The OCCHLTH Mnemonic-Construction and Content of a Tool for Increasing Awareness of Occupational Illness and Injury.

INTRODUCTION: Unidentified or nonmitigated occupational illnesses and injuries can complicate disease management. The "occupational health" (OCCHLTH) mnemonic aims to raise awareness of work-related exposures and associated illnesses and injuries. METHODS: Occupational safety and health history-taking elements were combined with peer-reviewed information [from the PubMed database (first review January 1, 2000, to February 8, 2016; updated to February 8, 2021)] about workplace exposure-outcome associations to create the mnemonic. RESULTS: Seven components constitute the OCCHLTH mnemonic. Literature results support its categories and subcategories. Three components represent symptom onset and health conditions. Four represent occupational exposures. Evaluating published occupational illness cases explored mnemonic applicability. CONCLUSIONS: Awareness of occupational risk factors can affect clinical decision-making. The OCCHLTH mnemonic encourages consideration of occupational causes of illness and injury to optimize patient care. Further evaluation of the utility of the OCCHLTH mnemonic is needed.

Evaluation of cytocompatibility and cell proliferation of electrospun chitosan/polyvinyl alcohol/montmorillonite clay scaffold with l929 cell lines in skin regeneration activity and in silico molecular docking studies.

The present investigation describes the development of a novel Chitosan/Polyvinyl Alcohol/Montmorillonite Clay (CS/PVA/MMT) scaffold by adopting an electrospinning method, and their biocompatibility was evaluated in vitro with L929 fibroblast cell line to ascertain its use in wound healing applications. The fabricated scaffold was characterized using analytical techniques. FT-IR measurement exhibited the existence of relevant functional groups and XRD implies scaffolds' amorphous nature. The scaffold's morphology and pore diameter were assessed using TEM and SEM. The pore diameter of the as-prepared scaffold was approximately 125 nm. The antimicrobial assay of the scaffold was evaluated against selected pathogens which demonstrated higher antimicrobial efficacy. The scavenging activity tested using the DPPH assay showed remarkable scavenging capability. The wound healing properties were tested through the Cytotoxicity assay conducted on the L929 assay which proved the scaffold to be a suitable material for cell proliferation. Also, a Molecular docking investigation was carried out for CS/PVA/MMT ligand using human neutrophil elastase (HNE) 1H1B protein as a receptor in the CB-Dock server. Studies conducted in silico revealed strong interaction and high binding energy ratings of CS/PVA/MMT ligand with key residues of human neutrophil elastase (HNE) 1H1B proteins that help in tissue regeneration activity.

An urgent call to address work-related psychosocial hazards and improve worker well-being.

Work-related psychosocial hazards are on the verge of surpassing many other occupational hazards in their contribution to ill-health, injury, disability, direct and indirect costs, and impact on business and national productivity. The risks associated with exposure to psychosocial hazards at work are compounded by the increasing background prevalence of mental health disorders in the working-age population. The extensive and cumulative impacts of these exposures represent an alarming public health problem that merits immediate, increased attention. In this paper, we review the linkage between work-related psychosocial hazards and adverse effects, their economic burden, and interventions to prevent and control these hazards. We identify six crucial societal actions: (1) increase awareness of this critical issue through a comprehensive public campaign; (2) increase etiologic, intervention, and implementation research; (3) initiate or augment surveillance efforts; (4) increase translation of research findings into guidance for employers and workers; (5) increase the number and diversity of professionals skilled in preventing and addressing psychosocial hazards; and (6) develop a national regulatory or consensus standard to prevent and control work-related psychosocial hazards.

Painful refractory erosive tongue lichen planus with malignant transformation.

We present a recent case of long standing erosive tongue lichen planus successfully treated by wide excision and reconstruction with a submental artery island flap. Erosive Lichen Planus is a progressive indolent potentially malignant condition that tends to end up with severe somatic or even neuropathic pain and malignant changes towards its final stages as elaborated in the presented commentary.

Development and characterization of rigid packaging material using cellulose/sugarcane bagasse and natural resins.

Composites developed from cellulose and natural resins have received much attention due to their low cost and positive environmental impact. Knowledge of the mechanical and degradation characteristics of cellulose based composite boards is essential to obtain indications of the strength and degradability of the resulting rigid packaging material. The composite was prepared with sugarcane bagasse and hybrid resin (a combination of epoxy and natural resin such as dammar, pine, and cashew nut shell liquid) with the mixing ratios (Bagasse fibers: Epoxy resin: Natural resin) 1:1:1.5, 1:1:1.75, and 1:1:2 using compression moulding method. Tensile strength, young's modulus, flexural strength, soil burial weight loss, microbial degradation, and CO2 evolution was determined. Cashew nut shell liquid (CNSL) resin-incorporated composite boards in the mixing ratio of 1:1:2 gave maximum flexural strength (5.10 MPa), tensile strength (3.10 MPa), and tensile modulus (0.97 MPa). The maximum degradation in soil burial test and CO2 evolution between the boards made using natural resin was found in the composite boards incorporated with CNSL resin with a mixing ratio of 1:1:1.5 were 8.30 % and 12.8 % respectively. The maximum weight loss percentage (3.49) in microbial degradation analysis was found in the composite board made using dammar resin in the mixing ratio of 1:1:1.5.

Spectroscopic profiling, DFT computations, molecular docking and molecular dynamic simulation of biologically active 5-isoquinolinesulfonic acid.

The title compound 5-isoquinolinesulfonic acid (5IQSA) is characterized using the FT-IR, FT-Raman, NMR and UV-Vis spectra. The optimized molecular geometry, vibrational assignments, infrared intensities and Raman scattering are precisely calculated using Density Functional Theory (DFT) with the B3LYP/6-311++G(d,p) basis set. The 1H and 13C NMR chemical shifts are computed and compared with the experimental data. The TD-DFT/M062X/6-311++G(d,p) method is used to compute UV-Vis for different solvents, and the results are compared to UV-Vis spectra obtained experimentally. The HOMO-LUMO band gap energy is calculated for various solvents and compared to the band gap of UV-Vis spectra. Molecular dynamics simulations are used to investigate the biomolecular stability. Non-Linear Optical (NLO) behaviour has been illustrated using hyperpolarizability calculations. Topological studies such as Reduced Gradient Density (RDG), Electron Localization Function (ELF) and Localized Orbital Locator (LOL) are performed. The Molecular Electrostatic Potential (MEP), Natural Bond Orbital (NBO) analysis, Fukui functions and thermodynamic properties were analysed. To explore the biological behaviour of the examined compound, molecular docking was performed to evaluate the hydrogen bond distance and binding energies with (2XA4) kinase inhibitor protein.Communicated by Ramaswamy H. Sarma.

Nanochitosan/carboxymethyl cellulose/TiO2 biocomposite for visible-light-induced photocatalytic degradation of crystal violet dye.

Development of novel bionanomaterials for water and wastewater treatment has gained increased attraction and attention in recent times. The present study reports an effective biocomposite-based nano-photocatalyst comprised of nanochitosan (NCS), carboxymethyl cellulose (CMC), and titanium dioxide (TiO2) synthesized by sol-gel technique. The as-prepared NCS/CMC/TiO2 photocatalyst was systematically characterized by X-ray diffraction, Fourier Transform Infrared spectroscopy, Scanning Electron Microscopy with energy dispersive X-beam spectroscopy, Differential scanning calorimetry (DSC), and Thermogravimetric analysis (TGA). Photocatalytic degradation of the crystal violet (CV) dye using this nano photocatalyst was studied by varying the irradiation time, catalyst dosage, feed pH, and initial dye concentration. Further, the kinetic analysis of dye degradation was explored using the Langmuir-Hinshelwood model, and a plausible photocatalytic mechanism was proposed. The modification of TiO2 using NCS and CMC accelerated photocurrent transport by increasing the number of photogenerated electrons and holes. Overall, the study indicated the excellent photocatalytic performance of 95% CV dye degradation by NCS/CMC/TiO2 than the bare inorganic TiO2 photocatalyst under visible light irradiation.

Unexpected case of chagas disease reactivation in endomyocardial biopsy for evaluation of cardiac allograft rejection.

Acute Chagas disease reactivation (CDR) after cardiac transplantation is a well-known phenomenon in endemic countries of Central and South America and Mexico, but is rare outside of those countries. In this report, we describe a case of a 49-year-old male who presented 25 weeks after heart transplant with clinical features concerning for acute rejection, including malaise, anorexia, weight loss, and fever. His immunosuppression therapy included tacrolimus, mycophenolate, and prednisone. An endomyocardial biopsy revealed lymphocytic and eosinophilic inflammation, myocyte damage, and rare foci of intracellular organisms consistent with Trypanosoma cruzi amastigotes. The patient had no known history of Chagas disease. Upon additional questioning, the patient endorsed bites from reduviid bugs during childhood in El Salvador. Follow-up serum PCR testing was positive for T. cruzi DNA. Tests for other infectious organisms and donor specific antibodies were negative. This case illustrates the striking clinical and histologic similarities between acute cellular rejection and acute CDR with cardiac involvement in heart transplant patients, and thus emphasizes the importance of pre-transplant testing for Chagas in patients with epidemiologic risk factors.

Vibrational spectroscopy, quantum computational and molecular docking studies on 2-chloroquinoline-3-carboxaldehyde.

The quantum mechanical density functional theory (DFT) approach was used to analyze vibrational spectroscopy for the title compound 2-chloroquinoline-3-carboxaldehyde, and the observations were compared to experimental results. B3LYP with the 6-311++ G (d, p) basis set produces the optimized molecular structure and vibrational assignments. The charge delocalization and hyper conjugative interactions were studied using NBO analysis. Fukui functions were used to determine the chemical reactivity of the examined molecule. The linear polarizability, first order polarizability, NLO and Thermodynamic properties are calculated. Additionally, Molecular electrostatic potential (MEP) and HOMO-LUMO are reported. Multi wavefunction analysis like ELF (Electron Localization Function) and LOL (Localized Orbital Locator) are analyzed. For the headline compound, drug-likeness properties were examined. Molecular docking analysis on the examined molecule are done to understand the biological functions of the headline molecule and the minimum binding energy, hydrogen bond interactions, are analyzed.

Sepsis in two hospitals in Rwanda: A retrospective cohort study of presentation, management, outcomes, and predictors of mortality.

PURPOSE: Few studies have assessed the presentation, management, and outcomes of sepsis in low-income countries (LICs). We sought to characterize these aspects of sepsis and to assess mortality predictors in sepsis in two referral hospitals in Rwanda. MATERIALS AND METHODS: This was a retrospective cohort study in two public academic referral hospitals in Rwanda. Data was abstracted from paper medical records of adult patients who met our criteria for sepsis. RESULTS: Of the 181 subjects who met eligibility criteria, 111 (61.3%) met our criteria for sepsis without shock and 70 (38.7%) met our criteria for septic shock. Thirty-five subjects (19.3%) were known to be HIV positive. The vast majority of septic patients (92.7%) received intravenous fluid therapy (median = 1.0 L within 8 hours), and 94.0% received antimicrobials. Vasopressors were administered to 32.0% of the cohort and 46.4% received mechanical ventilation. In-hospital mortality for all patients with sepsis was 51.4%, and it was 82.9% for those with septic shock. Baseline characteristic mortality predictors were respiratory rate, Glasgow Coma Scale score, and known HIV seropositivity. CONCLUSIONS: Septic patients in two public tertiary referral hospitals in Rwanda are young (median age = 40, IQR = 29, 59) and experience high rates of mortality. Predictors of mortality included baseline clinical characteristics and HIV seropositivity status. The majority of subjects were treated with intravenous fluids and antimicrobials. Further work is needed to understand clinical and management factors that may help improve mortality in septic patients in LICs.

Batch and column mode removal of the turquoise blue (TB) over bio-char based adsorbent from Prosopis Juliflora: Comparative study.

Biochar, created from Prosopis Juliflora (B-PJ) through an ionic polymerization route, was utilized as a sorbent to remediate turquoise blue (TB). The biochar was described utilizing Fourier change infrared spectroscopy. The effects of operating factors such as flow rate, bed depth, concentration, and solution pH were investigated in column mode. Thomas, Yoon-Nelson, and Adams-Bohart models were applied to examine the experimental column data and the correlation between operating factors. The greatest adsorption limit of the BPJ was discovered utilizing 200 mg/L of the adsorbate, B-PJ portion 3 g, at a contact time of 150 min and pH of 6. The adsorption energy and harmony isotherms were all around spoken to by the pseudo-second-request model and the Langmuir model, separately. The most extreme adsorption limit acquired from the Langmuir isotherm model was 0.005173 mg/g. The test energy information dissected utilizing various models featured that the pseudo-second request motor model created a prevalent depiction of the trial information. The adsorption energy followed a pseudo-second-request active model with high connection coefficients (R2 ˃0.98). These outcomes showed that alginate immobilized biochar is earth well-disposed locally accessible, powerful and practical adsorbent for the expulsion of TB color from modern wastewaters.

The Dermal Ridges as the Infallible Signature of Skin: An Overview.

Our skin is the largest organ and is composed of the dermis and epidermis. The skin surface has lines in the direction of elastic tension. The palmar and plantar skin lines are established before birth in the intrauterine development of the embryo. Dermatoglyphics is the study of epidermal lines on the palmar and plantar surface. It is a branch of biology, anthropology, genetics, and dermatology. Dermatoglyphics are closely associated with genetic factors. These attributes once formed in the womb remain unique and persist throughout the life of an individual unless the dermis is damaged. Digital and palmar dermatoglyphics are represented by fingerprint patterns, atd angle, a, b, c, d triradii, mail line index, etc. Sometimes either due to hereditary reasons, the pressure of intrauterine factors, or external environmental factors, chromosomal aberrations occur in the fetus. These aberrations are reflected in the form of increased angle of atd, variation in pattern frequency or ridge count between a-b triradii (ABRC), presence of unnatural flexion creases, and others in the fingerprints, palmprints, or footprints. These aberrations in dermatoglyphics are useful in studying the genetic abnormalities in ailments, personality disorders, and criminal tendencies.

Sample pooling, a population screening strategy for SARS-CoV2 to prevent future outbreak and mitigate the second-wave of infection of the virus

ProblemHow do we manage treatment and stabilization in clinical settings and static population communities like assisted living facility settings of their patient or resident populations during and post the SARS-CoV-2 pandemic? ScopeThis proposal explores the possible and predicted changes to standard operating procedures to the facility management and associated landscape and focuses on series of deployments, during and post peak SARS-CoV-2 activity, and will outline possible models for the current medical facility model that we operate with. This article primarily focuses on non-emergency facility management. Assumptions and understanding of the fieldWith a reduction in the numbers nationally, patients are highly motivated and likely to seek non-emergency and planned medical procedural treatment as early as possible as social distancing measures are eased and restrictions on non-urgent procedures are lifted. Conclusions and next stepsAn initial pan-national shutdown and suspension of services was necessary in an effort to ensure that essential medical services and resources were not strained. The authors feel that a strategic resumption of regular non-emergency treatments around the United States and continued provision of services at care facilities is possible with innovative testing strategies like pooled screening of large populations at a manageable price point. Moreover, pooling as a strategy when used widely, would be extremely effective at predicting outbreaks of the virus and as an effect help in mitigating the spread of the virus in its "second-wave". We have developed one such innovative pooling strategy that can be easily deployed across laboratories and reduce the cost of population wide COVID-19 testing significantly

Toxic heavy metal cadmium removal using chitosan and polypropylene based fiber composite.

The aim of the present work was to evaluate the performance of polypropylene (PP)/sisal fiber (SF)/banana fiber (BF) and chitosan-based hybrid (chitosan(CS)/SF)/BF) composite materials for the adsorptive removal of cadmium (Cd) ions from water waste. Polypropylene is harnessed for its importance in forming strong composite materials for various applications. Chitosan biopolymer encloses a great deal of amino and hydroxyl groups, which provide effective removal of Cd ions from wastewater. The batch adsorption studies proved that the removal of Cd ions was pH-dependent and attained optimum at pH 5.5 for both the composites. Langmuir and Freundlich models were applied for the obtained experimental values. Based on the R2 values, it was evidenced that the adsorption process was best fitted with the Freundlich isotherm than Langmuir. The sorption capacity of CS/SF/BF hybrid composite (Cmax = 419 mg/g) is higher than PP/SF/BF composite (Cmax = 304 mg/g), and allows multilayer adsorption. Kinetics studies revealed that the pseudo-second-order model was followed during the removal of Cd ion from wastewater. The overall evaluation proved that though both the adsorbents are suitable for the removal of Cd ions, the efficiency of CS-based ternary composite material is better than PP-based composite.

ED chest radiography for children with asthma exacerbation is infrequently associated with change of management.

BACKGROUND: Acute asthma exacerbations (AAE) account for many Pediatric Emergency Department (PED) visits. Chest radiography (CXR) is often performed in these patients to identify practice-changing findings such as pneumonia (PNA). Limited knowledge exists to balance the cost and radiation dose of CXR with expected yield of clinically meaningful information. OBJECTIVE: To determine in children with AAE with CXR, whether patient characteristics are associated with radiographic PNA; and significant practice change by initiation of antibiotic. DESIGN/METHODS: Retrospective chart review of AAE patients with CXR performed in a PED in 2014. We examined univariate associations between patient characteristics and PNA on CXR and administration of antibiotic. Multiple logistic regression models then subsequently examined adjusted associations between patient characteristics and both outcomes. RESULTS: Of 288 patients, 43 (15%) had PNA on CXR and 51 (17.8%) received antibiotics. There were no statistically significant univariate associations between either outcome and age, race, gender, insurance status, mode of PED arrival, fever or hypoxia (all p>0.11). Crackles were associated with antibiotic administration (p=0.03), but not PNA on CXR (p=0.07). Only previous antibiotic use within 7days had both significant univariate associations (p=0.002) and adjusted associations with both PNA on CXR (aOR 3.6) and antibiotic administration (aOR 3.3). CONCLUSION: CXR infrequently adds valuable information in children with AAE. Patients treated with antibiotic within 7days are more likely to have PNA identified on CXR and receive antibiotics. A larger study is needed to examine potential significance of hypoxia and crackles.

Metabolomics and Precision Medicine in Trauma: The State of the Field.

Trauma is a major problem in the United States. Mortality from trauma is the number one cause of death under the age of 45 in the United States and is the third leading cause of death for all age groups. There are approximately 200,000 deaths per year due to trauma in the United States at a cost of over $671 billion in combined healthcare costs and lost productivity. Unsurprisingly, trauma accounts for approximately 30% of all life-years lost in the United States. Due to immense development of trauma systems, a large majority of trauma patients survive the injury, but then go on to die from complications arising from the injury. These complications are marked by early and significant metabolic changes accompanied by inflammatory responses that lead to progressive organ failure and, ultimately, death. Early resuscitative and surgical interventions followed by close monitoring to identify and rescue treatment failures are key to successful outcomes. Currently, the adequacy of resuscitation is measured using vital signs, noninvasive methods such as bedside echocardiography or stroke volume variation, and other laboratory endpoints of resuscitation, such as lactate and base deficit. However, these methods may be too crude to understand cellular and subcellular changes that may be occurring in trauma patients. Better diagnostic and therapeutic markers are needed to assess the adequacy of interventions and monitor responses at a cellular and subcellular level and inform clinical decision-making before complications are clinically apparent. The developing field of metabolomics holds great promise in the identification and application of biochemical markers toward the clinical decision-making process.

Characterizing the Interrelationships of Prescription Opioid and Benzodiazepine Drugs With Worker Health and Workplace Hazards.

OBJECTIVE: Prescription opioid and benzodiazepine drug use, which has risen significantly, can affect worker health. Exploration of the scientific literature assessed (1) interrelationships of such drug use, occupational risk factors, and illness and injury, and (2) occupational and personal risk factor combinations that can affect their use. METHODS: The scientific literature from 2000 to 2015 was searched to determine any interrelationships. RESULTS: Evidence for eight conceptual models emerged based on the search yield of 133 articles. These models summarize interrelationships among prescription opioid and benzodiazepine use with occupational injury and illness. Factors associated with the use of these drugs included fatigue, impaired cognition, falls, motor vehicle crashes, and the use of multiple providers. CONCLUSION: Prescription opioid and benzodiazepine drugs may be both a personal risk factor for work-related injury and a consequence of workplace exposures.

A Case of Severe Iron Deficiency Anemia Associated with Long-Term Proton Pump Inhibitor Use.

The use of proton pump inhibitors (PPIs) in the treatment of gastrointestinal diseases has evolved over recent years. Initially intended for short-term use, PPIs are increasingly being used, often inappropriately, as long-term maintenance medications. The mechanism of action of PPIs is suppression of gastric basal and stimulated acid secretion by inhibiting the parietal cell H+/K+ ATP pump with a resultant increase in gastric pH and hypo- or achlorhydria. Although short-term use is related to few adverse effects, long-term use is associated with numerous complications. We present the case of a 58-year-old man with severe iron deficiency anemia due to malabsorption suspected to be caused by long-term PPI use. An extensive medical work up failed to reveal any definitive source of bleeding. An iron malabsorption test confirmed that iron was not being absorbed from the gastrointestinal tract. The Naranjo Adverse Drug Reaction Probability Scale and the Horn and Hansten Drug Interaction Probability Scale are suggestive of an association between long-term PPI use and the observed iron deficiency anemia. However, the patient's death and lack of an autopsy prevented confirmatory follow-up data from being obtained to connect long-term PPI use as the culprit. Although there are currently no recommendations regarding screening for iron deficiency and/or anemia in patients on long-term PPI therapy, physicians should be aware of this potential side effect and consider monitoring in high-risk patients.

Chest radiographic features of human metapneumovirus infection in pediatric patients.

BACKGROUND: Human metapneumovirus (HMPV) was identified in 2001 and is a common cause of acute respiratory illness in young children. The radiologic characteristics of laboratory-confirmed HMPV acute respiratory illness in young children have not been systematically assessed. OBJECTIVE: We systematically evaluated the radiographic characteristics of acute respiratory illness associated with HMPV in a prospective cohort of pediatric patients. MATERIALS AND METHODS: We included chest radiographs from children <5 years old with acute respiratory illness who were enrolled in the prospective New Vaccine Surveillance Network (NVSN) study from 2003 to 2009 and were diagnosed with HMPV by reverse transcription-polymerase chain reaction (RT-PCR). Of 215 HMPV-positive subjects enrolled at our tertiary care children's hospital, 68 had chest radiographs obtained by the treating clinician that were available for review. Two fellowship-trained pediatric radiologists, independently and then in consensus, retrospectively evaluated these chest radiographs for their radiographic features. RESULTS: Parahilar opacities were the most commonly observed abnormality, occurring in 87% of children with HMPV. Hyperinflation also occurred frequently (69%). Atelectasis (40%) and consolidation (18%) appeared less frequently. Pleural effusion and pneumothorax were not seen on any radiographs. CONCLUSION: The clinical presentations of HMPV include bronchiolitis, croup and pneumonia. Dominant chest radiographic abnormalities include parahilar opacities and hyperinflation, with occasional consolidation. Recognition of the imaging patterns seen with common viral illnesses like respiratory syncytial virus (RSV) and HMPV might facilitate diagnosis and limit unnecessary antibiotic treatment.

Non-chemical Risk Assessment for Lifting and Low Back Pain Based on Bayesian Threshold Models.

BACKGROUND: Self-reported low back pain (LBP) has been evaluated in relation to material handling lifting tasks, but little research has focused on relating quantifiable stressors to LBP at the individual level. The National Institute for Occupational Safety and Health (NIOSH) Composite Lifting Index (CLI) has been used to quantify stressors for lifting tasks. A chemical exposure can be readily used as an exposure metric or stressor for chemical risk assessment (RA). Defining and quantifying lifting nonchemical stressors and related adverse responses is more difficult. Stressor-response models appropriate for CLI and LBP associations do not easily fit in common chemical RA modeling techniques (e.g., Benchmark Dose methods), so different approaches were tried. METHODS: This work used prospective data from 138 manufacturing workers to consider the linkage of the occupational stressor of material lifting to LBP. The final model used a Bayesian random threshold approach to estimate the probability of an increase in LBP as a threshold step function. RESULTS: Using maximal and mean CLI values, a significant increase in the probability of LBP for values above 1.5 was found. CONCLUSION: A risk of LBP associated with CLI values > 1.5 existed in this worker population. The relevance for other populations requires further study.