. non-exposed. Conclusion(s): While most assessments show no group differences thus far, the severe SARS-CoV-2 exposed group are faring worse in terms of maternal mental health, infant auditory domains and infant hypermethylation of genes belonging to neurodevelopmental pathways. Follow up assessments at 1-15 years will inform as to whether these initial group differences are early signs of more severe neurodevelopmental outcomes. Funding Source: Other - One in Five Philanthropic organisation Keywords: SARS-CoV-2, Pregnancy, DNA methylation, in utero, Neurodevelopmental trajectoriesCopyright © 2023
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Obesity is a risk factor for severe COVID-19 disease during pregnancy. We hypothesized that the co-occurrence of high maternal body mass index (BMI) and gestational SARS-CoV-2 infection are detrimental to fetoplacental development. We conducted a systematic review following PRISMA/SWiM guidelines and 13 studies were eligible. In the case series studies (n = 7), the most frequent placental lesions reported in SARS-CoV-2(+) pregnancies with high maternal BMI were chronic inflammation (71.4%, 5/7 studies), fetal vascular malperfusion (FVM) (71.4%, 5/7 studies), maternal vascular malperfusion (MVM) (85.7%, 6/7 studies) and fibrinoids (100%, 7/7 studies). In the cohort studies (n = 4), three studies reported higher rates of chronic inflammation, MVM, FVM and fibrinoids in SARS-CoV-2(+) pregnancies with high maternal BMI (72%, n = 107/149; mean BMI of 30 kg/m2) compared to SARS-CoV-2(-) pregnancies with high BMI (7.4%, n = 10/135). In the fourth cohort study, common lesions observed in placentae from SARS-CoV-2(+) pregnancies with high BMI (n = 187 pregnancies; mean BMI of 30 kg/m2) were chronic inflammation (99%, 186/187), MVM (40%, n = 74/187) and FVM (26%, n = 48/187). BMI and SARS-CoV-2 infection had no effect on birth anthropometry. SARS-CoV-2 infection during pregnancy associates with increased prevalence of placental pathologies, and high BMI in these pregnancies could further affect fetoplacental trajectories.
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Although telehealth existed and was widely implemented in the past, its potential and necessity was amplified in 2020 with the onset of the COVID pandemic. Many providers and patients shifted from periodic office visits to the use of episodic computer and telephone-based contacts. Although somewhat useful, these interactions cannot take the place of data and laboratory assessments, and always preclude direct patient examination. The true potential for telehealth requires data inputs from the patient to the provider, including anthropometrics and personal device data, with subsequent provider assessment, support, and follow-up therapeutic recommendations. Telehealth provides the opportunity to shift from an episodic encounter system (every 3-6 months) for chronic disease management to a continuous remote care paradigm in which data are continuously collected and reviewed, and patient support and education, together with therapeutic interventions may be instituted as rapidly and as often as needed. Diabetes serves as an ideal intervention to be managed by this continuous remote care telehealth model. This presentation will describe one model of diabetes care delivery using nutrition as the primary intervention through telehealth with data on sustainability, durability and patient outcomes, in a research setting over 5 years and in a real world setting over 2 years.
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Background and purpose: The present study investigated the effect of six weeks of endurance and resistance training on pulmonary indices, physical performance, and quality of life in COVID-19 patients after discharge from hospital. Material(s) and Method(s): Thirty six patients with COVID-19 (mean age: 38.76+/-0.98 years, mean weight: 81.86+/-2.88 kg) were selected. At the beginning and end of the study, pulmonary (FEV1, FVC, FEV1/FVC, and MVV), physical (6-minute walk test), quality of life (SF-36), and anthropometry tests were performed. The patients were divided into three groups: Endurance training (45 minutes at 60-75% estimated HR), Resistance training (45 minutes at 40-70% of I-RM), and controls. The intervention was conducted for 6 weeks (3 sessions). One-way ANOVA test was used for statistical analysis. Result(s): Findings indicated a significant increase in FEV1 (P=0.029), FVC (P=0.047), FEV1/FVC (P=0.043) in the endurance training group compared to the control group, while difference was observed in MVV (P=0.041) and FEV1/FVC (P=0.022) between endurance training and resistance training groups. The 6-minute test distance increased in the endurance training (P=0.0001) and resistance training (P=0.001) groups compared to the control group, but no difference was observed between the training groups (P=0.48). Endurance and resistance training programs induced significant improvements in physical performance (P=0.024 and P=0.09, respectively) and general health (P=0.022 and P=0.015, respectively) dimensions compared to the control group. Conclusion(s): Moderate-intensity endurance training can improve pulmonary function, physical performance, and quality of life in patients with COVID-19 after discharge from hospital and can be used in rehabilitation programs of these patients.Copyright © 2023, Mazandaran University of Medical Sciences. All rights reserved.
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Background and purpose: The present study investigated the effect of six weeks of endurance and resistance training on pulmonary indices, physical performance, and quality of life in COVID-19 patients after discharge from hospital. Material(s) and Method(s): Thirty six patients with COVID-19 (mean age: 38.76+/-0.98 years, mean weight: 81.86+/-2.88 kg) were selected. At the beginning and end of the study, pulmonary (FEV1, FVC, FEV1/FVC, and MVV), physical (6-minute walk test), quality of life (SF-36), and anthropometry tests were performed. The patients were divided into three groups: Endurance training (45 minutes at 60-75% estimated HR), Resistance training (45 minutes at 40-70% of I-RM), and controls. The intervention was conducted for 6 weeks (3 sessions). One-way ANOVA test was used for statistical analysis. Result(s): Findings indicated a significant increase in FEV1 (P=0.029), FVC (P=0.047), FEV1/FVC (P=0.043) in the endurance training group compared to the control group, while difference was observed in MVV (P=0.041) and FEV1/FVC (P=0.022) between endurance training and resistance training groups. The 6-minute test distance increased in the endurance training (P=0.0001) and resistance training (P=0.001) groups compared to the control group, but no difference was observed between the training groups (P=0.48). Endurance and resistance training programs induced significant improvements in physical performance (P=0.024 and P=0.09, respectively) and general health (P=0.022 and P=0.015, respectively) dimensions compared to the control group. Conclusion(s): Moderate-intensity endurance training can improve pulmonary function, physical performance, and quality of life in patients with COVID-19 after discharge from hospital and can be used in rehabilitation programs of these patients.Copyright © 2023, Mazandaran University of Medical Sciences. All rights reserved.
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Aim: This study aimed at investigating the impact of COVID-19 lockdown on metabolic profile in bipolar disorder and schizophrenia patients at the time of COVID-19. Material(s) and Method(s): This study was completed with 190 individuals diagnosed with schizophrenia (116) and bipolar disorder (74). Waist circumference and blood pressure measurements were taken on the same date as triglyceride, glucose and HDL data in the electronic recording system of the participants. Initial assessment data are measurements within 3 months prior to the publication of the first case in Turkey. The second evaluation data, on the other hand, is the data obtained within 3 months after the date of removal or relaxation of the restrictions, which is defined as the normalization period. Result(s): A significant increase was observed in the incidence of metabolic syndrome in the participants after the COVID-19 lockdown. In addition, a significant increase in glucose, triglyceride and diastolic blood pressure values, and a significant decrease in HDL values were detected. There was no significant change in systolic blood pressure and waist circumference values. Discussion(s): It has been shown that the COVID-19 lockdown increases the incidence of metabolic syndrome in patients with schizophrenia and bipolar disorder and causes irregularities in metabolic syndrome parameters.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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The aim of this study is to investigate the usability of conventional masks to prevent the transmission of coronavirus 2019 (COVID-19) and subsequently design the proposed concept of the mask to reduce leakage and increase efficiency. Acute respiratory syndrome COVID-19 is spreading around the world and can be transmitted from one person with COVID-19 to another through personal contact and breathing. Improper design of current masks can lead to virus transmission. One hundred fifteen users participated in the study using a simple random sampling method in which N95-FFP2 face mask and surgery face mask usability tests were chosen as the most widely used face masks in Iranian people with an online usability questionnaire. Data were analyzed by SPSS. The results showed that the usability of the N95-FFP2 face mask with a total average of 4.46 and a surgical mask with a total average of 3.35 cannot be considered acceptable. Anthropometric and formal changes in people's faces and improper design of the face masks used make it necessary to review the mask redesign measures to increase the prevention of pathogens. In this study, new parameters for face mask design are proposed. Thirty different types of jaws have been considered with the help of CorelDRAW software, along with ideas for optimal mask design with UVW mask concept to be accessed by manufacturers around the world.
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Introduction: The prevalence of obesity among school children in Kerala is on a steady rise. Consumption of food with high glycaemic index, change in sleep patterns, reduced physical activity and the use of screen has been linked to obesity in children. Published literature on this association is scarce from urban Thiruvananthapuram, hence, the present study. Aim(s): To identify the association of various risk factors such as frequency of junk food consumption, dietary preferences, physical activity and daily screen time and weight related disorders among school going children (8-10 years) in Thiruvananthapuram. Material(s) and Method(s): The present cross-sectional case-control study was conducted in one Rural Government School (Venjaramoodu Government Upper Primary School) and one Urban Private School (S.N. Public School, Chenkottukonam) of Thiruvananthapuram, Kerala, India, and enrolled school going children aged 8-10 years with higher than recommended Body Mass Index (BMI) for age as cases, age and gender-matched children with normal BMI as controls. Participants with BMI above 23rd and below 27th adult equivalent for age and gender were considered overweight and those above 27th adult equivalent for age and gender were considered as obese. A structured questionnaire was sent home with the children, and the parents were requested to answer the questions along with written informed consent. Socio-demographic parameters, anthropometric measurements were obtained by trained staff, dietary habits, and details regarding physical activity and screen usage were collected. Variables were categorised according to the standard recommendations by World Health Organisation (WHO) and Indian Association of Paediatrics (IAP). Variables were expressed as frequencies and the tests of significance used were Chi-square test and Odds ratio, to express the strength of association between parameters. A p-value <0.05 was considered statistically significant. Result(s): The mean age of cases and controls was nine years. A total of 708 school children were screened and 352 participants (175 cases and 177 controls) were enrolled in the present study. The BMI of cases was 29.3 kg/m2 and of controls was 20.2 kg/m2. Higher than recommended screen time (p<0.001), more frequent junk food consumption (p<0.001) and lack of physical activity (p<0.001) were found to be significantly associated with obesity and overweight. Dietary preference was not associated with obesity or overweight and obesity and overweight was more common in children studying in private schools (p<0.001). Conclusion(s): Reducing screen time, reducing junk food consumption and increasing physical activity will help in reducing the prevalence of life style diseases among school children. Further evaluation is necessary to determine the factors contributing to the increased prevalence of these disorders in private schools.Copyright © 2023 Journal of Clinical and Diagnostic Research. All rights reserved.
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This paper proposes a respirator for children integrated with bamboo-based activated carbon filters and bipolar ionization as the sterilizer to increase protection from Covid-19 and other pathogens. The respirator, named as Bion-Kids, was designed based on the children's head-and-face anthropometry from direct measurement. The duration of sterilization process is controlled based on the activities, which are classified using the Recurrent Neural Network (RNN) model with dataset acquired from the accelerometer. Manufacturing process of the main body prototype comprises heat bending and 3D printing. The bamboo-based activated carbon filter was synthesized by applying heat and pressure at the strewed activated carbon particles on the N95 filter. Observation using scanning electron microscope showed the ability of the bamboo-based activated carbon filter to adsorb and trap the particles. Result of the qualitative fit test and questionnaire survey indicated that Bion-Kids is suitable and comfortable for the children's face. The result of filtration and bipolar ionization sterilization system analysis have also met the ISO14698 standard by not showing any infiltration of microorganisms on the blood agar media. This device may become an early-stage personal protective equipment against the transmission of Covid-19 and other pathogens. © 2022 THE AUTHORS
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Public transportation is a crucial part of our everyday lives, also, moving from one place to another is fraught with problems. The number of people using public transportation has increased, increasing transportation demand among the general population. Because of the COVID-19 outbreak, it is difficult for people to travel around the city without fear of contracting the disease;in this situation, people always wish for a better hygiene system and a low infection rate in the city. As a result, the primary goal of the study is to research and develop a viewpoint on the public transportation seating system, that is relevant to the Indian setting and attitude of following rules and regulations. Many things have been tried in the past to ensure the safety of travelers, and they have not proven as beneficial as they should be after following COVID-19 recommendations. The goal is to enhance the comfort and safety of passengers as well as give people easy access to the public transportation that is most widely used, like auto-rickshaws and buses. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Purpose of Study: Community health fairs have been developed to address the unmet needs for disease prevention and health education among underserved communities. Hispanic communities experience significant non-financial barriers (e.g., cultural and linguistic) that also contribute to lower rates of access and utilization of health care services, including important preventive screening services. Around 3% of Mobile County's population is Hispanic. The aim of this event was: (1) To perform basic health screening, provide health education, and administer COVID-19 and Influenza vaccines to children under the age of 18 years. (2) To act as a bridge between the Hispanic families in the community and the available resources to help them overcome barriers to accessing quality care. Methods Used: We started by identifying and finalizing the location and the date for the health fair with help from the Guadalupe Center (a faith-based organization). We planned to divide the health fair into three specialized zones: Health Screening, Health Education, and Vaccination. The Health Screening zone would include anthropometry, developmental screening, and vision screening. The Health Education zone would educate the families on asthma care, breastfeeding, drowning prevention, road safety, safe sleep practices, oral hygiene, adverse childhood experiences, and healthy lifestyle. The Vaccination Zone would administer COVID-19 and Influenza vaccines. We designed and printed brochures for all health education topics in English and in Spanish. Age and gender appropriate 'Health Passports' with growth charts and other key parameters to record the child's health status were also created. Resident and medical student volunteers were trained regarding documentation, health screening, health education, and referrals to early intervention or specialist services that accepted uninsured or Medicaid patients. Summary of Results: A total of 49 children underwent health screening and health education. Each child's health status was documented in age and gender appropriate 'Health Passport'. In addition to this, these children and their parents were educated at the various health education stations and provided with brochures. Around 40% of the children that were screened had an abnormal vision screen, the parents of these children were given a list of available resources for further follow-up. Six children with developmental delay were identified and early intervention forms were filled out for two and more information regarding the Individualized Education Program (IEP) was given to the other four families. Eight children were vaccinated for COVID-19 and five were vaccinated for Influenza. Conclusion(s): The Hispanic community has persistently faced barriers to access healthcare due to literacy and socioeconomic status. Academic institutions and community- based organizations must work to develop and sustain culturally relevant health education and outreach events to reduce these disparities. Copyright © 2023 Southern Society for Clinical Investigation.
ABSTRACT
Objectives The effects of in-utero SARS-CoV-2 exposure on the long-term health of exposed infant are unknown. Many in-utero events, including maternal illness, affect the developing fetus. Early impacts often manifest as body size differences, which can herald cardiometabolic risk later in life. Our objective is to determine the effects of in-utero SARS-CoV-2 exposure on fetal body growth and composition. Methods This study is nested in the COVID-19 Mother Baby Outcomes (COMBO) Initiative, a multidisciplinary collaborative intended to follow health outcomes in SARS-CoV-2 exposed mothers and their newborns. Anthropometric measures (weight, length, head circumference) and body composition measures by Quantitative Magnetic Resonance (QMR;fat mass, lean mass and total water) were obtained at two time points: 0-2 weeks of life and 16-32 weeks of life. Continuous variables were compared using Wilcoxon Rank Sum and categorical variables using chi2 test. Stepwise regression identified the most parsimonious model by AIC when estimating lean and fat mass, with exposure status, infant age, infant sex, mode of delivery, gestational age, maternal ethnicity and all anthropometric parameters in the full model, using the statistical program R (Version 4.0.3);p-value<0.05. Results The infant cohort to date (20 exposed [EXP], 19 unexposed [UNEXP]) includes 64% male, 62% born by vaginal delivery, and a median gestational age of 39.0 weeks (Table 1). Maternal Hispanic ethnicity differed between groups (78% EXP vs. 33% UNEXP, p=0.007). Distribution of crude anthropometric and body composition measures are shown in Table 2. Following stepwise model selection, the final lean mass model retained maternal exposure status as a predictor and gestational age and weight were significant predictors in the final linear regression model. In the final fat mass model, exposure status was not retained after stepwise model selection and length and weight were significant predictors (Table 3). Conclusions In a prospective observational cohort study of infants born during the COVID-19 pandemic, Hispanic maternal ethnicity was overrepresented in the exposed group, adding to our growing understanding of the COVID-19 pandemic exacerbating health disparities. In parsimonious linear regression models obtained using stepwise model selection, length and weight were predictors of fat mass, and gestational age and weight were predictors of lean mass. Recruitment and prospective measurements are ongoing.