The Impact of The Neonatology Improving Projects on Neonatal Services In Bisha City During Covid 19 Pandemic

Introduction: It is thought of as a necessary service to provide high-quality care during pregnancy, labour, and the postpartum period. The fields of obstetrics/midwifery and neonatology, which are generally referred to as perinatology, have reduced maternal and newborn mortality and morbidity globally, but the COVID-19 pandemic brought on by the SARS-CoV-2-related COVID-19 virus posed a threat to the security of healthcare. Material(s) and Method(s): A prospective comparative study was conducted in a tertiary care hospital, Bisha city. I want to compare the outcome for 2 years (July 2020-June 2022) after shifting to the new unit with previous 2 years before shifting (July 2018-June 2020) in different aspect: The days on the mechanical ventilation, The IVH rate, The Mortality rate. In this study, I want to compare neonatal services outcomes (for preterm babies less than 37 weeks gestational age) after developing the infrastructure, manpower, Supplies and Policies after the shifting to the new department. Result(s): This is a prospective comparative study conducted in the department of neonatology, in a tertiary care hospital, Bisha city. Mean gestational age in before shifting to new unit, after shifting were 31, 33.34 respectively. Average weight were 1496, 1565 in before shifting to new unit, after shifting respectively. In our study, Average days on the mechanical ventilation were 14.78 days in before shifting to new unit group. Average days on the mechanical ventilation were 4.33 days in after shifting to new unit group. Conclusion(s): The provision of high quality and evidence-based perinatal care must remain a priority, even in the face of a pandemic. Restructuring in health care facility with New advance mechanical ventilators supporting Volume-targeted ventilation, 9 single rooms isolation for septic babies, T-piece resuscitator (in all OR suits, Delivery suits and ER), Total parental nutrition and also the all NICU policies updated especially for Caffeine citrate and fluconazole administration to preterm babies according to the AAP guidelines. Also all the department stuff completed the NRP and STABLE provider course as mandatory requirement to work in the NICU department. IVH rate, mortality rate was drastically reduced after shifting to the new unit than before shifting to new unit. Hence hospital restructuring in neonatology plays a crucial role to reduce mortality rate.Copyright © 2021 Muslim OT et al.

Self-medication Practices for COVID-19 Prevention: A Study among Medical Students in Yogyakarta, Indonesia

The corona virus disease 2019 (COVID-19) pandemic has increased the interest in self-care strategies, including self-medication. Medical students, as future health practitioners, learn more about medications than other students. This study aimed to describe self-medication practices for preventing COVID-19 among medical students at Universitas Islam Indonesia. This observational study used a cross-sectional design and was undertaken in November- December 2020. The study sample included 336 undergraduate medical students determined using a consecutive sampling technique based on inclusion and exclusion criteria. Data were collected using an online questionnaire about self-medication practices in the preceding 3 months. Among a total of 336 students, 137 (41%) reported using self-medication intending to prevent COVID-19, and 126 (92%) of these 137 took preventive supplements, mainly vitamins C, D, and E, and omega-3. Seven students reported the use of zinc, mainly in combination with other vitamins. Students who practiced self-medication lived closer to people confirmed with COVID-19, washed their hands more often, and desinfected their belongings more frequently than their counterparts (p<0.05). The mean duration for consuming vitamins was 11-16 days. Forty students (29%) used herbal medicine to prevent COVID-19;ginger, turmeric, honey, black seed, cutcherry, and Curcuma were the most often consumed herbal remedies. Fourteen students (10%) reported taking over-the-counter medications to relieve symptoms related to COVID-19, including antipyretic, analgesic, antiseptic, antihistamine, decongestant, antitussive, and expectorant medications. Most respondents (82%) purchased their medications at pharmacies, and 11 (9%) obtained them from online shops. These findings show the high rate of self-medication using vitamins and herbal remedies for COVID-19 prevention among university medical students. Further studies are needed to explore students' knowledge about the risks of self-medication including the use of herbal medicines.Copyright © 2022 Marmara University Press.

Indian food habit & food ingredients may have a role in lowering the severity & high death rate from COVID-19 in Indians: findings from the first nutrigenomic analysis.

Background & objectives: During the COVID-19 pandemic, the death rate was reportedly 5-8 fold lower in India which is densely populated as compared to less populated western countries. The aim of this study was to investigate whether dietary habits were associated with the variations in COVID-19 severity and deaths between western and Indian population at the nutrigenomics level. Methods: In this study nutrigenomics approach was applied. Blood transcriptome of severe COVID-19 patients from three western countries (showing high fatality) and two datasets from Indian patients were used. Gene set enrichment analyses were performed for pathways, metabolites, nutrients, etc., and compared for western and Indian samples to identify the food- and nutrient-related factors, which may be associated with COVID-19 severity. Data on the daily consumption of twelve key food components across four countries were collected and a correlation between nutrigenomics analyses and per capita daily dietary intake was investigated. Results: Distinct dietary habits of Indians were observed, which may be associated with low death rate from COVID-19. Increased consumption of red meat, dairy products and processed foods by western populations may increase the severity and death rate by activating cytokine storm-related pathways, intussusceptive angiogenesis, hypercapnia and enhancing blood glucose levels due to high contents of sphingolipids, palmitic acid and byproducts such as CO2 and lipopolysaccharide (LPS). Palmitic acid also induces ACE2 expression and increases the infection rate. Coffee and alcohol that are highly consumed in western countries may increase the severity and death rates from COVID-19 by deregulating blood iron, zinc and triglyceride levels. The components of Indian diets maintain high iron and zinc concentrations in blood and rich fibre in their foods may prevent CO2 and LPS-mediated COVID-19 severity. Regular consumption of tea by Indians maintains high high-density lipoprotein (HDL) and low triglyceride in blood as catechins in tea act as natural atorvastatin. Importantly, regular consumption of turmeric in daily food by Indians maintains strong immunity and curcumin in turmeric may prevent pathways and mechanisms associated with SARS-CoV-2 infection and COVID-19 severity and lowered the death rate. Interpretation & conclusions: Our results suggest that Indian food components suppress cytokine storm and various other severity related pathways of COVID-19 and may have a role in lowering severity and death rates from COVID-19 in India as compared to western populations. However, large multi-centered case-control studies are required to support our current findings.

Implicit Racial Bias Across Ethnoracial Groups in Canada and the United States and Black Mental Health

Black Canadians and Americans experience disparities in access to quality mental health care and mental health overall. Implicit biases are unconscious, automatically activated attitudes and stereotypes, with the potential to yield racist behaviors. To date, research has focused on health provider bias and resultant consequences in the decision-making/treatment of racialized groups. Little has been done to characterize implicit anti-Black biases within White and non-White members of the general population or examine the relationship between biases and Black people's mental wellness. Black-White Implicit Association Test (BW-IAT;n = 450,185) data were used to detect the presence of implicit biases within 10 ethnoracial groups and compare Bias Scores between Canada and the United States. Mean BW-IAT Bias Scores were also assessed against participant explicit biases using warmth ratings and the Modern Racism Scale (MRS). Finally, state-level BW-IAT scores were used to predict state-based Black American mental health-related mortality using the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER) data set. Findings indicated: (a) the most ethnoracial groups have anti-Black implicit biases;(b) Canadian and American implicit biases are near identical;(c) explicit and implicit Bias Scores are weakly related, and Canadian and American explicit biases are near identical;and (d) implicit bias predicts poor mental health outcomes for Black Americans, even when controlling for explicit bias and White outcomes. This work underscores the need to dismantle ideologies of White superiority and the resultant oppressive attitudes, stereotypes, and behaviors present in the general population. This work also calls for accessible, province-level, race-based mental health data on underserved groups.Alternate :Les Canadiens noirs et les Afro-Américains font face à des disparités en ce qui concerne leur accès à des soins de santé mentale et particulièrement des soins de santé mentale de qualité. Les préjugés implicites sont des attitudes et des stéréotypes inconscients, soient des pensées automatiques, qui peuvent potentiellement provoquer des comportements racistes. Jusqu'à présent, les recherches à ce sujet ont mis une emphase sur les préjugés des prestataires de soins de santé et les conséquences qui en découlent dans la prise de décision et le traitement des groupes racialisés. Peu d'études ont été menées dans le but de mettre en évidence les préjugés implicites anti-Noirs chez les personnes de race blanche et les personnes d'autres races parmi la population générale ou d'examiner la relation entre les préjugés et le bien-être mental des Noirs. Les données du Black-White Implicit Association Test (BW-IAT;n = 450 185) ont été utilisées pour déterminer la présence de préjugés implicites au sein de 10 groupes ethnoraciaux et comparer les scores des préjugés entre le Canada et les États-Unis. Les scores moyens des préjugés du BW-IAT ont également été évalués par rapport aux préjugés explicites des participants à l'aide des warmth ratings et du Modern Racism Scale. Par la suite, les scores BW-IAT dans les différents États ont été utilisés pour prédire le taux de mortalité lié à la santé mentale des Noirs américains à l'aide de l'ensemble de données CDC WONDER. Les résultats indiquent que (1) la plupart des groupes ethnoraciaux ont des préjugés implicites anti-Noirs;(2) les préjugés implicites canadiens et américains sont presque identiques;(3) les scores de préjugés explicites et implicites ont une faible corrélation, et les préjugés explicites canadiens et américains sont presque identiques;et (4) les préjugés implicites prédisent de conséquences négatives sur la santé mentale des Noirs américains, même en contrôlant les préjugés explicites et les résultats des personnes blanches. Ces travaux soulignent la nécessité de démanteler, au sein de la population dans son ensemble, es idéologies de supériorité de la race blanche et les attitudes, stéréotypes et comportements oppressifs qui en découlent. Ce travail appelle également à l'accessibilité des données sur la santé mentale axées sur la race des groupes faiblement desservis, au niveau provincial.

A review of the health benefits of tea: implications of the biochemical properties of the bioactive constituents

Tea is the second-most drank and refreshing beverage after water since the time immemorial. Tea harbours more than 4000 bioactive compounds viz, different classes of polyphenols, unique amino acid L-Theanine, alkaloids (Caffeine, Theobromine), and Volatile Flavor Compounds (VFC). Tea's polyphenols make its inherent therapeutic potential unlimited. Tea's significance in managing cancer, diabetes, stomach ulcer, influenza, neurological diseases, etc. is well-documented. However, advantageous biochemical capabilities of tea have yet to be fully utilised. Hence, this review aims at to examine tea's variety, drinking habits, biochemistry, and therapeutic qualities. A number of significant online resources, including Google Scholar, PubMed, Science Direct, and others, were searched for various research works on tea and its health-promoting qualities by using keywords like tea, health benefits, bioactive components against diseases, etc. Current review highlighted that drinking a cup or more green tea is recommended for improving antioxidant status and to manage diabetes and obesity related problem. However after detailed review work on tea it become clear that not only green tea but also other varies of tea like black, white tea are also harbour lots of bioactive molecules since they are processed from same plant. Tea improves antioxidant status and manages diabetes and obesity. It also helps prevent and cure, heart disease, malignancy, digestive dysfunction, and metabolic disorders including obesity and diabetes. Epigallocatechin Gallate (EGCG), found in tea, has been shown to reduce complications from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV 2) infection. When taken in its traditional form to manage ailments, tea is sometimes controversial due to a lack of confirming evidence of its benefits. The paper covers the numerous health advantages of tea, focusing on the specific components contributing to such benefits, and stresses the value of diverse brewing processes.

Human T2R38 Bitter Taste Receptor Expression and COVID-19: From Immunity to Prognosis

Background: Bitter taste-sensing type 2 receptor (T2Rs or TAS2Rs) found on ciliated epithelial cells and solitary chemosensory cells have a role in respiratory tract immuni-ty. T2Rs have shown protection against SARS-CoV-2 by enhancing the innate immune response. The purpose of this review is to outline the current sphere of knowledge re-garding this association. Method(s): A narrative review of the literature was done by searching (T2R38 OR bitter taste receptor) AND (COVID-19 OR SARS-CoV-2) keywords in PubMed and google scholar. Result(s): T2R38, an isoform of T2Rs encoded by the TAS2R38 gene, may have a potential association between phenotypic expression of T2R38 and prognosis of COVID-19. Current studies suggest that due to different genotypes and widespread distributions of T2Rs within the respiratory tract and their role in innate immunity, treatment protocols for COVID-19 and other respiratory diseases may change accordingly. Based on the phenotypic expression of T2R38, it varies in innate immunity and host response to respiratory infection, systemic symptoms and hospitalization. Conclusion(s): This review reveals that patients' innate immune response to SARS-COV-2 could be influenced by T2R38 receptor allelic variations.Copyright © 2023, Avicenna Journal of Medical Biotechnology.

The effect of caffeine consumption habits of contact tracing teams on anxiety, insomnia, and cardiac symptoms during the COVID-19 pandemic period

Purpose: The aim of this study was to examine the caffeine consumption habits and insomnia and anxiety levels of the personnel working in the contact tracing teams in the COVID-19 pandemic and to reveal their relationship with each other and with cardiac symptoms. Design and Methods: The population of this cross-sectional study consisted of the personnel working in contact tracing teams affiliated with a provincial health directorate. Data were collected with online questionnaire forms. There are questions intended for the descriptive characteristics, caffeine consumption habits, and cardiac symptoms of the participants, Beck Anxiety Inventory and Insomnia Severity Index in the questionnaire form consisting of three parts. Result(s): Mild anxiety was detected in 12.0% of the participants, and medium and severe anxiety in 23.6%. The insomnia rate in the participants was found to be 35.6%. A positive correlation was detected between the anxiety scores of the participants and insomnia scores and the number of cardiac symptoms;as their daily caffeine consumption increased, the anxiety, insomnia, and the number of cardiac symptoms increased as well. Practice Implications: Psychological support for healthcare professionals like the contact tracing team working with infected patients in the pandemic period must be ready to be given when necessary.Copyright © 2022 Mattioli 1885. All rights reserved.

Insights into patterns of knowledge, practices, and safety use of energy drinks: A cross-sectional observational study

Background: Energy drinks (EDs) are largely consumed by adolescents and sports youths without understanding safety precautions and associated side effects. The aim of this study was to assess the knowledge, practices, and safety use, including the occurrence of side effects of EDs among adolescents and sports youths in Kyrenia, Northern Cyprus. Methods: This was a descriptive, cross-sectional study conducted among adolescents and sports youths in Kyrenia province, Northern Cyprus, using a structured three-part questionnaire, consisting of 22 items to assess the knowledge, practices, and safety use of EDs. Results: The most common reported adverse effects were insomnia and palpitations (24%), diuresis (18.7%), headache (17.7%), and stress (15.6%). The study participants reported a statistically significant low knowledge about the ingredients of EDs (P < 0.0001) and side effects of EDs (P = 0.05). Although statistically nonsignificant, the study participants also reported a low knowledge about ED intake during the COVID-19 pandemic. Conclusions: There is still a lack of knowledge regarding ED consumption among the adolescents and sports youths in Northern Cyprus reported by low level of knowledge about the ingredients of EDs, their potential effects, and incidence of side effects along with correct consumption during the COVID-19 pandemic which creates a barrier to healthy dietary patterns.

Modeling studies on the role of vitamins B1 (thiamin), B3 (nicotinamide), B6 (pyridoxamine), and caffeine as potential leads for the drug design against COVID-19.

In response to the COVID-19 pandemic, and the lack of effective and safe antivirals against it, we adopted a new approach in which food supplements with vital antiviral characteristics, low toxicity, and fast excretion have been targeted. The structures and chemical properties of the food supplements were compared to the promising antivirals against SARS-COV-2. Our goal was to exploit the food supplements to mimic the topical antivirals' functions but circumventing their severe side effects, which has limited the necessary dosage needed to exhibit the desired antiviral activity. On this line, after a comparative structural analysis of the chemicals mentioned above, and investigation of their potential mechanisms of action, we selected caffeine and some compounds of the vitamin B family and further applied molecular modeling techniques to evaluate their interactions with the RDB domain of the Spike protein of SARS-CoV-2 (SC2Spike) and its corresponding binding site on human ACE-2 (HssACE2). Our results pointed to vitamins B1 and B6 in the neutral form as potential binders to the HssACE2 RDB binding pocket that might be able to impair the SARS-CoV-2 mechanism of cell invasion, qualifying as potential leads for experimental investigation against COVID-19.

Your guide to getting a good night’s sleep

The health benefits of a good night’s sleep have been emphasised by scientists for decades.

Vascular Response to a Cardiac Rehabilitation Program Adapted for COVID-19

Background: Cardiac Rehabilitation (CR) is a supervised exercise and risk factor modification program for patients with cardiac conditions. Endothelial dysfunction is often present and is associated with worsening cardiac prognosis, and several studies have indicated that standard onsite CR has improved endothelial function in heart disease patients. However, during the COVID-19 pandemic, many CR programs transitioned to a virtual or hybrid model of care to increase safety of CR programs. Objective(s): The objective of this study was to determine vascular function of patients with coronary artery disease (CAD) measured before and after 4 months of outpatient CR using a virtual model of care. Method(s): Virtual CR included 1 virtual group session/week by videoconferencing and hybrid CR included 1 session/week (4 on-site and 12 virtual group sessions) for a total of 16 weeks. CAD patients (6 females, 4 males) mean age 68.1+/-7.5 years rested in a supine position to measure 1) brachial artery flow-mediated dilation (FMD), 2) microvascular function, and 3) augmentation index (AI) using ultrasound sonography (n=8) and an EndoPAT 2000 (n=9). Two patients completed virtual CR and the rest underwent hybrid CR. These measurements were obtained concurrently using an ultrasound transducer at the brachial artery proximal to a blood pressure cuff on the forearm with EndoPAT cuffs on the index fingers during 5-minute intervals of baseline, occlusion, and recovery. FMD results were analyzed using automated Cardiovascular Suite software. AI and Reactive Hyperemia Index (LnRHI) were determined using automatic analysis via the EndoPAT 2000. Anthropometrics, blood pressure, and food intake were recorded at each visit. Patients were advised to refrain from strenuous exercise, alcohol, caffeine, and highly saturated foods at least 12 hours prior to the study appointment. One tailed paired t-tests were conducted between baseline and completion. Result(s): Adherence to CR averaged 10.3+/-3.2 out of 16 sessions. FMD improved from (2.75+/-1.71% to 5.63+/-4.37%, p=0.048) while there was no improvement in AI (14.2+/-18.8 to 13.2+/-19.6, p=0.45) or LnRHI (0.56+/-0.12 to 0.52+/-0.20, p=0.24). Conclusion(s): While there was no improvement in LnRHI or AI after CR, FMD improved in CAD patients after 4 months of adapted CR. Our results indicate that while virtual and hybrid models of CR may not be sufficient for improving microvascular function and aortic stiffness in CAD, there is an improvement of endothelial function. Future studies should examine the effects of adherence, duration and exercise intensity within these alternative models of CR on aortic and microvascular improvements.

Delayed leukopenia following intentional azathioprine ingestion

Background: Azathioprine is a purine analog metabolized to 6- mercaptopurine (6-MP) utilizing glutathione. Its high oral bioavailability and longer duration of action make it viable as a treatment for ulcerative colitis or as an anti-rejection medication for renal transplant patients. Specific experience in overdose with this agent is limited although toxicity mimics 6-MP including hepatotoxicity, delayed leukopenia, and acute interstitial nephritis. Case report: A 46 year old female (64 kg) with a history of ulcerative colitis, migraines, and anxiety presented with a selfreported intentional ingestion of 1000mg azathioprine and presented to care approximately 8 h post-ingestion. Her compliance with azathioprine preceding the ingestion was unclear. She reported taking her other medications as prescribed (tadalafil, sulfasalazine, fioricet, alprazolam) the day prior to presentation. Other than one episode of emesis without pill fragments, myalgias, headache she had no other symptoms. Her presenting vital signs were HR 84, RR 22, BP 90/63, T 36.2 degreeC. Initial labs included a normal chemistry profile, undetectable serum acetaminophen and salicylates, an ethanol level of 50 mg/dL and venous lactate of 1.6mmol/L. She received a total of 3 L of crystalloid IV fluids with improvement in blood pressure to 125/66 and was transferred for higher level of care. Due to the delay in presentation and well appearance, activated charcoal and hemodialysis were considered but deferred. While inpatient she had laboratory evaluation including CBC and differential every 8 h. In the ED she developed a fever, 38.1 degreeC. PCR testing for COVID-19 was negative. Whole blood thiopurine metabolites (Prometheus Biosciences, Test 3200) were sent approximately 33 h from time of ingestion. 6-thioguanine levels were 108 pmol/8x10degree8 RBC, below the therapeutic reference range (230-400 pmol/8x10degree8 RBC). 6-methylmercaptopurine metabolites were below the lower limit of quantification (761pmol/8x10degree8 RBC). Genetic testing for thiopurine S-methyltransferase was declined by the patient. She was hospitalized for 4 days and did not develop any substantial vital sign abnormalities or creatinine elevation. Her absolute neutrophil count dropped to 500/mm3 approximately 76 h post-ingestion, but started to improve 84 h post-ingestion and granulocyte-macrophage colony-stimulating factor was deferred. Her peak AST was 113 IU/L, approximately 46 h post-ingestion and returned to normal (16 IU/L) upon follow-up 7 days postingestion. White blood cell count 7 days post-ingestion was 4.3 K/mm3. Discussion(s): Azathioprine overdose is rarely reported in the literature. Case reports describe delayed leukopenia and hepatotoxicity from repeat supratherapeutic ingestions, however, based upon limited experience serious toxicity from single acute ingestions appears rare. A report of a single acute ingestion of 7500mg of azathioprine resulted in moderate leukopenia (4.1 K/ mm3) 3 days post-ingestion. Peak immunosuppressive effects can take up to 2 weeks from initiation or change in dose. Symptoms in this case are consistent with effects from azathioprine including vomiting, transient hypotension, and myalgias. Conclusion(s): Intentional ingestions of azathioprine are infrequently reported and can result in serious delayed myelosuppression. We report a case of a single acute ingestion of >15 mg/kg resulting in delayed myelosuppression managed conservatively.

A case of refractory ventricular fibrillation after caffeine poisoning successfully treated by supportive care.

Caffeine (1,3,7-trimethylxantine), a structural analog of adenosine, is widely used as a central nervous system stimulant in beverages and drugs. Caffeine overdose induces hypokalemia, fatal ventricular fibrillation, and cardiac arrest, resulting in death. We describe a case of caffeine overdose that presented with refractory ventricular fibrillation that was treated with supportive care because invasive care for severely ill patients was limited due to the COVID-19 pandemic. A 20-year-old woman with no underlying medical history ingested 90,200-mg caffeine tablets (total dose 18 g) in a suicide attempt. She was transported to the emergency department 45 min after ingestion with dizziness, palpitations, nausea, and vomiting. She developed cardiac arrest 80 min after ingesting the caffeine, with refractory ventricular tachycardia that recurred for about 2.5 h. Advanced life support including defibrillation was started immediately and we gave intravenous Intralipid emulsion, potassium chloride, amiodarone, and esmolol, without hemodialysis or extracorporeal membrane oxygenation (ECMO). The ventricular fibrillation was stopped 4 h after ingestion. As supportive care, mechanical ventilation, sedatives, and neuromuscular blockade were continued until 12 h after ingestion. Although she suffered from prolonged, refractory ventricular tachycardia, she recovered without complications. This case report describes the clinical course of severe caffeine intoxication without an active elimination method, such as hemodialysis or ECMO and explores the treatment of caffeine intoxication with a literature review.

Risk and Resilience Pathways, Community Adversity, Decision-making, and Alcohol Use Among Appalachian Adolescents: Protocol for the Longitudinal Young Mountaineer Health Study Cohort.

BACKGROUND: Alcohol use impairs psychosocial and neurocognitive development and increases the vulnerability of youth to academic failure, substance use disorders, and other mental health problems. The early onset of alcohol use in adolescents is of particular concern, forecasting substance abuse in later adolescence and adulthood. To date, evidence suggests that youth in rural areas are especially vulnerable to contextual and community factors that contribute to the early onset of alcohol use. OBJECTIVE: The objective of the Young Mountaineer Health Study is to investigate the influence of contextual and health behavior variables on the early onset of alcohol use among middle school-aged youth in resource-poor Appalachian rural communities. METHODS: This is a program of prospective cohort studies of approximately 2200 middle school youth from a range of 20 rural, small town, and small city (population <30,000) public schools in West Virginia. Students are participating in 6 waves of data collection (2 per year) over the course of middle school (sixth to eighth grades; fall and spring) from 2020 to 2023. On the basis of an organizational arrangement, which includes a team of local data collection leaders, supervising contact agents in schools, and an honest broker system to deidentify data linked via school IDs, we are able to collect novel forms of data (self-reported data, teacher-reported data, census-linked area data, and archival school records) while ensuring high rates of participation by a large majority of youth in each participating school. RESULTS: In the spring of 2021, 3 waves of student survey data, 2 waves of data from teachers, and a selection of archival school records were collected. Student survey wave 1 comprised 1349 (response rate 80.7%) participants, wave 2 comprised 1649 (response rate 87%) participants, and wave 3 comprised 1909 (response rate 83.1%) participants. The COVID-19 pandemic has had a negative impact on the sampling frame size, resulting in a reduced number of eligible students, particularly during the fall of 2020. Nevertheless, our team structure and incentive system have proven vitally important in mitigating the potentially far greater negative impact of the pandemic on our data collection processes. CONCLUSIONS: The Young Mountaineer Health Study will use a large data set to test pathways linking rural community disadvantage to alcohol misuse among early adolescents. Furthermore, the program will test hypotheses regarding contextual factors (eg, parenting practices and neighborhood collective efficacy) that protect youth from community disadvantage and explore alcohol antecedents in the onset of nicotine, marijuana, and other drug use. Data collection efforts have been successful despite interruptions caused by the COVID-19 pandemic in 2020 and 2021. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/40451.

A COVID–19-járvány első két hullámának hatása a rendészeti hallgatók alkohol és koffeinfogyasztására, valamint dohányzási szokásaira

Cél: A tanulmány célja a COVID–19-járvány első két hullámának, valamint a bevezetett járványügyi intézkedések, és a magyar rendészeti hallgatók alkohol- és koffeinfogyasztása, illetve dohányzási szokásainak változása közötti összefüggések vizsgálata. Módszertan: Keresztmetszeti, kérdőíves vizsgálatot végeztünk a Nemzeti Közszolgálati Egyetem Rendészettudományi Karának (NKE RTK) rendészeti hallgatói körében (N=556). A vizsgálati minta (N=180) 57,2%-a férfi (n=103), 42,8%-a nő (n=77). Megállapítások: Az eredmények azt mutatják, hogy a pandémia első hullámának ideje alatt az alkoholt fogyasztó rendészeti hallgatók 9%-ánál, az alkalmi és rendszeres dohányzók 25%-ánál, míg a koffeines italt fogyasztók 13,5%-ánál nőtt a fogyasztás mértéke. A fogyasztás mértékének változásában egyik szer esetében sem volt szignifikáns különbség a férfiak és a nők között (palkohol=0,452471;pdohányzás=0,532113;pkoffein=0,059011;p>0,05). Az alkalmi és a rendszeres alkoholfogyasztók, valamint dohányosok körében ugyanakkor a szerhasználat mértékének változása és a meglévő fogyasztói mintázat között szignifikáns volt az összefüggés. A rendszeres alkoholfogyasztók körében 5,7-szer nagyobb arányban fordult elő a fogyasztás mértékének növekedése a pandémia ideje alatt, mint az alkalmi fogyasztók között (25,0% vs.4,4%). A napi dohányosok körében is csaknem kétszer nagyobb volt a szerhasználat mértékének növekedése az alkalmi dohányosokhoz viszonyítva (30,8 vs. 16,7%). Eredményeink azt mutatják, hogy a rendészeti hallgatók körében az alkoholfogyasztás mértékének növekedését elsősorban a távolléti oktatás bevezetésével megnövekedett strukturálatlan szabadidő ( =3,12;SD=1,454), az elrendelt rendvédelmi szolgálat ( =2,81;SD=1,515), illetve a lezárásokkal fokozódó szorongás ( =2,75;SD=1,437) eredményezte. Továbbá a különleges jogrend idején elrendelt rendvédelmi szolgálat szerepet játszhatott a dohányzás ( =3,81;SD=1,601) és a koffeinfogyasztás ( =3,86;SD=1,632) mértékének növekedésében is. Ezzel együtt viszont a társas interakciók csökkenésének mindhárom pszichoaktív szer fogyasztásának visszaesésében meghatározó szerepe lehet. Érték: A COVID–19-járvány első hullámának egyik legmeghatározóbb következménye a fiatal felnőttek körében az volt, hogy az egyetemek világszerte távolléti, online oktatásra álltak át. Az egyetemi hallgatók, így a rendészeti felsőoktatás hallgatói is számos kihívással kerültek szembe. Ezek különböző formában befolyásolták az alkohol- és koffeinfogyasztás, valamint a dohányzás mértékét.Alternate : Aim: The aim of this study is to investigate the relationship between the first two waves of the COVID–19 epidemic and the introduced epidemiological measures and the changes in alcohol and caffeine consumption and smoking habits among Hungarian law enforcement students. Methodology: Cross-sectional, questionnaire-based survey was conducted among law enforcement students (N=556) at the University of Public Service Faculty of Law Enforcement (UPS FLE). The study sample (N=180) was 57.2% male (n=103) and 42.8% female (n=77). Findings: The results show that during the first wave of the pandemic, 9% of law enforcement students, who consumed alcohol, 25% of occas ional and regular smokers and 13.5% of caffeinated drinkers increased their consumption. There was no significant difference between male and female in the consumption of any of these drugs (palcohol=0.452471;psmoking=0.532113;pcaffeine=0.059011;p>0.05). However, among occasional and regular alcohol users and smokers, there was a significant association between changes in the level of substance use and existing patterns of consumption. Regular drinkers were 5.7 times more likely to increase their consumption during the pandemic than occasional drinkers (25.0 vs. 4.4%). Daily smokers also showed a nearly two-fold increase in substance use compared to occasional smokers (30.8% vs. 16.7%). Our results suggest that the main reason for increase in alcohol consumption among law enforcement students were primarily due t o the increased unstructured leisure time ( =3.12;SD=1.454), the required law enforcement duty ( =2.81;SD=1.515), and the increased anxiety caused by lockdowns ( =2.75;SD=1,437). Furthermore, required law enforcement duty may also have played a role in the increase in smoking ( =3.81;SD=1.601) and caffeine consumption ( =3.86;SD=1.632). However, the reduction in social interactions may play a crucial role in the decrease of use of all three psychoactive substances. Value: One of the most striking consequences of the first wave of the COVID–19 epidemic among young adults was the introduction of online education in universities worldwide. University students, including law enforcement students, have faced many challenges. These influenced alcohol and caffeine consumption and smoking in different ways.

Supplement-Induced Thyrotoxicosis Presenting as New Onset Tachycardia

INTRODUCTION: Dietary and herbal supplements can contain clinically significant amounts of exogenous thyroid stimulants and hormones, including T3 and T4, thus placing consumers at increased risk of thyrotoxicosis and other metabolic-related adverse effects. We present a case of thyrotoxicosis in a young man with no history of thyroid disease, who was found to be consuming an extensive variety of supplements. DESCRIPTION: A 31 year old man with hypertension presented with 1 week of intermittent palpitations. He was in his usual state of health until 1 week prior to admission, when he noticed intermittent, self-resolving episodes of tachycardia as high as the 160s on his smart watch, associated with palpitations, dyspnea, low grade fevers, and intermittent dry cough. He came to the ED for persistence of symptoms. In the ED: T 98.8 F, HR 129, BP 152/77, RR 18, SpO2 98% on RA. CBC, BMP, UA, UTox, blood alcohol content, troponin and COVID tests were unremarkable. TSH was < .007 [0.358-3.740 ulU/mL], with a free thyroxine of 0.54 [0.70-1.48 ng/dL];other thyroid studies later returned with TSI < 0.10 [0.00-0.55 IU/L], free T3 32.50 [1.80-4.60 pg/mL], and an unremarkable thyroid ultrasound. CXR showed no acute infiltrates. EKG revealed sinus tachycardia, no Wolff-Parkinson-White syndrome, and no Brugada waveforms. He was given 2L NS, ceftriaxone 1g IV, aspirin 81mg PO, and tylenol 650mg PO, and admitted to the telemetry unit. Exam revealed an anxious appearing man with tachycardia. On ROS, patient admitted to drinking 6-8 cups of coffee daily, and to taking at least a dozen different supplements. He was started on propranolol 30 mg every 6 hours with improvement in his heart rate, and was counseled to stop the supplements and wean his caffeine intake. He was discharged the following day with plan for endocrinology and primary care follow-up. DISCUSSION: Thyrotoxicosis in this young patient with no history of thyroid disease posed a diagnostic quandary. This prompted further investigation into a more detailed social history, which revealed the extensive variety of supplements he was taking, consistent with thyrotoxicosis factitia. In patients presenting with newonset tachycardia, our case highlights the importance of collecting a thorough social history and maintaining early suspicion for thyroid disease and thyrotoxicosis.

Consumption trends of pharmaceuticals and psychoactive drugs in Latvia determined by the analysis of wastewater.

Wastewater-based epidemiology (WBE) was applied to evaluate seasonal variations of the consumption of pharmaceuticals (i.e. antibiotics, NSAIDs, antiepileptics, antihypertensives and others), caffeine, alcohol and nicotine in Latvia throughout 2021. In addition, weekly variation of caffeine, nicotine and alcohol consumption was investigated. Pronounced seasonality was observed in the consumption of antibiotics and decongestants, as well as caffeine, nicotine and alcohol. Correlation with COVID-19 statistics was observed in the case of macrolide antibiotics and antiasthmatic salbutamol. Comparison of the estimated consumption values obtained using the WBE approach and the statistics revealed that the majority of compounds data are in good agreement except angiotensin II receptor blocker group antihypertensives where the most overestimated consumption values were observed.

Flavonoids from Plants to Foods: From Green Extraction to Healthy Food Ingredient

Flavonoids have the ability to control the accumulation of reactive oxygen species (ROS) via scavenger activity. [...]flavonoids are important secondary metabolites produced by plants with several functions related to the physiology of the growth and stress responses. [...]nutrients with anti-inflammatory and antioxidant properties may prevent or attenuate the inflammatory and vascular manifestations associated with COVID-19. [...]following healthy dietary patterns may have beneficial effects to contrast infection but still need to be explored. [...]natural compounds, owing to their medicinal, ecological, and other safe properties, are becoming popular potential candidates in preventing and treating peptic ulcers. At present, most data come from laboratory model tests. [...]the in vivo models of peptic ulcer include ulcers caused by oxidative damage, ethanol, NSAIDs, stress and Helicobacter pylori or acid-ethanol (ethanol or ethanol/HCl)-induced acute gastric ulcer models.

The Impact of Lockdowns on Caffeine Consumption: A Systematic Review of the Evidence.

The Coronavirus disease 2019 (COVID-19) has been characterized by the World Health Organization as a pandemic in March 2020 and the lockdown measures that were implemented in an effort to limit the transmission of the virus affected the daily life of many people in all over the world. The aim of this systematic review was to investigate the changes during/after the lockdowns in caffeine consumption by coffee and energy drinks. A systematic literature search was conducted in three databases (PubMed, Embase, Web of Science) up to 31 December 2021 and out of 19,511 studies found and 12,885 screened, 16 studies were included according to eligibility criteria. Results regarding coffee consumption showed that a significant part of individuals decreased their consumption and in five studies an increase was reported, including women and seniors >60 years old. Energy drinks were also consumed less during the lockdown compared to the pre-lockdown time. Attention should be given for menopausal women where an increase in coffee consumption was found which could impair bone density, but further research is needed in order to make safe conclusions.