Participation in Cardiac Rehabilitation Program for Patients with Different Risk Categories in Sarawak Heart Center

Objective: Exercise therapy and education program are two important components of cardiac rehabilitation program (CRP). Compliance to the prescribed program is important in order to achieve the desired therapeutic effects. The study compared the various risk categories of participation in the CRP. Methods: This cross-sectional retrospective study enrolled 148 consecutive patients who attended the CRP in Sarawak Heart Center from March 2014 to February 2015. Subsequently, 106 patients proceeded for exercise stress test (EST) prior to enrolling into CRP. We analyzed the demographic, functional profile, association between risk category and participation in CRP. Results: The results showed that the cohort mean age was 54 years with a range of 30 and 75. As for functional assessment with six minute walk test, our participants could cover a varying distance of 132 to 600 meters with a mean distance of 407 meters. The mean maximum workload achievable for EST was 8.2 Mets (range 1.4-14.5 Mets). All low risk group patients were enrolled into the full program with only 8% default rate. 84.7% of moderate risk group entered the program with 15.3% default rate. Fifty percent of the high-risk group enrolled for the full program when they could achieve more than 4 Mets of maximum workload during the EST. The remaining of the high risk group alternatively participated in the education program which recorded the highest default rate of 18.2%. The low risk group had the best compliance rate which could be attributed to higher exercise program enjoyment. This study showed the association of the different risk categories and the level of participation in our center CRP. Conclusion: Our cardiac rehabilitation program had overall high participation rate in all risk categories, we could improve further the level of participation for the high risk group by introducing telemetry monitoring which allow more patients to enroll in full program

Completability and optimal factorization norms in tensor products of Banach function spaces

[EN] Given s-finite measure spaces ( 1, 1, mu 1) and ( 2, 2, mu 2), we consider Banach spaces X1(mu 1) and X2(mu 2), consisting of L0(mu 1) and L0(mu 2) measurable functions respectively, and study when the completion of the simple tensors in the projective tensor product X1(mu 1). p X2(mu 2) is continuously included in the metric space of measurable functions L0(mu 1. mu 2). In particular, we prove that the elements of the completion of the projective tensor product of L p-spaces are measurable functions with respect to the product measure. Assuming certain conditions, we finally showthat given a bounded linear operator T : X1(mu 1). p X2(mu 2). E (where E is a Banach space), a norm can be found for T to be bounded, which is ` minimal' with respect to a given property (2-rectangularity). The same technique may work for the case of n-spaces.J. M. Calabuig and M. Fernandez-Unzueta were supported by Ministerio de Economia, Industria y Competitividad (Spain) under project MTM2014-53009-P. M. Fernandez-Unzueta was also suported by CONACyT 284110. F. Galaz-Fontes was supported by Ministerio de Ciencia e Innovacion (Spain) and FEDER under project MTM2009-14483-C02-01. E. A. Sanchez Perez was supported by Ministerio de Economia, Industria y Competitividad (Spain) and FEDER under project MTM2016-77054-C2-1-P.Calabuig, JM.; Fernández-Unzueta, M.; Galaz-Fontes, F.; Sánchez Pérez, EA. (2019). Completability and optimal factorization norms in tensor products of Banach function spaces. Revista de la Real Academia de Ciencias Exactas Físicas y Naturales Serie A Matemáticas. 113(4):3513-3530. https://doi.org/10.1007/s13398-019-00711-7S351335301134Abramovich, Y.A., Aliprantis, C.D.: An invitation to operator theory. Graduate Studies in Mathematics, Vol 50, AMS (2002)Bennett, C., Sharpley, R.: Interpolation of Operators. Academic Press, Boston (1988)Bu, Q., Buskes, G., Kusraev, A.G.: Bilinear maps on products of vector lattices: a survey. In: Boulabiar, K., Buskes, G., Triki, A. (eds.) Positivity-Trends in Mathematics. Birkhäser Verlag AG, Basel, pp. 97–26 (2007)Buskes, G., Van Rooij, A.: Bounded variation and tensor products of Banach lattices. Positivity 7, 47–59 (2003)Calabuig, J.M., Fernández-Unzueta, M., Galaz-Fontes, F., Sánchez-Pérez, E.A.: Extending and factorizing bounded bilinear maps defined on order continuous Banach function spaces. RACSAM 108(2), 353–367 (2014)Calabuig, J.M., Fernández-Unzueta, M., Galaz-Fontes, F., Sánchez-Pérez, E.A.: Equivalent norms in a Banach function space and the subsequence property. J. Korean Math. Soc. https://doi.org/10.4134/JKMS.j180682Curbera, G.P., Ricker, W.J.: Optimal domains for kernel operators via interpolation. Math. Nachr. 244, 47–63 (2002)Curbera, G.P., Ricker, W.J.: Vector measures, integration and applications. In: Positivity. Birkhäuser Basel, pp. 127–160 (2007)Gil de Lamadrid, J.: Uniform cross norms and tensor products. J. Duke Math. 32, 797–803 (1965)Dunford, N., Schwartz, J.: Linear Operators, Part I: General Theory. Interscience Publishers Inc., New York (1958)Fremlin, D.H.: Tensor products of Archimedean vector lattices. Am. J. Math. 94(3), 777–798 (1972)Fremlin, D.H.: Tensor products of Banach lattices. Math. Ann. 211(2), 87–106 (1974)Yew, K.L.: Completely $$p$$-summing maps on the operator Hilbert space OH. J. Funct. Anal. 255, 1362–1402 (2008)Kwapien, S., Pelczynski, A.: The main triangle projection in matrix spaces and its applications. Stud. Math. 34(1), 43–68 (1970)Lindenstrauss, J., Tzafriri, L.: Classical Banach spaces II. Springer, Berlin (1979)Luxemburg, W.A.J., Zaanen, A.C.: Riesz Spaces I. North-Holland Publishing Company, Amsterdam (1971)Milman, M.: Some new function spaces and their tensor products. Depto. de Matemática, Facultad de Ciencias, U. de los Andes, Mérida, Venezuela (1978)Okada, S., Ricker, W.J., Sánchez Pérez, E.A.: Optimal domain and integral extension of operators acting in function spaces. Oper. Theory Adv. Appl., vol. 180. Birkhäuser, Basel (2008)Schep, A.R.: Factorization of positive multilinear maps. Illinois J. Math. 579–591 (1984)Zaanen, A.C.: Integration. North-Holland Publishing Company, Amsterdam-New York (1967)Zaanen, A.C.: Riesz Spaces II. North-Holland Publishing Company, Amsterdam (1983

Does a child’s language ability affect the correspondence between parent and teacher ratings of ADHD symptoms?

Background: Rating scales are often used to identify children with potential Attention-Deficit/Hyperactivity Disorder (ADHD), yet there are frequently discrepancies between informants which may be moderated by child characteristics. The current study asked whether correspondence between parent and teacher ratings on the Strengths and Weakness of ADHD symptoms and Normal behaviour scale (SWAN) varied systematically with child language ability. Method: Parent and teacher SWAN questionnaires were returned for 200 children (aged 61–81 months); 106 had low language ability (LL) and 94 had typically developing language (TL). After exploring informant correspondence (using Pearson correlation) and the discrepancy between raters, we report inter-class correlation coefficients, to assess inter-rater reliability, and Cohen’s kappa, to assess agreement regarding possible ADHD caseness. Results: Correlations between informant ratings on the SWAN were moderate. Children with LL were rated as having increased inattention and hyperactivity relative to children with TL; teachers, however, rated children with LL as having more inattention than parents. Inter-rater reliability of the SWAN was good and there were no systematic differences between the LL and TL groups. Case agreement between parent and teachers was fair; this varied by language group with poorer case agreement for children with LL. Conclusion: Children’s language abilities affect the discrepancy between informant ratings of ADHD symptomatology and the agreement between parents and teachers regarding potential ADHD caseness. The assessment of children’s core language ability would be a beneficial addition to the ADHD diagnostic process.</p

HPV16 oncogene expression levels during early cervical carcinogenesis are determined by the balance of epigenetic chromatin modifications at the integrated virus genome.

In cervical squamous cell carcinomas, high-risk human papillomavirus (HRHPV) DNA is usually integrated into host chromosomes. Multiple integration events are thought to be present within the cells of a polyclonal premalignant lesion and the features that underpin clonal selection of one particular integrant remain poorly understood. We previously used the W12 model system to generate a panel of cervical keratinocyte clones, derived from cells of a low-grade premalignant lesion naturally infected with the major HRHPV type, HPV16. The cells were isolated regardless of their selective advantage and differed only by the site of HPV16 integration into the host genome. We used this resource to test the hypothesis that levels of HPV16 E6/E7 oncogene expression in premalignant cells are regulated epigenetically. We performed a comprehensive analysis of the epigenetic landscape of the integrated HPV16 DNA in selected clones, in which levels of virus oncogene expression per DNA template varied ~6.6-fold. Across the cells examined, higher levels of virus expression per template were associated with more open chromatin at the HPV16 long control region, together with greater loading of chromatin remodelling enzymes and lower nucleosome occupancy. There were higher levels of histone post-translational modification hallmarks of transcriptionally active chromatin and lower levels of repressive hallmarks. There was greater abundance of the active/elongating form of the RNA polymerase-II enzyme (RNAPII-Ser2P), together with CDK9, the component of positive transcription elongation factor b complex responsible for Ser2 phosphorylation. The changes observed were functionally significant, as cells with higher HPV16 expression per template showed greater sensitivity to depletion and/or inhibition of histone acetyltransferases and CDK9 and less sensitivity to histone deacetylase inhibition. We conclude that virus gene expression per template following HPV16 integration is determined through multiple layers of epigenetic regulation, which are likely to contribute to selection of individual cells during cervical carcinogenesis.This work was supported by Cancer Research UK (Programme Grant A13080); the Medical Research Council; The Pathological Society of Great Britain and Ireland (E.L.A.K.); and the Agency for Science, Technology and Research, Singapore (Q.Y.A).This is the final version of the article. It first appeared from Nature Publishing Group via http://dx.doi.org/10.1038/onc.2016.

The impact of viral mutations on recognition by SARS-CoV-2 specific T cells.

We identify amino acid variants within dominant SARS-CoV-2 T cell epitopes by interrogating global sequence data. Several variants within nucleocapsid and ORF3a epitopes have arisen independently in multiple lineages and result in loss of recognition by epitope-specific T cells assessed by IFN-γ and cytotoxic killing assays. Complete loss of T cell responsiveness was seen due to Q213K in the A∗01:01-restricted CD8+ ORF3a epitope FTSDYYQLY207-215; due to P13L, P13S, and P13T in the B∗27:05-restricted CD8+ nucleocapsid epitope QRNAPRITF9-17; and due to T362I and P365S in the A∗03:01/A∗11:01-restricted CD8+ nucleocapsid epitope KTFPPTEPK361-369. CD8+ T cell lines unable to recognize variant epitopes have diverse T cell receptor repertoires. These data demonstrate the potential for T cell evasion and highlight the need for ongoing surveillance for variants capable of escaping T cell as well as humoral immunity.This work is supported by the UK Medical Research Council (MRC); Chinese Academy of Medical Sciences(CAMS) Innovation Fund for Medical Sciences (CIFMS), China; National Institute for Health Research (NIHR)Oxford Biomedical Research Centre, and UK Researchand Innovation (UKRI)/NIHR through the UK Coro-navirus Immunology Consortium (UK-CIC). Sequencing of SARS-CoV-2 samples and collation of data wasundertaken by the COG-UK CONSORTIUM. COG-UK is supported by funding from the Medical ResearchCouncil (MRC) part of UK Research & Innovation (UKRI),the National Institute of Health Research (NIHR),and Genome Research Limited, operating as the Wellcome Sanger Institute. T.I.d.S. is supported by a Well-come Trust Intermediate Clinical Fellowship (110058/Z/15/Z). L.T. is supported by the Wellcome Trust(grant number 205228/Z/16/Z) and by theUniversity of Liverpool Centre for Excellence in Infectious DiseaseResearch (CEIDR). S.D. is funded by an NIHR GlobalResearch Professorship (NIHR300791). L.T. and S.C.M.are also supported by the U.S. Food and Drug Administration Medical Countermeasures Initiative contract75F40120C00085 and the National Institute for Health Research Health Protection Research Unit (HPRU) inEmerging and Zoonotic Infections (NIHR200907) at University of Liverpool inpartnership with Public HealthEngland (PHE), in collaboration with Liverpool School of Tropical Medicine and the University of Oxford.L.T. is based at the University of Liverpool. M.D.P. is funded by the NIHR Sheffield Biomedical ResearchCentre (BRC – IS-BRC-1215-20017). ISARIC4C is supported by the MRC (grant no MC_PC_19059). J.C.K.is a Wellcome Investigator (WT204969/Z/16/Z) and supported by NIHR Oxford Biomedical Research Centreand CIFMS. The views expressed are those of the authors and not necessarily those of the NIHR or MRC

Spatial growth rate of emerging SARS-CoV-2 lineages in England, September 2020-December 2021

This paper uses a robust method of spatial epidemiological analysis to assess the spatial growth rate of multiple lineages of SARS-CoV-2 in the local authority areas of England, September 2020–December 2021. Using the genomic surveillance records of the COVID-19 Genomics UK (COG-UK) Consortium, the analysis identifies a substantial (7.6-fold) difference in the average rate of spatial growth of 37 sample lineages, from the slowest (Delta AY.4.3) to the fastest (Omicron BA.1). Spatial growth of the Omicron (B.1.1.529 and BA) variant was found to be 2.81× faster than the Delta (B.1.617.2 and AY) variant and 3.76× faster than the Alpha (B.1.1.7 and Q) variant. In addition to AY.4.2 (a designated variant under investigation, VUI-21OCT-01), three Delta sublineages (AY.43, AY.98 and AY.120) were found to display a statistically faster rate of spatial growth than the parent lineage and would seem to merit further investigation. We suggest that the monitoring of spatial growth rates is a potentially valuable adjunct to outbreak response procedures for emerging SARS-CoV-2 variants in a defined population