Background
There is a paucity of studies on the magnitude of reduction of vasovagal reaction by reduced collection volume. This study was thus conducted to determine the difference in reaction rates ...between two collection volumes among the young first‐time donors who are at particular risk of reaction.
Study Design and Methods
This retrospective study analyzed 38,436 whole blood donations made by young (aged 16 to 18 years) first‐time donors. The effect of collection volume on vasovagal reaction was compared among different weight subgroups for both sexes by chi‐square test.
Results
For females in all weight subgroups and two of the male lower‐weight subgroups, the reduction percentages ranged from 35% to 58% (p < 0.05). It was also noted that, among the females, a higher weight was associated with a higher percent reduction in the reaction rate.
Conclusion
With reduced collection volume, this study detected large and significant reduction in reaction rates among all females, as well as lower‐weight males.
Nuclear-derived cell-free DNA (cfDNA) molecules in blood plasma are nonrandomly fragmented, bearing a wealth of information related to tissues of origin. DNASE1L3 (deoxyribonuclease 1 like 3) is an ...important player in shaping the fragmentation of nuclear-derived cfDNA molecules, preferentially generating molecules with 5 CC dinucleotide termini (i.e., 5 CC-end motif). However, the fragment end properties of microbial cfDNA and its clinical implication remain to be explored.
We performed end motif analysis on microbial cfDNA fragments in plasma samples from patients with sepsis. A sequence context-based normalization method was used to minimize the potential biases for end motif analysis.
The end motif profiles of microbial cfDNA appeared to resemble that of nuclear cfDNA (Spearman correlation coefficient: 0.82, P value 0.001). The CC-end motif was the most preferred end motif in microbial cfDNA, suggesting that DNASE1L3 might also play a role in the fragmentation of microbe-derived cfDNA in plasma. Of note, differential end motifs were present between microbial cfDNA originating from infection-causing pathogens (enriched at the CC-end) and contaminating microbial DNA potentially derived from reagents or the environment (nearly random). The use of fragment end signatures allowed differentiation between confirmed pathogens and contaminating microbes, with an area under the receiver operating characteristic curve of 0.99. The performance appeared to be superior to conventional analysis based on microbial cfDNA abundance alone.
The use of fragmentomic features could facilitate the differentiation of underlying contaminating microbes from true pathogens in sepsis. This work demonstrates the potential usefulness of microbial cfDNA fragmentomics in metagenomics analysis.
Summary
Background : Colorectal cancer is one of the most common forms of gastrointestinal cancer in the world today. In the Asia–Pacific area, it is the fastest emerging gastrointestinal cancer.
Aim ...: To determine the basic demographic features of patients with colorectal cancer and the anatomic distribution and characteristics of the tumour in a local Asian population.
Methods : We conducted a review of consecutive patients who had undergone colonoscopy from 1999 to 2003 at the University of Malaya Medical Center, Kuala Lumpur, Malaysia.
Results : Analysis was carried out on 3404 patients who underwent colonoscopy. A total of 228 patients (7%) were diagnosed with carcinoma. The mean age of diagnosis (±s.d.) was 64.4 ± 13.1 years. The male to female ratio was 1.15. Polyps were noted in 470 patients (14%). Polyps detected concomitantly with a colorectal cancer were noted in 55 patients (2%). Four patients (0.1%) were diagnosed to have familial adenomatous polyposis coli. Of the 228 patients 209 (92%) had tumours at only one site whereas 19 (8%) had synchronous lesions. Tumours were mainly left sided 198 of 248 patients (80%) with the majority located in the recto‐sigmoid region. Detailed records of treatment were available only in 176 patients. A total of 147 of 176 patients (84%) underwent surgery and 50 (28%) also received adjuvant or palliative chemotherapy (28%). Seven of 154 patients (5%) were diagnosed to have stage A cancers, 64 (42%), stage B, 23 (15%), stage C and 60 (39%), stage D. Multivariate analysis using multiple logistic regression analysis showed that age ≥65 years (OR = 1.78; 95% CI: 1.35– 2.36) and Malay (OR = 2.09; 95% CI: 1.30–3.35) and Chinese (OR = 1.77; 95% CI: 1.77–2.69) race were significant independent predictive factors for colorectal cancer.
Conclusions : The demography of colorectal cancer is different from western patients. Tumours were mainly left sided in our patients. However, no differences in anatomic location were found between races, men and women and younger and older age groups. Colorectal cancer presented in an advanced stage in the majority of patients.
Although diagnostic lumbar selective nerve root blocks are often used to confirm the pain-generating nerve root level, the reported accuracy of these blocks has been variable and their usefulness is ...controversial. The purpose of this study was to evaluate the accuracy of diagnostic lumbar selective nerve root blocks to analyze potential causes of false results in a prospective, controlled, single-blinded manner.
A total of 105 block anesthetics were performed under fluoroscopic guidance in 47 consecutive patients with pure radiculopathy from a single confirmed level: 47 blocks were performed at the symptomatic level, and 58 were performed at the adjacent asymptomatic "control" level. Contrast and local anesthetics were injected, and spot radiographs were taken in all cases. We calculated the diagnostic value of the block anesthetics using concordance with the injected level. We analyzed the potential causes of false results using spot radiographs.
On the basis of a definition of a positive block as 70% pain relief, determined by receiver-operator characteristic (ROC) analysis, diagnostic lumbar selective nerve root block anesthetics had a sensitivity of 57%, a specificity of 86%, an accuracy of 73%, a positive predictive value of 77%, and a negative predictive value of 71%. False-negatives were due to the following causes identifiable on spot radiographs: insufficient infiltration, insufficient passage of the injectate, and intraepineural injections. On the other hand, false-positives resulted from overflow of the injectate from the injected asymptomatic level into either the epidural space or symptomatic level.
The accuracy of diagnostic lumbar selective nerve root blocks is only moderate. To improve the accuracy, great care should be taken to avoid inadequate blocks and overflow, and to precisely interpret spot radiographs.
This is a brief report of 4 paediatric cases of COVID-19 infection in Malaysia
COVID-19, a coronavirus, first detected in Wuhan, China has now spread rapidly to over 60 countries and territories ...around the world, infecting more than 85000 individuals. As the case count amongst children is low, there is need to report COVID-19 in children to better understand the virus and the disease.
In Malaysia, until end of February 2020, there were four COVID-19 paediatric cases with ages ranging from 20 months to 11 years. All four cases were likely to have contracted the virus in China. The children had no symptoms or mild flu-like illness. The cases were managed symptomatically. None required antiviral therapy.
There were 2 major issues regarding the care of infected children. Firstly, the quarantine of an infected child with a parent who tested negative was an ethical dilemma. Secondly, oropharyngeal and nasal swabs in children were at risk of false negative results. These issues have implications for infection control. Consequently, there is a need for clearer guidelines for child quarantine and testing methods in the management of COVID-19 in children.
•Effect of engine malfunctions on performance of a Euro VI diesel truck was simulated.•All malfunctions increased fuel consumption except for EGR fully closed.•Effect of malfunctions on HC and CO ...emissions was insignificant.•NO emission was increased by up to 16.1 times with after-treatment system faults.•Proper functioning of engine control systems is crucial to achieve the design standards.
Although new vehicles are designed to comply with specific emission regulations, their in-service performance would not necessarily achieve them due to wear-and-tear and improper maintenance, as well as tampering or failure of engine control and exhaust after-treatment systems. In addition, there is a lack of knowledge on how significantly these potential malfunctions affect vehicle performance. This study was therefore conducted to simulate the effect of various engine malfunctions on the fuel consumption and gaseous emissions of a 16-tonne Euro VI diesel truck using transient chassis dynamometer testing. The simulated malfunctions included those that would commonly occur in the intake, fuel injection, exhaust after-treatment and other systems. The results showed that all malfunctions increased fuel consumption except for the malfunction of EGR fully closed which reduced fuel consumption by 31%. The biggest increases in fuel consumption were caused by malfunctions in the intake system (16%–43%), followed by the exhaust after-treatment (6%–30%), fuel injection (4%–24%) and other systems (6%–11%). Regarding pollutant emissions, the effect of engine malfunctions on HC and CO emissions was insignificant, which remained unchanged or even reduced for most cases. An exception was EGR fully open which increased HC and CO emissions by 343% and 1124%, respectively. Contrary to HC and CO emissions, NO emissions were significantly increased by malfunctions. The largest increases in NO emissions were caused by malfunctions in the after-treatment system, ranging from 38% (SCR) to 1606% (DPF pressure sensor). Malfunctions in the fuel injection system (24%–1259%) and intercooler (438%–604%) could also increase NO emissions markedly. This study demonstrated clearly the importance of having properly functioning engine control and exhaust after-treatment systems to achieve the required performance of fuel consumption and pollutant emissions.
There is emerging evidence of the significance of paternal mental health problems among the expectant fathers during the antenatal and postnatal period. The present study aims at determining the ...prevalence of paternal perinatal anxiety and identifying its risk factors among the fathers.
A total of 622 expectant fathers were recruited in Hong Kong. The expectant fathers were assessed using standardized and validated psychological instruments on three time points including early pregnancy, late pregnancy and 6 week postnatal. Independent samples t-test, one way ANOVA, Pearson's correlation and multiple linear regression were used to examine the effect of hypothesized risk factors. Hierarchical multiple regression and mixed effect model were also conducted with potential confounding factors controlled for.
Results showed that a significant proportion of expectant fathers experienced anxiety during the perinatal period. Low self-esteem and poor social support were found to be risk factors of paternal anxiety across pregnancy to postnatal period. Work-family conflict could significantly predict paternal anxiety in the pregnancy period.
The present study points to the need for greater research and clinical attention to paternal anxiety, given that it is a highly prevalent problem and could be detrimental to their partner's well-being and children development. The present findings contributes to the theoretical understanding of the prevalence and risk factors of paternal perinatal anxiety and have implications for the design of effective identification, prevention, and interventions of these clinical problems.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Summary
Patient education and behavioural interventions for self‐management of type 2 diabetes mellitus (T2DM) are effective but place demands on manpower resources. This systematic review aimed to ...investigate the effectiveness of smartphone technologies (STs) for improving glycaemic control among T2DM patients. CENTRAL, MEDLINE, Embase, CINAHL and ScienceDirect were searched through December 2016. Randomized controlled trials comparing STs with usual diabetes care among T2DM patients and reporting change in glycated haemoglobin (HbA1c) level were included. Seventeen trials (2,225 participants) were included. There was a significant reduction in HbA1c (pooled weighted mean difference: −0.51%; 95% confidence interval: −0.71% to −0.30%; p < 0.001), favouring ST intervention. The pooled weighted mean difference was −0.83% in patients with T2DM <8.5 years and −0.22% in patients with T2DM ≥8.5 years, with significant subgroup difference (p = 0.007). No subgroup differences were found among different follow‐up durations, trial locations, patients' age, healthcare provider contract time, baseline body mass index and baseline HbA1c. Compared with usual diabetes care, STs improved glycaemic control among T2DM patients, especially for patients at earlier disease stages (duration of diagnosis <8.5 years). STs could be a complement or alternative to labour‐intensive patient education and behavioural interventions, but more studies on up‐to‐date technologies are needed.
The short isoform of ErbB3-binding protein 1 (Ebp1), p42, is considered to be a potent tumor suppressor in a number of human cancers, although the mechanism by which it exerts this tumor-suppressive ...activity is unclear. Here, we report that p42 interacts with the cSH2 domain of the p85 subunit of phosphathidyl inositol 3-kinase (PI3K), leading to inhibition of its lipid kinase activity. Importantly, we found that p42 induces protein degradation of the p85 subunit and further identified HSP70/CHIP complex as a novel E3 ligase for p85 that is responsible for p85 ubiquitination and degradation. In this process, p42 couples p85 to the HSP70/CHIP-mediated ubiquitin-proteasomal system (UPS), thereby promoting a reduction of p85 levels both in vitro and in vivo. Thus, the tumor-suppressing effects of p42 in cancer cells are driven by negative regulation of the p85 subunit of PI3K.
Background. Vitamin D, an important modulator of the immune system, has been shown to protect mucosal barrier homeostasis. This study investigates the effects of vitamin D deficiency on ...infection-induced changes in intestinal epithelial barrier function in vitro and on Citrobacter rodentium–induced colitis in mice. Methods. Polarized epithelial Caco2-bbe cells were grown in medium with or without vitamin D and challenged with enterohemorrhagic Escherichia coli O157:H7. Barrier function and tight junction protein expression were assessed. Weaned C57BL/6 mice were fed either a vitamin D-sufficient or vitamin D-deficient diet and then infected with C. rodentium. Disease severity was assessed by histological analysis, intestinal permeability assay, measurement of inflammatory cytokine levels, and microbiome analysis. Results. 1,25(OH)₂D₃ altered E. coli O157:H7-induced reductions in transepithelial electrical resistance (P<.01), decreased permeability (P<.05), and preserved barrier integrity. Vitamin D-deficient mice challenged with C. rodentium demonstrated increased colonic hyperplasia and epithelial barrier dysfunction (P<.0001 and P<.05, respectively). Vitamin D deficiency resulted in an altered composition of the fecal microbiome both in the absence and presence of C. rodentium infection. Conclusions. This study demonstrates that vitamin D is an important mediator of intestinal epithelial defenses against infectious agents. Vitamin D deficiency predisposes to more-severe intestinal injury in an infectious model of colitis.
PDF
