Summary Background In 2015, a large outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection occurred following a single patient exposure in an emergency room at the Samsung ...Medical Center, a tertiary-care hospital in Seoul, South Korea. We aimed to investigate the epidemiology of MERS-CoV outbreak in our hospital. Methods We identified all patients and health-care workers who had been in the emergency room with the index case between May 27 and May 29, 2015. Patients were categorised on the basis of their exposure in the emergency room: in the same zone as the index case (group A), in different zones except for overlap at the registration area or the radiology suite (group B), and in different zones (group C). We documented cases of MERS-CoV infection, confirmed by real-time PCR testing of sputum samples. We analysed attack rates, incubation periods of the virus, and risk factors for transmission. Findings 675 patients and 218 health-care workers were identified as contacts. MERS-CoV infection was confirmed in 82 individuals (33 patients, eight health-care workers, and 41 visitors). The attack rate was highest in group A (20% 23/117 vs 5% 3/58 in group B vs 1% 4/500 in group C; p<0·0001), and was 2% (5/218) in health-care workers. After excluding nine cases (because of inability to determine the date of symptom onset in six cases and lack of data from three visitors), the median incubation period was 7 days (range 2–17, IQR 5–10). The median incubation period was significantly shorter in group A than in group C (5 days IQR 4–8 vs 11 days 6–12; p<0·0001). There were no confirmed cases in patients and visitors who visited the emergency room on May 29 and who were exposed only to potentially contaminated environment without direct contact with the index case. The main risk factor for transmission of MERS-CoV was the location of exposure. Interpretation Our results showed increased transmission potential of MERS-CoV from a single patient in an overcrowded emergency room and provide compelling evidence that health-care facilities worldwide need to be prepared for emerging infectious diseases. Funding None.
Methylated non-CpGs (mCpH; H means A, C, and T) have emerged as key epigenetic marks in mammalian embryonic stem cells (ESCs) and neurons, regulating cell type-specific functions. In these two cell ...types, mCpHs show distinct motifs and correlations to transcription that could be a key in understanding the cell type-specific regulations. Thus, we attempted to uncover the underlying mechanism of the differences in ESCs and neurons by conducting a comprehensive analysis of public whole genome bisulfite sequencing data. Remarkably, there were cell type-specific mCpH patterns around methylated CpGs (mCpGs), resulted from preferential methylation at different contexts by DNA methyltransferase (DNMT) 3a and 3b. These DNMTs are differentially expressed in ESCs and brain tissues, resulting in distinct mCpH motifs in these two cell types. Furthermore, in ESCs, DNMT3b interacts with histone H3 tri-methylated at lysine 36 (H3K36me3), resulting in hyper-methylation at CpHs upon actively transcribed genes, including those involved in embryo development. Based on the results, we propose a model to explain the differential establishment of mCpHs in ESCs and neurons, providing insights into the mechanism underlying cell type-specific formation and function of mCpHs.
Background
Anastomotic leakage (AL) is a major complication of surgery for colorectal cancer (CRC), and is associated with increased morbidity and mortality; However, there are conflicting results on ...the impact of AL on long-term oncologic outcomes.
Objective
The aim of this meta-analysis was to assess the oncologic outcomes of AL following restorative surgery for CRC.
Methods
Multiple comprehensive databases, including PubMed, EMBASE, and The Cochrane Library, were searched for studies that assessed the oncologic effects of AL following surgery for CRC. The included studies evaluated local and distant recurrence, overall survival (OS), cancer-specific survival (CSS), and disease-free survival (DFS). Outcome data were pooled, and overall effect size was calculated using random effects models.
Results
Thirty-four nonrandomized studies including 78,434 patients met the inclusion criteria. The results show that AL was associated with increased local recurrence (relative risk RR 1.90, 95% confidence interval CI 1.48–2.44,
I
2
= 78%) and reduced OS (RR 1.36, 95% CI 1.24–1.50,
I
2
= 74%), CSS (RR 1.41, 95% CI 1.19–1.68,
I
2
= 56%), and DFS (RR 1.40, 95% CI 1.20–1.63,
I
2
= 86%). AL had no significant effect on distant recurrence (RR 1.20, 95% CI 0.94–1.53,
I
2
= 61%).
Conclusions
AL after restorative surgery for CRC is associated with increased local recurrence and reduced long-term survival, including OS, CSS, and DFS.
Inflammatory bowel disease (IBD) is an idiopathic inflammatory disorder characterized by chronic and relapsing manifestations. Several environmental factors are known as triggers for exacerbation of ...IBD. However, an association between exacerbation of IBD and ambient temperature is uncertain. This study aimed to estimate the risk of acute exacerbation of IBD due to ambient temperature. We performed a bidirectional case-crossover study using a nationwide claim data from South Korea. The external validation was conducted with a large prospective cohort in the United Kingdom. We confirmed significant associations between acute exacerbation of IBD and the short-term ambient temperature changes toward severe temperatures, in the cold weather (-19.4°C-4.3°C) (odd ratio OR = 1.13, 95% confidence interval CI: 1.13-1.14) and in the hot weather (21.3°C-33.5°C) (OR = 1.16, 95% CI: 1.15-1.17). However, the association was not significant in the moderate weather (4.3°C-21.3°C). The external validation suggested consistent results with additional elevation of acute exacerbation risk in the colder weather (-13.4°C to 2.6°C) (OR = 1.90, 95% CI: 1.62-2.22) and in the hotter weather (15.7°C-28.4°C) (OR = 1.41, 95% CI: 1.32-1.51). We observed and validated that the short-term ambient temperature changes were associated with acute exacerbation of IBD in the cold and hot weathers. Our findings provide evidence that temperature changes are associated with the acute exacerbation of IBD.
Reduced graphene oxide (rGO) is one of the promising sensing elements for high-performance chemoresistive sensors because of its remarkable advantages such as high surface-to-volume ratio, ...outstanding transparency, and flexibility. In addition, the defects on the surface of rGO, including oxygen functional groups, can act as active sites for interaction with gaseous molecules. However, the major drawback of rGO-based sensors is the extremely sluggish and irreversible recovery to the initial state after a sensing event, which makes them incapable of producing repeatable and reliable sensing signals. Here, we show that pristine GO can be used as the active sensing material with reversible and high response to NO2 at room temperature. First-principles calculations, in conjunction with experimental results, reveal the critical role of hydroxyl groups rather than epoxy groups in changing metallic graphene to the semiconducting GO. We show that the adaptive motions of the hydroxyl groups, that is, the rotation of these groups for the adsorption of NO2 molecules and relaxation to the original states during the desorption of NO2 molecules, are responsible for the fast and reversible NO2 sensing behavior of GO. Our work paves the way for realizing high-response, reversible graphene-based room-temperature chemoresistive sensors for further functional convergence.
Cancer remains to be one of the leading causes of death in the United States and around the world. The advent of modern drug-targeted therapies has undeniably improved cancer patients' cares. ...However, advanced metastasized cancer remains untreatable. Hence, continued searching for a safer and more effective chemoprevention and treatment is clearly needed for the improvement of the efficiency and to lower the treatment cost for cancer care. Cancer chemoprevention with natural phytochemical compounds is an emerging strategy to prevent, impede, delay, or cure cancer. This review summarizes the latest research in cancer chemoprevention and treatment using the bioactive components from natural plants. Relevant molecular mechanisms involved in the pharmacological effects of these phytochemicals are discussed. Pharmaceutical developmental challenges and opportunities in bringing the phytochemicals into the market are also explored. The authors wish to expand this research area not only for their scientific soundness, but also for their potential druggability.
A low complexity range-azimuth frequency-modulated continuous-waveform (FMCW) radar sensor using joint angle and delay estimation method without singular value decomposition (SVD) and eigenvalue ...decomposition (EVD) is presented in this paper. Conventional joint angle and delay estimation techniques exploit the dual-shift-invariant structure of received signals through matrix decompositions, such as SVD and EVD, which increases the computational burden. The proposed method utilizes the dual-shift-invariant structure through matrix inversion and performs angle and delay estimation using extended one-dimensional pseudospectrum searching instead of two-dimensional pseudospectrum searching to reduce the computational complexity. We demonstrate the effectiveness of the proposed method through Monte-Carlo simulations. The proposed algorithm is also verified by processing real FMCW data collected in an anechoic chamber.
Three-dimensionally porous carbon nanostructures have been widely used in energy storage applications owing to their large specific surface areas and excellent electrical properties. In addition, ...copper oxide has been considered as an effective pseudocapacitive material to significantly increase the energy density. In this paper, we introduce the synergetic combination of one-dimensional copper oxide nanowires and two-dimensional graphene sheets to fabricate a highly porous and electrically conductive three-dimensional hybrid nanostructure for high-performance supercapacitor electrodes with increased capacitances. The copper oxide nanowires were synthesized by reduction of copper nitrate and sequential oxidation at a high temperature. The copper oxide nanowire/graphene hybrid three-dimensional nanostructure was obtained by a self-assembly technique through a simple hydrothermal treatment. The hybrid nanostructure had an acceptable surface area and increased thermal stability. The porous hybrid nanostructure utilized as a supercapacitor electrode provided 1.6 times higher electrochemical capacitance than that of a graphene-only nanostructure-based electrode as well as superior capacitance stability with a retention of 91.2% retention after 5,000 charge−discharge cycles. Owing to the increased capacitance, the manufactured electrode exhibited high a specific energy density of 50.6 Wh kg−1 at a power density of 200 W kg−1, which demonstrates its potential for use in electrochemical energy storage devices.
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