Inhaled Corticosteroids May Not Affect the Clinical Outcomes of Pneumonia in Patients with Chronic Obstructive Pulmonary Disease

Background Although inhaled corticosteroids (ICS) is reportedly associated with a higher risk of pneumonia in chronic obstructive pulmonary disease (COPD), the clinical implications of ICS have not been sufficiently verified to determine their effect on the prognosis of pneumonia. Methods The electronic health records of patients hospitalized for pneumonia with underlying COPD were retrospectively reviewed. Pneumonia was confirmed using chest radiography or computed tomography. The clinical outcomes of pneumonia in patients with COPD who received ICS and those who received long-acting bronchodilators other than ICS were compared. Results Among the 255 hospitalized patients, 89 met the inclusion criteria. The numbers of ICS and non-ICS users were 46 and 43, respectively. The CURB-65 (confusion, uremia, respiratory rate, blood pressure, age ≥65 years) scores at the initial presentation of pneumonia were comparable between the two groups. The proportions of patients with multilobar infiltration, pleural effusion, and complicated pneumonia in the radiological studies did not vary between the two groups. Additionally, the defervescence time, proportion of mechanical ventilation, intensive care unit admission, length of hospital stays, and mortality rate at 30 and 90 days were not significantly different between the two groups. ICS use and blood eosinophils count were not associated with all pneumonia outcomes and mortality in multivariate analyses. Conclusion The clinical outcomes of pneumonia following ICS use in patients with COPD did not differ from those in patients treated without ICS. Thus, ICS may not contribute to the severity and outcomes of pneumonia in patients with COPD

Novel next generation sequencing panel method for the multiple detection and identification of foodborne pathogens in agricultural wastewater

Detecting and identifying the origins of foodborne pathogen outbreaks is a challenging. The Next-Generation Sequencing (NGS) panel method offers a potential solution by enabling efficient screening and identification of various bacteria in one reaction. In this study, new NGS panel primer sets that target 18 specific virulence factor genes from six target pathogens (Bacillus cereus, Yersinia enterocolitica, Staphylococcus aureus, Vibrio cholerae, Vibrio parahaemolyticus, and Vibrio vulnificus) were developed and optimized. The primer sets were validated for specificity and selectivity through singleplex PCR, confirming the expected amplicon size. Crosscheck and multiplex PCR showed no interference in the primer set or pathogenic DNA mixture. The NGS panel analysis of spiked water samples detected all 18 target genes in a single reaction, with pathogen concentrations ranging from 108 to 105 colony-forming units (CFUs) per target pathogen. Notably, the total sequence read counts from the virulence factor genes showed a positive association with the CFUs per target pathogen. However, the method exhibited relatively low sensitivity and occasional false positive results at low pathogen concentrations of 105 CFUs. To validate the detection and identification results, two sets of quantitative real-time PCR (qPCR) analyses were independently performed on the same spiked water samples, yielding almost the same efficiency and specificity compared to the NGS panel analysis. Comparative statistical analysis and Spearman correlation analysis further supported the similarity of the results by showing a negative association between the NGS panel sequence read counts and qPCR cycle threshold (Ct) values. To enhance NGS panel analysis for better detection, optimization of primer sets and real-time NGS sequencing technology are essential. Nonetheless, this study provides valuable insights into applying NGS panel analysis for multiple foodborne pathogen detection, emphasizing its potential in ensuring food safety

The seismo-acoustic dynamics of volcanic unrest and eruptions.

Volcanic systems are inherently complicated and therefore difficult to understand and forecast from monitored data. In an effort to understand volcanic processes, this thesis aims to estimate characteristics of varied seismo-acoustic signals during volcanic unrest and eruption at the southwest Pacific volcanoes: Ngauruhoe and Whakaari/White Island in New Zealand and Ambae in Vanuatu. These active volcanoes have formed through plate subduction and resultant magmatic activity over centuries and have experienced a variety of eruptive and non-eruptive unrest that has been monitored with variably dense monitoring networks. Using three case studies, this thesis addresses two main issues: 1) seismic waveform classification and analysis, and 2) the relationship between subsurface and surface volcanic observations. Volcano seismology techniques have been applied for many years in New Zealand to monitor the volcanoes. However, systematic studies of long-term trends are ongoing and crucial for developing methodologies to forecast eruptions. Building upon the existing research, I focus on two case studies associated with classification of long-term seismicity at New Zealand volcanoes. I apply different waveform detection/classification approaches depending on signal types. At Ngauruhoe, numbers of low frequency (LF) earthquakes persistently occurred from 2005 to 2010, which marked a new unrest episode since the last eruption in 1975. The LF signals are detected by a short-term averaging/long term averaging algorithm and classified using the analysis of a cross matrix. Micro-earthquakes similar to the detected waveforms are then recognised through application of a master event technique. Detailed analyses of temporal variations suggest a relationship between LF seismicity and meltwater-magma interaction at Ngauruhoe. At White Island, I apply more systematic approaches to very long period (VLP) signals recorded from 2007 to 2019. Volcanic VLPs are detected by a waveform semblance technique and clustered based on Pearson correlation distance. The results show VLP swarm activity as a long-term indicator of eruptive unrest at White Island. The LF/VLP earthquake types classified in this thesis will improve the local seismic monitoring systems and help to identify sources, and discuss mechanisms during future seismic unrest. At Ambae volcano, unlike New Zealand volcanoes, there is no precedent geophysical research about unrest and eruptions due to relatively remote place and sparse monitoring network. Therefore, this third case study of a shorter eruptive period provides fundamental and novel seismo-acoustic observations. Ambae volcano entered a new eruptive episode from September 2017 to late October 2018 with many phreatomagmatic, phreatic, and magmatic eruptions. In this case study, I investigate the last eruptive phase recorded at a temporary seismo-acoustic network. The research characterises comprehensive subsurface and surface volcanic activity and explores significant implications such as the impact of air- to-ground coupling activity and detecting volcanic eruptions and to tremor depth variations. The results allow us to understand how the signal of eruptive activity propagated through the different media, and allow us to infer possible source mechanisms of eruptions. The three case studies provide an improved interpretation of seismic activity at these volcanoes and how monitoring can be improved during times of seismic crisis. Moreover, the additional acoustic array analysis at Ambae can be used to confirm eruptions, and is applicable to other volcanoes for detecting unreported explosions and reducing ambiguity in seismic and eruptive monitoring

Classification of long-term very long period (VLP) volcanic earthquakes at Whakaari/White Island volcano, New Zealand

We have observed very long period earthquakes (VLPs) over the period 2007 to the end of 2019 at Whakaari/White Island volcano, New Zealand. The earthquakes exhibit similitude between waveforms which suggests repeating source locations and processes. VLPs recorded at two permanent stations were detected using waveform semblance and were then classified into two main families (F1 and F2) using a clustering analysis. The two families are characterized by ‘mirror image’ reverse waveform polarity suggesting that they are genetically related, but occur during different evolutionary phases of volcanic activity. F1 events occurred throughout the observation period, while F2 events mainly occurred as swarms that mark the onset of volcanic unrest. A detailed cluster analysis reveals possible sub-families implying slight temporal evolutions within a family. Our results add to our understanding of the volcanic magma–hydrothermal system at Whakaari/White Island indicating that relatively stable VLP sources may be exploited to improve monitoring for future unrest.[Figure not available: see fulltext.]New Zealand Natural Hazards Research PlatformMinistry of Business, Innovation and EmploymentResilience to Nature’s Challenge

Seismo-acoustic characterisation of the 2018 Ambae (Manaro Voui) eruption, Vanuatu

AbstractA new episode of unrest and phreatic/phreatomagmatic/magmatic eruptions occurred at Ambae volcano, Vanuatu, in 2017–2018. We installed a multi-station seismo-acoustic network consisting of seven 3-component broadband seismic stations and four 3-element (26–62 m maximum inter-element separation) infrasound arrays during the last phase of the 2018 eruption episode, capturing at least six reported major explosions towards the end of the eruption episode. The observed volcanic seismic signals are generally in the passband 0.5–10 Hz during the eruptive activity, but the corresponding acoustic signals have relatively low frequencies (< 1 Hz). Apparent very-long-period (< 0.2 Hz) seismic signals are also observed during the eruptive episode, but we show that they are generated as ground-coupled airwaves and propagate with atmospheric acoustic velocity. We observe strongly coherent infrasound waves at all acoustic arrays during the eruptions. Using waveform similarity of the acoustic signals, we detect previously unreported volcanic explosions at the summit vent region based on constant-celerity reverse-time-migration (RTM) analysis. The detected acoustic bursts are temporally related to shallow seismic volcanic tremor (frequency content of 5–10 Hz), which we characterise using a simplified amplitude ratio method at a seismic station pair with different distances from the vent. The amplitude ratio increased at the onset of large explosions and then decreased, which is interpreted as the seismic source ascent and descent. The ratio change is potentially useful to recognise volcanic unrest using only two seismic stations quickly. This study reiterates the value of joint seismo-acoustic data for improving interpretation of volcanic activity and reducing ambiguity in geophysical monitoring

Risk of Tuberculosis Caused by Fluticasone Propionate versus Budesonide in Chronic Obstructive Pulmonary Disease: A Nationwide Population-Based Study

Background: In chronic obstructive pulmonary disease (COPD), inhaled corticosteroids (ICSs) are recommended for use by patients with frequent exacerbations and blood eosinophilia. However, ICSs are often inappropriately prescribed and overused. COPD studies have reported an increased risk of tuberculosis among ICS users. This study aimed to compare the risk of tuberculosis according to the different ICS components. Methods: This study was conducted using a nationwide, population-based cohort. Patients newly diagnosed with COPD between 2005 and 2018, and treated with either fluticasone propionate or budesonide, were selected. The patients were followed up until the development of tuberculosis. Results: After propensity score matching, 16,514 fluticasone propionate and 16,514 budesonide users were identified. The incidence rate of tuberculosis per 100,000 person-years was 274.73 for fluticasone propionate and 214.18 for budesonide. The hazard ratio of tuberculosis in fluticasone propionate compared with budesonide was 1.28 (95% confidence interval 1.05–1.60). The risk of tuberculosis for fluticasone propionate increased with higher ICS cumulative doses: 1.01 (0.69–1.48), 1.16 (0.74–1.81), 1.25 (0.79–1.97), and 1.82 (1.27–2.62) from the lowest to highest quartiles, respectively. Conclusion: Fluticasone propionate is associated with a higher risk of tuberculosis than budesonide. ICS components can differently affect the risk of tuberculosis in patients with COPD

Adherence to Long-Acting Inhaler Use for Initial Treatment and Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Cohort Study

We aimed to determine the effect of long-acting inhaler use adherence on acute exacerbations in treatment-naïve patients with chronic obstructive pulmonary disease (COPD) using claims data from the Korean Health Insurance Review and Assessment Service from July 2015–December 2016. Patients with COPD aged ≥ 40 years who used long-acting inhalers were enrolled and observed for 6 months. Medication adherence was determined by the medication possession ratio (MPR); patients were categorized to adherence (MPR ≥ 80%) and non-adherence (MPR < 80%) groups. Ultimately, 3959 patients were enrolled: 60.4% and 39.6% in the adherence and non-adherence groups, respectively. The relative risk of acute exacerbation in the non-adherence group was 1.58 (95% confidence interval [CI] 1.25–1.99) compared with the adherence group. The adjusted logistic regression analysis revealed a relative risk of acute exacerbation in the non-adherence vs. adherence group of 1.68 (95% CI 1.32–2.14) regarding the number of inhalers used. Poor adherence to long-acting inhalers influenced increased acute exacerbation rates among patients with COPD. The acute exacerbation of COPD risk requiring hospitalization or ED visits was high in the non-adherence group, suggesting that efforts to improve medication adherence may help reduce COPD exacerbations even in the initial management of treatment-naïve patients

Selection of Representative Questionnaire Items from the Asthma Control Test

Asthma is a disease characterized by the appearance of transient or persistent symptoms in response to allergens, viral upper respiratory infections, and cold air. Asthma treatment aims to control, rather than cure, and digital systems can be useful in this regard. However, conventional assessment methods for asthma control are not suitable for digital healthcare. Therefore, we aimed to select representative questionnaire items suitable for digitally assessing the asthma control status. We analyzed the Asthma Control Test (ACT) and selected representative items. Throughout the year 2020, ACT results (2019 in total) collected from patients (>18 years old) with a principal diagnosis of asthma were analyzed. Individual questionnaire items were tested using Pearson’s correlation and receiver operating characteristic curves. Of the five questionnaire items, Q1, Q2, Q3, and Q5 yielded significant findings. Among these questionnaires, Q2 was the most descriptive and correlated questionnaire. Q5 was also significant but it was excluded since it was unable to apply to the digital health care system for asthma assessment method. The remaining three questionnaire items were selected and their sensitivity and specificity were assessed. Eight methods were analyzed, and the sum of scores of Q1–Q3 had the highest sensitivity and specificity (97% and 91%, respectively). The results suggested that, instead of the full items of ACT, the sum of Q1–Q3 can be used to assess the asthma control status. These findings will serve as the foundation for developing digital asthma control assessment tools

A quest for unrest in multiparameter observations at Whakaari/White Island volcano, New Zealand 2007–2018

Abstract The Whakaari/White Island volcano, located ~ 50 km off the east coast of the North Island in New Zealand, has experienced sequences of quiescence, unrest, magmatic and phreatic eruptions over the last decades. For the last 15 years, seismic data have been continuously archived providing potential insight into this frequently active volcano. Here we take advantage of this unusually long time series to retrospectively process the seismic data using ambient noise and tremor-based methodologies. We investigate the time (RSAM) and frequency (Power Spectral Density) evolution of the volcanic tremor, then estimate the changes in the shallow subsurface using the Displacement Seismic Amplitude Ratio (DSAR), relative seismic velocity (dv/v) and decorrelation, and the Luni-Seismic Correlation (LSC). By combining our new set of observations with the long-term evolution of earthquakes, deformation, visual observations and geochemistry, we review the activity of Whakaari/White Island between 2007 and the end of 2018. Our analysis reveals the existence of distinct patterns related to the volcano activity with periods of calm followed by cycles of pressurization and eruptions. We finally put these results in the wider context of forecasting phreatic eruptions using continuous seismic records.info:eu-repo/semantics/publishe

A formulated red ginseng extract inhibits autophagic flux and sensitizes to doxorubicin-induced cell death

Background: Ginseng is believed to have antitumor activity. Autophagy is largely a prosurvival cellular process that is activated in response to cellular stressors, including cytotoxic chemotherapy; therefore, agents that inhibit autophagy can be used as chemosensitizers in cancer treatment. We examined the ability of Korean Red Ginseng extract (RGE) to prevent autophagic flux and to make hepatocellular carcinoma (HCC) cells become more sensitive to doxorubicin. Methods: The cytotoxic effects of total RGE or its saponin fraction (RGS) on HCC cells were examined by the lactate dehydrogenase assay in a dose- or time-dependent manner. The effect of RGE or RGS on autophagy was measured by analyzing microtubule-associated protein 1A/1B-light chain (LC)3-II expression and LC3 puncta formation in HCC cells. Late-stage autophagy suppression was tested using tandem-labeled green fluorescent protein (GFP)–monomeric red fluorescent protein (mRFP)–LC3. Results: RGE markedly increased the amount of LC3-II, but green and red puncta in tandem-labeled GFP–mRFP–LC3 remained colocalized over time, indicating that RGE inhibited autophagy at a late stage. Suppression of autophagy through knockdown of key ATG genes increased doxorubicin-induced cell death, suggesting that autophagy induced by doxorubicin has a protective function in HCC. Finally, RGE and RGS markedly sensitized HCC cells, (but not normal liver cells), to doxorubicin-induced cell death. Conclusion: Our data suggest that inhibition of late-stage autophagic flux by RGE is important for its potentiation of doxorubicin-induced cancer cell death. Therapy combining RGE with doxorubicin could serve as an effective strategy in the treatment of HCC. Keywords: autophagic flux, cell death, ginseng extrac