Background: Severe asthma exacerbation is an important comorbidity of the 2009 HIN1 pandemic [A(H1N1)pdm09] in asthmatic patients. However, the mechanisms underlying severe asthma exacerbation remain unknown. Using a mouse model of asthma, we evaluated airway hyperresponsiveness (AHR) in mice with A(H1N1)pdm09 infection and those with seasonal influenza for comparison. We also measured AHR in paediatric participants infected with A(H1N1)pdm09. Methods: BALB/c mice aged 6-8 weeks were sensitized and challenged with ovalbumin. Either mouse-adapted A(H1N1)pdm09, seasonal H1N1 virus (1×105 pfu/20 μL), or mock treatment as a control was administered intranasally. At 3, 7, and 10 days after infection, each group of mice was evaluated for AHR by methacholine challenge using an animal ventilator, flexiVent®. Lung samples were resected and observed using light microscopy to assess the degree of airway inflammation. AHRs in paediatric participants were defined as the provocative acetylcholine concentration causing a 20% reduction in FEV1.0 (PC20). Results: Airway resistance was significantly enhanced in A(H1N1)pdm09-infected asthmatic mice compared to that in seasonal H1N1-infected mice (p<0.001), peaking at 7 days post-infection and then becoming similar to control levels by 10 days post-infection. Histopathological examination of lung tissues showed more intense infiltration of inflammatory cells and severe tissue destruction in A(H1N1)pdm09-infected mice at 7 days post-infection than at 10 days post-infection. AHRs in the paediatric participants were temporarily increased, and alleviated by 3 months after discharge. Conclusions: Our results suggest that enhanced AHR could contribute to severe exacerbation in human asthmatic patients with A(H1N1)pdm09 infection.
Right ventricular (RV) pseudoaneurysm is very rare and is seen after penetrating chest trauma, cardiac surgery, infective endocarditis, myocardial infarction, syphilis, endomyocardial biopsy, lead extraction. Idiopathic right ventricular pseudoaneurysm is even rarer. They have varied presentations depending on the etiology. Diagnosis is usually made by echocardiography. Cardiac magnetic resonance imaging (CMR) helps in delineating the aneurysm and relationship with surrounding structures and helps in guiding the surgery. We hereby report a case of idiopathic right ventricular pseudoaneurysm presented with ventricular tachycardia (VT). Aneurysm was successfully treated by surgical excision. Patient was doing well on follow up with no further VT episodes.
Animals often exhibit distinct microbial communities when maintained in captivity as compared to when in the wild. Such differentiation may be significant in headstart and reintroduction programs where individuals spend some time in captivity before release into native habitats. Using 16S rRNA gene sequencing, we (i) assessed differences in gut microbial communities between captive and wild Fijian crested iguanas (Brachylophus vitiensis) and (ii) resampled gut microbiota in captive iguanas released onto a native island to monitor microbiome restructuring in the wild. We used both cloacal swabs and fecal samples to further increase our understanding of gut microbial ecology in this Critically Endangered species. We found significant differentiation in gut microbial community composition and structure between captive and wild iguanas in both sampling schemes. Approximately two months post-release, microbial communities in cloacal samples from formerly captive iguanas closely resembled wild counterparts. Interestingly, microbial communities in fecal samples from these individuals remained significantly distinct from wild conspecifics. Our results indicate that captive upbringings can lead to differences in microbial assemblages in headstart iguanas as compared to wild individuals even after host reintroduction into native conditions. This investigation highlights the necessity of continuous monitoring of reintroduced animals in the wild to ensure successful acclimatization and release.
Incurable breast cancer bone metastasis causes widespread bone loss, resulting in fragility, pain, increased fracture risk, and ultimately increased patient mortality. Increased mechanical signals in the skeleton are anabolic and protect against bone loss, and they may also do so during osteolytic bone metastasis. Skeletal mechanical signals include interdependent tissue deformations and interstitial fluid flow, but how metastatic tumor cells respond to each of these individual signals remains under-investigated, a barrier to translation to the clinic. To delineate their respective roles, we report computed estimates of the internal mechanical field of a bone-mimetic scaffold undergoing combinations of high and low compression and perfusion using multiphysics simulations. Simulations were conducted in advance of multi-modal loading bioreactor experiments with bone metastatic breast cancer cells to ensure that mechanical stimuli occurring internally were physiological and anabolic. Our results show that mechanical stimuli throughout the scaffold were within the anabolic range of bone cells in all loading configurations, were homogenously distributed throughout, and that combined high magnitude compression and perfusion synergized to produce the largest wall shear stresses within the scaffold. These simulations, when combined with experiments, will shed light on how increased mechanical loading in the skeleton may confer anti-tumorigenic effects during metastasis.
Background: Specific details about cardiovascular complications, especially arrhythmias, related to COVID-19 are not well described. Objective: We sought to evaluate the incidence and predictive factors of cardiovascular complications and new-onset arrhythmias in Black and White hospitalized COVID-19 patients and determine the impact of new-onset arrhythmia on outcomes. Methods: We collected and analyzed baseline demographic and clinical data from COVID-19 patients hospitalized at the Tulane Medical Center in New Orleans, Louisiana, between March 1st and May 1st, 2020. Results: Among 310 hospitalized COVID-19 patients, the mean age was 61.4 ± 16.5 years, with 58,7% females, and 67% Black patients. Black patients were more likely to be younger, have diabetes and obesity . The incidence of cardiac complications was 20%, with 9% of patients having new-onset arrhythmia. There was no significant difference in cardiovascular outcomes between Black and White patients. D-dimer levels positively correlated with cardiac and new-onset arrhythmic event . New onset atrial arrhythmias predicted in-hospital mortality (OR=2.99 95% CI [1.35;6.63], p=0.007), a longer intensive care unit length of stay (mean of 6.14 days, 95% CI [2.51;9.77], p=0.001) and mechanical ventilation duration(mean of 9.08 days, 95% CI [3.75;14.40], p=0.001). Conclusion: Our results indicate that new onset atrial arrhythmias are commonly encountered in COVID-19 patients and can predict in-hospital mortality. Early elevation in D-dimer in COVID-19 patients is a significant predictor of new onset arrhythmias. Our finding suggest continuous rhythm monitoring should be adopted in this patient population during hospitalization to better risk stratify hospitalized patients and prompt earlier intervention.
Introduction: The “crosstalk” (CST) ablation technique has been reported to reduce unnecessary ablation during cryoballoon (CB) ablation (CBA). Nevertheless, it is unclear which situations will necessitate the adoption of the technique. Methods and Results: The effect of the technique was analyzed in AF patients underwent CBA from July 2017 to February 2020. The balloon occlusion status and nadir temperature (NT) were compared, and all ablated PVs were categorized into three groups according to the necessity and effectiveness of the technique. Of 1082 superior PVs (SPVs), 16, 40, and 1026 were identified in the CST success group, CST failure group, and control group, respectively. The proportion of SPVs ablated with complete occlusion with CB was significantly higher in the CST success group (100%) than in the CST failure group (16.7%) or control group (49.4%) (CST success group vs. CST failure group, p<0.001; CST success group vs. control group, p<0.002). The proportion of SPVs ablated with NT ≤-46°C was higher in the CST success group (100%) than in the CST failure group (56.7%) (p<0.05). The CST ablation technique was always effective if CBA of the SPVs was performed with both complete occlusion and NT ≤-46°C and was almost always ineffective if it did not meet these two criteria (sensitivity, 100%; specificity, 93%). Conclusion: Successful CST ablation was highly predicted if complete PV occlusion and NT ≤-46°C during CBA of the SPVs were achieved, which could be useful when adopting the technique targeting inferior PVs to reduce unnecessary freezing during SPV isolation.
This study presents a novel model to predict gas-water two-phase transport behaviors in shale microfractures by incorporating a mobile water film with varying thickness according to the extended Derjaguin-Landau-Verwey-Overbeek (DLVO) theory as well as multiple fluid transport mechanisms (i.e., real gas transport controlled by the Knudsen number and water slippage). This model is implemented in real shale microfractures via digital-core imaging. A gas-water displacement process is modelled by the invasion percolation theory, while a local multiphase distribution is determined by combining disjoining pressure with capillary force. Key findings reveal that gas relative permeability (RP) decreases by 17% and water RP enhances by 33.5%, when the mean aperture decreases from 1.67 to 0.0418μm. Neglecting water film brings a decrease in water RP and an overestimation of gas transport ability. Moreover, two critical microfracture apertures are determined, which enhances an understanding of the water film impact on gas-water transport properties in application.
Tuberculosis (TB) is a re-emerging disease occurring worldwide and causing multi-billion-dollar loss and human death annually. The situation is worse in developing countries like Ethiopia, where lower knowledge, attitude, and practice (KAP) of the people is imminent. A questionnaire-based cross-sectional study was conducted to assess KAP of livestock ouners towards human and bovine Tuberculosis. A total of 349 study participants were addressed through face to face interview. Descriptive statistics and Pearson’s chi-squares analysis were used to observe the data and the association between outcome (KAP) and predictor variables. Out of the 349 respondents interviewed, 223 (63.9%) of them were males, while 126 (36.1%) were females. The KAP measuring interview indicated that almost all (97.4%) of the participants know human tuberculosis, while 84(24.1%) are aware of bovine tuberculosis cause and mode of transmission. Inhalation was reported as a common route of transmission for human TB (41.1%). In contrast, 50% of the respondent mentioned inhalation, contact, and ingestion of raw animal products as the main route of TB transmission from animal to human. Among those who have heard of bTB, only 56 (66.7%) of respondents consider bovine tuberculosis as a significant threat to public health. The study showed that there is a lower KAP on bovine TB among cattle owners. Therefore, community awareness promotion and health education on human and bovine TB should be operated under a “One Health” umbrella
In last decades, many alleviation measures were proposed in order to improve the life of fretting fatigue affected components. The aim of such palliatives is that to counteract the high stress gradients that arise near the contact surface. In such a context, the shot peening treatment is worth noting. Therefore, in the present paper, the fatigue life of shot-peened aluminium and titanium alloy specimens, subject to fretting fatigue under partial slip regime, is assessed by means of the Carpinteri et al. criterion for fretting fatigue. Firstly, according to the superposition principle, the relaxed residual stresses (due to the shot peening treatment) are combined with the stress components due to fretting fatigue loading. Then fretting fatigue assessment is performed. In such a context, a novel theoretical law for the relaxed residual stress field is here proposed, the implementation of which shows very promising results in terms of fatigue life estimation of the shot-peened specimens examined.
A Time-Reversal ( TR) imaging method for multiple targets that incorporates fewer transmitters is suggested using temporal filtering and Frequency Focusing (FF) matrices. This study is intended for the detection of malignant breast tumors with minimal microwave radiation. A couple of scenarios with two and four tumors are considered here. Using only two transmitters and twelve receivers, we show that two tumors could be detected in an inhomogeneous tissue breast. The results are compared with conventional TR Multiple Signal Classification method (MUSIC), which requires more transmitters. It is shown that several well-resolved tumors that exceed transmitters could be detected by subregion Spatio-Temporal Filtering (SSTF). In our proposed method, we used the orthogonal subspace instead of the signal subspace to have a higher Signal to Clutter Ratios (SCR). Since the Born approximation is not used, multiple scattering is considered. In addition, white Gaussian noise is added to measurement simulations. A 3-GHz modulated Gaussian pulse with a 1-GHz bandwidth is employed for illuminating the medium. Finite-Element Time-Domain method (FETD) is used in the measurement simulations, and the analytic Green’s function of the background is utilized for backpropagation. Several simulations are provided that show the effectiveness of this approach.
The ability for marine ecosystems to maintain productivity and functionality under long term changes in resource availability relies on the diversity of functional groups. Nevertheless, the complexity of zooplankton interactions is rarely considered in trophic studies because of the lack of detailed information about feeding interactions in nature. In this study, we used DNA metabarcoding to detect trophic interactions of a wide range of micro- and mesozooplankton including ciliates, rotifers, cladocerans, copepods and their prey, by sequencing 16- and 18S rRNA genes. Our study demonstrates that functional group diversity goes beyond both phylogeny and size and reinforces the importance of diversity in resource use for stabilizing food web efficiency by allowing for alternative pathways of energy transfer. We further demonstrate the importance of ciliates and rotifers in recycling organic matter from degraded filamentous cyanobacteria within the pelagic zone, contributing to ecosystem production. The approach used in this study is a suitable entry point to ecosystem-wide food web modeling considering species-specific resource use of key consumers.
Ethiopia is one of the well-endowed countries in Sub-Saharan Africa in terms of natural resources. However, land degradation is a major problem in the country. The objective of this study was to assess farmers’ perception on soil and water conservation (SWC) practices and its implication on land degradation. Data were collected using questionnaires, interviews, and focus group discussions from 117 randomly selected households. The result indicated that the perception of farmers on SWC practices was significantly influenced by age, sex, marital status, household size, educational qualification, farm-size (ha), farmers’ experience, distance from the homestead, and household income. Besides, greater than 50% of the respondents were aware of the causes of land degradation by indicating population growth, over-cultivation, overgrazing; soil erosion, poor farming practices, and poverty as the major causes. Furthermore, most of the respondents (>75%) were aware of the consequences of land degradation by pointing out the loss of agricultural productivity, the difficulty of farming, and loss in livestock productivity as the major ones. Moreover, about 72.5% of the respondents indicated that land degradation on their farm-field was severe. The SWC measures practiced in the study area include cutoff drains, contour farming, waterways, check dams, fallowing, application of manures, and soil bunds. Thus, it can be concluded that the perception of SWC practices is affected by many factors. Besides, land degradation in the study area can be deceased first by creating awareness in the society on the consequences of land degradation and then implementing SWC measures.
A study of cannabinoid content in commercially available cold-pressed hemp seed oil (CPHSO) manufactured in North America and assayed using a validated low-LOQ analytical method with UHPLC-MS/MS quantitation was conducted. Thirty CPHSO samples from small, medium, and large-scale manufacturers were voluntarily submitted. Samples were produced from eleven known cultivars grown in three Canadian provinces and six US States, plus one sample from seeds imported from Poland and pressed in the USA. Oil density was measured for each sample, as were the content of sixteen cannabinoids with validated commercial reference standards, and reported in parts-per-million (ppm). Observational and statistical methods were used to examine variances in analyte concentrations, demonstrating significant differences in cannabinoid concentrations between samples. Several per-sample and per-analyte heatmaps aided in the visual examination of variances. A two-phase series of linear regressions were performed on normally distributed cannabinoids with raw and trimmed data sets to determine if content variations correlated to manufacturer cleaning, handling, and storage procedures, or if the variation was influenced more by cultivar. The research findings suggest that variance in cannabinoid content is likely most influenced by cultivar, but do not rule out contributions by supplier handling and processing techniques.
Abstract. Pseudomonas aeruginosa and Staphylococcus aureus are bacterial pathogens frequently associated with pulmonary complications and disease progression in cystic fibrosis (CF) patients. However, these bacteria increasingly show multiple resistance to antibiotics, necessitating novel management strategies. One possibility is phage therapy, where lytic bacteriophages (phages; bacteria-specific viruses) are administered to kill target bacterial pathogens. Recent publication of case reports of phage-therapy treatment of antibiotic-resistant lung infections in CF has garnered significant attention. These cases exemplify the renewed interest in phage therapy, as an older concept that is newly updated to include rigorous collection and analysis of patient data to assess clinical benefit, while informing the development of clinical trials. As outcomes of these trials become public, the results will valuably gauge the potential usefulness of phage therapy to address the rise in antibiotic-resistant bacterial infections. In addition, we highlight the further need for basic research on accurately predicting the different responses of target bacterial pathogens when phages are administered alone, sequentially or as mixtures (cocktails), and whether within-cocktail interactions among phages hold consequences for the efficacy of phage therapy in patient treatment.
Abstract INTRODUCTION: Effective Airway Clearance Techniques (ACT) is the key step in the management of Bronchiectasis. The aim of this study was to evaluate the efficacy of 3% Hypertonic Saline (HS) pre-medication in ACT in children with non Cystic Fibrosis (non-CF) bronchiectasis. METHODS: Five to 15 year old children with non-CF bronchiectasis were randomized either to receive 200µg of inhaled salbutamol followed by hypertonic saline nebulization (test) or only 200µg of inhaled salbutamol, prior to chest physiotherapy which is the conventional ACT (controls) for 8 weeks. After completion of first phase both groups went through one month washout period, before being crossed over to the opposite arms in the second phase. Spirometric parameters were recorded at the end of each phase. RESULTS: Fifty two children completed the study. Baseline characteristics of the two groups were similar. A significantly higher mean improvement was seen in predicted Forced Expiratory Volume in one second(FEV1) in the HS arm during phase 1 [HS=14.15±5.50 vs. conventional =5.04±5.55, p=0.001] and phase II [HS =10.81±5.51 vs. conventional =3.54 ±5.13, p=0.001]. HS arm showed a significantly higher mean improvement in predicted Forced Vital Capacity(FVC) in phase I[HS=13.77±5.73 vs. conventional= 7.54±4.90, p=0.001] and phase II, [HS=9.42±7.00 vs. conventional =4.42±4.00, p=0.003). Mean number of exacerbations experienced by a single child during phase I (2 months) were significantly less (p=0,001) in HS group compared to that of conventional group. CONCLUSIONS: Incorporating HS nebulization into ACT is an effective strategy to improve dynamic lung volumes and morbidity in children with non-CF bronchiectasis.
Objective: To examine the effect of prenatal maternal anxiety on birthweight and preterm birth, controlling for genetic confounding using a sibling comparison design. Design: This is a population-based prospective cohort study with a comparison of a population level analysis and a sibling analysis. Setting: This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health (https://www.fhi.no/en/studies/moba/ ). Sample: Women and their chiold participating in the MoBa (n= 78,117) and women participating with more than one pregnancy (n=12,480). Methods: Associations between prenatal maternal anxiety (measured across the 17th and 30th weeks) and birth outcomes (birthweight and gestational age) were examined using linear regression with adjustment for family-shared confounding in a sibling comparison design. Main outcomes: Birthweight (in grams) and gestational age (ultrasound measure in days) were obtained from the Medical Birth Registry of Norway. Results: The maternal anxiety score during pregnancy was inversely associated with newborn’s birthweight (Beta = -112,8 95% CI: –142.7, -83.0) and gestational age (Beta=-1.77, 95% CI: -2.42, -1.13) after adjustment for several covariates. The association of the maternal anxiety score with both newborn’s birthweight (Beta=-173.9, 95% CI: -252.3, -95.4) and gestational age (Beta=-1.08, 95% CI: -2.91, -0.75) remained but was largely weakened after further adjusting for the shared-family confounding in the sibling comparison design. Conclusion: The link between maternal prenatal anxiety and birthweight and gestational age remained after adjusting for shared family confounding, yet estimates were weakened after adjusting for environmental covariates.
Fever clinics are designed to provide prompt assessment, management, laboratory examination and decision-making for the potential infected cases, which serves as the crucial first-line of defense to control nosocomial infection. Guided by the primary principle of ‘early assessment, early detection, and early isolation’, fever clinics played a significant role in triaging suspected cases and minimize the risk of nosocomial infection during the Coronavirus Disease 2019 (COVID-19) combat in China. However, fever clinics failed to function normally as expected, with an astonishing number of healthcare workers infected. In this comment, we systematically evaluated the current limitations of fever clinics and recommended several countermeasures, aiming to enhance and maximize the capability and capacity of fever clinics for acute infectious diseases.