The association between the presence or absence of two HLA antigens and coeliac disease, thyrotoxicosis and ankylosing spondylitis has been studied in patients and controls. The simple empirical ...logistic model and a refinement due to Dyke and Patterson have been used to examine which conditional associations are important.
OBJECTIVE:Early operative debridement is a major determinant of outcome in necrotizing fasciitis. However, early recognition is difficult clinically. We aimed to develop a novel diagnostic scoring ...system for distinguishing necrotizing fasciitis from other soft tissue infections based on laboratory tests routinely performed for the evaluation of severe soft tissue infectionsthe Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score.
DESIGN:Retrospective observational study of patients divided into a developmental cohort (n = 314) and validation cohort (n = 140)
SETTING:Two teaching tertiary care hospitals.
PATIENTS:One hundred forty-five patients with necrotizing fasciitis and 309 patients with severe cellulitis or abscesses admitted to the participating hospitals.
INTERVENTIONS:None.
MEASUREMENTS AND MAIN RESULTS:The developmental cohort consisted of 89 consecutive patients admitted for necrotizing fasciitis. Control patients (n = 225) were randomly selected from patients admitted with severe cellulitis or abscesses during the same period. Hematologic and biochemical results done on admission were converted into categorical variables for analysis. Univariate and multivariate logistic regression was used to select significant predictors. Total white cell count, hemoglobin, sodium, glucose, serum creatinine, and C-reactive protein were selected. The LRINEC score was constructed by converting into integer the regression coefficients of independently predictive factors in the multiple logistic regression model for diagnosing necrotizing fasciitis. The cutoff value for the LRINEC score was 6 points with a positive predictive value of 92.0% and negative predictive value of 96.0%. Model performance was very good (Hosmer-Lemeshow statistic, p = .910); area under the receiver operating characteristic curve was 0.980 and 0.976 in the developmental and validation cohorts, respectively.
CONCLUSIONS:The LRINEC score is a robust score capable of detecting even clinically early cases of necrotizing fasciitis. The variables used are routinely measured to assess severe soft tissue infections. Patients with a LRINEC score of ≥6 should be carefully evaluated for the presence of necrotizing fasciitis.
Three clusters of coronavirus disease 2019 (COVID-19) linked to a tour group from China, a company conference, and a church were identified in Singapore in February, 2020.
We gathered epidemiological ...and clinical data from individuals with confirmed COVID-19, via interviews and inpatient medical records, and we did field investigations to assess interactions and possible modes of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Open source reports were obtained for overseas cases. We reported the median (IQR) incubation period of SARS-CoV-2.
As of Feb 15, 2020, 36 cases of COVID-19 were linked epidemiologically to the first three clusters of circumscribed local transmission in Singapore. 425 close contacts were quarantined. Direct or prolonged close contact was reported among affected individuals, although indirect transmission (eg, via fomites and shared food) could not be excluded. The median incubation period of SARS-CoV-2 was 4 days (IQR 3–6). The serial interval between transmission pairs ranged between 3 days and 8 days.
SARS-CoV-2 is transmissible in community settings, and local clusters of COVID-19 are expected in countries with high travel volume from China before the lockdown of Wuhan and institution of travel restrictions. Enhanced surveillance and contact tracing is essential to minimise the risk of widespread transmission in the community.
None.
Drug resistance is a major obstacle to the treatment of most human tumors. In this study, we find that dual-specificity phosphatase 16 (DUSP16) regulates resistance to chemotherapy in nasopharyngeal ...carcinoma, colorectal cancer, gastric and breast cancer. Cancer cells expressing higher DUSP16 are intrinsically more resistant to chemotherapy-induced cell death than cells with lower DUSP16 expression. Overexpression of DUSP16 in cancer cells leads to increased resistance to cell death upon chemotherapy treatment. In contrast, knockdown of DUSP16 in cancer cells increases their sensitivity to treatment. Mechanistically, DUSP16 inhibits JNK and p38 activation, thereby reducing BAX accumulation in mitochondria to reduce apoptosis. Analysis of patient survival in head & neck cancer and breast cancer patient cohorts supports DUSP16 as a marker for sensitivity to chemotherapy and therapeutic outcome. This study therefore identifies DUSP16 as a prognostic marker for the efficacy of chemotherapy, and as a therapeutic target for overcoming chemoresistance in cancer.
A hybrid material of reduced graphene oxide/titanium dioxide (rGO/TiO2) was successfully synthesized by facile hydrothermal technique. A different amount of GO ratios at 5%, 10%, 20%, and 30% were ...loaded with TiO2. It is a well-known fact that porous structure and crystallinity of resultant rGO/TiO2 play a crucial role in synergistic effect which facilitate electron transfer movement and reduce the volume changes during a charge-discharge cycle process. Based on the results obtained, an optimum of 10 wt % GO loading with TiO2 nanocrystals revealed that electrochemical performance achieved the highest specific capacity of 116.70 mAh/g with 0.2 A g−1 among samples. This result inferred that high efficiency of ion diffusion was obtained with low charge transfer resistance between TiO2 nanocrystals and rGO. The supercapattery was assembled in a configuration of optimized 10% rGO/TiO2 nanocomposites as anode while activated carbon as cathode. The result obtained a superior energy density of 54.37 Wh kg−1 at power density of 420.48 W kg−1. Additionally, the specific capacity still remained at 92% for 3000 charging-discharging cycles under a current density of 1 A g−1; hence, good life cycle stability, high specific capacity and low charge transfer resistance of rGO/TiO2 nanocomposites electrode suggested that the prepared materials was a promising anode material for supercapattery application.
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•A rGO-TiO2 nanocomposite has been explored as a supercapattery electrode.•10% rGO-TiO2 in 1 M KOH has been selected as an optimized electrode.•Specific capacity of 116.70 mAh/g has been obtained at current density of 0.2 Ag−1.•High values of energy (54.37 Wh/kg) and power (420.48 Wh/kg) densities were achieved.•Capacitance potential up to 92% after 3000 cycles has been achieved.
Emissions of natural gas and carbon dioxide due to fossil fuels have become a global issue which influences the development of various technologies. Demand for clean renewable power sources is ever ...increasing. However, renewable sources are intermittent in nature, which poses a challenge in electricity generation and power load stability. Lately, supercapacitors have attracted remarkable interest in the field of electricity storage due to their ability to store large amounts of electric charge, enabling high power output. Reduced graphene oxide incorporated with titanium dioxide (rGO/TiO
2
) nanocomposites are well considered as potential supercapattery materials due to their superior mechanical properties, notable strength, and abundance in Nature. rGO carbon material acts as the ion reservoir, facilitating faster electron transfer mobility, whereas mesoporous TiO
2
provides a larger surface area and more active sites, which improve the cycling stability and specific capacitance. Literature reports that supercapacitor performance mainly depends on the choice of the electroactive material, electrolyte, and current collector. This review focuses on recent developments in supercapacitor technology, storage mechanisms of different electrodes, a comprehensive discussion of different challenges related to energy storage devices, as well as the formation mechanism of rGO/TiO
2
hybrid electrodes.
Please see the Editorial Comment by Antonio Luna discussing this article. The 2019 5th edition of the WHO classification of digestive system tumors estimates that up to 35% of hepatocellular ...carcinomas (HCCs) can be classified as one of eight subtypes defined by molecular characteristics: steatohepatitic, clear cell, macrotrabecular-massive, scirrhous, chromophobe, fibrolamellar, neutrophil-rich, and lymphocyte-rich HCCs. Due to their distinct cellular and architectural characteristics, these subtypes may not display arterial phase hyperenhancement and washout appearance, which are the classic MRI features of HCC, creating challenges in noninvasively diagnosing such lesions as HCC. Moreover, certain subtypes with atypical imaging features have a worse prognosis than other HCCs. A range of distinguishing imaging features may help raise suspicion that a liver lesion represents one of these HCC subtypes. In this review, we describe the MRI features that have been reported in association with various HCC subtypes according to the 2019 WHO classification, with attention given to the current understanding of these subtypes' pathologic and molecular bases and relevance to clinical practice. Imaging findings that differentiate the subtypes from benign liver lesions and non-HCC malignancies are highlighted. Familiarity with these sub-types and their imaging features may allow the radiologist to suggest their presence, though histologic analysis remains needed to establish the diagnosis.
Rationale for redefining obesity in Asians Low, Serena; Chin, Mien Chew; Ma, Stefan ...
Annals of the Academy of Medicine, Singapore,
01/2009, Letnik:
38, Številka:
1
Journal Article
Recenzirano
Odprti dostop
There has been extensive research on defining the appropriate body mass index (BMI) cut-off point for being overweight and obese in the Asian population since the World Health Organisation (WHO) ...Expert Consultation Meeting in 2002.
We reviewed the literature on the optimal BMI cut-off points for Asian populations. We searched PubMed, EMBASE, National Institute for Health Research Centre for Reviews and Dissemination (NHS CRD) Database, Cochrane Library and Google. Attempts to identify further studies were made by examining the reference lists of all retrieved articles. There were 18 articles selected for the review.
There were 13 studies which have identified the BMI cut-off points for Asian populations lower than the international BMI cut-off points recommended by the WHO. Many of the studies have recommended lowering BMI cut-off point specific for Asian populations. A few studies concurred with the recommended cut-off point for Asian populations recommended by International Association for the Study of Obesity (IASO), the International Obesity Task Force (IOTF) and the WHO in 2002. Asian populations were also noted to have higher cardiovascular risk factors than Western populations at any BMI level.
Further research would be needed to look at the all-cause mortality at same BMI levels between Asians and Caucasians in order to evaluate the BMI cut-off recommendations for Asian populations. It is necessary to develop and redefine appropriate BMI cut-off points which are country-specific and ethnic-specific for Asians. These will facilitate the development of appropriate preventive interventions to address the public health problem posed by obesity.
Early childhood nutritional deficiency has detrimental consequences on physical and cognitive development. We conducted a single-center, single-blind, two-arm pilot randomized no-treatment controlled ...trial (the Child of Urban Poverty Iron Project (CUPIP); NCT03819530) in a people’s housing project locale in Selangor, Malaysia, between September 2019 and February 2020, to assess the trial’s general feasibility and preliminary benefits of daily micronutrient supplementation for iron storage and anthropometric outcomes in under-5 children. Those with history of premature births, congenital abnormalities, or baseline hemoglobin <70 g/L were excluded. Participants received baseline deworming and were simply randomized in a 1:1 ratio to either micronutrient (4-month daily micronutrient packets) or control (no micronutrient supplementation) groups. Information on anthropometric, erythrocytic, and iron storage endpoints were collected. Overall, 45 (25 micronutrient and 20 controls) participants were enrolled and completed 4-month endpoint assessments. Micronutrient recipients demonstrated higher median mean corpuscular volume, serum ferritin level with no significant differences in all anthropometric endpoints. In conclusion, this pilot trial was implementable, demonstrating that micronutrient supplementation significantly improved hematological, but not anthropometric, endpoints, of under-5-year-old children living in an underprivileged environment. A definitive well-designed trial with larger sample sizes and greater attrition control should be contemplated in the future.
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