[Safety of modified T-piece resuscitator versus nasal cannula oxygen in electronic bronchoscopy for infants: a prospective randomized controlled study]. / 改良Tç»„åˆå¤è‹å™¨ä¸Žé¼»å¯¼ç®¡å¸æ°§ç”¨äºŽå©´å„¿ç”µå­æ”¯æ°”ç®¡é•œæ£€æŸ¥çš„å®‰å ¨æ€§æ¯”è¾ƒï¼šä¸€é¡¹å‰çž»æ€§éšæœºå¯¹ç §ç ”ç©¶.

OBJECTIVES: To optimize the oxygen therapy regimens for infants with pulmonary diseases during bronchoscopy. METHODS: A prospective randomized, controlled, and single-center clinical trial was conducted on 42 infants who underwent electronic bronchoscopy from July 2019 to July 2021. These infants were divided into a nasal cannula (NC) group and a modified T-piece resuscitator (TPR) group using a random number table. The lowest intraoperative blood oxygen saturation was recorded as the primary outcome, and intraoperative heart rate and respiratory results were recorded as the secondary outcomes. RESULTS: Compared with the NC group, the modified TPR group had a significantly higher level of minimum oxygen saturation during surgery and a significantly lower incidence rate of hypoxemia (P<0.05). In the modified TPR group, there were 6 infants with mild hypoxemia, 2 with moderate hypoxemia, and 1 with severe hypoxemia, while in the NC group, there were 3 infants with mild hypoxemia, 5 with moderate hypoxemia, and 9 with severe hypoxemia (P<0.05). The modified TPR group had a significantly lower incidence rate of intraoperative respiratory rhythm abnormalities than the NC group (P<0.05), but there was no significant difference in the incidence rate of arrhythmias between the two groups (P>0.05). CONCLUSIONS: Modified TPR can significantly reduce the risk of hypoxemia in infants with pulmonary diseases during electronic bronchoscopy, and TPR significantly decreases the severity of hypoxemia and the incidence of respiratory rhythm abnormalities compared with traditional NC.

Modelling the field personnel resources to control foot-and-mouth disease outbreaks in New Zealand.

The objective of the study was to simulate New Zealand's foot-and-mouth disease (FMD) operational plan to determine personnel requirements for an FMD response and understand how the numbers of front-line staff available could affect the size and duration of FMD outbreaks, when using stamping-out (SO) measures with or without vaccination. The model utilized a national dataset of all known livestock farms. Each simulation randomly seeded infection into a single farm. Transmission mechanisms included direct and indirect contacts, local and airborne spread. Prior to each simulation, the numbers of personnel available for front-line tasks (including contact tracing, surveillance of at-risk farms, depopulation and vaccination) were set randomly. In a random subset of simulations, vaccination was allowed to be deployed as an adjunct to SO. The effects of personnel numbers on the size and duration of epidemics were explored using machine learning methods. In the second stage of the study, using a subset of iterations where numbers of personnel were unconstrained, the number of personnel used each day were quantified. When personnel resources were unconstrained, the 95th percentile and maximum number of infected places (IPs) were 78 and 462, respectively, and the 95th percentile and maximum duration were 69 and 217 days, respectively. However, severe constraints on personnel resources allowed some outbreaks to exceed the size of the UK 2001 FMD epidemic which had 2026 IPs. The number of veterinarians available had a major influence on the size and duration of outbreaks, whereas the availability of other personnel types did not. A shortage of veterinarians was associated with an increase in time to detect and depopulate IPs, allowing for continued transmission. Emergency vaccination placed a short-term demand for additional staff at the start of the vaccination programme, but the overall number of person days used was similar to SO-only strategies. This study determined the optimal numbers of front-line personnel required to implement the current operational plans to support an FMD response in New Zealand. A shortage of veterinarians was identified as the most influential factor to impact disease control outcomes. Emergency vaccination led to earlier control of FMD outbreaks but at the cost of a short-term spike in demand for personnel. In conclusion, a successful response needs to have access to sufficient personnel, particularly veterinarians, trained in response roles and available at short notice.

Informing adaptive management strategies: Evaluating a mechanism to predict the likely qualitative size of foot-and-mouth disease outbreaks in New Zealand using data available in the early response phase of simulated outbreaks.

The objective of the study was to define and then evaluate an early decision indicator (EDI) trigger that operated within the first 5 weeks of a response that would indicate a large and/or long outbreak of FMD was developing, to be able to inform control options within an adaptive management framework. To define the EDI trigger, a previous dataset of 10,000 simulated FMD outbreaks in New Zealand, controlled by the standard stamping-out approach, was re-analysed at various time points between Days 11 and 35 of each response to find threshold values of cumulative detected infected premises (IPs) that indicated upper quartile sized outbreaks and estimated dissemination rate (EDR) values that indicated sustained spread. Both sets of thresholds were then parameterized within the InterSpread Plus modelling framework, such that if either the cumulative IPs or the EDR exceeded the defined thresholds, the EDI trigger would fire. A new series of simulations were then generated. The EDI trigger was like two diagnostic tests interpreted in parallel, with the diagnostic outcome positive if either test was positive at any time point between Days 11 and 35 inclusive. The diagnostic result was then compared to the final size of each outbreak, to see if the outbreak was an upper quartile outbreak in terms of cumulative IPs and/or final duration. The performance of the EDI trigger was then evaluated across the population of outbreaks, and the sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were calculated. The Se, Sp, PPV and NPV for predicting large outbreaks were 0.997, 0.513, 0.404 and 0.998, respectively. The study showed that the EDI trigger was very sensitive to detecting large outbreaks, although not all outbreaks predicted to be large were so, whereas outbreaks predicted to be small invariably were small. Therefore, it shows promise as a mechanism that could support an adaptive management approach to FMD control.

An updated nomenclature for keratin-associated proteins (KAPs).

Most protein in hair and wool is of two broad types: keratin intermediate filament-forming proteins (commonly known as keratins) and keratin-associated proteins (KAPs). Keratin nomenclature was reviewed in 2006, but the KAP nomenclature has not been revised since 1993. Recently there has been an increase in the number of KAP genes (KRTAPs) identified in humans and other species, and increasingly reports of variation in these genes. We therefore propose that an updated naming system is needed to accommodate the complexity of the KAPs. It is proposed that the system is founded in the previous nomenclature, but with the abbreviation sp-KAPm-nL*x for KAP proteins and sp-KRTAPm-n(p/L)*x for KAP genes. In this system "sp" is a unique letter-based code for different species as described by the protein knowledge-based UniProt. "m" is a number identifying the gene or protein family, "n" is a constituent member of that family, "p" signifies a pseudogene if present, "L" if present signifies "like" and refers to a temporary "place-holder" until the family is confirmed and "x" signifies a genetic variant or allele. We support the use of non-italicised text for the proteins and italicised text for the genes. This nomenclature is not that different to the existing system, but it includes species information and also describes genetic variation if identified, and hence is more informative. For example, GenBank sequence JN091630 would historically have been named KRTAP7-1 for the gene and KAP7-1 for the protein, but with the proposed nomenclature would be SHEEP-KRTAP7-1*A and SHEEP-KAP7-1*A for the gene and protein respectively. This nomenclature will facilitate more efficient storage and retrieval of data and define a common language for the KAP proteins and genes from all mammalian species.

Identification of the ovine keratin-associated protein KAP1-2 gene (KRTAP1-2).

Keratin-associated proteins (KAPs) are a major component of wool and other keratin-containing tissues. While four KAP1-n proteins have been identified in sheep, only three genes have been described encoding KAP1-1, KAP1-3 and KAP1-4. Here, we used a sequence conserved across the known KAP1-n genes to search the inaugural Ovine Genome Sequence (v1.0) and identified a new KAP1-n sequence on chromosome 11. PCR amplification of this sequence revealed an open reading frame of 474-bp that putatively encodes a polypeptide sequence very similar to the previously described ovine KAP1-2 protein and suggests that the newly identified sequence represents the previously unidentified KAP1-2 gene (KRTAP1-2). Its expression in skin was confirmed by PCR, and the mRNA was localized to the cortex of the mid-keratinization zone of a growing wool fibre using a gene-specific probe and in situ hybridization. PCR-SSCP analysis of KRTAP1-2 revealed nine unique banding patterns representing nine different DNA sequences. One sequence was identical to, and the other eight were homologous to, the sequence identified above, suggesting that they were allelic variants of ovine KRTAP1-2. There were ten single nucleotide substitutions identified, although only three of these were non-synonymous and would potentially result in amino acid changes. The variation identified here may influence the expression or protein structure of KAP1-2 and consequently wool structure and wool traits.

Annotation of sheep keratin intermediate filament genes and their patterns of expression.

Keratin IF (KRT) and keratin-associated protein genes encode the majority of wool and hair proteins. We have identified cDNA sequences representing nine novel sheep KRT genes, increasing the known active genes from eight to 17, a number comparable to that in the human. However, the absence of KRT37 in the type I family and the discovery of type II KRT87 in sheep exemplify species-specific compositional differences in hair KRT genes. Phylogenetic analysis of hair KRT genes within type I and type II families in the sheep, cattle and human genomes revealed a high degree of consistency in their sequence conservation and grouping. However, there were differences in the fibre compartmentalisation and keratinisation zones for the expression of six ovine KRT genes compared with their human orthologs. Transcripts of three genes (KRT40, KRT82 and KRT84) were only present in the fibre cuticle. KRT32, KRT35 and KRT85 were expressed in both the cuticle and the fibre cortex. The remaining 11 genes (KRT31, KRT33A, KRT33B, KRT34, KRT36, KRT38-39, KRT81, KRT83 and KRT86-87) were expressed only in the cortex. Species-specific differences in the expressed keratin gene sets, their relative expression levels and compartmentalisation are discussed in the context of their underlying roles in wool and hair developmental programmes and the distinctive characteristics of the fibres produced.

Emerging issues with the current keratin-associated protein nomenclature.

Keratin associated proteins (KAPs) are a class of proteins that associate with keratin intermediate filament proteins through disulphide linkages to give fibres such as hair and wool their unique properties. Up to 90 proteins from some 25 families have been identified and this does not include polymorphic variants of individual proteins within these families. The existence of this diverse group of proteins has been known for some 75 years but, despite this, there is still no universally accepted nomenclature for them. This paper sets out the case for revising the current system to deal with this nomenclature issue.

Expression patterns of keratin intermediate filament and keratin associated protein genes in wool follicles.

The catalogue of hair keratin intermediate filaments (KIFs) and keratin-associated proteins (KAPs) present in wool follicles is incomplete. The full coding sequences for three novel sheep KIFs (KRT27, KRT35 and KRT38) and one KAP (KRTAP4-3) were established in this study. Spatial expression patterns of these and other genes (KRT31, KRT85, KRTAP6-1 and trichohyalin) were determined by in situ hybridisation in wool follicles at synchronised stages of growth. Transcription proceeded in the order: trichohyalin, KRT27, KRT85, KRT35, KRT31, KRT38, KRTAP6-1 and KRTAP4-3, as determined by increasing distance of their expression zones from the germinal matrix in anagen follicles. Expression became gradually more restricted to the lower follicle during follicle regression (catagen), and ceased during dormancy (telogen). Some genes (KRT27, KRT31, KRT85 and KRTAP6-1), but not others, were expressed in cortical cells forming the brush-end, indicating specific requirements for the formation of this anchoring structure. The resumption of keratin expression was observed only in later stages of follicle reactivation (proanagen). KIF expression patterns in primary wool follicles showed general resemblance to their human homologues but with some unique features. Consistent differences in localisation between primary and secondary wool follicles were observed. Asymmetrical expression of KRT27, KRT31, KRT35, KRT85 and trichohyalin genes in secondary follicles were associated with bulb deflection and follicle curvature, suggesting a role in the determination of follicle and fibre morphology.