Multisystem inflammatory syndrome in children (MIS-C) post-COVID-19 in Iran: clinical profile, cardiac features, and outcomes

BACKGROUND

In April 2020, an association between multisystem inflammatory syndromes (MIS-C) was observed in children with severe acute respiratory syndrome coronavirus infection (SARS-CoV-2). Most patients had heart involvement alone, and most patients had pericardial effusion. This study aimed to express and emphasize cardiac involvement in pediatric patients with respiratory symptoms who were diagnosed with COVID-19.

METHODS

This study was conducted in July 2021 in Kerman province, Southeastern Iran, during a notable surge in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. The study included 904 pediatric patients diagnosed with COVID-19. Data collection involved a comprehensive assessment of clinical symptoms and manifestations. Patients with fever lasting more than five days were admitted to the hospital. Echocardiography was utilized for cardiac involvement diagnosis, with 47 patients undergoing this diagnostic procedure.

RESULTS

Of the 904 patients, most of them had high fevers (74%). Fifty-five patients had a fever for more than five days and were hospitalized. Of the 47 patients who underwent echocardiography, 45 (81%) had heart involvement. In 75% of patients, pericardial effusion was the only cardiac involvement. Patients with pericardial effusion were treated with dexamethasone up to 3 mg every 8 h for 72 h.

CONCLUSIONS

MIS-C has a wide range of clinical symptoms. In cases where the fever is prolonged and there are gastrointestinal symptoms, physicians have clinical suspicion to diagnose this syndrome. Most cases of pericardial effusion are alone and improve with treatment with glucocorticosteroids.

An 18-Month Epidemiologic Survey of 3364 Deceased COVID-19 Cases; a Retrospective Cross-sectional Study

Introduction

The COVID-19 pandemic has been considered an international problem. This study aimed to survey the demographic and clinical characteristics of the deceased COVID-19 patients.

Methods

The present cross-sectional study was performed on all deceased COVID-19 patients who died in Imam Reza Hospital, Mashhad, Iran, from March 20, 2020, to September 23, 2021. Their data, including age, gender, complaints, and clinical symptoms at the time of admission, as well as information at the time of death (hour, shift, holiday/non-holiday) were analyzed and reported.

Results

3364 deaths due to COVID-19 have been registered during the study period (60.46% male). The patients' mean age was 66.99±16.97 (range: 1-101) years (92.7% of them were Iranian). The mortality at night shifts was less than day shifts (1643 vs. 1721). The average amount of deaths/day on holidays and workdays was (5.63 vs. 6.24). The number of deaths varied during the various hours of the day and night. Diabetes and cardiovascular diseases were the most common confounding factors, which were observed in 22.44% and 15.36% of the cases, respectively.

Conclusion

Based on the findings of this series, COVID-19 mortality was frequently observed in male patients, those with the mean age of 66.99 years, morning shifts, and workdays.

Growth performance, internal organ traits, intestinal morphology, and microbial population of broiler chickens fed quinoa seed-based diets with phytase or protease supplements and their combination

The aim of this study was to evaluate the effects of quinoa seed-based diets with phytase and protease enzymes, individually or in combination, on the productive performance, internal organs, microbiota activity, and intestinal morphology of broiler chickens. A total of 250 1-day-old broiler chicks (ROSS 308) were randomly distributed into five treatments with each five replicate pens of 10 birds in a 42-day trial. Dietary treatments were a conventional diet (CC) based on a corn-soybean meal or an experimental diet (EC) which contained 150 g/kg of quinoa seed. Other treatments were EC diet supplemented with 500 FTU/kg phytase (EPH), 0.2 g/kg protease (EPR) enzymes, or their combination (EPPC). At the end of the trial, the feed intake of the EPH broilers was higher than those of the EC and EPPC birds (P < 0.05). Meanwhile, broiler chickens fed the EPH and EPPC diets had higher body weight gain compared with those of the birds fed the other diets (P < 0.05). The EC and EPPC broilers consumed less feed than the EPH birds (P < 0.05), while CC and EPR birds were intermediate. The EC group had the highest feed conversion ratio among all groups (P < 0.05). The EPPC group had the best feed conversion ratio compared with other groups except for the EPH group (P < 0.05). The highest relative weight of the bursa and spleen was observed in EPPC and CC groups, respectively. The pancreas had the lowest weight in the broilers fed protease-supplemented diet. An increase in villus length and villus width was observed in birds fed EPH and EC diets, respectively (P < 0.05). The ratio of VL to crypt depth was greater in the phytase-supplemented group (P < 0.05). Inclusion of phytase or phytase + protease to QS diet increased the cecal Lactobacillus population, while the count of Coliforms decreased in EPR and EPPC groups (P < 0.05). It is concluded that addition of phytase and protease enzymes to QS-based diet may have beneficial effects on the growth performance, gut bacteria ecology, and intestinal morphology of broiler chickens.

The efficiency of CO2 market in the phase III EU ETS: analyzing in the context of a dynamic approach

This study has investigated the changing efficiency for the phase III EU ETS CO₂ market using the daily historical data of allowance future prices and coverage from August 2015 to December 2020. We have applied two alternative tests for checking dependency by linear and nonlinear methods to achieve this goal, including generalized spectral (GS) and automatic portmanteau (AQ). Also, we had a comprehensive look at the carbon market evolution and the EU ETS scheme development over time. The analysis of observed results validates the adaptive market hypothesis (AMH) in the market, which corresponds with the oscillatory behavior of the applied test statistics' p-values. The other aspect of the study was to analyze the existence of evolutionary behavior on the market. To reach this purpose, we checked the results by applying a rolling window technique with four different time windows (50, 100, 150, and 250 days) on the test statistics in harmony with the adaptive market hypothesis. The obtained results show that overall, market efficiency has been improved by implementing higher window lengths.

Fournier’s gangrene following an ant bite in a healthy man: A very rare case report

Objective: Necrotizing fasciitis of the perinea, referred to as Fournier’s gangrene, is a necrotizing infection of the perinea. To the best of our knowledge, there is no report on the Fournier’s gangrene following an ant bite and this is a rare case report of this type. Case Presentation: In this rare case report we describe a 20-year-old man who developed Fournier’s gangrene following an ant bite which resulted in his death. He sustained numerous ant bites in the perinea. Subsequently, he suffered from itching of the area and had scratched the area frequently leading to dermal ulcers and laceration, pain, and swelling of the scrotal area followed by fever and diminished consciousness. Finally, he presented to the emergency room (ER) after 72 hours of ant bites with a shock. Physical examination revealed extensive necrosis of scrotum. The primary treatments including antibiotic therapy, normal saline solution, and dopamine were not effective. Conclusion: Even a simple nonpoisonous insect bite can lead to Fournier’s gangrene and death. Paying greater attention to the site of bite, especially in the perinea which is anatomically more susceptible to infection, observing hygienic principles, and quick access to healthcare centers may prevent the patient’s death.

Angiotensin Converting Enzyme Insertion/Deletion Polymorphism is Associated with Breast Cancer Risk: A Meta-Analysis

Background: A number of case-control studies were conducted to investigate the association of angiotensin converting enzyme insertion/deletion (ACE I/D) polymorphism with breast cancer. But the results remain controversial. This meta-analysis aims to comprehensively evaluate the association of ACE I/D polymorphism with breast cancer. Method: A comprehensive literature search on PubMed, Google Scholar, SCOPUS and ISI Web of Knowledge databases for studies published up to June 01, 2018 was performed. Summary odds ratios (ORs) and 95% confidence intervals (CI) were estimated. Publication bias of literatures was evaluated using funnel plots and Egger’s test. Results: A total of 20 studies including 2846 breast cancer cases 9,299 controls meeting the predefined criteria were involved in the meta-analysis. Overall, the ACE I/D polymorphisms was significantly associated with breast cancer under the allele model (I vs. D: OR= 0.803, 95% CI 0.647-0.996, p=0.046), the homozygote model (II vs. DD: OR= 0.662, 95% CI 0.462-0.947, p=0.024), the heterozygote model (ID vs. DD: OR= 0.707, 95% CI 0.528-0.946, p=0.020), the dominant model (II+ID vs. DD: OR= 0.691, 95% CI 0.507-0.941, p=0.019). In the subgroup analysis by ethnicity, a significant association was found among Asian and Caucasian populations, but not among mixed populations. Conclusions: This meta-analysis suggests that ACE I/D polymorphism may be associated with increased risk of breast cancer, especially among Asian and Caucasians. However, well-designed studies with larger sample size and more ethnic groups are needed to further validate the results.

Association between Polymorphisms of ERCC5 Gene and Susceptibility to Gastric Cancer: A Systematic Review and Meta-Analysis

Background:

several epidemiological studies have suggested that polymorphisms of the Excision Repair Cross Complementing Group-5 (ERCC5) gene might be related to gastric cancer risk; however, the results have been inconsistent or controversial. Therefore, we have performed a systematic review and meta-analysis to clarify the association between the ERCC5 gene polymorphisms and gastric cancer risk.

Materials and Methods:

An electronic search was conducted of several databases, including PubMed, Web of Science, and Google Scholar for articles that describe the association between polymorphisms of the ERCC5 gene and susceptibility of gastric cancer.

Results:

A total of 33 case control studies in 15 publications were included in the present meta-analysis. There were significant associations between gastric cancer susceptibility and ERCC5 gene rs751402 C>T (T vs. C: OR = 1.166, 95% C = 1.066-1.274, p= 0.001; TT vs. CC: OR = 0.723, 95% CI = 0.587-0.890, p = 0.002; TT+TC vs. CC: OR = 0.853, 95% CI = 0.757-0.961, p = 0.009; TT vs. TC+CC: OR = 0.793, 95% CI = 0.659-0.955, p = 0.015), rs2296147 T>C (C vs. T: OR = 1.268, 95% C = 1.049-1.532, p= 0.014), rs873601 G>A polymorphisms (A vs. G, OR = 1.087, 95% C = 1.021-1.159, p= 0.010; AA vs. GG, OR = 1.184, 95% CI = 1.043-1.343, p = 0.009, AA vs. AG+GG, OR = 1.156, 95% CI = 1.040-1.284, p = 0.007), but not rs2094258 C>T and rs1047768 T>C.

Conclusion:

the current meta-analysis demonstrates that rs751402 C>T, rs2296147 T>C, and rs873601 G>A polymorphisms of ERCC5 gene are associated with the susceptibility of gastric cancer.

Association between the p53 codon 72 polymorphism and primary open-angle glaucoma risk: Meta-analysis based on 11 case-control studies

The TP53 is important in functions of cell cycle control, apoptosis, and maintenance of DNA integrity. Studies on the association between p53 codon 72 polymorphism and primary open-angle glaucoma (POAG) risk have yielded conflicting results. Published literature from PubMed and Web of Science databases was retrieved. All studies evaluating the association between p53 codon 72 polymorphisms and POAG were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated. Eleven separate studies including 2541 cases and 1844 controls were pooled in the meta-analysis. We did not detect a significant association between POAG risk and p53 codon 72 polymorphism overall population except allele genetic model (C vs. G: OR = 0.961, 95% CI = 0.961-0.820, P = 0.622). In the stratified analysis for Asians and Caucasians, there was an association between p53 codon 72 polymorphism and POAG. In the dominant model in the overall population and by ethnicity subgroups, the highest elevated POAG risk was presented. In summary, these results indicate that p53 codon 72 polymorphism is likely an important genetic factor contributing to susceptibility of POAG. However, more case-controls studies based on larger sample size and stratified by ethnicity are suggested to further clarify the relationship between p53 codon 72 polymorphism and POAG.

Internal bioerosion in dead and live hard corals in intertidal zone of Hormuz Island (Persian Gulf)

Internal macrobioeroders and their erosion rate in three live and dead coral genera (Favia, Platygyra and Porites) from the intertidal zone of the Hormuz Island were studied by collecting five live and five dead colonies from each genus, from which 4 mm cross-sections were cut and photographed. Photos were analyzed using the Coral Point Count with Excel extensions. Totally, 9 taxa were identified: four bivalve species, one sponge, three polychaetes, and one barnacle. Bioerosion rate did not significantly differ among the three live corals, but among the dead ones only Porites was significantly more eroded than Favia. Sponge had the highest role in the erosion of the dead Platygyra, while barnacles were the most effective eroding organism in the live Platygyra. Polychaetes, followed by bivalves, were the most destructive bioeroders on the dead and live Porites. Further, none of the bioeroding organisms had selectively chosen either the dead or live Favia.

Comparison of genu varum treating results using open and closed wedge high tibial osteotomy

High tibial osteotomy methods include open and closed wedge techniques. The study aims at comparing results of osteotomy methods in patients suffering from genu varum deformity. In a cohort study, 32 patients with genu varum deformity (42 knees) were evaluated. They were divided into two groups and matched according to age and gender. The patients were treated with open and closed wedge osteotomy. After surgery, they were followed up and compared for 6 months. Thirty two patients with genu varum deformity (10 cases of bilateral deformity (31.2%) including 25 women (87.2%) and 7 men (21.8%) were studied. Incidence of complications was the same after open and closed wedge osteotomy operation (12.5%). Patients overall satisfaction from open and closed wedge methods was 87.5 and 75%, respectively. There was statistically significant difference between two groups considering operation duration, weight bearing duration and return to routine activities (p < 0.001). There was no difference in other parameters including varus angle correction, Lysholm score Tegner activity as well as Insall Salvati index. This study demonstrated that there is no difference between two osteotomy methods considering patients' clinical outcomes and both methods are successful in final treatment results.

Synthesis of a closed-loop combined plant and controller model

In practice, a controlled system consists of two distinct entities: the plant and the controller. These two entities are coupled by a feedback mechanism to give the closed-loop behavior of the controlled system. Under this structure, the controlled behavior of the system can be analyzed by simulation which is costly and time consuming. In this study, we synthesize a combined plant and controller model. We consider the practical issues and propose a method which combines the advantages of Petri nets (PN) and the supervisory controller design based on Formal Language Theory. The resultant combined model is a PN and represents the controlled closed-loop behavior of the system. This model can be used for the functional and the performance analysis of the system, verification of the controller and the control code generation.

The effect of Pleurotus spp. fungi on chemical composition and in vitro digestibility of rice straw

This study was carried out to test the potentially of using rice straw substrate for the cultivation of four Pleurotus species including Pleurotus florida, Pleurotus djamor, Pleurotus sajor-caju and Pleurotus ostreatus and the effect of these species on the chemical composition, cell wall degradation and digestibility of rice straw. Rice straw soaked in water for 24 h and then it was pasteurized at 100 degrees C for 6 h. Rice straw was inoculated with spawns of four Pleurotus fungi (Pleurotus florida, Pleurotus djamor, Pleurotus sajor-caju and Pleurotus ostreatus) and packed in the plastic bags and incubated in a fermentation chamber at 23-27 degrees C and 75-85% relative humidity. After 60th day, rice straw samples from all groups were taken and analyzed for chemical composition and in vitro digestibility. The data obtained were analyzed according to the complete randomized design model consisting of four treatments plus one control and four replicates. The results of this study showed that fungal treatment increased (p<0.05) the Crude Protein (CP), silica, Ca and P contents of the rice straw but the hemicellulose, Organic Matter (OM), Acid Detergent Fiber (ADF), Neutral Detergent Fiber (NDF) and Acid Detergent Lignin (ADL) contents decreased. However, the ability of the fungi to degrade these components varied among the species. The ability of Pleurotus sajor-caju and Pleurotus ostreatus were higher than the other species in decreasing the hemicellulose, NDF, ADF and ADL contents. The highest Biological Efficiency (BE) was produced by sajor-caju species with 56.02 and the lowest was belong to Pleurotus djamor species with an average 51.17%. All species of fungi incubated on rice straw showed increased (p<0.05) the in vitro dry mater and organic matter digestibility. Rice straw treated with sajor-caju fungus had the highest in vitro dry matter digestibility (IVDMD) and in vitro organic matter digestibility (IVOMD) with 80.10 and 82.18%, respectively. In general this experiment cleared that treatment with sajor-caju can improve the quality of rice straw to be useful feed for ruminant nutrition.