Metabarcoding of pathogenic parasites based on copro-DNA analysis of wild animals in South Korea.

Four species of dominant wild animals, namely, Prionailurus bengalensis euptilurus, Nyctereutes procyonoides koreensis, Hydropotes inermis argyropus, and Sus scrofa coreanus, are hosts of potential infectious agents, including helminths and protozoa. Therefore, it is necessary to analyze the infectious agents present in these wild animals to monitor and control the spread of pathogens. In the present study, fecal samples from 51 wild animals were collected from the mountains of Yangpyeong, Hoengseong, and Cheongyang in South Korea and metabarcoding of the V9 region of the 18S rRNA gene was performed to identify various parasite species that infect these wild animals. Genes from nematodes, such as Metastrongylus sp., Strongyloides spp., Ancylostoma sp., and Toxocara sp., were detected in the fecal samples from wild animals. In addition, platyhelminthes, including Spirometra sp., Echinostomatidae gen. sp., Alaria sp., Neodiplostomum sp., and Clonorchis sp., and protozoa, including Entamoeba sp., Blastocystis sp., Isospora sp., Tritrichomonas sp., Pentatrichomonas sp., and Cryptosporidium sp., were detected. In the present study, various parasites infecting wild animals were successfully identified using metabarcoding. Our technique may play a crucial role in monitoring parasites within wild animals, especially those causing zoonoses.

Synthesis of 2,3-Benzotropones via Palladium(II)-Catalyzed Aerobic Dehydrogenation from 1-Benzosuberones and Sequential Diels-Alder Reaction to Yield Benzobicyclo[3.2.2]nonenones.

An approach to 2,3-benzotropone from 1-benzosuberone via palladium(II)-catalyzed aerobic dehydrogenation was developed. This method first provided a catalytic route to various 2,3-benzotropones from their corresponding 1-benzosuberones in good yields. In addition, the reaction could be applied to a one-pot Diels-Alder reaction with maleimide, providing a complex benzobicyclo[3.2.2]nonenone in ≤90% yield. Kinetic analysis supporting our proposed mechanism was also performed, underscoring the robustness of the developed synthetic pathway.

Gut microbiota differences induced by Toxoplasma gondii seropositivity in stray cats in South Korea.

T. gondii is a highly prevalent parasite worldwide, with cats serving as its final host. However, few studies have investigated the impact of T. gondii infection on cat gut microbiota. Therefore, this study examined the influence of T. gondii infection on the gut microbiota of stray cats and identified potential pathogens in their feces. This study examined T. gondii infection through blood of stray cats and the influence of microbiota in their feces using 16S rRNA gene amplicon sequencing. The results revealed significant differences in gut microbiota composition and diversity between the T. gondii seropositive and seronegative groups. Seropositive samples displayed a lower number of operational taxonomic units and reduced Shannon index than the seronegative samples. The seropositive and seronegative groups exhibited enrichment of taxa, including Escherichia and Enterobacteriaceae and Collinsella, Bifidobacterium, and Roseburia, respectively. Furthermore, potential pathogen species, including Campylobacter, Escherichia, and Streptococcus, were identified in the fecal samples. These findings suggest that T. gondii infection significantly impacts gut microbiota composition and diversity in stray cats. Additionally, an increased potential pathogen load, represented by Escherichia spp., was observed. These results underscore the importance of monitoring the prevalence of zoonotic pathogens in stray cats, as they can serve as reservoirs for zoonotic diseases.

Ampicillin treated German cockroach extract leads to reduced inflammation in human lung cells and a mouse model of Asthma.

Cockroaches can cause allergic sensitization in humans via contact with their feces or frass. Antibiotics can affect concentration of major allergen and total bacteria production in German cockroaches (Blattella germanica). This study examined the ability of antibiotic-treated German cockroaches to induce allergic airway inflammation and the effect of antibiotics on their lipopolysaccharide and Bla g1, 2, and 5 expression levels. Specifically, we measured the ability of German cockroach extract (with or without prior antibiotic exposure) to induce allergic inflammation in human bronchial epithelial cells and a mouse model of asthma. Bacterial 16S rRNA and lipopolysaccharide levels were lower in ampicillin-treated cockroaches than in the control group. The Bla g1, Bla g2, and Bla g5 expression in ampicillin-treated cockroaches decreased at both the protein and RNA levels. In human bronchial epithelial cell lines BEAS-2B exposed to the ampicillin-treated extract, expression levels of interleukin-6 and interleukin-8 were lower than that in the control group. The total cell count and eosinophil count in bronchoalveolar lavage fluid was also lower in mice exposed to the ampicillin-treated extract than in those exposed to normal cockroach extract. Mouse lung histopathology showed reduced immune cell infiltration and mucus production in the ampicillin group. Our results showed that ampicillin treatment reduced the symbiont bacterial population and major allergen levels in German cockroaches, leading to reduced airway inflammation in mice. These results can facilitate the preparation of protein extracts for immunotherapy or diagnostics applications.

The microbiota in feces of domestic pigeons in Seoul, Korea.

In Korea, feral pigeons pose significant public health risks because they carry various zoonotic pathogens. Human population density is a significant factor in zoonotic disease events. Seoul is one of the largest cities by population density among developed countries and where most of the homeless population in Korea exists. We designed this study to compare the microbiota of pigeon feces by regional characteristics and the presence of homeless individuals. Therefore, this study used 16S rRNA amplicon sequencing to detect possible pathogenic microbes and assess the current risk of zoonosis in Seoul, South Korea. Pigeon fecal samples (n = 144) obtained from 19 public sites (86 and 58 fecal samples from regions in and outside Seoul, respectively) were examined. Potentially pathogenic bacteria were also detected in the fecal samples; Campylobacter spp. was found in 19 samples from 13 regions, Listeriaceae was found in seven samples, and Chlamydia spp. was found in three samples from two regions. Principal coordinates analysis and permutational multivariate analysis of variance revealed a significant difference in bacterial composition between the regions in Seoul (n = 86) and outside Seoul (n = 58) and between the regions with (n = 81) and without (n = 63) homeless individuals. Overall, this study identified various potentially pathogenic microorganisms in pigeon feces at public sites in South Korea. Moreover, this study demonstrates that the microbial composition was influenced by regional characteristics and homelessness. Taken together, this study provides important information for public health strategic planning and disease control.

A Study on mPPO Development and Injection Molding Process for Lightweight Stack Enclosure of FCEV.

The automobile industry is focused on eco-friendly vehicles with the goal of carbon neutrality (Netzero), and vehicle weight reduction is essential to achieve high fuel efficiency for driving performance and distance compared to internal combustion engines. This is important for the light-weight stack enclosure of FCEV. Moreover, mPPO needs to be developed with injection molding for the replacement of existing material (aluminum). For this purpose, this study develops mPPO and presents it through physical property tests, predicts the injection molding process flow system for stack enclosure production, proposes injection molding process conditions to secure productivity, and verifies conditions through mechanical stiffness analysis. As a result of the analysis, the runner system with pin-point gate and tab gate's sizes are proposed. In addition, injection molding process conditions were proposed with the results of cycle time 107.627 s and reduced weld lines. As a result of the strength analysis, it can withstand the load 5933 kg. Therefore, it is possible to reduce weight and material costs using the mPPO existing manufacturing process with existing aluminum, and it is expected that there would be effects, such as reducing the production cost by securing productivity through reducing cycle time.

Glucose Regulation after Partial Pancreatectomy: A Comparison of Pancreaticoduodenectomy and Distal Pancreatectomy in the Short and Long Term

Background@#Long term quality of life is becoming increasingly crucial as survival following partial pancreatectomy rises. The purpose of this study was to investigate the difference in glucose dysregulation after pancreaticoduodenectomy (PD) or distal pancreatectomy (DP). @*Methods@#In this prospective observational study from 2015 to 2018, 224 patients who underwent partial pancreatectomy were selected: 152 (67.9%) received PD and 72 (32.1%) received DP. Comprehensive assessment for glucose regulation, including a 75 g oral glucose tolerance test was conducted preoperatively, and 1, 12, and 52 weeks after surgery. Patients were further monitored up to 3 years to investigate development of new-onset diabetes mellitus (NODM) in patients without diabetes mellitus (DM) at baseline or worsening of glucose regulation (≥1% increase in glycosylated hemoglobin [HbA1c]) in those with preexisting DM. @*Results@#The disposition index, an integrated measure of β-cell function, decreased 1 week after surgery in both groups, but it increased more than baseline level in the PD group while its decreased level was maintained in the DP group, resulting in a between-group difference at the 1-year examination (P<0.001). During follow-up, the DP group showed higher incidence of NODM and worsening of glucose regulation than the PD group with hazard ratio (HR) 4.29 (95% confidence interval [CI], 1.49 to 12.3) and HR 2.15 (95% CI, 1.09 to 4.24), respectively, in the multivariate analysis including dynamic glycemic excursion profile. In the DP procedure, distal DP and spleen preservation were associated with better glucose regulation. DP had a stronger association with glucose dysregulation than PD. @*Conclusion@#Proactive surveillance of glucose dysregulation is advised, particularly for patients who receive DP.

Comparison of the efficacy and safety between a new monophasic hyaluronic acid filler and a biphasic hyaluronic acid filler in correcting facial wrinkles

Background@#The longstanding and common use of hyaluronic acid (HA) has driven the expanded development of various commercial HA fillers. However, differences in the components of these HA fillers lead to variations in their effect. We compared the in vivo safety and efficacy of biphasic HA (BHA) and a new monophasic HA (MHA) for improving facial wrinkles. We investigated differences in outcomes after their injection into nasolabial folds (NLFs) using the Wrinkle Severity Rating Scale (WSRS), patient satisfaction using the Global Aesthetic Improvement Scale (GAIS), and pain using a visual analog scale (VAS). We also performed a safety assessment of the two fillers. @*Methods@#This matched-pair, double-blind, randomized study compared the degree of temporal wrinkle improvement in the NLFs of 91 participants using the BHA filler versus the new MHA filler. Safety and efficacy were compared at 8 and 24 weeks. @*Results@#At 24 weeks after application, the average WSRS scores were 2.17±0.72 (BHA) and 2.07±0.71 (MHA) (P=0.034). The average GAIS scores, as measured by a treating investigator at 8 weeks and 24 weeks, were 0.94±0.76 (BHA) and 0.98±0.78 (MHA) at 8 weeks (P=0.181), and 0.44±0.64 (BHA) and 0.49±0.69 (MHA) at 24 weeks (P=0.103). The VAS pain score was 0 points at 30 minutes after filler application in both groups. @*Conclusions@#Both the BHA filler and the new MHA filler were safe and effective for improving facial wrinkles in NLFs, but the new MHA filler was more effective for the cosmetic improvement of wrinkle severity than the BHA filler.

Genetic variations in HMGCR and PCSK9 and kidney function: a Mendelian randomization study

Background@#The genetically predicted lipid-lowering effect of HMGCR or PCSK9 variant can be used to assess drug proxy effects on kidney function. @*Methods@#Mendelian randomization (MR) analysis-identified HMGCR and PCSK9 genetic variants were used to predict the low-density lipoprotein (LDL) cholesterol-lowering effects of medications targeting related molecules. Primary summary-level outcome data for log-estimated glomerular filtration rate (eGFR; creatinine) were provided by the CKDGen Consortium (n = 1,004,040 European) from a meta-analysis of CKDGen and UK Biobank data. We also conducted a separate investigation of summary-level data from CKDGen (n = 567,460, log-eGFR [creatinine]) and UK Biobank (n = 436,581, log-eGFR [cystatin C]) samples. Summary-level MRs using an inverse variance weighted method and pleiotropy-robust methods were performed. @*Results@#Summary-level MR analysis indicated that the LDL-lowering effect predicted genetically by HMGCR variants (50-mg/dL decrease) was significantly associated with a decrease in eGFR (–1.67%; 95% confidence interval [CI], –2.20% to –1.13%). Similar significance was found in results from the pleiotropy-robust MR methods when the CKDGen and UK Biobank data were analyzed separately. However, the LDL-lowering effect predicted genetically by PCSK9 variants was significantly associated with an increase in eGFR (+1.17%; 95% CI, 0.10%–2.25%). The results were similarly supported by the weighted median method and in each CKDGen and UK Biobank dataset, but the significance obtained by MR-Egger regression was attenuated. @*Conclusion@#Genetically predicted HMG-CoA reductase inhibition was associated with low eGFR, while genetically predicted PCSK9 inhibition was associated with high eGFR. Clinicians should consider that the direct effect of different types of lipid-lowering medication on kidney function can vary.

Urine myo-inositol as a novel prognostic biomarker for diabetic kidney disease: a targeted metabolomics study using nuclear magnetic resonance

As a leading cause of chronic kidney disease, clinical demand for noninvasive biomarkers of diabetic kidney disease (DKD) beyond proteinuria is increasing. Metabolomics is a popular method to identify mechanisms and biomarkers. We investigated urinary targeted metabolomics in DKD patients. Methods: We conducted a targeted metabolomics study of 26 urinary metabolites in consecutive patients with DKD stage 1 to 5 (n = 208) and healthy controls (n = 26). The relationships between estimated glomerular filtration rate (eGFR) or urine protein-creatinine ratio (UPCR) and metabolites were evaluated. Multivariate Cox analysis was used to estimate relationships between urinary metabolites and the target outcome, end-stage renal disease (ESRD). C statistics and time-dependent receiver operating characteristics (ROC) were used to assess diagnostic validity. Results: During a median 4.5 years of follow-up, 103 patients (44.0%) progressed to ESRD and 65 (27.8%) died. The median fold changes of nine metabolites belonged to monosaccharide and tricarboxylic acid (TCA) cycle metabolites tended to increase with DKD stage. Myo-inositol, choline, and citrates were correlated with eGFR and choline, while mannose and myo-inositol were correlated with UPCR. Elevated urinary monosaccharide and TCA cycle metabolites showed associations with increased morality and ESRD progression. The predictive power of ESRD progression was high, in the order of choline, myo-inositol, and citrate. Although urinary metabolites alone were less predictive than serum creatinine or UPCR, myo-inositol had additive effect with serum creatinine and UPCR. In time-dependent ROC, myo-inositol was more predictive than UPCR of 1-year ESRD progression prediction. Conclusion: Myo-inositol can be used as an additive biomarker of ESRD progression in DKD.

Considerations on ABO Genotyping Results: Lessons from ABO*AW.10 Allele Cases / 대한수혈학회지

We would like to introduce domestic subscribers of the Korean Journal of Blood Transfusion to the important aspects to be considered while selecting a reference allele and reporting a new allele candidate. ABO*A1.02 has only a single nucleotide substitution of c.467C＞T in ABO*A1.01, and when ABO*A1.01 is used as the reference allele, the ABO*AW.10 allele should be marked as having both c.467C＞T and c.784G＞A variants. Unfortunately, it has not been modified as such in the ISBT database. For this reason, in the journal Transfusion (2020), the official journal of the Association for the Advancement of Blood Biotherapies, there was a report of a new allele with c.467C＞T and c.784G＞A variants. Cases of ABO*AW.10 allele with a weak A phenotype are not uncommon in Koreans, and it is necessary to accurately mark the reference allele. The blood type A reference allele of the International Society of Blood Transfusion (ISBT) database currently used for ABO alleles reporting is based on ABO*A1.01. Therefore, it should be considered that the ABO*AW.10 allele has both the c.467C＞T and c.784G＞A variants together.

Effect of Lactobacillus plantarum LMT1-48 on Body Fat in Overweight Subjects: A Randomized, Double-Blind, Placebo-Controlled Trial

Background@#We investigated whether Lactobacillus plantarum strain LMT1-48, isolated from Korean fermented foods and newborn feces, is a suitable probiotic supplement to treat overweight subjects. @*Methods@#In this randomized, double-blind, placebo-controlled clinical trial, 100 volunteers with a body mass index of 25 to 30 kg/m2 were assigned randomly (1:1) to receive 2×1010 colony forming units of LMT1-48 or to a placebo treatment group. Body composition was measured by dual-energy X-ray absorptiometry, and abdominal visceral fat area (VFA) and subcutaneous fat area were measured by computed tomography scanning. Changes in body fat, VFA, anthropometric parameters, and biomarkers were compared between the two treatment groups (ClinicalTrials.gov number: NCT03759743). @*Results@#After 12 weeks of treatment, the body weight decreased significantly from 76.6±9.4 to 75.7±9.2 kg in the LMT1-48 group but did not change in the placebo group (P=0.022 between groups). A similar pattern was found in abdominal VFA between the two groups (P=0.041). Serum insulin levels, the corresponding homeostasis model assessment of insulin resistance, and leptin levels decreased in the LMT1-48 group but increased in the placebo group (all P<0.05). Decrease in body weight and body mass index by treatment with LMT1-48 was correlated with increase in Lactobacillus levels significantly. LMT1-48 also increased Oscillibacter levels significantly, which were negatively correlated with triglyceride and alanine transaminase levels. @*Conclusion@#Administration of LMT1-48 decreased body weight, abdominal VFA, insulin resistance, and leptin levels in these subjects with overweight, suggesting its anti-obesogenic therapeutic potential.

Synthesis of Xanthones via Copper(II)-Catalyzed Dehydrogenative Cyclization and Successive Aromatization in a One-Step Sequence.

In this study, an unprecedented approach to the xanthone scaffold from cyclohexyl(2-hydroxyphenyl)methanone via dehydrogenative cyclization and a successive aromatization cascade is reported. This methodology affords a novel route to the privileged structure with a wide substrate scope (a total of 29 compounds, ≤96% yield) in a highly atom-economic manner.

Metabarcoding of bacteria and parasites in the gut of Apodemus agrarius.

BACKGROUND: The striped field mouse Apodemus agrarius is a wild rodent commonly found in fields in Korea. It is a known carrier of various pathogens. Amplicon-based next-generation sequencing (NGS) targeting the 16S ribosomal RNA (rRNA) gene is the most common technique used to analyze the bacterial microbiome. Although many bacterial microbiome analyses have been attempted using feces of wild animals, only a few studies have used NGS to screen for parasites. This study aimed to rapidly detect bacterial, fungal and parasitic pathogens in the guts of A. agrarius using NGS-based metabarcoding analysis. METHODS: We conducted 18S/16S rDNA-targeted high-throughput sequencing on cecal samples collected from A. agrarius (n = 48) trapped in May and October 2017. Taxa of protozoa, fungi, helminths and bacteria in the cecal content were then identified. RESULTS: Among the protozoa identified, the most prevalent was Tritrichomonas sp., found in all of the cecal samples, followed by Monocercomonas sp. (95.8% prevalence; in 46/48 samples) and Giardia sp. (75% prevalence; in 36/48 samples). For helminths, Heligmosomoides sp. was the most common, found in 85.4% (41/48) of samples, followed by Hymenolepis sp. (10.4%; 5/48) and Syphacia sp. (25%; 12/48). The 16S rRNA gene analysis showed that the microbial composition of the cecal samples changed by season (P = 0.005), with the linear discriminant analysis effect size showing that in the spring Escherichia coli and Lactobacillus murinus were more abundant and Helicobacter rodentium was less abundant. Helicobacter japonicus was more abundant and Prevotella_uc was less abundant in males. The microbial composition changed based on the Heligmosomoides sp. infection status (P = 0.019); specifically, Lactobacillus gasseri and Lactobacillus intestinalis were more abundant in the Heligmosomoides sp.-positive group than in the Heligmosomoides sp.-negative group. CONCLUSIONS: This study demonstrated that bacterial abundance changed based on the season and specific parasitic infection status of the trapped mice. These results highlight the advantages of NGS technology in monitoring zoonotic disease reservoirs.

Immunoglobulin somatic hypermutation in a defined biochemical system recapitulates affinity maturation and permits antibody optimization.

We describe a purified biochemical system to produce monoclonal antibodies (Abs) in vitro using activation-induced deoxycytidine deaminase (AID) and DNA polymerase η (Polη) to diversify immunoglobulin variable gene (IgV) libraries within a phage display format. AID and Polη function during B-cell affinity maturation by catalyzing somatic hypermutation (SHM) of immunoglobulin variable genes (IgV) to generate high-affinity Abs. The IgV mutational motif specificities observed in vivo are conserved in vitro. IgV mutations occurred in antibody complementary determining regions (CDRs) and less frequently in framework (FW) regions. A unique feature of our system is the use of AID and Polη to perform repetitive affinity maturation on libraries reconstructed from a preceding selection step. We have obtained scFv Abs against human glucagon-like peptide-1 receptor (GLP-1R), a target in the treatment of type 2 diabetes, and VHH nanobodies targeting Fatty Acid Amide Hydrolase (FAAH), involved in chronic pain, and artemin, a neurotropic factor that regulates cold pain. A round of in vitro affinity maturation typically resulted in a 2- to 4-fold enhancement in Ab-Ag binding, demonstrating the utility of the system. We tested one of the affinity matured nanobodies and found that it reduced injury-induced cold pain in a mouse model.

Novel Dimer Derivatives of PF-543 as Potential Antitumor Agents for the Treatment of Non-Small Cell Lung Cancer.

Lung cancer can be divided into non-small cell lung cancer (NSCLC) and small cell lung cancer, and the incidence and mortality rate are continuously increasing. In many cases, lung cancer cannot be completely treated with surgery, so chemotherapy is used in parallel; however, the treatment often fails due to drug resistance. Therefore, it is necessary to develop a new therapeutic agent with a new target. The expression of sphingosine kinase promotes cancer cell growth and survival and induces resistance to chemotherapeutic agents. Sphingosine-1-phosphate (S1P), produced by sphingosine kinase (SK), has been shown to regulate cancer cell death and proliferation. PF-543, currently known as an SK inhibitor, has been reported to demonstrate low anticancer activity in several cancers. Therefore, in this study, a derivative of PF-543 capable of increasing anticancer activity was synthesized and its efficacy was evaluated by using an NSCLC cell line and xenograft animal model. Based on the cytotoxic activity of the synthesized compound on lung cancer cells, the piperidine forms (Compounds 2 and 4) were observed to exhibit superior anticancer activity than the pyrrolidine forms of the head group (Compounds 1 and 3). Compounds 2 and 4 showed inhibitory effects on SK1 and SK2 activity, and S1P produced by SK was reduced by both compounds. Compounds 2 and 4 demonstrated an increase in the cytotoxicity in the NSCLC cells through increased apoptosis. As a result of using an SK1 and SK2 siRNA model to determine whether the cytotoxic effects of Compounds 2 and 4 were due to SK1 and SK2 inhibition, it was found that the cytotoxic effect of the derivative was SK1 and SK2 dependent. The metabolic stability of Compounds 2 and 4 was superior compared to PF-543, and the xenograft experiment was performed using Compound 4, which had more excellent MS. Compound 4 demonstrated the inhibition of tumor formation. The results of this experiment suggest that the bulky tail structure of PF-543 derivatives is effective for mediating anticancer activity, and the results are expected to be applied to the treatment of NSCLC.

Utility of Bioelectrical Impedance Analysis for Body Composition Assessment / 임상당뇨병

People with obesity are at high risk of type 2 diabetes, cardiovascular diseases, and certain types of malignancy. A significant reduction in muscle mass is also associated with increased risk of developing sarcopenia. In general, body composition is affected by several factors, including ethnicity, environment, genetics, and lifestyle patterns. Assessment of body composition is an important tool for maintaining good general health and longevity, and is utilized by physicians and researchers to monitor disease severity and nutritional status. It can also be used to monitor the effectiveness of dietary and drug interventions. Dual energy X-ray absorptiometry is regarded as the gold standard method for analyzing body composition. However, there is an associated risk of a small amount of radiation exposure. In addition, severely obese people are not candidates for this method. Recently, bioelectrical impedance analysis (BIA) has been developed. BIA poses no radiation hazard, is easy applicable and relatively inexpensive. Thus, BIA is widely used in fitness centers as well as in hospitals. Several studies have been conducted to assess the effectiveness of BIA for measuring body composition, but most have focused on subjects of European descent. Of note, body composition differs among ethnic groups: Asians have a greater tendency toward obesity at a lower body mass index than Caucasians. Therefore, an ethnicity-specific approach is required for precise estimation of body composition using BIA. In conclusion, healthcare providers should have a thorough understanding of body composition assessment and the advantages and disadvantages of different measurement methods.

Risk factors for the deterioration of patients with mild COVID-19 admitted to a COVID-19 community treatment center

Background@#The rapid increase in the number of coronavirus disease (COVID-19) patients led to the operation of COVID-19 facilities for patients with mild COVID-19 in South Korea. We analyzed the correlation and effect of risk factors associated with the worsening of patients with mild COVID-19 leading to their transfer from a community treatment center to a hospital. @*Methods@#This retrospective cohort observational study included 1,208 COVID-19 patients with mild symptoms who were admitted to the Namsan Community Treatment Center between June 2020 and January 2021. A chi-square test was performed to examine the differences in the transfer rate by age, sex, nationality, presence of symptoms at admission, and season, and a multivariable logistic regression analysis was performed to examine the association of variables to the hospitalization rate. @*Results@#Of the 1,208 patients, 212 (17.5%) were transferred to a hospital due to clinical deterioration. Increasing odds of hospital transfer were associated significantly with higher age and presentation in autumn, whereas sex and symptomatic illness at admission did not show a statistically significant association. @*Conclusion@#The findings indicate the importance of the initial risk classification of COVID-19 patients based on thorough assessment and close monitoring, timely allocation of appropriate resources to high-risk groups that are likely to develop severe disease, and reduction of medical resource wastage and limiting of administrative force to ensure that patients receive the best treatment.

Association between obesity and COVID-19

Since December 2019, most countries have struggled with the novel coronavirus, severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). During the coronavirus disease-2019 (COVID-19) pandemic, weight gain became prevalent because the preventive measures against the spread of SARS-CoV-2 infection resulted in decreased physical activity and increased consumption of unhealthy food among the general public.Current Concepts: Several mechanisms have been proposed for the association between obesity and COVID-19. SARS-CoV-2 infection aggravates inflammation and hypoxia in obese people, which can lead to severe COVID-19 disease. COVID-19 affects the immune system, resulting in various complications. Several cytokines, including interleukin-6, are integral to the progression of COVID-19. Thus, COVID-19-associated inflammation and immune dysfunction predispose patients to the complications of obesity, such as cardiovascular diseases and diabetes mellitus.Discussion and Conclusion: Obese patients are commonly prescribed antidiabetic agents, blood pressure lowering medications, and lipid-lowering medications such as statins. The routine intake of these drugs is a protective factor against all-cause mortality. During the COVID-19 pandemic, preventive measures, such as minimizing team sports and closing public exercise facilities, might have contributed to the weight gain in obese individuals. Thus, an active lifestyle with regular home exercise and a healthy diet should be advised for obese patients.

Primary non-Hodgkin lymphoma of the parotid gland: a case report

Most malignant lymphomas of the head and neck region are non-Hodgkin lymphomas (NHL), and diffuse large B-cell lymphoma is the most common subtype. The prevalence of malignant lymphoma among parotid tumors is low, approximately 1% to 4%. The most common symptom of parotid lymphoma is a unilateral, non-tender, firm mass that slowly grows in size over time. As its clinical manifestations are non-specific, a comprehensive assessment is required for an accurate diagnosis. The initial work-up includes imaging tools, such as computed tomography and magnetic resonance imaging. However, NHL of the parotid gland is difficult to distinguish from other types of benign tumors prior to biopsy; histopathological evaluation and subsequent immunohistochemical staining are needed for the final diagnosis. Once a definitive diagnosis is established, patients should be referred to an oncologist for staging. Treatment is mainly based on systemic chemotherapy, whereas radiotherapy is indicated for certain cases. Here, we report the case of a 53-year-old man who presented with a progressively enlarging mass in the right parotid area, which was later diagnosed as malignant lymphoma of the parotid gland after superficial parotidectomy.