Age as a predisposing factor of respiratory alkalosis in accidental carbon monoxide poisoning

AbstractAimsThe purpose of this study was to determine the frequency of and identify the predisposing factors for respiratory alkalosis in patients with accidental carbon monoxide (CO) poisoning.MethodsPatients presenting to the emergency department with accidental CO poisoning were retrospectively identified and divided into Group A (no respiratory alkalosis) and Group B (respiratory alkalosis). Charts were reviewed for neurologic status, various demographic factors, and laboratory data.ResultsA total 96 patients, 37 (38.5%) men and 59 (61.5%) women, were identified. Of these, the 58 (60.4%) patients without respiratory alkalosis were placed in Group A and the 38 (39.6%) patients with respiratory alkalosis were placed in Group B. Independent multivariate predictors of CO poisoning presenting with respiratory alkalosis were age [odds ratio (OR), 1.04; 95% confidence interval (CI), 1.01–1.08] and respiratory rate (OR, 1.16; 95% CI, 1.01–1.33). The rates of respiratory alkalosis in patients younger than 15 years, 15–29 years, 30–44 years, 45–59 years, and older than 59 years were 17.4%, 32.4%, 51.9%, 75%, and 75%, respectively (p<0.01).ConclusionsRespiratory alkalosis in the patients with CO poisoning is not an uncommon finding, and as age increases, the percentage becomes higher. When emergency physicians are faced with patients presenting with respiratory alkalosis of undetermined cause, CO poisoning should be taken into consideration, especially in the elderly

Dual pathogenicity island transfer by piggybacking lateral transduction

Lateral transduction (LT) is the process by which temperate phages mobilize large sections of bacterial genomes. Despite its importance, LT has only been observed during prophage induction. Here, we report that superantigen-carrying staphylococcal pathogenicity islands (SaPIs) employ a related but more versatile and complex mechanism of gene transfer to drive chromosomal hypermobility while self-transferring with additional virulence genes from the host. We found that after phage infection or prophage induction, activated SaPIs form concatamers in the bacterial chromosome by switching between parallel genomic tracks in replication bubbles. This dynamic life cycle enables SaPIbov1 to piggyback its LT of staphylococcal pathogenicity island vSaα, which encodes an array of genes involved in host-pathogen interactions, allowing both islands to be mobilized intact and transferred in a single infective particle. Our findings highlight previously unknown roles of pathogenicity islands in bacterial virulence and show that their evolutionary impact extends beyond the genes they carry

Areca Users in Combination with Tobacco and Alcohol Use Are Associated with Younger Age of Diagnosed Esophageal Cancer in Taiwanese Men

BACKGROUND: Whether the habitual use of substances (tobacco, alcohol, or areca nut (seed of the Areca palm)) can affect the age of esophageal squamous cell carcinoma (ESCC) presentation has rarely been examined. METHODS: The study subjects were those who were males and the first time to be diagnosed as ESCC (ICD-9 150) and who visited any of three medical centers in Taiwan between 2000 and 2009. A standardized questionnaire was used to collect substance uses and other variables. RESULTS: Mean age (±SD) at presentation of ESCC was 59.2 (±11.3) years in a total of 668 cases. After adjusting for other covariates, alcohol drinkers were 3.58 years younger to have ESCC than non-drinkers (p = 0.002). A similar result was found among areca chewers, who were 6.34 years younger to have ESCC than non-chewers (p<0.0001), but not among cigarette smokers (p = 0.10). When compared to the group using 0-1 substances, subjects using both cigarettes and alcohol were nearly 3 years younger to contract ESCC. Furthermore, those who use areca plus another substance were 7-8 years younger. Subjects using all three substances had the greatest age difference, 9.20 years younger (p<0.0001), compared to the comparison group. CONCLUSION: Our findings suggest that habitually consuming tobacco, alcohol, and areca nut can influence the age-onset of ESCC. Since the development of ESCC is insidious and life-threatening, our observation is worthy to be reconfirmed in the large-scale and long-term follow-up prospective cohort studies to recommend the screening strategy of this disease

Real-time DNA microarray analysis

We present a quantification method for affinity-based DNA microarrays which is based on the real-time measurements of hybridization kinetics. This method, i.e. real-time DNA microarrays, enhances the detection dynamic range of conventional systems by being impervious to probe saturation in the capturing spots, washing artifacts, microarray spot-to-spot variations, and other signal amplitude-affecting non-idealities. We demonstrate in both theory and practice that the time-constant of target capturing in microarrays, similar to all affinity-based biosensors, is inversely proportional to the concentration of the target analyte, which we subsequently use as the fundamental parameter to estimate the concentration of the analytes. Furthermore, to empirically validate the capabilities of this method in practical applications, we present a FRET-based assay which enables the real-time detection in gene expression DNA microarrays

Genome hypermobility by lateral transduction

Genetic transduction is a major evolutionary force that underlies bacterial adaptation. Here we report that the temperate bacteriophages of Staphylococcus aureus engage in a distinct form of transduction we term lateral transduction. Staphylococcal prophages do not follow the previously described excision-replication-packaging pathway but instead excise late in their lytic program. Here, DNA packaging initiates in situ from integrated prophages, and large metameric spans including several hundred kilobases of the S. aureus genome are packaged in phage heads at very high frequency. In situ replication before DNA packaging creates multiple prophage genomes so that lateral-transducing particles form during normal phage maturation, transforming parts of the S. aureus chromosome into hypermobile regions of gene transfer

Interest-driven creator theory: towards a theory of learning design for Asia in the twenty-first century

Asian education is known for its examination-driven orientation, with the downsides of distorting the processes of learning and teaching, diminishing students’ interest in learning, and failing to nurture twenty-first century competencies among students. As a group of Asian researchers, we have been developing Interest-Driven Creator (IDC) Theory, a design theory based on three anchored concepts, namely interest, creation, and habit. Each of these anchored concepts is represented by a loop composed of three components. In the interest loop, the three components are triggering, immersing, and extending. The components of the creation loop are imitating, combining, and staging. The habit loop consists of cuing environment, routine, and harmony. These three loops are interconnected in various ways, with their characteristics revealed by the design process. We hypothesize that technology-supported learning activities that are designed with reference to IDC Theory will enable students to develop interest in learning, be immersed in the creation process, and, by repeating this process in their daily routines, strengthen habits of creation. Furthermore, students will excel in learning performance, develop twenty-first century competencies, and become lifelong interest-driven creators. To sharpen our understanding and further the development of the theory, we need more discussion and collaborative efforts in the community. Hypotheses arising from this theory can be tested, revised, or refined by setting up and investigating IDC Theory-based experimental sites. By disseminating the framework, foundations, and practices to the various countries and regions of Asia, we hope that it will bring about compelling examples and hence a form of quality education for the twenty-first century, which is an alternative to the examination-driven education system. In this paper, we present an overall introduction to IDC Theory and its history, and discuss some of the steps for advancing it in the future

IDC theory: habit and the habit loop

Interest-driven creator (IDC) theory is a design theory that intends to inform the design of future education in Asia. It consists of three anchored concepts, namely, interest, creation, and habit. This paper presents the third anchored concept habit as well as the habit loop. IDC theory assumes that learners, when driven by interest, can be engaged in knowledge creation. Furthermore, by repeating such process in their daily learning routines, learners will form interest-driven creation habits. The habit loop, the process of building such a habit, consists of three component concepts— cuing environment, routine, and harmony. The cuing environment is a habit trigger that tells the students’ brain to get prepared and go into an automatic mode, letting learning behavior unfold. Routine refers to the behavioral patterns the students repeat most often, literally etched into their neural pathways. Harmony refers to the affective outcome of the routine activity as well as the integration or stabilization of habits; that is, through the routine behavior and action, students may feel that their needs get fulfilled, feel satisfied, and experience inner peace. It is our hope that such habitual behavior of creating knowledge can be sustained so long that students ultimately become lifelong interest-driven creators. This paper focuses on the description of the three components of the habit loop and discusses how these components are related to the interest loop and the creation loop in supporting learners in developing their interest-driven creation capability

Highlights from the 2019 International Myopia Summit on 'controversies in myopia'.

Myopia is an emerging public health issue with potentially significant economic and social impact, especially in East Asia. However, many uncertainties about myopia and its clinical management remain. The International Myopia Summit workgroup was convened by the Singapore Eye Research Institute, the WHO Regional Office for the Western Pacific and the International Agency for the Prevention of Blindness in 2019. The aim of this workgroup was to summarise available evidence, identify gaps or unmet needs and provide consensus on future directions for clinical research in myopia. In this review, among the many 'controversies in myopia' discussed, we highlight three main areas of consensus. First, development of interventions for the prevention of axial elongation and pathologic myopia is needed, which may require a multifaceted approach targeting the Bruch's membrane, choroid and/or sclera. Second, clinical myopia management requires co-operation between optometrists and ophthalmologists to provide patients with holistic care and a tailored approach that balances risks and benefits of treatment by using optical and pharmacological interventions. Third, current diagnostic technologies to detect myopic complications may be improved through collaboration between clinicians, researchers and industry. There is an unmet need to develop new imaging modalities for both structural and functional analyses and to establish normative databases for myopic eyes. In conclusion, the workgroup's call to action advocated for a paradigm shift towards a collaborative approach in the holistic clinical management of myopia

Depression and quality of life among Macau residents in the 2022 COVID-19 pandemic wave from the perspective of network analysis

BackgroundIn the summer of 2022, Macau experienced a surge of COVID-19 infections (the 618 COVID-19 wave), which had serious effects on mental health and quality of life (QoL). However, there is scant research on mental health problems and QoL among Macau residents during the 618 COVID-19 wave. This study examined the network structure of depressive symptoms (hereafter depression), and the interconnection between different depressive symptoms and QoL among Macau residents during this period.MethodA cross-sectional study was conducted between 26th July and 9th September 2022. Depressive symptoms were measured with the 9-item Patient Health Questionnaire (PHQ-9), while the global QoL was measured with the two items of the World Health Organization Quality of Life-brief version (WHOQOL-BREF). Correlates of depression were explored using univariate and multivariate analyses. The association between depression and QoL was investigated using analysis of covariance (ANCOVA). Network analysis was used to evaluate the structure of depression. The centrality index “Expected Influence” (EI) was used to identify the most central symptoms and the flow function was used to identify depressive symptoms that had a direct bearing on QoL.ResultsA total 1,008 participants were included in this study. The overall prevalence of depression was 62.5% (n = 630; 95% CI = 60.00–65.00%). Having depression was significantly associated with younger age (OR = 0.970; p &lt; 0.001), anxiety (OR = 1.515; p &lt; 0.001), fatigue (OR = 1.338; p &lt; 0.001), and economic loss (OR = 1.933; p = 0.026). Participants with depression had lower QoL F (1, 1,008) =5.538, p = 0.019). The most central symptoms included PHQ2 (“Sad Mood”) (EI: 1.044), PHQ4 (“Fatigue”) (EI: 1.016), and PHQ6 (“Guilt”) (EI: 0.975) in the depression network model, while PHQ4 (“Fatigue”), PHQ9 (“Suicide”), and PHQ6 (“Guilt”) had strong negative associations with QoL.ConclusionDepression was common among Macao residents during the 618 COVID-19 wave. Given the negative impact of depression on QoL, interventions targeting central symptoms identified in the network model (e.g., cognitive behavioral therapy) should be developed and implemented for Macau residents with depression