Modified Nishida muscle transposition procedure combined with superior rectus muscle tenotomy for inferior rectus muscle aplasia.

The modified Nishida muscle transposition procedure, in which one-third of each vertical rectus muscle belly is sutured onto the sclera in the infero- and superotemporal quadrants without either tenotomy of the vertical rectus muscles or splitting of the vertical rectus muscle is an effective treatment for abducens nerve palsy. We report a case of inferior rectus muscle aplasia treated using the modified Nishida procedure to transpose both horizontal rectus muscles inferiorly combined with superior rectus tenotomy.

[Assessment of CO2 Co-benefits of Air Pollution Control Policies in Taiyuan's 14th Five-Year Plan].

To quantitatively evaluate the co-benefits of air pollution reduction and carbon dioxide reduction of Taiyuan's 14th Five-Year Plan air pollution prevention and control policies, this study used the Beijing-Tianjin-Hebei Greenhouse Gas-Air Pollution Interaction and Synergy Model (GAINS-JJJ) to simulate and evaluate the emission reduction potential and CO2 co-benefit of 13 air pollution control measures. The emission reductions of PM2.5, PM10, SO2, NOx, VOCs, and NH3 in 2025 were 1.8 (5%, compared with that in the baseline scenario), 2.5 (2%), 3.7 (16%), 20.0 (27%), 13.6 (15%), and 0.0 kt (0%), respectively. The reduction in CO2 emissions was 9.0 Mt (13%), whereas CH4 emissions increased by 203.3 kt (25% increase relative to that in the baseline scenario). SO2, NOx, and VOCs emission reductions derived from the power, industrial combustion, and solvent use sectors. CO2 reduction occurred mainly in the industrial combustion sector, and CH4 emission increased mainly due to the increase in coal mining activity. The highest synergistic CO2 reductions were achieved by restricting energy consumption in the high energy-consuming and high-emitting sectors; prohibiting new capacity in the steel, coke, cement, and flat glass industries; and replacing coal-fired power generation with renewable energy. Furthermore, the CO2 reduction co-benefit was highest for VOCs. In addition, this study suggests that promoting the policy of terminal electrification and simultaneously increasing the share of clean energy and the ability to consume renewable energy generation in the power sector are the keys to decreasing the emissions in Taiyuan.

Effect of rapid rehabilitation care on surgical site wound infection and pain in patients with intertrochanteric femoral fractures: A meta-analysis.

This study examines the effects of rapid rehabilitation on surgical site wound infections and pain in patients with intertrochanteric femoral fractures. A computerised search was conducted for randomised controlled trials (RCTs) on rapid rehabilitation care in patients undergoing surgery for intertrochanteric femoral fractures published in the China National Knowledge Infrastructure, China Biomedical Literature Database, Wanfang Database, VIP, PubMed, Embase, Cochrane Library and Web of Science. The search was conducted from the time of the database construction to August 2023. Two investigators independently performed literature screening, data extraction and quality assessment based on predefined inclusion and exclusion criteria. Meta-analysis was performed via RevMan 5.4 software. Encompassing 21 studies involving 2004 patients, with 1007 patients receiving rapid rehabilitation care and 997 receiving routine care, our analysis revealed that rapid rehabilitation care significantly reduced postoperative complications (odds ratio [OR] = 0.24, 95% confidence interval [CI]: 0.17-0.33, p < 0.001), wound infections (OR = 0.30, 95% CI: 0.14-0.65, p = 0.002) and hospital stay (mean difference [MD] = -5.23, 95% CI: -6.03 to -4.43, p < 0.001). Moreover, compared with routine care, it notably improved wound pain (MD = -1.51, 95% CI: -1.98 to -1.05, p < 0.001) in patients undergoing surgery for intertrochanteric femoral fractures. Our findings underscore the effectiveness of rapid rehabilitation care in reducing wound pain, postoperative complications and wound infections among patients with intertrochanteric femoral fractures.

Serum Soluble Vascular Endothelial Growth Factor Receptor 1 as a Potential Biomarker of Hepatopulmonary Syndrome.

Background and Aims: The results of basic research implicate the vascular endothelial growth factor (VEGF) family as a potential target of hepatopulmonary syndrome (HPS). However, the negative results of anti-angiogenetic therapy in clinical studies have highlighted the need for markers for HPS. Therefore, we aimed to determine whether VEGF family members and their receptors can be potential biomarkers for HPS through clinical and experimental studies. Methods: Clinically, patients with chronic liver disease from two medical centers were enrolled and examined for HPS. Patients were divided into HPS, intrapulmonary vascular dilation [positive contrast-enhanced echocardiography (CEE) and normal oxygenation] and CEE-negative groups. Baseline information and perioperative clinical data were compared between HPS and non-HPS patients. Serum levels of VEGF family members and their receptors were measured. In parallel, HPS rats were established by common bile duct ligation. Liver, lung and serum samples were collected for the evaluation of pathophysiologic changes, as well as the expression levels of the above factors. Results: In HPS rats, all VEGF family members and their receptors underwent significant changes; however, only soluble VEGFR1 (sFlt-1) and the sFlt-1/ placental growth factor (PLGF) ratio were changed in almost the same manner as those in HPS patients. Furthermore, through feature selection and internal and external validation, sFlt-1 and the sFlt-1/PLGF ratio were identified as the most important variables to distinguish HPS from non-HPS patients. Conclusions: Our results from animal and human studies indicate that sFlt-1 and the sFlt-1/PLGF ratio in serum are potential markers for HPS.

LncRNA modulates Hippo-YAP signaling to reprogram iron metabolism.

Iron metabolism dysregulation is tightly associated with cancer development. But the underlying mechanisms remain poorly understood. Increasing evidence has shown that long noncoding RNAs (lncRNAs) participate in various metabolic processes via integrating signaling pathway. In this study, we revealed one iron-triggered lncRNA, one target of YAP, LncRIM (LncRNA Related to Iron Metabolism, also named ZBED5-AS1 and Loc729013), which effectively links the Hippo pathway to iron metabolism and is largely independent on IRP2. Mechanically, LncRIM directly binds NF2 to inhibit NF2-LATS1 interaction, which causes YAP activation and increases intracellular iron level via DMT1 and TFR1. Additionally, LncRIM-NF2 axis mediates cellular iron metabolism dependent on the Hippo pathway. Clinically, high expression of LncRIM correlates with poor patient survival, suggesting its potential use as a biomarker and therapeutic target. Taken together, our study demonstrated a novel mechanism in which LncRIM-NF2 axis facilitates iron-mediated feedback loop to hyperactivate YAP and promote breast cancer development.

Relationships of body composition and adipocytokines with outcomes in metastatic castration-resistant prostate cancer patients receiving docetaxel chemotherapy.

We evaluated the relationships of body composition and serum adipocytokine levels with progression-free survival (PFS) and overall survival (OS) in metastatic castration-resistant prostate cancer (mCRPC) patients receiving docetaxel. The medical records of mCRPC patients who received docetaxel between January 2011 and December 2015 at Fudan University Shanghai Cancer Center (Shanghai, China) were reviewed. The following body composition parameters were calculated using computed tomography: skeletal muscle index (SMI), visceral adipose tissue index (VATI), and subcutaneous adipose tissue index (SATI). Pretreatment serum adipocytokine levels, including interleukin 6, insulin, leptin, monocyte chemoattractant protein-1, adiponectin, and resistin, were measured using the multiplex bead-based immunoassays. Cox regression and Kaplan-Meier methods were used for survival analyses. Of the 453 mCRPC patients initially identified, 105 were included in the analysis. High VATI group patients had longer PFS (median, 10 months vs 7 months, P = 0.008) and OS (median, 24 months vs 15 months, P = 0.017), compared with low VATI group patients. SMI and SATI were not significantly associated with PFS or OS. Of the six detected adipocytokines, only leptin was associated with mCRPC prognosis. High leptin group patients had shorter PFS (median, 7 months vs 12 months, P = 0.0018) and OS (median, 17 months vs 22 months, P = 0.042), compared with low leptin group patients. Multivariate analysis showed that a high VATI was an independent protective factor for PFS and OS, while a high leptin level was an independent risk factor for PFS and OS. Therefore, VATI and serum leptin levels could provide important information concerning mCRPC prognosis.

A phosphatidic acid-binding lncRNA SNHG9 facilitates LATS1 liquid-liquid phase separation to promote oncogenic YAP signaling.

Long noncoding RNAs (lncRNAs) are emerging as a new class of important regulators of signal transduction in tissue homeostasis and cancer development. Liquid-liquid phase separation (LLPS) occurs in a wide range of biological processes, while its role in signal transduction remains largely undeciphered. In this study, we uncovered a lipid-associated lncRNA, small nucleolar RNA host gene 9 (SNHG9) as a tumor-promoting lncRNA driving liquid droplet formation of Large Tumor Suppressor Kinase 1 (LATS1) and inhibiting the Hippo pathway. Mechanistically, SNHG9 and its associated phosphatidic acids (PA) interact with the C-terminal domain of LATS1, promoting LATS1 phase separation and inhibiting LATS1-mediated YAP phosphorylation. Loss of SNHG9 suppresses xenograft breast tumor growth. Clinically, expression of SNHG9 positively correlates with YAP activity and breast cancer progression. Taken together, our results uncover a novel regulatory role of a tumor-promoting lncRNA (i.e., SNHG9) in signal transduction and cancer development by facilitating the LLPS of a signaling kinase (i.e., LATS1).

Organic Liquid Fertilizer Coupled With Single Application of Chemical Fertilization Improves Growth, Biomass, and Yield Components of Cotton Under Mulch Drip Irrigation.

Excessive fertilization, low nutrient utilization rate, and continuous deterioration of cotton field environment have adversely affected the sustainable development of cotton in Xinjiang province of China. To overcome these issues, we hypothesized that an appropriate combination of liquid organic fertilizer and chemical fertilizer (CF) would effectively reduce the input of CF without sacrificing the quality and yield of cotton. A 2-year field experiment explores the effects of three fertilization treatments on the growth, biomass accumulation, and yield of cotton. The three fertilization treatments, namely, no application of fertilizer (CK), the single application of CF, and the combined application of organic liquid fertilizer and CF (F0.6-F1.4), were set up in five ratios. Compared with CF treatment, the combined application of organic liquid fertilizer and CF treatments (F0.6-F1.2) speeded the growth period of cotton by 2-7 days with increased plant height, stem diameter, functional leaf width, and more number of branches, with 9.7-23.5 and 8.4-28.5% higher total plant biomass (TPB) and reproductive organs biomass (ROB), respectively. Compared with CF treatment, the rapid growth duration and maximum accumulation rate of reproductive organs were the highest in F0.8 treatment, with an average increase of 4.6 days and 20.3%. Increment in biomass accumulation contributed to an average increase of 21.8 and 18.9% in cotton boll number and yield, respectively, under F0.8 treatment. Principal component analysis shows that the total biomass, ROB, and total bolls per unit area were positively correlated with the yield, while stem diameter and vegetative organ biomass are negatively correlated with the yield. In conclusion, under film mulching with drip irrigation, organic liquid fertilizer combined with CF reduced by 20% (F0.8 treatment: N, P2O5, and K2O were 182, 104, and 76 kg hm-2, respectively) can sustain the normal growth, promote the accumulation rate of ROB, and lead to efficient cotton production.

Salivary gland function in women with Hashimoto's thyroiditis without xerostomia and the correlation with auto-thyroid antibodies.

BACKGROUND: Hashimoto's thyroiditis (HT) may cause salivary dysfunction in patients resulting in xerostomia, but little is known about changes in salivary function in patients with no obvious dry mouth symptoms. In this study we assessed salivary function in women with HT, who had not experienced xerostomia and, for the first time, evaluated the effects of thyroid auto-antibodies on this function.: METHODS: Sixty consecutive subjects were included, comprising 32 women (mean age, 36 ±â€Š12 years) diagnosed with HT accompanied by differentiated thyroid cancer (DTC) in the study group (HT group), along with a control group (DTC group) of 28 women (mean age, 40 ±â€Š12 years) diagnosed with DTC only. Salivary gland scintigraphy was used to assess salivary function with the semi-quantitative parameters of maximum absorption ratio and maximum secretion ratio, the decrease of which indicate impaired salivary function. Moreover, the HT and DTC groups were divided into four subgroups (Anti- HT, Anti+ HT, Anti- DTC, and Anti+ DTC), based on the presence of anti-thyroid peroxidase antibody (TPOAb) and anti-thyroglobulin antibody (TgAb). Finally, salivary gland semi-quantitative parameters were correlated with levels of thyroid-stimulating hormone (TSH), TGAb, and TPOAb in the HT and DTC groups. RESULTS: None of the semi-quantitative parameters examined in parotid or submandibular glands differed significantly between the HT and DTC groups. However, the maximum secretion ratio for the parotid and submandibular glands were significantly different in the subgroup comparison (p < 0.05). Furthermore, the TgAb, TPOAb, and TSH values correlated significantly with salivary excretive function (p ≤ 0.05). CONCLUSION: Women with HT without xerostomia may not have salivary functional impairment during hypothyroidism. Serum thyroid autoantibody and TSH levels may mainly influence salivary excretive function but not uptake function.

Selective Formation of Polyaniline Confined in the Nanopores of a Metal-Organic Framework for Supercapacitors.

In this study, a strategy that can result in the polyaniline (PANI) solely confined within the nanopores of a metal-organic framework (MOF) without forming obvious bulk PANI between MOF crystals is developed. A water-stable zirconium-based MOF, UiO-66-NH2 , is selected as the MOF material. The polymerization of aniline is initiated in the acidic suspension of UiO-66-NH2 nanocrystals in the presence of excess poly(sodium 4-styrenesulfonate) (PSS). Since the pore size of UiO-66-NH2 is too small to enable the insertion of the bulky PSS, the quick formation of pore-confined solid PANI and the slower formation of well dispersed PANI:PSS occur within the MOF crystals and in the bulk solution, respectively. By taking advantage of the resulting homogeneous PANI:PSS polymer solution, the bulk PANI:PSS can be removed from the PANI/UiO-66-NH2 solid by successive washing the sample with fresh acidic solutions through centrifugation. As this is the first time reporting the PANI solely confined in the pores of a MOF, as a demonstration, the obtained PANI/UiO-66-NH2 composite material is applied as the electrode material for supercapacitors. The PANI/UiO-66-NH2 thin films exhibit a pseudocapacitive electrochemical characteristic, and their resulting electrochemical activity and charge-storage capacities are remarkably higher than those of the bulk PANI thin films.

[Clinical effect of a scrotal rapid recovery dressing device in the treatment of acute epididymitis].

OBJECTIVE: To study the protective effect of a scrotal rapid recovery dressing device, scrotal girdle, on the scrotum of the patient with acute epididymitis, so as to improve the prognosis and the patient's satisfaction. METHODS: A total of 120 patients with acute epididymitis were treated in our hospital from December 2018 to November 2019, 60 with the scrotal girdle plus local cold compress in addition to antibiotics administration (the scrotal girdle group) and the other 60 with antibiotics only (the control group), all for 6 days. Then, comparisons were made between the two groups of patients in the improvement of scrotal swelling, total effectiveness rate and the patients' satisfaction with therapeutic outcomes. RESULTS: After 6 days of treatment, the patients in the scrotal girdle group, compared with the controls, showed significantly lower scrotal swelling scores (1.01 ± 0.34 vs 1.38 ± 0.20, P < 0.05), a higher total effectiveness rate (83.33% vs 65%, P < 0.05) and higher satisfaction with the therapeutic outcomes (86.67% vs 56.67%, P < 0.05). CONCLUSIONS: For the treatment of acute epididymitis, the application of the scrotal girdle for protection can significantly relieve scrotal pain and discomfort, improve the therapeutic effect and patients' satisfaction, and enhance the patients' recovery and quality of life.

[Responses of root physiological characteristics of different drought-tolerant cotton varieties to drought]. / ä¸¤ä¸ªä¸åŒè€æ—±æ€§æ£‰èŠ±å“ç§æ ¹ç³»ç”Ÿç†ç‰¹æ€§å¯¹å¹²æ—±çš„å“åº”.

In order to explore the physiological responses of root system of different drought-resistant cotton varieties to drought and their relationships with biomass, we examined the effects of drought stress on root vigor, antioxidant enzyme activities and anatomic structure (duct diameter, number) and biomass of different drought-tolerant varieties, including the drought-inolerant variety 'Xinluzao 17' (L17) and the drought-tolerant variety 'Xinluzao 22' (L22). Both varieties were grown under soil column cultivation conditions, with conventional irrigation (CK), mild drought (W1) and moderate drought (W2) treatments. The results showed that drought stress caused significant reductions in soluble protein (SP) content, root vigor (RV), the number of cork layers, the number of rhizome ducts, the diameter of the ducts in both varieties. The higher root MDA content, CAT, POD and SOD activities in response to drought led to reduction of aboveground dry mass. Compared with that of L17, SP content, 0-40 cm and 80-120 cm soil layer RV, the number of cork layers, the number of rhizome ducts, the diameter of ducts, and the aboveground dry mass of L22 all signi-ficantly increased. Under the W2 treatment, the RV decrease of L22 was 26.2% lower than that of L17, and CAT, POD, SOD activities and the thickness of cortex were 43.6%, 6.9%, 25.4%, 19.9% higher than that of L17. There were positive correlations between dry mass and RV, SOD, POD, the number of cork layers, the diameter and number of rhizome ducts. Therefore, cotton variety with strong drought tolerance could maintain higher root activity, cork layer number, the diameter of rhizome ducts, and number under drought conditions, and thus promote the accumulation of aboveground biomass, which was the physiological mechanism for their stronger drought tolerance.

[Application value of a metamorphic mechanism-based special dressing system for patients after scrotal surgery].

OBJECTIVE: To investigate the application of a metamorphic mechanism-based special dressing system (MMDS) in improving the prognosis and comfort of the patient after scrotal surgery. METHODS: We included 48 cases of scrotal surgery using the traditional method for postoperative dressing from June 2017 to June 2018 (the control group) and another 48 cases employing MMDS postoperatively from July 2018 to June 2019 (the MMDS group). We observed the differences between the two groups of patients in the incidence of scrotal edema, pain score, hospitalization days, patients' satisfaction, and dressing time. RESULTS: The scrotal edema score showed no statistically significant difference between the MMDS and control groups at 24 hours after operation (P > 0.05) but remarkably lower in the former than in the latter group at 48 hours (1.42 ± 0.5 vs 2.27 ± 0.7, P < 0.05) and 72 hours postoperatively (1.35 ± 0.2 vs 2.25 ± 0.7, P < 0.05). The MMDS group, compared with the controls, also exhibited a lower pain score (2.2 ± 1.0 vs 3.4 ± 1.5, P < 0.05), shorter hospitalization time (ï¼»5.96 ± 1.2ï¼½ vs ï¼»9.13 ± 2.3ï¼½ d, P < 0.05) and higher satisfaction score (98.1 ± 1.6 vs 92.8 ± 2.8, P < 0.05), as well as shorter dressing time at 24, 48 and 72 hours after operation (P < 0.05). CONCLUSIONS: The metamorphic mechanism-based special dressing system is a safe, efficient, simple and feasible method for dressing after scrotal surgery, which can effectively promote recovery and improve the quality of life of the patients.

Polyoxometalate adsorbed in a metal-organic framework for electrocatalytic dopamine oxidation.

A redox-active vanadium-based polyoxometalate, V10O28, was post-synthetically immobilized into a water-stable zirconium-based metal-organic framework, NU-902. The adsorbed V10O28 in NU-902 renders charge hopping in the framework in aqueous electrolytes, and the obtained V10O28@NU-902 can be used as a heterogeneous electrocatalyst for electrochemical dopamine sensors.

[Responses of cotton canopy structure characteristics to drip irrigation quota in north Xinjiang, China]. / æ–°ç–†åŒ—éƒ¨æ£‰èŠ±å† å±‚ç»“æž„ç‰¹å¾å¯¹æ»´çŒå®šé¢çš„å“åº”.

We investigated the effects of different drip irrigation quotas on leaf area index (LAI), diffuse non-interceptance (DIFN), light interception rate (LIR), canopy apparent photosynthetic rate (CAP), and cotton yield of Xinluzao 45 in field of north Xinjiang. There were five drip irrigation treatments, i.e. W1: 600 m3·hm-2, W2: 540 m3·hm-2, W3: 480 m3·hm-2, W4: 420 m3·hm-2, W5: 360 m3·hm-2. The results showed that with the decrease in drip irrigation quota, LAI, LIR and CAP of cotton substantially decreased, with the difference between W1 and W2 being not statistically significant from the full squaring to boll opening stage. Moreover, DIFN was enhanced with the reduction in drip irrigation quota. Highest seed and lint yield (6549 kg·hm-2 and 2677 kg·hm-2, respectively) presented in W1. W2 got a 6.5% reduction of seed cotton yield compared with W1, but the irrigation water use efficiency was enhanced by 3.9%. LAI, LIR and CAP were positively correlated with seed cotton yield from full flowering stage to full boll stage. Therefore, drip irrigation quota at 540 m3·hm-2 could increase irrigation water use efficiency, maintain higher leaf area index, increase diffuse non-interceptance, and ensure light interception rate from full flowering stage to full boll stage, which could enhance canopy apparent photosynthetic rate and water use efficiency without sacrificing yield.

A new application of modified Nishida muscle transposition procedure for medial rectus muscle transection following endoscopic sinus surgery without tenotomy or splitting muscles.

The modified Nishida muscle transposition procedure, in which the one-third of the vertical rectus muscle bellies are sutured onto the sclera in the infero- and superotemporal quadrants without either tenotomy of the vertical rectus muscles or splitting of the vertical rectus muscle is an effective treatment for abducens nerve palsy. We report 2 cases of large-angle exotropia caused by medial rectus transection following the endoscopic sinus surgery treated using the modified Nishida procedure to transpose both vertical rectus muscles nasally, combined with lateral rectus muscle recession.

The significance of preoperative hematological inflammatory markers in patients with meningiomas.

OBJECTIVE: This study was designed to evaluate whether preoperative hematological inflammatory markers would be useful in predicting the pathological grade of meningiomas. PATIENTS AND METHODS: A retrospective study of 944 patients with newly diagnosed meningioma was conducted. Preoperative blood results were obtained, including platelet, leukocyte, neutrophil, lymphocyte, and monocyte counts, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), albumin level, globulin level, and albumin-to-globulin ratio (AGR). Logistic regression analysis was performed to identify the independent predictive factors for high-grade meningiomas. RESULTS: Univariate logistic regression analysis indicated that the hematological inflammatory markers associated with tumor grade were leukocyte, neutrophil, and monocyte counts and the LMR (P < 0.05 for all). Multivariate logistic regression analysis showed that high leukocyte count (P = 0.007) and low LMR (P = 0.041) were independent predictive factors for high-grade meningiomas. CONCLUSIONS: Preoperative high leukocyte count and low LMR were independent predictive factors of high-grade meningiomas, suggesting that leukocyte count and LMR could be useful in the assessment of the grade of meningiomas.

Full-Genome Sequence of an Enterovirus 71 Strain Isolated from a Throat Swab from a Child with Severe Hand-Foot-and-Mouth Disease in Changzhou, China, in 2017.

The full-length genome sequence of a human enterovirus 71 (EV71) strain (EV71/CZTN01/CHN/2017) was isolated from a throat swab from a child in Changzhou, China, in 2017. According to the phylogenetic analyses, the full-genome sequence in this study belongs to sub-subgenotype C4a.

Global Prevalence of Asymptomatic Norovirus Infection: A Meta-analysis.

BACKGROUND: Studies about asymptomatic norovirus infections have been frequently reported. We aim to assess the global prevalence of asymptomatic infections. METHOD: We identified publications that included the proportion of asymptomatic norovirus infections by searching in PubMed, Ovid, Scopus, and Web of Science and by screening references from the articles reviewed. The principal summary data were the prevalence of asymptomatic norovirus infection. Random-effect models for meta-analysis were fitted to generate estimates of overall and subgroup prevalence. FINDINGS: Of 81 studies included, asymptomatic norovirus prevalence was estimated at 7% (95% CI: 6%-9%). Africa, Meso America and South America had higher prevalence (15%, 14%, 11%, respectively) while the prevalence in Europe and North America was lower (4%). Prevalence was similar between community and hospital (9%). Prevalence was higher in children (8%) than adults (4%). For food handlers, prevalence was estimated at 3%. In context of outbreaks, prevalence estimated from 15 studies was as high as 18% (95% CI: 10%-30%). INTERPRETATION: This knowledge could have an impact on the development of transmission prevention strategies in the future. The high prevalence indicated asymptomatic individuals must not be overlooked. OUTSTANDING QUESTIONS: The high prevalence indicated asymptomatic individuals must not be overlooked. Asymptomatic individuals may play an important role in norovirus transmission. This knowledge could have an impact on the development of transmission prevention strategies.