CONTENTS OF TRACE ELEMENTS IN THE HAIR OF APLASTIC ANEMIA PATIENTS AND THEIR TREATMENT BASED ON AN OVERALL ANALYSIS OF SYMPTOMS AND SIGNS

The content of 12 trace elements in the hair of 20 aplastic anemia patients was determined and compared with that of normal subjects as control. The results showed that patients with deficiency of yin had a significant decrease in lithium, calcium, strontium, and chromium, those with deficiency of yang had a distinct decrease in zinc magnesium barium, strontium, calcium, and lithium, and those with deficiency of both yin and yang had a general decrease in all the 12 trace elements. Changes in trace element content in hair may serve as a guide to opening up new vistas in the treatment of aplastic anemia on the basis of an overall analysis of symptoms and signs.

ACUPUNCTURE TREATMENT OF 40 CASES OF SEVERE HICCUP BASED ON DIFFERENTIATION OF SYMPTOMS AND SIGNS

In the present study, the authors selected points according to differentiation of symptoms and signs and applied filiform needles to treating 40 cases of hiccup who had tried treatment with Western and Chinese drugs but without any effect and achieved satisfactory results. After acupuncture treatment, 34 cases (85 %) were cured, 4 (10 %) improved markedly and 2(5 %) improved, with total effective rate of 100 %.

Non-motor signs and symptoms in Parkinson’s disease

Motor symptoms are cardinal clinical features of Parkinson’s disease (PD). Progress in drug therapy and rehabilitation has been presenting beneficial effect for motor symptoms. However, non-motor symptoms and signs in PD have been accumulated growing attentions and its amelioration may also give beneficial effect for PD patients’ and their care givers’ quality of life. In this mini-review, I overviewed non-motor symptoms and signs in PD.

Oral and peri-oral signs and symptoms of herbal dentifrices in patients in two oral medicine clinics in Lagos—A preliminary study

Background: Herbal dentifrices appear to have become an attractive alternative for some consumers and its use has gained appreciable acceptance in Nigeria. This could be partly due to the perception that herbal toothpastes like other herbal products are “natural”, devoid of chemicals and therefore superior to regular toothpastes. Aggressive advertisement of the products may also contribute to this new trend. Mucosal symptoms such as glossitis and intolerance to spicy foods seen in patients attending the oral diagnosis clinic are usually associated with anaemia and nutritional deficiency states. The disturbing trend of an increasing number of patients presenting with such oral mucosal symptoms associated with the use of herbal dentifrices prompted this study. This trend was observed in two isolated oral medicine clinics. Objective: To sensitize oral health, allied professionals and consumers on the possible adverse effects of regular use of some herbal dentifrices sold in Nigeria. Materials and Methods: Routine patients of two oral medicine clinics in Lagos, namely the Randle General Hospital and the Lagos University Teaching Hospital who complained of some adverse mucosal signs and symptoms following the regular use of two identified herbal toothpastes made up the study population. The study was conducted between April 2010-April 2011. A detailed history and examination was carried out on these patients and clinical photographs of oral signs observed was taken in consenting patients. Data analysis was done using the Epi-info 6 software. P values ≤ 0.05 was considered statistically significant and data was presented in table format. Results: A total of 45 patients, 9 (20%) males and 36 (80%) fe-males were seen. The age range of patients was 14 - 78 years;mean age 45.5 ± 14.9 years. The duration of use of herbal dentifrices ranged from 2 weeks - 84 months (mean 24 ± 11.5 months). Oral signs and symptoms seen include, burning mouth and peppery sensation, mucosal erythema, lichenoid reaction, xerostomia, loss of taste sensation, angio-oedema and oral and peri-oral pigmentation. In many patients, resolution of symptoms was progressive within 2 weeks of withdrawal of the herbal toothpaste and its replacement with a conventional fluoride toothpaste. Most of the patients however required further treatment. A statistically significant association was found between the use of the identified herbal dentifrices and the following mucosal signs and symptoms namely, burning mouth and peppery sensation ,loss of taste sensation, soreness, erythema and lichenoid straie (p value ≤ 0.05). There was no statistically significant association between the use of herbal toothpaste and mucosal signs and symptoms of xerostomia, angular cheilitis, mucosal itching, angio-oedema and numbness (p value > 0.0.5) Conclusion: The regular use of the herbal dentifrices identified in this study can result in oral signs and symptoms affecting taste , nutrition, aesthetics and general oral physiology in some consumers. These findings suggest that further long term clinical trials need to be conducted on the herbal dentifrices to identify the noxious agents causing these symptoms. The formulation and use of these dentifrices need to be standardized and regulated. There is also a need to formulate a treatment protocol for these patients.

This pain drives me crazy:Psychiatric symptoms in women with interstitial cystitis/bladder pain syndrome

BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term cystitis suggests an inflammatory or infectious origin,no definite cause has been identified.It occurs in both sexes,but women are twice as much affected.AIM To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.METHODS Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")AND("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36.Search on ClinicalTrials.gov produced 14 studies,of which none had available data.Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October 2023.These studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to catastrophizing.CONCLUSION Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS.Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.

CLINICAL OBSERVATION ON ACUPOINT DIGITAL PRESSING FOR TREATING IRRITABLE SYMPTOMS AND SIGNS OF POSTOPERATION OF MYOPORTHOSIS

Objective: To explore a new effective approach for treatment of the local irritable symptoms and signs resulted from myoporthosis operation. Methods: 263 cases of radial keratotomy outpatients were divided into control group (n=49, 90 eyes) and treatment group (n=214, 412 eyes). Patients of control group were treated with 0.5% Chloramphenicol eye drops, 3 times daily, 1-2 drops/time, and with 0.5% Erythromycine eye ointment every night. In treatment group, patients were treated with acupoint and hand reflection area digital pressing method except with the same eye drops and eye ointment. Body acupoints used were Cuanzhu (BL 2), Yuyao (EX HN 4), Sizhukong (TE 23), Sibai (ST 2) and Taiyang (EX HN 5). The hand reflex areas used were Eye Area, Liver Area, Kidney Area, Spleen Area, Heart Area and Lung Area. Five days constituted a therapeutic course. Results: Following 3 courses (15 days) of treatment, the markedly effective rate and total effective rate of treatment group and control group were 74.51% and 38.89%, 94.17% and 66.67% respectively. There was a significant difference between two groups in the total effective rate (P<0.05), showing the therapeutic effect of treatment group being better than that of control group. Conclusion: Acupoint digital pressing is rather effective in treatment of myoporthosis post operation irritable symptoms and signs.

Liquid Subcutaneous Levodopa-Carbidopa ND0612 Effects on Motor Symptoms in Individuals with Parkinson’s Disease: A Systematic Review and Meta-Analysis

Objective: In the manuscript titled “Liquid subcutaneous Levodopa-Carbidopa ND0612 effects on motor symptoms in individuals with Parkinson’s Disease: A systematic review and meta-analysis”, the objective was to conduct a systematic review with meta-analysis to investigate the effects ND0612 24-hour dosing regimen has on motor symptoms in individuals with Parkinson’s Disease (PD). Introduction: ND0612 is a novel minimally invasive continuous subcutaneous delivery system of liquid Levodopa-Carbidopa being investigated for the treatment of PD in individuals experiencing motor symptoms. Methods: A systematic literature search was conducted in PubMed, Cochrane, and EBSCO databases to identify randomized controlled trials investigating the effects of ND0612 on motor symptoms in individuals with PD. Outcomes included the Unified Parkinson’s Disease Rating Scale (UPDRS) Part II and Part III scores. Methodological quality was assessed using the Cochrane Grading of Recommendations Assessment, Development, and Evaluation approach. Meta-analysis was performed using a random effects model with the DerSimonian and Laird method to estimate the effects of the ND0612 24-hour dosing regimen on UPDRS Part II and Part III scores. Results: Three studies were included in our review. There were statistically significant reductions in UPDRS Part II scores (mean difference (MD) −3.299;95% confidence interval (CI) −3.438, −3.159) and in UPDRS Part III scores (MD −12.695;95% CI −24.428, −0.962) in the ND0612 24-hour dosing regimen. Results were based on very low certainty of evidence. Conclusion: Based on very low certainty evidence, the ND0612 24-hour dosing regimen is effective at improving motor symptoms in individuals with PD. Our findings suggest that ND0612 is more effective at improving UPDRS Part II and Part III scores in individuals with PD than other pharmacological and non-pharmacological treatments, warranting further study.

Association of serum interleukin-6 with negative symptoms in stable early-onset schizophrenia

BACKGROUND Accumulating evidence suggests that the inflammatory cytokine interleukin-6(IL-6)contributes to the pathophysiology of psychiatric disorders.However,there was no study concerning the relationship between IL-6 concentrations and clinical features in the chronic phase of early-onset schizophrenia(EOS).AIM To investigate the relationship between serum IL-6 concentration and the clinical features of EOS.METHODS We measured serum IL-6 Levels from 74 patients with chronic schizophrenia,including 33 with age at onset<21 years(EOS group)and 41 with onset≥21 years in[adult-onset schizophrenia(AOS)group],and from 41 healthy controls.Symptom severities were evaluated using the Positive and Negative Syndrome Scale(PANSS).RESULTS Serum IL-6 concentrations were higher in both EOS and AOS groups than healthy controls(F=22.32,P<0.01),but did not differ significantly between EOS and AOS groups(P>0.05)after controlling for age,body mass index,and other covariates.Negative symptom scores were higher in the EOS group than the AOS group(F=6.199,P=0.015).Serum IL-6 concentrations in the EOS group were negatively correlated with both total PANSS-negative symptom score(r=-0.389,P=0.032)and avolition/asociality subscore(r=-0.387,P=0.026).CONCLUSION Patients with EOS may have more severe negative symptoms than those with adult-onset schizophrenia during the chronic phase of the illness.IL-6 signaling may regulate negative symptoms and its avolition/asociality subsymptoms among the early-onset chronic schizophrenic patients.

Sleep Quality and Emotional Adaptation among Freshmen in Elite Chinese Universities during Prolonged COVID-19 Lockdown:The Mediating Role of Anxiety Symptoms

Under the effects of COVID-19 and a number of ongoing lockdown tactics,anxiety symptoms and poor sleep quality have become common mental health issues among college freshmen and are intimately related to their emotional adaptation.To explore this connection,this study gathered data from a sample of 256 freshmen enrolled in an elite university in China in September 2022.The association between sleep quality,anxiety symptoms,and emotional adaptation was clarified using correlation analysis.Additionally,the mediating function of anxiety symptoms between sleep quality and emotional adaptation was investigated using a structural equation model.The results reveal that:(1)Chinese elite university freshmen who were subjected to prolonged lockdown had poor sleep quality and mild anxiety symptoms;(2)a significant positive correlation between poor sleep quality and anxiety symptoms was identified;(3)anxiety symptoms were found to have a significant negative impact on emotional adaptation;(4)poor sleep quality had a negative impact on emotional adaptation through anxiety symptoms.This research makes a valuable contribution by offering insights into the intricate relationship between sleep quality and emotional adaptation among freshmen in elite Chinese universities during prolonged lockdown conditions,and it is beneficial for schools and educators to further improve school schedules and psychological health initiatives.

Relationship between physical activity and specific working memory indicators of depressive symptoms in university students

BACKGROUND The detection rate of depression among university students has been increasing in recent years,becoming one of the main psychological diseases that endangers their physical and mental health.According to statistics,self-harm and suicide,for which there is no effective intervention,are the second leading causes of death.AIM To explore the relationship between different elements and levels of physical activity and college students’depression-symptom-specific working memory indicators.METHODS Of 143 college students were analyzed using the Beck Depression Self-Rating Scale,the Physical Activity Rating Scale,and the Working Memory Task.RESULTS There was a significant difference between college students with depressive symptoms and healthy college students in completing verbal and spatial working memory(SWM)tasks correctly(all P<0.01).Physical Activity Scale-3 scores were significantly and positively correlated with the correct rate of the verbal working memory task(r=0.166)and the correct rate of the SWM task(r=0.210)(all P<0.05).There were significant differences in the correct rates of verbal and SWM tasks according to different exercise intensities(all P<0.05)and different exercise durations(all P<0.05),and no significant differences in the correct rates of verbal and SWM tasks by exercise frequency(all P>0.05).CONCLUSION An increase in physical exercise among college students,particularly medium-and high-intensity exercise and exercise of 30 min or more,can improve the correct rate of completing working memory tasks.

Correlation between abdominal computed tomography signs and postoperative prognosis for patients with colorectal cancer

BACKGROUND Patients with different stages of colorectal cancer(CRC)exhibit different abdominal computed tomography(CT)signs.Therefore,the influence of CT signs on CRC prognosis must be determined.AIM To observe abdominal CT signs in patients with CRC and analyze the correlation between the CT signs and postoperative prognosis.METHODS The clinical history and CT imaging results of 88 patients with CRC who underwent radical surgery at Xingtan Hospital Affiliated to Shunde Hospital of Southern Medical University were retrospectively analyzed.Univariate and multivariate Cox regression analyses were used to explore the independent risk factors for postoperative death in patients with CRC.The three-year survival rate was analyzed using the Kaplan-Meier curve,and the correlation between postoperative survival time and abdominal CT signs in patients with CRC was analyzed using Spearman correlation analysis.RESULTS For patients with CRC,the three-year survival rate was 73.86%.The death group exhibited more severe characteristics than the survival group.A multivariate Cox regression model analysis showed that body mass index(BMI),degree of periintestinal infiltration,tumor size,and lymph node CT value were independent factors influencing postoperative death(P<0.05 for all).Patients with characteristics typical to the death group had a low three-year survival rate(log-rankχ2=66.487,11.346,12.500,and 27.672,respectively,P<0.05 for all).The survival time of CRC patients was negatively correlated with BMI,degree of periintestinal infiltration,tumor size,lymph node CT value,mean tumor long-axis diameter,and mean tumor short-axis diameter(r=-0.559,0.679,-0.430,-0.585,-0.425,and-0.385,respectively,P<0.05 for all).BMI was positively correlated with the degree of periintestinal invasion,lymph node CT value,and mean tumor short-axis diameter(r=0.303,0.431,and 0.437,respectively,P<0.05 for all).CONCLUSION The degree of periintestinal infiltration,tumor size,and lymph node CT value are crucial for evaluating the prognosis of patients with CRC.

Interaction between catechol-O-methyltransferase Val/Met polymorphism and cognitive reserve for negative symptoms in schizophrenia

BACKGROUND Cognitive reserve(CR)and the catechol-O-methyltransferase(COMT)Val/Met polymorphism are reportedly linked to negative symptoms in schizophrenia.However,the regulatory effect of the COMT genotype on the relationship between CR and negative symptoms is still unexamined.AIM To investigate whether the relationship between CR and negative symptoms could be regulated by the COMT Val/Met polymorphism.METHODS In a cross-sectional study,54 clinically stable patients with schizophrenia underwent assessments for the COMT genotype,CR,and negative symptoms.CR was estimated using scores in the information and similarities subtests of a short form of the Chinese version of the Wechsler Adult Intelligence Scale.RESULTS COMT Met-carriers exhibited fewer negative symptoms than Val homozygotes.In the total sample,significant negative correlations were found between negative symptoms and information,similarities.Associations between information,similarities and negative symptoms were observed in Val homozygotes only,with information and similarities showing interaction effects with the COMT genotype in relation to negative symptoms(information,β=-0.282,95%CI:-0.552 to-0.011,P=0.042;similarities,β=-0.250,95%CI:-0.495 to-0.004,P=0.046).CONCLUSION This study provides initial evidence that the association between negative symptoms and CR is under the regulation of the COMT genotype in schizophrenia.

Study on the occurrence and influencing factors of gastrointestinal symptoms in hemodialysis patients with uremia

BACKGROUND Gastrointestinal symptoms are common in patients with uremia undergoing hemodialysis,and these symptoms seriously affect patients'prognosis.AIM To assess the occurrence and factors influencing gastrointestinal symptoms in patients with uremia undergoing hemodialysis.METHODS We retrospectively selected 98 patients with uremia who underwent regular hemo-dialysis treatment in the blood purification center of our hospital from December 2022 to December 2023.The gastrointestinal symptoms and scores of each dimension were evaluated using the Gastrointestinal Symptom Grading Scale(GSRS).Patients were divided into gastrointestinal symptoms and no gastrointestinal symptom groups according to whether they had gastrointestinal symptoms.The factors that may affect gastrointestinal symptoms were identified by single-factor analysis.Multiple logistic regression analysis was performed to identify independent risk factors for gastrointestinal symptoms.RESULTS Gastrointestinal symptoms included indigestion,constipation,reflux,diarrhea,abdominal pain,and eating disorders,and the total average GSRS score was 1.35±0.47.This study showed that age,number of tablets,dialysis time,glucocorticoid,parathyroid hormone(PTH),combined diabetes mellitus and C-reactive protein(CRP)were independent risk factors for gastrointestinal symptoms in patients with uremia undergoing hemodialysis,whereas body mass index(BMI),hemoglobin(Hb),and urea clearance index were independent protective factors(P<0.05).CONCLUSION Gastrointestinal symptoms are mostly mild in patients with uremia undergoing hemodialysis,most commonly including dyspepsia,eating disorders,and gastroesophageal reflux.The independent influencing factors mainly include the BMI,age,number of pills taken,dialysis time,urea clearance index,Hb,use of glucocorticoids,and thyroid hormone level.PTH,CRP,and diabetes are clinically related factors influencing the occurrence of gastrointestinal symptoms,and targeted prevention can be performed.

Observation on the Nursing Effect of Ginger Moxibustion on Gastrointestinal Symptoms in Patients with Heart Failure Due to Yang Qi Deficiency

Objective:To evaluate the nursing measures and effects of ginger moxibustion in the treatment of heart failure(yang qi deficiency type)with gastrointestinal symptoms.Methods:86 patients with heart failure(yang qi deficiency type)accompanied by gastrointestinal symptoms who were admitted to the hospital between January 2023 and January 2024 were selected and divided into 43 cases in each group by random number table grouping;Group I implemented integrated care,while Group II adopted conventional care.The indicators of care were compared between the two groups.Results:After the nursing care,the digestive symptom scores of Group I were lower than those of Group I,and the psychological scores were lower than those of Group II(P<0.05).Conclusion:Ginger moxibustion can improve gastrointestinal symptoms and enhance the psychological health of patients with heart failure(yang qi deficiency type)with gastrointestinal symptoms.

Does local vaginal estrogen after tension-free transobturator vaginal tape reduce overactive bladder symptoms in postmenopausal women? A prospective randomized, controlled study

Objective:We aimed to evaluate the efficacy of topical estrogen after transvaginal tension-free vaginal tape-obturator(TVT-O)in the treatment of de novo overactive bladder symptoms that appear after surgery.Methods:This is a prospective randomized controlled study performed in the Urology and Gynecology Departments,Kasr Al Ainy Hospital,Cairo University,Cairo,Egypt.Two hundred and ten postmenopausal females presenting during the period between January 2017 and November 2020 with stress urinary incontinence were included in the study.Patients were divided into two groups,105 patients in Group A(treatment group)and 105 patients in Group B(control group).Patients in Group A underwent transvaginal TVT-O followed by local vaginal estrogen treatment for 6 months,while patients in Group B underwent transvaginal TVT-O only.The study included any postmenopausal female with urodynamic stress urinary incontinence.All patients had to fulfill a 3-day bladder diary,overactive bladder symptoms score,urine analysis,urodynamic study,and post-voiding residual urine measurement by abdominal ultrasound preoperatively and at 3-month and 6-month follow-ups.Results:At 6-month follow-up,daytime frequency was reduced to 8%in Group A(increased to 21%in Group B)with a statistically significant difference between both groups(p=0.009).At 6-month follow-up,nocturia was 8%in Group A(11%in Group B)with no statistically significant difference between both groups(p=0.469).There was a statistically significant difference between both groups as regards to urinary urgency at 6-month follow-up(p=0.024).There was a statistically significant difference in postoperative wound healing events as regards to cure,hyperemia,gapping,and wound infection 1 week after intervention between both groups(p=0.008).No local or systemic side-effects were reported from local estrogen use.Conclusion:Local vaginal estrogen treatment given to postmenopausal patients after midurethral sling procedures can reduce the symptoms of daytime frequency and urinary urgency.Long-term follow-up is needed.

Lung adenocarcinoma with initial binocular symptoms

Dear Editor,Lung adenocarcinoma with choroidal metastasis is a common form of cancer,with breast cancer accounting for 40%-53%and lung cancer accounting for 20%-29%of primary cases with choroidal metastases[1].This type of metastatic cancer typically affects people aged 40-70y,and is more prevalent in women than men[1].Ocular symptoms,including vision loss,can be an early indication of the disease,as many tumors are asymptomatic in their early stages.Studies have shown that 40.3%of cases involve the macular region,which explains why ocular symptoms are often the first manifestation of the disease[2].When choroidal metastasis is suspected in patients without a history of cancer,a combination of diagnostic tools should be used to identify the primary source of the tumor.Choroidal tumors can serve as an indication of future lung cancer diagnosis in some patients with lung cancer[1].In this report,we present a case of bilateral lung adenocarcinoma where ocular symptoms were the first indication of the disease.

Network analysis of suicide ideation and depression-anxiety symptoms among Chinese adolescents

Background The co-occurrence of depression and anxiety among adolescents is typically associated with suicide ideation.Aims The study aimed to investigate the symptom-level relationship between suicide ideation and the comorbidity of depression and anxiety.Methods 1501 adolescents aged 12-19 years were assessed using the Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder Scale,and 716 adolescents who scored≥5 on both scales were selected as participants.Network analysis was used to identify the network structure of depressive symptoms and anxiety symptoms.Participants were categorised into either the suicide ideation or non-suicide ideation groups based on their scoring on the suicide-related item in PHQ-9.A comparison was made between the depression-anxiety symptom networks of the two groups.Results‘Restlessness’,‘sad mood’and‘trouble relaxing’were the most prominent central symptoms in the depression-anxiety symptom network,and‘restlessness’,‘nervousness’and‘reduced movement’were the bridge symptoms in this network.‘Sad mood’was found to be directly related to‘suicide ideation’with the highest variance.The network structure was significantly different in properties between the suicide ideation group and the non-suicide ideation group,with‘restlessness’and‘sad mood’exhibiting significantly higher influence in the network of the suicide ideation group than that in the non-suicide ideation group.Conclusion Restlessness and sad mood could be targeted for the intervention of depression-anxiety symptoms among adolescents with suicide ideation.

Symptoms and signs of acute alcoholic hepatitis

Although there is not one specific sign or symptom related to alcoholic hepatitis(AH),a constellation of symptoms and signs can help make the diagnosis of AH with reasonable accuracy.Documentation of chronic and active alcohol abuse is paramount in making a diagnosis of AH.Clinical presentation after abstinence for more than 3 m should raise doubts about the diagnosis of AH and dictate the need for considering other causes of liver disease,decompensation of alcoholic cirrhosis,sepsis and malignancy as the cause of patient's clinical profile.

Simulation based on a modified social force model for sensitivity to emergency signs in subway station

The subway is the primary travel tool for urban residents in China. Due to the complex structure of the subway and high personnel density in rush hours, subway evacuation capacity is critical. The subway evacuation model is explored in this work by combining the improved social force model with the view radius using the Vicsek model. The pedestrians are divided into two categories based on different force models. The first category is sensitive pedestrians who have normal responses to emergency signs. The second category is insensitive pedestrians. By simulating different proportions of the insensitive pedestrians, we find that the escape time is directly proportional to the number of insensitive pedestrians and inversely proportional to the view radius. However, when the view radius is large enough, the escape time does not change significantly, and the evacuation of people in a small view radius environment tends to be integrated. With the improvement of view radius conditions, the escape time changes more obviously with the proportion of insensitive pedestrians. A new emergency sign layout is proposed, and the simulations show that the proposed layout can effectively reduce the escape time in a small view radius environment. However, the evacuation effect of the new escape sign layout on the large view radius environment is not apparent. In this case, the exit setting emerges as an additional factor affecting the escape time.

Omicron Infections in Otolaryngology Practice: A Retrospective Observational Study on Testing, Symptoms and Vaccination Status

Background: With the appearance of the SARS-CoV-2 Omicron variant the high rate of vaccination breakthroughs showed that current vaccines against COVID-19 can no longer provide adequate protection against infection. However, it is still assumed that vaccination might have a positive effect on the course of the disease. In Germany, general practitioners and specialists are usually the first treatment providers for acute illnesses. In addition, patients with infections of the upper respiratory tract often primarily consult an ear, nose and throat specialist. Most of the Omicron-infected people have a mild course of the disease and, if necessary, receive medical care on an outpatient basis. Little is known about the effectiveness of corona vaccinations on Omicron infections in relation to the clinical symptoms. In our outpatient office, we recorded a sharp increase of corona positive Omicron-infections in the beginning of 2022, despite of vaccinations against COVID-19. In a retrospective analysis, we evaluated the data of our SARS-CoV-2 tested patients with regard to clinical symptoms reported and vaccination status. The focus was particularly on the question to what extent the vaccination status in the case of Omicron infections influences the symptoms of the disease. Methods: We retrospectively evaluated the data of all patients in the first quarter of 2022 who were suspected for COVID-19. At that time, the Omicron variant was dominant in Germany. Clinical symptoms, cycle threshold (Ct) values, and the vaccination status were recorded. Symptomatic patients who tested negative for SARS-CoV-2 served as a control group. Results: Of the total cohort (n = 353), 241 (68%) patients were tested SARS-CoV-2 positive. The symptoms of the corona-positive patients were essentially similar to those of a mild to moderate cold, but compared to SARS-CoV-2-negative patients (n = 69) with a clear shift in favor of fever (35% versus 16%), cough (76% versus 52%) and increased feeling of illness (59% versus 43%), respectively. Ct values revealed no difference between unvaccinated (mean 19.15;SD 3.52) and vaccinated cases (mean 18.15;SD 3.87;p = 0.272). There was no significant correlation between the vaccination status and clinical symptom score in different age groups (age 12 to 17, r (28) = 0.26, p = 0.26;age > 18 to 60, r (191) = 0.06, p = 0.378). Conclusions: According to our results with infections with the Omicron variant, there were no differences between unvaccinated and vaccinated patients concerning clinical symptoms or potential infectivity, especially in children and adolescents. This might have impact on further vaccination programs.