Understanding the excess COVID-19 burden among immigrants in Norway.

BACKGROUND: We aim to use intermarriage as a measure to disentangle the role of exposure to virus, susceptibility and care in differences in burden of COVID-19, by comparing rates of COVID-19 infections between immigrants married to a native and to another immigrant. METHODS: Using data from the Norwegian emergency preparedness, register participants (N=2 312 836) were linked with their registered partner and categorized based on own and partner's country of birth. From logistic regressions, odds ratios (OR) of COVID-19 infection (15 June 2020-01 June 2021) and related hospitalization were calculated adjusted for age, sex, municipality, medical risk, occupation, household income, education and crowded housing. RESULTS: Immigrants were at increased risk of COVID-19 and related hospitalization regardless of their partners being immigrant or not, but immigrants married to a Norwegian-born had lower risk than other immigrants. Compared with intramarried Norwegian-born, odds of COVID-19 infection was higher among persons in couples with one Norwegian-born and one immigrant from Europe/USA/Canada/Oceania (OR 1.42-1.46) or Africa/Asia/Latin-America (OR 1.91-2.01). Odds of infection among intramarried immigrants from Africa/Asia/Latin-America was 4.92. For hospitalization, the corresponding odds were slightly higher. CONCLUSION: Our study suggests that the excess burden of COVID-19 among immigrants is explained by differences in exposure and care rather than susceptibility.

Nanosecond-Timescale Low Energy Switching of In-Plane Magnetic Tunnel Junctions through Dynamic Oersted-Field-Assisted Spin Hall Effect.

We investigate fast-pulse switching of in-plane-magnetized magnetic tunnel junctions (MTJs) within 3-terminal devices in which spin-transfer torque is applied to the MTJ by the giant spin Hall effect. We measure reliable switching, with write error rates down to 10-5, using current pulses as short as just 2 ns in duration. This represents the fastest reliable switching reported to date for any spin-torque-driven magnetic memory geometry and corresponds to a characteristic time scale that is significantly shorter than predicted possible within a macrospin model for in-plane MTJs subject to thermal fluctuations at room temperature. Using micromagnetic simulations, we show that in the three-terminal spin-Hall devices the Oersted magnetic field generated by the pulse current strongly modifies the magnetic dynamics excited by the spin-Hall torque, enabling this unanticipated performance improvement. Our results suggest that in-plane MTJs controlled by Oersted-field-assisted spin-Hall torque are a promising candidate for both cache memory applications requiring high speed and for cryogenic memories requiring low write energies.

Impact of oral health education on oral hygiene knowledge, practices, plaque control and gingival health of 13- to 15-year-old school children in Bangalore city.

OBJECTIVES: To assess effectiveness of an oral health education (OHE) programme on oral hygiene knowledge, practices, plaque control and gingival health of 13- to 15-year-old school children in Bangalore city. METHODS: Three schools were randomly selected and assigned to experimental I, experimental II and control groups. At baseline, a 20-item questionnaire was used to assess the oral hygiene knowledge and practices. Clinical examinations (Turesky-Gilmore-Glickman modification of Quigley Hein plaque index; Loe-Silness gingival index) were performed by 2 examiners. OHE was provided by the investigator for experimental groups I (lecture using a PowerPoint presentation) and II (lecture using a PowerPoint presentation with toothbrushing demonstration). Control group did not receive any intervention. Reinforcement was provided for experimental groups at 3 and 6 months. At end of 9 months, questionnaire was administered and clinical examinations were performed. Data were analysed using chi-square, anova and post hoc Tukey's tests. RESULTS: Nine months post-intervention, there was significant improvement in oral hygiene knowledge and practices in experimental groups. There were significant reductions in mean plaque index and gingival index scores in the experimental groups. The control group did not show any significant improvement. CONCLUSION: Active involvement of school children with reinforcement of OHE can improve oral hygiene knowledge, practices and gingival health and decrease plaque levels.

Bioactive constituents of Homalomena aromatica essential oil and its antifungal activity against dermatophytes and yeasts.

Homalomena aromatica rhizomes are rich source of essential oils, which have been attributed for various medicinal uses. In the present investigation, essential oil from H. aromatica rhizomes was isolated and subjected to gas chromatography-mass spectrum (GC-MS) analysis. Fifty-five chemical constituents were reported from H. aromatica rhizomes of which T-muurolol (5.32%), viridiflorol (3.69%), α-selinene (2.19%), M-cymene (2.19%) and γ-Muurolene (1.81%) were identified and reported for the first time. Other major components were identified as linalool (62.5%), terpene-4-ol (7.08%), δ-cadinene (5.57%), α-cadinol (3.71%) and spatulenol (1.81%). H. aromatica rhizome essential oil showed high antimicrobial activity against Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum fulvum, Microsporum gypseum, Trichosporon beigelii and Candida albicans.

Towards an evidence-based process for the clinical interpretation of copy number variation.

The evidence-based review (EBR) process has been widely used to develop standards for medical decision-making and to explore complex clinical questions. This approach can be applied to genetic tests, such as chromosomal microarrays, in order to assist in the clinical interpretation of certain copy number variants (CNVs), particularly those that are rare, and guide array design for optimal clinical utility. To address these issues, the International Standards for Cytogenomic Arrays Consortium has established an EBR Work Group charged with building a framework to systematically assess the potential clinical relevance of CNVs throughout the genome. This group has developed a rating system enumerating the evidence supporting or refuting dosage sensitivity for individual genes and regions that considers the following criteria: number of causative mutations reported; patterns of inheritance; consistency of phenotype; evidence from large-scale case-control studies; mutational mechanisms; data from public genome variation databases; and expert consensus opinion. The system is designed to be dynamic in nature, with regions being reevaluated periodically to incorporate emerging evidence. The evidence collected will be displayed within a publically available database, and can be used in part to inform clinical laboratory CNV interpretations as well as to guide array design.

Mango ginger (Curcuma amada Roxb.)--a promising spice for phytochemicals and biological activities.

Mango ginger (Curcuma amada Roxb.) is a unique spice having morphological resemblance with ginger but imparts a raw mango flavour. The main use of mango ginger rhizome is in the manufacture of pickles and culinary preparations. Ayurveda and Unani medicinal systems have given much importance to mango ginger as an appetizer, alexteric, antipyretic, aphrodisiac, diuretic, emollient, expectorant and laxative and to cure biliousness, itching, skin diseases, bronchitis, asthma, hiccough and inflammation due to injuries. The biological activities of mango ginger include antioxidant activity, antibacterial activity, antifungal activity, anti-inflammatory activity, platelet aggregation inhibitory activity, cytotoxicity, antiallergic activity, hypotriglyceridemic activity, brine-shrimp lethal activity, enterokinase inhibitory activity, CNS depressant and analgesic activity. The major chemical components include starch, phenolic acids, volatile oils, curcuminoids and terpenoids like difurocumenonol, amadannulen and amadaldehyde. This article brings to light the major active components present in C. amada along with their biological activities that may be important from the pharmacological point of view.

Polyphenols of pseudostem of different banana cultivars and their antioxidant activities.

The present investigation is focused on potential use of banana pseudostem (BPS), which otherwise is disposed off as a waste or incinerated, as a source of polyphenols or antioxidants. The total phenolics (TP) and total flavonoids (TF) in various solvent extracts of pseudostem (PS) of different banana cultivars varied from 7.58 to 291 mg gallic acid equivalent (GAE/g of extract) and from 4 to 80 mg catechin equivalent (CE/g of extract), respectively. Acetone extract showed high antioxidant activity (AOA) in all of the in vitro models tested, whereas methanol extract exhibited high metal chelating activity. Among the banana cultivars, Nanjanagudu Rasabale (NR) showed the highest TP (291 mg GAE/g of extract), TF (80 mg CE/g of extract), and AOA. A detailed study on phenolic acids by reverse phase HPLC and ESI-MS revealed the presence of phenolic acids such as gentisic acid, (+)-catechin, protocatechuic acid, caffeic acid, ferulic acid, and cinnamic acid in cultivar NR. The differences in AOA of banana cultivars are in accordance with their phenolic and flavonoid concentrations.

Antimicrobial, antioxidant, cytotoxicity and platelet aggregation inhibitory activity of a novel molecule isolated and characterized from mango ginger (Curcuma amada Roxb.) rhizome.

Mango ginger (Curcuma amada Roxb.) rhizome is used in the manufacture of pickles and other food preparations due to its unique raw mango flavour. The chloroform extract of mango ginger rhizome was subjected to antibacterial activity-guided purification by repeated silica gel column chromatography to obtain a pure compound. The structure of the isolated compound was deduced by analysing UV, IR, LC-MS and 2D-HMQCT NMR spectral data, and named it as amadaldehyde, a novel compound. It exhibited a wide range of antibacterial activity with potential bactericidal activity against several bacteria. The purified compound also exhibited antioxidant activity, cytotoxicity and platelet aggregation inhibitory activities.

Study of the efficacy of toothpaste containing casein phosphopeptide in the prevention of dental caries: a randomized controlled trial in 12- to 15-year-old high caries risk children in Bangalore, India.

Casein phosphopeptide (CPP) has the potential to be added to mouth rinses, gels, toothpastes, chewing gums and confectioneries. Until now CPP has been studied in vitro, in situ and in animals, but clinical trials are lacking. This study was conducted to evaluate the efficacy of CPP-containing toothpaste in preventing dental caries in schoolchildren. The study was conducted among 150 schoolchildren randomly divided into three groups, each using one of three types of toothpastes: (a) containing 2% w/w CPP; (b) containing 1,190 mg/kg fluoride as 0.76% sodium monofluorophosphate (SMFP); (c) placebo toothpaste without CPP or fluoride. Students brushed with the given toothpastes for 24 months. Oral hygiene and caries experience were assessed at baseline, 12 and 24 months. The increments in caries lesions were calculated and analyzed to assess the caries-preventive effect. A significant reduction in caries increment was observed among students using CPP toothpaste or SMFP toothpaste, compared with the group using the placebo toothpaste. The reduction in caries increment was not significantly different between the CPP and SMFP groups. Oral Hygiene Index score increased from the 12-month to the 24-month examination. It is concluded that CPP can be effectively incorporated into calcium carbonate-based toothpaste and that toothpaste containing CPP is effective in preventing caries. Toothpaste containing 2% CPP seemed to have an efficacy similar to paste containing 1,190 mg/kg SMFP in the prevention of caries.

Clinical and molecular delineation of the 17q21.31 microdeletion syndrome.

BACKGROUND: The chromosome 17q21.31 microdeletion syndrome is a novel genomic disorder that has originally been identified using high resolution genome analyses in patients with unexplained mental retardation. AIM: We report the molecular and/or clinical characterisation of 22 individuals with the 17q21.31 microdeletion syndrome. RESULTS: We estimate the prevalence of the syndrome to be 1 in 16,000 and show that it is highly underdiagnosed. Extensive clinical examination reveals that developmental delay, hypotonia, facial dysmorphisms including a long face, a tubular or pear-shaped nose and a bulbous nasal tip, and a friendly/amiable behaviour are the most characteristic features. Other clinically important features include epilepsy, heart defects and kidney/urologic anomalies. Using high resolution oligonucleotide arrays we narrow the 17q21.31 critical region to a 424 kb genomic segment (chr17: 41046729-41470954, hg17) encompassing at least six genes, among which is the gene encoding microtubule associated protein tau (MAPT). Mutation screening of MAPT in 122 individuals with a phenotype suggestive of 17q21.31 deletion carriers, but who do not carry the recurrent deletion, failed to identify any disease associated variants. In five deletion carriers we identify a <500 bp rearrangement hotspot at the proximal breakpoint contained within an L2 LINE motif and show that in every case examined the parent originating the deletion carries a common 900 kb 17q21.31 inversion polymorphism, indicating that this inversion is a necessary factor for deletion to occur (p<10(-5)). CONCLUSION: Our data establish the 17q21.31 microdeletion syndrome as a clinically and molecularly well recognisable genomic disorder.

Identification of difurocumenonol, a new antimicrobial compound from mango ginger (Curcuma amada Roxb.) rhizome.

AIM: The aim of the present work was to purify and characterize potential natural antibacterial compound from mango ginger (Curcuma amada Roxb.) rhizome. METHODS AND RESULTS: The mango ginger rhizome powder was sequentially extracted and screened for antibacterial activity by agar well diffusion method and broth dilution method. Nonpolar extracts of mango ginger showed high antibacterial activity against gram-positive bacteria with low minimum inhibitory concentration (60-180 ppm). Among five extracts of mango ginger, the chloroform extract demonstrated highest antibacterial activity. Antibacterial activity-guided fractionation of the chloroform extract by repeated silica gel column chromatography yielded pure compound. The purified antibacterial compound was analysed by UV, IR, LC-MS and 2D-HMQCT NMR spectra and was identified as a difurocumenonol, a novel compound not reported previously. CONCLUSIONS: Mango ginger extracts and isolated difurocumenonol demonstrated high antibacterial activity against gram-negative and gram-positive bacteria. SIGNIFICANCE AND IMPACT OF THE STUDY: A novel and natural antibacterial compound as well as mango ginger extracts can be used as food preservative to control the growth of food-borne pathogens and as a source of mango flavour.

Isolation and characterization of antioxidant and antibacterial compound from mango ginger (Curcuma amada Roxb.) rhizome.

The chloroform extract of mango ginger (Curcuma amada Roxb.) rhizome was subjected to antioxidant activity-guided purification by repeated silica gel column chromatography to obtain a pure antioxidant compound. The structure was deduced by analyzing UV, IR, liquid chromatography-mass spectrometry (LC-MS) and two-dimensional heteronuclear multiple quantum coherence transfer spectroscopy (2D-HMQCT) NMR spectral data, and named it as "Amadannulen", a novel compound. It exhibited DPPH radical scavenging activity, super oxide radical scavenging activity, lipid peroxidation inhibitory activity and metal chelating activity. Amadannulen also showed antibacterial activity against both Gram-positive and Gram-negative bacteria tested. It also exhibited bactericidal activity against M. luteus, B. cereus and B. subtilis.

In vitro studies on the binding, antioxidant, and cytotoxic actions of punicalagin.

The protective bioactivity of punicalagin, a high molecular weight polyphenol isolated from pomegranate fruit pith and carpellary membrane, against oxidative damages to lipids, amino acids constituting the proteins, and guanosine as a model for DNA has been investigated. The ABTS*-, guanosine, and tryptophan radical generated pulse radiolytically were repaired by punicalagin, k = (0.9-15) x 10(7) dm3 mol-1 s-1. The results are rationalized on the basis of the scavenging activity of punicalagin against various one-electron oxidizing radicals, namely, .OH, N3., and NO2. . The formation of the transient species in these reactions and the rate constants of the scavenging reactions have been probed using a time-resolved kinetic spectrophotometric technique. The antioxidant action of punicalagin is expressed not only through its scavenging reactions but also by its ability to form metal chelates. Binding of punicalagin with bovine serum albumin and metal ions such as iron and copper revealed different binding affinities, whereas its binding with DNA was very weak and nonspecific. In vitro cytotoxic studies against three cell lines, namely, Vero (normal African green monkey kidney cell line), Hep-2 (human larynx epithelial cancer cell line), and A-549 (human small cell lung carcinoma cell line) showed that this polyphenol is toxic only at higher concentration.

Multiple pathogenic and benign genomic rearrangements occur at a 35 kb duplication involving the NEMO and LAGE2 genes.

The X-linked dominant and male-lethal disorder incontinentia pigmenti (IP) is caused by mutations in a gene called NEMO (IKK-gamma). We recently reported the structure of NEMO and demonstrated that most IP patients carry an identical deletion that arises due to misalignment between repeats. Affected male abortuses with the IP deletion had provided clues that a second, incomplete copy of NEMO was present in the genome. We have now identified clones containing this truncated copy (Delta NEMO) and incorporated them into a previously constructed physical contig in distal Xq28. Delta NEMO maps 22 kb distal to NEMO and only contains exons 3-10, confirming our proposed model. A sequence of 26 kb 3' of the NEMO coding sequence is also present in the same position relative to the Delta NEMO locus, bringing the total length of the duplication to 35.5 kb. The LAGE2 gene is also located within this duplicated region, and a similar but unique LAGE1 gene is located just distal to the duplicated loci. Mapping and sequence information indicated that the duplicated regions are in opposite orientation. Analysis of the great apes suggested that the NEMO/LAGE2 duplication occurred after divergence of the lineage leading to present day humans, chimpanzees and gorillas, approximately 10-15 million years ago. Intriguingly, despite this substantial evolutionary history, only 22 single nucleotide differences exist between the two copies over the entire 35.5 kb, making the duplications >99% identical. This high sequence identity and the inverted orientations of the two copies, along with duplications of smaller internal sections within each copy, predispose this region to various genomic alterations. We detected four rearrangements that involved NEMO, Delta NEMO or LAGE1 and LAGE2. The high sequence similarity between the two NEMO/LAGE2 copies may be due to frequent gene conversion, as we have detected evidence of sequence transfer between them. Together, these data describe an unusual and complex genomic region that is susceptible to various types of pathogenic and polymorphic rearrangements, including the recurrent lethal deletion associated with IP.

A recurrent deletion in the ubiquitously expressed NEMO (IKK-gamma) gene accounts for the vast majority of incontinentia pigmenti mutations.

Incontinentia pigmenti (IP) is an X-linked dominant disorder characterized by abnormal skin pigmentation, retinal detachment, anodontia, alopecia, nail dystrophy and central nervous system defects. This disorder segregates as a male lethal disorder and causes skewed X-inactivation in female patients. IP is caused by mutations in a gene called NEMO, which encodes a regulatory component of the IkappaB kinase complex required to activate the NF-kappaB pathway. Here we report the identification of 277 mutations in 357 unrelated IP patients. An identical genomic deletion within NEMO accounted for 90% of the identified mutations. The remaining mutations were small duplications, substitutions and deletions. Nearly all NEMO mutations caused frameshift and premature protein truncation, which are predicted to eliminate NEMO function and cause cell lethality. Examination of families transmitting the recurrent deletion revealed that the rearrangement occurred in the paternal germline in most cases, indicating that it arises predominantly by intrachromosomal misalignment during meiosis. Expression analysis of human and mouse NEMO/Nemo showed that the gene becomes active early during embryogenesis and is expressed ubiquitously. These data confirm the involvement of NEMO in IP and will help elucidate the mechanism underlying the manifestation of this disorder and the in vivo function of NEMO. Based on these and other recent findings, we propose a model to explain the pathogenesis of this complex disorder.

Survival of male patients with incontinentia pigmenti carrying a lethal mutation can be explained by somatic mosaicism or Klinefelter syndrome.

Incontinentia pigmenti (IP), or "Bloch-Sulzberger syndrome," is an X-linked dominant disorder characterized by abnormalities of skin, teeth, hair, and eyes; skewed X-inactivation; and recurrent miscarriages of male fetuses. IP results from mutations in the gene for NF-kappaB essential modulator (NEMO), with deletion of exons 4-10 of NEMO accounting for >80% of new mutations. Male fetuses inheriting this mutation and other "null" mutations of NEMO usually die in utero. Less deleterious mutations can result in survival of males subjects, but with ectodermal dysplasia and immunodeficiency. Male patients with skin, dental, and ocular abnormalities typical of those seen in female patients with IP (without immunodeficiency) are rare. We investigated four male patients with clinical hallmarks of IP. All four were found to carry the deletion normally associated with male lethality in utero. Survival in one patient is explained by a 47,XXY karyotype and skewed X inactivation. Three other patients possess a normal 46,XY karyotype. We demonstrate that these patients have both wild-type and deleted copies of the NEMO gene and are therefore mosaic for the common mutation. Therefore, the repeat-mediated rearrangement leading to the common deletion does not require meiotic division. Hypomorphic alleles, a 47,XXY karyotype, and somatic mosaicism therefore represent three mechanisms for survival of males carrying a NEMO mutation.

NF-kappaB signaling and human disease.

Despite substantial progress in understanding the NF-kappaB signaling pathway, the connections between this pathway and human disease are only now being elucidated. Genes that function within or upstream of the NF-kappaB pathway have been found to cause four distinct disorders and two allelic conditions. Investigation of these genes and disorders has brought significant insight into the role of NF-kappaB in various aspects of physiological development.

Atypical forms of incontinentia pigmenti in male individuals result from mutations of a cytosine tract in exon 10 of NEMO (IKK-gamma).

Familial incontinentia pigmenti (IP [MIM 308310]), or Bloch-Sulzberger syndrome, is an X-linked dominant and male-lethal disorder. We recently demonstrated that mutations in NEMO (IKK-gamma), which encodes a critical component of the NF-kappaB signaling pathway, were responsible for IP. Virtually all mutations eliminate the production of NEMO, causing the typical skewing of X inactivation in female individuals and lethality in male individuals, possibly through enhanced sensitivity to apoptosis. Most mutations also give rise to classic signs of IP, but, in this report, we describe two mutations in families with atypical phenotypes. Remarkably, each family included a male individual with unusual signs, including postnatal survival and either immune dysfunction or hematopoietic disturbance. We found two duplication mutations in these families, at a cytosine tract in exon 10 of NEMO, both of which remove the zinc (Zn) finger at the C-terminus of the protein. Two deletion mutations were also identified in the same tract in additional families. However, only the duplication mutations allowed male individuals to survive, and affected female individuals with duplication mutations demonstrated random or slight skewing of X inactivation. Similarly, NF-kappaB activation was diminished in the presence of duplication mutations and was completely absent in cells with deletion mutations. These results strongly indicate that male individuals can also suffer from IP caused by NEMO mutations, and we therefore urge a reevaluation of the diagnostic criteria.

Genomic rearrangement in NEMO impairs NF-kappaB activation and is a cause of incontinentia pigmenti. The International Incontinentia Pigmenti (IP) Consortium.

Familial incontinentia pigmenti (IP; MIM 308310) is a genodermatosis that segregates as an X-linked dominant disorder and is usually lethal prenatally in males. In affected females it causes highly variable abnormalities of the skin, hair, nails, teeth, eyes and central nervous system. The prominent skin signs occur in four classic cutaneous stages: perinatal inflammatory vesicles, verrucous patches, a distinctive pattern of hyperpigmentation and dermal scarring. Cells expressing the mutated X chromosome are eliminated selectively around the time of birth, so females with IP exhibit extremely skewed X-inactivation. The reasons for cell death in females and in utero lethality in males are unknown. The locus for IP has been linked genetically to the factor VIII gene in Xq28 (ref. 3). The gene for NEMO (NF-kappaB essential modulator)/IKKgamma (IkappaB kinase-gamma) has been mapped to a position 200 kilobases proximal to the factor VIII locus. NEMO is required for the activation of the transcription factor NF-kappaB and is therefore central to many immune, inflammatory and apoptotic pathways. Here we show that most cases of IP are due to mutations of this locus and that a new genomic rearrangement accounts for 80% of new mutations. As a consequence, NF-kappaB activation is defective in IP cells.