Household and behavioral determinants of indoor PM2.5 in a rural solid fuel burning Native American community.

Indoor and outdoor concentrations of PM2.5 were measured for 24 h during heating and non-heating seasons in a rural solid fuel burning Native American community. Household building characteristics were collected during the initial home sampling visit using technician walkthrough questionnaires, and behavioral factors were collected through questionnaires by interviewers. To identify seasonal behavioral factors and household characteristics associated with indoor PM2.5 , data were analyzed separately by heating and non-heating seasons using multivariable regression. Concentrations of PM2.5 were significantly higher during the heating season (indoor: 36.2 µg/m3 ; outdoor: 22.1 µg/m3 ) compared with the non-heating season (indoor: 14.6 µg/m3 ; outdoor: 9.3 µg/m3 ). Heating season indoor PM2.5 was strongly associated with heating fuel type, housing type, indoor pests, use of a climate control unit, number of interior doors, and indoor relative humidity. During the non-heating season, different behavioral and household characteristics were associated with indoor PM2.5 concentrations (indoor smoking and/or burning incense, opening doors and windows, area of surrounding environment, building size and height, and outdoor PM2.5 ). Homes heated with coal and/or wood, or a combination of coal and/or wood with electricity and/or natural gas had elevated indoor PM2.5 concentrations that exceeded both the EPA ambient standard (35 µg/m3 ) and the WHO guideline (25 µg/m3 ).

Quality of Fixed Dental Prostheses and Patient Satisfaction in a Sample From Saudi Arabia.

BACKGROUND: The objective of the study was to retrospectively assess the clinical performance of dental prostheses, single crowns, and three-unit bridges to identify clinical biological and mechanical complications in the Ha'il province of Saudi Arabia. METHODS: The study was conducted between March 2021 to October 2021 and included 421 patients who underwent crown and tooth-supported fixed partial denture (FPD) procedures at the Dental Polyclinics Center in the Ha'il region of Saudi Arabia from 2010-2020. The planned sampling approach was applied. Patients who underwent crown and FPD placements at the dental center within the scheduled period were identified through clinical assessments. The inclusion criteria were met by patients with three-unit FPDs and a single crown containing a natural contralateral tooth or teeth. A total of six general dentists conducted clinical exams. Patient satisfaction and technical and biological issues were the evaluation criteria for crowns and FPDs. The frequency and percentage of the various characteristics employed in the current investigation were ascertained using cross-tabulation. The Chi-square test was employed to assess the associations between categorical variables, with p-values ≤ 0.05 considered significant.  Results: Marginal integrity was recorded in 332 participants (78.9%), which was satisfactory for the majority of the restoration. The acceptance morphology was present in 252 (59.9%) restorations. The highest rate of the restorations 274 (66.2%) had satisfactory color. In 86 cases (20.4%), there was visible periodontal depth of at least 5 mm. Three hundred and six (72.7%) of the fixed restorations had gingival bleeding connected to them, and 96 (22.8%) teeth had periapical lesions. A total of 311 patients (73.9%) reported they were satisfied with their fixed restorations. CONCLUSIONS: The technical and biological complications noted in the current study were not higher compared with other studies of crowns and fixed dental prostheses. The majority of patients were satisfied with the restoration.

Loss of Slc12a2 specifically in pancreatic ß-cells drives metabolic syndrome in mice.

The risk of type-2 diabetes and cardiovascular disease is higher in subjects with metabolic syndrome, a cluster of clinical conditions characterized by obesity, impaired glucose metabolism, hyperinsulinemia, hyperlipidemia and hypertension. Diuretics are frequently used to treat hypertension in these patients, however, their use has long been associated with poor metabolic outcomes which cannot be fully explained by their diuretic effects. Here, we show that mice lacking the diuretic-sensitive Na+K+2Cl-cotransporter-1 Nkcc1 (Slc12a2) in insulin-secreting ß-cells of the pancreatic islet (Nkcc1ßKO) have reduced in vitro insulin responses to glucose. This is associated with islet hypoplasia at the expense of fewer and smaller ß-cells. Remarkably, Nkcc1ßKO mice excessively gain weight and progressive metabolic syndrome when fed a standard chow diet ad libitum. This is characterized by impaired hepatic insulin receptor activation and altered lipid metabolism. Indeed, overweight Nkcc1ßKO but not lean mice had fasting and fed hyperglycemia, hypertriglyceridemia and non-alcoholic steatohepatitis. Notably, fasting hyperinsulinemia was detected earlier than hyperglycemia, insulin resistance, glucose intolerance and increased hepatic de novo gluconeogenesis. Therefore, our data provide evidence supporting the novel hypothesis that primary ß-cell defects related to Nkcc1-regulated intracellular Cl-homeostasis and ß-cell growth can result in the development of metabolic syndrome shedding light into additional potential mechanisms whereby chronic diuretic use may have adverse effects on metabolic homeostasis in susceptible individuals.

Long-term Immunity Against Hepatitis B Virus After Routine Immunization Among Adults Visiting Primary Care Centers in Riyadh, Saudi Arabia.

Objective This study aimed to determine the persistence of induced immunity against hepatitis B virus (HBV) among adults routinely vaccinated during their infancy and correlate the level of induced immunity with participant characteristics. Methodology This was a cross-sectional study conducted among visitors to primary care centers of the Ministry of Health (MOH) in Riyadh, the Kingdom of Saudi Arabia (KSA) during the period from August 2020 to January 2021. The study population included healthy adults of both genders who had received full doses of the HBV vaccine in infancy. Data related to participant characteristics were collected using a self-administered questionnaire. A blood sample was then taken from each participant to measure the serum level of hepatitis B surface antigen (HBsAg), antibodies against HBsAg (anti-HBs), and antibodies against hepatitis B core antigen (ani-HBc). Results A total of 400 subjects participated in the study; the mean age of the cohort was 25 years. Almost all of them were Saudis (99.30%), and more than half (57.50%) were males. Only 24.30% had an anti-HBs antibodies level of ≥10 IU/L, and all respondents were negative for HBs antigen. No significant association between participant characteristics and anti-HBs antibody levels was found. Conclusion A decline in immunity many years after HBV vaccinations taken in infancy has been well-documented. However, for low-risk populations, the boosting of HBV vaccines is probably unnecessary since the immune memory provides sufficient protection despite low or undetectable anti-HBs antibodies.

Comparison of Perceived and Observed Hand Hygiene Compliance in Healthcare Workers in MERS-CoV Endemic Regions.

This study investigated healthcare workers' perceptions of hand hygiene practices by comparing personal reports, as assessed by questionnaires, to direct observations of the workers' hand hygiene practices. The study employed a cross-sectional research design. Observations were made using a 16-item checklist, based on three sources: Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and Boyce and Pittet's guidelines of hand hygiene. The checklist was used for both direct-observation and self-reported data collection purposes. Pearson correlation and Multivariate Analysis of Covariance (MANCOVA) were utilized to statistically determine the relationship between healthcare workers' reports of hand hygiene practices and observed hand hygiene behaviors. The study was conducted in the outpatient examination rooms and emergency departments of three types of hospitals in the Eastern region of Saudi Arabia where Middle East respiratory syndrome coronavirus (MERS-CoV) is endemic and is observed in routine cases and outbreaks. The total sample size included 87 physicians and nurses recruited while on duty during the scheduled observation periods, with each healthcare worker being observed during individual medical examinations with at least three patients. No statistically significant correlations between the healthcare workers' perceptions of hand hygiene practices and healthcare workers' actual behaviors were evident. Based on the self-report questionnaires, significant differences were found between physicians' and nurses' hand hygiene practices reports. Healthcare workers clearly understand the importance of careful hand hygiene practices, but based on researchers' observations, the medical personnel failed to properly implement protocol-driven hand hygiene applications. However, the significant differences between physicians' and nurses' self-reports suggest further inquiry is needed to fully explore these discrepancies.