Development and evaluation of a RT-RAA-combined CRISPR/Cas12a assay for the detection of African horse sickness virus

African horse sickness(AHS)is an acute and fatal vectorborne infectious disease of equids,caused by the African horse sickness virus(AHSV).The World Organization for Animal Health(WOAH)has classified AHS as a notifiable animal disease,and AHS has also been classified as a Class I animal infectious disease in China.AHS is mainly found in Africa,the Middle East and the Arabian Peninsula.China is currently recognized by the WOAH as an AHS-free zone.

Principle for the Installation of Accommodation for Sick guards in Public Health Establishments in Brazzaville in the Republic of Congo

The results of scientific studies of human social facts in the field of health show that the management of a patient should involve the patient’s entourage,whatever the status or size of the health establishment.In healthcare establishments in the Congo,the following are recognised as being responsible for medical care:specialist doctors,doctors,midwives,nurses and care assistants.The patient’s family and close friends are responsible for looking after the patient and financing care.The hospital infrastructure does not provide any space for the patient warden who accompany the patient during reception and hospitalisation.This makes Congolese hospitals inefficient for patient care.How can we integrate the function of the Sick guard and the assistance of the family,in order to reduce the mortality rate and repair the harm caused to patients requiring the presence of relatives during their stay in hospital,which is considered to be a dangerous place?This article examines the functional principles for configuring the space that patient warden would occupy in the patient care system.On the basis of a documentary analysis of sociological and architectural studies of existing facilities,this article proposes a typical accommodation model with the spaces needed to ensure the well-being and effectiveness of the patient warden with the patient.These are rooms with minimum space for 2 to 4 individual beds,equipped with toilets and showers.The accommodation has a dining area,kitchen and laundry facilities.In the future,this accommodation will become part of the hospital estate and may be occupied by orderlies and patient warden recruited by the hospital administration.

Anlotinib-induced sick sinus syndrome:Two case reports

BACKGROUND This manuscript describes the first known cases of sick sinus syndrome(SSS)associated with the use of anlotinib in non-small cell lung cancer patients,highlighting the need for increased vigilance and cardiac monitoring.CASE SUMMARY Two patients with non-small cell lung cancer developed SSS after 15 months and 5 months of anlotinib treatment,respectively,presenting with syncope and palpit-ations.Electrocardiogram confirmed SSS,and different treatment approaches were taken for each patient.One patient received a dual-chamber permanent pacemaker,while the other discontinued the medication and experienced symptom resolution.CONCLUSION Anlotinib can induce SSS,suggesting that cardiac monitoring is crucial during anlotinib treatment.Individualized management strategies are necessary for affected individuals.

Physiological Variables Associated with the Development of Acute Mountain Sickness

Objective To identify the physiological variables associated with the development of acute mountain sickness(AMS).Methods Eighty four young Chinese men residing at low altitude were taken to an altitude of 4000 m within 40 hours.At sea level and at high altitude,we measured the heart rate,blood pressure,and peripheral oxygen saturation(SpO2)respectively.We also collect blood samples from each participants before and after the altitude elevation.The blood routine and biochemical examinations were performed for all blood samples.The revised Lake Louise Criteria was adopted to diagnose AMS after the subjects arrived at the target high altitude.The association between the presence of AMS and subjects’physiological variables were analysed statistically.Results Of 84 participants,34(40.5%)developed AMS.Compared with non AMS group,in the AMS group,the percentage of neutrophils was significantly higher(64.5%±11.2%vs.58.1%±8.8%,P=0.014),while the level of SpO2 was significantly lower(79.4%±5.4%vs.82.7%±5.6,P=0.008).Binary logistic regression analyses emphasized the association of neutrophils(OR:1.06,95%CI:1.01-1.12,P=0.034)and SpO2 level(OR:0.87,95%CI:0.79-0.95,P=0.004)with the development of AMS.Conclusion The ability to sustain SpO2 after altitude elevation and the increase of neutrophils were associated with the development of AMS in young males.

Association between smoking and the risk of acute mountain sickness： a meta-analysis of observational studies

Background: People rapidly ascending to high altitudes(>2500m) may suffer from acute mountain sickness(AMS). The association between smoking and AMS risk remains unclear. Therefore, we performed a meta-analysis to evaluate the association between smoking and AMS risk.Methods: The association between smoking and AMS risk was determined according to predefined criteria established by our team. Meta-analysis was conducted according to the PRISMA guidelines. We included all relevant studies listed in the Pub Med and Embase databases as of September 2015 in this meta-analysis and performed systemic searches using the terms "smoking", "acute mountain sickness" and "risk factor". The included studies were required to provide clear explanations regarding their definitions of smoking, the final altitudes reached by their participants and the diagnostic criteria used to diagnose AMS. Odds ratios(ORs) were used to evaluate the association between smoking and AMS risk across the studies, and the Q statistic was used to test OR heterogeneity, which was considered significant when P<0.05. We also computed 95% confidence intervals(CIs). Data extracted from the articles were analyzed with Review Manager 5.3(Cochrane Collaboration, Oxford, UK).Results: We used seven case-control studies including 694 smoking patients and 1986 non-smoking controls to analyze the association between smoking and AMS risk. We observed a significant association between AMS and smoking(OR=0.71, 95% CI 0.52–0.96, P=0.03).Conclusion: We determined that smoking may protect against AMS development. However, we do not advise smoking to prevent AMS. More studies are necessary to confirm the role of smoking in AMS risk.

Sex-based differences in the prevalence of acute mountain sickness: a meta-analysis

Background:When lowlanders rapidly ascend to altitudes>2500 m,they may develop acute mountain sickness(AMS).The individual susceptibility,ascending velocity,time spent at altitude,activity levels and altitude reached are considered risk factors for AMS.However,it is not clear whether sex is a risk factor.The results have been inconclusive.We conducted a meta-analysis to test whether there were sex-based differences in the prevalence of AMS using Lake Louise Scoring System.Methods:Systematic searches were performed in August 2019 in EMBASE,PubMed,and Web of Science for prospective studies with AMS data for men and women.The titles and abstracts were independently checked in the primary screening step,and the selected full-text articles were independently assessed in the secondary screening step by the two authors(YPH and JLW)based on pre-defined inclusion criteria.The meta-analysis was performed using by the STATA 14.1 software program.A random-effects model was employed.Results:Eighteen eligible prospective studies were included.A total of 7669 participants(2639[34.4%]women)were tested.The results showed that there was a statistically significant higher prevalence rate of AMS in women than in men(RR=1.24,95%CI 1.09–1.41),regardless of age or race.However,the heterogeneity was significant in the analysis(Tau2=0.0403,Chi2=50.15,df=17;I2=66.1%,P=0.000),it was main caused by different numbers of subjects among the studies(coefficient=–2.17,P=0.049).Besides,the results showed that there was no evidence of significant publication bias in the combined studies on the basis of Egger’s test(bias coefficient=1.48,P=0.052)and Begg’s test(P=0.130).Conclusions:According to this study,the statistically significant finding emerging from this study was that women have a higher prevalence of AMS.However,the authors could not exclude studies where patients were on acetazolamide.Our analysis provided a direction for future studies of the relationship of sex and the risk of AMS,such as the pathological mechanism and prevention research.

Anesthetic Management of a Patient with Sick Sinus Syndrome during General Anesthesia for Maxillofacial Surgery

Sick sinus syndrome (SSS) is a generalized abnormality of cardiac impulse formation. Patients with SSS occasionally need temporary pacing during general anesthesia. The most common issue arising in the perioperative period is electromagnetic interference with device function. We report a case of a 66-year-old man who required temporary cardiac pacing during maxillary cyst extirpation using electrocautery.

EPAS1 and VEGFA gene variants are related to the symptoms of acute mountain sickness in Chinese Han population: a cross-sectional study

Background: More people ascend to high altitude(HA) for various activities, and some individuals are susceptible to HA illness after rapidly ascending from plains. Acute mountain sickness(AMS) is a general complaint that affects activities of daily living at HA. Although genomic association analyses suggest that single nucleotide polymorphisms(SNPs) are involved in the genesis of AMS, no major gene variants associated with AMS-related symptoms have been identified.Methods: In this cross-sectional study, 604 young, healthy Chinese Han men were recruited in June and July of 2012 in Chengdu, and rapidly taken to above 3700 m by plane. Basic demographic parameters were collected at sea level, and heart rate, pulse oxygen saturation(Sp O2), systolic and diastolic blood pressure and AMS-related symptoms were determined within 18–24 h after arriving in Lhasa. AMS patients were identified according to the latest Lake Louise scoring system(LLSS). Potential associations between variant genotypes and AMS/AMS-related symptoms were identified by logistic regression after adjusting for potential confounders(age, body mass index and smoking status).Results: In total, 320 subjects(53.0%) were diagnosed with AMS, with no cases of high-altitude pulmonary edema or high-altitude cerebral edema. Sp O2 was significantly lower in the AMS group than that in the non-AMS group(P=0.003). Four SNPs in hypoxia-inducible factor-related genes were found to be associated with AMS before multiple hypothesis testing correction. The rs6756667(EPAS1) was associated with mild gastrointestinal symptoms(P=0.013), while rs3025039(VEGFA) was related to mild headache(P=0.0007). The combination of rs6756667 GG and rs3025039 CT/TT further increased the risk of developing AMS(OR=2.70, P<0.001).Conclusions: Under the latest LLSS, we find that EPAS1 and VEGFA gene variants are related to AMS susceptibility through different AMS-related symptoms in the Chinese Han population;this tool might be useful for screening susceptible populations and predicting clinical symptoms leading to AMS before an individual reaches HA.Trial registration: Chinese Clinical Trial Registration, Chi CTR-RCS-12002232. Registered 31 May 2012.

Rong Shuan Jiao Nang in the treatment of acute mountain sickness and high altitude myocardial ischemic syndrome in Yushu

To evaluate the therapeutic effects of Rong Shuan Jiao Nang （RSJN） on treatment of acute mountain sickness （AMS） and high altitude myocardial ischemic syndrome in workers in Yushu, three groups were studied： group A （60 patients with AMS, given RSJN）, group B （15 patients with altitude myocardial ischemic syndrome, given RSJN）, and group C （control, without drugs）. All studied subjects were lowland workers who were first time entry to Yushu for work at an altitude of 4 250 m. During the course of treatment, a routing physical examina- tion was performed, AMS Lake Louise Scores were estimated, arterial oxygen saturation （SaO2）, electrocardiography and hemoglobin concentration were measured before and after using RSJN for 10 days. In group A, the effective rate was 68 %, symptomatic improvement in 54 cases （90 %） within 5 days. In group B, the effective rate was 93 %, episodes of angina pectoris stopped in 12 patients within 3 - 7 days, one lasted 8 days. After treatment, the level of SaO2 increased 15.5 %, 21.8 % and 5.6 % in group A, group B and group C, respectively. RSJN tak- en at the start of the arrival at Yushu can decrease AMS scores and facilitate cure. If taken after the illness has begun, RSJN may help lessen symptoms, especially effectively improved angina pectoris of the high altitude myocardial ischemic syndrome. Symptoms usually subside after 3 - 8 days. RSJN should be continually used lbr at least 7 days after ascent.

The denitrogenation by breathing oxygen-rich gas to prevent altitude decompression sickness

Objective While the technology of the molecular sieve oxygen generation system(MSOGS) onboard was used,pilots could not breathe pure oxygen to eliminate nitrogen during a high altitude flight.There is no report whether it is a threat to altitude decompression sickness(ADS) or not in that condition.This experiment was intended to observe the effects of breathing different oxygen-rich gases of MSOGS on denitrogenation,so that we could make the medical physiological requirements for MSOGS on-board and provide experimental basis for aeromedical supply.Method Eight healthy males were breathed oxygenrich gases(60%,70%,80%,90%and 99.6%) in turn for 60 min,and the concentration of nitrogen,oxygen,carbon dioxide and argon at the end of expiration interval in the oxygen mask were continuously measured by a flight mass spectrometer through the oxygen mask.According to the variety of the denitrogenation rate by breathing different oxygen-rich gases,its change law was analyzed.Results There were significant differences(P<0.05) about denitrogenation rate in different oxygen-rich gases due to different oxygen concentration and breathing time.The denitrogenation rate of pure oxygen was higher than that of the others.It was indicated that the concentration of nitrogen in lung would decrease along with the increase in oxygen concentration of oxygen-rich gases,and the nitrogen concentration in the lung almost decreased by 50% or even more if people were breathed 60%～90% oxygen-rich gas longer than 60 s.Conclusion The man-made respiration environment of low nitrogen can be provided by breathing oxygen-rich gases,although the denitrogenation velocity of breathing oxygen-rich gases is lower than that of breathing pure oxygen.So it can be used as a measure to eliminate and lower the nitrogen in the body to prevent from ADS.

Changes in oxygen saturation can not help diagnose acute mountain sickness(AMS)： ascending to Lhasa on the Qinghai-Tibet train

Objective: Acute mountain sickness(AMS) is a common condition in individuals who ascend to altitudes over 2 500 m. There is no measurements that can reliably predict or diagnose this condition. We therefore determined whether pulse oximetry data are associated with the development of AMS and can help diagnose AMS. Methods: We studied 58 young male undergraduates who traveled from Chongqing(300 m) to Lhasa(3 658 m) by train. We collected data on the ascent profiles and AMS symptoms based on the Lake Louise Score(LLS). The resting arterial oxygen saturation(R-Sp O2) and pulse rate were then measured using finger pulse oximetry. Results: In Golmud(2 800 m) and Tanggula(5 200 m), R-SpO_2 was significantly lower in the AMS group than in the group without AMS(P<0.05). However, upon arrival in Lhasa(3 658 m), the R-SpO_2 was higher in the AMS group than in the non-AMS group(P<0.05). In Tanggula, the change in the SpO_2(CR-SpO_2) in the AMS group was higher than that in the non-AMS group(P<0.05). But in Lhasa, the CR-SpO_2 in the AMS group was lower than that in the non-AMS group(P<0.05). We also monitored heart rate(HR) throughout the study. In Xining(2 200 m) and Golmud, the HRs in the AMS group were higher than those in the non-AMS group. However, the HRs in the AMS group were lower than those in the non-AMS group in Tanggula and Lhasa. Conclusion: Based on the results of this study, the R-SpO_2 graph was not consistent. We can thus conclude that the utility of SpO_2 remains limited in the diagnosis of AMS. The results suggest that using pulse oximetry to diagnose AMS is not valuable in people ascending to Lhasa on the Qinghai-Tibet train.

The Contribution of Tanzanian National Parks in Controlling the Vectors of Sleeping Sickness

This paper summarises efforts to control Sleeping sickness [Human African Trypanosomiasis (HAT)] by Tsetse flies and Trypanosomiaisis (T & T) control for the 7 consecutive years although started a decade ago in Tanzania National Parks (TANAPA). These efforts are critical for curbing HAT incidences and HAT epidemics. HAT cases have had profound negative impacts on human health, affecting local residents and international travel as well as tourism industry resulting into human and animal health burden and reduction in tourism income. Understanding the current efforts is essential in the proper planning and decision making on developing effective control strategy against T & T control. In this paper, we summarize the recent efforts in the control of T & T in National Parks and discuss the constraints faced. The information will enable TANAPA and other concerned authorities to make informed decision on optimal ways of controlling HAT in National Parks. The results show that much control efforts have so far concentrated in Serengeti, Ruaha, Tarangire and Katavi National Parks where tsetse fly challenges are high. A total 21,143 (average 3020) Insecticide Treated Targets (ITT) were deployed in different areas in the parks and 82,899 (average 20,725) cars entering these parks were sprayed from 2007/2008 to 2014/2015 and 2007/2008 to 2010/2011 respectively. Deployed ITTs lead to a drastic reduction of FTDs of the two dominant tsetse species to 1.3 and 1.4 of G. swynnertoni and G. pallidipes respectively, and the decline was significant at P = 0.011. The major challenges faced include tsetse re-invasion in controlled areas;resurgence of HAT cases when control efforts are relaxed, ITT maintenance and inadequate health education programs. The control strategy should be continuous and scaled up as failure to implement an effective and sustainable system for HAT control will increase the risk of new epidemic that would impede tourism development.

Chronic Physical Stress Does Not Interact with Epstein-Barr Virus (EBV)-Encoded Dutpase to Alter the Sickness Response

Most adult humans have been infected with Epstein-Barr virus (EBV), which is thought to contribute to the development of chronic fatigue syndrome. Stress is known to influence the immune system and can exacerbate the sickness response. Although a role for psychological stress in the sickness response, particularly in combination with EBV-encoded deoxyuridine triphosphate nucleotidohydrolase (dUTPase) has been established, and the role of physical stressors in these interactions remains unspecified. In this study, we seek to determine the interaction of chronic physical (swim) stress and EBV-encoded dUTPase injection. We hypothesize that a chronic physical stressor will exacerbate the sickness response following EBV-encoded dUTPase injection. To test this hypothesis mice receive daily injections of EBV-encoded dUTPase or vehicle and are subjected to 15 min of swim stress each day for 14 days or left unmanipulated. On the final evening of injections mice undergo behavioral testing. EBV-encoded dUTPase injection alone produces some sickness behaviors. The physical swimming stress does not alter the sickness response.

The dynamic distribution of nitric oxide synthase in the small intestine of mice with intestinal radiation sickness

in order to understand the dynamic change of nitric oxide (NO) and its pathological significance during intestinal radiation sickness, we gave mice 60Co γ-ray irradiation and sacrificed them after different periods of survival.The dynamic distribution of nitric oxide synthase (NOS) in the small intestines (duodenum, jejunum and ileum) was studied by using NADPH-diaphorase histochemistry. The results showed that in the animal groups that survived 48 h and 72 h after irradiation (the 48 h and 72 h groups), the number of NOS-positive neuronal bodies and the density of NOS-positive fibers increased obviously in the myenteric plexus and deep muscular plexus as compared with the control group. The neuronal bodies and fibers were stained intensely. The NOS-positive reaction product in the glandular cavities of the intestines and on the mucosa also increased. The results suggest that the activation of NOS or increase of NO production might be one of the main causes of intestinal and vascular dilatation during intestinal radiation sickness.

Effects of endothelial nitric oxide synthase uncoupling on pulmonary endothelial dysfunction in rats with decompression sickness

Background: To investigate the effects of unsafe decompression on rat pulmonary endothelial function and its relevant mechanisms.Methods: Sixty male Sprague-Dawley(SD) rats were randomly divided into a control group(n=30) and a decompression sickness(DCS) group(n=30). The DCS model was established by placing the rats in the DCS group in a pressurized cabin where they were exposed to a 600 k Pa compressed air environment for 60 min, and the pressure was then reduced by 100 k Pa/min until it reached atmospheric pressure. After the surviving rats in the DCS group and the rats in the control group were anesthetized, their pulmonary arteries were stripped to test the in vitro pulmonary artery endothelium-dependent vasodilation capacity. Western blotting was used to measure the expression and dissociation of endothelial nitric oxide synthase(e NOS) in pulmonary artery tissues and all protein nitration levels in pulmonary artery tissues; reactive oxygen species(ROS) formation was measured via in vitro pulmonary artery superoxide anion probe dihydroethidium(DHE) staining.Results: After experiencing unsafe decompression, 10 of the 30 rats in the DCS group died. The pulmonary artery endothelium-dependent vasodilation capacity in the surviving rats decreased significantly(P<0.05). The difference in e NOS expression between the DCS group and the control group was statistically insignificant(P>0.05), but the ratio of e NOS monomer/dimer in the DCS group was significantly higher than that in the control group(P<0.05). All protein tyrosine nitration levels in the pulmonary artery tissues of the DCS group were significantly higher than those of the control group(P<0.05). The results of DHE staining showed that the amount of ROS formation in the pulmonary arteries of the DCS group was significantly higher than that of the control group(P<0.05).Conclusion: Unsafe decompression during a simulated submarine escape process can lead to e NOS dimer uncoupling in the pulmonary artery endothelium. The dissociated e NOS monomer cannot synthesize nitric oxide(NO) and thus affect the endothelium-dependent vasodilation capacity. The e NOS monomer can promote peroxynitrite(ONOO–) synthesis, leading to an increase in protein tyrosine nitration levels in pulmonary artery tissues and causing disorder in cell cycle regulation. The e NOS monomer can also cause an increase in the formation of ROS and thus mediate peroxidation damage.

A Health Impairment Process of Sickness Presenteeism in Norwegian Physicians: The Mediating Role of Exhaustion

Although work factors have been associated with both presenteeism and exhaustion among hospital physicians, we lack knowledge on the dynamic relationship between demands in the work context and presenteeism and how this can be mediated by symptoms of exhaustion when controlling for job resources. The objective of this study is to examine a health impairment process of presenteeism among university hospital physicians. A cross-sectional survey of 545 university hospital physicians in Norway was conducted. Variables included in the model were presenteeism, exhaustion, work-family conflict, role conflict, social support and control over work pace. Findings from structural equation modeling indicated that exhaustion mediates the relationship between job demands and presenteeism. Job resources had no direct effect on presenteeism in the hypothesized model. The variables in the study explained 17% of the variance in presenteeism. The study is one of the first to demonstrate that the relationship between job demands and presenteeism is mediated by exhaustion when controlling for job resources. The results highlight the importance of considering the link between health symptoms and job demands to reduce the negative effects of presenteeism.

Benefit of Using Sick Child Care Facilities to the Children and Their Parents

Introduction: Sick child care is a form of nursing care provided temporarily for sick children when they cannot be cared for by their parents at home. To clarify the benefits of using sick child care facilities for children and their parents, we surveyed these parents about the benefits of such care and their needs. Method: Study design: Descriptive research. We studied parents whose children had used one of the 11 sick child care facilities for sick children in Hiroshima City in 2014. A total of 156 parents consented to participate in the study. We investigated their usage situation of sick child care, perceived benefits of such care, and care-related requests in a quantitative and qualitative manner. Results: Both nuclear families consisting of the dual income parents and their children and single-mother households reported that their children (mean age: 2.46 years [SD: 1.77 years]) had used sick child care because of infectious diseases. Approximately 10% of the parents were using the fee reduction systems of sick child care intended for people with a low income. Parents viewed sick child care as beneficial both in early the health recovery of children, and as support for child raising and working. On the other hand, some parents left their children at home alone when sick child care was not available due to the limited number of sick child care facilities and an insufficient capacity to accept children. Some parents desired an increased number of care facilities, as well as a reduction in or subsidies for care fees. Conclusion: The results of this study suggest that, to ensure children’s health and safety, and support their parents for working and child raising, there is a need to increase the number of sick child care facilities along with expanding care services.

Associated or Concomitant Diseases Influence Significantly the Health-Sickness Concept in Celiacs

It is well-known that feeling to be a healthy or sick person most probably results from the mind than from the body. We all know healthy people who feel sick and vice versa. We were interested in the health and sickness feeling of celiac people, their autorating of these feelings and its conditioning factors as well as their expectations. In this paper we present the results of an inquiry to evaluate these situations. We performed a descriptive, transversal and prospective study for 2 years to groups of celiacs and their families. They received a closed inquiry to be completed before the beginning of the talk. The inquiry included personal data and the co-existence of associated or concomitant (AoC) diseases. Most of the sample’s patients felt to be a healthy person (86.8%). Mothers see their children as healthy and the auto rated criteria is significantly better than the adult celiac person (“t”= -6.024 (p = 0.000)). AoC diseases influenced negatively in the feeling of being healthy and strongly decreased the autorating. Longer time passed on treatment reflects an increase feeling of health and of the autorating. In people with AoC diseases and who feel sick, the increased time of treatment did not show significant differences. People with “gluten sensitivity” felt sicker and auto rated themselves with a lower number than celiacs. Many pediatric gastroenterologists notice that the newly agreed definition of celiac disease, referring it as “autoimmune, chronic, incurable, and multisystemic”, results in a very negative character of the condition which might compromise the future labour of this people as well as their admittance to different health insurance systems.

Transcatheter closure for decompression sickness with a patent foramen ovale:A case report

A patent foramen ovale is one of the predisposing factors of neurotic decompression sickness.Transcatheter closure of a patent foramen ovale is effective in the secondary prevention of decompression sickness associated with intracardiac shunt.The size of the umbrella should not be limited to the diagnosis of a patent foramen ovale or an atrial septal defect but should be determined by the supporting force of the soft margin of the atrial septum.The surgical method of patent foramen ovale closure is the same as that of the closure of an atrial septal defect,but the closure umbrella of a patent foramen ovale is different from that of the closure umbrella of an atrial septal defect.The size of the umbrella of the right atrium is larger than that of the left atrium,and it is better to close the atrial septum.