"They Protect us as if they were our Mom" Masking Attitudes from Freelist Survey Data and Qualitative Interviews in San Diego School Communities.

BACKGROUND: Despite being disproportionately impacted by COVID-19 due to a lack of structural support, marginalized communities have been largely ignored in the politically polarized debate over school masking. In response to this, we sought to explore masking attitudes by centering the voices of parents and children at historically marginalized, predominantly Hispanic schools in southern California. METHODS: We conducted a mixed-methods study with parents and children attending 26 low-income predominantly Hispanic-serving elementary schools. A random sample of parents was asked to provide a freelist of words they associate with masking. A subset of parents with children aged 4-6 was recruited from these surveys to participate in parent-child interviews (PCI). We calculated Smith's salience index for all unique items, stratifying by language (English/Spanish). Item salience guided PCI thematic analysis for additional context and meaning. RESULTS: 648 participants provided 1118 unique freelist items in English and Spanish. 19 parent-child pairs were interviewed, 11 in Spanish and 8 in English. The most salient words were "safety"(0.37), "protection"(0.12), "prevention"(0.05), "health"(0.04), "good"(0.03), "can't breathe"(0.03), "necessary"(0.02), "care"(0.02), "precaution"(0.02), and "unnecessary"(0.02). Spanish speakers had a more favorable view of masking than English speakers, particularly regarding "protection" (0.20 vs 0.08) and "prevention" (0.10 vs 0.02). DISCUSSION: Masking is an affordable individual-level risk mitigation that protects the communities that have inequitably shouldered the burdens of the COVID-19 pandemic. We recommend that policymakers prioritize the views of those most impacted when deciding on risk mitigation policies like school masking.

PCR-RFLP Analysis of Insulin-Like Growth Factor 2 Gene Polymorphisms in Two Commercial Broiler Chicken Strains (Cobb 500 and Hubbard F-15) and Their Associations with Performance Traits.

The present research aimed to study the polymorphisms of the chicken insulin-like growth factor 2 (IGF2) in two commercial broiler breeds (Cobb 500 and Hubbard F-15). In total, 300 avian blood samples were obtained. The genomic DNA was isolated using a fast salt-extraction technique. Moreover, polymerase chain reaction (PCR) was used to amplify 1146 bp fragments of the gene. The amplified fragments were subjected to restriction enzyme digestion using the HinfI endonuclease enzyme, and the digested products were separated on a 2% agarose gel. The findings indicated that there were two alleles T and C for the target locus, with frequencies of 73.3% and 26.7%, respectively. Three distinct genotype variations, TT, TC, and CC, were found, with genotype frequencies of 59.1%, 28.4%, and 12.5%, respectively. A test based on actual and anticipated frequencies of various genotypic variances of the IGF2 gene revealed that the divergence from Hardy-Weinberg equilibrium was not significant (P≤0.01) in commercial broiler breeds (Cobb 500 and Hubbard F-15) chickens. In addition, it was found that birds with genotype TC had a greater body mass at 8 weeks of age, compared to those with genotypes TT and CC. It was determined that the IGF2 gene exhibited a significant degree of variability and might be regarded as a possible genetic marker in selection and breeding programs for poultry.

Assessing the diagnostic accuracy and interobserver agreement of MRI perfusion in differentiating disease progression and pseudoprogression following treatment for glioblastoma in a tertiary UK centre.

AIM: To assess the local diagnostic accuracy and interobserver agreement of dynamic susceptibility contrast-enhanced magnetic resonance perfusion (DSC MRP) reporting in differentiating between disease progression and pseudoprogression (PP) at a tertiary UK centre. MATERIALS AND METHODS: This retrospective study included adults with histology-proven glioblastoma who underwent an index DSC MRP examination following treatment. Each index examination was evaluated by three reporters independently, including qualitative assessment and measurement of mean regional cerebral blood volume (rCBVmean) ratios. Consensus opinion was used as the reference standard and considered clinical, radiological and histological follow-up information. Examination reports were compared to each other and to the consensus opinion. RESULTS: Thirty-two cases were included (19 progression, 13 pseudoprogression). Interobserver agreement was fair for qualitative opinion (κ=0.58, 95% confidence interval [CI] 0.40-0.76) and good for rCBVmean ratio measurement (intraclass correlation coefficient [ICC, two-way random effects model] 0.63, 95% CI=0.43-0.78). Qualitative opinion showed diagnostic accuracies of 77.1% (95% CI=67.4-85.1) for progression and 75% (95% CI=65.1-83.3) for pseudoprogression. rCBVmean ratios were higher for progression (6.85 ± 3.98) than pseudoprogression (3.71 ± 3.40); a 3.0 threshold value maximised the sum of sensitivity (91.1%) and specificity (69.7%) on receiver operating characteristic analysis. CONCLUSIONS: DSC MRP and rCBVmean ratio measurement aid differentiation between progression and pseudoprogression following treatment for glioblastoma. Measurement of the rCBVmean ratio shows good interobserver agreement and can change opinion and improve confidence in DSC MRP reporting. Individual centres should validate their own threshold rCBVmean ratio values to optimise diagnostic accuracy.

Shape transition and coalescence of Au islands on Ag (110) by molecular dynamics simulation.

We have used molecular dynamics simulations based on many body semi-empirical potentials described by the embedded atom method, to analyze and understand the diffusion and coalescence phenomena of Au-clusters during the heteroepitaxial growth on Ag (110) surface. Temperature ranging from 300 to 700 K were considered. In this study, we examined the heterogeneous system Aun/Ag(110), where n is the number of atoms in each cluster/island (with n = 15, ….35). Our results show that the clusters diffuse on the Ag (110) surface via different diffusion processes, namely, the exchange mechanism and the simple jump, which generate a 2D to 3D transition. Formation and adsorption energies of clusters with different sizes have been computed using static simulations. The dynamic study of coalescence for two islands of system Au15; Au0 - 9/Ag(110) at different temperatures makes it possible to deduce the detail of cluster shape and the influence of its temperature on the stability of the system and its growth during this evolution.

The investigation of biological removal of nitrogen and phosphorous from domestic wastewater by inserting anaerobic/anoxic holding tank in the return sludge line of MLE-OSA modified system.

In this study, the biological removal of nitrogen and phosphorous (BNR) was investigated by applying modified MLE-OSA technique. To conduct this study, three pilot plants scale were designed and established: 1) MLE similar to the current method used in Sari Wastewater Treatment Plant as control reactor 2) MLE-OSA4 with 4-h hydrolic retention time in sludge holding tank 3) MLE-OSA6 with 6-h hydrolic retention time in sludge holding tank. In this modified process for combining OSA technique with MLE system, two anaerobic/anoxic tanks were installed in the return sludge line with capacities of 70 and 107 l for MLE-OSA4 and MLE-OSA6, respectively. To set up the process, outlet sewage of the primary settlement tank of Sari Wastewater Treatment Plant was used. After a period of 45-60 days and reaching the steady state, the reactors were operated and the main, controllable parameters and laboratory experiments such as DO, ORP, Temperature, pH, COD, BOD5, MLSS, and nutrients (N&P) were precisely analyzed according to standard methods for examination of water and wastewater. The results showed that utilizing MLE-OSA system with 4 and 6 h hydraulic retention times decreased the ORP by around 109 ± 9 to 160 ± 25 mv and increased sludge retention time from 29 to 33 days. Moreover the percentages of phosphorus removal efficiency in MLE, MLE-OSA4 and MLE-OSA6 processes were 31 ± 5.2, 36.8 ± 1.9, and 39.4 ± 1.9 and the percentages of total nitrogen removal efficiency were 67.2 ± 7.6, 75.6 ± 4.8, and 78.5 ± 2.2 respectively. This study revealed that the modified MLE-OSA is more efficient than MLE for P and N removal. Hence it can replace this process.

BK Virus Associated Haemorrhagic Cystitis. A systematic review of current prevention and treatment strategies.

BACKGROUND: BK virus is a major cause of late onset haemorrhagic cystitis in patients undergoing Haematopoietic Cell Transplantation (HCT). The evidence for the management of BK Virus Associated Haemorrhagic Cystitis (BKV-HC) is limited. Much of the published data consists of non-randomised case series and case reports. To our knowledge this is the first systematic review for the management of BKV-HC in both paediatric and adult populations. Our primary outcome was to examine the evidence for strategies of 1) prevention and 2) cessation of haematuria associated with BKV. Secondary outcomes were to assess the toxicity of treatment strategies and devise management recommendations for clinicians. MATERIALS AND METHODS: We performed a systematic review of the PubMed and Central databases to evaluate the current evidence. A search protocol was prepared and registered with the PROSPERO database (CRD42017082442). The review was conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement and AMSTAR (Assessing the methodological quality of systematic reviews) guidelines. Results were classified by treatment type. Qualitative analysis of included articles was performed, and grades of recommendations were devised for each treatment. RESULTS: Of 896 titles screened, 44 articles were included for qualitative analysis. The overall quality of evidence was low. There is insufficient evidence to recommend prophylactic quinolones. 40 studies evaluated treatments for established BKV-HC. There are no high-quality comparative studies. Cidofovir is the most studied treatment but quality of evidence is low, and grade of recommendation is weak. Hyperbaric oxygen therapy, Fibrin glue, Leflunomide, Sodium Pentosan Polysulfate, Intravesical Alum and Radiological embolisation have all been described but the effectiveness of these treatments is unclear. CONCLUSION: There remains no clear specific treatment for BKV-HC. An effective multi-disciplinary approach leading to early recognition and initiation of treatment is encouraged. The development of novel therapies followed by well-designed clinical studies are urgently needed.

Preparation and characterization of chitosan/Fe2O3 nano composite for the adsorption of thorium (IV) ion from aqueous solution.

In this study, novel chitosan/Fe2O3nano composite Ch/Fe-Onc was synthesized and evaluated as an adsorbent for removing thorium (IV) (Th4+) ion from aqueous solution. The Ch/Fe-Onc was characterized by X-ray diffraction (XRD), Brunauer-Emmett-Teller (BET), Fourier transform infrared (FTIR) and scanning electron microscopy (SEM). Response surface methodology (RSM) was used in the optimization of Th4+ adsorption for parameters such as pH, the initial metal ion concentration (Th4+ concentration) and contact time. The statistical measures (i.e. analysis of variance, R2, the lack of fit test and the P value) specify that the developed model is proper. Furthermore, the adsorption kinetics was well defined by the pseudo-second-order equation, while the adsorption isotherms were better fitted by the Langmuir model. The adsorption capacity of Ch/Fe-Onc was 430 mg Th4+g-1 composite which leads to 99% removal at 25 °C. Moreover, thermodynamic parameters which state the natural and endothermic nature of the reactions were determined. The loaded Th4+ can be easily regenerated with HNO3 and the Ch/Fe-Onc can be used repeatedly without any significant reduction in its adsorption capacity. The desorption level of Th4+ from the Ch/Fe-Onc by using 0.1 M HNO3, was more than 95%.

[Impact of mitral annuloplasty combined with surgical revascularization in ischemic mitral regurgitation]. / Impact de l'annuloplastie mitrale combinée à la revascularisation chirurgicale dans l'insuffisance mitrale ischémique.

INTRODUCTION: Ischemic Mitral Regurgitation (IMR) is a serious complication of coronary artery disease and is associated with a poor prognosis. The optimal surgical treatment of IMR involves controversies in its indications and modalities. OBJECTIVES: To determine whether mitral annuloplasty associated with surgical revascularization improved short and mid terms outcomes compared with revascularization alone in patients with IMR. METHODS: Between January 2007 and January 2011, 81 patients operated on Department of Cardiovascular Surgery "B" were included in this study divided into 3 groups. Group 1: 28 patients with IMR had mitral valve surgery associated with surgical revascularization. Group 2: 26 patients with IMR had surgical revascularization without mitral valve surgery. Group 3: 27 patients without IMR had isolated revascularization. Clinical end-points were operative mortality, late mortality, postoperative functional status (NYHA), and the Effective Regurgitant Orifice (ERO) at last follow-up. The mean follow-up was 5 years for groups 1 and 2 and 4 years for group 3. RESULTS: There was no difference between the 3 groups regarding age, sex, cardiovascular risk factors, and extension of coronary artery disease. The Left Ventricle End Diastolic Diameter (LVEDD) and the Left Ventricle Ejection Fraction (LVEF) were slightly different. Late and operative mortality were higher in group 2 compared to groups 1 and 3. Postoperative functional status (NYHA) improved both in groups 1 and 2. In group 1, there was a decrease in ERO. CONCLUSION: Mitral annuloplasty combined to revascularization improves symptoms, postoperative ERO and short- and mid-term survival compared with revascularization alone.

An investigation of desalination by nanofiltration, reverse osmosis and integrated (hybrid NF/RO) membranes employed in brackish water treatment.

BACKGROUND: As an appropriate tool, membrane process is used for desalination of brackish water, in the production of drinking water. The present study aims to investigate desalination processes of brackish water of Qom Province in Iran. METHODS: This study was carried out at the central laboratory of Water and Wastewater Company of the studied area. To this aim, membrane processes, including nanofiltration (NF) and reverse osmosis (RO), separately and also their hybrid process were applied. Moreover, water physical and chemical parameters, including salinity, total dissolved solids (TDS), electric conductivity (EC), Na+1 and Cl-1 were also measured. Afterward, the rejection percent of each parameter was investigated and compared using nanofiltration and reverse osmosis separately and also by their hybrid process. The treatment process was performed by Luna domestic desalination device, which its membrane was replaced by two NF90 and TW30 membranes for nanofiltration and reverse osmosis processes, respectively. All collected brackish water samples were fed through membranes NF90-2540, TW30-1821-100(RO) and Hybrid (NF/RO) which were installed on desalination household scale pilot (Luna water 100GPD). Then, to study the effects of pressure on permeable quality of membranes, the simulation software model ROSA was applied. RESULTS: Results showed that percent of the salinity rejection was recorded as 50.21%; 72.82 and 78.56% in NF, RO and hybrid processes, respectively. During the study, in order to simulate the performance of nanofiltartion, reverse osmosis and hybrid by pressure drive, reverse osmosis system analysis (ROSA) model was applied. The experiments were conducted at performance three methods of desalination to remove physic-chemical parameters as percentage of rejections in the pilot plant are: in the NF system the salinity 50.21, TDS 43.41, EC 43.62, Cl 21.1, Na 36.15, and in the RO membrane the salinity 72.02, TDS 60.26, EC 60.33, Cl 43.08, Na 54.41. Also in case of the rejection in hybrid system of those parameters and ions included salinity 78.65, TDS 76.52, EC 76.42, Cl 63.95, and Na 70.91. CONCLUSIONS: Comparing rejection percent in three above-mentioned methods, it could be concluded that, in reverse osmosis process, ions and non-ion parameters rejection ability were rather better than nanofiltration process, and also better in hybrid compared to reverse osmosis process. The results reported in this paper indicate that the integration of membrane nanofiltration with reverse osmosis (hybrid NF/RO) can be completed by each other probably to remove salinity, TDS, EC, Cl, and Na.

Utility of the QuantiFERON-TB Gold In-Tube assay for the diagnosis of tuberculosis in Moroccan children.

SETTING: The utility of interferon-gamma release assays (IGRAs), such as the QuantiFERON-TB Gold In-Tube (QFT-GIT) test, in diagnosing active tuberculosis (TB) in children is unclear and depends on the epidemiological setting. OBJECTIVE: To evaluate the performance of QFT-GIT for TB diagnosis in children living in Morocco, an intermediate TB incidence country with high bacille Calmette-Gurin vaccination coverage. DESIGN: We prospectively recruited 109 Moroccan children hospitalised for clinically suspected TB, all of whom were tested using QFT-GIT. RESULTS: For 81 of the 109 children, the final diagnosis was TB. The remaining 28 children did not have TB. QFT-GIT had a sensitivity of 66% (95%CI 5277) for the diagnosis of TB, and a specificity of 100% (95%CI 88100). The tuberculin skin test (TST) had lower sensitivity, at 46% (95%CI 3360), and its concordance with QFT-GIT was limited (69%). Combining QFT-GIT and TST results increased sensitivity to 83% (95%CI 6992). CONCLUSION: In epidemiological settings such as those found in Morocco, QFT-GIT is more sensitive than the TST for active TB diagnosis in children. Combining the TST and QFT-GIT would be useful for the diagnosis of active TB in children, in combination with clinical, radiological and laboratory data.

Sexual maturation in Moroccan patients with juvenile idiopathic arthritis.

Abnormal puberty is often reported in children suffering from many chronic diseases. Juvenile idiopathic arthritis (JIA) is the most common joint disorder in developing children. The aim of this study was to assess sexual maturation of Moroccan children with JIA and to compare the development of secondary sexual characteristics in children with JIA to children in the general population. Forty children with JIA and 74 healthy controls were included in a cross-sectional study. The diagnosis of JIA was made according to the criteria of the International League of Association of Rheumatology. Every child was examined for the development of genitalia as per criteria given by Tanner. The children with JIA were also divided into 3 groups: pre-puberty (stage 1), puberty (stages 2-3) and post-puberty (stage 4-5), and the association between puberty and cumulative dose of steroids, disease duration, disease activity, height, weight and age was investigated. Forty children with JIA were included (22 male, 18 female); the mean of age of the patients was 11 ± 4.23 years. Puberty in the patients (mean of tanner 2.43 ± 1.36) was lower than controls (2.55 ± 1.36). The prevalence of the children in prepuberty was of 15 (37.5 %) and 8 (20 %) in postpuberty. The prevalence of the children having a delayed puberty was of 6 (15 %) versus 1(1.4 %) in healthy controls (p = 0.005). There was an association between dose of corticosteroids, age at the administration of corticosteroids and the delayed puberty in boys (p = 0.009). In addition, there was no significant association in both sex between this poor puberty and duration of JIA (p = 0.45 in boys and p = 1.99 in girls) and its activity calculated by the DAS28 (p = 0.73 in boys and p = 1). Our study suggests that the puberty is retarded in Moroccan patients with JIA comparing to healthy children and that the dose of corticosteroid and the age at its administration may contribute to delayed puberty in boys.

Equality in Distribution of Human Resources: the Case of Iran's Ministry of Health and Medical Education.

BACKGROUND: Equity in access to and utilization of health services is a common goal of policy-makers in most countries. The fair allocation of human resources is one of the dimensions of equity, which was evaluated in this study. METHODS: We evaluated the equity of human resources' distribution among Iran's medical science universities between 2005 and 2009 by inequality measures including Lorenze curve, Gini coefficient and Rabin hood indexes. RESULTS: In the distribution 60403 recruitment licenses among medical universities with 72456140 covered populations, Gini coefficient was 0.167 and Robin Hood Index 0.11. CONCLUSIONS: Calculations indicated Recruitment licenses are equitably distributed in MOH&ME of Iran. However a portion of recruitment licenses should redistributed for achieving perfect equal distribution among all public medical universities of Iran.

Evaluating the metallic pollution of riverine water and sediments: a case study of Aras River.

Metallic pollution caused by elements Zn, Cu, Fe, Pb, Ni, Cd, and Hg in water and sediments of Aras River within a specific area in Ardabil province of Iran is considered. Water and sediment samples were collected seasonally and once respectively from the five selected stations. Regarding WHO published permissible values, only Ni concentration in spring and summer water samples has exceeded the acceptable limit up to four times greater than the limit. The concentration of metals Ni, Pb, and Fe in river water shows a direct relationship with river water discharge and the amount of precipitation. Enhanced soil erosion, bed load dissolution, and runoffs may play a key role in remarkable augmentation of metallic ions concentration. Furthermore, excessive use of pesticides which contain a variety of metallic ions (mainly Cu) in spring and summer may also result in an increase in the metals' concentration. The potential risk of Ni exposure to the water environment of the study area is assigned to juice, dairy products, edible oil, and sugar cane factories as well as soybean crop lands which are located within the sub-basin of Aras River in the study area. Regarding the sediment samples, the bioavailable metal concentrations indicate an ascending order from the first station towards the last one. In comparison with earth crust, sedimental and igneous rocks the reported metallic concentration values, except for Cd, lie within the low-risk status. Regarding Cd, the reported values in some stations (S2, S4, and S5) are up to ten times greater than that of shale which may be considered as a remarkable risk potential. The industrial and municipal wastewater generated by Parsabad moqan industrial complex and residential areas, in addition to the discharges of animal husbandry centers, may be addressed as the key factors in the sharp increase of metallic pollution potential in stations 4 and 5.

Clinical outcomes of multiple rib fractures: does age matter?

PURPOSE: To evaluate the clinical outcomes of multiple rib fracture due to blunt trauma in young patients, a 3-year retrospective study was conducted. Patients with ≥3 rib fractures were divided into two groups (group I: <45 years old and group II: ≥45 years old). Mortality, hospital stay, ventilatory support, chest tubes insertion and associated injuries were studied. RESULTS: Of the 902 patients admitted with blunt chest trauma, 240 (27 %) met the inclusion criteria and 72.5 % patients were <45 years old. The most common causes of injury were motor vehicle crash (59 %) and fall (29 %). The Injury Severity Score (ISS) was higher in group I (16 ± 9 vs. 13 ± 6; p = 0.04). Hospital mortality was higher in group II (6 vs. 2 %; p = 0.18). Pneumothorax, haemothorax and ventilatory support were comparable. Patients in group II were more likely to undergo chest tubes insertion (26 vs. 14 %; p = 0.04), while group I had a significantly higher incidence of associated abdominal injuries (25 vs. 12 %; p = 0.03). CONCLUSION: Old age presenting with rib fractures is associated with higher mortality in comparison to young age; however, this difference becomes statistically insignificant in the presence of multiple rib fracture.

Evolution of a new surface water quality index for Karoon catchment in Iran.

Water quality standards are developed worldwide by national and international agencies for pollution control decision-making. Use-based water quality classification criteria and Water Quality Indices (WQIs) also play an important role in the assessment of the suitability of water resources for various applications. The present study proposes a better overall index for water quality in Iran and its application in Karoon River by exploring the behavior and limitations of conventional methods for quality evaluation. For this purpose, six variables were employed. Water quality determinants of the new index include Dissolved Oxygen, Total Dissolved Solids, Turbidity, Nitrate, Fecal coliform and pH. Besides, the mathematical equations applied to transform the actual concentration values into quality indices have been formulated. This study compares a new index called the Iranian Water Quality Index with other pre-existing indices such as NSFWQI, Oregon, CPCB WQI, MDOE WQI, Kaurish and Younos WQI, and Ahmed Said WQI. Results revealed that the overall quality of the surface water falls under the 'good' class. A case study of Karoon River is made to illustrate the application of this new index system.