Clinical Features, Antiviral Treatment, and Patient Outcomes: A Systematic Review and Comparative Analysis of the Previous and the 2022 Mpox Outbreaks.

BACKGROUND: This study aims to comparatively analyze clinical features, treatment, and patient outcomes between the previous and the 2022 mpox (monkeypox) outbreaks. METHODS: Five bibliographic databases were searched for studies reporting clinical features, management, and patient outcomes of mpox. Systematic review and meta-analysis were performed. RESULTS: In total, 73 studies were included in the systematic review, of which 33 studies were subjected to meta-analysis. Previous outbreaks substantially affected children, whereas the 2022 outbreak primarily affected male adults, of which 94.66% (95% confidence interval [CI], 88.03-98.95) were men who have sex with men. Furthermore, 72.47% (95% CI, 51.04-89.71) reported high-risk sexual activity and the overall human immunodeficiency virus (HIV) prevalence was 37.65% (95% CI, 30.09-45.50). Skin lesions remain the typical symptom; however, their anatomic distribution differed. Systemic manifestations were common, but rectal pain was unique to the 2022 outbreak. The estimated overall fatality during past outbreaks in Africa was 4.61% (95% CI, 2.39%-7.35%), whereas 6.34% (95% CI, 3.35%-10.10%) of patients from the 2022 outbreak required hospitalization. Antiviral treatment, in particular tecovirimat, has been prescribed for a subset of patients, but the efficacy remains inconclusive. CONCLUSIONS: These findings are important for better understanding the disease and guiding adequate response to mpox outbreaks.

Risk aggregation considering probabilistic and consequential interactions: A general formulation with computational cost handling.

Complicated interaction between risk events is the critical obstacle preventing accurate risk aggregation, which is an important issue in risk management. Recent research integrates interaction into risk aggregation with different perspectives and lacks a comprehensive discussion of this issue, making the risk aggregation process not universal for diverse cases, especially in subjective risk assessment contexts. Therefore, this article proposes a theoretically convincing risk aggregation method embedding different types of interaction to support decision analysis more effectively. The main contributions of this article are as follows: (a) more in-depth and stricter definitions, measures, and graphical descriptions of different types of interaction are developed to ensure the accuracy of risk aggregation; (b) a formal risk aggregation approach that could apply in both objective and subjective risk assessment contexts while elegantly embedding risk interactions is proposed; (c) the additivity of risks and risk sets in the risk aggregation process is discussed in detail and the conditions for additivity are clarified; (d) the quasi-two/three-additive measures, which approximately obtain the aggregate risk value within sufficient reliability, are proposed to greatly reduce the computational cost. To examine the applicability of the proposed general risk aggregation method, a case study is finally presented to show the complete risk aggregation process and its application in the decision-making stage.

Specific capture and determination of glycoprotein using a hybrid epitopes and monomers-mediated molecular-imprinted polymer enzyme-free electrochemical biosensor.

A novel molecular-imprinted polymer (MIP)-based enzyme-free biosensor was created for the selective detection of glycoprotein transferrin (Trf). For this purpose, MIP-based biosensor for Trf was prepared by electrochemical co-polymerization of novel hybrid monomers 3-aminophenylboronic acid (M-APBA) and pyrrole on a glassy carbon electrode (GCE) modified with carboxylated multi-walled carbon nanotubes (cMWCNTs). Hybrid epitopes of Trf (C-terminal fragment and glycan) have been selected as templates. The produced sensor exhibited great selective recognition ability toward Trf under optimal preparation conditions, offering good analytical range (0.125-1.25 µM) with a detection limit of 0.024 µM. The proposed hybrid epitope in combination with hybrid monomer-mediated imprinting strategy was successfully applied to detect Trf in spiked human serum samples, with recoveries and relative standard deviations ranging from 94.7 to 106.0% and 2.64 to 5.32%, respectively. This study provided a reliable protocol for preparing hybrid epitopes and monomers-mediated MIP for the synergistic and effective determination of glycoprotein in complicated biological samples.

Facile post-gelation soaking strategy toward low-alkaline konjac glucomannan gels.

A facile post-gelation soaking strategy for producing low-alkaline konjac glucomannan (KGM) gels was investigated in this work. The dealkalization kinetics of soaking alkali-induced gels in citric acid (CA) solutions was determined. A comparison of sensory, textural, and water holding properties was made between untreated and post-soaking gels. Post-gelation exposure to acid took less time for lowering the gel pH at higher CA concentrations, eliminated the unattractive flavor of KGM gels and endowed them a higher hardness and breaking force. Comparatively, the whiteness of post-soaking gels was increased by 3.8%-13.1% with volume being decreased by 4.9%-8.6%, while the discrepancies were less apparent after a long-term storage. Low-alkaline gels treated by 4 g/L CA shared similar textural features with conventional KGM gels. Despite the difference in water distribution and water holding capacity of KGM gels, the syneresis of resultant low-alkaline KGM gels was not significantly affected.

Treating SARS-CoV-2 Omicron variant infection by molnupiravir for pandemic mitigation and living with the virus: a mathematical modeling study.

Treating severe COVID-19 patients and controlling the spread of SARS-CoV-2 are concurrently important in mitigating the pandemic. Classically, antiviral drugs are primarily developed for treating hospitalized COVID-19 patients with severe diseases to reduce morbidity and/or mortality, which have limited effects on limiting pandemic spread. In this study, we simulated the expanded applications of oral antiviral drugs such as molnupiravir to mitigate the pandemic by treating nonhospitalized COVID-19 cases. We developed a compartmental mathematical model to simulate the effects of molnupiravir treatment assuming various scenarios in the Omicron variant dominated settings in Denmark, the United Kingdom and Germany. We found that treating nonhospitalized cases can limit Omicron spread. This indirectly reduces the burden of hospitalization and patient death. The effectiveness of this approach depends on the intrinsic nature of the antiviral drug and the strategies of implementation. Hypothetically, if resuming pre-pandemic social contact pattern, extensive application of molnupiravir treatment would dramatically (but not completely) mitigate the COVID-19 burden, and thus there remains lifetime cost of living with the virus.

Investigation of intake air temperature effect on co-combustion characteristics of NH3/gasoline in naturally aspirated high compression ratio engine with sub-chamber.

Recently, ammonia (NH3), which has a higher energy density than hydrogen, has gained attention for zero-carbon emission goals in the transportation sector. However, in a conventional internal combustion engine (ICE), NH3 combustion mechanism is still under investigation. In this paper, to further expand the knowledge on the adoption of NH3 in ICEs, authors conducted NH3/gasoline co-combustion experiments in a modified, 17.7:1 compression ratio, naturally aspirated spark-assisted CI engine with sub-chamber. The sub-chamber was chosen in order to enhance the combustion speed of NH3. In addition, the sub-chamber was equipped with glow and spark plugs to overcome the high auto-ignition temperature of NH3. Engine performance and NOX emissions were studied under three different intake air temperatures. During the experiments, NH3 content was increased gradually where the engine was run under lean conditions. Although higher NH3 content was achieved compared to our previous work, increasing the intake air temperature resulted in decreased charging efficiency. In addition, corrosion was found on the piston ring after 120 h of operation, negatively affecting the engine performance. Furthermore, NH3/gasoline co-combustion duration was shortened drastically with the influence of the sub-chamber, where the longest combustion duration under the present conditions was found to be 17°CA.

A multi-regional, hierarchical-tier mathematical model of the spread and control of COVID-19 epidemics from epicentre to adjacent regions.

Epicentres are the focus of COVID-19 research, whereas emerging regions with mainly imported cases due to population movement are often neglected. Classical compartmental models are useful, however, likely oversimplify the complexity when studying epidemics. This study aimed to develop a multi-regional, hierarchical-tier mathematical model for better understanding the complexity and heterogeneity of COVID-19 spread and control. By incorporating the epidemiological and population flow data, we have successfully constructed a multi-regional, hierarchical-tier SLIHR model. With this model, we revealed insight into how COVID-19 was spread from the epicentre Wuhan to other regions in Mainland China based on the large population flow network data. By comprehensive analysis of the effects of different control measures, we identified that Level 1 emergency response, community prevention and application of big data tools significantly correlate with the effectiveness of local epidemic containment across different provinces of China outside the epicentre. In conclusion, our multi-regional, hierarchical-tier SLIHR model revealed insight into how COVID-19 spread from the epicentre Wuhan to other regions of China, and the subsequent control of local epidemics. These findings bear important implications for many other countries and regions to better understand and respond to their local epidemics associated with the ongoing COVID-19 pandemic.

Distinct effectiveness in containing COVID-19 epidemic: Comparative analysis of two cities in China by mathematical modeling.

For better preparing future epidemic/pandemic, important lessons can be learned from how different parts of China responded to the early COVID-19 epidemic. In this study, we comparatively analyzed the effectiveness and investigated the mechanistic insight of two highly representative cities of China in containing this epidemic by mathematical modeling. Epidemiological data of Wuhan and Wenzhou was collected from local health commission, media reports and scientific literature. We used a deterministic, compartmental SEIR model to simulate the epidemic. Specific control measures were integrated into the model, and the model was calibrated to the recorded number of hospitalized cases. In the epicenter Wuhan, the estimated number of unisolated or unidentified cases approached 5000 before the date of city closure. By implementing quarantine, a 40% reduction of within-population contact was achieved initially, and continuously increased up to 70%. The expansion of emergency units has finally reduced the mean duration from disease onset to hospital admission from 10 to 3.2 days. In contrast, Wenzhou is characterized as an emerging region with large number of primarily imported cases. Quick response effectively reduced the duration from onset to hospital admission from 20 to 6 days. This resulted in reduction of R values from initial 2.3 to 1.6, then to 1.1. A 40% reduction of contact through within-population quarantine further decreased R values until below 1 (0.5; 95% CI: 0.4-0.65). Quarantine contributes to 37% and reduction of duration from onset to hospital admission accounts for 63% to the effectiveness in Wenzhou. In Wuhan, these two strategies contribute to 54% and 46%, respectively. Thus, control measures combining reduction of duration from disease onset to hospital admission and within-population quarantine are effective for both epicenters and settings primarily with imported cases.

Estimating the burden and modeling mitigation strategies of pork-related hepatitis E virus foodborne transmission in representative European countries.

Hepatitis E virus (HEV) is an emerging zoonotic pathogen posing global health burden, and the concerns in Europe are tremendously growing. Pigs serve as a main reservoir, contributing to pork-related foodborne transmission. In this study, we aim to specifically simulate this foodborne transmission route and to assess potential interventions. We firstly established a dose-response relationship between the risk of transmission to human and the amount of ingested viruses. We further estimated the incidence of HEV infection specifically attributed to pork-related foodborne transmission in four representative European countries. Finally, we demonstrated a proof-of-concept of mitigating HEV transmission by implementing vaccination in human and pig populations. Our modeling approach bears essential implications for better understanding the transmission of pork-related foodborne HEV and for developing mitigation strategies.

[Effect of esculentoside A on cellular adhesion].

AIM: To investigate the anti-inflammatory mechanism of esculentoside A (EsA) and to observe the effects of EsA on cellular adhesion between human umbilical vein endothelial cell (VEC304) and human neutrophil and to further observe the mRNA expression of intercellular adhesion molecule-1 (ICAM-1) and cluster of differentiation 18(CD18). METHODS: The hemocyte counting method was used for assaying the adhesion rate between VEC304 and neutrophil. The RT-PCR method was used for measuring the mRNA expression of ICAM-1 and CD18. RESULTS: The adhesion rate between VEC304 and neutrophil was increased with treatment of lipopolysaccharide(LPS). EsA (3 - 12 x 10(-6) mumol.L-1) was shown to inhibit the high cellular adhesion induced by LPS. A further investigation of adhesion molecules mRNA expression was undertaken using semi-quantitative reverse transcribed polymerase chain reaction (RT-PCR). The results of RT-PCR from VEC304 and human neutrophil treating with LPS showed that ICAM-1 and CD18 mRNA expressions were higher than those of normal cells, while this increased expression of ICAM-1 and CD18 mRNA was remarkably attenuated by the addition of EsA. CONCLUSION: EsA was found to inhibit the increased adhesion rate induced by LPS. Moreover, LPS induced high expression of ICAM-1 and CD18 was inhibited with treatment of EsA. It might be involved in the mechanisms of anti-inflammation of EsA.

Effect of esculentoside A on autoimmunity in mice and its possible mechanisms.

AIM: To investigate the influence of esculentoside A (EsA) on autoimmunity in mice and its possible mechanisms. METHODS: The level of anti-ds DNA antibody, proliferation of lymphoid cells, and inflammation by pathologic section of joint in mice were examined. The autoimmunity model is made through immunizing mice with formaldehyde treated Campylobacter jejuni strain CJ-S131 and Freund's complete adjuvant. The apoptosis of T cell was analyzed through morphology and flow cytometry (FACS). The expression of ICAM-1 mRNA in human umbilical vein endothelial cell line (ECV304) was determined by coupled reverse transcription and PCR amplification (RT-PCR). RESULTS: EsA could potently lower the level of anti-ds DNA antibody, inhibit the proliferation of lymphoid cells, and ameliorate inflammation in the joint of model mouse. The apoptosis of thymocyte activated by ConA was markedly accelerated while the expression of ICAM-1 mRNA in ECV304 was decreased by EsA. CONCLUSION: EsA has the positive curative effect on autoimmunity in a mouse model, which may function through inhibition of expression of ICAM-1 mRNA in ECV304 and acceleration of thymocyte apoptosis.

Effects of esculentoside A on production of interleukin-1, 2, and prostaglandin E2.

AIM: To investigate the influence of esculentoside A (EsA) on immunological function and its mechanism of anti-inflammation. METHODS: Interleukin-1 production was measured by thymocyte co-stimulating assay; the radioactivity of [(3)H]arachidonic acid (AA) was used to evaluate the release of AA; prostaglandin E2 production was measured with radioimmunoassay (RIA); IL-2 and IFN-gamma were detected by ELISA method. RESULTS: EsA (3-12 micromol/L)could potently inhibit the production of IL-1 and PGE(2) from both silent and LPS induced macrophages. EsA had no significant effect on the release of AA from murine macrophages. EsA could inhibit the production of IL-2 from murine lymphocytes induced by ConA, but not affect the production from silent lymphocytes. EsA showed no effect on the production of IFN-gamma from both silent and ConA induced lymphocytes. CONCLUSION: EsA could affect the immunological function through inhibiting the production of IL-2 from activated splenocytes and the inhibition of production of IL-1 and PGE(2) might be one of the anti-inflammation mechanisms of EsA.