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Yan G, Chew KL, Chai LYA. Update on Non-Culture-Based Diagnostics for Invasive Fungal Disease. Mycopathologia 2021; 186:575-582. [PMID: 34213735 DOI: 10.1007/s11046-021-00549-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 03/19/2021] [Indexed: 02/06/2023]
Abstract
Diagnostic tests for fungi provide the mycological evidence to strengthen diagnosis of invasive fungal disease. Conventional microbiology and histopathology have their limitations. Recognizing this, there have been attempts at developing new methods to improve yield of diagnosing invasive fungal disease (IFD). The recent focus has been on non-culture-based antigen detection and molecular methods. The use of antigen detection of IFD through 1,3-β-D-glucan and galactomannan assay have been expanded, followed by development of lateral flow assays, and in combination with other diagnostic modalities to further increase diagnostic yield. The molecular diagnostic front has seen initiatives to standardize polymerase chain reaction methodologies to detect fungi and anti-fungal resistance, new platforms such as the T2Candida Biosystems and foray into fungal metagenomics. As these newer assays undergo stringent validation before incorporation into the diagnostic algorithm, the clinician needs to be mindful of their bedside utility as well as their limitation.
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Liu X, Wu Q, Yan G, Duan J, Chen Z, Yang P, Bragazzi NL, Lu Y, Yuan H. Cardiometabolic index: a new tool for screening the metabolically obese normal weight phenotype. J Endocrinol Invest 2021; 44:1253-1261. [PMID: 32909175 DOI: 10.1007/s40618-020-01417-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/01/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE People with the metabolically obese normal weight (MONW) phenotype are considered as an extremely high-risk group for unfavorable health consequences, but they are frequently undetected due to deceptive body mass index (BMI) and complex assessment. This study aimed to explore the clinical usefulness of cardiometabolic index (CMI) in identifying MONW individuals. METHODS This cross-sectional study involved a total of 47,683 normal-weight subjects aged ≥ 18 years. Participants underwent anthropometrics, routine biochemical tests, and questionnaires for a full evaluation of the metabolic profile. The odds ratio (OR) of CMI and MONW phenotype was determined by the Logistic regression models and the diagnostic accuracy of CMI was evaluated by the receiver operating characteristic (ROC) curve analysis. RESULTS The prevalence of MONW phenotype was 11.0%. After multivariate adjustment, the ORs for MONW in the highest compared with the lowest quartile of CMI was 71.20 (95% CI 55.19-91.86), and 1-SD increment of CMI brought a 54% additional risk. In ROC analysis, compared with BMI and waist circumference, CMI showed superior performance for identifying MONW individuals with an AUC of 0.853 (95% CI 0.847-0.860) in men and 0.912 (95% CI 0.906-0.918) in women, respectively. Moreover, CMI exhibited the highest diagnostic accuracy in younger age groups (aged 18-34 for men; aged 18-34 and 35-44 for women), in which AUCs surpassed 0.9 in both sexes. CONCLUSIONS CMI could be served as a valuable indicator to identify MONW phenotype of Chinese adults, particularly for young people.
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Dickens BSL, Lim JT, Low JW, Lee CK, Sun Y, Nasir HBM, Akramullah FABM, Yan G, Oon J, Yan B, Sun L, Cook AR, Tambyah PA, Chai LYA. Simple "Rule-of-6" Predicts Severe Coronavirus Disease 2019 (COVID-19). Clin Infect Dis 2021; 72:1861-1862. [PMID: 32628752 PMCID: PMC7454428 DOI: 10.1093/cid/ciaa938] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Zhang G, Yan G, Liu Y, Zhu S, Wang X. 050 Loss of retinoic acid receptor-related receptor alpha (Rorα) promotes the progression of UV-induced cSCC. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Zeng Q, Zhang G, Yan G, Wang P, Wang X. 025 ALA-PDT inhibits skin squamous cell carcinoma (cSCC) via regulating formation of tertiary lymphoid structures. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Wang P, Yan G, Xue H, Cao Y, Zhang G, Wang X. 119 Proteomics and lipidomics reveal the protective mechanism of dietary n-3 PUFA supplementation for photoaging. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lee CK, Tham JWM, Png S, Chai CN, Ng SC, Tan EJM, Ng LJ, Chua RP, Sani M, Seow Y, Yan G, Tang J. Clinical performance of Roche cobas 6800, Luminex ARIES, MiRXES Fortitude Kit 2.1, Altona RealStar, and Applied Biosystems TaqPath for SARS-CoV-2 detection in nasopharyngeal swabs. J Med Virol 2021; 93:4603-4607. [PMID: 33719033 PMCID: PMC8250924 DOI: 10.1002/jmv.26940] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 01/21/2023]
Abstract
We compared the performance of five assays for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) detection on nasopharyngeal swab samples: Roche “cobas,” Luminex “ARIES,” MiRXES “Fortitude,” Altona “RealStar,” and Thermo Fisher Scientific “TaqPath.” A total of 94 nasopharyngeal swab samples were obtained from 80 confirmed coronavirus disease 2019 cases in the first 2 weeks of illness (median, 7 days; range, 2–14 days) and 14 healthy controls. After collection, all samples were transported to the hospital clinical laboratory within 24 h. These samples were tested on all five assays within 3 days of sample receipt. Of the 94 samples, 69 yielded the same result on all platforms, resulting in an agreement of 73.4% (69 of 94). Of these, 14 were the healthy control swabs which all tested negative, demonstrating good specificity across all platforms. The ARIES assay had the lowest detection rate (68.8%), followed by Fortitude (85.0%), RealStar (86.3%), cobas (95.0%), and TaqPath (100%). Statistically significant differences were observed for ARIES, Fortitude, and RealStar when compared against the best performing TaqPath using McNemar's χ2 test. A consensus result was established based on the results obtained by the cobas, Fortitude, RealStar, and TaqPath. Six discrepancies had failed to reach a consensus and were adjudicated using the Cepheid Xpert Xpress SARS‐CoV‐2. Overall, the TaqPath and cobas assays were the most sensitive at detecting their designated SARS‐CoV‐2 gene targets. On the other hand, the ARIES assay was the least sensitive, thus warranting the need for assay re‐optimization before go‐live at the testing laboratory.
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Ooi KH, Liu MM, Tay JWD, Teo SY, Kaewsapsak P, Jin S, Lee CK, Hou J, Maurer-Stroh S, Lin W, Yan B, Yan G, Gao YG, Tan MH. An engineered CRISPR-Cas12a variant and DNA-RNA hybrid guides enable robust and rapid COVID-19 testing. Nat Commun 2021; 12:1739. [PMID: 33741959 PMCID: PMC7979722 DOI: 10.1038/s41467-021-21996-6] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/22/2021] [Indexed: 12/13/2022] Open
Abstract
Extensive testing is essential to break the transmission of SARS-CoV-2, which causes the ongoing COVID-19 pandemic. Here, we present a CRISPR-based diagnostic assay that is robust to viral genome mutations and temperature, produces results fast, can be applied directly on nasopharyngeal (NP) specimens without RNA purification, and incorporates a human internal control within the same reaction. Specifically, we show that the use of an engineered AsCas12a enzyme enables detection of wildtype and mutated SARS-CoV-2 and allows us to perform the detection step with loop-mediated isothermal amplification (LAMP) at 60-65 °C. We also find that the use of hybrid DNA-RNA guides increases the rate of reaction, enabling our test to be completed within 30 minutes. Utilizing clinical samples from 72 patients with COVID-19 infection and 57 healthy individuals, we demonstrate that our test exhibits a specificity and positive predictive value of 100% with a sensitivity of 50 and 1000 copies per reaction (or 2 and 40 copies per microliter) for purified RNA samples and unpurified NP specimens respectively.
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Loh J, Tham SM, Tambyah PA, Yan G, Lee CK, Chai LYA. Range of Varicella Zoster Co-Infections with COVID-19, Singapore. Infect Chemother 2021; 53:391-394. [PMID: 34216133 PMCID: PMC8258286 DOI: 10.3947/ic.2020.0154] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 04/20/2021] [Indexed: 12/18/2022] Open
Abstract
There have been recent descriptions of the novel coronavirus disease 2019 (COVID-19) presenting as 'varicella-like exanthem'. We report three cases of patients with Varicella-Zoster Virus (VZV) and COVID-19 co-infections, presenting in three varied ways. These cases highlight the need for heightened alertness to how such co-infections can present, to pick up overlapping 'dual pathologies' during this current pandemic given that infection control measures including airborne precautions are crucial for both COVID-19 and VZV.
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Tham JWM, Ng SC, Chai CN, Png S, Tan EJM, Ng LJ, Chua RP, Sani M, Chiang D, Tan KX, Tee NWS, Jureen R, Tan SS, Yan G, Yan B, Lee CK. Parallel testing of 241 clinical nasopharyngeal swabs for the detection of SARS-CoV-2 virus on the Cepheid Xpert Xpress SARS-CoV-2 and the Roche cobas SARS-CoV-2 assays. Clin Chem Lab Med 2020; 59:e45-e48. [PMID: 33554503 DOI: 10.1515/cclm-2020-1338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/08/2020] [Indexed: 11/15/2022]
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Yan G, Ang A, Tham SM, Ng A, Chew KL. Relative Bradycardia in Patients with Mild-to-Moderate Coronavirus Disease, Japan. Emerg Infect Dis 2020; 27. [PMID: 33183492 PMCID: PMC7774561 DOI: 10.3201/eid2701.203312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Tan SS, Saw S, Yan G, Chong AT, Yang Z, Tan AP, Vathsala A, Sethi SK. Limitations of rapid diagnostic testing in the work-up of dengue infection – a case report. Clin Chem Lab Med 2020; 58:e245-e246. [DOI: 10.1515/cclm-2020-0288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/24/2020] [Indexed: 11/15/2022]
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Tham SM, Lim WY, Lee CK, Loh J, Premkumar A, Yan B, Kee A, Chai L, Tambyah PA, Yan G. Four Patients with COVID-19 and Tuberculosis, Singapore, April-May 2020. Emerg Infect Dis 2020; 26:2764-2766. [PMID: 32667283 PMCID: PMC7588516 DOI: 10.3201/eid2611.202752] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Coronavirus disease (COVID-19) and tuberculosis (TB) developed in 4 foreign workers living in dormitories in Singapore during April–May 2020. Clinical manifestations and atypical radiographic features of COVID-19 led to the diagnosis of TB through positive interferon-gamma release assay and culture results. During the COVID-19 pandemic, TB should not be overlooked.
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Nie GK, Xu C, Wei QK, Li J, Xiao T, Sun H, Kong XL, Yin K, Zhao GH, Zhang BG, Yan G, Huang BC. [Analysis of drug - resistant gene polymorphisms in Plasmodium falciparum imported from Equatorial Guinea to Shandong Province in 2015 and 2016]. ZHONGGUO XUE XI CHONG BING FANG ZHI ZA ZHI = CHINESE JOURNAL OF SCHISTOSOMIASIS CONTROL 2020; 32:612-617. [PMID: 33325196 DOI: 10.16250/j.32.1374.2020114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To investigate the drug-resistant gene polymorphisms in Plasmodium falciparum imported from Equatorial Guinea to Shandong Province. METHODS From 2015 to 2016, blood samples were collected from imported P. falciparum malaria patients returning from Equatorial Guinea to Shandong Province, and genome DNA of the malaria parasite was extracted. The drug-resistant Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and K13 genes of P. falciparum were amplified using a PCR assay, followed by DNA sequencing, and the sequences were aligned. RESULTS The target fragments of all 5 drug-resistant genes of P. falciparum were successfully amplified and sequenced. There were 72.8%, 18.6%, and 8.6% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfcrt gene, respectively, and all mutant haplotypes were CVIET (the underline indicates the mutation site). There were 20.0%, 61.4% and 18.6% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfmdr1 gene, respectively, and the mutant haplotypes mainly included YF and NF (the underlines indicate the mutation sites). There were 1.4%, 98.6%, and 0 of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfdhfr gene, respectively, and AIRNI was the predominant mutant haplotype (the underline indicates the mutation site). There were 1.4%, 94.3%, and 4.3% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfdhps gene, respectively, and SGKAA was the predominant mutant haplotype (the underline indicates the mutation site). The complete drug-resistant IRNGE genotype consisted of 8.6% of the Pfdhfr and Pfdhps genes, and the K13 gene A578S mutation occurred in 1.4% of the parasite samples. CONCLUSIONS There are mutations in the Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and K13 genes of P. falciparum imported from Equatorial Guinea to Shandong Province, with a low frequency in the Pfcrt gene mutation and a high frequency in the Pfmdr1, Pfdhfr, and Pfdhps gene mutations, and the K13 gene A578S mutation is detected in the parasite samples.
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Archuleta S, Cross G, Somani J, Lum L, Santosa A, Alagha RA, Allen DM, Ang A, Beh D, Chai L, Chan SM, Lim SM, Olszyna DP, Ong C, Oon J, Salada BMA, Smitasin N, Sun L, Tambyah PA, Tham SM, Yan G, Yee CH, Dan YY, Jureen R, Tee N, Mahadevan M, Yau YW, Quek SC, Liu EH, Sin C, Bagdasarian N, Fisher DA. Responding to COVID-19: how an academic infectious diseases division mobilized in Singapore. BMC Med 2020; 18:179. [PMID: 32507112 PMCID: PMC7276279 DOI: 10.1186/s12916-020-01641-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/19/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND On January 30, COVID-19 was declared a Public Health Emergency of International Concern-a week after Singapore's first imported case and 5 days before local transmission. The National University Hospital (NUH) is Singapore's third largest hospital with 1200 beds, heavy clinical workloads, and major roles in research and teaching. MAIN BODY With memories of SARS still vivid, there was an urgent requirement for the NUH Division of Infectious Diseases to adapt-undergoing major reorganization to face rapidly changing priorities while ensuring usual essential services and standards. Leveraging on individual strengths, our division mobilized to meet the demands of COVID-19 while engaging in high-level coordination, strategy, and advocacy. We present our experience of the 60 days since the nation's first case. During this time, our hospital has managed 3030 suspect cases, including 1300 inpatients, 37 confirmed cases, and overseen 4384 samples tested for COVID-19. CONCLUSION Complex hospital adaptations were supported by an unprecedented number of workflows and coordination channels essential to safe and effective operations. The actions we describe, aligned with international recommendations and emerging evidence-based best practices, may serve as a framework for other divisions and institutions facing the spread of COVID-19 globally.
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Yan G, Lee CK, Lam LTM, Yan B, Chua YX, Lim AYN, Phang KF, Kew GS, Teng H, Ngai CH, Lin L, Foo RM, Pada S, Ng LC, Tambyah PA. Covert COVID-19 and false-positive dengue serology in Singapore. THE LANCET. INFECTIOUS DISEASES 2020; 20:536. [PMID: 32145189 PMCID: PMC7128937 DOI: 10.1016/s1473-3099(20)30158-4] [Citation(s) in RCA: 168] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 02/27/2020] [Indexed: 12/16/2022]
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Park J, Yan G, Kwon KC, Liu M, Gonnella PA, Yang S, Daniell H. Oral delivery of novel human IGF-1 bioencapsulated in lettuce cells promotes musculoskeletal cell proliferation, differentiation and diabetic fracture healing. Biomaterials 2020; 233:119591. [PMID: 31870566 PMCID: PMC6990632 DOI: 10.1016/j.biomaterials.2019.119591] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/16/2019] [Accepted: 10/30/2019] [Indexed: 12/16/2022]
Abstract
Human insulin-like growth factor-1 (IGF-1) plays important roles in development and regeneration of skeletal muscles and bones but requires daily injections or surgical implantation. Current clinical IGF-1 lacks e-peptide and is glycosylated, reducing functional efficacy. In this study, codon-optimized Pro-IGF-1 with e-peptide (fused to GM1 receptor binding protein CTB or cell penetrating peptide PTD) was expressed in lettuce chloroplasts to facilitate oral delivery. Pro-IGF-1 was expressed at high levels in the absence of the antibiotic resistance gene in lettuce chloroplasts and was maintained in subsequent generations. In lyophilized plant cells, Pro-IGF-1 maintained folding, assembly, stability and functionality up to 31 months, when stored at ambient temperature. CTB-Pro-IGF-1 stimulated proliferation of human oral keratinocytes, gingiva-derived mesenchymal stromal cells and mouse osteoblasts in a dose-dependent manner and promoted osteoblast differentiation through upregulation of ALP, OSX and RUNX2 genes. Mice orally gavaged with the lyophilized plant cells significantly increased IGF-1 levels in sera, skeletal muscles and was stable for several hours. When bioencapsulated CTB-Pro-IGF-1 was gavaged to femoral fractured diabetic mice, bone regeneration was significantly promoted with increase in bone volume, density and area. This novel delivery system should increase affordability and patient compliance, especially for treatment of musculoskeletal diseases.
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Yan G, Tan KB, Chandran NS, Chai L, Chew KL, Somani J, Tambyah PA. Histoplasmosis presenting with Sweet's syndrome. Clin Microbiol Infect 2020; 26:795-796. [PMID: 32035234 DOI: 10.1016/j.cmi.2020.01.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/02/2020] [Accepted: 01/24/2020] [Indexed: 10/25/2022]
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Yan G, Liu S, Schlink AC, Flematti GR, Brodie BS, Bohman B, Greeff JC, Vercoe PE, Hu J, Martin GB. Volatiles from Merino fleece evoke antennal and behavioural responses in the Australian sheep blow fly Lucilia cuprina. MEDICAL AND VETERINARY ENTOMOLOGY 2019; 33:491-497. [PMID: 31136024 DOI: 10.1111/mve.12383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/02/2019] [Accepted: 05/03/2019] [Indexed: 06/09/2023]
Abstract
To identify flystrike-related volatile compounds in wool from Merino sheep, the attractiveness of wool to Lucilia cuprina Wiedmann (Diptera: Calliphoridae) was examined. First, a selection of wool samples guided by previous knowledge of sheep lines, predicted to be more susceptible or more resistant to flystrike, was tested. The attractiveness of the 10 samples selected was not associated with field susceptibility: two samples from the more resistant line were identified as most attractive and two samples from the more susceptible line were identified as least attractive, based on the behavioural assays with gravid flies. Comparison of the headspace volatiles of these samples, using solid phase microextraction and gas chromatography-mass spectrometry-electroantennographic detection, revealed octanal and nonanal to be present in the attractive wool samples that elicited responses from the fly antenna. Furthermore, the two compounds were not present in wool that was least attractive to L. cuprina. In laboratory bioassays, octanal and nonanal evoked antennal and behavioural responses in gravid L. cuprina, thus confirming their potential role as semiochemicals responsible for attracting L. cuprina to Merino sheep.
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Luo E, Wang D, Tang C, Yan G, Hou J, Liu B. P5476Usefulness of haemoglobin level combined with CAMI-STEMI score for predicting MACCE in patients with acute ST-elevation myocardial infarction after PCI. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Early risk stratification was strongly recommended to guide therapeutic management and to improve outcome for ST elevation myocardial infarction (STEMI) patients. Anaemia and high haemoglobin levels are common in STEMI patients, but the effect of the haemoglobin level on the prognosis of STEMI patients remains in dispute. The China Acute Myocardial Infarction registry-ST Elevation Myocardial Infarction (CAMI-STEMI) score can predict in-hospital mortality among Chinese STEMI patients, with similar performance to the well-established Thrombolysis in Myocardial Infarction (TIMI) score, while relying solely on simple and practical variables. This study aimed to evaluate the prognostic value of the haemoglobin level combined with the CAMI-STEMI score in STEMI patients after percutaneous coronary intervention (PCI).
Methods
We included 360 STEMI patients who underwent PCI. The patients were divided into 3 groups according to the first haemoglobin value after PCI, group 1 (male: Hb<120 g/L, female: Hb<110 g/L; 42 cases), group 2 (male: 120 g/L ≤ Hb<160 g/L, female: 110 g/L≤Hb<150 g/L; 278 cases), and group 3 (male: Hb ≥160 g/L, female: Hb ≥150 g/L; 40 cases). Clinical characteristics, and the incidence of major adverse cardiovascular and cerebral events (MACCE) during the follow-up period were recorded.
Results
The incidence of MACCE in the 3 groups increased with a decrease in the haemoglobin level. Multivariate regression analysis showed that the CAMI-STEMI score was an independent predictor of MACCE incidence at 30 days after PCI and that anaemia was an independent predictor of MACCE incidence at 6 months and 1 year after PCI. A high haemoglobin level was an independent predictor of MACCE incidence at 1 year after PCI. The area under receiver operating characteristic curves (AUCs) of the haemoglobin level, CAMI-STEMI score and haemoglobin level combined with CAMI-STEMI score predicting the occurrence of MACCE in STEMI patients within 30 days after PCI were 0.604, 0.614, and 0.639, respectively.
Figure 1. MACCE-free survival curve
Conclusion
The CAMI-STEMI score was an independent predictor of MACCE incidence at 30 days after PCI. The haemoglobin level combined with the CAMI-STEMI score improved the predictive value of MACCE in STEMI patients within 30 days after PCI.
Acknowledgement/Funding
This study was supported by grants to Chengchun Tang from the National Natural Science Foundation of China (Research Grant #81670237)
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Derua YA, Kahindi SC, Mosha FW, Kweka EJ, Atieli HE, Zhou G, Lee MC, Githeko AK, Yan G. Susceptibility of Anopheles gambiae complex mosquitoes to microbial larvicides in diverse ecological settings in western Kenya. MEDICAL AND VETERINARY ENTOMOLOGY 2019; 33:220-227. [PMID: 30628101 PMCID: PMC6995353 DOI: 10.1111/mve.12353] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 08/20/2018] [Accepted: 11/01/2018] [Indexed: 05/26/2023]
Abstract
The microbial larvicides Bacillus thuringiensis var. israelensis (Bti) and Bacillus sphaericus (Bs) (Bacillales: Bacillaceae) are well known for their efficacy and safety in mosquito control. In order to assess their potential value in future mosquito control strategies in western Kenya, the current study tested the susceptibility of five populations of Anopheles gambiae complex mosquitoes (Diptera: Culicidae), collected from five diverse ecological sites in this area, to Bti and Bs under laboratory conditions. In each population, bioassays were conducted with eight concentrations of larvicide (Bti/Bs) in four replicates and were repeated on three separate days. Larval mortality was recorded at 24 h or 48 h after the application of larvicide and subjected to probit analysis. A total of 2400 An. gambiae complex larvae from each population were tested for their susceptibility to Bti and Bs. The mean (± standard error of the mean, SEM) lethal concentration values of Bti required to achieve 50% and 95% larval mortality (LC50 and LC95 ) across the five populations were 0.062 (± 0.005) mg/L and 0.797 (± 0.087) mg/L, respectively. Corresponding mean (± SEM) values for Bs were 0.058 (± 0.005) mg/L and 0.451 (± 0.053) mg/L, respectively. Statistical analysis indicated that the five populations of An. gambiae complex mosquitoes tested were fully susceptible to Bti and Bs, and there was no significant variation in susceptibility among the tested populations.
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Yan G, Pang L, Cook AR, Ho HJ, Win MS, Khoo AL, Wong JG, Lee CK, Yan B, Jureen R, Ho SS, Lye DC, Tambyah PA, Leo YS, Fisher D, Oon J, Bagdasarian N, Chow A, Smitasin N, Chai LYA. Distinguishing Zika and Dengue Viruses through Simple Clinical Assessment, Singapore. Emerg Infect Dis 2019; 24:1565-1568. [PMID: 30016242 PMCID: PMC6056111 DOI: 10.3201/eid2408.171883] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Dengue virus and Zika virus coexist in tropical regions in Asia where healthcare resources are limited; differentiating the 2 viruses is challenging. We showed in a case–control discovery cohort, and replicated in a validation cohort, that the diagnostic indices of conjunctivitis, platelet count, and monocyte count reliably distinguished between these viruses.
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Lee CK, Chai CN, Capinpin SM, Ang A, Ng SY, Lee PL, Ng CWS, Yan G, Lee HK, Chiu LL, Jureen R, Yan B, Loh TP. Evaluation of the Luminex ARIES HSV 1&2 Assay and Comparison with the FTD Neuro 9 and In-house Real-Time PCR Assays for Detecting Herpes Simplex Viruses. Ann Lab Med 2018; 38:440-445. [PMID: 29797814 PMCID: PMC5973918 DOI: 10.3343/alm.2018.38.5.440] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 12/15/2017] [Accepted: 05/03/2018] [Indexed: 11/20/2022] Open
Abstract
Background Human herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) are responsible for a plethora of human diseases, of which cutaneous and mucocutaneous infections are the most prevalent. In its most severe form, HSV infection can cause meningitis/encephalitis. We compared the Luminex ARIES HSV 1&2 assay (Luminex Corp., Austin, TX, USA), an automated sample-to-result molecular solution, to two non-automated HSV DNA assays. Methods A total of 116 artificial controls were used to determine the analytical performance of the ARIES assay. Controls were prepared by spiking universal transport medium (UTM) and cerebrospinal fluid (CSF) samples from patients who tested negative for HSV by an in-house HSV-1 and -2 DNA assay with reference materials (SeraCare Life Sciences, MA, USA; ZeptoMetrix Corp., MA, USA). Another 117 clinical samples were then used to compare the clinical performance of the ARIES assay with those of an in-house assay and the FTD Neuro 9 assay (Fast Track Diagnostics, Junglinster, Luxembourg). Results The analytical sensitivity (95% limit of detection) of the ARIES assay was 318 copies/mL (UTM samples) and 935 copies/mL (CSF samples) for HSV-1 strain 96 and 253 copies/mL (UTM samples) and 821 copies/mL (CSF samples) for HSV-2 strain 09. No cross-reactivity was observed in samples spiked with 14 non-HSV microorganisms. Compared with the reference result (agreement between the in-house and FTD Neuro 9 results), the ARIES assay had overall concordance rates of 98.2% (111/113) and 100% (113/113) for HSV-1 and HSV-2, respectively. Conclusions The ARIES assay appears to be an excellent alternative for rapid detection and differentiation of HSV in skin and genital infections, meningitis, and encephalitis.
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Tuno N, Kohzu A, Tayasu I, Nakayama T, Githeko A, Yan G. An Algal Diet Accelerates Larval Growth of Anopheles gambiae (Diptera: Culicidae) and Anopheles arabiensis (Diptera: Culicidae). JOURNAL OF MEDICAL ENTOMOLOGY 2018; 55:600-608. [PMID: 29365176 DOI: 10.1093/jme/tjx244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Indexed: 06/07/2023]
Abstract
The population sizes of Anopheles gambiae Giles (Diptera: Culicidae) and Anopheles arabiensis Patton (Diptera: Culicidae) increase dramatically with the onset of the rainy season in sub-Saharan Africa, but the ecological mechanisms underlying the increases are not well understood. As a first step toward to understand, we investigated the proliferation of algae, the major food of mosquito larvae, in artificial fresh water bodies exposed to sunlight for a short period, and old water bodies exposed to sunlight for a long period, and the effects thereof on the development of these anopheline larvae. We found that an epizoic green algal species of the genus Rhopalosolen (Chlorophyta: Chlorophyceae) proliferated immediately after water freshly taken from a spring was placed in sunlight. This alga proliferated only briefly (for ~10 d) even if the water was repeatedly exposed to sunlight. However, various algal species were observed in water that remained under sunlight for 40 d or longer (i.e., in old water bodies). The growth performance of larvae was higher in sunlight-exposed (alga-rich) water than in shade-stored (alga-poor) water. Stable isotope analysis suggested that these two anopheline species fed on Rhopalosolen algae in fresh water bodies but hardly at all on other algae occurring in the old water bodies. We concluded that freshly formed ground water pools facilitate high production of anopheline species because of the proliferation of Rhopalosolen algae therein, and the increase in the number of such pools in the rainy season, followed by rapid increases in A. gambiae and A. arabiensis numbers.
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Zhang L, Meng Q, Chen S, Zhang M, Chen B, Wu B, Yan G, Wang X, Jia Z. Treatment outcomes of multidrug-resistant tuberculosis patients in Zhejiang, China, 2009–2013. Clin Microbiol Infect 2018; 24:381-388. [DOI: 10.1016/j.cmi.2017.07.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 07/02/2017] [Accepted: 07/07/2017] [Indexed: 02/01/2023]
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