Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which has been characterized by fever, respiratory, and gastrointestinal ...symptoms as well as shedding of virus RNA into feces. We performed a systematic review and meta-analysis of published gastrointestinal symptoms and detection of virus in stool and also summarized data from a cohort of patients with COVID-19 in Hong Kong.
We collected data from the cohort of patients with COVID-19 in Hong Kong (N = 59; diagnosis from February 2 through February 29, 2020),and searched PubMed, Embase, Cochrane, and 3 Chinese databases through March 11, 2020, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We analyzed pooled data on the prevalence of overall and individual gastrointestinal symptoms (loss of appetite, nausea, vomiting, diarrhea, and abdominal pain or discomfort) using a random effects model.
Among the 59 patients with COVID-19 in Hong Kong, 15 patients (25.4%) had gastrointestinal symptoms, and 9 patients (15.3%) had stool that tested positive for virus RNA. Stool viral RNA was detected in 38.5% and 8.7% among those with and without diarrhea, respectively (P = .02). The median fecal viral load was 5.1 log10 copies per milliliter in patients with diarrhea vs 3.9 log10 copies per milliliter in patients without diarrhea (P = .06). In a meta-analysis of 60 studies comprising 4243 patients, the pooled prevalence of all gastrointestinal symptoms was 17.6% (95% confidence interval CI, 12.3–24.5); 11.8% of patients with nonsevere COVID-19 had gastrointestinal symptoms (95% CI, 4.1–29.1), and 17.1% of patients with severe COVID-19 had gastrointestinal symptoms (95% CI, 6.9–36.7). In the meta-analysis, the pooled prevalence of stool samples that were positive for virus RNA was 48.1% (95% CI, 38.3–57.9); of these samples, 70.3% of those collected after loss of virus from respiratory specimens tested positive for the virus (95% CI, 49.6–85.1).
In an analysis of data from the Hong Kong cohort of patients with COVID-19 and a meta-analysis of findings from publications, we found that 17.6% of patients with COVID-19 had gastrointestinal symptoms. Virus RNA was detected in stool samples from 48.1% patients, even in stool collected after respiratory samples had negative test results. Health care workers should therefore exercise caution in collecting fecal samples or performing endoscopic procedures in patients with COVID-19, even during patient recovery.
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This study examined how patients with cancer estimate caregiver burden (CB) and the association between their underestimation of CB and their caregivers' self‐ratings of their quality of life ...(CQOLC‐K; Korean version of the Caregiver Quality of Life Index‐Cancer), depression and anxiety (Korean version of the Hospital Anxiety and Depression Scale). Participants consisted of 990 patient‐caregiver dyads recruited from a nationwide cross‐sectional survey conducted in South Korea. Medical baseline data were retrieved from the hospital information systems of the participating centres. The patients with cancer who underestimated CB ranged from 18.62% (for physical CB) to 23.33% (for social CB). They had less advanced cancer, a lower income, were the caregiver's spouse, reported higher levels of family avoidance of communication about cancer, and had female caregivers. The patients' underestimation of CB was significantly related to lower CQoL and higher levels of caregiver depression and anxiety. The current study provides empirical evidence for the link between the underestimation of CB by patients with cancer and compromised caregiving experiences of cancer caregivers. Open family communication about cancer was discussed as one of several practical strategies for decreasing patients' underestimation of CB.
Comprehensive whole-genome structural variation detection is challenging with current approaches. With diploid cells as DNA source and the presence of numerous repetitive elements, short-read DNA ...sequencing cannot be used to detect structural variation efficiently. In this report, we show that genome mapping with long, fluorescently labeled DNA molecules imaged on nanochannel arrays can be used for whole-genome structural variation detection without sequencing. While whole-genome haplotyping is not achieved, local phasing (across >150-kb regions) is routine, as molecules from the parental chromosomes are examined separately. In one experiment, we generated genome maps from a trio from the 1000 Genomes Project, compared the maps against that derived from the reference human genome, and identified structural variations that are >5 kb in size. We find that these individuals have many more structural variants than those published, including some with the potential of disrupting gene function or regulation.
Transboundary air pollution is one of the critical environmental problems in Southeast Asia; nevertheless the interaction between transboundary haze and local planetary boundary layer (PBL) remains ...unclear due to a lack of sufficient observations and sophisticated simulations. This study applied LiDAR observations and model simulations to comprehensively evaluate the interaction between transboundary haze and local PBL during a recent transboundary haze episode in Singapore in October 2023. Results show that upper‐level southeasterly wind, especially the nocturnal low‐level jet, created favorable conditions for aerosol transport when fire hotspot numbers increased in Indonesia. The rapid diurnal increase in PBL height facilitated the entrainment of upper‐level haze into the PBL, interacting with ground‐level aerosols through turbulent mixing. Model simulations further show the significant contributions of fire emissions to the transboundary haze episode in maritime Southeast Asia. The impacts extended toward the southern region of Peninsular Malaysia, driven by the persistent prevailing southeasterly wind.
Plain Language Summary
In Southeast Asia, transboundary air pollution that crosses borders is a significant environmental issue. However, we don’t fully understand how the remote haze interacts with local upper‐level atmosphere. Our study used LiDAR observations and model simulations to thoroughly examine this problem during a recent episode in Singapore in October 2023. Our findings indicate that upper‐level southeasterly wind, particularly a low‐level jet during the night, played a crucial role in transporting aerosols when there was an increase in fire hotspot numbers in Indonesia. In the daytime, the rise of planetary boundary layer (PBL) height helped drive the upper‐level haze into the PBL, where it mixed with aerosols near the ground through the vertical movement of air parcels. Additionally, our simulations revealed that emissions from fires significantly contributed to the transboundary haze episode in maritime Southeast Asia. The impact of this haze extended toward the southern region of Peninsular Malaysia, primarily due to the persistent southeasterly wind prevailing in the area.
Key Points
Nocturnal low‐level jet created favorable conditions for haze transport to Singapore when hotspot numbers increased in Indonesia
Diurnal increase in planetary boundary layer height facilitated the mixing of transboundary haze and ground‐level aerosols
Source apportionment shows that fire and other sectoral emissions in Indonesia influenced the southern part of Peninsular Malaysia
This national survey was undertaken to propose the classification of extranodal natural killer (NK)/T-cell lymphoma (NTCL) subtypes and to clarify a clinical heterogeneity.
Two hundred and eighty ...patients newly diagnosed as NTCL were enrolled from 22 Korean medical centers. Two subsets were compared: one involving the upper aerodigestive tract (UAT) and another involving the non-upper aerodigestive tract (NUAT) region, which comprises the skin, gastrointestinal tract, and liver or soft tissues. Clinical prognostic factors, survival outcomes, and independent predictors for survival were compared between each subset.
NUAT-NTCL (59 patients) had significantly higher proportions of disseminated disease, aggressive biologic features, and unfavorable host reactions compared with UAT-NTCL (221 patients). NUAT-NTCL had shortened 5-year overall survival (OS) (22% versus 41%, P = 0.001). Ann Arbor staging, the International Prognostic Index, and the NTCL prognostic index failed to predict the OS of NUAT-NTCL, but did predict the OS in UAT-NTCL. Independent predictors for OS by multivariate analyses differed between each subset. In the NUAT subset, extranodal sites and regional nodes predicted the OS, while Ann Arbor staging, age, performance status, and lactate dehydrogenase level predicted the OS in the UAT subset.
NUAT-NTCL may represent a distinctive disease entity in terms of clinical factors, independent predictors, and survival outcomes.
Extensive traffic noise transmission loss measurements were carried out inside selected residential units of a standalone 32-storey housing block located next to a very busy and noisy main trunk road ...in the present study. A total of 35 units, which were all equipped with plenum windows, was surveyed. These plenum windows are intended to help reduce noise exposure of the residents and at the same time allow for a reasonable level of natural ventilation. The results show that the traffic noise transmission losses of the unit façades installed with the plenum windows adopted in this housing block vary between 10.6 and 13.0 dBA and are only weakly dependent on elevation from the trunk road. The results also validate in-situ the prediction model established previously by the authors using laboratory and site mockup data. Generalized models for both empirical and experimental estimation of the traffic noise transmission loss across a residential flat unit façade installed with multiple plenum windows are developed. The differences between their estimations are well within engineering tolerance.
•Traffic noise in congested cities has become more serious over the years.•Closing windows is not a solution as it will jeopardize indoor air quality.•Plenum windows offer good sound reduction and allow for natural ventilation.•Their on-site performance tested and noise reduction prediction formula validated.•The prediction formula is generalized for façades with many such windows.
Inherited muscular disorders (IMDs) are clinically and genetically heterogeneous genetic disorders. We investigated the mutational spectrum and genotype–phenotype correlations in Korean patients with ...IMD. We developed a targeted panel of 69 known IMD genes and recruited a total of 209 Korean patients with IMD. Targeted capture sequencing identified 994 different variants. Among them, 98 variants were classified as pathogenic/likely pathogenic variants; 38 were novel variations. A total of 39 patients had the pathogenic/likely pathogenic variants. Among them, 75 (36%) patients were genetically confirmed, and 18 (9%) patients had one heterozygous variant of recessive myopathy. However, two genetically confirmed patients had an additional heterozygous variant of another recessive myopathy. Four patients with one heterozygous variant of a recessive myopathy showed different phenotypes, compared with the known phenotype of the identified gene. The major causative genes of Korean patients with IMDs were DMD (19 patients), COL6A1 (9), DYSF (9), GNE (7), LMNA (7), CAPN3 (6), and RYR1 (5). This study showed the mutational and clinical spectra in Korean patients with IMD and confirmed the usefulness of strategies utilizing targeted sequencing.
Pulse current electrodeposition of Fe–36 wt.% Ni (Invar alloy) was carried out to investigate the effect of saccharin on the microstructure of the electrodeposited films. Electrodeposition without ...saccharin in electrolyte gave burnt and torn deposits, due to the very high internal stress that developed during electrodeposition. With a saccharin concentration less than 3.0 g/L in electrolyte, the surface of the electrodeposit was smooth and bright with a uniform thickness. The deposits were composed of FCC and BCC mixed phases and an FCC phase having nanosize grains, in which the {111} and {200} preferred orientations were predominant. With a saccharin concentration of more than 4.5 g/L, however, the surface became rough and dull with an appearance of faceted islands. This structure was related to the development of a (200) fiber texture in the BCC phase. Based on TEM observation, it was found that some BCC grains grew to microsize, while the FCC grains remained as nanosized. Dominant growth of the BCC grains is related to stress relaxation by slip deformation.
Persistent impairment in cognitive function has been described in euthymic individuals with bipolar disorder. Collective work indicates that obesity is associated with reduced cognitive function in ...otherwise healthy individuals. This sub-group post-hoc analysis preliminarily explores and examines the association between overweight/obesity and cognitive function in euthymic individuals with bipolar disorder.
Euthymic adults with DSM-IV-TR-defined bipolar I or II disorder were enrolled. Subjects included in this post-hoc analysis (n=67) were divided into two groups (normal weight, body mass index BMI of 18.5-24.9 kg/m2; overweight/obese, BMI ≥ 25.0 kg/m2). Demographic and clinical information were obtained at screening. At baseline, study participants completed a comprehensive cognitive battery to assess premorbid IQ, verbal learning and memory, attention and psychomotor processing speed, executive function, general intellectual abilities, recollection and habit memory, as well as self-perceptions of cognitive failures.
BMI was negatively correlated with attention and psychomotor processing speed as measured by the Digit Symbol Substitution Test (P<0.01). Overweight and obese bipolar individuals had a significantly lower score on the verbal fluency test when compared to normal weight subjects (P<0.05). For all other measures of cognitive function, non-significant trends suggesting a negative association with BMI were observed, with the exception of measures of executive function (i.e., trail making test B) and recollection memory (i.e., process-dissociation task).
Notwithstanding the post-hoc methodology and relatively small sample size, the results of this study suggest a possible negative effect of overweight/obesity on cognitive function in euthymic individuals with bipolar disorder. Taken together, these data provide the impetus for more rigorous evaluation of the mediational role of overweight/obesity (and other medical co-morbidity) on cognitive function in psychiatric populations.
In the absence of a mandatory reporting (MR) structure, it is unclear how nurses perceive or exercise their role in child protection. This study examined knowledge and perceptions of child protection ...and MR among nurses working in Hong Kong. This cross-sectional web-based survey used the Child Abuse Report Intention Scale to measure nurses' child protection knowledge and attitudes, and their perceived norms, control, and intention to report suspected maltreatment. Nurses also indicated if they support MR and to provide an explanation for their preference. Quantitative data were described and analyzed using bivariate and regression analyses. Open-ended responses were analyzed using directed content analysis. A convenient sample of 91 nurses working in Hong Kong completed the survey. The majority (86%) were female with a mean of 9.5 years of nursing experience; their mean knowledge score was 6.64 out of 13 (range 2-10). Compared with other maltreatment types, sexual abuse was perceived to be most severe and most likely to be reported. Perceived severity and attitudes toward child maltreatment was significantly associated with nurses' intention to report. Over half (58%) supported MR; those against MR expressed concerns about lack of support from management. Although nurses working in Hong Kong still hold polarized views about MR, findings point to the importance of creating a supportive reporting culture, and designing training programs that focus on changing perceptions about child protection in order to improve their tendency to report.
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