The DISTANCE study: Determining the impact of social distancing on trauma epidemiology during the COVID-19 epidemic-An interrupted time-series analysis.

BACKGROUND: The large-scale social distancing efforts to reduce SARS-CoV-2 transmission have dramatically changed human behaviors associated with traumatic injuries. Trauma centers have reported decreases in trauma volume, paralleled by changes in injury mechanisms. We aimed to quantify changes in trauma epidemiology at an urban Level I trauma center in a county that instituted one of the earliest shelter-in-place orders to inform trauma care during future pandemic responses. METHODS: A single-center interrupted time-series analysis was performed to identify associations of shelter-in-place with trauma volume, injury mechanisms, and patient demographics in San Francisco, California. To control for short-term trends in trauma epidemiology, weekly level data were analyzed 6 months before shelter-in-place. To control for long-term trends, monthly level data were analyzed 5 years before shelter-in-place. RESULTS: Trauma volume decreased by 50% in the week following shelter-in-place (p < 0.01), followed by a linear increase each successive week (p < 0.01). Despite this, trauma volume for each month (March-June 2020) remained lower compared with corresponding months for all previous 5 years (2015-2019). Pediatric trauma volume showed similar trends with initial decreases (p = 0.02) followed by steady increases (p = 0.05). Reductions in trauma volumes were due entirely to changes in nonviolent injury mechanisms, while violence-related injury mechanisms remained unchanged (p < 0.01). CONCLUSION: Although the shelter-in-place order was associated with an overall decline in trauma volume, violence-related injuries persisted. Delineating and addressing underlying factors driving persistent violence-related injuries during shelter-in-place orders should be a focus of public health efforts in preparation for future pandemic responses. LEVEL OF EVIDENCE: Epidemiological study, level III.

Long noncoding RNAs in thyroid cancer.

PURPOSE OF REVIEW: Our understanding of the molecular pathology events involved in thyroid cancer initiation and progression and its subtypes has markedly improved as a result of multiomic studies. Recently, long noncoding RNA (lncRNA) have been shown to have a role in cancer initiation and progression and have also been studied in thyroid cancer. RECENT FINDINGS: lncRNA are dysregulated in thyroid cancer. lncRNA have tumor suppressive and oncogenic function in thyroid cancer cells and play a role in some of the established genetic drivers of thyroid cancer initiation and progression. Lastly, some lncRNA are associated with clinicopathologic features of thyroid cancer and circulating blood lncRNA could potentially detect the presence of thyroid cancer. SUMMARY: We highlight the possible clinical utility of analyzing lncRNAs as biomarkers for thyroid cancer diagnosis and prognosis and their association with common genetic changes associated with thyroid cancer.

A comparative study of characteristics and risky behaviors among the Iranian opium and opium dross addicts.

BACKGROUND: Iran ranks first per capita in the use of opiates, but we have little information about possible differences regarding the 2 most commonly used illicit drugs, namely opium and its dross (residue). DESIGN: This is a cross-sectional study. SETTING: A cross-sectional study about drug abuse and drug dependence in Iran was conducted from April 2006 to August 2008 in the prisons of 28 Iranian provinces, in the treatment centers, and in the streets. PARTICIPANTS: To pursue the objectives of this research, participants included 2979 opiate addicts including opium users (n = 2636) and dross users (n = 343), who were not significantly different by gender (P = 0.269) or age (P = 0.452). MEASUREMENTS: An anonymous questionnaire was completed through an interview that gathered sociodemographic characteristics and information about some high-risk behaviors. RESULT: : By the end of the study, we concluded that dross addicts, in comparison with opium addicts, were mostly immigrants from rural areas to urban areas (P = 0.031 χ test, 95% confidence interval [CI]), mostly uneducated, illiterate, or semiliterate (P = 0.04 χ test, 95% CI), had illegal occupations (P = 0.048 χ test, 95% CI), were cigarette smokers (P < 0.000 χ test, 95% CI), and had experienced drug injections (P = 0.032 χ test, 95% CI) and drug overdose (P = 0.007 χ test, 95% CI). They also had a history of hospital admission within the preceding year because of drug overdose (P < 0.000) and a record of being arrested and jailed in the past year (P = 0.028 χ test, 95% CI). CONCLUSION: These results indicated the need for more intensive and effective care for the opioid addicts in Iran.

Dopamine receptors in human peripheral blood lymphocytes: changes in mRNA expression in opioid addiction.

Gradual adaptations of the brain to repeated drug exposure may induce addiction. Brain mesolimbic dopaminergic pathway is the site of the effect of addictive drugs. The dopamine receptors in peripheral blood lymphocytes may reflect the status of homologous brain receptors. In the present study, the effects of opioid addiction on mRNA expression of dopamine D(3), D(4) and D(5) receptors in human peripheral blood lymphocytes were investigated, using a real-time PCR method. Four groups each comprising 30 individuals were enrolled in the study: opioid addicted, methadone maintained, long-term abstinent and normal subjects. The results indicated that dopamine D(3) receptor mRNA expression was increased in addicted and methadone maintained subjects by a factor of 1.74 and 1.98, respectively, but no change was observed in the abstinent group. The dopamine D(4) receptor mRNA expression was reduced in abstinent and addicted subjects (but not in the methadone group) and reached 0.44 and 0.53 the amount of the control group, respectively. Expression of dopamine D(5) receptor mRNA showed a significant reduction in abstinent subjects (0.41 the amount of the control group). However, in the addicted and methadone maintained groups, the change of expression level was not statistically significant. It can be concluded that persisting deficiency of dopamine D(4) and D(5) receptors may be a risk factor urging individuals to addiction, and methadone may exert its therapeutic effects through normalizing mRNA expression of these receptors. The dopamine D(3) receptor may have a negative feedback role in addiction; however, we have no explanation for the persisting up-regulation of this receptor in methadone subjects.