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This study evaluated the differences in clinical outcomes of COVID-19 infection between ethnic minorities and the White ethnic group in the UK. Systematic review and meta-analysis. This study included adult residents in the UK with confirmed COVID-19 infection. The outcomes evaluated in this study were mortality, intensive care unit (ICU) admission and invasive mechanical ventilation (IMV). Outcome data were compared between individuals from ethnic minority groups and individuals from a White ethnic background. MEDLINE, Embase, Cochrane, medRxiv and PROSPERO were searched for articles published between May 2020 and April 2021. The risk of bias was evaluated using the Newcastle–Ottawa Scale checklist. PROSPERO ID: CRD42021248117. Fourteen studies (767,177 participants) were included in the current review. In the adjusted analysis, the pooled odds ratio (OR) for mortality following COVID-19 infection was higher for Black (OR 1.83, 95% confidence interval [CI]: 1.21–2.76, number of studies [k] = 6), Asian (OR 1.16, 95% CI: 0.85–1.57, k = 6) and Mixed and Other (MO) ethnic groups (OR 1.12, 95% CI: 1.04–1.20, k = 5) compared with the White ethnic group. The adjusted and unadjusted ORs of ICU admission for many of the ethnic minority groups were more than double the OR values for the White ethnic group (Black ethnic group = OR 2.32, 95% CI: 1.73–3.11, k = 5; Asian ethnic group = OR 2.34, 95% CI: 1.89–2.90, k = 5; and MO ethnic group = OR 2.26, 95% CI: 1.64–3.11, k = 4). In the adjusted analysis for IMV, the ORs were similarly significantly raised in ethnic minority groups compared with the White ethnic group (Black ethic group = OR 2.03, 95% CI: 1.80–2.29, k = 3; Asian ethnic group = OR 1.84, 95% CI: 1.20–2.80, k = 3; and MO ethnic group = OR 2.09, 95% CI: 1.35–3.22, k = 3). This review found that in the UK, Black, Asian and MO ethnic groups experienced increased COVID-19–related disease severity and mortality compared with the White ethnic group majority. [ABSTRACT FROM AUTHOR]

The article discusses basic eye care in Bell's palsy. Topics discussed include definition of Bell's palsy as an idiopathic lower motor neuron facial paresis of acute onset and unilateral; potential complication of Bell's palsy such as corneal damage during the acute phase, dryness and risk of corneal abrasion; and the risk of Bell's palsy to individuals with diabetes and hypertension.

This work estimates the optimal performance, and evaluates a process modification to approach optimal ammonia production and subsequent energy produced, in the ammonia synthesis heat recovery system for a 10 MW(e) solar thermal power plant which typically requires a 1500-MTD ammonia synthesis reactor. The one-dimensional steady-state pseudo-homogeneous plug flow model is considered for the simulation of ammonia conversion in a synthesis reactor. The mass and energy conservation equations, together with the thermodynamics and reaction kinetics, are numerically solved for the ammonia concentration and temperature profile in the reactor. The resulting gas temperature is compared with the optimal, and equilibrium, temperature profiles, determined from a variational formulation. It is found that with optimal performance, the ammonia production can increase by 15 % over that in the reference design. This requires an inlet temperature of the order of 900 K which exceeds industrially achievable inlet temperatures by approximately 200 K. We thus consider one process modification-non-uniform distribution in three catalyst beds to reduce the gap between the actual and optimal temperatures, and evaluate the effect of small changes in catalyst concentration. It is found that the improvement caused by a 50 and 25 % concentration increase in the first and second beds respectively, results in a 10 % increase in ammonia conversion. Thus, in an industrial synthesis reactor, an optimal configuration can be achieved by determining a variable catalyst concentration, in a large number of catalyst beds, to achieve enhanced ammonia conversion and energy recovery in a solar thermal power plant. [ABSTRACT FROM AUTHOR]

Summary Introduction: Protein C (PC) Asn2Ile is a rare pro-thrombotic variant in which loss of anticoagulant function in vivo is likely to result from defective PC binding to the endothelial PC receptor and phospholipid. Methods: To characterize the consequences of this functional defect on the diagnostic performance of commercial PC activity assays, we performed one antigen, three chromogenic and three coagulometric assays on plasma from a subject who was heterozygous for the PC Asn2Ile substitution. Results: As anticipated, the PC antigen (96.2 IU/dl) and chromogenic PC activity assays (98.4 IU/dl) were insensitive to PC Asn2Ile, which has intact enzymatic activity and is secreted normally. There was a marked reduction in apparent PC activity by STACLOT coagulometric assay (50.4 IU/dl). However, there was only a small reduction in apparent PC activity by CRYOcheck Clot C assay (69.5 IU/dl) and by HemosIL ProClot assay, the PC activity was within the laboratory reference range (91 IU/dl). This discrepancy between coagulometric assays could not be explained by lupus anticoagulant, activated PC resistance or elevated plasma factor VIII activity. Conclusion: We demonstrate that coagulometric assays are not equally sensitive to clinically important functional defects of PC and that multiple assays may be required to identify all variants. [ABSTRACT FROM AUTHOR]

Summary. Glanzmann Thrombasthenia (GT) is a rare autosomal recessive disorder which usually manifests as severe mucocutaneous bleeding and is caused by deficiency of the platelet glycoprotein IIb-IIIa. Pregnancy in women with GT presents particular challenges as there is increased risk of both maternal and foetal bleeding. To improve understanding and clarify the optimum management of pregnancy in this disorder, we performed a systematic review of the world literature of pregnancy and GT. This identified three single-centre case series of patients with GT that included brief descriptions of women in pregnancy and 31 detailed case reports of 40 pregnancies in 35 women that resulted in 38 live births. Among the detailed case reports, ante-natal bleeding was described in 50% of pregnancies but was usually mild and occurred at mucocutaneous sites. Primary postpartum haemorrhage (PPH) was reported in 34% of pregnancies and secondary PPH in 24%. PPH was frequently severe and occurred up to 20 days after delivery. There was a wide variation in approach to prevention and treatment of PPH but most women received platelet transfusion, sometimes with additional recombinant FVIIa and anti-fibrinolytics. Maternal alloimmunization against platelet antigens was reported in 73% of pregnancies and was associated with four neonatal deaths. These data emphasize the need for multidisciplinary management of pregnancy in women with GT. Delivery plans should recognize the need for prevention and aggressive treatment of PPH and should minimize foetal bleeding risk in pregnancies complicated by alloimmunization. [ABSTRACT FROM AUTHOR]

Haemophilia A and B in one individual may arise from co-incident inheritance of independent mutations in the F8 and F9 genes. However, this association is rare and has been studied poorly at a genetic level. We report a male patient with abnormal bleeding and reduced factor VIII:C (26 IU dL) and factor IX:C (35 IU dL). This index case harboured a F8 c.979C>G transversion (predictive of p.Leu327Val) and a F9 c.845A>G transition (predictive of p.His282Arg) which have been previously associated with mild haemophilia A and B, respectively. Identical F8 and F9 mutations were identified in the mother and maternal grandmother. However, an affected maternal uncle showed only the F8 c.979C>G mutation, indicating haemophilia A alone. The sister of the index case was heterozygous only for F9 c.845A>G, indicating carriership of haemophilia B alone. The non-Mendelian inheritance of F8 c.979C>G and F9 c.845A>G in this kindred is consistent with recombination between F8 and F9 and illustrates the large recombination distance between these loci. Recognition of this phenomenon was essential for accurate genetic counselling in this kindred. [ABSTRACT FROM AUTHOR]

Objectives:Epistaxis can be caused or exacerbated by anticoagulant and antiplatelet therapy. This prospective study assessed the prevalence of epistaxis in patients taking anticoagulant and antiplatelet medication, and monitored differences in patients’ clinical courses.Method:Prospective data were collected for consecutive patients referred with epistaxis from the emergency department over a seven-month period. Emergency department records were used to investigate prevalence and referral rates.Results:Over the study period, 290 patients presented to the emergency department with epistaxis; this represented 0.9 per cent of all emergency attendances. Of these patients, 119 (39 per cent) were referred on to the ENT department, 62 per cent of whom were currently taking anticoagulant or antiplatelet medication. Patients taking anticoagulant and antiplatelet medication were a significantly older group (relative risk 1.50 (1.08–2.28), p = 0.01) requiring longer in-patient stays (relative risk 2.50 (1.01–4.97), p = 0.01) and more aggressive local haemostasis measures. Most patients taking warfarin had an international normalised ratio outside the appropriate range for their disease. Hypertension was not a factor in these patients’ clinical course.Conclusion:Increasingly, emergency and ENT departments are being presented with epistaxis in patients taking anticoagulant or antiplatelet medication. A better understanding of such medication and its effects may enable more effective management of these patients. [ABSTRACT FROM PUBLISHER]

Background and Aim: The quality of day-old chicks is a cornerstone to successful poultry production. Chicks with a poor quality start slowly in the field and may have high feed intake, poor growth rate, and poor feed conversion ratio. The current study aimed to assess chick quality challenges encountered from day-old chicks hatched in most commercial hatcheries in Ghana. Materials and Methods: A total of 300 day-old chicks each were obtained from commercial hatcheries in Ghana and Europe. The chicks were labeled as locally hatched broiler day-old chicks (LBDOC) and foreign hatched broiler day-old chicks (FBDOC), respectively. Chicks were reared and monitored from day old to 21 days post-hatch. Sample of chicks (n=25) from each hatchery was euthanized weekly at 1, 7, 14, and 21 days and blood samples collected for analysis. The parameters measured included physical, hematological, immunological, histological, and bacteriological characteristics. All data were analyzed by SAS Proc GLM at p<0.05. Results: The live weight of chicks was higher in FBDOC compared to LBDOC on the 1st day. The chick length and shank length of FBDOC were longer than the LBDOC. The 7-day chick mortality was 6% in LBDOC as compared to 1.5% in FBDOC. The LBDOC also had a higher wet and dry residual yolk sac percentages as well as higher residual yolk sac fluid volume than the FBDOC. The rate of yolk sac disappearance of the FBDOC was higher than the LBDOC. More than half of the LBDOC had developed navel strings and leaky navel compared to FBDOC. The LBDOC recorded Escherichia coli, Proteus, Streptococcus spp., and Gram-negative bacteria in the residual yolk sac isolated through the 21 days while FBDOC recorded E. coli, Proteus, and Gram-negative bacteria. The intestinal villi count, lengths, width, and surface area were all not significantly different. The blood monocyte levels appeared higher in FBDOC than LBDOC, which give evidence of higher immunity in FBDOC than LBDOC. Conclusion: The results indicate a challenging situation in maintaining the quality of locally hatched broiler day-old-chicks compared to foreign hatched broiler-day-old-chicks. The study demonstrates that chick quality impact goes beyond the physical characteristics of chick weight and chick length, and the higher performance of FBDOC may be influenced by compliance with international hatchery standards and vaccination protocols. [ABSTRACT FROM AUTHOR]

The hydrazone derived ketimine of dehydroacetic acid and its metal {Cu(II), Ni(II), Zn(II), Fe(III), Cd(II), Pd(II), La(III), Nd(III), Ce(III)} complexes are synthesized and characterized by IR, 1H and 13C NMR, and UV-Vis spectroscopy. DNA studies have been carried out for metal complexes by electronic absorption spectroscopy. It is determined that metal complexes bind to DNA through intercalation. The complexes of Cu(II), Zn(II) and Pd(II) demonstrate significant activity against HeLa cells (cervical cancer). [ABSTRACT FROM AUTHOR]