Enterovirus D68 (EV-D68) has been infrequently reported historically, and is typically associated with isolated cases or small clusters of respiratory illness. Beginning in August, 2014, increases in ...severe respiratory illness associated with EV-D68 were reported across the USA. We aimed to describe the clinical, epidemiological, and laboratory features of this outbreak, and to better understand the role of EV-D68 in severe respiratory illness.
We collected regional syndromic surveillance data for epidemiological weeks 23 to 44, 2014, (June 1 to Nov 1, 2014) and hospital admissions data for epidemiological weeks 27 to 44, 2014, (June 29 to Nov 1, 2014) from three states: Missouri, Illinois and Colorado. Data were also collected for the same time period of 2013 and 2012. Respiratory specimens from severely ill patients nationwide, who were rhinovirus-positive or enterovirus-positive in hospital testing, were submitted between Aug 1, and Oct 31, 2014, and typed by molecular sequencing. We collected basic clinical and epidemiological characteristics of EV-D68 cases with a standard data collection form submitted with each specimen. We compared patients requiring intensive care with those who did not, and patients requiring ventilator support with those who did not. Mantel-Haenszel χ(2) tests were used to test for statistical significance.
Regional and hospital-level data from Missouri, Illinois, and Colorado showed increases in respiratory illness between August and September, 2014, compared with in 2013 and 2012. Nationwide, 699 (46%) of 1529 patients tested were confirmed as EV-D68. Among the 614 EV-D68-positive patients admitted to hospital, age ranged from 3 days to 92 years (median 5 years). Common symptoms included dyspnoea (n=513 84%), cough (n=500 81%), and wheezing (n=427 70%); 294 (48%) patients had fever. 338 59% of 574 were admitted to intensive care units, and 145 (28%) of 511 received ventilator support; 322 (52%) of 614 had a history of asthma or reactive airway disease; 200 (66%) of 304 patients with a history of asthma or reactive airway disease required intensive care compared with 138 (51%) of 270 with no history of asthma or reactive airway disease (p=0·0004). Similarly, 89 (32%) of 276 patients with a history of asthma or reactive airway disease required ventilator support compared with 56 (24%) of 235 patients with no history of asthma or reactive airway disease (p=0·039).
In 2014, EV-D68 caused widespread severe respiratory illness across the USA, disproportionately affecting those with asthma. This unexpected event underscores the need for robust surveillance of enterovirus types, enabling improved understanding of virus circulation and disease burden.
None.
Diabetes mellitus is a chronic hormonal and metabolic disorder in which our body cannot generate necessary insulin or does not act in response to it, accordingly, ensuing in discordantly high blood ...sugar (glucose) levels. Diabetes mellitus can lead to systemic dysfunction in the multiorgan system, including cardiac dysfunction, severe kidney disease, lowered quality of life, and increased mortality risk from diabetic complications. To uncover possible therapeutic targets to treat diabetes mellitus, the in silico drug design technique is widely used, which connects the ligand molecules with target proteins to construct a protein-ligand network. To identify new therapeutic targets for type 2 diabetes mellitus, Azadirachta indica is subjected to phytochemical screening using in silico molecular docking, pharmacokinetic behavior analysis, and simulation-based molecular dynamic analysis. This study has analyzed around 63 phytochemical compounds, and the initial selection of the compounds was made by analyzing their pharmacokinetic properties by comparing them with Lipinski’s rule of 5. The selected compounds were subjected to molecular docking. The top four ligand compounds were reported along with the control drug nateglinide based on their highest negative molecular binding affinity. The protein-ligand interaction of selected compounds has been analyzed to understand better how compounds interact with the targeted protein structure. The results of the in silico analysis revealed that 7-Deacetyl-7-oxogedunin had the highest negative docking score of −8.9 Kcal/mol and also demonstrated standard stability in a 100 ns molecular dynamic simulation performed with insulin receptor ectodomain. It has been found that these substances may rank among the essential supplementary antidiabetic drugs for treating type 2 diabetes mellitus. It is suggested that more in vivo and in vitro research studies be carried out to support the conclusions drawn from this in silico research strategy.
Abstract
In effort to engage secondary school students’ awareness towards Science, Technology, Engineering and Mathematics (STEM), the Recreational Mathematics programme is designed. The main ...objective of this programme is to promote secondary school students’ interest towards Mathematics subject. The participants were grade 5 students from Sekolah Menengah Kebangsaan Sungai Burong, Kuala Selangor, Malaysia. This programme contained 7 Mathematics activities involved basic concept of algebra. For each activity, they were guided by Universiti Selangor’s facilitators and mentors. The effectiveness of Recreational Mathematics programme was assessed through these activities. Data on a total of 91 students was collected and it was found that 75% students agreed on the success of the programme management. More than half of the students were interested with the method guided by the facilitators and mentors. They enjoyed studying this subject through mathematical games and activities. Nevertheless, there is a challenge to be encountered while conducting this programme. It was found that 96% of the students were not aware on the importance of STEM and more specifically the significance of mathematical subject. These findings show that STEM activities should be continuously run especially to the students in the rural area.
The applications of silver nanowires (AgNWs) are clearly relevant to their purity and morphology. Therefore, the synthesis parameters should be precisely adjusted in order to obtain AgNWs with a high ...aspect ratio. Consequently, controlling the reaction time versus the reaction temperature of the AgNWs is crucial to synthesize AgNWs with a high crystallinity and is important in fabricating optoelectronic devices. In this work, we tracked the morphological alterations of AgNWs during the growth process in order to determine the optimal reaction time and temperature. Thus, here, the UV-Vis absorption spectra were used to investigate how the reaction time varies with the temperature. The reaction was conducted at five different temperatures, 140-180 °C. As a result, an equation was developed to describe the relationship between them and to calculate the reaction time at any given reaction temperature. It was observed that the average diameter of the NWs was temperature-dependent and had a minimum value of 23 nm at a reaction temperature of 150 °C. A significant purification technique was conducted for the final product at a reaction temperature of 150 °C with two different speeds in the centrifuge to remove the heavy and light by-products. Based on these qualities, a AgNWs-based porous Si (AgNWs/P-Si) device was fabricated, and current-time pulsing was achieved using an ultra-violet (UV) irradiation of a 375 nm wavelength at four bias voltages of 1 V, 2 V, 3 V, and 4 V. We obtained a high level of sensitivity and detectivity with the values of 2247.49% and 2.89 × 10
Jones, respectively. The photocurrent increased from the μA range in the P-Si to the mA range in the AgNWs/P-Si photodetector due to the featured surface plasmon resonance of the AgNWs compared to the other metals.
Pathogenesis of varicose veins Oklu, Rahmi; Habito, Roy; Mayr, Manuel ...
Journal of vascular and interventional radiology
23, Številka:
1
Journal Article
Recenzirano
Despite the high prevalence of varicose veins and the recent surge in research on the condition, the precise mechanisms underlying their development remain uncertain. In the past decade, there has ...been a shift from initial theories based on purely mechanical factors to hypotheses pointing to complex molecular changes causing histologic alterations in the vessel wall and extracellular matrix. Despite progress in understanding the molecular aspects of venous insufficiency, therapies for symptomatic varicose veins are directed toward anatomic and physical interventions. The present report reviews current evidence identifying the underlying biochemical alterations in the pathogenesis of varicose veins.
Contemporary mortality data for myectomy are well known to experts in dedicated HCM centers but may not have penetrated sufficiently into the practicing general cardiology community. ...this is an ...opportune time to tabulate the most recent operative mortality data from 5 major high-volume HCM myectomy centers in North America (Table 1). ...perceptions of HCM and myectomy have been contaminated by older obsolete published reports skewed to a grim portrayal of outcome, including high operative mortality (1,2). ...a contemporary understanding of the safety (and efficacy) (1,2) attributable to myectomy is crucial to assessing the role of surgery in the management armamentarium for this disease.
This paper analyzed land cover changes in Gazipur Sadar - an important urban fringe of expanding Dhaka City, Bangladesh, by leveraging remotely sensed imageries between 1973 and 2017. Landsat images ...of1973, 1991, 2006, and 2017 were classified using widely-preferred supervised classification method. Compared against ground-truth data, the reported classification accuracy ranges from 85% to 89%. Our classified land cover maps reveal that built-up areas in Gazipur Sadar increased by 312.9%, mostly replacing vegetation cover. An overall 199.7% decrease of vegetative covers highlights on the degree of urbanization process and increasing population pressure faced by Gazipur Sadar over the past decades. The rapid decrease of vegetative cover only 57 sq. km remains out of 344 sq. km throughout the region, including the Sal (Shorea robusta) forest and other floral species - invaluable resources for biodiversity and ecosystem health, should be taken as 'alarming' situation by the local authority responsible for promoting and managing sustainable development goals. In that light, this study emphasizes on the need for a critical assessment of future development initiatives in the Gazipur Sadar area and suggests for maintaining acceptable tradeoffs between development and environmental protection.
Why we need more septal myectomy surgeons: An emerging recognition Maron, Barry J., MD; Dearani, Joseph A., MD; Maron, Martin S., MD ...
Journal of thoracic and cardiovascular surgery/The Journal of thoracic and cardiovascular surgery/The journal of thoracic and cardiovascular surgery,
11/2017, Letnik:
154, Številka:
5
Journal Article
Graft-versus-host disease (GVHD) is the major limitation of allogeneic haemopoietic stem-cell transplantation (HSCT), for which no approved treatments are available. Use of mesenchymal stromal cells ...(MSCs) has become standard practice in some European countries, but controversy exists for their benefit. The aim of this meta-analysis was to analyse available evidence for the benefit of MSC treatments in steroid-resistant acute GVHD.
We did a systematic review and meta-analysis to assess response to and survival after MSC treatment in patients with steroid-refractory acute GVHD. We searched MEDLINE, Embase, Ovid, and Cochrane Central databases for published studies, and we used ClinicalTrials.gov and other websites to find unpublished studies and conference abstracts. We included prospective and retrospective studies in which MSCs were administered to patients with steroid-refractory acute GVHD. Data were extracted independently by two investigators based on strict selection criteria. A random-effects model was used to pool outcomes across studies because of anticipated heterogeneity. Our primary outcome was survival at 6 months from the first infusion of MSCs.
We identified 628 citations with our search, of which 610 were excluded after review and a further five did not contain pertinent data. Thus, our meta-analysis included 13 non-randomised studies at moderate risk of bias, comprising a total of 336 patients. Six studies provided data for the primary outcome analysis (119 patients). Survival at 6 months after MSC treatment was 63% (95% CI 50-74; I(2)=41%). Survival did not differ with respect to age, MSC culture medium, or dose of MSCs delivered.
Available evidence suggests that infusion of MSCs could be an acceptable treatment for patients with steroid-refractory acute GVHD. Randomised clinical trials are needed urgently to assess different treatment modalities for steroid-refractory acute GVHD.
None.
Abstract Objective To evaluate the effects of L-carnitine compared with placebo or control on morbidity and mortality in the setting of acute myocardial infarction. Methods A systematic review and ...meta-analysis of 13 controlled trials (N=3629) was conducted to determine the effects of L-carnitine vs placebo or control on mortality, ventricular arrhythmias (VAs), angina, heart failure, and reinfarction. These trials were identified via searches of the Ovid MEDLINE, PubMed, and Excerpta Medica (Embase) databases between May 1, 2012, and August 31, 2012. Results Compared with placebo or control, L-carnitine was associated with a significant 27% reduction in all-cause mortality (odds ratio, 0.73; 95% CI, 0.54-0.99; P =.05; risk ratio RR, 0.78; 95% CI, 0.60-1.00; P =.05), a highly significant 65% reduction in VAs (RR, 0.35; 95% CI, 0.21-0.58; P <.0001), and a significant 40% reduction in the development of angina (RR, 0.60; 95% CI, 0.50-0.72; P <.00001), with no reduction in the development of heart failure (RR, 0.85; 95% CI, 0.67-1.09; P =.21) or myocardial reinfarction (RR, 0.78; 95% CI, 0.41-1.48; P =.45). Conclusion Compared with placebo or control, L-carnitine is associated with a 27% reduction in all-cause mortality, a 65% reduction in VAs, and a 40% reduction in anginal symptoms in patients experiencing an acute myocardial infarction. Further study with large randomized controlled trials of this inexpensive and safe therapy in the modern era is warranted.
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