Impact of the 2015 wildfires on Malaysian air quality and exposure: a comparative study of observed and modeled data

In September and October 2015, Equatorial Asia experienced the most intense biomass burning episodes over the past two decades. These events, mostly enhanced by the extremely dry weather associated with the occurrence of strong El Niño conditions, resulted in the transnational transport of hazardous pollutants from the originating sources in Indonesian Borneo and Sumatra to the highly populated Malaysian Peninsula. Quantifying the population exposure form this event is a major challenge, and only two model-based studies have been performed to date, with limited evaluation against measurements. This manuscript presents a new data set of 49 monitoring stations across Peninsular Malaysia and Malaysian Borneo active during the 2015 haze event, and performs the first comparative study of PM10 (particulate matter with diameter < 10 µm) and carbon monoxide (CO) against the output of a state-of-the-art regional model (WRF-Chem). WRF-Chem presents high skills in describing the spatio-temporal patterns of both PM10 and CO and thus was applied to estimate the impact of the 2015 wildfires on population exposure. This study showed that more than 60% of the population living in the highly populated region of the Greater Klang Valley was systematically exposed to unhealthy/hazardous air quality conditions associated with the increased pollutant concentrations from wildfires and that almost 40% of the Malaysian population was on average exposed to PM10 concentrations higher than 100 µg m−3 during September and October 2015

Changes in hemostasis parameters in nonfatal methicillin-sensitive Staphylococcus aureus bacteremia complicated by endocarditis or thromboembolic events : a prospective gender-age adjusted cohort study

The aim of this study was to examine the changes in hemostasis parameters in endocarditis and thromboembolic events in nonfatal methicillin-sensitive Staphylococcus aureus bacteremia (MS-SAB) - a topic not evaluated previously. In total, 155 patients were recruited and were categorized according to the presence of endocarditis or thromboembolic events with gender-age adjusted controls. Patients who deceased within 90 days or patients not chosen as controls were excluded. SAB management was supervised by an infectious disease specialist. Patients with endocarditis (N = 21), compared to controls (N = 21), presented lower antithrombin III at day 4 (p <0.05), elevated antithrombin III at day 90 (p <0.01), prolonged activated partial thromboplastin time at days 4 and 10 (p <0.05), and enhanced thrombin-antithrombin complex at day 4 (p <0.01). Thromboembolic events (N = 8), compared to controls (N = 34), significantly increased thrombin-antithrombin complex at day 4 (p <0.05). In receiver operating characteristic analysis, the changes in these hemostasis parameters at day 4 predicted endocarditis and thromboembolic events (p <0.05). No differences in hemoglobin, thrombocyte, prothrombin fragment, thrombin time, factor VIII, D-dimer or fibrinogen levels were observed between cases and controls. The results suggest that nonfatal MS-SAB patients present marginal hemostasis parameter changes that, however, may have predictability for endocarditis or thromboembolic events. Larger studies are needed to further assess the connection of hemostasis to complications in SAB.Peer reviewe

Controlling multistability in a vibro-impact capsule system

This is the final version of the article. Available from Springer Verlag via the DOI in this record.This work concerns the control of multistability in a vibro-impact capsule system driven by a harmonic excitation. The capsule is able to move forward and backward in a rectilinear direction, and the main objective of this work is to control such motion in the presence of multiple coexisting periodic solutions. A position feedback controller is employed in this study, and our numerical investigation demonstrates that the proposed control method gives rise to a dynamical scenario with two coexisting solutions, corresponding to forward and backward progression. Therefore, the motion direction of the system can be controlled by suitably perturbing its initial conditions, without altering the system parameters. To study the robustness of this control method, we apply numerical continuation methods in order to identify a region in the parameter space in which the proposed controller can be applied. For this purpose, we employ the MATLAB-based numerical platform COCO, which supports the continuation and bifurcation detection of periodic orbits of non-smooth dynamical systems.The second author has been supported by a Georg Forster Research Fellowship granted by the Alexander von Humboldt Foundation, Germany. The authors would like to thank Dr. Haibo Jiang for stimulating discussions and comments on this work

Antimicrobial and Efflux Pump Inhibitory Activity of Caffeoylquinic Acids from Artemisia absinthium against Gram-Positive Pathogenic Bacteria

Background: Traditional antibiotics are increasingly suffering from the emergence of multidrug resistance amongst pathogenic bacteria leading to a range of novel approaches to control microbial infections being investigated as potential alternative treatments. One plausible antimicrobial alternative could be the combination of conventional antimicrobial agents/antibiotics with small molecules which block multidrug efflux systems known as efflux pump inhibitors. Bioassay-driven purification and structural determination of compounds from plant sources have yielded a number of pump inhibitors which acted against gram positive bacteria. Methodology/Principal Findings: In this study we report the identification and characterization of 4′,5′-O-dicaffeoylquinic acid (4′,5′-ODCQA) from Artemisia absinthium as a pump inhibitor with a potential of targeting efflux systems in a wide panel of Gram-positive human pathogenic bacteria. Separation and identification of phenolic compounds (chlorogenic acid, 3′,5′-ODCQA, 4′,5′-ODCQA) was based on hyphenated chromatographic techniques such as liquid chromatography with post column solid-phase extraction coupled with nuclear magnetic resonance spectroscopy and mass spectroscopy. Microbial susceptibility testing and potentiation of well know pump substrates revealed at least two active compounds; chlorogenic acid with weak antimicrobial activity and 4′,5′-ODCQA with pump inhibitory activity whereas 3′,5′-ODCQA was ineffective. These intitial findings were further validated with checkerboard, berberine accumulation efflux assays using efflux-related phenotypes and clinical isolates as well as molecular modeling methodology. Conclusions/Significance: These techniques facilitated the direct analysis of the active components from plant extracts, as well as dramatically reduced the time needed to analyze the compounds, without the need for prior isolation. The calculated energetics of the docking poses supported the biological information for the inhibitory capabilities of 4′,5′-ODCQA and furthermore contributed evidence that CQAs show a preferential binding to Major Facilitator Super family efflux systems, a key multidrug resistance determinant in gram-positive bacteria.National Institutes of Health (U.S.) (grant R01GM59903)National Institutes of Health (U.S.) (grant R01AI050875)Netherlands Organization for Scientific Research (VICI grant 700.56.442)Massachusetts Technology Transfer Center (MTTC)National Institutes of Health (U.S.) (grant 5U54MH084690-02

Shared Decision Making Tools for People Facing Stroke Prevention Strategies in Atrial Fibrillation: A Systematic Review and Environmental Scan.

OBJECTIVE: Shared decision making (SDM) tools can help implement guideline recommendations for patients with atrial fibrillation (AF) considering stroke prevention strategies. We sought to characterize all available SDM tools for this purpose and examine their quality and clinical impact. METHODS: We searched through multiple bibliographic databases, social media, and an SDM tool repository from inception to May 2020 and contacted authors of identified SDM tools. Eligible tools had to offer information about warfarin and ≥1 direct oral anticoagulant. We extracted tool characteristics, assessed their adherence to the International Patient Decision Aids Standards, and obtained information about their efficacy in promoting SDM. RESULTS: We found 14 SDM tools. Most tools provided up-to-date information about the options, but very few included practical considerations (e.g., out-of-pocket cost). Five of these SDM tools, all used by patients prior to the encounter, were tested in trials at high risk of bias and were found to produce small improvements in patient knowledge and reductions in decisional conflict. CONCLUSION: Several SDM tools for stroke prevention in AF are available, but whether they promote high-quality SDM is yet to be known. The implementation of guidelines for SDM in this context requires user-centered development and evaluation of SDM tools that can effectively promote high-quality SDM and improve stroke prevention in patients with AF

High transcript levels of vitamin D receptor are correlated with higher mRNA expression of human beta defensins and IL-10 in mucosa of HIV-1-exposed seronegative individuals

RESUMEN: La vitamina D (VitD) es un inmunomodulador endógena que podría proteger de la infección por VIH-1 la reducción de la activación inmune y la inducción de la expresión de VIH-1 anti-péptidos. Para establecer una correlación entre VitD y resistencia natural a la infección VIH-1, un estudio de casos y controles utilizando sangre y mucosa muestras de 58 VIH-1 expuesto, pero seronegativos (HESN) individuos , 43 VIH-1 seropositivos (SP) y 59 no controles sanos -exposed (HCS) se llevó a cabo. La concentración VitD en el plasma se determinó por ELISA, y de ARNm de unidades relativas (RU) de VDR, IL-10 , TGF-β, TNF-α e IL-1β en las células mononucleares de sangre periférica (PBMCs), oral y genital mucosa se cuantificó por QRT-PCR. mRNA niveles de humana beta -defensin (HBD) -2 y -3 se informó anteriormente y utilizados para correlaciones. Significativamente más altos niveles de VitD se encontraron en plasma, así como mayor mRNA RU de VDR en PBMCs, y en genital mucosa de HESN en comparación con HC. Además, superior mRNA RU de TNF-α, IL-1β y IL-10 , e inferior mRNA RU de TGF-β se encontraron en PBMC de HESNs en comparación con HC. También se observó mayor IL-10 mRNA RU en genital mucosa de HESNs en comparación con HC, y los ARNm de los niveles de TNF-α en oral y genital mucosa de SPs estábamos más alta en comparación con HESNs. Por otra parte, las correlaciones positivas entre VDR y la IL-10 mRNA RU en PBMCs y genital mucosa encontrados de HESNs. Por último, HBD-2 y HBD-3 ARNm RU fueron positivamente correlacionadas con VDR mRNA expresión en forma oral mucosa de HESNs. Estos resultados sugieren que los altos niveles de VitD y su receptor están asociadas con resistencia natural a la infección por VIH-1. Sobre regulación de los anti-inflamatoria IL-10 , y la inducción de anti-VIH-1 defensinas en la mucosa podría ser parte de los mecanismos implicados en esta asociación. Sin embargo, se necesitan más estudios para definir las asociaciones causales.ABSTRACT: Vitamin D (VitD) is an endogenous immunomodulator that could protect from HIV-1 infection reducing immune activation and inducing the expression of anti-HIV-1 peptides. To establish a correlation between VitD and natural resistance to HIV-1 infection, a case-control study using blood and mucosa samples of 58 HIV-1-exposed but seronegative (HESN) individuals, 43 HIV-1 seropositives (SPs) and 59 non-exposed healthy controls (HCs) was carried out. The VitD concentration in plasma was determined by ELISA, and mRNA relative units (RU) of VDR, IL-10, TGF-β, TNF-α and IL-1β in peripheral blood mononuclear cells (PBMCs), oral and genital mucosa was quantified by qRT-PCR. mRNA levels of human beta-defensin (HBD) -2 and -3 were previously reported and used for correlations. Significantly higher levels of VitD were found in plasma as well as higher mRNA RU of VDR in PBMCs, and in genital mucosa from HESN compared to HCs. In addition, higher mRNA RU of TNF-α, IL-1β and IL-10, and lower mRNA RU of TGF-β were found in PBMC from HESNs compared to HCs. We also observed higher IL-10 mRNA RU in genital mucosa of HESNs compared to HCs, and the mRNA levels of TNF-α in oral and genital mucosa of SPs were higher compared to HESNs. Furthermore, positive correlations between VDR and IL-10 mRNA RU in PBMCs and genital mucosa of HESNs were found. Finally, HBD-2 and HBD-3 mRNA RU were positively correlated with VDR mRNA expression in oral mucosa from HESNs. These results suggest that high levels of VitD and its receptor are associated with natural resistance to HIV-1 infection. Up-regulation of the anti-inflammatory IL-10, and the induction of anti-HIV-1 defensins in mucosa might be part of the mechanisms involved in this association. However, further studies are required to define causal associations