Secular trends of health care resource utilization and costs between Brugada syndrome and congenital long QT syndrome: A territory‐wide study

Background Health care resource utilization (HCRU) and costs are important metrics of health care burden, but they have rarely been explored in the setting of cardiac ion channelopathies. Hypothesis This study tested the hypothesis that attendance-related HCRUs and costs differed between patients with Brugada syndrome (BrS) and congenital long QT syndrome (LQTS). Methods This was a retrospective cohort study of consecutive BrS and LQTS patients at public hospitals or clinics in Hong Kong, China. HCRUs and costs (in USD) for Accident and Emergency (A&E), inpatient, general outpatient and specialist outpatient attendances were analyzed between 2001 and 2019 at the cohort level. Comparisons were made using incidence rate ratios (IRRs [95% confidence intervals]). Results Over the 19-year period, 516 BrS (median age of initial presentation: 51 [interquartile range: 38−61] years, 92% male) and 134 LQTS (median age of initial presentation: 21 [9−44] years, 32% male) patients were included. Compared to LQTS patients, BrS patients had lower total costs (2 008 126 [2 007 622−2 008 629] vs. 2 343 864 [2 342 828−2 344 900]; IRR: 0.857 [0.855−0.858]), higher costs for A&E attendances (83 113 [83 048−83 177] vs. 70 604 [70 487−70 721]; IRR: 1.177 [1.165−1.189]) and general outpatient services (2,176 [2,166−2,187] vs. 921 [908−935]; IRR: 2.363 [2.187−2.552]), but lower costs for inpatient stay (1 391 624 [1 391 359−1 391 889] vs. 1 713 742 [1 713 166−1 714 319]; IRR: 0.812 [0.810−0.814]) and lower costs for specialist outpatient services (531 213 [531 049−531 376] vs. 558 597 [558268−558926]; IRR: 0.951 [0.947−0.9550]). Conclusions Overall, BrS patients consume 14% less health care resources compared to LQTS patients in terms of attendance costs. BrS patients require more A&E and general outpatient services, but less inpatient and specialist outpatient services than LQTS patients

Effects of thioglycolic acid on in vivo oocytes maturation in mice.

BACKGROUND: Thioglycolic acid (TGA) is widely used in the hairdressing industry, which mostly caters to women. Recently, TGA has been reported to impair several organs, especially reproductive ones such as testes and ovaries. The reproductive toxicity of TGA on females has become an issue that cannot be neglected. METHODOLOGY/PRINCIPAL FINDINGS: In the present work, superovulated female mice were percutaneously treated with different doses of TGA (37.81, 75.62, and 151.25 mg/kg). The mice were sacrificed to collect ovulated oocytes, whose numbers were counted and compared. Immunofluorescence-stained oocytes were observed under a confocal microscope to investigate the effects of TGA on spindle morphology, distribution of cortical granules (CGs), and parthenogenetic activation. The number of ovulated oocytes was decreased by TGA. The ovulated oocytes in the 151.25 mg/kg TGA group were significantly less than in the control and in the 37.81 mg/kg TGA groups. The ovulated oocytes in the 75.62 mg/kg TGA group were less than in the 37.81 mg/kg dose group. Abnormal spindle configuration in vivo was also induced by TGA. The spindle areas in the 75.62 and 151.25 mg/kg TGA groups were significantly larger than in the control and 37.81 mg/kg TGA groups. The parthenogenetic activation of ovulated oocytes in vitro was inhibited as well. The percentage of activated oocytes in the 75.62 and 151.25 mg/kg TGA groups was significantly lower than in the control and 37.81 mg/kg TGA groups. The percentage in the 151.25 mg/kg TGA group was also less than in the 75.62 mg/kg group. CG distribution was not affected by TGA. CONCLUSION: Mice were percutaneously treated with TGA. Consequently, the number of ovulated oocytes decreased, abnormal spindle configurations were induced, and the parthenogenetic activation of ovulated oocytes was inhibited. CG distribution was not affected

Identification and validation of reference genes for normalization of gene expression analysis using qRT-PCR in Megalurothrips usitatus (thysanoptera: thripidae)

Introduction: Gene expression analysis by reverse transcription quantitative polymerase chain reaction (qRT-PCR) has been widely used in research including insects. The selection of appropriate reference genes is the key to obtaining accurate and reliable results from qRT-PCR. However, studies on the expression stability of reference genes in Megalurothrips usitatus remain lacking.Methods: In this study, qRT-PCR was used to analyze the expression stability of candidate reference genes in M. usitatus. The expression levels of six candidate reference gene transcription of M. usitatus were analyzed. GeNorm, NormFinder, BestKeeper, and ΔCt were used to analyze the expression stability of M. usitatus treated with biological factors (developmental period treatment) and abiotic factors (light, temperature, insecticide treatment, respectively). Comprehensive stability ranking of candidate reference genes was recommended by RefFinder.Results and Discussion: Results showed that ribosomal protein S (RPS) was the most suitable expression in insecticide treatment. Ribosomal protein L (RPL) was the most suitable expression at developmental stage and light treatment, whereas elongation factor was the most suitable expression in temperature treatment. RefFinder was used to comprehensively analyze the above four treatments, and the results showed that RPL and actin (ACT) showed high stability in each treatment. Therefore, this study identified these two genes as reference genes in the qRT-PCR analysis of different treatment conditions of M. usitatus. Ourfindings will be beneficial for improving the accuracy of qRT-PCR analysis for future functional analysis of the target gene expression in M. usitatus

Effect of TGA on the parthenogenetic activation of oocytes.

<p>*Compared to control group, <i>P</i><0.05.</p>Δ<p>Compared to the 37.81 mg/kg TGA group, <i>P</i><0.05.</p>#<p>Compared to the 75.62 mg/kg TGA group, <i>P</i><0.05.</p

Parthenogenetically activated oocytes (×300) with pronucleus (PN) and polar body (PB).

<p>The black arrow shows PN and the white arrow shows PB. A: The activated oocyte with 1 PN and 2 PB. B: The activated oocyte with 2 PN and 1 PB. C: The activated oocyte with 2 cells.</p

Effect of TGA on the number of ovulated oocytes.

<p>*Compared to control group; <i>P</i><0.05.</p>Δ<p>Compared to 37.81 mg/kg TGA group; <i>P</i><0.05.</p

Effect of TGA on the spindle morphology of <i>in vivo</i> matured oocytes (×600).

<p>The oocytes were stained immunocytochemically with anti-α-tubulin monoclonal antibody and fluoroscein isothiocyanate to observe the spindle (green). Counterstaining with PI was also performed to detect the chromosomes (red).</p

Effect of TGA administration on the spindle area of <i>in vivo</i> matured oocytes (<i>n</i> = 22).

<p>* Compare to control group, <i>P</i><0.05; ^Δ Compared to 37.81 mg/kg TGA group, <i>P</i><0.05; ^# Compared to 75.62 mg/kg TGA group, <i>P</i><0.05.</p