Assessment of intervention measures for the 2003 SARS epidemic in Taiwan by use of a back-projection method

OBJECTIVES. To reconstruct the infection curve for the 2003 severe acute respiratory syndrome (SARS) epidemic in Taiwan and to ascertain the temporal changes in the daily number of infections that occurred during the course of the outbreak. METHOD. Back-projection method. RESULTS. The peaks of the epidemic correspond well with the occurrence of major infection clusters in the hospitals. The overall downward trend of the infection curve after early May corresponds well to the date (May 10) when changes in the review and classification procedure were implemented by the SARS Prevention and Extrication Committee. CONCLUSION. The major infection control measures taken by the Taiwanese government over the course of the SARS epidemic, particularly those regarding infection control in hospitals, played a crucial role in containing the outbreak. © 2007 by The Society for Healthcare Epidemiology of America. All rights reserved.published_or_final_versio

Comparison of hydrogen port injection and direct injection (DI) in a single-cylinder dual-fuel diesel engine

Hydrogen direct injection (DI) in a dual-fuel diesel engine is a new technology that can resolve two major issues of its port injection counterpart - knocking and NOx emissions. Compared to widely studied hydrogen port injection in a diesel engine, the hydrogen DI concept executes a near top-dead centre (TDC) injection to cause hydrogen mixing-controlled combustion. The slower burning rate is expected to hinder a rapid pressure rise and subsequent pressure ringing (i.e. knocking) and to reduce NOx emissions, which are problematic in premixed combustion dominant, hydrogen port injection dual-fuel diesel engines. This study directly compares the in-cylinder pressure, efficiency and engine-out emissions of port injected and direct injected hydrogen-diesel dual-fuel combustion in the same engine. The tests were performed in a single-cylinder engine equipped with three injection systems including a hydrogen port injector, a hydrogen direct injector and a common-rail diesel direct injector. The engine was operated at intermediate load using a fixed total energy input of 820 J with hydrogen energy fraction of 50%. The results show that mixing-controlled combustion of the hydrogen in direct injection mode leads to lower in-cylinder pressure and thus lower engine efficiency. However, the severe pressure ringing observed for the hydrogen port injection is avoided and engine-out NOx emission is reduced, indicating the hydrogen DI operation is more stable, its combustion is cleaner and a higher hydrogen utilisation can be achieved

Antibody-dependent infection of human macrophages by severe acute respiratory syndrome coronavirus

Public health risks associated to infection by human coronaviruses remain considerable and vaccination is a key option for preventing the resurgence of severe acute respiratory syndrome coronavirus (SARS-CoV). We have previously reported that antibodies elicited by a SARS-CoV vaccine candidate based on recombinant, full-length SARS-CoV Spike-protein trimers, trigger infection of immune cell lines. These observations prompted us to investigate the molecular mechanisms and responses to antibody-mediated infection in human macrophages.published_or_final_versio

Antibody-dependent enhancement of SARS coronavirus infection and its role in the pathogenesis of SARS

1. Anti-SARS-CoV spike antibodies promote infection of primary human immune cells by SARS-CoV. 2. The antibody-dependent enhancement (ADE) infection pathway grants SARS-CoV an opportunity to infect primary human macrophages, but it does not sustain productive viral replication in the infected cells. 3. ADE of SARS-CoV infection does not alter pro-inflammatory gene expression profile of primary human macrophages. 4. Infectivity of SARS-CoV does not rely solely on the potency of target cells to bind — via Fcγ receptor II (CD32) — infectious immune complexes, but depends on the properties of the intracellular domain of the FcγRII. 5. Occurrence of ADE of SARS-CoV infection into human primary macrophages, without alteration to their pro-inflammatory properties, advocates cautious development of SARS-CoV vaccine in humans, and provides new ways of investigation to understand the pathogenesis of SARS.published_or_final_versio

Primary omental fibromatosis presenting as an incarcerated inguinal hernia: Case report from a single institution over 20 years

This paper has been presented in 12th International Congress of Asia-Pacific Hernia Society in Tokyo, Japan during period of 27th–28th October, 2016

Impact of COVID-19 on 1-year survival outcomes in hepatocellular carcinoma: a multicenter cohort study

INTRODUCTION: The COVID-19 pandemic has caused severe disruption of healthcare services worldwide and interrupted patients' access to essential services. During the first lockdown, many healthcare services were shut to all but emergencies. In this study, we aimed to determine the immediate and long-term indirect impact of COVID-19 health services utilisation on hepatocellular cancer (HCC) outcomes. METHODS: A prospective cohort study was conducted from 1 March 2020 until 30 June 2020, correlating to the first wave of the COVID-19 pandemic. Patients were enrolled from tertiary hospitals in the UK and Germany with dedicated HCC management services. All patients with current or past HCC who were discussed at a multidisciplinary meeting (MDM) were identified. Any delay to treatment (DTT) and the effect on survival at one year were reported. RESULTS: The median time to receipt of therapy following MDM discussion was 49 days. Patients with Barcelona Clinic Liver Cancer (BCLC) stages-A/B disease were more likely to experience DTT. Significant delays across all treatments for HCC were observed, but delay was most marked for those undergoing curative therapies. Even though severe delays were observed in curative HCC treatments, this did not translate into reduced survival in patients. CONCLUSION: Interruption of routine healthcare services because of the COVID-19 pandemic caused severe delays in HCC treatment. However, DTT did not translate to reduced survival. Longer follow is important given the delay in therapy in those receiving curative therapy

Parkinson's disease without nigral degeneration: a pathological correlate of scans without evidence of dopaminergic deficit (SWEDD)?

Objective To describe 5 cases of Parkinson's disease lacking any detectable histopathology. Background The diagnosis of Parkinson's disease is supported histologically by the findings of α-synuclein immunopositive Lewy bodies and neurites and severe substantia nigra cell loss. Bradykinesia as defined by slowness of initiation of movement and a progressive reduction in speed and amplitude on finger tapping is a clinical correlate of pars compacta nigral degeneration. There are very few published cases of Parkinson's disease in which no pathological abnormality was found, and some of these cases were in hindsight thought to have probably been cases of indeterminate senile tremor or dystonic tremor. Methods Retrospective case notes review of the Queen Square Brain Bank archival collection and detailed neuropathological analysis of the selected cases. Results 5 cases considered to have Parkinson's disease by neurologists throughout the entirety of their illness that lacked any histopathological findings known to be associated with Parkinson's syndromes were identified out of a total number of 773 brains with a final clinical diagnosis of Parkinson's disease in the Queen Square Brain Bank. Retrospective case note analysis did not suggest dystonic tremor or indeterminate tremor in any of them. There was a reduction in tyrosine hydroxylase (TH) density in the striatum in these cases when compared with healthy controls, but not in the substantia nigra. Conclusions Striatal dopamine deficiency without nigral cell loss is the most likely explanation for the clinical findings; other possible explanations include slowness due to comorbidities misinterpreted as bradykinesia, a tardive syndrome related to undisclosed previous neuroleptic exposure, or ‘soft age-related’ parkinsonian signs. These cases emphasise the need to regularly review the diagnosis in cases of suspected Parkinson's disease and highlight the need for precision in the neurological examination particularly of elderly patients. These cases may represent a distinct entity of diagnostic exclusion and may be considered one explanation for the radiological phenomenon of SWEDD (scans without evidence of dopaminergic deficit)

Inter-hemispheric EEG coherence analysis in Parkinson's disease : Assessing brain activity during emotion processing

Parkinson’s disease (PD) is not only characterized by its prominent motor symptoms but also associated with disturbances in cognitive and emotional functioning. The objective of the present study was to investigate the influence of emotion processing on inter-hemispheric electroencephalography (EEG) coherence in PD. Multimodal emotional stimuli (happiness, sadness, fear, anger, surprise, and disgust) were presented to 20 PD patients and 30 age-, education level-, and gender-matched healthy controls (HC) while EEG was recorded. Inter-hemispheric coherence was computed from seven homologous EEG electrode pairs (AF3–AF4, F7–F8, F3–F4, FC5–FC6, T7–T8, P7–P8, and O1–O2) for delta, theta, alpha, beta, and gamma frequency bands. In addition, subjective ratings were obtained for a representative of emotional stimuli. Interhemispherically, PD patients showed significantly lower coherence in theta, alpha, beta, and gamma frequency bands than HC during emotion processing. No significant changes were found in the delta frequency band coherence. We also found that PD patients were more impaired in recognizing negative emotions (sadness, fear, anger, and disgust) than relatively positive emotions (happiness and surprise). Behaviorally, PD patients did not show impairment in emotion recognition as measured by subjective ratings. These findings suggest that PD patients may have an impairment of inter-hemispheric functional connectivity (i.e., a decline in cortical connectivity) during emotion processing. This study may increase the awareness of EEG emotional response studies in clinical practice to uncover potential neurophysiologic abnormalities

Optimization of an Electron Transport Layer to Enhance the Power Conversion Efficiency of Flexible Inverted Organic Solar Cells

The photovoltaic (PV) performance of flexible inverted organic solar cells (IOSCs) with an active layer consisting of a blend of poly(3-hexylthiophene) and [6, 6]-phenyl C61-butlyric acid methyl ester was investigated by varying the thicknesses of ZnO seed layers and introducing ZnO nanorods (NRs). A ZnO seed layer or ZnO NRs grown on the seed layer were used as an electron transport layer and pathway to optimize PV performance. ZnO seed layers were deposited using spin coating at 3,000 rpm for 30 s onto indium tin oxide (ITO)-coated polyethersulphone (PES) substrates. The ZnO NRs were grown using an aqueous solution method at a low temperature (90°C). The optimized device with ZnO NRs exhibited a threefold increase in PV performance compared with that of a device consisting of a ZnO seed layer without ZnO NRs. Flexible IOSCs fabricated using ZnO NRs with improved PV performance may pave the way for the development of PV devices with larger interface areas for effective exciton dissociation and continuous carrier transport paths