Malaria and soil-transmitted intestinal helminth co-infection and its effect on anemia: a meta-analysis

This study aimed to synthesize available evidence on the extent of malaria and soil-transmitted intestinal helminth (STH) co-infections in people living in endemic countries and to explore the effect of interactions between malaria and STHs on anemia. We searched relevant studies in electronic databases up to March 2013. Studies comparing malaria and STH co-infected patients with those not co-infected were included and the effect estimates were pooled using a random-effects model. We identified 30 studies for meta-analyses of which 17 were cross-sectional design. The majority of included studies (80%) were carried out in African countries. Among pregnant women, those infected with hookworm were found to have higher association with malaria infection compared with those without (summary OR: 1.36; 95% CI: 1.17-1.59; I2: 0%). Among non-pregnant adults, the summary OR of the association between anemia and the combined malaria and STH was 2.91 (1.38-6.14). The summary OR of the association between anemia and malaria alone was 1.53 (0.97-2.42), while the association between anemia and STH alone was 0.28 (0.04-1.95). There is no good evidence to support a different effect of malaria and STH on anemia. A subgroup analysis showed a higher risk of malaria infection in the primigravidae (summary OR: 1.61; 95% CI: 1.3-1.99; I2: 0%). In conclusion, the malaria-STH co-infection was variable with complex outcomes on anemi

Psycho-behavioural responses of the general population to COVID-19 after mass vaccination: a cross-sectional study

Abstract Background Previous studies have examined public psycho-behavioural responses in the early stages of the epidemic, little is known after mass vaccination has been implemented. This study aimed to investigate the public's behavioural (adoption of COVID-19 precautionary measures) and psychological (depression, anxiety and stress) responses to COVID-19 and their relationships after the launch of the territory-wide vaccination programme in Hong Kong. Methods A cross-sectional survey study using anonymous online or face-to-face questionnaires was conducted between June 2021 and September 2021. A convenience sample of Hong Kong Chinese residents aged ⩾18 years were recruited online by referrals and from a university-run community vaccination centre. Results A total of 1893 valid questionnaires were received. The results showed that Hong Kong residents have high levels of adoption of precautionary measures and low levels of depression, anxiety and stress after the mass vaccination. Hierarchical regression analysis identified that in the fully adjusted model, the adoption of precautionary measures was a consistent protective factor (β ranged −1.51 to −1.67, p < 0.001) for depression, anxiety and stress amid the COVID-19 pandemic. Conclusions This study offers new information on the public's psycho-behavioural responses to the pandemic, as well as insights into public health planning after introducing the mass vaccination

Knowledge, practices, compliance and beliefs of university nursing students’ toward hand hygiene: A cross-sectional survey

Nursing students can contribute to healthcareassociated infections if having inadequate knowledge and noncompliance of hand hygiene. Effective hand hygiene is considered the most effective measure for preventing healthcare-associated infections. This study investigated the knowledge, practices, compliance, and beliefs of university nursing students toward hand hygiene. By using a well-validated, self-report hand hygiene questionnaire, a cross-sectional survey was performed. In the convenience sampling, 421 out of 506 questionnaires were returned (83.2%). There were 169 (40.14%), 170 (40.38%) and 82 (19.48%) nursing students from Years 1, 2 and 3, respectively. The respondents’ overall mean score for hand hygiene knowledge was 7.33/10 (SD = 1.52) with an increasing trend of knowledge performance along study year was observed. The hand hygiene practice inventory was 4.76/5 (SD = 0.303). The mean scores for respondents from Years 1, 2 and 3 were 4.75 (SD = 0.367), 4.82 (SD = 0.20) and 4.69 (SD = 0.290), respectively. The self-reported hand hygiene compliance rate was 88.17% (SD = 11.922) and the mean score on the health beliefs scale was 4.03/5 (SD = 0.34). The university nursing students demonstrated moderate knowledge, good practices, a high compliance rate and positive beliefs toward hand hygiene. More effort on educating healthcare professionals about alcohol-based hand rubs and the promotion of hand cream usage to prevent hand-hygiene-induced skin irritations are suggested. Regular training workshops or seminars could be arranged to maintain knowledge levels and cultivate a positive attitude toward hand hygiene

The Soft Gluon Emission Process in the Color-Octet Model for Heavy Quarkonium Production

The Color-Octet Model has been used successfully to analyze many problems in heavy quarkonium production. We examine some of the conceptual and practical problems of the soft gluon emission process in the Color-Octet Model. We use a potential model to describe the initial and final states in the soft gluon emission process, as the emission occurs at a late stage after the production of the heavy quark pair. It is found in this model that the soft gluon M1 transition, 1S0(8)->3S1(1), dominates over the E1 transition, 3PJ(8)->3S1(1), for J/psi and psi' production. Such a dominance may help resolve the questions of isotropic polarization and color-octet matrix element universality in the Color-Octet Model.Comment: 26 pages, in LaTe

Cathelicidin preserves intestinal barrier function in polymicrobial sepsis.

ObjectivesThe intestinal epithelium compartmentalizes the sterile bloodstream and the commensal bacteria in the gut. Accumulating evidence suggests that this barrier is impaired in sepsis, aggravating systemic inflammation. Previous studies reported that cathelicidin is differentially expressed in various tissues in sepsis. However, its role in sepsis-induced intestinal barrier dysfunction has not been investigated.DesignTo examine the role of cathelicidin in polymicrobial sepsis, cathelicidin wild-(Cnlp+/+) and knockout (Cnlp-/-) mice underwent cecal-ligation and puncture (CLP) followed by the assessment of septic mortality and morbidity as well as histological, biochemical, immunological, and transcriptomic analyses in the ileal tissues. We also evaluated the prophylactic and therapeutic efficacies of vitamin D3 (an inducer of endogenous cathelicidin) in the CLP-induced murine polymicrobial sepsis model.ResultsThe ileal expression of cathelicidin was increased by three-fold after CLP, peaking at 4 h. Knockout of Cnlp significantly increased 7-day mortality and was associated with a higher murine sepsis score. Alcian-blue staining revealed a reduced number of mucin-positive goblet cells, accompanied by reduced mucin expression. Increased number of apoptotic cells and cleavage of caspase-3 were observed. Cnlp deletion increased intestinal permeability to 4kD fluorescein-labeled dextran and reduced the expression of tight junction proteins claudin-1 and occludin. Notably, circulating bacterial DNA load increased more than two-fold. Transcriptome analysis revealed upregulation of cytokine/inflammatory pathway. Depletion of Cnlp induced more M1 macrophages and neutrophils compared with the wild-type mice after CLP. Mice pre-treated with cholecalciferol (an inactive form of vitamin D3) or treated with 1alpha, 25-dihydroxyvitamin D3 (an active form of VD3) had decreased 7-day mortality and significantly less severe symptoms. Intriguingly, the administration of cholecalciferol after CLP led to worsened 7-day mortality and the associated symptoms.ConclusionsEndogenous cathelicidin promotes intestinal barrier integrity accompanied by modulating the infiltration of neutrophils and macrophages in polymicrobial sepsis. Our data suggested that 1alpha, 25-dihydroxyvitamin D3 but not cholecalciferol is a potential therapeutic agent for treating sepsis

Color-Octet Fraction in J/Psi Production and Absorption

The cross section between a $c \bar c$ pair and a nucleon is small and sensitive to the $c - \bar c$ separation if the pair is in a color-singlet state, but very large and insensitive to the separation if it is in a color-octet state. We use this property in an absorption model involving both color components to deduce the color structure of $c \bar c$ pairs produced in $p(B)A \to \psi X$ reactions. Our analysis shows that the NA3, NA38 and E772 data are not inconsistent with the theoretical picture that color-octet and color-singlet precursors are produced in roughly equal proportions if the produced color-singlet precursors are pointlike and transparent. However, if the color-singlet precursors are not transparent but have a cross section of a few mb, these data do show a definite preference for a larger fraction of color-singlet precursors. In either case, the color-octet fraction increases with $x_F$, approaching unity as $x_F$ becomes large.Comment: 9 pages, updated to include new result

Risk of thyroid dysfunction associated with mRNA and inactivated COVID-19 vaccines: a population-based study of 2.3 million vaccine recipients

Background: In view of accumulating case reports of thyroid dysfunction following COVID-19 vaccination, we evaluated the risks of incident thyroid dysfunction following inactivated (CoronaVac) and mRNA (BNT162b2) COVID-19 vaccines using a population-based dataset. / Methods: We identified people who received COVID-19 vaccination between 23 February and 30 September 2021 from a population-based electronic health database in Hong Kong, linked to vaccination records. Thyroid dysfunction encompassed anti-thyroid drug (ATD)/levothyroxine (LT4) initiation, biochemical picture of hyperthyroidism/hypothyroidism, incident Graves’ disease (GD), and thyroiditis. A self-controlled case series design was used to estimate the incidence rate ratio (IRR) of thyroid dysfunction in a 56-day post-vaccination period compared to the baseline period (non-exposure period) using conditional Poisson regression. / Results: A total of 2,288,239 people received at least one dose of COVID-19 vaccination (57.8% BNT162b2 recipients and 42.2% CoronaVac recipients). 94.3% of BNT162b2 recipients and 92.2% of CoronaVac recipients received the second dose. Following the first dose of COVID-19 vaccination, there was no increase in the risks of ATD initiation (BNT162b2: IRR 0.864, 95% CI 0.670–1.114; CoronaVac: IRR 0.707, 95% CI 0.549–0.912), LT4 initiation (BNT162b2: IRR 0.911, 95% CI 0.716–1.159; CoronaVac: IRR 0.778, 95% CI 0.618–0.981), biochemical picture of hyperthyroidism (BNT162b2: IRR 0.872, 95% CI 0.744–1.023; CoronaVac: IRR 0.830, 95% CI 0.713–0.967) or hypothyroidism (BNT162b2: IRR 1.002, 95% CI 0.838–1.199; CoronaVac: IRR 0.963, 95% CI 0.807–1.149), GD, and thyroiditis. Similarly, following the second dose of COVID-19 vaccination, there was no increase in the risks of ATD initiation (BNT162b2: IRR 0.972, 95% CI 0.770–1.227; CoronaVac: IRR 0.879, 95%CI 0.693–1.116), LT4 initiation (BNT162b2: IRR 1.019, 95% CI 0.833–1.246; CoronaVac: IRR 0.768, 95% CI 0.613–0.962), hyperthyroidism (BNT162b2: IRR 1.039, 95% CI 0.899–1.201; CoronaVac: IRR 0.911, 95% CI 0.786–1.055), hypothyroidism (BNT162b2: IRR 0.935, 95% CI 0.794–1.102; CoronaVac: IRR 0.945, 95% CI 0.799–1.119), GD, and thyroiditis. Age- and sex-specific subgroup and sensitivity analyses showed consistent neutral associations between thyroid dysfunction and both types of COVID-19 vaccines. / Conclusions: Our population-based study showed no evidence of vaccine-related increase in incident hyperthyroidism or hypothyroidism with both BNT162b2 and CoronaVac

Adversarial Sensor Attack on LiDAR-based Perception in Autonomous Driving

In Autonomous Vehicles (AVs), one fundamental pillar is perception, which leverages sensors like cameras and LiDARs (Light Detection and Ranging) to understand the driving environment. Due to its direct impact on road safety, multiple prior efforts have been made to study its the security of perception systems. In contrast to prior work that concentrates on camera-based perception, in this work we perform the first security study of LiDAR-based perception in AV settings, which is highly important but unexplored. We consider LiDAR spoofing attacks as the threat model and set the attack goal as spoofing obstacles close to the front of a victim AV. We find that blindly applying LiDAR spoofing is insufficient to achieve this goal due to the machine learning-based object detection process. Thus, we then explore the possibility of strategically controlling the spoofed attack to fool the machine learning model. We formulate this task as an optimization problem and design modeling methods for the input perturbation function and the objective function. We also identify the inherent limitations of directly solving the problem using optimization and design an algorithm that combines optimization and global sampling, which improves the attack success rates to around 75%. As a case study to understand the attack impact at the AV driving decision level, we construct and evaluate two attack scenarios that may damage road safety and mobility. We also discuss defense directions at the AV system, sensor, and machine learning model levels.Comment: Accepted at the ACM Conference on Computer and Communications Security (CCS), 201

Cost-effectiveness of non-invasive methods for assessment and monitoring of liver fibrosis and cirrhosis in patients with chronic liver disease: systematic review and economic evaluation

BACKGROUND: Liver biopsy is the reference standard for diagnosing the extent of fibrosis in chronic liver disease; however, it is invasive, with the potential for serious complications. Alternatives to biopsy include non-invasive liver tests (NILTs); however, the cost-effectiveness of these needs to be established. OBJECTIVE: To assess the diagnostic accuracy and cost-effectiveness of NILTs in patients with chronic liver disease. DATA SOURCES: We searched various databases from 1998 to April 2012, recent conference proceedings and reference lists. METHODS: We included studies that assessed the diagnostic accuracy of NILTs using liver biopsy as the reference standard. Diagnostic studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Meta-analysis was conducted using the bivariate random-effects model with correlation between sensitivity and specificity (whenever possible). Decision models were used to evaluate the cost-effectiveness of the NILTs. Expected costs were estimated using a NHS perspective and health outcomes were measured as quality-adjusted life-years (QALYs). Markov models were developed to estimate long-term costs and QALYs following testing, and antiviral treatment where indicated, for chronic hepatitis B (HBV) and chronic hepatitis C (HCV). NILTs were compared with each other, sequential testing strategies, biopsy and strategies including no testing. For alcoholic liver disease (ALD), we assessed the cost-effectiveness of NILTs in the context of potentially increasing abstinence from alcohol. Owing to a lack of data and treatments specifically for fibrosis in patients with non-alcoholic fatty liver disease (NAFLD), the analysis was limited to an incremental cost per correct diagnosis. An analysis of NILTs to identify patients with cirrhosis for increased monitoring was also conducted. RESULTS: Given a cost-effectiveness threshold of £20,000 per QALY, treating everyone with HCV without prior testing was cost-effective with an incremental cost-effectiveness ratio (ICER) of £9204. This was robust in most sensitivity analyses but sensitive to the extent of treatment benefit for patients with mild fibrosis. For HBV [hepatitis B e antigen (HBeAg)-negative)] this strategy had an ICER of £28,137, which was cost-effective only if the upper bound of the standard UK cost-effectiveness threshold range (£30,000) is acceptable. For HBeAg-positive disease, two NILTs applied sequentially (hyaluronic acid and magnetic resonance elastography) were cost-effective at a £20,000 threshold (ICER: £19,612); however, the results were highly uncertain, with several test strategies having similar expected outcomes and costs. For patients with ALD, liver biopsy was the cost-effective strategy, with an ICER of £822. LIMITATIONS: A substantial number of tests had only one study from which diagnostic accuracy was derived; therefore, there is a high risk of bias. Most NILTs did not have validated cut-offs for diagnosis of specific fibrosis stages. The findings of the ALD model were dependent on assuptions about abstinence rates assumptions and the modelling approach for NAFLD was hindered by the lack of evidence on clinically effective treatments. CONCLUSIONS: Treating everyone without NILTs is cost-effective for patients with HCV, but only for HBeAg-negative if the higher cost-effectiveness threshold is appropriate. For HBeAg-positive, two NILTs applied sequentially were cost-effective but highly uncertain. Further evidence for treatment effectiveness is required for ALD and NAFLD. STUDY REGISTRATION: This study is registered as PROSPERO CRD42011001561. FUNDING: The National Institute for Health Research Health Technology Assessment programme

Institutional risk factors for norovirus outbreaks in Hong Kong elderly homes: a retrospective cohort study

<p>Abstract</p> <p>Background</p> <p>Most of the institutional outbreaks of norovirus in Hong Kong occur in elderly homes, the proportion being 69% in 2006. Residents in elderly homes are a special population seriously affected by norovirus infections, it is necessary to investigate the risk factors of the norovirus outbreaks in Hong Kong elderly homes at the facility level.</p> <p>Methods</p> <p>A cohort of 748 elderly homes was followed up from January 2005 to December 2007; each elderly home was treated as one observation unit and the outcome event was the norovirus outbreak. Cox regression models were fitted to estimate the rate ratio (RR) and 95% confidence interval (CI) for the potential risk factors.</p> <p>Results</p> <p>A total of 276 norovirus outbreaks were confirmed during the study period; the outbreak rate was 12.2 (95% CI: 9.9-14.6) per 100 home-years; elderly homes with a larger capacity (RR = 1.4, 95% CI: 1.3-1.5 (per 30-resident increment)), a higher staff-to-resident ratio (RR = 1.2, 95% CI: 1.1-1.3 (per 1/30 increment) and better wheelchair accessibility (RR = 2.0, 95% CI: 1.3-3.2) were found to have an elevated norovirus outbreak rate in Hong Kong elderly homes; Elderly homes with partitions between beds had a lower rate of norovirus outbreaks (RR = 0.6, 95% CI: 0.4-0.8).</p> <p>Conclusions</p> <p>Elderly home capacity, staff-to-resident ratio and wheelchair accessibility were risk factors for norovirus outbreaks in Hong Kong elderly homes. Partitions between beds were a protective factor of norovirus outbreaks. These results should be considered in the infection control in Hong Kong elderly homes.</p