Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to pro...Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to provide advice and guidance in risk departments. Methods: According to the latest plan of diagnosis and treatment, prevention and control issued by the National Health Commission, expert advice and consensus, combined with the actual situation in our hospital, a series of infection prevention and control measures of COVID-19 in risk department was formulated. Results: During the epidemic period, the prevention and control measures of nine risk departments including emergency operation, anesthesiology, endoscopy center, blood purification center, otolaryngology, stomatology, medical imaging department, medical cosmetology department and pulmonary function room were established from six aspects, including pre-examination and screening, medical technology control, personnel management, personal protection, environmental disinfection, medical waste disposal, etc. Conclusion: During the epidemic period, the infection prevention and control strategy of risk departments is one of the key links to control the spread of the epidemic, and risk departments must pay attention to and strictly implement various infection prevention and control measures.展开更多
Background: Maternal and neonatal mortality remains a public health problem in Benin. Each year, approximately 1500 maternal deaths and more than 12,000 newborn deaths are recorded there. In order to correct the situa...Background: Maternal and neonatal mortality remains a public health problem in Benin. Each year, approximately 1500 maternal deaths and more than 12,000 newborn deaths are recorded there. In order to correct the situation, strategies such as the implementation of Emergency Obstetric and Neonatal Care (EmONC) were initiated. Objective: Determine the rates of maternal deaths in EmONC centers in the Collines department from 2018 to 2022. Framework and Methods: The study took place in Benin precisely in the Collines department. This was a descriptive cross-sectional study. Data collection was carried out during the first two weeks of January 2023 and covered data from the 09 Basic Emergency Obstetric and Neonatal Care centers (BEMONC) and the Obstetric and Neonatal Care centers of Complete Emergency (CEmONC) of the Collines department from 2018 to 2022. An estimate of the ratios of maternal deaths occurring at the level of the EmONC centers of the Collines department from 2018-2022 was carried out followed by constructive suggestions. Results: During the five years (2018 to 2022), the Collines department recorded 42,582 live births with 148 maternal deaths, i.e. a ratio of 348 maternal deaths per 100,000 live births. Between 2018 and 2022, the highest maternal death ratio was recorded in 2019, i.e. 425 maternal deaths per 100,000 live births for all EmONC centers and 607 maternal deaths per 100,000 live births in EmONC centers. The highest maternal death ratio at the BEmONC center level was recorded in 2020, i.e. 129 maternal deaths per 100,000 births. Conclusion: These results suggest that despite the implementation of EmONC in the Collines department, maternal deaths have not decreased. To improve these outcomes for a reduction in maternal deaths, urgent action must be taken.展开更多
The objective to this work was to evaluate the enzymatic activity in the culture of Solanum lycopersicum L.infected with Fusarium oxysporum after the combined application of Beauveria bassiana and plant extracts.Solan...The objective to this work was to evaluate the enzymatic activity in the culture of Solanum lycopersicum L.infected with Fusarium oxysporum after the combined application of Beauveria bassiana and plant extracts.Solanum lycopersicum plantlets were transplanted 15 days after the emergency.Five days after transplanting,Beauveria bassiana spores were applied at a concentration of 1×10^(7)spores mL^(−1)onto soil(along with A.indica(N)and P.auritum(H)leaf extracts)where S.lycopersicum plants were planted.Eight days after transplanting,spores of F.oxysporum strain were applied at a concentration of 1×10^(6)spores mL^(−1)to soil where S.lycopersicum plants were growing.The development of S.lycopersicum plants was monitored for 114 days,whereby a randomized complete block treatment design was used,the roots of the plants were crushed with liquid nitrogen,after which UV/VIS spectrophotometry was used to determine protein concentration,as well as the activity ofβ-1,3-glucanases,peroxidases(POX,EC1.11.1.7),catalase and chitinases.The treatments combining B.bassiana and A.indica and P.auritum extracts,had a significant difference in enzymatic activity levels,thus contributing to better defense mechanisms and a greater protection to S.lycopersicum plants in the presence of F.oxysporum.The application of B.bassiana and plant extracts to the ground mitigated damage caused by F.oxysporum on S.lycopersicum plants.展开更多
BACKGROUND Disorders of consciousness including coma in non-trauma patients can be caused by a wide variety of pathologies affecting the central nervous system.They represent a frequent challenge in emergency medicine...BACKGROUND Disorders of consciousness including coma in non-trauma patients can be caused by a wide variety of pathologies affecting the central nervous system.They represent a frequent challenge in emergency medicine and are combined with a very high in-hospital mortality.Hence,early treatment of these patients is vital and increases the likelihood of a good outcome.AIM To identify the causes of altered consciousness presentation to the Emergency Department at Suez Canal University Hospital.METHODS This was a descriptive cross-sectional study conducted on 87 patients with acute non-traumatic disturbed level of consciousness(DLOC)at the Emergency Department.RESULTS The mean age of the studied patients was 60.5±13.6 years.Among them,60%were males and 40%were females.The most common cause of acute non-traumatic DLOC was systemic infection,such as sepsis and septic shock(25.3%),followed by respiratory causes(24.1%)and neurological causes(18.4%).CONCLUSION The most common cause of acute non-traumatic DLOC was systemic infections followed by respiratory and neurological causes.展开更多
Arsenic(As)contaminated food chains have emerged as a serious public concern for humans and animals and are known to affect the cultivation of edible crops throughout the world.Therefore,the present study was designed...Arsenic(As)contaminated food chains have emerged as a serious public concern for humans and animals and are known to affect the cultivation of edible crops throughout the world.Therefore,the present study was designed to investigate the individual as well as the combined effects of exogenous silicon(Si)and sodium nitroprusside(SNP),a nitric oxide(NO)donor,on plant growth,metabolites,and antioxidant defense systems of radish(Raphanus sativus L.)plants under three different concentrations of As stress,i.e.,0.3,0.5,and 0.7 mM in a pot experiment.The results showed that As stress reduced the growth parameters of radish plants by increasing the level of oxidative stress markers,i.e.,malondialdehyde and hydrogen peroxide.However,foliar application of Si(2 mM)and pretreatment with SNP(100μM)alone as well as in combination with Si improved the plant growth parameters,i.e.,root length,fresh and dry weight of plants under As stress.Furthermore,As stress also reduced protein,and metabolites contents(flavonoids,phenolic and anthocyanin).Activities of antioxidative enzymes such as catalase(CAT),ascorbate peroxidase(APX),guaiacol peroxidase(POD),and polyphenol oxidase(PPO),as well as the content of non-enzymatic antioxidants(glutathione and ascorbic acid)decreased under As stress.In most of the parameters in radish,As III concentration showed maximum reduction,as compared to As I and II concentrations.However,the individual and combined application of Si and NO significantly alleviated the As-mediated oxidative stress in radish plants by increasing the protein,and metabolites content.Enhancement in the activities of CAT,APX,POD and PPO enzymes were recorded.Contents of glutathione and ascorbic acid were also enhanced in response to co-application of Si and NO under As stress.Results obtained were more pronounced when Si and NO were applied in combination under As stress,as compared to their individual application.In short,the current study highlights that Si and NO synergistically regulate plant growth through lowering the As-mediated oxidative stress by upregulating the metabolites content,activity of antioxidative enzymes and non-enzymatic antioxidants in radish plants.展开更多
The 84 km Panama Canal connecting the Atlantic and Pacific oceans has historically been a strategic waterway for shipping and the location of United States (US) military bases. Since the construction of Lake Gatun res...The 84 km Panama Canal connecting the Atlantic and Pacific oceans has historically been a strategic waterway for shipping and the location of United States (US) military bases. Since the construction of Lake Gatun reservoir, canal locks and navigation channel through the Isthmus of Panama tropical forests in the 1910s, chemicals, pesticides, and herbicides have been essential for controlling upland and wetland vegetation as well as managing mosquito-borne diseases. Chemicals and pesticides flowed into Lake Gatun via land surface runoff and subsurface drainage either attached to the sediment or in solution during the rainy season. Lake Gatun and the Panama Canal was the drinking water source for most of the civilian and military population living in the Panama Canal Zone. Between 1948 and 1999, US military base commanders had the ability to order, from the Federal Supply Catalog, commercially available herbicide 2,4,5-T with unknown amounts of dioxin TCDD for use on the military base grounds in the Panama Canal Zone. The herbicide 2,4,5-T was transported to Panama Canal Zone ports, including the ports Cristobal on the Caribbean and Balboa on the Pacific, and distributed to the US military bases in Panama by rail or truck. The US National Toxicology Program and the International Agency for the Research on Cancer listed dioxin and TCDD as known human carcinogens. Dioxins are endocrine disrupters and can cause certain chloracne, cancers, developmental and reproductive effects. In 1985, the United States government banned the manufacture of the herbicide 2,4,5-T, with unknown amounts of dioxin TCDD, after it was shown to cause cancer in animals. The objectives of this study are to determine: 1) the fate of dioxin TCDD, a contaminant in the herbicide 2,4,5-T, sprayed on the US military base vegetation in the Panama Canal Zone from 1948 to 1999, 2) the transport of dioxin TCDD rich sediment via soil erosion and overland flow into Lake Gatun and Panama Canal waterways and 3) the human health impacts of dioxin TCDD, a known carcinogen, on US military and Panamanian civilians exposed to dioxin TCDD in the Panama Canal Zone.展开更多
BACKGROUND: We aimed to explore the impact of the emergency department length of stay(EDLOS) on the outcome of trauma patients.METHODS: A retrospective study was conducted on all trauma patients requiring hospitalizat...BACKGROUND: We aimed to explore the impact of the emergency department length of stay(EDLOS) on the outcome of trauma patients.METHODS: A retrospective study was conducted on all trauma patients requiring hospitalization between 2015 and 2019. Patients were categorized into 4 groups based on the EDLOS(<4 h, 4–12 h,12–24 h, and >24 h). Data were analyzed using Chi-square test(categorical variables), Student’s t-test(continuous variables), correlation coefficient, analysis of variance and multivariate logistic regression analysis for identifying predictors of short EDLOS and hospital mortality.RESULTS: The study involved 7,026 patients with a mean age of 32.1±15.6 years. Onefifth of patients had a short EDLOS(<4 h) and had higher level trauma team T1 activation(TTA-1), higher Injury Severity Score(ISS), higher shock index(SI), and more head injuries than the other groups(P=0.001). Patients with an EDLOS >24 h were older(P=0.001) and had more comorbidities(P=0.001) and fewer deaths(P=0.001). Multivariate regression analysis showed that the predictors of short EDLOS were female gender, GCS, SI, hemoglobin level, ISS, and blood transfusion. The predictors of mortality were TTA-1(odds ratio [OR]=4.081, 95%CI: 2.364–7.045), head injury(OR=3.920, 95%CI: 2.413–6.368), blood transfusion(OR=2.773, 95%CI: 1.668–4.609), SI(OR=2.132, 95%CI: 1.364–3.332), ISS(OR=1.077, 95%CI: 1.057–1.096), and age(OR=1.040, 95%CI: 1.026–1.054). CONCLUSIONS: Patients with shorter EDLOS had different baseline characteristics and hospital outcomes compared with patients with longer EDLOS. Patients with prolonged EDLOS had better outcomes;however, the burden of prolonged boarding in the ED needs further elaboration.展开更多
A headspace solid-phase microextraction-gas chromatography-mass spectrometry(HS-SPME/GC-MS)method was used to study the volatile organic compounds(VOCs)associated with the differential immune response of tomato plants...A headspace solid-phase microextraction-gas chromatography-mass spectrometry(HS-SPME/GC-MS)method was used to study the volatile organic compounds(VOCs)associated with the differential immune response of tomato plants infected with the recombinant strain of potato virus Y(PVY^(C)-to),necrogenic to tomato.Analysis was carried out in UC82(UC),a virus susceptible tomato variety,comparing the same UC plants grafted or not onto a virus tolerant tomato ecotype,Manduria(Ma);the three types of samples used for the GC-MS analysis were mock-inoculated UC/Ma plants,UC/Ma+PVY^(C)-to and UC+PVY^(C)-to plants;the VOCs obtained were 111.Results from symptomatic PVY^(C)-to-infected UC plants showed a VOCs composition enriched in alcohols,fatty acid derivates,benzenoids,and salicylic acid derivatives,while in mock-inoculated UC/Ma plants VOCs were mainly characterized by methyl ester compounds.The VOC profile was in line with RNAseq data analyses,denoting that PVY^(C)-to viral RNA accumulation and disease symptoms induce the specific transcriptional activation of genes involved in VOCs biosynthesis.Furthermore,principal component analysis highlighted that VOCs of PVY^(C)-to-infected and mock-inoculated grafted plants were much closer each other than that of symptomatic PVY^(C)-to-infected non-grafted UC plants.These results suggest that VOCs profiles of tomato plants are related to the viral RNA accumulation,disease intensity and graft-derived tolerance to PVY^(C)-to infection.展开更多
Glycosylated volatiles are considered as hidden aroma precursors that affect fruit flavor and are involved in plant defense response. Several uridine-diphosphate(UDP)-glycosyltransferase(UGT) members related to the gl...Glycosylated volatiles are considered as hidden aroma precursors that affect fruit flavor and are involved in plant defense response. Several uridine-diphosphate(UDP)-glycosyltransferase(UGT) members related to the glycosylation of volatiles have been identified from grapevine berries. Although grapevine leaves produced much higher levels of glycosylated volatiles than berries, UGTs responsible for the production of glycosylated volatiles in leaves have not yet been identified. Here, eight novel UGT genes were cloned, among these four members that belong to UGT85A family(named UGT85A24, UGT85A25, UGT85A26, and UGT85A27) were localized in the cytoplasm and their recombinant proteins showed activity toward volatiles detected in grapevine, with geraniol as the preferred substrate in vitro. Two UGT genes with 98.1% homology differ in R/S-linalool selection. The UGT85A26-catalyzed substrate showed enrichment in S-linalool, whereas UGT85A27 showed a strong preference for R-linalool. UGT85A24 and UGT85A25 were expressed mainly in berries, and UGT85A26 and UGT85A27 were expressed predominantly in grapevine mature leaves and correlated with the highest content of glycosylated volatiles in the mature leaves. Methyl jasmonate(MeJA) induced the expression of UGT85A26 and UGT85A27 as well as the production of linalyl-β-glucoside, citronellyl-β-glucoside and phenethyl-β-glucoside. Transient overexpression of UGT85A26 and UGT85A27 in tobacco leaves led to the accumulation of linalyl-β-glucoside and an increase in citronellyl-β-glucoside in vivo. These results indicate that the expression of UGT85A26 and UGT85A27 is a major regulator affecting the content of glycosylated volatiles in grapevine.展开更多
Multiple studies have reported decreased emergency department(ED)patient volumes during the coronavirus disease(COVID-19)pandemic,[1-6]including areas most affected by the virus.[7]Most existing studies have investiga...Multiple studies have reported decreased emergency department(ED)patient volumes during the coronavirus disease(COVID-19)pandemic,[1-6]including areas most affected by the virus.[7]Most existing studies have investigated general trends in ED presentations and have not examined the impact of COVID-19 on different types of EDs,specific ED patient groups,or illness presentations.展开更多
BACKGROUND:Altered mental status(AMS) is a very common emergency case,but the exact etiology of many AMS patients is unknown.Patients often manifest vague symptoms,thus,AMS diagnosis and treatment are highly challengi...BACKGROUND:Altered mental status(AMS) is a very common emergency case,but the exact etiology of many AMS patients is unknown.Patients often manifest vague symptoms,thus,AMS diagnosis and treatment are highly challenging for emergency physicians.The aim of this study is to provide a framework for the assessment of AMS patients.This assessment should allow providers to better understand the etiology of mental status changes and therefore improve diagnostic skills and management.METHODS:This is a prospective cohort observational study.We recruited all adult patients with undifferentiated AMS at a single center tertiary care academic emergency department over 24months(June 2009 to June 2011).Demographic characteristics,clinical manifestations,assessment approaches,causative factors,emergency treatments and outcomes were collected prospectively.RESULTS:In 1934 patients with AMS recruited,accounting for 0.93%of all emergency department(ED) patients,1 026(53.1%) were male,and 908(46.9%) female.Their average age was 51.95±15.71 years.Etiologic factors were neurological(n=641;35.0%),pharmacological and toxicological(n=421;23.0%),systemic and organic(n=266;14.5%),infectious(n=167;9.1%),endocrine/metabolic(n=145;7.9%),psychiatric(n=71;3.9%),traumatic(n=38;2.1%),and gynecologic and obstetric(n=35;1.9%).Total mortality rate was 8.1%(n=156).The death rate was higher in elderly patients(≥60) than in younger patients(10.8%vs.6.9%,P=0.003).CONCLUSIONS:Patients with AMS pose a challenge for ED physicians.The most frequently encountered diagnostic categories causing AMS were primary CNS disorders,intoxication,organ system dysfunction,and endocrine/metabolic diseases.AMS has a high fatality rate in the ED.AMS is an important warning signal for ED patients because of its potentially fatal and reversible effects.Prompt evaluation and treatment are essential to decreasing morbidity and mortality associated with AMS.展开更多
Host defense peptides(HDPs)are small molecules with broad-spectrum antimicrobial activities against infectious bacteria,viruses,and fungi.Increasing evidence suggests that HDPs can also indirectly protect hosts by mod...Host defense peptides(HDPs)are small molecules with broad-spectrum antimicrobial activities against infectious bacteria,viruses,and fungi.Increasing evidence suggests that HDPs can also indirectly protect hosts by modulating their immune responses.Due to these dual roles,HDPs have been considered one of the most promising antibiotic substitutes to improve growth performance,intestinal health,and immunity in farm animals.This review describes the antimicrobial and immunomodulatory roles of host defense peptides and their recent applications in animal production.展开更多
Botanical herbicide has been a hot topic in the research and development of novel pesticides. The herbicidal activity and biochemical characteristics of the botanical compound drupacine were studied by evaluating its ...Botanical herbicide has been a hot topic in the research and development of novel pesticides. The herbicidal activity and biochemical characteristics of the botanical compound drupacine were studied by evaluating its effects on seed germination, seedling growth, morphological and physiological characteristics of Amaranthus retroflexus. Drupacine inhibited seed germination and seedling growth, and had a median inhibition concentration(IC50) value of 38.99 mg L-1against A. retroflexus root. The α-amylase activity and soluble sugar content in treated plants were significantly lower than that of the control. The expression of α-amylase gene was dosage-dependently inhibited compared to the untreated control. This suggested that inhibition of α-amylase activity was a mode of action on seed germination. The root hairs were significantly decreased and part of the root cap fell off after treatment with drupacine. The ultrastructure observation showed that cell damage of root tips increased with the treatment time. Drupacine also increased the relative conductivity and malondialdehyde(MDA) content. Peroxidase(POD), catalase(CAT), and superoxide dismutase(SOD) activities were significantly enhanced in the treatment compared to the control. These findings indicated that the physiological and biochemical reaction changes leading to morphological and membrane injuries were the main effects of drupacine on the inhibition of seedling growth. Drupacine can be developed as a botanical herbicide.展开更多
BACKGROUND: Mild to moderate musculoskeletal trauma is a common cause for an emergency room visit, and frequent pain is one of the cardinal symptoms of consultation. The objective of this study is to assess the percep...BACKGROUND: Mild to moderate musculoskeletal trauma is a common cause for an emergency room visit, and frequent pain is one of the cardinal symptoms of consultation. The objective of this study is to assess the perception of a single subcutaneous dose of 50 mg tramadol for pain management in patients with mild to moderate musculoskeletal trauma, likewise to appraise the perception of pain by subcutaneous injection.METHODS: A total of 77 patients, who met inclusion criteria, received a single subcutaneous dose of tramadol. Pain control was evaluated based on the verbal numerical pain scale(0–10) at baseline, 20 and 60 minutes; similarly, pain perception was evaluated secondary to subcutaneous injection of the analgesic.RESULTS: On admission, the average pain perceived by patients was 8; twenty minutes later, 89% of the patients reported fi ve or less, and after sixty minutes, 94% had three or less on the verbal numerical pain scale. Of the patients, 88% reported pain perception by verbal numeric scale of 3 or less by injection of the drug, and 6.5% required a second analgesic for pain control. Two events with drug administration(soft tissue infection and mild abdominal rectus injection) were reported.CONCLUSION: We conclude that a single subcutaneous dose of tramadol is a safe and effective option for the management of patients with mild to moderate pain and musculoskeletal disease in the emergency department.展开更多
BACKGROUND:Anaphylaxis is characterized by acute episodes of potentially life-threatening symptoms that are often treated in the emergency setting.Current guidelines recommend:1) quick diagnosis using standard criteri...BACKGROUND:Anaphylaxis is characterized by acute episodes of potentially life-threatening symptoms that are often treated in the emergency setting.Current guidelines recommend:1) quick diagnosis using standard criteria;2) first-line treatment with epinephrine;and 3) discharge with a prescription for an epinephrine auto-injector,written instructions regarding long-term management,and a referral(preferably,allergy) for follow-up.However,studies suggest low concordance with guideline recommendations by emergency medicine(EM) providers.The study aimed to evaluate how emergency departments(EDs) in the United States(US) manage anaphylaxis in relation to guideline recommendations.METHODS:This was an online anonymous survey of a random sample of EM health providers in US EDs.RESULTS:Data analysis included 207 EM providers.For respondent EDs,approximately 9%reported using agreed-upon clinical criteria to diagnose anaphylaxis;42%reported administering epinephrine in the ED for most anaphylaxis episodes;and <50%provided patients with a prescription for an epinephrine auto-injector and/or an allergist referral on discharge.Most provided some written materials,and follow-up with a primary care clinician was recommended.CONCLUSIONS:This is the first cross-sectional survey to provide "real-world" data showing that practice in US EDs is discordant with current guideline recommendations for the diagnosis,treatment,and follow-up of patients with anaphylaxis.The primary gaps are low(or no) utilization of standard criteria for defining anaphylaxis and inconsistent use of epinephrine.Prospective research is recommended.展开更多
Three crucial hurdles hinder studies on human cytomegalovirus(HCMV): strict species specificity, differences between in vivo and in vitro infection, and the complexity of gene regulation. Ever since the sequencing of ...Three crucial hurdles hinder studies on human cytomegalovirus(HCMV): strict species specificity, differences between in vivo and in vitro infection, and the complexity of gene regulation. Ever since the sequencing of the whole genome was first accomplished, functional studies on individual genes have been the mainstream in the CMV field. Gene regulation has therefore been elucidated in a more detailed fashion. However, viral gene regulation is largely controlled by both cellular and viral components. In other words, viral gene expression is determined by the virus–host interaction. Generally, cells respond to viral infection in a defensive pattern; at the same time, viruses try to counteract the cellular defense or else hide in the host(latency). Viruses evolve effective strategies against cellular defense in order to achieve replicative success. Whether or not they are successful, cellular defenses remain in the whole viral replication cycle: entry, immediate–early(IE) gene expression, early gene expression, DNA replication, late gene expression, and viral egress. Many viral strategies against cellular defense, and which occur in the immediate–early time of viral infection, have been documented. In this review, we will summarize the documented biological functions of IE1 and pp71 proteins, especially with regard to how they counteract cellular intrinsic defenses.展开更多
Background: The world of cancer care is an emotional place, given the severity of the disease being treated, the heavy workload, the suffering of patients, and the high number of deaths. The nursing staff who work the...Background: The world of cancer care is an emotional place, given the severity of the disease being treated, the heavy workload, the suffering of patients, and the high number of deaths. The nursing staff who work there may be exposed to constant stress from these factors. This study aimed to explore the psychological experience of the nursing staff of the Medical Oncology Department of the Yaoundé General Hospital. Methods: We carried out a cross-sectional study, in June 2017, involving the nursing staff of the Medical Oncology Department of the Yaoundé General Hospital. Results: Sixteen out of 18 nurses were interviewed. All had worked in at least one other department prior to Oncology. The number of years of experience in Oncology ranged from less than one year to 13 years. The choice of the Oncology department was involuntary for 100% of the staff;of these, 62% had intentions of changing departments. Twenty-five percent had applied for a change of department, which was unsuccessful. Stress was expressed by 94% of the staff;93% thought that there was a solution to the stress experienced on a daily basis in the Oncology department. The main solutions proposed to manage this stress were: support for the staff, provision of work materials, and staff training. Conclusion: The nursing staff of the Medical Oncology Department of the Yaoundé General Hospital experiences a high level of stress and are in need of solutions.展开更多
In this research,green synthesized magnesium oxide nanoparticles(MgO NPs)from lemon fruit extracts and their fungicidal potential was evaluated against Alternaria dauci infection on carrot(Daucus carota L.)under green...In this research,green synthesized magnesium oxide nanoparticles(MgO NPs)from lemon fruit extracts and their fungicidal potential was evaluated against Alternaria dauci infection on carrot(Daucus carota L.)under greenhouse conditions.The scanning and transmission electron microscopy(SEM and TEM)and ultra-violet(UV)visible spectroscopy were used to validate and characterize MgO NPs.The crystalline nature of MgONPs was determined using selected area electron diffraction(SAED).MgO NPs triggered substantial antifungal activity against A.dauci when exposed to 50 and 100 mg L^(–1)concentrations but the higher antifungal potential was noticed in 100 mg L^(–1)under invitro conditions.In fungal inoculated plants,a marked decrease in growth,photosynthetic pigments,and an increase in phenol,proline contents,and defense-related enzymes of carrot were seen over control(distilled water).However,foliar application of MgO NPs at 50 and 100 mg L^(–1)resulted in significant improvement of plant growth,photosynthetic pigments,phenol and proline contents,and defense enzymes activity of carrots with and without A.dauci infection.Spraying of MgO NPs at 100 mg L^(–1)had more plant length(17.11%),shoot dry weight(34.38%),plant fresh weight(20.46%),and root dry weight(49.09%)in carrots when challenged with A.dauci over inoculated control.The leaf blight indices and percent disease severity were also reduced in A.dauci inoculated plants when sprayed with MgO NPs.The non-bonding interactions of Alternaria genus protein with nanoparticles were studied using molecular docking.展开更多
Background: The centers of disease control and prevention define a non-urgent Emergency Department (NU-ED) visit as a medical condition requiring treatment within more than 24 hours. These visits constitute one of the...Background: The centers of disease control and prevention define a non-urgent Emergency Department (NU-ED) visit as a medical condition requiring treatment within more than 24 hours. These visits constitute one of the main reasons for emergency department (ED) overcrowding, which greatly affects healthcare workers’ wellbeing, health costs, patients’ satisfaction and treatment outcomes. Currently, there is no solid definition of non-urgent emergency visits, which is the first step towards dealing and potentially solving this issue. Having that, the aim of the current study is to define and validate the criteria for NU-ED visits in Israel. Methods: This qualitative study included twelve senior physicians and nurses working in Emergency Department and/or Health Maintenance Organizations (HMOs) across Israel. The study was performed using in-depth, semi-structured, open-ended interviews. Qualitative data analysis was performed by conventional content analysis. Results: The urgency of medical visits was defined based on these two questions: 1) Does the medical condition require an immediate treatment? 2) Is the emergency department the only place that can provide the required treatment at a certain timepoint? We found that non-urgent visits mostly occur during the nights and weekends, when medical treatments are not available in the HMOs. Visitors for non-urgent cases mostly complained about minor injuries or chronic conditions, fever, abdominal or chest pain. Most visits occurred based on referral from the family physician or the nurse from the call center. Participants reported a lack of awareness and knowledge about the roles of the EDs and the available options in the HMOs, which seem unable to provide patients with appropriate treatments. The usage of triage scales seems to ensure that patients are being treated based on the clinical urgency of their condition. Medical cases that score above 3 can be defined as non-urgent visits. Therefore, implementation of these scales in the community and their use in decision making of referrals to emergency department might greatly reduce non-urgent visits. Conclusions: Participants defined urgent ED visits as medical situations that need to be treated immediately, while there are no available treatment options in the HMOs. Participants identified many reasons behind NU referrals to the ED, mainly, low awareness about the role of ED, low availability of certain tests in the HMOs, and inability to provide adequate treatment in the community.展开更多
The sweet potato weevil(Cylas formicarius(Fab.)(Coleoptera: Brentidae)) is a pest that feeds on sweet potato(Ipomoea batatas(L.) Lam.(Solanales: Convolvulaceae)), causing substantial economic losses annually. However,...The sweet potato weevil(Cylas formicarius(Fab.)(Coleoptera: Brentidae)) is a pest that feeds on sweet potato(Ipomoea batatas(L.) Lam.(Solanales: Convolvulaceae)), causing substantial economic losses annually. However, no safe and effective methods have been found to protect sweet potato from this pest. Herbivore-induced plant volatiles(HIPVs)promote various defensive bioactivities, but their formation and the defense mechanisms in sweet potato have not been investigated. To identify the defensive HIPVs in sweet potato, the release dynamics of volatiles was monitored.The biosynthetic pathways and regulatory factors of the candidate HIPVs were revealed via stable isotope tracing and analyses at the transcriptional and metabolic levels. Finally, the anti-insect activities and the defense mechanisms of the gaseous candidates were evaluated. The production of(Z)-3-hexenyl acetate(z3HAC) and allo-ocimene was induced by sweet potato weevil feeding, with a distinct circadian rhythm. Ipomoea batatas ocimene synthase(IbOS) is first reported here as a key gene in allo-ocimene synthesis. Insect-induced wounding promoted the production of the substrate,(Z)-3-hexenol, and upregulated the expression of IbOS, which resulted in higher contents of z3HAC and allo-ocimene,respectively. Gaseous z3HAC and allo-ocimene primed nearby plants to defend themselves against sweet potato weevils. These results provide important data regarding the formation, regulation, and signal transduction mechanisms of defensive volatiles in sweet potato, with potential implications for improving sweet potato weevil management strategies.展开更多
文摘Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to provide advice and guidance in risk departments. Methods: According to the latest plan of diagnosis and treatment, prevention and control issued by the National Health Commission, expert advice and consensus, combined with the actual situation in our hospital, a series of infection prevention and control measures of COVID-19 in risk department was formulated. Results: During the epidemic period, the prevention and control measures of nine risk departments including emergency operation, anesthesiology, endoscopy center, blood purification center, otolaryngology, stomatology, medical imaging department, medical cosmetology department and pulmonary function room were established from six aspects, including pre-examination and screening, medical technology control, personnel management, personal protection, environmental disinfection, medical waste disposal, etc. Conclusion: During the epidemic period, the infection prevention and control strategy of risk departments is one of the key links to control the spread of the epidemic, and risk departments must pay attention to and strictly implement various infection prevention and control measures.
文摘Background: Maternal and neonatal mortality remains a public health problem in Benin. Each year, approximately 1500 maternal deaths and more than 12,000 newborn deaths are recorded there. In order to correct the situation, strategies such as the implementation of Emergency Obstetric and Neonatal Care (EmONC) were initiated. Objective: Determine the rates of maternal deaths in EmONC centers in the Collines department from 2018 to 2022. Framework and Methods: The study took place in Benin precisely in the Collines department. This was a descriptive cross-sectional study. Data collection was carried out during the first two weeks of January 2023 and covered data from the 09 Basic Emergency Obstetric and Neonatal Care centers (BEMONC) and the Obstetric and Neonatal Care centers of Complete Emergency (CEmONC) of the Collines department from 2018 to 2022. An estimate of the ratios of maternal deaths occurring at the level of the EmONC centers of the Collines department from 2018-2022 was carried out followed by constructive suggestions. Results: During the five years (2018 to 2022), the Collines department recorded 42,582 live births with 148 maternal deaths, i.e. a ratio of 348 maternal deaths per 100,000 live births. Between 2018 and 2022, the highest maternal death ratio was recorded in 2019, i.e. 425 maternal deaths per 100,000 live births for all EmONC centers and 607 maternal deaths per 100,000 live births in EmONC centers. The highest maternal death ratio at the BEmONC center level was recorded in 2020, i.e. 129 maternal deaths per 100,000 births. Conclusion: These results suggest that despite the implementation of EmONC in the Collines department, maternal deaths have not decreased. To improve these outcomes for a reduction in maternal deaths, urgent action must be taken.
基金funded by the Tecnológico Nacional de México(TECNM):Project No.6602.18-P.
文摘The objective to this work was to evaluate the enzymatic activity in the culture of Solanum lycopersicum L.infected with Fusarium oxysporum after the combined application of Beauveria bassiana and plant extracts.Solanum lycopersicum plantlets were transplanted 15 days after the emergency.Five days after transplanting,Beauveria bassiana spores were applied at a concentration of 1×10^(7)spores mL^(−1)onto soil(along with A.indica(N)and P.auritum(H)leaf extracts)where S.lycopersicum plants were planted.Eight days after transplanting,spores of F.oxysporum strain were applied at a concentration of 1×10^(6)spores mL^(−1)to soil where S.lycopersicum plants were growing.The development of S.lycopersicum plants was monitored for 114 days,whereby a randomized complete block treatment design was used,the roots of the plants were crushed with liquid nitrogen,after which UV/VIS spectrophotometry was used to determine protein concentration,as well as the activity ofβ-1,3-glucanases,peroxidases(POX,EC1.11.1.7),catalase and chitinases.The treatments combining B.bassiana and A.indica and P.auritum extracts,had a significant difference in enzymatic activity levels,thus contributing to better defense mechanisms and a greater protection to S.lycopersicum plants in the presence of F.oxysporum.The application of B.bassiana and plant extracts to the ground mitigated damage caused by F.oxysporum on S.lycopersicum plants.
文摘BACKGROUND Disorders of consciousness including coma in non-trauma patients can be caused by a wide variety of pathologies affecting the central nervous system.They represent a frequent challenge in emergency medicine and are combined with a very high in-hospital mortality.Hence,early treatment of these patients is vital and increases the likelihood of a good outcome.AIM To identify the causes of altered consciousness presentation to the Emergency Department at Suez Canal University Hospital.METHODS This was a descriptive cross-sectional study conducted on 87 patients with acute non-traumatic disturbed level of consciousness(DLOC)at the Emergency Department.RESULTS The mean age of the studied patients was 60.5±13.6 years.Among them,60%were males and 40%were females.The most common cause of acute non-traumatic DLOC was systemic infection,such as sepsis and septic shock(25.3%),followed by respiratory causes(24.1%)and neurological causes(18.4%).CONCLUSION The most common cause of acute non-traumatic DLOC was systemic infections followed by respiratory and neurological causes.
文摘Arsenic(As)contaminated food chains have emerged as a serious public concern for humans and animals and are known to affect the cultivation of edible crops throughout the world.Therefore,the present study was designed to investigate the individual as well as the combined effects of exogenous silicon(Si)and sodium nitroprusside(SNP),a nitric oxide(NO)donor,on plant growth,metabolites,and antioxidant defense systems of radish(Raphanus sativus L.)plants under three different concentrations of As stress,i.e.,0.3,0.5,and 0.7 mM in a pot experiment.The results showed that As stress reduced the growth parameters of radish plants by increasing the level of oxidative stress markers,i.e.,malondialdehyde and hydrogen peroxide.However,foliar application of Si(2 mM)and pretreatment with SNP(100μM)alone as well as in combination with Si improved the plant growth parameters,i.e.,root length,fresh and dry weight of plants under As stress.Furthermore,As stress also reduced protein,and metabolites contents(flavonoids,phenolic and anthocyanin).Activities of antioxidative enzymes such as catalase(CAT),ascorbate peroxidase(APX),guaiacol peroxidase(POD),and polyphenol oxidase(PPO),as well as the content of non-enzymatic antioxidants(glutathione and ascorbic acid)decreased under As stress.In most of the parameters in radish,As III concentration showed maximum reduction,as compared to As I and II concentrations.However,the individual and combined application of Si and NO significantly alleviated the As-mediated oxidative stress in radish plants by increasing the protein,and metabolites content.Enhancement in the activities of CAT,APX,POD and PPO enzymes were recorded.Contents of glutathione and ascorbic acid were also enhanced in response to co-application of Si and NO under As stress.Results obtained were more pronounced when Si and NO were applied in combination under As stress,as compared to their individual application.In short,the current study highlights that Si and NO synergistically regulate plant growth through lowering the As-mediated oxidative stress by upregulating the metabolites content,activity of antioxidative enzymes and non-enzymatic antioxidants in radish plants.
文摘The 84 km Panama Canal connecting the Atlantic and Pacific oceans has historically been a strategic waterway for shipping and the location of United States (US) military bases. Since the construction of Lake Gatun reservoir, canal locks and navigation channel through the Isthmus of Panama tropical forests in the 1910s, chemicals, pesticides, and herbicides have been essential for controlling upland and wetland vegetation as well as managing mosquito-borne diseases. Chemicals and pesticides flowed into Lake Gatun via land surface runoff and subsurface drainage either attached to the sediment or in solution during the rainy season. Lake Gatun and the Panama Canal was the drinking water source for most of the civilian and military population living in the Panama Canal Zone. Between 1948 and 1999, US military base commanders had the ability to order, from the Federal Supply Catalog, commercially available herbicide 2,4,5-T with unknown amounts of dioxin TCDD for use on the military base grounds in the Panama Canal Zone. The herbicide 2,4,5-T was transported to Panama Canal Zone ports, including the ports Cristobal on the Caribbean and Balboa on the Pacific, and distributed to the US military bases in Panama by rail or truck. The US National Toxicology Program and the International Agency for the Research on Cancer listed dioxin and TCDD as known human carcinogens. Dioxins are endocrine disrupters and can cause certain chloracne, cancers, developmental and reproductive effects. In 1985, the United States government banned the manufacture of the herbicide 2,4,5-T, with unknown amounts of dioxin TCDD, after it was shown to cause cancer in animals. The objectives of this study are to determine: 1) the fate of dioxin TCDD, a contaminant in the herbicide 2,4,5-T, sprayed on the US military base vegetation in the Panama Canal Zone from 1948 to 1999, 2) the transport of dioxin TCDD rich sediment via soil erosion and overland flow into Lake Gatun and Panama Canal waterways and 3) the human health impacts of dioxin TCDD, a known carcinogen, on US military and Panamanian civilians exposed to dioxin TCDD in the Panama Canal Zone.
文摘BACKGROUND: We aimed to explore the impact of the emergency department length of stay(EDLOS) on the outcome of trauma patients.METHODS: A retrospective study was conducted on all trauma patients requiring hospitalization between 2015 and 2019. Patients were categorized into 4 groups based on the EDLOS(<4 h, 4–12 h,12–24 h, and >24 h). Data were analyzed using Chi-square test(categorical variables), Student’s t-test(continuous variables), correlation coefficient, analysis of variance and multivariate logistic regression analysis for identifying predictors of short EDLOS and hospital mortality.RESULTS: The study involved 7,026 patients with a mean age of 32.1±15.6 years. Onefifth of patients had a short EDLOS(<4 h) and had higher level trauma team T1 activation(TTA-1), higher Injury Severity Score(ISS), higher shock index(SI), and more head injuries than the other groups(P=0.001). Patients with an EDLOS >24 h were older(P=0.001) and had more comorbidities(P=0.001) and fewer deaths(P=0.001). Multivariate regression analysis showed that the predictors of short EDLOS were female gender, GCS, SI, hemoglobin level, ISS, and blood transfusion. The predictors of mortality were TTA-1(odds ratio [OR]=4.081, 95%CI: 2.364–7.045), head injury(OR=3.920, 95%CI: 2.413–6.368), blood transfusion(OR=2.773, 95%CI: 1.668–4.609), SI(OR=2.132, 95%CI: 1.364–3.332), ISS(OR=1.077, 95%CI: 1.057–1.096), and age(OR=1.040, 95%CI: 1.026–1.054). CONCLUSIONS: Patients with shorter EDLOS had different baseline characteristics and hospital outcomes compared with patients with longer EDLOS. Patients with prolonged EDLOS had better outcomes;however, the burden of prolonged boarding in the ED needs further elaboration.
基金funding from the European Union Next Generation EU(PIANO NAZIONALE DI RIPRESA E RESILIENZA(PNRR)–MISSIONE 4 COMPONENTE 2,INVESTIMENTO 1.4–D.D.103217/06/2022,CN00000022)。
文摘A headspace solid-phase microextraction-gas chromatography-mass spectrometry(HS-SPME/GC-MS)method was used to study the volatile organic compounds(VOCs)associated with the differential immune response of tomato plants infected with the recombinant strain of potato virus Y(PVY^(C)-to),necrogenic to tomato.Analysis was carried out in UC82(UC),a virus susceptible tomato variety,comparing the same UC plants grafted or not onto a virus tolerant tomato ecotype,Manduria(Ma);the three types of samples used for the GC-MS analysis were mock-inoculated UC/Ma plants,UC/Ma+PVY^(C)-to and UC+PVY^(C)-to plants;the VOCs obtained were 111.Results from symptomatic PVY^(C)-to-infected UC plants showed a VOCs composition enriched in alcohols,fatty acid derivates,benzenoids,and salicylic acid derivatives,while in mock-inoculated UC/Ma plants VOCs were mainly characterized by methyl ester compounds.The VOC profile was in line with RNAseq data analyses,denoting that PVY^(C)-to viral RNA accumulation and disease symptoms induce the specific transcriptional activation of genes involved in VOCs biosynthesis.Furthermore,principal component analysis highlighted that VOCs of PVY^(C)-to-infected and mock-inoculated grafted plants were much closer each other than that of symptomatic PVY^(C)-to-infected non-grafted UC plants.These results suggest that VOCs profiles of tomato plants are related to the viral RNA accumulation,disease intensity and graft-derived tolerance to PVY^(C)-to infection.
基金supported by the Key Project for New Agricultural Cultivar Breeding in Zhejiang Province (Grant No.2021C02066-6)China Postdoctoral Science Foundation (Grant No.2020M671732)the Fundamental Research Funds for the Zhejiang Provincial Universities (Grant No.2021XZZX026)。
文摘Glycosylated volatiles are considered as hidden aroma precursors that affect fruit flavor and are involved in plant defense response. Several uridine-diphosphate(UDP)-glycosyltransferase(UGT) members related to the glycosylation of volatiles have been identified from grapevine berries. Although grapevine leaves produced much higher levels of glycosylated volatiles than berries, UGTs responsible for the production of glycosylated volatiles in leaves have not yet been identified. Here, eight novel UGT genes were cloned, among these four members that belong to UGT85A family(named UGT85A24, UGT85A25, UGT85A26, and UGT85A27) were localized in the cytoplasm and their recombinant proteins showed activity toward volatiles detected in grapevine, with geraniol as the preferred substrate in vitro. Two UGT genes with 98.1% homology differ in R/S-linalool selection. The UGT85A26-catalyzed substrate showed enrichment in S-linalool, whereas UGT85A27 showed a strong preference for R-linalool. UGT85A24 and UGT85A25 were expressed mainly in berries, and UGT85A26 and UGT85A27 were expressed predominantly in grapevine mature leaves and correlated with the highest content of glycosylated volatiles in the mature leaves. Methyl jasmonate(MeJA) induced the expression of UGT85A26 and UGT85A27 as well as the production of linalyl-β-glucoside, citronellyl-β-glucoside and phenethyl-β-glucoside. Transient overexpression of UGT85A26 and UGT85A27 in tobacco leaves led to the accumulation of linalyl-β-glucoside and an increase in citronellyl-β-glucoside in vivo. These results indicate that the expression of UGT85A26 and UGT85A27 is a major regulator affecting the content of glycosylated volatiles in grapevine.
文摘Multiple studies have reported decreased emergency department(ED)patient volumes during the coronavirus disease(COVID-19)pandemic,[1-6]including areas most affected by the virus.[7]Most existing studies have investigated general trends in ED presentations and have not examined the impact of COVID-19 on different types of EDs,specific ED patient groups,or illness presentations.
文摘BACKGROUND:Altered mental status(AMS) is a very common emergency case,but the exact etiology of many AMS patients is unknown.Patients often manifest vague symptoms,thus,AMS diagnosis and treatment are highly challenging for emergency physicians.The aim of this study is to provide a framework for the assessment of AMS patients.This assessment should allow providers to better understand the etiology of mental status changes and therefore improve diagnostic skills and management.METHODS:This is a prospective cohort observational study.We recruited all adult patients with undifferentiated AMS at a single center tertiary care academic emergency department over 24months(June 2009 to June 2011).Demographic characteristics,clinical manifestations,assessment approaches,causative factors,emergency treatments and outcomes were collected prospectively.RESULTS:In 1934 patients with AMS recruited,accounting for 0.93%of all emergency department(ED) patients,1 026(53.1%) were male,and 908(46.9%) female.Their average age was 51.95±15.71 years.Etiologic factors were neurological(n=641;35.0%),pharmacological and toxicological(n=421;23.0%),systemic and organic(n=266;14.5%),infectious(n=167;9.1%),endocrine/metabolic(n=145;7.9%),psychiatric(n=71;3.9%),traumatic(n=38;2.1%),and gynecologic and obstetric(n=35;1.9%).Total mortality rate was 8.1%(n=156).The death rate was higher in elderly patients(≥60) than in younger patients(10.8%vs.6.9%,P=0.003).CONCLUSIONS:Patients with AMS pose a challenge for ED physicians.The most frequently encountered diagnostic categories causing AMS were primary CNS disorders,intoxication,organ system dysfunction,and endocrine/metabolic diseases.AMS has a high fatality rate in the ED.AMS is an important warning signal for ED patients because of its potentially fatal and reversible effects.Prompt evaluation and treatment are essential to decreasing morbidity and mortality associated with AMS.
文摘Host defense peptides(HDPs)are small molecules with broad-spectrum antimicrobial activities against infectious bacteria,viruses,and fungi.Increasing evidence suggests that HDPs can also indirectly protect hosts by modulating their immune responses.Due to these dual roles,HDPs have been considered one of the most promising antibiotic substitutes to improve growth performance,intestinal health,and immunity in farm animals.This review describes the antimicrobial and immunomodulatory roles of host defense peptides and their recent applications in animal production.
基金funded by the Provincial Natural Science Foundation of Hebei for Excellent Young Scholar, China (C2021204071)the Science and Technology Project of Hebei Education Department (QN2021079)+1 种基金the Key Research and Development Project of Hebei Province (21326511D and 19226504D)the China Agriculture Research System of MOF and MARA (CARS-02)。
文摘Botanical herbicide has been a hot topic in the research and development of novel pesticides. The herbicidal activity and biochemical characteristics of the botanical compound drupacine were studied by evaluating its effects on seed germination, seedling growth, morphological and physiological characteristics of Amaranthus retroflexus. Drupacine inhibited seed germination and seedling growth, and had a median inhibition concentration(IC50) value of 38.99 mg L-1against A. retroflexus root. The α-amylase activity and soluble sugar content in treated plants were significantly lower than that of the control. The expression of α-amylase gene was dosage-dependently inhibited compared to the untreated control. This suggested that inhibition of α-amylase activity was a mode of action on seed germination. The root hairs were significantly decreased and part of the root cap fell off after treatment with drupacine. The ultrastructure observation showed that cell damage of root tips increased with the treatment time. Drupacine also increased the relative conductivity and malondialdehyde(MDA) content. Peroxidase(POD), catalase(CAT), and superoxide dismutase(SOD) activities were significantly enhanced in the treatment compared to the control. These findings indicated that the physiological and biochemical reaction changes leading to morphological and membrane injuries were the main effects of drupacine on the inhibition of seedling growth. Drupacine can be developed as a botanical herbicide.
文摘BACKGROUND: Mild to moderate musculoskeletal trauma is a common cause for an emergency room visit, and frequent pain is one of the cardinal symptoms of consultation. The objective of this study is to assess the perception of a single subcutaneous dose of 50 mg tramadol for pain management in patients with mild to moderate musculoskeletal trauma, likewise to appraise the perception of pain by subcutaneous injection.METHODS: A total of 77 patients, who met inclusion criteria, received a single subcutaneous dose of tramadol. Pain control was evaluated based on the verbal numerical pain scale(0–10) at baseline, 20 and 60 minutes; similarly, pain perception was evaluated secondary to subcutaneous injection of the analgesic.RESULTS: On admission, the average pain perceived by patients was 8; twenty minutes later, 89% of the patients reported fi ve or less, and after sixty minutes, 94% had three or less on the verbal numerical pain scale. Of the patients, 88% reported pain perception by verbal numeric scale of 3 or less by injection of the drug, and 6.5% required a second analgesic for pain control. Two events with drug administration(soft tissue infection and mild abdominal rectus injection) were reported.CONCLUSION: We conclude that a single subcutaneous dose of tramadol is a safe and effective option for the management of patients with mild to moderate pain and musculoskeletal disease in the emergency department.
基金supported in part by an unrestricted educational grant from Mylan Specialty Pharmaceuticals(Basking Ridge,NJ)
文摘BACKGROUND:Anaphylaxis is characterized by acute episodes of potentially life-threatening symptoms that are often treated in the emergency setting.Current guidelines recommend:1) quick diagnosis using standard criteria;2) first-line treatment with epinephrine;and 3) discharge with a prescription for an epinephrine auto-injector,written instructions regarding long-term management,and a referral(preferably,allergy) for follow-up.However,studies suggest low concordance with guideline recommendations by emergency medicine(EM) providers.The study aimed to evaluate how emergency departments(EDs) in the United States(US) manage anaphylaxis in relation to guideline recommendations.METHODS:This was an online anonymous survey of a random sample of EM health providers in US EDs.RESULTS:Data analysis included 207 EM providers.For respondent EDs,approximately 9%reported using agreed-upon clinical criteria to diagnose anaphylaxis;42%reported administering epinephrine in the ED for most anaphylaxis episodes;and <50%provided patients with a prescription for an epinephrine auto-injector and/or an allergist referral on discharge.Most provided some written materials,and follow-up with a primary care clinician was recommended.CONCLUSIONS:This is the first cross-sectional survey to provide "real-world" data showing that practice in US EDs is discordant with current guideline recommendations for the diagnosis,treatment,and follow-up of patients with anaphylaxis.The primary gaps are low(or no) utilization of standard criteria for defining anaphylaxis and inconsistent use of epinephrine.Prospective research is recommended.
基金supported by a pilot grant from the Research Center for Minority Institutes (RCMI) program (2G12RR003050-24/8G12MD007579-27) (Q.T.)an American Cancer Society grant (RSG-090289-01MPC) (Q.T)+1 种基金NIH/NIAID SC1AI112785 (Q.T.)the Ponce Health Sciences University/RCMI Publications Office (G12 RR003050/8G12MD007579-27)
文摘Three crucial hurdles hinder studies on human cytomegalovirus(HCMV): strict species specificity, differences between in vivo and in vitro infection, and the complexity of gene regulation. Ever since the sequencing of the whole genome was first accomplished, functional studies on individual genes have been the mainstream in the CMV field. Gene regulation has therefore been elucidated in a more detailed fashion. However, viral gene regulation is largely controlled by both cellular and viral components. In other words, viral gene expression is determined by the virus–host interaction. Generally, cells respond to viral infection in a defensive pattern; at the same time, viruses try to counteract the cellular defense or else hide in the host(latency). Viruses evolve effective strategies against cellular defense in order to achieve replicative success. Whether or not they are successful, cellular defenses remain in the whole viral replication cycle: entry, immediate–early(IE) gene expression, early gene expression, DNA replication, late gene expression, and viral egress. Many viral strategies against cellular defense, and which occur in the immediate–early time of viral infection, have been documented. In this review, we will summarize the documented biological functions of IE1 and pp71 proteins, especially with regard to how they counteract cellular intrinsic defenses.
文摘Background: The world of cancer care is an emotional place, given the severity of the disease being treated, the heavy workload, the suffering of patients, and the high number of deaths. The nursing staff who work there may be exposed to constant stress from these factors. This study aimed to explore the psychological experience of the nursing staff of the Medical Oncology Department of the Yaoundé General Hospital. Methods: We carried out a cross-sectional study, in June 2017, involving the nursing staff of the Medical Oncology Department of the Yaoundé General Hospital. Results: Sixteen out of 18 nurses were interviewed. All had worked in at least one other department prior to Oncology. The number of years of experience in Oncology ranged from less than one year to 13 years. The choice of the Oncology department was involuntary for 100% of the staff;of these, 62% had intentions of changing departments. Twenty-five percent had applied for a change of department, which was unsuccessful. Stress was expressed by 94% of the staff;93% thought that there was a solution to the stress experienced on a daily basis in the Oncology department. The main solutions proposed to manage this stress were: support for the staff, provision of work materials, and staff training. Conclusion: The nursing staff of the Medical Oncology Department of the Yaoundé General Hospital experiences a high level of stress and are in need of solutions.
基金the Researchers Supporting Project Number(RSP2023R339)at King Saud University,Riyadh,Saudi Arabia。
文摘In this research,green synthesized magnesium oxide nanoparticles(MgO NPs)from lemon fruit extracts and their fungicidal potential was evaluated against Alternaria dauci infection on carrot(Daucus carota L.)under greenhouse conditions.The scanning and transmission electron microscopy(SEM and TEM)and ultra-violet(UV)visible spectroscopy were used to validate and characterize MgO NPs.The crystalline nature of MgONPs was determined using selected area electron diffraction(SAED).MgO NPs triggered substantial antifungal activity against A.dauci when exposed to 50 and 100 mg L^(–1)concentrations but the higher antifungal potential was noticed in 100 mg L^(–1)under invitro conditions.In fungal inoculated plants,a marked decrease in growth,photosynthetic pigments,and an increase in phenol,proline contents,and defense-related enzymes of carrot were seen over control(distilled water).However,foliar application of MgO NPs at 50 and 100 mg L^(–1)resulted in significant improvement of plant growth,photosynthetic pigments,phenol and proline contents,and defense enzymes activity of carrots with and without A.dauci infection.Spraying of MgO NPs at 100 mg L^(–1)had more plant length(17.11%),shoot dry weight(34.38%),plant fresh weight(20.46%),and root dry weight(49.09%)in carrots when challenged with A.dauci over inoculated control.The leaf blight indices and percent disease severity were also reduced in A.dauci inoculated plants when sprayed with MgO NPs.The non-bonding interactions of Alternaria genus protein with nanoparticles were studied using molecular docking.
文摘Background: The centers of disease control and prevention define a non-urgent Emergency Department (NU-ED) visit as a medical condition requiring treatment within more than 24 hours. These visits constitute one of the main reasons for emergency department (ED) overcrowding, which greatly affects healthcare workers’ wellbeing, health costs, patients’ satisfaction and treatment outcomes. Currently, there is no solid definition of non-urgent emergency visits, which is the first step towards dealing and potentially solving this issue. Having that, the aim of the current study is to define and validate the criteria for NU-ED visits in Israel. Methods: This qualitative study included twelve senior physicians and nurses working in Emergency Department and/or Health Maintenance Organizations (HMOs) across Israel. The study was performed using in-depth, semi-structured, open-ended interviews. Qualitative data analysis was performed by conventional content analysis. Results: The urgency of medical visits was defined based on these two questions: 1) Does the medical condition require an immediate treatment? 2) Is the emergency department the only place that can provide the required treatment at a certain timepoint? We found that non-urgent visits mostly occur during the nights and weekends, when medical treatments are not available in the HMOs. Visitors for non-urgent cases mostly complained about minor injuries or chronic conditions, fever, abdominal or chest pain. Most visits occurred based on referral from the family physician or the nurse from the call center. Participants reported a lack of awareness and knowledge about the roles of the EDs and the available options in the HMOs, which seem unable to provide patients with appropriate treatments. The usage of triage scales seems to ensure that patients are being treated based on the clinical urgency of their condition. Medical cases that score above 3 can be defined as non-urgent visits. Therefore, implementation of these scales in the community and their use in decision making of referrals to emergency department might greatly reduce non-urgent visits. Conclusions: Participants defined urgent ED visits as medical situations that need to be treated immediately, while there are no available treatment options in the HMOs. Participants identified many reasons behind NU referrals to the ED, mainly, low awareness about the role of ED, low availability of certain tests in the HMOs, and inability to provide adequate treatment in the community.
基金supported by the National Natural Science Foundation of China–Guangdong Natural Science Foundation Joint Project (U1701234)。
文摘The sweet potato weevil(Cylas formicarius(Fab.)(Coleoptera: Brentidae)) is a pest that feeds on sweet potato(Ipomoea batatas(L.) Lam.(Solanales: Convolvulaceae)), causing substantial economic losses annually. However, no safe and effective methods have been found to protect sweet potato from this pest. Herbivore-induced plant volatiles(HIPVs)promote various defensive bioactivities, but their formation and the defense mechanisms in sweet potato have not been investigated. To identify the defensive HIPVs in sweet potato, the release dynamics of volatiles was monitored.The biosynthetic pathways and regulatory factors of the candidate HIPVs were revealed via stable isotope tracing and analyses at the transcriptional and metabolic levels. Finally, the anti-insect activities and the defense mechanisms of the gaseous candidates were evaluated. The production of(Z)-3-hexenyl acetate(z3HAC) and allo-ocimene was induced by sweet potato weevil feeding, with a distinct circadian rhythm. Ipomoea batatas ocimene synthase(IbOS) is first reported here as a key gene in allo-ocimene synthesis. Insect-induced wounding promoted the production of the substrate,(Z)-3-hexenol, and upregulated the expression of IbOS, which resulted in higher contents of z3HAC and allo-ocimene,respectively. Gaseous z3HAC and allo-ocimene primed nearby plants to defend themselves against sweet potato weevils. These results provide important data regarding the formation, regulation, and signal transduction mechanisms of defensive volatiles in sweet potato, with potential implications for improving sweet potato weevil management strategies.
