The effect of HIV and mpox co-infection on clinical outcomes: Systematic review and meta-analysis.

INTRODUCTION: Co-infection with HIV and mpox is a significant issue for public health because of the potential combined impact on clinical outcomes. However, the existing literature lacks a comprehensive synthesis of the available evidence. The purpose of this meta-analysis is to provide insight into the impact of HIV and mpox co-infection on clinical outcomes. METHODS: We systematically searched major electronic databases (PubMed, Embase, Cochrane Central, and Web of Science) for pertinent studies published up to June 2023. Included were studies that described the clinical outcomes of people who had both mpox and HIV. We performed the analysis using OpenMeta and STATA 17 software. RESULTS: With an overall number of participants of 35 207, 21 studies that met the inclusion criteria were considered. The greatest number of the studies (n = 10) were cohort designs, with three being cross-sectional and eight being case series studies. The meta-analysis found that people who had both HIV and mpox had a higher hospitalization rate than those who only had mpox (odds ratio [OR] 1.848; 95% confidence interval [CI] 0.918-3.719, p = 0.085, I2 = 60.19%, p = 0.020). Furthermore, co-infected patients had higher mortality rates than those who did not have HIV co-infection (OR 3.887; 95% CI 2.272-6.650, p < 0.001). Meta-regression analysis showed that CD4 levels can significantly predict the risk of hospitalization (p = 0.016) and death (p = 0.031). DISCUSSION: HIV causes immunosuppression, making it difficult for the body to mount an effective immune response against pathogens such as mpox. Individuals who are co-infected are at a higher risk of severe disease and death, according to our findings. Although hospitalization rates did not differ significantly between the two groups, it is critical to prioritize interventions and improve management strategies tailored specifically for people living with HIV. CONCLUSION: This meta-analysis provides substantial evidence that HIV and mpox co-infection has a negative impact on clinical outcomes. Co-infected individuals had higher hospitalization and significantly higher mortality rates. These findings highlight the significance of early diagnosis, prompt treatment initiation, and effective management strategies for people living with HIV and mpox.

Reemergence of Marburgvirus disease: Update on current control and prevention measures and review of the literature.

In 1967, the very first case of the Marburgvirus disease (MVD) was detected in Germany and Serbia sequentially. Since then, MVD has been considered one of the most serious and deadly infectious diseases in the world with a case-fatality rate between 23% and 90% and a substantial number of recorded deaths. Marburgvirus belongs to the family of Filoviridae (filoviruses), which causes severe viral hemorrhagic fever (VHF). Some major risk factors for human infections are close contact with African fruit bats, MVD-infected non-human primates, and MVD-infected individuals. Currently, there is no vaccine or specific treatment for MVD, which emphasizes the seriousness of this disease. In July 2022, the World Health Organization reported outbreaks of MVD in Ghana after two suspected VHF cases were detected. This was followed in February and March 2023 with the emergence of the virus in two countries new to the virus: Equatorial Guinea and Tanzania, respectively. In this review, we aim to highlight the characteristics, etiology, epidemiology, and clinical symptoms of MVD, along with the current prevention measures and the possible treatments to control this virus.

SARS-CoV-2 Omicron and its current known unknowns: A narrative review.

The emergence of the SARS-CoV-2 Omicron variant (B.1.1.529) has created great global distress. This variant of concern shows multiple sublineages, importantly B.1.1.529.1 (BA.1), BA.1 + R346K (BA.1.1), and B.1.1.529.2 (BA.2), each with unique properties. However, little is known about this new variant, specifically its sub-variants. A narrative review was conducted to summarise the latest findings on transmissibility, clinical manifestations, diagnosis, and efficacy of current vaccines and treatments. Omicron has shown two times higher transmission rates than Delta and above ten times more infectious than other variants over a similar period. With more than 30 mutations in the spike protein's receptor-binding domain, there is reduced detection by conventional RT-PCR and rapid antigen tests. Moreover, the two-dose vaccine effectiveness against Delta and Omicron variants was found to be approximately 21%, suggesting an urgent need for a booster dose to prevent the possibility of breakthrough infections. However, the current vaccines remain highly efficacious against severe disease, hospitalisation, and mortality. Japanese preliminary lab data elucidated that the Omicron sublineage BA.2 shows a higher illness severity than BA.1. To date, the clinical management of Omicron remains unchanged, except for monoclonal antibodies. Thus far, only Bebtelovimab could sufficiently treat all three sub-variants of Omicron. Further studies are warranted to understand the complexity of Omicron and its sub-variants. Such research is necessary to improve the management and prevention of Omicron infection.

Duplex sequencing provides detailed characterization of mutation frequencies and spectra in the bone marrow of MutaMouse males exposed to procarbazine hydrochloride.

Mutagenicity testing is an essential component of health safety assessment. Duplex Sequencing (DS), an emerging high-accuracy DNA sequencing technology, may provide substantial advantages over conventional mutagenicity assays. DS could be used to eliminate reliance on standalone reporter assays and provide mechanistic information alongside mutation frequency (MF) data. However, the performance of DS must be thoroughly assessed before it can be routinely implemented for standard testing. We used DS to study spontaneous and procarbazine (PRC)-induced mutations in the bone marrow (BM) of MutaMouse males across a panel of 20 diverse genomic targets. Mice were exposed to 0, 6.25, 12.5, or 25 mg/kg-bw/day for 28 days by oral gavage and BM sampled 42 days post-exposure. Results were compared with those obtained using the conventional lacZ viral plaque assay on the same samples. DS detected significant increases in mutation frequencies and changes to mutation spectra at all PRC doses. Low intra-group variability within DS samples allowed for detection of increases at lower doses than the lacZ assay. While the lacZ assay initially yielded a higher fold-change in mutant frequency than DS, inclusion of clonal mutations in DS mutation frequencies reduced this discrepancy. Power analyses suggested that three animals per dose group and 500 million duplex base pairs per sample is sufficient to detect a 1.5-fold increase in mutations with > 80% power. Overall, we demonstrate several advantages of DS over classical mutagenicity assays and provide data to support efforts to identify optimal study designs for the application of DS as a regulatory test.

X-band MMICs for a Low-Cost Radar Transmit/Receive Module in 250 nm GaN HEMT Technology.

This paper describes Monolithic Microwave Integrated Circuits (MMICs) for an X-band radar transceiver front-end implemented in 0.25 µm GaN High Electron Mobility Transistor (HEMT) technology. Two versions of single pole double throw (SPDT) T/R switches are introduced to realize a fully GaN-based transmit/receive module (TRM), each of which achieves an insertion loss of 1.21 dB and 0.66 dB at 9 GHz, IP1dB higher than 46.3 dBm and 44.7 dBm, respectively. Therefore, it can substitute a lossy circulator and limiter used for a conventional GaAs receiver. A driving amplifier (DA), a high-power amplifier (HPA), and a robust low-noise amplifier (LNA) are also designed and verified for a low-cost X-band transmit-receive module (TRM). For the transmitting path, the implemented DA achieves a saturated output power (Psat) of 38.0 dBm and output 1-dB compression (OP1dB) of 25.84 dBm. The HPA reaches a Psat of 43.0 dBm and power-added efficiency (PAE) of 35.6%. For the receiving path, the fabricated LNA measures a small-signal gain of 34.9 dB and a noise figure of 2.56 dB, and it can endure higher than 38 dBm input power in the measurement. The presented GaN MMICs can be useful in implementing a cost-effective TRM for Active Electronically Scanned Array (AESA) radar systems at X-band.

What drives the acceptability of restrictive health policies: An experimental assessment of individual preferences for anti-COVID 19 strategies.

The public acceptability of a policy is an important issue in democracies, in particular for anti-COVID-19 policies, which require the adherence of the population to be applicable and efficient. Discrete choice experiment (DCE) can help elicit preference ranking among various policies for the whole population and subgroups. Using a representative sample of the French population, we apply DCE methods to assess the acceptability of various anti-COVID-19 measures, separately and as a package. Owing to the methods, we determine the extent to which acceptability depends on personal characteristics: political orientation, health vulnerability, or age. The young population differs in terms of policy preferences and their claim for monetary compensation, suggesting a tailored policy for them. The paper provides key methodological tools based on microeconomic evaluation of individuals' preferences for improving the design of public health policies.

Human Papillomavirus-Associated Sexual Risks Among High School Students in the U.S.: Does Sexual Orientation Play a Role?

We examined the association between sexual orientation and human papillomavirus (HPV)-related risky sexual behaviors among high school students in the U.S. We used the 2015 Youth Risk Behavior Survey, a three-stage cluster sample, nationally representative, cross-sectional study. Participants were sexually active students (Grades 9-12) in public, private, and Catholic schools in 50 states and the District of Columbia (n = 5,958). Sexual orientation dimensions were: sexual self-identity (heterosexual, gay, lesbian, bisexual, and not sure) and sex of sexual contacts. HPV-associated risky sexual risk behaviors selected a priori were early sexual debut (≤ 12 or ≥ 13 years old) and number of lifetime partners (≥ 2 or ≥ 4). Separate multiple logistic regression analyses estimated association between sexual orientation and sex of sexual contacts, and HPV-associated risky sexual behaviors. Among the 5,958 high school students, a quarter had ≥ 4, and two-thirds had ≥ 2 sexual partners. Students who self-identified as bisexual (aOR = 2.43, 99% CI 1.19-4.98) or "not sure" (aOR = 4.56, 99% CI 2.54-8.17) were more likely to have sexual debut before 13 years. Similarly, students whose sexual contacts were adolescent females who had sex with females and males were more likely to have sexual debut before they turned 13 years of age (aOR = 3.46, 99% CI 1.83-6.48), or had ≥ 4 sexual partners (aOR = 2.66, 99% CI 1.74-4.08), or had ≥ 2 sexual partners (aOR = 3.09, 99% CI 1.91-5.00). In conclusion, HPV-associated risky sexual behavior is prevalent among high school students, especially sexual minorities. Interventions tailored to this population could increase HPV vaccine uptake and prevent future HPV-associated cancers and other negative outcomes.

Vietnamese female sex workers in rural cross-border areas of Guangxi, China: migration and HIV/STI risk behaviors.

China's HIV/AIDS epidemic continues to grow in rural and less developed areas. This consecutive cross-sectional study examines demographic and behavioral factors associated with HIV/STI infection, Hepatitis C (HCV) and other sexually transmitted infections (STIs) among Vietnamese female sex workers (FSW), a vulnerable population who cross into Guangxi, China. This study is a secondary data analysis of 303 Vietnamese and 4,348 Chinese FSWs recruited over seven years from two Chinese counties that border Vietnam. Logistic regression models compared demographics, HIV/STI status, HIV/AIDS-related knowledge, attitudes, and risk behaviors between Vietnamese FSWs and Chinese FSWs. Compared with Chinese FSWs, Vietnamese FSWs were younger, had attained lower education levels, were highly mobile, more likely to report using drugs, and were more vulnerable to HIV/STIs. Younger age, less educational attainment, shorter time in their current working location, no voluntary HIV testing in the last year, greater drug use, and not using condoms for all commercial sex in the last month were associated with higher HIV/STIs. In conclusion, several factors were associated with HIV/STI risk in Vietnamese cross-border FSWs. There is a pressing need to improve support systems for Vietnamese cross-border FSW and health system cooperation across the Chinese/Vietnamese border.

Secure Communication in Cooperative SWIPT NOMA Systems with Non-Linear Energy Harvesting and Friendly Jamming.

This paper studies the secure communication of a non-orthogonal multiple-access (NOMA) relaying system in the presence of an eavesdropper in which the NOMA communication between a source and two users is assisted by an energy-harvesting (EH) relay. The relay extracts a part of its received signal strength using a power-splitting (PS) policy then harvests energy using a non-linear EH (NLEH) circuit. A friendly jammer sends jamming signals to help secure communication. The jammer is exploited as an additional energy source. A store-and-transmit (SaT) scheme which allows the EH relay to perform energy storing and information transmitting is proposed. For performance evaluation, the closed-form expressions for three metrics, secrecy outage probability (SOP), average achievable secrecy rate (AASR) and average stored energy (ASE) are derived. These results enable studies on the effects of various system parameters, such as NOMA power-allocation factors, target secrecy rates, jammer's location, and relay's power levels, on the system performance.

ggCyto: next generation open-source visualization software for cytometry.

Motivation: Open source software for computational cytometry has gained in popularity over the past few years. Efforts such as FlowCAP, the Lyoplate and Euroflow projects have highlighted the importance of efforts to standardize both experimental and computational aspects of cytometry data analysis. The R/BioConductor platform hosts the largest collection of open source cytometry software covering all aspects of data analysis and providing infrastructure to represent and analyze cytometry data with all relevant experimental, gating and cell population annotations enabling fully reproducible data analysis. Data visualization frameworks to support this infrastructure have lagged behind. Results: ggCyto is a new open-source BioConductor software package for cytometry data visualization built on ggplot2 that enables ggplot-like functionality with the core BioConductor flow cytometry data structures. Amongst its features are the ability to transform data and axes on-the-fly using cytometry-specific transformations, plot faceting by experimental meta-data variables and partial matching of channel, marker and cell populations names to the contents of the BioConductor cytometry data structures. We demonstrate the salient features of the package using publicly available cytometry data with complete reproducible examples in a Supplementary Material. Availability and implementation: https://bioconductor.org/packages/devel/bioc/html/ggcyto.html. Supplementary information: Supplementary data are available at Bioinformatics online.

High dynamic range proteome imaging with the structured illumination gel imager.

A current challenge for proteomics is detecting proteins over the large concentration ranges found in complex biological samples such as whole-cell extracts. Currently, no unbiased, whole-proteome analysis scheme is capable of detecting the full range of cellular proteins. This is due in part to the limited dynamic range of the detectors used to sense proteins or peptides. We present a new technology, structured illumination (SI) gel imager, which detects fluorescently labeled proteins in electrophoretic gels over a 1 000 000-fold concentration range. SI uses computer-generated masks to attenuate the illumination of highly abundant proteins, allowing for long exposures of low-abundance proteins, thus avoiding detector saturation. A series of progressively masked gel images are assembled into a single, very high dynamic range image. We demonstrate that the SI imager can detect proteins over a concentration range of approximately 1 000 000-fold, making it a useful tool for comprehensive, unbiased proteome-wide surveys.

In-gel equilibration for improved protein retention in 2DE-based proteomic workflows.

The 2DE is a powerful proteomic technique, with excellent protein separation capabilities where intact proteins are spatially separated by pI and molecular weight. 2DE is commonly used in conjunction with MS to identify proteins of interest. Current 2DE workflow requires several manual processing steps that can lead to experimental variability and sample loss. One such step is the transition between first dimension IEF and second-dimension SDS-PAGE, which requires exchanging denaturants and the reduction and alkylation of proteins. This in-solution-based equilibration step has been shown to be rather inefficient, losing up to 30% of the original starting material through diffusion effects. We have developed a refinement of this equilibration step using agarose stacking gels poured on top of the second-dimension SDS-PAGE gel, referred to as in-gel equilibration. We show that in-gel equilibration is effective at reduction and alkylation in SDS-PAGE gels. Quantification of whole-cell extracts separated on 2DE gels shows that in-gel equilibration increases protein retention, decreased intergel variability, and simplifies 2DE workflow.

A comparison of ketamine and morphine analgesia in prehospital trauma care: a cluster randomized clinical trial in rural Quang Tri province, Vietnam.

BACKGROUND: The use of opioid analgesics in prehospital trauma care has been reported to have negative side effects on the airway and circulation. Several studies of urban trauma management have recommend ketamine as a safe and efficient analgesic. To date, however, no controlled trials of prehospital opioid analgesics versus ketamine in rural trauma management have been published. OBJECTIVE: This study aimed to compare the analgesic effects and side effects of ketamine and morphine in a prehospital, low-resource setting. METHODS: The study was conducted with a prospective, cluster-randomized design. The Quang Tri province of Vietnam was divided into two sectors that alternated monthly between ketamine and morphine treatments. A total of 169 trauma patients were treated outside hospital settings with ketamine, while 139 patients were treated with morphine. RESULTS: The treatment effects were measured by comparing the Visual Analogue Scale (VAS) ratings in the field to those upon on admission. The analgesic effects were positive and similar for the two drugs. The rate of vomiting was significantly lower in the ketamine group (5%) than in the morphine group (19%, 95% CI for difference 8-22%). The rate of hallucinations and agitation was higher in ketamine-treated patients (11%) than in the morphine-treated patients (1.5%, 95% CI for difference 4-16%). In this study, patients with head trauma (n = 57) showed no adverse effects on consciousness level after being treated with ketamine. CONCLUSION: Ketamine had an analgesic effect similar to morphine and carried a lower risk of airway problems. The risk of hallucinations and agitation was increased in the ketamine group. These findings are of medical significance, particularly in rough and low-resource scenarios.

Assessing the genotoxicity of N-nitrosodiethylamine with three in vivo endpoints in male Big Blue® transgenic and wild-type C57BL/6N mice.

The detection of N-nitrosamines in drug products has raised global regulatory interest in recent years due to the carcinogenic potential of some nitrosamines in animals and a need to identify a testing strategy has emerged. Ideally, methods used would allow for the use of quantitative analysis of dose-response data from in vivo genotoxicity assays to determine a compound-specific acceptable intake for novel nitrosamines without sufficient carcinogenicity data. In a previous study we compared the dose-response relationships of N-nitrosodiethylamine (NDEA) in three in vivo genotoxicity endpoints in rats. Here we report a comparison of NDEA's genotoxicity profile in mice. Big Blue® mice were administered NDEA at doses of 0.001, 0.01, 0.1, 1 and 3 mg/kg/day by oral gavage for 28 days followed by 3 days of expression. Statistically significant increases in the NDEA induced mutations were detected by both the transgenic rodent mutation assay (TGR) using the cII endpoint and by duplex sequencing in the liver but not bone marrow of mice. In addition, administration of NDEA for two consecutive days in male C57BL/6N mice caused elevated DNA damage levels in the liver as measured by % tail DNA in comet assay. The benchmark dose (BMD) analysis shows a BMDL50 of 0.03, 0.04 and 0.72 mg/kg/day for TGR, duplex sequencing and comet endpoints, respectively. Overall, this study demonstrated a similar genotoxicity profile of NDEA between mice and rats and provides a reference that can be used to compare the potential potency of other novel nitrosamines for the induction of gene mutations.

Frequencies and spectra of aflatoxin B1-induced mutations in liver genomes of NEIL1-deficient mice as revealed by duplex sequencing.

Increased risk for the development of hepatocellular carcinoma (HCC) is driven by a number of etiological factors including hepatitis viral infection and dietary exposures to foods contaminated with aflatoxin-producing molds. Intracellular metabolic activation of aflatoxin B1 (AFB1) to a reactive epoxide generates highly mutagenic AFB1-Fapy-dG adducts. Previously, we demonstrated that repair of AFB1-Fapy-dG adducts can be initiated by the DNA glycosylase NEIL1 and that male Neil1-/- mice were significantly more susceptible to AFB1-induced HCC relative to wild-type mice. To investigate the mechanisms underlying this enhanced carcinogenesis, WT and Neil1-/- mice were challenged with a single, 4 mg/kg dose of AFB1 and frequencies and spectra of mutations were analyzed in liver DNAs 2.5 months post-injection using duplex sequencing. The analyses of DNAs from AFB1-challenged mice revealed highly elevated mutation frequencies in the nuclear genomes of both males and females, but not the mitochondrial genomes. In both WT and Neil1-/- mice, mutation spectra were highly similar to the AFB1-specific COSMIC signature SBS24. Relative to wild-type, the NEIL1 deficiency increased AFB1-induced mutagenesis with concomitant elevated HCCs in male Neil1-/- mice. Our data establish a critical role of NEIL1 in limiting AFB1-induced mutagenesis and ultimately carcinogenesis.

Revisionary notes on the genus Aulacocentrum Brues (Hymenoptera, Braconidae, Macrocentrinae) from Vietnam.

This paper contains descriptions and illustrations of five new species of the genus Aulacocentrum Brues, 1922, from Vietnam, viz. Aulacocentrumassitum Long & Pham, sp. nov.; A.glabrum Long, sp. nov.; A.imparum Long & van Achterberg, sp. nov.; A.intermedium Long & van Achterberg, sp. nov.; and A.simulatum Long, sp. nov. Additionally, Aulacocentrumseticella van Achterberg & He is newly recorded for Vietnam's braconid fauna. A checklist and a key to the Oriental and East Palaearctic Aulacocentrum species is provided and the in-country distribution of the Vietnamese species is given.

Comparison of the transgenic rodent mutation assay, error corrected next generation duplex sequencing, and the alkaline comet assay to detect dose-related mutations following exposure to N-nitrosodiethylamine.

N-Nitrosodiethylamine (NDEA), a well-studied N-nitrosamine, was tested in rats to compare the dose-response relationship of three genotoxicity endpoints. Mutant / mutation frequencies were determined using the transgenic rodent (TGR) gene mutation assay and error corrected next generation sequencing (ecNGS) (i.e., duplex sequencing (DS)), and genetic damage was detected by the alkaline comet assay. Big Blue® (cII Locus) animals (n = 6 per dose group) were administered doses of 0.001, 0.01, 0.1, 1, 3 mg/kg/day NDEA by oral gavage. Samples were collected for cII mutation and DS analyses following 28-days of exposure and 3 days recovery. In a separate study, male Sprague-Dawley (SD) rats (n = 6 per dose group) were administered the same doses by oral gavage for two consecutive days and then samples collected for the alkaline comet assay. A dose-related increase in mutant / mutation frequencies of the liver but not duodenum was observed using the TGR assay and DS with DS resulting in a slightly more sensitive response, with a lower benchmark dose (BMD). In addition, a dose-related increase in percent tail DNA was observed in the liver using the alkaline comet assay. Therefore, DS and comet assays showed good utility for hazard identification and dose-response analysis of a representative N-nitrosamine comparable to the TGR gene mutation assay.

The role of nursing leadership in promoting evidence-based nursing practice.

Although the undermining of the nursing profession, time constraints, and the lack of inclusive teaching of evidence-based nursing (EBN) in the nursing school's curriculum have long been identified as being some of the main barriers to the adoption of evidence-based practice (EBP) by nurses, the specific role of nurse leaders in directly influencing and supporting evidence-based nursing is not well demonstrated. This opinion piece discusses potential factors that influence the implementation of EBP into clinical routine practice, as well as how nursing leadership styles can contribute to its promotion in contemporary healthcare settings.

Antibacterial Activity against Escherichia coli and Cytotoxicity of Maillard Reaction Product of Chitosan and Glucosamine Prepared by Gamma Co-60 Ray Irradiation.

In this study, the gamma ray-induced Maillard reaction method was carried out for chitosan (CTS) and glucosamine (GA) to improve the water solubility and antibacterial activity. The mixture solution of CTS and GA was exposed to gamma rays at a dose of 25 kGy and freeze-dried to obtain a Maillard reaction product (MRP) powder. The physicochemical and biological properties of the CTS-GA MRP powder were investigated. The CTS-GA MRP powder expressed good solubility at a concentration of 0.05 g/mL. In addition, the result of the antibacterial activity test against Escherichia coli revealed that the CTS-GA MRP powder exhibited highly antibacterial activity at pH 7; in particular, bacterial density was reduced by over 4 logs. Furthermore, the cytotoxicity test of the CTS-GA MRP powder on mouse fibroblast cells (L929) showed non-cytotoxicity with high cell viability (>90%) at concentrations of 0.1-1 mg/mL. Owing to the high antibacterial activity and low cytotoxicity, the water-soluble CTS-GA MRP powder can be used as a favorable natural preservative for food and cosmetics.

Sulfur-Promoted Oxidative Cyclization of Pentan-1-ones: Direct Access to Tetrasubstituted Furans from Deoxybenzoins and Chalcones.

Furan is an important heterocyclic scaffold in natural product, bioorganic, and medicinal chemistry as well as in materials science. The system S8/DABCO/DMSO was found to efficiently mediate the oxidative cyclization of 1,2,3,5-tetraarylpentan-1-ones A, which were obtained in situ as the Michael adducts of chalcones 1 and deoxybenzoins 2, to furan 3. The strategy provided convenient and direct access to tetrasubstituted furans 3 from readily available starting materials with high functional group tolerance.