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1.
Cell Genom ; 4(10): 100633, 2024 Oct 09.
Article in English | MEDLINE | ID: mdl-39389017

ABSTRACT

Monitoring biochemical phenotypes during pregnancy is vital for maternal and fetal health, allowing early detection and management of pregnancy-related conditions to ensure safety for both. Here, we conducted a genetic analysis of 104 pregnancy phenotypes in 20,900 Chinese women. The genome-wide association study (GWAS) identified a total of 410 trait-locus associations, with 71.71% reported previously. Among the 116 novel hits for 45 phenotypes, 83 were successfully replicated. Among them, 31 were defined as potentially pregnancy-specific associations, including creatine and HELLPAR and neutrophils and ESR1, with subsequent analysis revealing enrichments in estrogen-related pathways and female reproductive tissues. The partitioning heritability underscored the significant roles of fetal blood, embryoid bodies, and female reproductive organs in pregnancy hematology and birth outcomes. Pathway analysis confirmed the intricate interplay of hormone and immune regulation, metabolism, and cell cycle during pregnancy. This study contributes to the understanding of genetic influences on pregnancy phenotypes and their implications for maternal health.


Subject(s)
Genome-Wide Association Study , Phenotype , Humans , Female , Pregnancy , Adult , Asian People/genetics , China , Polymorphism, Single Nucleotide , East Asian People
2.
Article in English | MEDLINE | ID: mdl-39331630

ABSTRACT

Platelet acts as a crucial monitoring indicator for hypercoagulability and thrombosis and a key target for drug regulation. Genotype-phenotype association studies have confirmed that platelet traits are quantitatively regulated by multiple genes. However, there is currently a lack of genetic studies on the heterogeneity of platelet traits in ß-thalassemia under hypercoagulable state. Here, we studied the phenotypic heterogeneity of platelet count (PLT) and mean platelet volume (MPV) in 1020 ß-thalassemia patients. We further performed a functionally informed whole genome sequencing association analysis of common variants and rare variants (RVs) for PLT and MPV in 916 patients through integrative analysis of whole-genome sequencing data and functional annotation data. Extreme phenotypic heterogeneity of platelet traits was observed in ß-thalassemia patients. Additionally, the common variant based gene-level analysis identified the novel gene of RNF144B associated with MPV. The RV analysis identified several novel associations in both coding and noncoding genome, including missense RVs of PPP2R5C associated with PLT and missense RVs of TSSK1B associated with MPV. In conclusion, we performed a comprehensive and systematic whole genome scan of platelet traits in the ß-thalassemia cohort, demonstrating the specificity of genetic regulation of platelet traits in the context of ß-thalassemia, providing potential targets for intervention.

3.
ACS Omega ; 9(36): 37882-37890, 2024 Sep 10.
Article in English | MEDLINE | ID: mdl-39281899

ABSTRACT

A single breast cancer is a prevalent form of cancer, affecting over 2.3 million women worldwide, as reported by the World Health Organization. Recently, researchers have extensively explored the utilization of biomaterials in breast cancer theranostics. One notable biomaterial being investigated is various structures of copper sulfide (CuS). In this work, a microsphere (MS) structure composed of CuS was employed for label-free imaging of MCF-7 breast cancer cells and normal Vero cells, respectively. Various label-free imaging techniques, such as bright field, dark field, phase contrast (PC), and differential interference contrast (DIC), were employed to capture images of CuS MSs, cell, and intact CuS MSs within a cell. The study compared the outcomes of each imaging technique and determined that DIC imaging provided the highest resolution for cells incubated with CuS MSs. Furthermore, the combination of PC and DIC techniques proved to be effective for imaging breast cancer cells in conjunction with CuS MSs. This research underscores the potential of CuS MSs for label-free cell detection and emphasizes the significance of selecting appropriate imaging techniques to attain high-quality images in the field of cell observation.

4.
Exp Neurol ; 381: 114943, 2024 Nov.
Article in English | MEDLINE | ID: mdl-39242069

ABSTRACT

The mechanisms of secondary injury following spinal cord injury are complicated. The role of ferroptosis, which is a newly discovered form of regulated cell death in the neurovascular unit(NVU), is increasingly important. Ferroptosis inhibitors have been shown to improve neurovascular homeostasis and attenuate secondary spinal cord injury(SCI). This review focuses on the mechanisms of ferroptosis in NVU cells and NVU-targeted therapeutic strategies according to the stages of SCI, and analyzes possible future research directions.


Subject(s)
Ferroptosis , Spinal Cord Injuries , Spinal Cord Injuries/pathology , Spinal Cord Injuries/physiopathology , Ferroptosis/physiology , Ferroptosis/drug effects , Humans , Animals
5.
Article in English | MEDLINE | ID: mdl-39227237

ABSTRACT

Monkeypox (Mpox) has emerged as a global threat since 2022. We reported 14 cases of Mpox in 10 people with HIV (PWH) and 4 people without HIV (PWoH), of whom 64.3% had sexually transmitted co-infections. Severe complications of Mpox and prolonged viral shedding might occur in both PWH and PWoH.

6.
Heart Rhythm ; 2024 Jul 10.
Article in English | MEDLINE | ID: mdl-38997056

ABSTRACT

BACKGROUND: Prior studies have investigated cardiac anatomy and clinical parameters as predictors for pulmonary vein and non-pulmonary vein triggers. OBJECTIVE: We aimed to assess the link between the descending aorta to left inferior pulmonary vein (Dao-LIPV) distance and the occurrence of triggers and drivers in atrial fibrillation (AF) ablation procedures. METHODS: Drug-refractory AF patients who underwent first-time index catheter ablation from January 2010 to December 2019 were retrospectively assembled. The Dao-LIPV distance was measured from preablation pulmonary vein computed tomography. Patients were assigned to groups on the basis of the presence of LIPV triggers or drivers. Multivariate logistic regression was used to identify risk factors. RESULTS: A total of 886 consecutive patients with drug-refractory AF were studied, and 63 (7.1%) patients were identified to have LIPV triggers or drivers. The Dao-LIPV distance had a better predictive performance (area under the curve, 0.70) compared with persistent AF (area under the curve, 0.57). Multivariate logistic regression analysis showed that Dao-LIPV distance ≤2.5 mm (odds ratio, 3.96; 95% CI, 2.15-7.29; P < .001) and persistent AF (odds ratio, 1.73; 95% CI, 1.02-2.94]; P = .044) were independent predictors for the presence of LIPV triggers or drivers. A risk score model was established to predict the probability of LIPV triggers or drivers with persistent AF (10.2%), Dao-LIPV distance ≤2.5 mm (11.4%), and both (15.0%). CONCLUSION: The proximity of the Dao-LIPV was correlated to the presence of LIPV triggers or drivers. We developed a risk score model indicating that persistent AF and Dao-LIPV distances ≤2.5 mm significantly increase the risk of LIPV triggers or drivers, aiding electrophysiologists in preparing for and performing catheter ablation more effectively.

7.
Rev Cardiovasc Med ; 25(3): 92, 2024 Mar.
Article in English | MEDLINE | ID: mdl-39076938

ABSTRACT

Background: Gender is a well-recognized risk factor in atrial fibrillation (AF)-related ischemic stroke. The association of gender with the use of oral anticoagulants (OACs) and prognosis remains unknown. Methods: The National Health Insurance Research Database in Taiwan identified 203,775 patients with AF aged ≥ 20 years from 2012 to 2018, with 55.4% of males. Our main study cohort included 67,426 patients using OACs. The study endpoints include death, ischemic stroke, intracranial hemorrhage, major bleeding, and composite adverse events. Results: Significant differences were found in baseline characteristics between sexes. Female patients with AF were older and had higher CHA 2 DS 2 -VASc and HAS-BLED scores. Non-vitamin K antagonist oral anticoagulant (NOAC) use was more prominent in females while the use of warfarin was similar in both sexes. The distribution of baseline characteristics between the warfarin and NOAC groups in both sexes was much alike. Among the whole study cohort, NOAC was associated with a decreased risk of clinical endpoints compared to warfarin, which remained the same in subgroup analyses of both sexes. Additionally, a greater risk reduction of ischemic stroke with NOAC was observed in female patients compared to male patients (adjusted hazard ratio: 0.517 in males, 0.425 in females, interaction p = 0.040). Conclusions: This nationwide cohort demonstrated the differences between male and female patients with AF, including baseline characteristics, risk profiles, and medication use. Despite great differences in baseline demographic data, NOAC was associated with better clinical outcomes compared to warfarin in both sexes, and females benefited more than males in preventing ischemic stroke using NOACs.

8.
J Dent ; 147: 105122, 2024 08.
Article in English | MEDLINE | ID: mdl-38871071

ABSTRACT

OBJECTIVES: This study aims to update the relevant epidemiological information of untreated caries in permanent teeth. METHODS: Data were derived from the Global Burden of Disease (GBD) study 2019. We described temporal trends in age-standardized prevalence rate (ASPR) of untreated caries in permanent teeth by gender and region from 1990 to 2019. Age-period-cohort (APC) model was utilized to analyze age, period and cohort effects on prevalence, and we used the Bayesian age-period-cohort (BAPC) model to make projections of prevalence between 2020 and 2049. RESULTS: The global ASPR of untreated caries in permanent teeth presented a decreasing trend from 1990 to 2019 (26593.58/105 vs. 25625.53/105), with females exceeding males annually. Negative correlation was observed between ASPR and Socio-demographic Index (SDI) levels. APC analyses showed that net drift was -0.16 % globally and generally below 0 across all SDI regions. The overall global peak in prevalence occurred in the 20-24 years group (36319.99/105), and there was a decrease trend in the overall global period rate ratio (RR). Compared to younger birth cohorts, prior birth cohorts had higher prevalence risks globally and across all SDI regions. Significant upward trends was predicted in the global ASPR of untreated caries in permanent teeth for both genders from 2020 to 2049. CONCLUSIONS: Age-period-cohort effects exerted a significant impact on the prevalence of untreated caries in permanent teeth during the study period. CLINICAL SIGNIFICANCE: The ASPR of untreated caries in permanent teeth may increase in the next 30 years by projections. And the disease burden of untreated caries in permanent teeth may be affected by population ageing. It is essential to implement targeted prevention and control policies to disadvantaged groups and attempt to reduce caries inequalities.


Subject(s)
Dental Caries , Dentition, Permanent , Humans , Dental Caries/epidemiology , Male , Prevalence , Female , Adult , Adolescent , Young Adult , Cohort Studies , Child , Middle Aged , Global Health/statistics & numerical data , Aged , Bayes Theorem , Age Factors , Global Burden of Disease/trends , Child, Preschool , Forecasting
9.
J Microbiol Immunol Infect ; 57(4): 609-616, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38845335

ABSTRACT

BACKGROUND: Urine leukocyte count under microscopy is one of the most frequently used routine screening tests for urinary tract infection (UTI). Nevertheless, it is observed that pyuria is lacking in 10-25% of children with UTI. This study aims to determine the factors related to pyuria-negative UTI in young infants aged under four months old. METHOD: This retrospective cross-sectional study was conducted on 157 patients aged under 4 months old with UTI. All subjects had paired urinalysis and urine culture, which were collected via transurethral catheterization. According to the results of their urinalysis, the patients were then classified as UTI cases with pyuria and UTI cases without pyuria. The clinical characteristics and outcomes of both groups were analyzed. RESULT: Among the 157 UTI patients, the prevalence of pyuria-negative UTI was 44%. Significant risk factors associated with pyuria-negative UTI included non-E.coli pathogens, younger age, shorter duration of fever prior to hospital visit, lower white blood cell (WBC) count upon hospital visit, and absence of microscopic hematuria. CONCLUSIONS: We found that non-E.coli uropathogens were the strongest factor related to pyuria-negative UTI. The absence of pyuria cannot exclude the diagnosis of UTI in young infants, and it's reasonable to perform both urinalysis and urine culture as a part of the assessment of febrile or ill-looking young infants.


Subject(s)
Pyuria , Urinary Tract Infections , Humans , Infant , Cross-Sectional Studies , Urinary Tract Infections/diagnosis , Urinary Tract Infections/microbiology , Retrospective Studies , Male , Female , Risk Factors , Urinalysis , Prevalence , Infant, Newborn , Leukocyte Count
10.
J Formos Med Assoc ; 2024 Jun 20.
Article in English | MEDLINE | ID: mdl-38906731

ABSTRACT

Longitudinal analysis of antibody responses following three-dose COVID-19 vaccination in patients with chronic liver disease (CLD) has been limited. From August 2021 to February 2023, sequential anti-SARS-CoV-2 spike IgG titers were determined in 45 patients with CLD who received two or three doses of COVID-19 vaccine. The geometric mean of anti-spike IgG at four weeks after the second and third doses were 1313.16 BAU/mL and 3042.29 BAU/mL, respectively, and it decreased significantly from four to 24 weeks after the second (1313.16 vs. 198.42 BAU/mL, p = 0.002) and the third (3042.29 vs. 636.71 BAU/mL, p < 0.001) dose. The anti-spike IgG titers in participants receiving prime-boost homologous mRNA vaccines (BNT162b2 or mRNA-1273) were comparable between participants with and those without significant liver fibrosis at each follow-up time point. This study demonstrated a notable decrease in anti-spike IgG after completion of the vaccination schedule in patients with CLD, highlighting the importance of additional booster doses.

11.
J Antimicrob Chemother ; 79(8): 2008-2016, 2024 Aug 01.
Article in English | MEDLINE | ID: mdl-38906829

ABSTRACT

BACKGROUND: Genotyping isolates of a specific pathogen may demonstrate unique patterns of antimicrobial resistance, virulence or outcomes. However, evidence for genotype-outcome association in Candida glabrata is scarce. We aimed to characterize the mycological and clinical relevance of genotypes on C. glabrata bloodstream infections (BSIs). METHODS: Non-duplicated C. glabrata blood isolates from hospitalized adults were genotyped by MLST, and further clustered by the unweighted pair group method with arithmetic averages (UPGMA). A clonal complex (CC) was defined by UPGMA similarities of >90%. Antifungal susceptibility testing was performed by a colorimetric microdilution method and interpreted following CLSI criteria. RESULTS: Of 48 blood isolates evaluated, 13 STs were identified. CC7 was the leading CC (n = 14; 29.2%), including 13 ST7. The overall fluconazole and echinocandin resistance rates were 6.6% and 0%, respectively. No specific resistance patterns were associated with CC7 or other CCs. Charlson comorbidity index (adjusted OR, 1.49; 95% CI, 1.05-3.11) was the only predictor for CC7. By multivariable Cox regression analyses, CC7 was independently associated with 28 day mortality [adjusted HR (aHR), 3.28; 95% CI, 1.31-8.23], even after considering potential interaction with neutropenia (aHR, 3.41; 95% CI, 1.23-9.42; P for interaction, 0.24) or limited to 34 patients with monomicrobial BSIs (aHR, 2.85; 95% CI, 1.15-7.08). Also, the Kaplan-Meier estimate showed greater mortality with CC7 (P = 0.003). Fluconazole resistance or echinocandin therapy had no significant impact on mortality. CONCLUSIONS: Our data suggested comorbid patients were at risk of developing CC7 BSIs. Further, CC7 was independently associated with worse outcomes.


Subject(s)
Antifungal Agents , Candida glabrata , Candidemia , Drug Resistance, Fungal , Genotype , Microbial Sensitivity Tests , Multilocus Sequence Typing , Humans , Candida glabrata/genetics , Candida glabrata/drug effects , Candida glabrata/isolation & purification , Male , Female , Middle Aged , Candidemia/microbiology , Candidemia/drug therapy , Candidemia/mortality , Aged , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Prognosis , Drug Resistance, Fungal/genetics , Adult , Aged, 80 and over , Fluconazole/pharmacology , Fluconazole/therapeutic use
12.
Imeta ; 3(1): e171, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38868505

ABSTRACT

In this study, we have successfully constructed a comprehensive database of metagenome-assembled genomes (MAGs) pertaining to the gut microbiota of the giant panda. Through our analysis, we have identified significant reservoirs of antibiotic resistance genes (ARGs), namely Escherichia coli, Citrobacter portucalensis, and Klebsiella pneumoniae. Furthermore, we have elucidated the primary contributors to ARGs, including Streptococcus alactolyticus and Clostridium SGBP116, in both captive and wild pandas. Additionally, our findings have demonstrated a higher prevalence of ARGs in the metagenome, with notable expression of the RPOB2 gene in S. alactolyticus. Crucially, 1217 ARGs shared homology with human gut ARGs, underscoring the interaction relationship between pandas and human microbiomes. These findings are instrumental in understanding the antibiotic resistance landscape in the giant panda's gut, providing a framework for developing strategies to combat antibiotic resistance and safeguard the health of this endangered species.

13.
J Microbiol Immunol Infect ; 57(4): 629-637, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38777653

ABSTRACT

BACKGROUND: Mycoplasma genitalium is an emerging etiology of sexually transmitted infections (STIs) with increasing resistance to antimicrobials. Surveillance on the epidemiology of M. genitalium infection and antimicrobial resistance is warranted. METHODS: Between September 2021 and August 2023, people with HIV (PWH) and people without HIV (PWoH) at risk of STIs were screened for M. genitalium infection using a multiplex polymerase-chain-reaction assay of specimens collected from the rectum, urethra, oral cavity, and vagina. The prevalences of resistance-associated mutations (RAMs) of M. genitalium to fluoroquinolones, macrolides, and tetracycline were investigated. RESULTS: During the 2-year study period, 1021 participants were enrolled, including 531 PWH and 490 PWoH. Overall, 83 (8.1%) and 34 (7.6%) participants had M. genitalium infection at baseline and during follow-up, respectively, with the rectum being the most common site of detection (61.5%). With the first course of antimicrobial treatment, 27 of 63 (42.9%) participants with M. genitalium infection were cured during follow-up, including 24 of 58 (41.4%) who received doxycycline monotherapy. The prevalence of RAMs to macrolides, fluoroquinolones, and tetracyclines at baseline were 24.3%, 22.4%, and 7.9%, respectively. Though PWH had more M. genitalium infection (10.2% vs 5.9%, p = 0.01), a higher rate of RAMs to macrolides (41.0% vs 14.7%, p < 0.01) was found in PWoH. CONCLUSIONS: Among high-risk populations, the prevalence of M. genitalium infection was 8.1%. The overall genotypic resistance of M. genitalium to macrolides and fluoroquinolones was moderately high in Taiwan. Detection of M. genitalium infection and antimicrobial resistance is warranted to ensure resistance-guided antimicrobial treatments to be administered.


Subject(s)
Anti-Bacterial Agents , Drug Resistance, Bacterial , Fluoroquinolones , Macrolides , Mutation , Mycoplasma Infections , Mycoplasma genitalium , Humans , Mycoplasma genitalium/genetics , Mycoplasma genitalium/drug effects , Mycoplasma genitalium/isolation & purification , Macrolides/pharmacology , Macrolides/therapeutic use , Taiwan/epidemiology , Fluoroquinolones/pharmacology , Fluoroquinolones/therapeutic use , Mycoplasma Infections/epidemiology , Mycoplasma Infections/drug therapy , Mycoplasma Infections/microbiology , Female , Male , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Adult , Drug Resistance, Bacterial/genetics , Prevalence , Middle Aged , HIV Infections/drug therapy , HIV Infections/epidemiology , Microbial Sensitivity Tests
14.
Chemistry ; 30(41): e202400833, 2024 Jul 19.
Article in English | MEDLINE | ID: mdl-38781011

ABSTRACT

It remains a challenge to accomplish colloidal synthesis of noble-metal nanocrystals marked by high quality, large quantity, and batch-to-batch consistency. Here we report a self-airtight setup for achieving robust, reproducible, and scalable production of Ag nanocubes with uniform and controlled sizes from 18 to 60 nm. Different from the conventional open-to-air setup, the self-airtight system makes it practical to stabilize the reaction condition by minimizing the loss of volatile reagents. The new setup also allows us to easily optimize the amount of O2 (from air) trapped in the system, ensuring burst nucleation of single-crystal seeds, followed by their slow growth into nanocubes. Most significantly, the new setup allows for the production of Ag nanocubes at gram quantities without sacrificing uniformity, corner/edge sharpness, controlled size, and high purity across different batches. The availability of high-quality Ag nanocubes in such a large quantity is anticipated to substantially boost their use in applications related to plasmonics, catalysis, and biomedicine.

15.
Front Cardiovasc Med ; 11: 1306055, 2024.
Article in English | MEDLINE | ID: mdl-38689859

ABSTRACT

Introduction: Signal-averaged electrocardiography (SAECG) provides diagnostic and prognostic information regarding cardiac diseases. However, its value in other nonischemic cardiomyopathies (NICMs) remains unclear. This study aimed to investigate the role of SAECG in patients with NICM. Methods and results: This retrospective study included consecutive patients with NICM who underwent SAECG, biventricular substrate mapping, and ablation for ventricular arrhythmia (VA). Patients with baseline ventricular conduction disturbances were excluded. Patients who fulfilled at least one SAECG criterion were categorized into Group 1, and the other patients were categorized into Group 2. Baseline and ventricular substrate characteristics were compared between the two groups. The study included 58 patients (39 men, mean age 50.4 ± 15.5 years), with 34 and 24 patients in Groups 1 and 2, respectively. Epicardial mapping was performed in eight (23.5%) and six patients (25.0%) in Groups 1 and 2 (p = 0.897), respectively. Patients in Group 1 had a more extensive right ventricular (RV) low-voltage zone (LVZ) and scar area than those in Group 2. Group 1 had a larger epicardial LVZ than Group 2. Epicardial late potentials were more frequent in Group 1 than in Group 2. There were more arrhythmogenic foci within the RV outflow tract in Group 1 than in Group 2. There was no significant difference in long-term VA recurrence. Conclusion: In our NICM population, a positive SAECG was associated with a larger RV endocardial scar, epicardial scar/late potentials, and a higher incidence of arrhythmogenic foci in the RV outflow tract.

16.
Article in English | MEDLINE | ID: mdl-38743892

ABSTRACT

Objective: To improve the preoperative management of patients undergoing day arthroscopy. Methods: Based on the evidence-based concept, the preoperative management strategy of daytime arthroscopic surgery was practiced, and the implementation effect of patients undergoing daytime arthroscopic surgery before and after evidence application was compared. The evidence-based strategies adopted in this study include: informed consent,seven aspects: anesthesia assessment, health education, prohibition of drinking and eating, preoperative medication guidance, surgical arrangement, and emergency management. Results: After applying evidence-based strategies, significant improvements were observed in various quality indicators, including reduced waiting time, reduced surgical cancellations, increased patient satisfaction, and reduced unplanned hospitalization rates. Conclusion: Based on the evidence-based concept, the practice of preoperative management strategies for patients undergoing daytime arthroscopic surgery optimizes the daytime surgical process from the strict implementation of patient health education and evaluation, as well as the establishment of compliant and reasonable surgical schedules and emergency mechanisms. This improves the preoperative management behavior of daytime surgery, enhances the patient's medical experience, and enhances the quality of daytime surgical care, providing a good basis for management and decision-making.

17.
Annu Rev Neurosci ; 47(1): 235-253, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38608643

ABSTRACT

The intricate network of the brain's neurons and synapses poses unparalleled challenges for research, distinct from other biological studies. This is particularly true when dissecting how neurons and their functional units work at a cell biological level. While traditional microscopy has been foundational, it was unable to reveal the deeper complexities of neural interactions. However, an imaging renaissance has transformed our capabilities. Advancements in light and electron microscopy, combined with correlative imaging, now achieve unprecedented resolutions, uncovering the most nuanced neural structures. Maximizing these tools requires more than just technical proficiency. It is crucial to align research aims, allocate resources wisely, and analyze data effectively. At the heart of this evolution is interdisciplinary collaboration, where various experts come together to translate detailed imagery into significant biological insights. This review navigates the latest developments in microscopy, underscoring both the promise of and prerequisites for bending this powerful tool set to understanding neuronal cell biology.


Subject(s)
Microscopy , Neurons , Neurons/physiology , Animals , Humans , Microscopy/methods , Cell Biology , Brain/physiology , Synapses/physiology
18.
Front Med (Lausanne) ; 11: 1328589, 2024.
Article in English | MEDLINE | ID: mdl-38560383

ABSTRACT

Background: Concurrent sexually transmitted infections (STIs) are common in sexually active populations. We aimed to estimate the prevalence and coinfection rates of bacterial STIs among sexually active, HIV-positive men who have sex with men (MSM), and to assess the potential benefits of different combination treatment regimens in managing concurrent bacterial STIs. Methods: From September 2021 to September 2023, HIV-positive MSM underwent STI testing when they had symptoms suggestive of STIs or recently acquired hepatitis C virus (HCV) infection or early syphilis. The oral rinse, rectal swab, and urethral swab specimens were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma spp., Ureaplasma spp., and Trichomonas vaginalis with the use of multiplex real-time polymerase-chain-reaction assays. The estimated coinfection rates were used to evaluate the benefits of different combination treatment regimens for managing coinfections. Results: During the study period, 535 participants (median age, 37 years; and CD4 count, 615 cells/mm3) were enrolled. On their first visits, at least one bacterial pathogen was detected in 57.9% and concomitant bacterial infections were found in 32.9% of the participants. The most commonly identified pathogen was U. urealyticum (36.3%), followed by C. trachomatis (22.8%), and N. gonorrhoeae (19.8%). The factors associated with any bacterial STIs included older age (per 1-year increase, adjusted odds ratio [AOR], 0.97; 95% confidence interval [CI], 0.95-1.00), early syphilis (AOR, 1.87; 95% CI, 1.22-2.84), and having more than 5 sex partners in the preceding 3 months (AOR, 2.08, 95% CI, 1.07-4.06). A combination therapy of benzathine penicillin G with a 7-day course of doxycycline could simultaneously treat 27.1% of C. trachomatis coinfections in participants with early syphilis, while a combination therapy of ceftriaxone with doxycycline could simultaneously treat 40.6% of chlamydial coinfections in participants with gonorrhea. Conclusion: Bacterial STIs were prevalent and concomitant infections were not uncommon among sexually active, HIV-positive MSM, supporting regular screening for bacterial STIs. The effectiveness of preemptive use of doxycycline as combination therapy for concurrent STIs warrants more investigations.

19.
J Infect Public Health ; 17(5): 929-937, 2024 May.
Article in English | MEDLINE | ID: mdl-38599013

ABSTRACT

BACKGROUND: Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a substantial healthcare challenge. This study assessed the in vitro efficacy of selected antibiotic combinations against CRKP infections. METHODS: Our research involved the evaluation of 40 clinical isolates of CRKP, with half expressing Klebsiella pneumoniae carbapenemase (KPC) and half producing Metallo-ß-lactamase (MBL), two key enzymes contributing to carbapenem resistance. We determined the minimum inhibitory concentrations (MICs) of four antibiotics: eravacycline, tigecycline, polymyxin-B, and ceftazidime/avibactam. Synergistic interactions between these antibiotic combinations were examined using checkerboard and time-kill analyses. RESULTS: We noted significant differences in the MICs of ceftazidime/avibactam between KPC and MBL isolates. Checkerboard analysis revealed appreciable synergy between combinations of tigecycline (35%) or eravacycline (40%) with polymyxin-B. The synergy rates for the combination of tigecycline or eravacycline with polymyxin-B were similar among the KPC and MBL isolates. These combinations maintained a synergy rate of 70.6% even against polymyxin-B resistant isolates. In contrast, combinations of tigecycline (5%) or eravacycline (10%) with ceftazidime/avibactam showed significantly lower synergy than combinations with polymyxin-B (P < 0.001 and P = 0.002, respectively). Among the MBL CRKP isolates, only one exhibited synergy with eravacycline or tigecycline and ceftazidime/avibactam combinations, and no synergistic activity was identified in the time-kill analysis for these combinations. The combination of eravacycline and polymyxin-B demonstrated the most promising synergy in the time-kill analysis. CONCLUSION: This study provides substantial evidence of a significant synergy when combining tigecycline or eravacycline with polymyxin-B against CRKP strains, including those producing MBL. These results highlight potential therapeutic strategies against CRKP infections.


Subject(s)
Azabicyclo Compounds , Bacterial Proteins , Carbapenem-Resistant Enterobacteriaceae , Klebsiella Infections , Tetracyclines , Humans , Ceftazidime/therapeutic use , Tigecycline/pharmacology , Carbapenems/pharmacology , Carbapenems/therapeutic use , Klebsiella pneumoniae , Klebsiella Infections/drug therapy , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , beta-Lactamases/pharmacology , Polymyxins/pharmacology , Polymyxins/therapeutic use , Microbial Sensitivity Tests
20.
Artif Intell Med ; 150: 102821, 2024 04.
Article in English | MEDLINE | ID: mdl-38553161

ABSTRACT

In the field of medical diagnosis and patient monitoring, effective pattern recognition in neurological time-series data is essential. Traditional methods predominantly based on statistical or probabilistic learning and inference often struggle with multivariate, multi-source, state-varying, and noisy data while also posing privacy risks due to excessive information collection and modeling. Furthermore, these methods often overlook critical statistical information, such as the distribution of data points and inherent uncertainties. To address these challenges, we introduce an information theory-based pipeline that leverages specialized features to identify patterns in neurological time-series data while minimizing privacy risks. We incorporate various entropy methods based on the characteristics of different scenarios and entropy. For stochastic state transition applications, we incorporate Shannon's entropy, entropy rates, entropy production, and the von Neumann entropy of Markov chains. When state modeling is impractical, we select and employ approximate entropy, increment entropy, dispersion entropy, phase entropy, and slope entropy. The pipeline's effectiveness and scalability are demonstrated through pattern analysis in a dementia care dataset and also an epileptic and a myocardial infarction dataset. The results indicate that our information theory-based pipeline can achieve average performance improvements across various models on the recall rate, F1 score, and accuracy by up to 13.08 percentage points, while enhancing inference efficiency by reducing the number of model parameters by an average of 3.10 times. Thus, our approach opens a promising avenue for improved, efficient, and critical statistical information-considered pattern recognition in medical time-series data.


Subject(s)
Entropy , Humans , Markov Chains , Time Factors
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