Nutrition in times of crisis: A qualitative study in Siargao Island, Philippines, during the COVID-19 pandemic

Objectives@#Despite the public-health significance of both malnutrition and crises, little has been done to explore the convergence of the two domains and develop ways to improve policies and practices, especially in rural communities. This article remedies that knowledge gap by focusing on nutrition-related changes, responses, and practices during crisis situations in Siargao Island, Philippines, using the COVID-19 pandemic as a backdrop.@*Methods@#Forty-six (46) semi-structured interviews were conducted among parents, caregivers, local health workers, and local officials of Del Carmen, Siargao Island. Principles of thematic analysis were applied to data analysis using NVivo 12. Afterwards, the preliminary data were presented in a virtual validation session with the local community and stakeholders.@*Results@#Despite the high prevalence of malnutrition amid a backdrop of economic and nutritional difficulties, the community members generally viewed their children as healthy. Rice remained (disproportionately) central to people’s diets; possible alternatives like root crops were considered emergency foods only and not culturally acceptable as staples, in spite of their cheap and ubiquitous nature. Lastly, the economic and financial repercussions of the COVID-19 pandemic have also negatively affected the community members’ overall nutrition and food sources.@*Conclusion@#More efforts should be directed toward encouraging the consumption of root vegetables and fruits as rice alternatives in everyday diet—a costeffective strategy that would also promote dietary diversification. More importantly, nutrition responses should consider local food systems in terms of specific local economies and geographies, while health promotion efforts should engage with local notions of ‘health’ and ‘nutrition’ and encourage community participation in (re)designing policy interventions.

Associations between isomers and alternatives of per- and polyfluoroalkyl substances and fasting blood glucose / 环境与职业医学

Background Previous research indicated that isomers and alternatives of per- and polyfluoroalkyl substances (PFAS) probably disturb glucose metabolism; however, current epidemiological evidence on the associations of PFAS with fasting blood glucose is inconsistent. Besides, studies on the joint association of multiple components of PFAS and fasting blood glucose as well as the key component are scarce. Objective To evaluate the associations of PFAS isomers and alternatives with fasting blood glucose and their joint effects, as well as identify the key component among population without glucose metabolism problems. Methods We selected 923 adults without glucose metabolism problems or missing data from the Isomers of C8 Health Project in China (2015—2016). Serum PFAS isomers and alternatives and fasting blood glucose were measured using ultra-performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MS/MS) and automatic biochemical analyzer. We applied multiple linear regression to explore the associations of 16 pollutants which were detected among over 80% participants with fasting blood glucose. Meanwhile, we utilized qgcomp and Bayesian kernel machine regression (BKMR) models to explore the joint effects of PFAS isomers and alternatives mixture on target outcome indicators and identify the key component. Results The average age among the 923 participants in this study was (62.4±13.8) years old, including 472 men (51.1%) and 451 women (48.9%). Among selected PFAS isomers and alternatives, the highest serum concentration was ∑3+4+5m-PFOS (perfluoro-3/4/5-methylheptanesulfonate) with a median concentration of 10.20 ng·mL−1. The concentrations of linear perfluorooctane sulfonate (n-PFOS, 9.61 ng·mL−1), perfluorooctanoic acid (PFOA, 4.55 ng·mL−1), linear perfluorohexane sulfonic acid (n-PFHxS, 2.48 ng·mL−1), 6:2 chlorinated polyfluorinated ethersulfonic acid (6:2 Cl-PFESA, 1.90 ng·mL−1), perfluoro-6-methylheptanesulfonate (iso-PFOS, 1.85 ng·mL−1), perfluorobutanoic acid (PFBA, 1.81 ng·mL−1), perfluorinated n-nonanoic acid (PFNA, 1.39 ng·mL−1), and perfluoro-1-methylheptanesulfonate (1m-PFOS, 1.27 ng·mL−1) were higher than 1.00 ng·mL−1. After being adjusted for selected confounders, PFAS isomers and alternatives were positively associated with fasting blood glucose. With 1 ln unit concentration increment of 6:2 Cl-PFESA and PFNA, the estimated changes of fasting blood glucose were 0.18 (95%CI: 0.13, 0.23) mmol·L−1 and 0.24 (95%CI: 0.18, 0.30) mmol·L−1, respectively. The multi-pollutant models indicated a joint association of PFAS isomers and alternatives mixture with fasting blood glucose. The BKMR models reveals that as the quantiles of mixture elevated from the 50th to the 75th percentile, the values of fasting blood glucose increased 0.25 (95%CI: 0.21, 0.30) mmol·L−1, and the posterior inclusion probability of PFNA was 0.92, implying that PFNA was the key component. Conclusion PFAS isomers and alternatives are positively associated with fasting blood glucose. PFNA is the key component of the joint association.

An antigen self-assembled and dendritic cell-targeted nanovaccine for enhanced immunity against cancer

The rise of nanotechnology has opened new horizons for cancer immunotherapy. However, most nanovaccines fabricated with nanomaterials suffer from carrier-related concerns, including low drug loading capacity, unpredictable metabolism, and potential systemic toxicity, which bring obstacles for their clinical translation. Herein, we developed an antigen self-assembled nanovaccine, which was resulted from a simple acryloyl modification of the antigen to induce self-assembly. Furthermore, a dendritic cell targeting head mannose monomer and a mevalonate pathway inhibitor zoledronic acid (Zol) were integrated or absorbed onto the nanoparticles (denoted as MEAO-Z) to intensify the immune response. The synthesized nanovaccine with a diameter of around 70 nm showed successful lymph node transportation, high dendritic cell internalization, promoted costimulatory molecule expression, and preferable antigen cross-presentation. In virtue of the above superiorities, MEAO-Z induced remarkably higher titers of serum antibody, stronger cytotoxic T lymphocyte immune responses and IFN-γ secretion than free antigen and adjuvants. In vivo, MEAO-Z significantly suppressed EG7-OVA tumor growth and prolonged the survival time of tumor-bearing mice. These results indicated the translation promise of our self-assembled nanovaccine for immune potentiation and cancer immunotherapy.

Comparative metabolomics provides novel insights into the basis of petiole color differences in celery (Apiumgraveolens L.) / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Plant metabolites are important for plant development and human health. Plants of celery (Apiumgraveolens L.) with different-colored petioles have been formed in the course of long-term evolution. However, the composition, content distribution, and mechanisms of accumulation of metabolites in different-colored petioles remain elusive. Using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS), 1159 metabolites, including 100 lipids, 72 organic acids and derivatives, 83 phenylpropanoids and polyketides, and several alkaloids and terpenoids, were quantified in four celery cultivars, each with a different petiole color. There were significant differences in the types and contents of metabolites in celery with different-colored petioles, with the most striking difference between green celery and purple celery, followed by white celery and green celery. Annotated analysis of metabolic pathways showed that the metabolites of the different-colored petioles were significantly enriched in biosynthetic pathways such as anthocyanin, flavonoid, and chlorophyll pathways, suggesting that these metabolic pathways may play a key role in determining petiole color in celery. The content of chlorophyll in green celery was significantly higher than that in other celery cultivars, yellow celery was rich in carotenoids, and the content of anthocyanin in purple celery was significantly higher than that in the other celery cultivars. The color of the celery petioles was significantly correlated with the content of related metabolites. Among the four celery cultivars, the metabolites of the anthocyanin biosynthesis pathway were enriched in purple celery. The results of quantitative real-time polymerase chain reaction (qRT-PCR) suggested that the differential expression of the chalcone synthase (CHS) gene in the anthocyanin biosynthesis pathway might affect the biosynthesis of anthocyanin in celery. In addition, HPLC analysis revealed that cyanidin is the main pigment in purple celery. This study explored the differences in the types and contents of metabolites in celery cultivars with different-colored petioles and identified key substances for color formation. The results provide a theoretical basis and technical support for genetic improvement of celery petiole color.

Pharmaceutical care for a gastric cancer patient with post-operation abdominal infection and cellulitis / 药学实践与服务

Objective To explore the effective management of post-operation infections through clinical pharmacists participating in the treatment of a gastric cancer patient with post operation abdominal infection and cellulitis. Methods Clinical pharmacists provided an rational anti-infective treatment plan with the combination of pharmacy and clinical practice, conducted medication education for the patient, and participated in the process of pharmacy care for the patient. Results Physicians modified the medication plan according to the recommendations from the clinical pharmacists. The patient’s infection was effectively controlled and the symptoms were alleviated. Conclusion With their professional knowledge, clinical pharmacists can select the best antibacterial drug regimen for the treatment of post-operation infections and provide patients with optimal pharmaceutical care.

Identification of a super-spreading chain of transmission associated with COVID-19

BackgroundSuper-spreading events were associated with the outbreaks of SARS and MERS, but their association with the outbreak of COVID-19 remains unknown. Here, we report a super-spreading transmission chain of SARS-CoV-2 involving an index patient, seven cancer patients, 40 health care workers and four family members. MethodsWe conducted a retrospective study to identify the index patient and the exposed individuals linked to a chain of transmission associated with COVID-19. We collected and analyzed the data on demographic features, exposure history, clinical presentation, laboratory investigation, radiological examination, and disease outcome of these patients. ResultsWe identified the index patient and another presumptive "super-spreader", who initiated and amplified a super-spreading transmission chain associated with COVID-19, respectively. There were 31 female and 21 male patients in this cohort, and the median age was 37 years (range: 22-79 years). Each of them had an exposure history with the index patient or his close contacts. Approximately 87% (45/52) of the patients had fever or other symptoms, 96% (50/52) had abnormal chest CT-scan findings, 86% of the tested patients (39/45) were positive for SARS-CoV-2 in the nasopharyngeal or throat swab specimen, 85% of the tested patients (29/34) were positive for SARS-CoV-2-specific IgM and/or IgG, 15% of the RT-PCR positive patients were tested negative for the specific IgM and/or IgG at the convalescent phase, and 15% of the RT-PCR negative patients were tested positive for the specific IgM and/or IgG. The severe patients experienced a significant decrease in oximetry saturation, lymphocyte, and platelet counts, along with a significant increase in C-reactive protein, D-dimer, and lactate dehydrogenase. All six fatal cases had comorbidities and five of the seven cancer patients (71%) died within 2-20 days of the disease onset. ConclusionsThe super-spreading events were associated with the outbreak of COVID-19 in Wuhan and its impact on disease transmission warrants further investigation. Cancer patients appeared highly vulnerable to COVID-19. The finding that a significant portion of SARS-CoV-2 infected patients were tested negative for the serum specific IgM and IgG at the convalescent phase should be addressed by additional studies.

Different neurons in the basal forebrain regulate sleep?wake / 中华神经科杂志

The basal forebrain is a heterogeneous structure at the base of the brain that participates in the regulation of sleep?wake, cognition, consciousness, and attention. Previous studies have suggested that these functions are mainly mediated by cholinergic neurons in the basal forebrain. With advances in research techniques, the understanding of basal forebrain cholinergic neurons, as well as GABAergic neurons and glutamatergic neurons, is deepened. The role of different neurons in the basal forebrain in the regulation of sleep?wake is summarized in this article. GABAergic neurons play a key role in promoting wakefulness, cholinergic neurons play an important role in sleep?wake homeostasis, and glutamatergic neurons provide excitation signals to other neurons.

The study on the association of long-term ambient fine particulate matters exposure and elevated blood pressure in children / 中华预防医学杂志

Objective@#To evaluate the association of long-term ambient fine particulate matters (PM2.5) exposure with elevated blood pressure in children.@*Methods@#From April 2012 to June 2013, we used cluster randomized sampling method to investigate 9 354 children aged 5-17 years old from 68 primary and middle schools in the seven Northeastern Cities (Shenyang, Dalian, Fushun, Anshan, Benxi, Liaoyang and Dandong) in Liaoning Province, and measured their blood pressure (BP). A spatial statistical model nested by aerosol optical depth (AOD) was used to inverse PM2.5 concentrations. Generalized additive model was used to quantify the association between PM2.5 exposure and blood pressure in children. To examine the associations, two-level regression model was used to evaluate individual characteristics′ modifying effect on the health influence of PM2.5.@*Results@#The prevalence of hypertension in children was 13.78% (1 289/9 354). The results showed that there was an associations between hypertension and pollutants, and the multivariable regression analysis indicated that the increase in mean systolic blood pressure (SBP), diastolic blood pressure (DBP), and the OR of hypertension associated with a 10 μg/m3 increase for PM2.5 were 3.12 (95%CI: 2.71-3.54) mmHg (1 mmHg=0.133 kPa), 1.45 (95%CI:1.12-1.78) mmHg, and 1.55 (95%CI: 1.10-2.19), respectively. Compared with non-breastfeeding children (OR=2.10, 95%CI: 1.39-3.17), children who were breastfeeding (OR=1.49, 95%CI: 1.00-2.20) exhibited consistently weaker effects, and the interaction effect of P value was 0.002.@*Conclusion@#Study findings indicate that long-term exposure to PM2.5 is associated with increased arterial BP and hypertension among the children. Breastfeeding may reduce this association.

Different neurons in the basal forebrain regulate sleep-wake / 中华神经科杂志

The basal forebrain is a heterogeneous structure at the base of the brain that participates in the regulation of sleep-wake, cognition, consciousness, and attention. Previous studies have suggested that these functions are mainly mediated by cholinergic neurons in the basal forebrain. With advances in research techniques, the understanding of basal forebrain cholinergic neurons, as well as GABAergic neurons and glutamatergic neurons, is deepened. The role of different neurons in the basal forebrain in the regulation of sleep-wake is summarized in this article. GABAergic neurons play a key role in promoting wakefulness, cholinergic neurons play an important role in sleep-wake homeostasis, and glutamatergic neurons provide excitation signals to other neurons.

The application value of situational simulation teaching in the trainee teaching of cardiovascular medicine / 中华医学教育探索杂志

Objective To explore the value of situational simulation teaching in the in the trainee teaching of cardiovascular medicine. Methods 7-year students of Beijing university of traditional Chinese medicine in the 2016-2017 school year were divided into experimental group and control group, with 50 students in each group. Situational simulation teaching was used in the experimental group while the control group carried out regular teaching. Student self-assessment questionnaire and clinical test were used to evaluate teaching effect. SPSS 21.0 was used for statistical processing, and t-test was used for comparison between groups. Results Student self-assessment questionnaire showed that, the scores of study interest, theoretical knowledge, thinking, clinical practical ability and the overall satisfaction in the experimental group were significantly higher than that in the control group, the difference was statistically significant (P<0.05); As to clinical test, theory knowledge and case analysis assessment in the experimental group were higher than that in the control group, and the difference was statistically significant (P<0.05). Conclusion Situational simulation teaching is helpful to improve the clinical comprehensive ability of students.