Epidemiological Study of Carbon Monoxide Deaths in North Jordan 2009-2018.

BACKGROUND: Carbon monoxide (CO) poisoning rate has stayed the same around the globe over the last quarter of a decade. However, the number of people who die compared to the number of people who get poisoned, and the mortality rate has declined dramatically. OBJECTIVE: The aim of this study was to evaluate the severity of the CO poisoning problem in Jordan and compare it to other countries and to search for any related factors that could affect the death rate. METHODS: A retrospective study was conducted in the Forensic Medicine Teaching Centre, Irbid, Jordan for a 10-years period (2009 -2018). 5,725 autopsy reports were assessed, and only 71 CO-related death cases were selected and analyzed based on the following risk factors: age, gender, year and month of death, nationality, address, the settings that the cases occurred in, carboxyhemoglobin saturation (COHb%) and the presence of alcohol and drugs in blood. RESULTS: The rate of deaths due to CO poisoning showed a general decline over the reviewed years. Most victims were males (70.4%). And although the death rate showed an increase with age, the age group between 20-year-old and 39-year-old accounted for 38% of all cases. Most cases happened in the winter months, December, January, and February. 87.1% of the cases occurred at home settings. The average COHb% was 68%±13% and ranged from 12%-83%. CONCLUSION: Although the incidence is decreasing with time, CO is still a threat that must be dealt with. As all cases in our study were accidental cases and good preventive measures, such as good CO detectors and good air flow in the places that hold devices that could generate CO, and proper education to the public, especially in the colder regions of the country, could prove useful in decreasing the incidence of CO deaths further.

DNA dosimeter measurements of beam profile using a novel simultaneous processing technique.

A DNA dosimeter (DNAd) was previously developed that uses double-strand breaks (DSB) to measure dose. This dosimeter has been tested to measure dose in scenarios where transient-charged particle equilibrium (TCPE) has been established. The probability of double strand break (PDSBo), which is the ratio of broken double-stranded DNA (dsDNA) to the initial unbroken dsDNA in the dosimeter, was used to quantify DSBs and related to dose. The goal of this work is to produce a new technique to process and analyze the DNAd and quantify DNA-DSBs. This technique included simultaneously processing multiple DNAds and also establishing a new form to the probability of double strand break (PDSBn), which was then used to test the DNAd in a non-TCPE condition by taking beam penumbra measurements. The technique utilized a 384-well plate, and the measurements were made at the edge of a 10 × 10 cm field and compared to film measurements. During these penumbra measurements, while observing the positional differences in the higher gradient region at 4.1 and 4.55 cm from the center of the radiation field, the distance to agreement of PDSBo to film were 0.38 cm and 0.26 cm while the distance to agreement of PDSBn to film were 0.11 cm and 0.06 cm, respectively. Finally, the developed new separation technique reduced the time needed for the analysis of 25 samples from 200 min to 30 min.

Optimizing the response, precision, and cost of a DNA double-strand break dosimeter.

We developed a dosimeter that measures biological damage following delivery of therapeutic beams in the form of double-strand breaks (DSBs) to DNA. The dosimeter contains DNA strands that are labeled on one end with biotin and on the other with fluorescein and attached to magnetic microbeads. Following irradiation, a magnet is used to separate broken from unbroken DNA strands. Then, fluorescence is utilized to measure the relative amount of broken DNA and determine the probability for DSB. The long-term goal for this research is to evaluate whether this type of biologically based dosimeter holds any advantages over the conventional techniques. The purpose of this work was to optimize the dosimeter fabrication and usage to enable higher precision for the long-term research goal. More specifically, the goal was to optimize the DNA dosimeter using three metrics: the response, precision, and cost per dosimeter. Six aspects of the dosimeter fabrication and usage were varied and evaluated for their effect on the metrics: (1) the type of magnetic microbeads, (2) the microbead to DNA mass ratio at attachment, (3) the type of suspension buffer used during irradiation, (4) the concentration of the DNA dosimeter during irradiation, (5) the time waited between fabrication and irradiation of the dosimeter, and (6) the time waited between irradiation and read out of the response. In brief, the best results were achieved with the dosimeter when attaching 4.2 µg of DNA with 1 mg of MyOne T1 microbeads and by suspending the microbead-connected DNA strands with 200 µl of phosphate-buffered saline for irradiation. Also, better results were achieved when waiting a day after fabrication before irradiating the dosimeter and also waiting an hour after irradiation to measure the response. This manuscript is meant to serve as guide for others who would like to replicate this DNA dose measurement technique.

Hedgehog signaling in the airway epithelium of patients with chronic obstructive pulmonary disease.

Genome-wide association studies have linked gene variants of the receptor patched homolog 1 (PTCH1) with chronic obstructive pulmonary disease (COPD). However, its biological role in the disease is unclear. Our objective was to determine the expression pattern and biological role of PTCH1 in the lungs of patients with COPD. Airway epithelial-specific PTCH1 protein expression and epithelial morphology were assessed in lung tissues of control and COPD patients. PTCH1 mRNA expression was measured in bronchial epithelial cells obtained from individuals with and without COPD. The effects of PTCH1 siRNA knockdown on epithelial repair and mucous expression were evaluated using human epithelial cell lines. Ptch1+/- mice were used to assess the effect of decreased PTCH1 on mucous expression and airway epithelial phenotypes. Airway epithelial-specific PTCH1 protein expression was significantly increased in subjects with COPD compared to controls, and its expression was associated with total airway epithelial cell count and thickness. PTCH1 knockdown attenuated wound closure and mucous expression in airway epithelial cell lines. Ptch1+/- mice had reduced mucous expression compared to wildtype mice following mucous induction. PTCH1 protein is up-regulated in COPD airway epithelium and may upregulate mucous expression. PTCH1 provides a novel target to reduce chronic bronchitis in COPD patients.

Alfalfa hay improves nursing performance of Awassi ewes and performance of growing lambs when used as a source of forage compared with wheat straw.

Two experiments were conducted to evaluate the effect of replacing wheat straw (WS) with alfalfa hay (ALF) in diets fed to Awassi lactating ewes (exp. 1) and weaned lambs (exp. 2). In each experiment, sheep were fed 1 of 3 treatment diets containing WS only, WS and ALF mix (50:50; WS-ALF), or ALF only as the forage sources. In exp. 1, 33 lactating Awassi ewes were assigned randomly to treatment diets (11 ewes/diet) and fed ad libitum for 56 days. Intakes of dry matter (DM) and crude protein (CP) were greater (P = 0.001) in WS-ALF and ALF diets than WS diet. Ewe weight-of-lamb weaned, and nursing-lamb average daily gain (ADG) was greatest for ALF, intermediate for WS-ALF, and least for WS treatment groups (P < 0.0001). Milk production (kg/day) tended to be greater (P = 0.07) in ALF diets compared with WS diets. Milk protein, total solids, and lactose production (g/day) were greater (P < 0.04) in ewes fed ALF and WS-ALF diets compared with WS diet. In exp. 2, 27 newly weaned lambs were randomly assigned to treatment diets (9 lambs/treatment) and fed ad libitum for 70 days. Intake and digestibility of DM were greater (P < 0.05) in lambs fed the ALF diet compared with the WS diet. Lamb total gain and ADG were greater (P < 0.01) for lambs fed WS-ALF and ALF diets compared with WS diet. Replacement of wheat straw with alfalfa hay improved most of performance and productivity measured variables of Awassi lactating ewes and growing lambs.

Latrophilin receptors: novel bronchodilator targets in asthma.

BACKGROUND: Asthma affects 300 million people worldwide. In asthma, the major cause of morbidity and mortality is acute airway narrowing, due to airway smooth muscle (ASM) hypercontraction, associated with airway remodelling. However, little is known about the transcriptional differences between healthy and asthmatic ASM cells. OBJECTIVES: To investigate the transcriptional differences between asthmatic and healthy airway smooth muscle cells (ASMC) in culture and investigate the identified targets using in vitro and ex vivo techniques. METHODS: Human asthmatic and healthy ASMC grown in culture were run on Affymetrix_Hugene_1.0_ST microarrays. Identified candidates were confirmed by PCR, and immunohistochemistry. Functional analysis was conducted using in vitro ASMC proliferation, attachment and contraction assays and ex vivo contraction of mouse airways. RESULTS: We suggest a novel role for latrophilin (LPHN) receptors, finding increased expression on ASMC from asthmatics, compared with non-asthmatics in vivo and in vitro, suggesting a role in mediating airway function. A single nucleotide polymorphism in LPHN1 was associated with asthma and with increased LPHN1 expression in lung tissue. When activated, LPHNs regulated ASMC adhesion and proliferation in vitro, and promoted contraction of mouse airways and ASMC. CONCLUSIONS: Given the need for novel inhibitors of airway remodelling and bronchodilators in asthma, the LPHN family may represent promising novel targets for future dual therapeutic intervention.

Susceptibility to chronic mucus hypersecretion, a genome wide association study.

BACKGROUND: Chronic mucus hypersecretion (CMH) is associated with an increased frequency of respiratory infections, excess lung function decline, and increased hospitalisation and mortality rates in the general population. It is associated with smoking, but it is unknown why only a minority of smokers develops CMH. A plausible explanation for this phenomenon is a predisposing genetic constitution. Therefore, we performed a genome wide association (GWA) study of CMH in Caucasian populations. METHODS: GWA analysis was performed in the NELSON-study using the Illumina 610 array, followed by replication and meta-analysis in 11 additional cohorts. In total 2,704 subjects with, and 7,624 subjects without CMH were included, all current or former heavy smokers (≥20 pack-years). Additional studies were performed to test the functional relevance of the most significant single nucleotide polymorphism (SNP). RESULTS: A strong association with CMH, consistent across all cohorts, was observed with rs6577641 (p = 4.25×10(-6), OR = 1.17), located in intron 9 of the special AT-rich sequence-binding protein 1 locus (SATB1) on chromosome 3. The risk allele (G) was associated with higher mRNA expression of SATB1 (4.3×10(-9)) in lung tissue. Presence of CMH was associated with increased SATB1 mRNA expression in bronchial biopsies from COPD patients. SATB1 expression was induced during differentiation of primary human bronchial epithelial cells in culture. CONCLUSIONS: Our findings, that SNP rs6577641 is associated with CMH in multiple cohorts and is a cis-eQTL for SATB1, together with our additional observation that SATB1 expression increases during epithelial differentiation provide suggestive evidence that SATB1 is a gene that affects CMH.

Vaginal birth after caesarean section (VBAC) in women with spontaneous labour: predictors of success.

We evaluated the predictors of VBAC success in Jordanian women with a single previous low transverse caesarean section of a gestational age of at least 28 weeks, followed by a trial of spontaneous labour at two tertiary hospitals between January 2008 and February 2010. Among 207 women, 117 (57%) women achieved a successful VBAC. Multivariate analysis showed that a cervical dilatation of ≥ 7 cm at the time of previous caesarean section was an independent predictor of successful VBAC (with a success rate of 80%). Parity of ≥ 2 was significantly associated with increased odds of success (OR = 2.7, 95% CI: 1.2, 6.2). Compared with women who had no previous VBAC, those with previous VBAC had higher odds of success (OR = 3.8 (95% CI: 1.5, 9.5). We concluded that women with a previous caesarean section who achieved a cervical dilatation of ≥ 7 cm before caesarean, had a previous history of successful VBAC and had parity of ≥ 2, have the greatest likelihood of successful VBAC.

Effect of prenatal administration of therapeutic doses of topiramate on ossification of ribs and vertebrae in rat fetuses.

There are few studies that have addressed the effects of prenatal exposure of topiramate on ossification of the bones derived from the paraxial mesoderm. This study aimed to evaluate skeletal ossification of ribs and vertebrae in 20-day-old rat fetuses after maternal exposure to two therapeutic doses of topiramate. Three groups of Sprague-Dawley pregnant rats were used: control, topiramate 50 mg/kg/day and topiramate 100 mg/kg/day treated groups. Topiramate was administered by gavage from day 6-19 of gestation. Fetuses were collected on day 20 by caesarean section. Fetal bones were stained with alizarin red and ossification was assessed. Results showed significant delayed ossification of ribs and vertebrae in topiramate-exposed fetuses at both doses and the effects were not dose dependent. In all examined groups, there was a direct correlation between the fetal weight and the number of complete ossified vertebral centers. Also, there were significant increases in skeletal abnormalities, particularly in ribs in both treated groups when compared to the control group. In conclusion, therapeutic doses of topiramate should be taken cautiously during pregnancy as they lead to fetal growth restriction and increases abnormalities of axial skeleton in rat fetuses.

Umbilical cord prolapse: a 10-year retrospective study in two civil hospitals, North Jordan.

Umbilical cord prolapse (UCP) is an obstetric emergency. The objective of our study was to determine the frequency of cord prolapse, its aetiological factors and to evaluate fetal prognosis. This was a retrospective review of cord prolapse deliveries in the main two civil hospitals in North Jordan between 1995 and 2005, at Princess Badeea Hospital and at King Abdullah University Hospital (KAUH) in Irbid, North Jordan. There were 146 patients identified with UCP among a total of 64,192 consecutive births. The incidence of cord prolapse was one in 440 cases (146/64,192). It occurred mostly in women over 25 years, and significantly more in pre-term births, low birth weight babies, multigravida, and only a few were associated with induced cases. It was not associated with higher rates of perinatal mortality and this supports the benefit of clinical management of UCP by emergency (crash) delivery.

Osteomyelitis of the scapula with secondary septic arthritis of the shoulder joint.

We report a delayed diagnosis of osteomyelitis of the scapula involving the inferior angle and extending to the glenoid, with secondary septic arthritis of the glenohumeral joint in a 7-month-old female infant. The patient was treated with arthrotomy of the shoulder joint, anterior drainage of pus and intravenous antibiotics. The diagnosis was delayed as the patient was found to have bilateral lung abscess and other foci of infection, for which she was treated in the neonatal intensive care unit, with all the medical efforts directed towards saving her life. The diagnosis of septic shoulder arthritis is uncommon and difficult, requiring a high index of suspicion, which was another reason for the delayed diagnosis.

The transcriptome of the implant biopsy identifies donor kidneys at increased risk of delayed graft function.

Improved assessment of donor organ quality at time of transplantation would help in management of potentially usable organs. The transcriptome might correlate with risk of delayed graft function (DGF) better than conventional risk factors. Microarray results of 87 consecutive implantation biopsies taken postreperfusion in 42 deceased (DD) and 45 living (LD) donor kidneys were compared to clinical and histopathology-based scores. Unsupervised analysis separated the 87 kidneys into three groups: LD, DD1 and DD2. Kidneys in DD2 had a greater incidence of DGF (38.1 vs. 9.5%, p < 0.05) than those in DD1. Clinical and histopathological risk scores did not discriminate DD1 from DD2. A total of 1051 transcripts were differentially expressed between DD1 and DD2, but no transcripts separated DGF from immediate graft function (adjusted p < 0.01). Principal components analysis revealed a continuum from LD to DD1 to DD2, i.e. from best to poorest functioning kidneys. Within DD kidneys, the odds ratio for DGF was significantly increased with a transcriptome-based score and recipient age (p < 0.03) but not with clinical or histopathologic scores. The transcriptome reflects kidney quality and susceptibility to DGF better than available clinical and histopathological scoring systems.

Mathematical-statistical models of generated hazardous hospital solid waste.

This research work was carried out under the assumption that wastes generated from hospitals in Irbid, Jordan were hazardous. The hazardous and non-hazardous wastes generated from the different divisions in the three hospitals under consideration were not separated during collection process. Three hospitals, Princess Basma hospital (public), Princess Bade'ah hospital (teaching), and Ibn Al-Nafis hospital (private) in Irbid were selected for this study. The research work took into account the amounts of solid waste accumulated from each division and also determined the total amount generated from each hospital. The generation rates were determined (kilogram per patient, per day; kilogram per bed, per day) for the three hospitals. These generation rates were compared with similar hospitals in Europe. The evaluation suggested that the current situation regarding the management of these wastes in the three studied hospitals needs revision as these hospitals do not follow methods of waste disposals that would reduce risk to human health and the environment practiced in developed countries. Statistical analysis was carried out to develop models for the prediction of the quantity of waste generated at each hospital (public, teaching, private). In these models number of patients, beds, and type of hospital were revealed to be significant factors on quantity of waste generated. Multiple regressions were also used to estimate the quantities of wastes generated from similar divisions in the three hospitals (surgery, internal diseases, and maternity).

Assessment of toxic potential of local Jordanian Bacillus thuringiensis strains on Drosophila melanogaster and Culex sp. (Diptera).

AIMS: To assess the toxic potential of different local Jordanian Bacillus thuringiensis isolates on larvae of Drosophila melanogaster and Culex sp. METHODS AND RESULTS: Scanning electron microscopy revealed the presence of spherical, bi-pyramidal, and bi-pyramidal and cuboidal parasporal bodies produced by the toxic isolates. Spherical inclusions dominated. The toxicity of the isolates to the two insects, determined using 24-well plates or vials, indicated that the 50% lethal concentration (LC50) of the bacterial suspension for D. melanogaster and Culex sp. larvae varied from 4.60 to 8.65, and from 5.30 to 6.74, respectively. CONCLUSION: Comparison of the LC50 values of isolate 82 with those of the reference strain B. t. israelensis showed that this isolate has a higher toxicity potential. SIGNIFICANCE AND IMPACT OF THE STUDY: Some local Jordanian B. thuringiensis isolates exhibit toxic potential that could be used to control some important pests, and could replace chemical pesticides.

Diversity of Bacillus thuringiensis in different habitats of northern Jordan.

A survey of Bacillus thuringiensis was conducted for 17 locations in Northern Jordan representing 12 different habitats. Eighty isolates were identified as B. thuringiensis in the majority of the tested samples. Results showed that soils contaminated with the slaughterhouses waste materials had the highest content of spore-forming bacteria [(4.05-2.2) 10(7) CFU/g)] and B. thuringiensis [(4.05-7.9) 10(7) CFU/g)] with a (5.5%-14.9%) and (5.2%-7.7%) of the total viable bacterial count, respectively. These bacteria were more abundant in soils contaminated with such animal by-products.

Developmental studies on Drosophila melanogaster glutathione S-transferase and its induction by oxadiazolone.

Glutathione S-transferase activity toward 1-chloro-2,4-dinitrobenzene was detected in various developmental stages of Drosophila melanogaster. The specific activity of the enzyme was 110, 35, 25 and 15 nmol/min/mg protein in crude extracts prepared from eggs, larvae, pupae and adult stages respectively. The enzymes from larval, pupal and adult stages were purified and compared. Incorporation of the widely used herbicide oxadiazolone at concentrations of 375 and 563 part/million into the culture media caused 4- and 2.5-fold increase in the enzyme activity in pupal and adult stages respectively.