Background: and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.

Background: South Asians generally have an unfavourable metabolic phenotype compared with white Caucasians, including central obesity and insulin resistance. The Wnt protein family interacts with insulin signaling, and impaired Wnt signaling is associated with adiposity and type 2 diabetes mellitus. We aimed to investigate Wnt signaling in relation to insulin signaling in South Asians compared with white Caucasians. Methods: Ten Dutch South Asian men with prediabetes and overweight or obesity and 10 matched Dutch white Caucasians were included. Blood samples were assayed for the Wnt inhibitor sclerostin. Subcutaneous white adipose tissue (WAT) and skeletal muscle biopsies were assayed for Wnt and insulin signaling gene expression with quantitative reverse transcription polymerase chain reaction (Clinicaltrials.gov NCT02291458). Results: Plasma sclerostin was markedly higher in South Asians compared with white Caucasians (+65%, P<0.01). Additionally, expression of multiple Wnt signaling genes and key insulin signaling genes were lower in WAT in South Asians compared with white Caucasians. Moreover, in WAT in both ethnicities, Wnt signaling gene expression strongly positively correlated with insulin signaling gene expression. In skeletal muscle, WNT10B expression in South Asians was lower, but expression of other Wnt signaling and insulin signaling genes was comparable between ethnicities. Wnt and insulin signaling gene expression also positively correlated in skeletal muscle, albeit less pronounced. Conclusion South Asian men with overweight or obesity and prediabetes have higher plasma sclerostin and lower Wnt signaling gene expression in WAT compared with white Caucasians. We interpret that reduced Wnt signaling could contribute to impaired insulin signaling in South Asians.

Korea is located within the East Asian-Australian flyway of wild migratory birds during the fall and winter seasons. Consequently, the likelihood of introduction of numerous subtypes and pathotypes of the Avian influenza (AI) virus to Korea has been thought to be very high. In the current study, we surveyed wild bird feces for the presence of AI virus that had been introduced to Korea between September 2017 and February 2018. To identify and characterize the AI virus, we employed commonly used methods, namely, virus isolation (VI) via egg inoculation, real-time reverse transcription-polymerase chain reaction (rRT-PCR), conventional RT-PCR (cRT-PCR) and a newly developed next generation sequencing (NGS) approach. In this study, 124 out of 11,145 fresh samples of wild migratory birds tested were rRT-PCR positive; only 52.0% of VI positive samples were determined as positive by rRT-PCR from fecal supernatant. Fifty AI virus specimens were isolated from fresh fecal samples and typed. The cRT-PCR subtyping results mostly coincided with the NGS results, although NGS detected the presence of 11 HA genes and four NA genes that were not detected by cRT-PCR. NGS analysis confirmed that 12% of the identified viruses were mixed-subtypes which were not detected by cRT-PCR. Prevention of the occurrence of AI virus requires a workflow for rapid and accurate virus detection and verification. However, conventional methods of detection have some limitations. Therefore, different methods should be combined for optimal surveillance, and further studies are needed in aspect of the introduction and application of new methods such as NGS.
Animals ; Birds ; Feces ; Influenza in Birds ; Korea ; Methods ; Ovum ; Seasons

The Ministry of Health (MOH) has updated the Clinical Practice Guidelines on Lipids to provide doctors and patients in Singapore with evidence-based treatment for lipids. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH Clinical Practice Guidelines on Lipids, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html.
Adult ; Cardiovascular Diseases ; complications ; therapy ; Child ; Coronary Artery Disease ; complications ; therapy ; Decision Support Systems, Clinical ; Dyslipidemias ; blood ; complications ; therapy ; Evidence-Based Medicine ; Female ; Humans ; Kidney Failure, Chronic ; complications ; therapy ; Life Style ; Lipids ; blood ; Lipoproteins, LDL ; blood ; Male ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy Complications ; Risk Assessment ; Risk Factors ; Singapore

Artificial sweeteners (AS) are ubiquitous in food and beverage products, yet little is known about their effects on the gastrointestinal (GI) tract, and whether they play a role in the development of GI symptoms, especially in patients with irritable bowel syndrome. Utilizing the PubMed and Embase databases, we conducted a search for articles on individual AS and each of these terms: fermentation, absorption, and GI tract. Standard protocols for a systematic review were followed. At the end of our search, we found a total of 617 eligible papers, 26 of which were included. Overall, there is limited medical literature available on this topic. The 2 main areas on which there is data to suggest that AS affect the GI tract include motility and the gut microbiome, though human data is lacking, and most of the currently available data is derived from in vivo studies. The effect on motility is mainly indirect via increased incretin secretion, though the clinical relevance of this finding is unknown as the downstream effect on motility was not studied. The specific effects of AS on the microbiome have been conflicting and the available studies have been heterogeneous in terms of the population studied and both the AS and doses evaluated. Further research is needed to assess whether AS could be a potential cause of GI symptoms. This is especially pertinent in patients with irritable bowel syndrome, a population in whom dietary interventions are routinely utilized as a management strategy.
Absorption ; Beverages ; Fermentation ; Gastrointestinal Tract ; Humans ; Incretins ; Irritable Bowel Syndrome ; Microbiota ; Sweetening Agents*

Transforming growth factor-β (TGF-β) members are key cytokines that control embryogenesis and tissue homeostasis via transmembrane TGF-β type II (TβR II) and type I (TβRI) and serine/threonine kinases receptors. Aberrant activation of TGF-β signaling leads to diseases, including cancer. In advanced cancer, the TGF-β/SMAD pathway can act as an oncogenic factor driving tumor cell invasion and metastasis, and thus is considered to be a therapeutic target. The activity of TGF-β/SMAD pathway is known to be regulated by ubiquitination at multiple levels. As ubiquitination is reversible, emerging studies have uncovered key roles for ubiquitin-removals on TGF-β signaling components by deubiquitinating enzymes (DUBs). In this paper, we summarize the latest findings on the DUBs that control the activity of the TGF-β signaling pathway. The regulatory roles of these DUBs as a driving force for cancer progression as well as their underlying working mechanisms are also discussed.
Animals ; Humans ; Molecular Targeted Therapy ; Receptors, Transforming Growth Factor beta ; metabolism ; Signal Transduction ; Smad Proteins ; physiology ; Transforming Growth Factor beta ; physiology ; Ubiquitin Thiolesterase ; metabolism ; Ubiquitin-Specific Proteases ; Ubiquitination

Background: Hue city is a cultural and tourism center of The middle and the whole country. Beside developing tourism services, food processing establishments, traditional specialities, eating and drinking services especially street food services more and more develop plentifully and multiform, satisfy daily demand of consumers. Objectives: Assessment on improvement level on some targets of street food safety and hygiene after 2 years intervention. Subjects and method: All street food processing establishments in 3 wards: V\u0129nh Ninh, Ph\xfa H\u1ed9i, V\ufffd?D\ufffd?of Hue city. Method: Cross-sectional study with comparison before and after intervention. Results: Kitchen utensils samples have met hygiene requirements and the proportion of food samples without borax both increase. The infection rate of bacteria in cook\ufffd?hands, kitchen utensils, cooked food were improved after 2 years carried out targeted model. Clean water for processing street food have not enough although 100% households use running water. The proportion of people were trained about food safety and hygiene knowledges and health examination increase. The situation of using food colourings and poisonous additives decrease remarkably. Salesclerks have more consciousness of preserving and covering food. 86,4% of food processing establishments have recycle bins obtain requirement to reduce polluted food. Conclusion: Street food is an important stage of food supplying network in 3 wards above. Somewhere having interest of Government and local authorities, Steering committee have efficient activities street food model develop conveniently.
Food Safety/ methods

Background: At present, management and supervision on food safety and hygiene quality have many difficulties because supervisory system from province to district, commune is still insufficient. Objectives: Assessment on food safety and hygiene situation at Thua Thien Hue province, propose solutions to intensify State management on food safety and hygiene quality and step by step enhance efficiency of food safety and hygiene activities in the next years. Subjects and method: Food processing establishments at Thua Thien Hue province. Method: Inspection in Action months for food safety and hygiene, supervision usually on food processing establishments were chosen accidentally in area. Food samples were inspected indexes of microorganisms, physicochemical have met the criteria of Ministry of Health. Results: The proportion of food processing establishments and cafeterias which have not met the regulations on food safety and hygiene was decreasing from 40,93% to 27,45%. Also in 2002-2006, 36,71% of kitchen utensils and the cooks\ufffd?hands failed to meet the regulations. Regarding to microorganisms, the indices of ice-cream, bean sweet porridge and soft drinks had improved remarkably. The index of ice had been decreased from 33,02% to 22,56%. 45,25% of bowls and plates didn\u2019t meet chemical and physical criteria. 68,4% of food colourings didn\u2019t meet criteria because inorganic and industrial colourings were used. Traditional foods still contain borax although the prevalence is decreasing from 65% to 35%. Ice cream and bean sweet porridge cooked with saccharine were 37,34%. Conclusion: Understanding of producers and consumers about food have still many limitations.
Food Safety/ methods ;

Limbal stem cell transplantation (Limbal transplantation) is a surgical technique of ocular epithelial transplantation advocated for a variety of Ocular surface disorders with presumed stem cell deficiency- especially chemical injury of the eye. We report 2 cases (2 eye) of chemical injury successfully treated by limbal autologous transplantation in 1998. The value, indications, complications and prospect of this procedure are discussed.
Stem Cell Transplantation ; Eye Burns ; therapeutics

The solubility of paracetamol in water is very low. In the manufacturing process of paracetamol tablets, designing the formula and selecting the characteristics of semi final product (such as flow rate, apparent density, granules size and moisture content) greatly affect the finished product's quality (such as hardness, uniformity of weight, dissolution rate of the tablets). The purpose of our research is finding out the optimal criteria to ensure good in vitro bioavailability for paracetamol tablets.
Pancreatitis ; Infant