COVID toe in an adolescent boy: a case report Wong, J S C; Wong, T S; Chua, G T ...
Hong Kong medical journal = Xianggang yi xue za zhi,
04/2022, Letnik:
28, Številka:
2
Journal Article
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The appearance of chilblain-like lesions was not thought to be associated with a poor disease outcome.2 3 A major limitation of these reports is that only 11% of cases hospitalised tested positive ...for SARS-CoV-2 by polymerase chain reaction (PCR), with the remainder untested or testing negative. Another systematic review also concluded that some, but not all paediatric cases, who developed chilblain-like lesions during the COVID-19 pandemic had positive SARS-CoV-2 PCR, serology or viral particles confirmed in electron microscopy.5 Larger-scale epidemiological study is needed to confirm an association between these chilblain-like lesions and COVID-19 infection. Joshua SC Wong 1 †; TS Wong 1 †; Gilbert T Chua 2 †; Christy Wan 1; SH Lau 1; Samuel CS Ho 1; Jaime S Rosa Duque 2; Ian CK Wong 3,4; Kelvin KW To 5; Winnie WY Tso 2; Christine S Wong 6; Marco HK Ho 2; Janette Kwok 7; CB Chow 1; Paul KH Tam 8,9; Godfrey CF Chan; 2; WH Leung 2; YL Lau 2; Patrick Ip 2; Mike YW Kwan; CUHK 1 1 Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong 2 Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 3 Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong 4 Research Department of Practice and Policy, UCL School of Pharmacy, University College London, United Kingdom 5 Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 6 Dermatology Division, Department of Medicine, Queen Mary Hospital, Hong Kong 7 Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong 8 Division of Paediatric Surgery, Department of Surgery, The University of Hong Kong, Hong Kong 9 Dr Li Dak-Sum Research Centre, The University of Hong Kong–Karolinska Institutet Collaboration in Regenerative Medicine, The University of Hong Kong, Hong Kong † Co-first authors
Subway systems are indispensable for urban societies, but microbiological characteristics of subway aerosols are relatively unknown. Previous studies investigating microbial compositions in subways ...employed methodologies that underestimated the diversity of microbial exposure for commuters, with little focus on factors governing subway air microbiology, which may have public health implications. Here, a culture-independent approach unraveling the bacterial diversity within the urban subway network in Hong Kong is presented. Aerosol samples from multiple subway lines and outdoor locations were collected. Targeting the 16S rRNA gene V4 region, extensive taxonomic diversity was found, with the most common bacterial genera in the subway environment among those associated with skin. Overall, subway lines harbored different phylogenetic communities based on α- and β-diversity comparisons, and closer inspection suggests that each community within a line is dependent on architectural characteristics, nearby outdoor microbiomes, and connectedness with other lines. Microbial diversities and assemblages also varied depending on the day sampled, as well as the time of day, and changes in microbial communities between peak and nonpeak commuting hours were attributed largely to increases in skin-associated genera in peak samples. Microbial diversities within the subway were influenced by temperature and relative humidity, while carbon dioxide levels showed a positive correlation with abundances of commuter-associated genera. This Hong Kong data set and communities from previous studies conducted in the United States formed distinct community clusters, indicating that additional work is required to unravel the mechanisms that shape subway microbiomes around the globe.
We present a detailed timing analysis of the bright black hole X-ray binary MAXI J1820+070 (ASASSN-18ey), during its first detected outburst lasting from 2018 March until 2019 October based on ...Swift/XRT window timing mode observations, corresponding UVOT data and NICER observations. The light curves clearly show four outbursts, with the source remaining in the hard state during its first outburst, while the rise of the second outburst corresponds with the transition to the soft state. A similar double outburst of GX339-4 has been observed in 2004. Here it is followed by two hard-state only outbursts. In many observations the power density spectra showed type-C quasi-periodic oscillations (QPOs) with characteristic frequencies below 1 Hz, which suggests that the source stayed in a state of low effective accretion for large parts of its outburst. The absence of other types of QPOs hinders a precise determination of the state transitions, but from combining NICER and Swift/XRT data, we find that MAXI J1820+070 went from the hard-intermediate to the soft state in less than one day. The covariance ratios derived from NICER data show an increase toward lower energies, which indicate that the source should make a transition to the soft state. This transition finally took place, after MAXI J1820+070 stayed in the hard state at rather constant luminosity for about 116 days. The steepness of the increase of the covariance ratios is not correlated with the amount of rms variability and it does not show a monotonic evolution along the outburst.
Recent observations strongly suggest that the millisecond pulsar binary PSR J1023+0038 has developed an accretion disk since 2013 June. We present a multi-wavelength analysis of PSR J1023+0038, which ...reveals that (1) its gamma-rays suddenly brightened within a few days in 2013 June/July and has remained at a high gamma-ray state for several months; (2) both UV and X-ray fluxes have increased by roughly an order of magnitude; and (3) the spectral energy distribution has changed significantly after the gamma-ray sudden flux change. Time variabilities associated with UV and X-rays are on the order of 100-500 s and 50-100 s, respectively. Our model suggests that a newly formed accretion disk, due to the sudden increase of the stellar wind, could explain the changes of all these observed features. The increase of UV is emitted from the disk, and a new component in gamma-rays is produced by inverse Compton scattering between the new UV component and pulsar wind. The increase of X-rays results from the enhancement of injection pulsar wind energy into the intra-binary shock due to the increase of the stellar wind. We also predict that the radio pulses may be blocked by the evaporated winds from the disk, and the pulsar is still powered by rotation.
We have conducted a systematic survey for the X-ray properties of millisecond pulsars (MSPs). Currently, there are 47 MSPs with confirmed X-ray detections. We have also placed the upper limits for ...the X-ray emission from the other 36 MSPs by using the archival data. We have normalized their X-ray luminosities Lx and their effective photon indices Γ into a homogeneous data set, which enables us to carry out a detailed statistical analysis. Based on our censored sample, we report a relation of L x 10 31.05 ( E ˙ 10 35 ) 1.31 erg s−1 (2-10 keV) for the MSPs. The inferred X-ray conversion efficiency is found to be lower than the previously reported estimate that could be affected by selection bias. Lx also correlates/anti-correlates with the magnetic field strength at the light cylinder BLC/characteristic age τ. On the other hand, there is no correlation between Lx and their surface magnetic field strength Bs. We have further divided the sample into four classes: (i) black-widows, (ii) redbacks, (iii) isolated MSPs, and (iv) other MSP binaries, and compare the properties among them. We noted that while the rotational parameters and the orbital periods of redbacks and black-widows are similar, Lx of redbacks are significantly higher than those of black-widows in the 2-10 keV band. Also the Γ of redbacks are apparently smaller than those of black-widows, which indicates that the X-ray emission of redbacks are harder than that of black-widows. This can be explained by the different contribution of intrabinary shocks in the X-ray emission of these two classes.
The purpose of this study was to identify the risk factors predisposing to aneurysm rupture and to provide a reliable estimation for likelihood of rupture in unruptured intracranial aneurysms.
The ...authors performed a nested case-control study of 290 aneurysms (123 unruptured aneurysms and 167 ruptured aneurysms) occurring during a prospective cohort study in 1493 consecutive patients with newly diagnosed intracranial aneurysm and were treated in a single institute between January 1995 and December 2006. Controls were matched for age, treatment group, number of lesion, sex, region and study period in which the incidence of ruptured and unruptured intracranial aneurysm was equivalently balanced. The authors assessed the predictive risk factors associated with aneurysmal rupture based on the clinical and angiographic findings reported in the patients' medical records.
Between January 1997 and December 2002, 167 patients with ruptured intracranial aneurysms were assigned to group 1, and 123 patients with unruptured intracranial aneurysms during the same period were assigned to group 2. Aspect ratio (OR 3.76), maximum diameter of neck (N(max)) < or =3 mm (OR 2.56) and family history of cerebrovascular disease (OR 5.63) were strongly correlated with aneurysm rupture (p<0.05).
There are differences between the clinical and intrinsic characteristics of patients with unruptured and ruptured intracranial aneurysm. It will be helpful to make rational decisions regarding the optimal therapeutic strategy for unruptured intracranial aneurysm.
Recent studies have suggested potential roles of the microbiome in cervicovaginal diseases. However, there has been no report on the cervical microbiome in cervical intraepithelial neoplasia (CIN). ...We aimed to identify the cervical microbiota of Korean women and assess the association between the cervical microbiota and CIN, and to determine the combined effect of the microbiota and human papillomavirus (HPV) on the risk of CIN. The cervical microbiota of 70 women with CIN and 50 control women was analysed using pyrosequencing based on the 16S rRNA gene. The associations between specific microbial patterns or abundance of specific microbiota and CIN risk were assessed using multivariate logistic regression, and the relative excess risk due to interaction (RERI) and the synergy index (S) were calculated. The phyla Firmicutes, Actinobacteria, Bacteroidetes, Proteobacteria, Tenericutes, Fusobacteria and TM7 were predominant in the microbiota and four distinct community types were observed in all women. A high score of the pattern characterized by predominance of Atopobium vaginae, Gardnerella vaginalis and Lactobacillus iners with a minority of Lactobacillus crispatus had a higher CIN risk (OR 5.80, 95% CI 1.73‒19.4) and abundance of A. vaginae had a higher CIN risk (OR 6.63, 95% CI 1.61‒27.2). The synergistic effect of a high score of this microbial pattern and oncogenic HPV was observed (OR 34.1, 95% CI 4.95‒284.5; RERI/S, 15.9/1.93). A predominance of A. vaginae, G. vaginalis and L. iners with a concomitant paucity of L. crispatus in the cervical microbiota was associated with CIN risk, suggesting that bacterial dysbiosis and its combination with oncogenic HPV may be a risk factor for cervical neoplasia.
We present a radio-quiet quasar at z = 0.237 discovered "turning on" by the intermediate Palomar Transient Factory (iPTF). The transient, iPTF 16bco, was detected by iPTF in the nucleus of a galaxy ...with an archival Sloan Digital Sky Survey spectrum with weak narrow-line emission characteristic of a low-ionization nuclear emission-line region (LINER). Our follow-up spectra show the dramatic appearance of broad Balmer lines and a power-law continuum characteristic of a luminous ( erg s−1) type 1 quasar 12 yr later. Our photometric monitoring with PTF from 2009-2012 and serendipitous X-ray observations from the XMM-Newton Slew Survey in 2011 and 2015 constrain the change of state to have occurred less than 500 days before the iPTF detection. An enhanced broad H /O iii λ5007 line ratio in the type 1 state relative to other changing-look quasars also is suggestive of the most rapid change of state yet observed in a quasar. We argue that the >10 increase in Eddington ratio inferred from the brightening in UV and X-ray continuum flux is more likely due to an intrinsic change in the accretion rate of a preexisting accretion disk than an external mechanism such as variable obscuration, microlensing, or the tidal disruption of a star. However, further monitoring will be helpful in better constraining the mechanism driving this change of state. The rapid "turn-on" of the quasar is much shorter than the viscous infall timescale of an accretion disk and requires a disk instability that can develop around a black hole on timescales less than 1 yr.
The origins of the high-energy cosmic neutrino flux remain largely unknown. Recently, one high-energy neutrino was associated with a tidal disruption event (TDE). Here we present AT2019fdr, an ...exceptionally luminous TDE candidate, coincident with another high-energy neutrino. Our observations, including a bright dust echo and soft late-time x-ray emission, further support a TDE origin of this flare. The probability of finding two such bright events by chance is just 0.034%. We evaluate several models for neutrino production and show that AT2019fdr is capable of producing the observed high-energy neutrino, reinforcing the case for TDEs as neutrino sources.
We present a spectral-timing analysis of observations taken in fall 2017 of the newly detected X-ray transient MAXI J1535-571. We included 38 Swift/XRT window timing mode observations, 3 XMM-Newton ...observations, and 31 Neutron star Interior Composition Explorer observations in our study. We computed the fundamental diagrams commonly used to study black hole transients, and fitted power density and energy spectra to study the evolution of spectral and timing parameters. The observed properties are consistent with a bright black hole X-ray binary ( erg cm−2 s−1) that evolves from the low-hard-state to the high-soft state and back to the low-hard-state. In some observations the power density spectra showed type-C quasiperiodic oscillations, giving additional evidence that MAXI J1535-571 is in a hard state during these observations. The duration of the soft state with less than 10 days is unusually short and observations taken in spring 2018 show that MAXI J1535-571 entered a second (and longer) soft state.
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