The most prevalent conditions among ocular surgery and COVID-19 patients are fungal eye infections, which may cause inflammation and dry eye, and may cause ocular morbidity. Amphotericin-B eye drops are commonly used in the treatment of ocular fungal infections. Lactoferrin is an iron-binding glycoprotein with broad-spectrum antimicrobial activity and is used for the treatment of dry eye, conjunctivitis, and ocular inflammation. However, poor aqueous stability and excessive nasolacrimal duct draining impede these agens\' efficiency. The aim of this study was to examine the effect of Amphotericin-B, as an antifungal against Candida albicans, Fusarium, and Aspergillus flavus, and Lactoferrin, as an anti-inflammatory and anti-dry eye, when co-loaded in triblock polymers PLGA-PEG-PEI nanoparticles embedded in P188-P407 ophthalmic thermosensitive gel. The nanoparticles were prepared by a double emulsion solvent evaporation method. The optimized formula showed particle size (177.0 ± 0.3 nm), poly-dispersity index (0.011 ± 0.01), zeta-potential (31.9 ± 0.3 mV), and entrapment% (90.9 ± 0.5) with improved ex-vivo pharmacokinetic parameters and ex-vivo trans-corneal penetrability, compared with drug solution. Confocal laser scanning revealed valuable penetration of fluoro-labeled nanoparticles. Irritation tests (Draize Test), Atomic force microscopy, cell culture and animal tests including histopathological analysis revealed superiority of the nanoparticles in reducing signs of inflammation and eradication of fungal infection in rabbits, without causing any damage to rabbit eyeballs. The nanoparticles exhibited favorable pharmacodynamic features with sustained release profile, and is neither cytotoxic nor irritating in-vitro or in-vivo. The developed formulation might provide a new and safe nanotechnology for treating eye problems, like inflammation and fungal infections.

We aimed to evaluate the changes in eating behaviours of the adult population across 16 European countries due to the COVID-19 confinement and to evaluate whether these changes were somehow related to the severity of the containment measures applied in each country. An anonymous online self-reported questionnaire on socio-demographic characteristics, validated 14-items Mediterranean diet (MedDiet) Adherence Screener (MEDAS) as a reference of a healthy diet, eating and lifestyle behaviours prior to and during the COVID-19 confinement was used to collect data. The study included an adult population residing in 16 European countries at the time of the survey. Aggregated Stringency Index (SI) score, based on data from the Oxford COVID-19 Government Response Tracker, was calculated for each country at the time the questionnaire was distributed (range: 0-100). A total of 36,185 participants completed the questionnaire (77.6% female, 75.2% with high educational level and 42.7% aged between 21 and 35 years). In comparison to pre-confinement, a significantly higher adherence to the MedDiet during the confinement was observed across all countries (overall MEDAS score prior to- and during confinement: 5.23 ± 2.06 vs. 6.15 ± 2.06; p < 0.001), with the largest increase seen in Greece and North Macedonia. The highest adherence to MedDiet during confinement was found in Spain and Portugal (7.18 ± 1.84 and 7.34 ± 1.95, respectively). Stricter contingency restrictions seemed to lead to a significantly higher increase in the adherence to the MedDiet. The findings from this cross-sectional study could be used to inform current diet-related public health guidelines to ensure optimal nutrition is followed among the population, which in turn would help to alleviate the current public health crisis.

UNASSIGNED: Ménière\'s Disease, a long-term debilitating disorder has been increasingly found among patients with hypothyroidism. Our study aims to evaluate the prevalence of ménière\'s disease among hypothyroid patients and assess the interrelationship between patients\' symptomology and ménière\'s disease.
UNASSIGNED: A cross-sectional study was performed at the endocrinology clinics at Damascus Hospital and Syrian Red Crescent Hospital, Damascus, Syria between September 2021 and January 2022. Patients with hypothyroidism were interviewed using a questionnaire. The questionnaire contained questions about socio-demographic information, hypothyroid history, diagnostic criteria of ménière\'s disease, chief complaint, medical history, and lab test results. Patients, who reported ménière\'s disease symptoms, were referred to the otorhinolaryngology clinic for confirmation or exclusion of ménière\'s disease. At the clinic, patients underwent an otoscopy and a pure tone audiometry, probable and definite ménière\'s disease was diagnosed accordingly.
UNASSIGNED: Of 217 hypothyroid patients included in the sample, 17 (7.8%) were diagnosed with definite ménière\'s disease and 31 (14.3%) were diagnosed with probable ménière\'s disease. Hypothyroid symptoms reported among patients diagnosed with definite ménière\'s disease compared to no diagnosis differed by feeling low (χ2 (1, 217) = 4.014, p = 0.045), and depressive appearance (χ2 (1, 217) = 8.887, p = 0.003). Patients diagnosed with definite ménière\'s disease, probable ménière\'s disease, and both definite and probable ménière\'s disease were more likely to report that their symptoms affected their lifestyle compared to those that reported no effect (χ2 (3, 217) = 62.565, p < 0.001), (χ2 (3, 217) = 31.380, p < 0.001), and (χ2 (3, 217) = 35.542, p < 0.001), respectively.
UNASSIGNED: A high number of hypothyroid patients were diagnosed with MD. Clinicians should consider clinically screening for MD among hypothyroid patients presenting to clinics.

UNASSIGNED: The relationship between pre-ablation left ventricular diastolic dysfunction (LVDD) and prognosis in patients with left ventricular systolic dysfunction (LVSD) undergoing atrial fibrillation (AF) ablation remains unclear.
UNASSIGNED: The prognosis of 173 patients with impaired left ventricular ejection fraction (<50%) who underwent AF ablation was examined. The primary outcome was a composite of all-cause mortality, heart failure (HF) hospitalization, and worsening HF symptoms requiring unplanned outpatient intensification of decongestive therapy.
UNASSIGNED: During the follow-up period (median, 3.5 years), the primary outcome after AF ablation occurred in 28 patients (16%). The receiver operating characteristic curve analysis showed that early septal diastolic mitral annular velocity (e\') had a larger area under the curve (0.70) than other LVDD parameters, and optimal cut-off values of LVDD, represented by e\', septal E (early diastolic left ventricular filling velocity)/e\', and peak tricuspid valve regurgitation velocity (TRV), were 5.0 cm/s, 13.2, and 2.5 m/s, respectively. Multivariate analysis revealed that e\' ≤5.0 cm/s (standard hazard ratio [HR], 3.87; 95% confidence interval [CI], 1.73-8.69; p = 0.001), septal E/e\' ≥13.2 (HR, 3.62; 95% CI, 1.60-8.21; p = 0.002), and peak TRV ≥ 2.5 m/s (HR, 2.42; 95% CI, 1.13-5.16; p = 0.02) independently predicted the outcome. Patients with New York Heart Association functional status ≥ III had a 3.3-4.5-fold higher risk of the outcome.
UNASSIGNED: LVDD or severe HF symptoms predict poor outcomes in patients with LVSD undergoing AF ablation. Therefore, patients with LVDD or severe HF symptoms should receive more intensive treatment even after AF ablation.

Analysis through logistic regression explored to investigate the relationship between binary or multivariable ordinal response probability and in one or more explanatory variables. The main objectives of this study to investigate advanced prediction risk factor of Coronary Heart Disease (CHD) using a logit model. Attempts made to reduce risk factors, increase public or professional awareness. Logit model used to evaluate the probability of a person develop CHD, considering any factors such as age, gender, high low-density lipoprotein (LDL) cholesterol, low high-density lipoprotein (HDL) cholesterol, high blood pressure, family history of CHD younger than 45, diabetes, smoking, being post-menopausal for women and being older than 45 for men. Logit concept of brief statistics described with slight modification to estimate the parameters testing for the significance of the coefficients, confidence interval fits the simple, multiple logit models. Besides, interpretation of the fitted logit regression model introduced. Variables showing best results within the scientific context, good explanation data assessed to fit an estimated logit model containing chosen variables, this present experiment used the statistical inference procedure; chi-square distribution, likelihood ratio, Score, or Wald test and goodness-of-fit. Health promotion started with increased public or professional awareness improved for early detection of CHD, to reduce the risk of mortality, aimed to be Saudi vision by 2030.

UNASSIGNED: Although visual dysfunction is one of the most common non-motor symptoms among patients with Parkinson\'s disease (PD), it is not known whether visual impairment (VI) predates the onset of clinical PD. Therefore, we aim to examine the association of VI with the future development of PD in the UK Biobank Study.
UNASSIGNED: The UK Biobank Study is one of the largest cohort studies of health, enrolling over 500,000 participants aged 40-69 years between 2006 and 2010 across the UK. VI was defined as a habitual distance visual acuity (VA) worse than 0·3 logarithm of the minimum angle of resolution (LogMAR) in the better-seeing eye. Incident cases of PD were determined by self report data, hospital admission records or death records, whichever came first. Multivariable Cox proportional hazard regression models were used to investigate the association between VI and the risk of incident PD.
UNASSIGNED: A total of 117,050 participants were free of PD at the baseline assessment. During the median observation period of 5·96 (IQR: 5·77-6·23) years, PD occurred in 222 (0·19%) participants. Visually impaired participants were at a higher risk of developing PD than non-VI participants (p < 0·001). Compared with the non-VI group, the adjusted hazard ratio was 2·28 (95% CI 1·29-4·05, p = 0·005) in the VI group. These results were consistent in the sensitivity analysis, where incident PD cases diagnosed within one year after the baseline assessment were excluded.
UNASSIGNED: This cohort study found that VI was associated with an increased risk of incident PD, suggesting that VI may serve as a modifiable risk factor for prevention of future PD.

UNASSIGNED: Coronavirus disease 2019 (COVID-19) is associated with a hypercoagulable state. Limited data exist informing the relationship between anticoagulation therapy and risk for COVID-19 related hospitalization and mortality.
UNASSIGNED: We evaluated all patients over the age of 18 diagnosed with COVID-19 in a prospective cohort study from March 4th to August 27th, 2020 among 12 hospitals and 60 clinics of M Health Fairview system (USA). We investigated the relationship between (1) 90-day anticoagulation therapy among outpatients before COVID-19 diagnosis and the risk for hospitalization and mortality and (2) Inpatient anticoagulation therapy and mortality risk.
UNASSIGNED: Of 6195 patients, 598 were immediately hospitalized and 5597 were treated as outpatients. The overall case-fatality rate was 2•8% (n = 175 deaths). Among the patients who were hospitalized, the inpatient mortality was 13%. Among the 5597 COVID-19 patients initially treated as outpatients, 160 (2.9%) were on anticoagulation and 331 were eventually hospitalized (5.9%). In a multivariable analysis, outpatient anticoagulation use was associated with a 43% reduction in risk for hospital admission, HR (95% CI = 0.57, 0.38-0.86), p = 0.007, but was not associated with mortality, HR (95% CI=0.88, 0.50 - 1.52), p = 0.64. Inpatients who were not on anticoagulation (before or after hospitalization) had an increased risk for mortality, HR (95% CI = 2.26, 1.17-4.37), p = 0.015.
UNASSIGNED: Outpatients with COVID-19 who were on outpatient anticoagulation at the time of diagnosis experienced a 43% reduced risk of hospitalization. Failure to initiate anticoagulation upon hospitalization or maintaining outpatient anticoagulation in hospitalized COVID-19 patients was associated with increased mortality risk.
UNASSIGNED: No funding was obtained for this study.

By the end of year 2019, the new virus SARS-CoV-2 appeared, causing the Coronavirus Disease 2019 (COVID-19), and spread very fast globally. A continuing need for diagnostic tools is a must to contain its spread. Till now, the gold standard method, the reverse transcription polymerase chain reaction (RT-PCR), is the precise procedure to detect the virus. However, SARS-CoV-2 may escape RT-PCR detection for several reasons. The development of well-designed, specific and sensitive serological test like enzyme immunoassay (EIA) is needed. This EIA can stand alone or work side by side with RT-PCR. In this study, we developed several EIAs including plates that are coated with either specially designed SARS-CoV-2 nucleocapsid or surface recombinant proteins. Each protein type can separately detect anti-SARS-CoV-2 IgM or IgG antibodies. For each EIAs, the cut-off value, specificity and sensitivity were determined utilizing RT-PCR confirmed Covid-19 and pre-pandemic healthy and other viruses-infected sera. Also, the receiver operator characteristic (ROC) analysis was performed to define the specificities and sensitivities of the optimized assay. The in-house EIAs were validated by comparing against commercial EIA kits. All in-house EIAs showed high specificity (98-99%) and sensitivity (97.8-98.9%) for the detection of IgG/IgM against RBD and N proteins of SARS-CoV-2. From these results, the developed Anti-RBD and anti-N IgG and IgM antibodies EIAs can be used as a specific and sensitive tool to detect SARS-CoV-2 infection, calculate the burden of disease and case fatality rates.

UNASSIGNED: Elevated homocysteine (Hcy) is associated with several pathologies. Gene-diet interactions related to Hcy might be used to customize dietary advice to reduce disease incidence. To explore this possibility, we investigated interactions between anthropometry, biochemical markers and diet and single-nucleotide polymorphisms (SNPs) in relation to Hcy concentrations. Five SNPs of Hcy-metabolizing enzymes were analyzed in 2010 black South Africans.
UNASSIGNED: Hcy was higher with each additional methylenetetrahydrofolate reductase (MTHFR) C677T minor allele copy, but was lower in methionine synthase (MTR) 2756AA homozygotes than heterozygotes. Individuals harboring cystathionine β synthase (CBS) 833 T/844ins68 had lower Hcy concentrations than others. No interactive effects were observed with any of the anthropometrical markers. MTHFR C677T and CBS T833C/844ins68 homozygote minor allele carriers presented with lower Hcy as high density lipoprotein cholesterol (HDL-c) increased. Hcy concentrations were negatively associated with dietary protein and animal protein intake in the TT and TC genotypes, but positively in the CC genotype of CBS T833C/844ins68. Hcy was markedly higher in TT homozygotes of MTHFR C677T as added sugar intake increased. In CBS T833C/844ins68 major allele carriers, biotin intake was negatively associated with Hcy; but positively in those harboring the homozygous minor allele.
UNASSIGNED: The Hcy-SNP associations are modulated by diet and open up the possibility of invoking dietary interventions to treat hyperhomocysteinemia. Future intervention trials should further explore the observed gene-diet and gene-blood lipid interactions.

OBJECTIVE: Telangiectatic osteosarcoma (TOS), a rare variant of osteosarcoma, may be easily misdiagnosed as aneurysmal bone cyst (ABC). The aims of this study were to investigate the diagnostic and prognostic factors of TOS by reviewing our experience with TOS and to develop a diagnostic model that may distinguish TOS from ABC.
METHODS: We identified 51 cases of TOS treated at the First Affiliated Hospital of Sun Yat-Sen University from March 2001 to January 2016 and reviewed their records, imaging information and pathological studies. A diagnostic model was developed to differentiate TOS and ABC by Bayes discriminant analysis and was evaluated. The log-rank test was used to analyze the prognostic factors of TOS and to compare the outcome differences between TOS and other high-grade osteosarcoma subtypes.
RESULTS: The multi-disciplinary diagnostic method employed that combined clinical, imaging, and pathological studies enhanced the diagnostic accuracy. Age 18 years or younger and pathologic fracture were more common among the TOS patients than among the ABC patients (P = .004 and .005, respectively). The average white blood cell (WBC), platelet, lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) values of the TOS patients were higher than those of the ABC patients (P = .002, .003, .007, and .007, respectively). Our diagnostic model, including the aforementioned factors, accurately predicted 62% and 78% of the TOS patients in the training and validation sets, respectively. The 5-year estimates of event-free survival and overall survival of the TOS patients were 52.5 ± 9.4% and 54.9 ± 8.8%, respectively, which were similar to those of patients with other osteosarcoma subtypes (P = .950 and .615, respectively). Tumor volume and the LDH level were predictive prognostic factors (P = .040 and .044) but not the presence of pathologic fracture or misdiagnosis (P = .424 and .632, all respectively).
CONCLUSIONS: The multi-disciplinary diagnostic method and diagnostic model based on predictive factors, i.e., age, the presence of pathologic fracture, and platelet, LDH, ALP and WBC levels, aided the differentiation of TOS and ABC. Smaller tumors and normal LDH levels were associated with better outcomes.