Multiscale problems can usually be approximated through numerical homogenization by an equation with some effective parameters that can capture the macroscopic behavior of the original system on the ...coarse grid to speed up the simulation. However, this approach usually assumes scale separation and that the heterogeneity of the solution can be approximated by the solution average in each coarse block. For complex multiscale problems, the computed single effective properties/continuum might be inadequate. In this paper, we propose a novel learning-based multi-continuum model to enrich the homogenized equation and improve the accuracy of the single continuum model for multiscale problems with some given data. Without loss of generalization, we consider a two-continuum case. The first flow equation keeps the information of the original homogenized equation with an additional interaction term. The second continuum is newly introduced, and the effective permeability in the second flow equation is determined by a neural network. The interaction term between the two continua aligns with that used in the Dual-porosity model but with a learnable coefficient determined by another neural network. The new model with neural network terms is then optimized using trusted data. We discuss both direct back-propagation and the adjoint method for the PDE-constraint optimization problem. Our proposed learning-based multi-continuum model can resolve multiple interacted media within each coarse grid block and describe the mass transfer among them, and it has been demonstrated to significantly improve the simulation results through numerical experiments involving both linear and nonlinear flow equations.
To examine the clinical efficacy of the trivalent seasonal influenza vaccination among Chinese older adults residing in a nursing home.
A 12-month prospective cohort study. Participants were divided ...into 2 groups based on their own choice on vaccination of trivalent seasonal influenza vaccine: vaccinated group and unvaccinated group.
Fifty-eight nursing homes in Hong Kong.
A total of 1859 older adults residing in a nursing home.
All-cause mortality, pneumonia-related mortality, all-cause hospitalization, and pneumonia-related hospitalization.
A total of 1859 older adults residing in a nursing home were included: 1214 (65.3%) in the vaccinated group and 645 (34.7%) in the unvaccinated group. At 12 months of study, for all-cause mortality, 14.6% (177 of 1214) of the vaccinated group and 20.2% (130 of 645) of the unvaccinated group had died (P < .001). Multivariate analysis showed the hazard ratio for the vaccinated group was 0.72 (95% confidence interval CI: 0.54-0.95; P < .01). For pneumonia-related mortality, 9.4% (114 of 1214) of the vaccinated group and 12.7% (82 of 645) of the unvaccinated group died (P = .033). Multivariate analysis showed the hazard ratio for the vaccinated group was 0.80 (CI: 0.62-0.98; P < .05). The median number of all-cause hospitalizations per 1000 person-months was 55 (0-111) for the vaccinated group and 55 (0-167) for the unvaccinated group (P < .01). The median number of pneumonia-related hospitalizations per 1000 person-months was 0 (0-55) for the vaccinated group and 0 (0-111) for the unvaccinated group (P < .01).
Vaccination of trivalent seasonal influenza vaccine in Chinese nursing home older adults significantly reduced all-cause and pneumonia-related mortality and hospitalization.
(-)-Epigallocatechin-3-gallate (EGCG) is a major polyphenol in green tea. Many health promoting effects of EGCG have been reported based on its antioxidative and gene modulation properties, but no ...study has demonstrated a protective effect of EGCG against glutamate-induced neuronal damage. Excessive glutamate stimulation on neuronal cells leads to accumulation of reactive oxygen species (ROS) which ultimately contribute to cell death in stroke, trauma and other neurodegenerative disorders. In this study, mouse hippocampal cell line, HT-22, was used to determine the effect of EGCG on glutamate neurotoxicity. It was found that EGCG protected HT-22 cells against glutamate neurotoxicity when administered 10 h after glutamate incubation. The protective action of EGCG is mainly due to its antioxidative effect.
Resistance to glucocorticoids (GCs), the common agents for remission induction in pediatric B-cell precursor acute lymphoblastic leukemia (BCP-ALL), poses a significant therapeutic hurdle. Therefore, ...dissecting the mechanisms shaping GC resistance could lead to new treatment modalities. Here, we showed that CD9- BCP-ALL cells were preferentially resistant to prednisone and dexamethasone over other standard cytotoxic agents. Concordantly, we identified significantly more poor responders to the prednisone prephase among BCP-ALL patients with a CD9- phenotype, especially for those with adverse presenting features including older age, higher white cell count and BCR-ABL1. Furthermore, gain- and loss-of-function experiments dictated a definitive functional linkage between CD9 expression and GC susceptibility, as demonstrated by the reversal and acquisition of relative GC resistance in CD9low and CD9high BCP-ALL cells, respectively. Despite physical binding to the GC receptor NR3C1, CD9 did not alter its expression, phosphorylation or nuclear translocation but potentiated the induction of GC-responsive genes in GCresistant cells. Importantly, the MEK inhibitor trametinib exhibited higher synergy with GCs against CD9- than CD9+ lymphoblasts to reverse drug resistance in vitro and in vivo. Collectively, our results elucidate a previously unrecognized regulatory function of CD9 in GC sensitivity, and inform new strategies for management of children with resistant BCP-ALL.
•Group B Streptococcus (GBS) and Escherichia coli remain the most common causes of meningitis in neonates and young infants•GBS screening and intrapartum antibiotic prophylaxis were effective in ...preventing early-onset GBS meningitis•Antibiotic-resistant Escherichia coli in neonatal meningitis is an increasing concern
Meningitis in neonates and young infants leads to significant morbidity and mortality worldwide. This study aimed to investigate pathogens, antibiotic resistance and secular change of incidence in Hong Kong.
A retrospective search was performed on meningitis in neonates and infants aged <3 months in three Hong Kong public hospitals from 2004 to 2019. Medical charts were reviewed, with focus on the identification and antibiotic resistance of the pathogens.
A total of 200 cases of meningitis were identified (67% were bacterial). Group B Streptococcus (GBS) and Escherichia coli (E. coli) were the commonest bacterial pathogens. The annual rates of early-onset GBS meningitis decreased after the implementation of universal GBS screening and intrapartum antibiotic prophylaxis (IAP) in 2012, while that of late-onset GBS meningitis remained similar. A significant portion of E. coli isolates were resistant to ampicillin and/or gentamicin.
GBS and E. coli were the most common bacteria for meningitis in this age group. The annual rate of bacterial meningitis in Hong Kong has declined in recent years, which has been attributed to the decline in early-onset GBS meningitis due to universal GBS screening and IAP. Antimicrobial-resistant bacterial strains that cause meningitis require further clinical and public health attention.
Abstract
Aims
Intimate partner violence (IPV) is a public health challenge negatively affecting victims’ health. Telomere length (TL), a marker for biological ageing, might be reflective of the ...mechanisms through which IPV leads to adverse health outcomes. The objective of the current study was to explore the association between IPV and leucocyte TL.
Methods
We conducted an analysis using a subset of the UK Biobank (
N
= 144 049). Physical, sexual and emotional IPV were reported by the participants. DNA was extracted from peripheral blood leukocytes. TL was assayed by quantitative polymerase chain reaction. We used multivariable linear regressions to test the associations between IPV and TL adjusted for age, sex, ethnicity, deprivation, education, as well as symptoms of depression and post-traumatic stress disorder in a sensitivity analysis.
Results
After adjusting for sociodemographic factors, any IPV was associated with 0.02-
s.d.
shorter TL (
β
= −0.02, 95% CI −0.04 to −0.01). Of the three types of IPV, physical violence had a marginally stronger association (
β
= −0.05, 95% CI −0.07 to −0.02) than the other two types. The associations of numbers of IPV and TL showed a dose–response pattern whereby those who experienced all three types of IPV types had the shortest TL (
β
= −0.07, 95% CI −0.12 to −0.03), followed by those who experienced two types (
β
= −0.04, 95% CI −0.07 to −0.01). Following additional adjustment for symptoms of depression and PTSD, the associations were slightly attenuated but the general trend by number of IPVs remained.
Conclusions
Victims of IPV, particularly those exposed to multiple types of IPVs, had shorter TL indicative of accelerated biological ageing. Given that all three types of IPV are linked to TL, clinical practitioners need to comprehensively identify all types of IPV and those who received multiple types. Further studies should explore the association of violence with changes in TL over time, as well as to which extent biological ageing is a mechanistic factor.
The efficacy of influenza vaccination in older nursing home residents is frequently overestimated due to frailty selection bias. Limited data exist to examine this issue.
We conducted a prospective ...cohort study from December 2009 to November 2010 to evaluate the efficacy of influenza vaccination in old nursing home residents with respect to their functional status. Participants were stratified according to the Barthel Index (BI) into good functioning (GF; BI > 60), intermediate functioning (IF; BI = 5-60), and poor functioning (PF; BI = 0). Participants were vaccinated by monovalent H1N1 2009 and trivalent seasonal influenza vaccinations (H1N1-TIV), TIV alone, or remained unvaccinated by choice. The associations between all-cause mortality, vaccination efficacy, and functional status were examined.
A total of 711 older nursing home residents were enrolled (GF group: N = 230; IF group: N = 246; PF group: N = 235). At 12 months, H1N1-TIV recipients had the lowest all-cause mortality, whereas unvaccinated residents had the highest all-cause mortality in all three functional status groups. In the comparison between H1N1-TIV recipients and TIV alone recipients, the hazard ratios (HRs) of all-cause mortality were lower in the GF group and higher in the PF group (GF group: HR 0.30 0.07-0.95, p < .05; IF group: HR 0.40 0.18-0.86, p < .05; PF group: HR 0.53 0.28-0.99, p < .05). The same observation was found in comparison between other vaccination statuses (H1N1-TIV vs unvaccinated and TIV alone vs unvaccinated).
Influenza vaccination was associated with reduced all-cause mortality in older nursing home residents with different functional statuses. Vaccine efficacy in reducing mortality declined with increasingly impaired functional status.
Abstract
Bias Blind Spot (BBS) is the phenomenon that people tend to perceive themselves as less susceptible to biases than others. In three pre-registered experiments (overall N = 969), we ...replicated two experiments of the first demonstration of the phenomenon by Pronin et al. (2002). We found support of the BBS hypotheses, with effects in line with findings in the original study: Participants rated themselves as less susceptible to biases than others (
d
= –1.00 –1.33, –0.67). Deviating from the original, we found an unexpected effect that participants rated themselves as having fewer shortcomings (
d
= –0.34 –0.46, –0.23), though there was support for the target’s main premise that BBS was stronger for biases than for shortcomings (
d
= –0.43 –0.56, –0.29). Extending the replications, we found that beliefs in own free will were positively associated with BBS (r ∼ 0.17–0.22) and that beliefs in both own and general free will were positively associated with self-other asymmetry related to personal shortcomings (
r
∼ 0.16–0.24). Materials, datasets, and code are available on https://osf.io/3df5s/.
OBJECTIVES: To assess the prevalence of tuberculous infection and active tuberculosis (TB) in old age homes in Hong Kong and to determine whether there is institutional transmission in these homes.
...DESIGN: Cross‐sectional.
SETTING: Old age homes.
PARTICIPANTS: Total of 2,243 residents, representing 84.6% of all residents in 15 old age homes; 1,698 were women, and 545 were men, with an average age of 82.
MEASUREMENTS: All residents had a questionnaire‐based interview, medical record review, two‐stage tuberculin testing using two units purified protein derivative‐RT23, and a chest x‐ray. Those with radiological abnormalities had sputum examined for acid‐fast bacilli.
RESULTS: The estimated prevalence rate of active TB in this population was 669 per 100,000, significantly higher in men than in women (1,101 per 100,000 vs 530 per 100,000). The proportion with positive tuberculin reactivity (≥10 mm induration) after two‐stage testing was 68.6%, significantly higher in men than in women. There was no evidence of active transmission of disease in these old age homes, with restriction fragment length polymorphism (RFLP) analysis performed on five cases of active pulmonary TB in the home with the highest rate of TB showing unique RFLP patterns.
CONCLUSION: The rate of active TB and TB infection in old age homes in Hong Kong is still high. Because treatment for latent TB carries a high risk for liver dysfunction in this population, clinicians and other healthcare workers need a high index of suspicion and to diagnose and treat this disease as early as possible to prevent transmission.
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