Purpose
Thyroid dysfunction in COVID-19 carries clinical and prognostic implications. In this study, we developed a prediction score (ThyroCOVID) for abnormal thyroid function (TFT) on admission ...amongst COVID-19 patients.
Methods
Consecutive COVID-19 patients admitted to Queen Mary Hospital were prospectively recruited during July 2020–May 2021. Thyroid-stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) were measured on admission. Multivariable logistic regression analysis was performed to identify independent determinants of abnormal TFTs. ThyroCOVID was developed based on a clinical model with the lowest Akaike information criteria.
Results
Five hundred and forty six COVID-19 patients were recruited (median age 50 years, 45.4% men, 72.9% mild disease on admission). 84 patients (15.4%) had abnormal TFTs on admission. Patients with abnormal TFTs were more likely to be older, have more comorbidities, symptomatic, have worse COVID-19 severity, higher SARS-CoV-2 viral loads and more adverse profile of acute-phase reactants, haematological and biochemical parameters. ThyroCOVID consisted of five parameters: symptoms (malaise), comorbidities (ischaemic heart disease/congestive heart failure) and laboratory parameters (lymphocyte count, C-reactive protein, and SARS-CoV-2 cycle threshold values). It was able to identify abnormal TFT on admission with an AUROC of 0.73 (95% CI 0.67–0.79). The optimal cut-off of 0.15 had a sensitivity of 75.0%, specificity of 65.2%, negative predictive value of 93.5% and positive predictive value of 28.1% in identifying abnormal TFTs on admission amongst COVID-19 patients.
Conclusion
ThyroCOVID, a prediction score to identify COVID-19 patients at risk of having abnormal TFT on admission, was developed based on a cohort of predominantly non-severe COVID-19 patients.
Recent evidence suggests that a subpopulation of cancer cells, cancer stem cells (CSCs), is responsible for tumor growth in colorectal cancer. However, the role of CSCs in colorectal cancer ...metastasis is unclear. Here, we identified a subpopulation of CD26
+ cells uniformly present in both the primary and metastatic tumors in colorectal cancer patients with liver metastasis. Furthermore, in patients without distant metastasis at the time of presentation, the presence of CD26
+ cells in their primary tumors predicted distant metastasis on follow-up. Isolated CD26
+ cells, but not CD26
− cells, led to development of distant metastasis when injected into the mouse cecal wall. CD26
+ cells were also associated with enhanced invasiveness and chemoresistance. Our findings have uncovered a critical role of CSCs in metastatic progression of cancer. Furthermore, the ability to predict metastasis based on analysis of CSC subsets in the primary tumor may have important clinical implication as a selection criterion for adjuvant therapy.
► Metastatic colorectal cancers contain a subset of CD26
+ cancer stem cells ► Nonmetastatic tumors with CD26
+ CSCs frequently proceed to metastasis ► Isolated CD26
+ CSCs can initiate distant metastasis in a mouse model ► CD26
+ CSCs show enhanced invasiveness and migratory potential
Retinal ischemia/reperfusion injury is a common feature of various retinal diseases such as glaucoma and diabetic retinopathy. Lutein, a potent anti-oxidant, is used to improve visual function in ...patients with age-related macular degeneration (AMD). Lutein attenuates apoptosis, oxidative stress and inflammation in animal models of acute retinal ischemia/hypoxia. Here, we further show that lutein improved Műller cell viability and enhanced cell survival upon hypoxia-induced cell death through regulation of intrinsic apoptotic pathway. Moreover, autophagy was activated upon treatment of cobalt (II) chloride, indicating that hypoxic injury not only triggered apoptosis but also autophagy in our in vitro model. Most importantly, we report for the first time that lutein treatment suppressed autophagosome formation after hypoxic insult and lutein administration could inhibit autophagic event after activation of autophagy by a pharmacological approach (rapamycin). Taken together, lutein may have a beneficial role in enhancing glial cell survival after hypoxic injury through regulating both apoptosis and autophagy.
Background:
Little is known of the clinical outcome of patients with older-onset inflammatory bowel disease IBD. We performed a systematic review to determine phenotype and outcomes of older-onset ...IBD compared with younger-onset subjects.
Methods:
A systematic search of Embase and Medline up to June 2015 identified studies investigating phenotype and outcomes of older-onset diagnosed at age ≥ 50 years Crohn’s disease CD and ulcerative colitis UC subjects. Pooled analyses of disease phenotype, medication use, and disease-related surgery were calculated.
Results:
We analysed findings from 43 studies comprising 8274 older-onset and 34641 younger-onset IBD subjects. Compared with younger-onset patients, older-onset CD patients were more likely to have colonic disease (odds ratio OR 2.56, 95% confidence interval CI 1.88 – 3.48) and inflammatory behaviour OR 1.19, 95% CI 1.07 – 1.33, and less likely to have penetrating disease or perianal involvement. More older-onset UC patients had left-sided colitis OR 1.49, 95% CI 1.18 – 1.88. Although fewer older-onset IBD patients received immunomodulators CD: OR 0.44; UC: OR 0.60 or biologicals CD: OR 0.34; UC: OR 0.41, older-onset CD was similar in the need for surgery OR 0.70, 95% CI 0.40 – 1.22 whereas more older-onset UC patients underwent surgery OR 1.36, 95% CI 1.18 – 1.57.
Conclusions:
Elderly IBD patients present with less complicated disease, but have similar or higher rates of surgery than non-elderly patients. Whether this reflects a non-benign disease course, physicians’ reluctance to employ immunomodulators, or both, merits further study which is essential for improving the care of IBD in the elderly.
Time-domain science has undergone a revolution over the past decade, with tens of thousands of new supernovae (SNe) discovered each year. However, several observational domains, including SNe within ...days or hours of explosion and faint, red transients, are just beginning to be explored. Here we present the Young Supernova Experiment (YSE), a novel optical time-domain survey on the Pan-STARRS telescopes. Our survey is designed to obtain well-sampled griz light curves for thousands of transient events up to z 0.2. This large sample of transients with four-band light curves will lay the foundation for the Vera C. Rubin Observatory and the Nancy Grace Roman Space Telescope, providing a critical training set in similar filters and a well-calibrated low-redshift anchor of cosmologically useful SNe Ia to benefit dark energy science. As the name suggests, YSE complements and extends other ongoing time-domain surveys by discovering fast-rising SNe within a few hours to days of explosion. YSE is the only current four-band time-domain survey and is able to discover transients as faint as ∼21.5 mag in gri and ∼20.5 mag in z, depths that allow us to probe the earliest epochs of stellar explosions. YSE is currently observing approximately 750 deg2 of sky every 3 days, and we plan to increase the area to 1500 deg2 in the near future. When operating at full capacity, survey simulations show that YSE will find ∼5000 new SNe per year and at least two SNe within 3 days of explosion per month. To date, YSE has discovered or observed 8.3% of the transient candidates reported to the International Astronomical Union in 2020. We present an overview of YSE, including science goals, survey characteristics, and a summary of our transient discoveries to date.
Women with atrial fibrillation are at a higher risk of stroke, despite treatment with warfarin. It is unclear if women treated with direct oral anticoagulants (DOACs) have better clinical outcomes, ...especially when considering the quality of anticoagulation control of warfarin.
This study compared the effectiveness and safety outcomes of DOACs versus warfarin in men and women with stratifications for anticoagulation control.
Patients newly diagnosed with atrial fibrillation and prescribed oral anticoagulants during 2010 to 2015 were identified using the Hong Kong clinical database. Propensity score matching was performed in men and women separately. Further analysis was conducted to stratify warfarin users according to their anticoagulation control. Cox regression was used to compare the risk of ischemic stroke or systemic embolism, intracranial hemorrhage (ICH), gastrointestinal bleeding, and all-cause mortality in the specific sex.
There were 4,972 men and 4,834 women successfully matched in our cohort. Compared with warfarin, DOAC use was associated with a lower risk of ICH (hazard ratio HR: 0.16; 95% confidence interval CI: 0.06 to 0.40) and all-cause mortality (HR: 0.55; 95% CI: 0.39 to 0.77) in women but not in men. The treatment by sex interaction was significant for ICH only, and a significantly lower risk of ICH remained in the DOAC group when compared with warfarin users with good anticoagulation control (HR: 0.13; 95% CI: 0.02 to 1.00) among women only. The risks of ischemic stroke or systemic embolism and gastrointestinal bleeding with DOACs versus warfarin were comparable in both sexes.
DOACs were associated with a lower risk of ICH and all-cause mortality in women only, where the association of lower ICH risk remained when compared with warfarin users with good anticoagulation control.
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What is the effect of physical exercise on cognitive decline and behavioural problems in people with mild cognitive impairment (MCI) or dementia? What is the effect of physical exercise on particular ...domains of cognitive function? How do training protocols and patients' characteristics influence the outcomes?
Systematic review and meta-analysis of randomised trials.
People with MCI or dementia as their primary diagnosis.
Physical exercise.
Cognitive function including global cognition, memory, executive function, reasoning, attention, language, and behavioural problems.
Forty-six trials involving 5099 participants were included in this review. Meta-analysis of the data estimated that aerobic exercise reduced the decline in global cognition, with a standardised mean difference (SMD) of 0.44, 95% CI 0.27 to 0.61, I2 = 69%. For individual cognitive functions, meta-analysis estimated that exercise lessened working memory decline (SMD 0.28, 95% CI 0.04 to 0.52, I2 = 40%). The estimated mean effect on reducing the decline in language function was favourable (SMD 0.17), but this estimate had substantial uncertainty (95% CI –0.03 to 0.36, I2 = 67%). The effects of exercise on other cognitive functions were unclear. Exercise also reduced behavioural problems (SMD 0.36, 95% CI 0.07 to 0.64, I2 = 81%).
Physical exercise can reduce global cognitive decline and lessen behavioural problems in people with MCI or dementia. Its benefits on cognitive function can be primarily attributed to its effects on working memory. Aerobic exercise at moderate intensity or above and a total training duration of > 24 hours can lead to a more pronounced effect on global cognition.
ABSTRACT
During the past decade, the dynamical importance of magnetic fields in molecular clouds has been increasingly recognized, as observational evidence has accumulated. However, how a magnetic ...field affects star formation is still unclear. Typical star formation models still treat a magnetic fields as an isotropic pressure, ignoring the fundamental property of dynamically important magnetic fields: their direction. This study builds on our previous work, which demonstrated how the mean magnetic field orientation relative to the global cloud elongation can affect cloud fragmentation. After the linear mass distribution reported earlier, we show here that the mass cumulative function (MCF) of a cloud is also regulated by the field orientation. A cloud elongated closer to the field direction tends to have a shallower MCF: in other words, a higher portion of the gas is at high density. The evidence is consistent with our understanding of the bimodal star formation efficiency discovered earlier, which is also correlated with the field orientation.
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