Evaluating the Effectiveness of Targeted Public Health Control Strategies for Chlamydia Transmission in Omaha, Nebraska: A Mathematical Modeling Approach

Objectives: Sexually Transmitted Infections (STIs) have a great public health impact globally. STIs are one of the most critical health problems in the United States of America (USA). Here, we present a mathematical model for testing several interventions that are designed for various communities in order to control the Chlamydia epidemic. Study Design: Based on a community sexual behavior survey, we constructed and parameterized a mathematical disease transmission model to estimate the spread dynamics of Chlamydia in young adults in the northern part of Omaha, Nebraska. Methods: A differential equations based continuous time simulation model is run for various scenarios. The model considers only one age group i.e., 19 - 25 ages, which is considered as the highest risk group for this sexually transmitted disease. Our model assumes homogeneous mixing within this age group and use published estimates to model mixing rates between individuals. Results: The presented model quantified the potential value of screening and treatment programs for Chlamydia in reducing the burden of disease in this specific community. By increasing the screening and treatment rates from 35% to 85%, great public health benefit can be achieved in two years, i.e., total cases reduction around 9% just in this considered age group. Conclusions: Computational results show that behavioral change based interventions on prevention have some effect on reducing the prevalence in the targeted age group;however, more benefit can be obtained with frequent screening and treatment programs.

Knowledge, attitudes, and beliefs about HIV/AIDS of Sudanese and Bantu Somali immigrant women living in Omaha, Nebraska

A needs assessment of the knowledge, attitudes, practices, and beliefs about HIV/AIDS prevention was conducted among 100 Sudanese and Bantu Somali women immigrants aged 19 years and older, recruited through a community organization between April and July 2006. Information was collected by interview using interpreters to administer a 60-item test and a 116-item questionnaire that had been translated into Nuer and Arabic. Women in this study had low levels of education, poor knowledge about HIV transmission and prevention and safer sex practices, and poor attitudes to HIV/AIDS. They believe that HIV/AIDS is a punishment from God, HIV-positive people should be separated from society, carrying a condom indicates having loose morals, women should not experience sexual pleasure, and men should decide when and how to have sexual intercourse. Education, gender, and cultural beliefs are critical in the spread of HIV. Efforts to educate immigrant and displaced populations, particularly women, are essential.

Considerations for the use of porcine organ donation models in preclinical organ donor intervention research

Use of animal models in preclinical transplant research is essential to the optimization of human allografts for clinical transplantation.Animal models of organ donation and preservation help to advance and improve technical elements of solid organ recovery and facilitate research of ischemia-reperfusion injury,organ preservation strategies,and future donor-based interventions.Important considerations include cost,public opinion regarding the conduct of animal research,translational value,and relevance of the animal model for clinical practice.We present an overview of two porcine models of organ donation:donation following brain death(DBD)and donation following circulatory death(DCD).The cardiovascular anatomy and physiology of pigs closely resembles those of humans,making this species the most appropriate for pre-clinical research.Pigs are also considered a potential source of organs for human heart and kidney xenotransplantation.It is imperative to minimize animal loss during procedures that are surgically complex.We present our experience with these models and describe in detail the use cases,procedural approach,challenges,alternatives,and limitations of each model.

Biomimetic natural biomaterials for tissue engineering and regenerative medicine:new biosynthesis methods,recent advances,and emerging applications

Biomimetic materials have emerged as attractive and competitive alternatives for tissue engineering(TE)and regenerative medicine.In contrast to conventional biomaterials or synthetic materials,biomimetic scaffolds based on natural biomaterial can offer cells a broad spectrum of biochemical and biophysical cues that mimic the in vivo extracellular matrix(ECM).Additionally,such materials have mechanical adaptability,micro-structure interconnectivity,and inherent bioactivity,making them ideal for the design of living implants for specific applications in TE and regenerative medicine.This paper provides an overview for recent progress of biomimetic natural biomaterials(BNBMs),including advances in their preparation,functionality,potential applications and future challenges.We highlight recent advances in the fabrication of BNBMs and outline general strategies for functionalizing and tailoring the BNBMs with various biological and physicochemical characteristics of native ECM.Moreover,we offer an overview of recent key advances in the functionalization and applications of versatile BNBMs for TE applications.Finally,we conclude by offering our perspective on open challenges and future developments in this rapidly-evolving field.

Paradigm shift in transfusion practices during early COVID-19 pandemic:A single center retrospective study

BACKGROUND The advent of coronavirus disease 2019(COVID-19)unveiled the worst national blood crisis that the United States had witnessed in over a decade.With the pandemic influencing the different stages of the acquisition of blood products outside the hospital setting,we aimed to explore the possible barriers contributing to the shortage of blood products within the medical community.the COVID era and pre-COVID era.METHODS We conducted a retrospective cross-sectional study on hospitalized patients distinguishing the pattern of blood transfusion during the COVID and pre-COVID era in a community hospital.Data was tabulated to include the number of red blood cell(RBC)transfusions and if transfusions met restrictive blood transfusion criteria as per institutional guidelines.Chi-square was applied to test the statistical association between qualitative variables.Unpaired t test and Mann Whitney U test were applied respectively to test the mean difference of quantitative variables.RESULTS A total of 208 patients were included in the study,of which 108 were during COVID era and 100 were during pre-COVID era.The leading reason for admission in both the COVID era and pre-COVID era transfused patients was shortness of breath(53.7%and 36%P=0.001),followed by gastrointestinal bleeding(25.9%and 21%P=0.001).There was a higher percentage of RBC transfusions in the intensive care unit in the COVID-era group than in the pre-COVID era group(38.9%vs 22%,P=0.008).The restrictive transfusion criteria were met in 62%vs 79%in the COVID and pre-COVID eras,respectively(P=0.008).CONCLUSION The COVID-era group received RBC transfusions with less stringent adherence to restrictive blood transfusion practices in comparison to pre-COVID era group.

Retrospective study evaluating association of colorectal tumors and hepatitis C virus

BACKGROUND Chronic hepatitis C virus(HCV)has been associated with hepatic and extrahe-patic malignancies.Limited studies have shown an association between colorectal adenomas and HCV populations.AIM To study the prevalence of colorectal adenomas in patients with HCV compared to the general population and to evaluate if it is an independent risk factor for colorectal adenomas.METHODS Patients were divided into HCV and non-HCV based on their HCV RNA titers.Patients with alcoholic liver disease,hepatitis B infection,and inflammatory bowel disease were excluded.Continuous variables were analyzed using the Mann-Whitney U test,and categorical variables usingχ^(2) with P<0.05 were considered statistically significant.The significant covariates(independent variables)were matched in both groups by propensity score matching,followed by multivariate regression analysis.RESULTS Of the 415 patients screened,109 HCV patients and 97 non-HCV patients with colonoscopy results were included in the study.HCV patients were older,had a smoking history,had less frequent aspirin use,and had a lower body mass index(BMI)(P<0.05).The HCV cohort had a significantly increased number of patients with adenomas(adenoma detection rate of 53.2%vs 34%.P=0.006).We performed a propensity-matched multivariate analysis where HCV infection was significantly associated with colorectal adenoma(OR:2.070,P=0.019).CONCLUSION Our study shows a significantly higher rate of adenomas in HCV patients compared to the general population.Prospective studies would help determine if the increase in adenoma detection lowers the risk for colorectal cancer.

Impact of frailty on endoscopic retrograde cholangiopancreatography outcomes in nonagenarians:A United States national experience

BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an essential therapeutic tool for biliary and pancreatic diseases.Frail and elderly patients,especially those aged≥90 years are generally considered a higher-risk population for ERCP-related complications.AIM To investigate outcomes of ERCP in the Non-agenarian population(≥90 years)concerning Frailty.METHODS This is a cohort study using the 2018-2020 National Readmission Database.Patients aged≥90 were identified who underwent ERCP,using the international classification of diseases-10 code with clinical modification.Johns Hopkins’s adjusted clinical groups frailty indicator was used to classify patients as frail and non-frail.The primary outcome was mortality,and the secondary outcomes were morbidity and the 30 d readmission rate related to ERCP.We used univariate and multivariate regression models for analysis.RESULTS A total of 9448 patients were admitted for any indications of ERCP.Frail and non-frail patients were 3445(36.46%)and 6003(63.53%)respectively.Indications for ERCP were Choledocholithiasis(74.84%),Biliary pancreatitis(9.19%),Pancreatico-biliary cancer(7.6%),Biliary stricture(4.84%),and Cholangitis(1.51%).Mortality rates were higher in frail group[adjusted odds ratio(aOR)=1.68,P=0.02].The Intra-procedural complications were insigni-ficant between the two groups which included bleeding(aOR=0.72,P=0.67),accidental punctures/lacerations(aOR=0.77,P=0.5),and mechanical ventilation rates(aOR=1.19,P=0.6).Post-ERCP complication rate was similar for bleeding(aOR=0.72,P=0.41)and post-ERCP pancreatitis(aOR=1.4,P=0.44).Frail patients had a longer length of stay(6.7 d vs 5.5 d)and higher mean total charges of hospitalization($78807 vs$71392)compared to controls(P<0.001).The 30 d all-cause readmission rates between frail and non-frail patients were similar(P=0.96).CONCLUSION There was a significantly higher mortality risk and healthcare burden amongst nonagenarian frail patients undergoing ERCP compared to non-frail.Larger studies are warranted to investigate and mitigate modifiable risk factors.

Remimazolam for sedation in gastrointestinal endoscopy:A comprehensive review

Worldwide,a majority of routine endoscopic procedures are performed under some form of sedation to maximize patient comfort.Propofol,benzodiazepines and opioids continue to be widely used.However,in recent years,Remimazolam is gaining immense popularity for procedural sedation in gastrointestinal(GI)endoscopy.It is an ultra-short-acting benzodiazepine sedative which was approved by the Food and Drug Administration in July 2020 for use in procedural sedation.Remimazolam has shown a favorable pharmacokinetic and pharmacodynamic profile in terms of its non-specific metabolism by tissue esterase,volume of distribution,total body clearance,and negligible drug-drug interactions.It also has satisfactory efficacy and has achieved high rates of successful sedation in GI endoscopy.Furthermore,studies have demonstrated that the efficacy of Remimazolam is non-inferior to Propofol,which is currently a gold standard for procedural sedation in most parts of the world.However,the use of Propofol is associated with hemodynamic instability and respiratory depression.In contrast,Remimazolam has lower incidence of these adverse effects intra-procedurally and hence,may provide a safer alternative to Propofol in procedural sedation.In this comprehensive narrative review,highlight the pharmacologic characteristics,efficacy,and safety of Remimazolam for procedural sedation.We also discuss the potential of Remimazolam as a suitable alternative and how it can shape the future of procedural sedation in gastroenterology.

ERK/JNK在黄鳝雌、雄发育阶段生殖腺中的表达和定位

为探讨MAPK家族中ERK和JNK两个主要亚族在黄鳝雌、雄发育阶段生殖腺中的表达状况,应用蛋白质免疫印迹杂交技术和免疫组织化学法检测了ERK、JNK在黄鳝卵巢组织和精巢组织中的表达和定位。蛋白免疫印迹杂交显示:ERK在黄鳝雌、雄性腺组织中均有强的表达;JNK在性腺中的表达总体上弱于ERK,JNK1在精巢组织中的表达比卵巢组织显著降低,但JNK2在雌、雄性腺组织中的表达无明显差异。在免疫组织化学的观察中,ERK和JNK在卵原细胞和精原细胞中均为阳性反应,且定位相似:细胞质及细胞核核质呈阳性反应,核仁阴性。随着卵母细胞生长和成熟,ERK和JNK在卵母细胞胞质中阳性反应逐渐减弱。实验结果提示,ERK和JNK在黄鳝卵巢发育。

基于子带相似性分析的JPEG2000图像无参考质量评价

无失真图像中相邻尺度同一方向子带的小波系数是相互关联的,而编码压缩使得这种相关性随着压缩率而变化的。该文采用余弦相似性来模拟相邻尺度同方向子带图像的相关性,根据提取的子带相似性特征矢量和统计工具来分析人的主观质量评价得分MOS(Mean Opinion Scores)与子带余弦相似性的关系,得到了一种新的无参考质量模型。实验结果显示该文提出的JPEG2000无参考质量评价方法与MOS具有较高的相关性,而且复杂度低,运行时间少。

Math1基因内耳导入后噪声性聋豚鼠听功能改变观察

目的观察Math1基因内耳导入对噪声性聋豚鼠听功能的影响,探讨Math1基因过表达对噪声损伤耳蜗的生物学效应,为内耳基因治疗提供实验基础和理论依据。方法经脉冲噪声致聋的豚鼠45只(各频率ABR阈值均≥95dB SPL),雌雄不限,实验开始时体重250～300g。随机分为3组:Ad-Math1-EGFP组(30只);Ad-EGFP组(5只);空白组(10只)。各组豚鼠在基因转导后4周、8周分别测试双耳ABR。测试完毕后处死动物,观察听泡及耳蜗无炎性病变者记录听阈结果。结果Math1导入后4周,导入耳各频率ABR阈值低于对照耳(右耳),也低于Ad-EGFP组及空白组,平均达到85dB SPL。Math1导入后8周,导入耳各频率ABR阈值低于对照耳(右耳),也低于Ad-EGFP组及空白组,与4周时比较,进一步好转,平均达到75dB SPL。结论Math1基因内耳导入可使噪声导致全聋的豚鼠听功能部分恢复,为噪声性聋的治疗打开了新的思路和手段。

蛋白磷酸酶-2Ac在不同倍性鱼6种组织中的分化表达模式

蛋白磷酸酶-2A是最重要的丝氨酸/苏氨酸蛋白磷酸酶之一,对于调控多细胞的生命活动起着非常重要的作用。以异源四倍体鲫鲤及其二倍体父/母本(湘江野鲤/红鲫)和子代三倍体湘云鲫等为实验材料,运用Westernblot技术及荧光免疫组织化学技术等实验手段,得到了Protein Phosphatase-2A(PP2A)的催化亚基在上述不同倍性鱼体内6种不同组织的表达模式:Protein Phosphatase-2Ac(PP2Ac)在异源四倍体鲫鲤及其二倍体父/母本及子代三倍体湘云鲫不同组织中蛋白水平均有表达,而且出现了明显的种属特异性和组织特异性,如在大脑、肌肉、肝脏三组织中,三倍体湘云鲫中PP2Ac的表达相对最高。而在肾脏组织中,PP2Ac在异源四倍体鲫鲤中的表达水平最高,父本与三倍体湘云鲫中的表达比较相近,且最低;而在性腺组织中则是父本精巢中的表达最高;在心脏组织中,PP2Ac在母本红鲫中的表达相对较高。这种明显的种属之间组织特异性可能说明了子代与父母本之间的变异性。荧光免疫组化实验结果显示,从整体水平来看,4种不同鱼的同一组织中,PP2Ac的相对定位是非常相似的,这可能说明了异源四倍体鲫鲤与其二倍体父/母本及子代三倍体湘云鲫之间的遗传相似性。研究结果为进一步探索PP2Ac在脊椎动物不同组织中的功能提供了实验依据。

PP-1催化亚基(PP-1c)在成体小白鼠不同组织器官中的分化表达与定位

为了确定蛋白磷酸酶-1(protein phosphatase-1)的催化亚基(PP-1c)在小白鼠不同器官组织(肌肉、卵巢、肾、胃、脾、大脑、心、肝、肺及乳腺)中的表达模式,运用RT-PCR、Western印迹及荧光免疫组织化学技术等实验手段进行了检测和分析.结果表明,在mRNA水平,PP-1c在大脑中表达最高,卵巢及肺中表达次之,在肌肉、肾、心、肝中表达较低,在胃和乳腺中表达最低;在蛋白质水平,肝中表达最高,肾、大脑、肺和乳腺中表达较高,而肌肉、卵巢、心和脾中表达相对较低,胃中表达最低.免疫荧光组织化学实验结果显示,PP-1c的表达也具有明显的组织特异性和细胞特异性.这些结果为进一步探讨PP-1在哺乳动物不同组织器官中的功能提供了重要的实验依据.

婴幼儿睾丸生殖细胞肿瘤15例临床病理和诊治分析

睾丸生殖细胞肿瘤是一组罕见、复杂的异源性肿瘤,有良性和恶性,是婴幼儿时期最常见的肿瘤,约60%～75%在3岁以前发病,因此早期、及时明确诊断和选择合适的治疗方案尤为重要。本文通过回顾我院收治的15例婴幼儿睾丸生殖细胞肿瘤,探讨它的临床病理特征、免疫组化和治疗方法,以期对该病的临床诊治有所裨益。

PP-1与PP-2A在金鱼眼(球)不同组织/细胞中的表达模式

为确定蛋白磷酸酶-1和-2A(protein phosphatase-1 and phosphatase-2A,PP-1,PP-2A)在水生低等脊椎动物眼球不同组织/细胞中的表达模式,提取金鱼眼球中4种组织视网膜、晶体上皮细胞、晶体纤维和角膜的RNA和蛋白,利用RT-PCR和Western印迹技术进行检测.同时运用荧光免疫组织化学技术进行了定位表达研究.结果表明:1)在mRNA水平上,PP-1催化亚基α和PP-2A催化亚基β在金鱼视网膜、晶体上皮和角膜中表达强烈,与其在高等哺乳类脊椎动物如小鼠中的表达形成鲜明的对比;2)在蛋白水平上,PP-1和PP-2A催化亚基在金鱼视网膜和晶体上皮细胞中的表达较高,而在角膜中的表达最低.这与它们在小鼠眼球视网膜和角膜中同时具备高表达的模式形成对比;3)在金鱼发育48h的眼球中,PP-1和PP-2A催化亚基定位于视网膜的色素视网膜和神经视网膜细胞中,晶体上皮和纤维细胞中及角膜上皮细胞中,而在性成熟金鱼眼球中,此二酶催化亚基主要定位于视网膜的色素视网膜,神经视网膜及晶体上皮细胞中.这些结果为探讨PP-1和PP-2A在金鱼眼球不同组织中的功能打下了重要基础。

jnk3基因在金鱼和斑马鱼不同发育时期胚胎与成体不同组织中的分化表达

JNKs是丝裂原活化蛋白激酶(MAPK)家族重要成员,参与应激反应和动物体轴的构建。为了进一步了解JNK家族在动物发育中的功能,首次分离和克隆了金鱼jnk3基因,研究了jnk3在金鱼和斑马鱼组织特异性和胚胎发育特异性表达状况。金鱼jnk3基因cDNA总长1 794 bp,其中阅读框1 293 bp,编码430个氨基酸。对jnk3基因序列及其推导的氨基酸序列进行同源性分析,结果显示,jnk3基因在脊椎动物较为保守,金鱼jnk3基因核苷酸序列与斑马鱼、人的同源性分别为94.1%和80.7%,金鱼jnk3基因氨基酸序列与斑马鱼、人的同源性分别为99.7%和93.4%。jnk3基因在鱼类成体中的表达存在着显著的组织差异,在金鱼和斑马鱼脑和精巢组织的表达具专一性,此外在斑马鱼心脏中也检测到jnk3的表达。RT-PCR检测结果显示,在鱼类胚胎发育中,神经胚期开始检测到jnk3基因mRNA表达,从神经胚到心跳期胚胎,jnk3基因表达水平逐渐增高,此后直至出膜一直保持较高的表达水平。研究表明,jnk3基因可能在鱼类后期的胚胎发育和成体脑、精巢与心脏发育中具有重要作用。

蛋白磷酸酶PP-1c在不同倍性鱼6种组织中的分化表达模式

以异源四倍体鲫鲤及其二倍体父/母本(湘江野鲤/红鲫)和子代三倍体湘云鲫等为实验材料,运用W estern-blotting技术及荧光免疫组织化学技术等实验手段,分析了PP-1的催化亚基在上述不同倍性鱼体内的表达模式:蛋白水平检测发现PP-1c在不同倍性鱼的大脑、心脏、肌肉、肾脏、肝脏和性腺6种主要器官组织中均有表达,且不同的组织中显示了明显的差异表达模式,而PP-1c在这4种不同鱼的肌肉组织中的表达差异更显著,其中在异源四倍体鲫鲤中表达最低,在父/母本红鲫中的表达水平相对较高,子代三倍体湘云鲫中的表达最高,这种差异性可能从生化的角度说明了子代与父母本之间的变异性。免疫荧光组化实验结果显示,从整体水平来看,4种不同鱼的同一组织中,PP-1c的表达模式是非常相似的,这可能从蛋白和细胞的水平说明了异源四倍体鲫鲤与其二倍体父/母本及子代三倍体湘云鲫之间的遗传相似性。但对于同一组织的不同细胞的具体表达部位是有差异的,具有细胞特异性。

睾丸富于细胞纤维瘤临床病理观察

目的:探讨睾丸富于细胞纤维瘤的临床病理特征、鉴别诊断和预后。方法:对1例睾丸富于细胞纤维瘤的临床表现、组织形态和免疫组化进行综合分析,并结合文献讨论其病理特点及鉴别诊断。结果:30岁男性患者,右侧睾丸不适并无痛性肿大为主诉。睾丸纤维瘤实性边界清楚,包膜亦厚亦薄,切面灰白色,镜下梭型瘤细胞排列成席纹状、鱼骨状或束状,细胞丰富,细胞核无多形性,核分裂像为0～1个/10HP。免疫组化显示肿瘤细胞波形蛋白(+)、S-100局灶(+)、平滑肌蛋白局灶(+)、肌纤维蛋白(-)、α-抑制素(-)、CD34(-)、CD99(-)、Ki-67阳性率不足1%。结论:睾丸富于细胞纤维瘤是一种罕见的睾丸性索间质肿瘤,与卵巢同源性肿瘤病理特征相同;容易与睾丸的其它梭型细胞肿瘤混淆,形态学结合免疫组化可资鉴别;手术切除预后良好。

PP2A-Aα/β在金鱼及斑马鱼发育中的分化表达模式

以金鱼和斑马鱼为研究对象,运用RT-PCR和Western Blot技术分析蛋白磷酸酶2A(PP2A)结构亚基A(PP2A-Aα/β)在金鱼、斑马鱼成体9种组织和12个发育时期胚胎中mRNA和蛋白水平的表达情况,得到其分化表达模式为:(1)在mRNA水平上,PP2A-Aα/β在金鱼、斑马鱼9种组织中具有较强表达;种属差异性和组织差异性均较大;结构亚基A的两亚型Aα和Aβ的表达存在差异。(2)在蛋白水平上,PP2A-Aα/β在金鱼、斑马鱼9种组织中均有表达;种属差异性不大但出现明显的组织差异性。(3)PP2A-Aα/βmRNA在金鱼和斑马鱼卵裂期到囊胚期胚胎中大量存在,PP2A-AαmRNA在金鱼眼色素期量剧增推测其对金鱼眼色素的形成至关重要。(4)PP2A-Aα/β基因在金鱼、斑马鱼12个发育时期胚胎中均有较高水平的蛋白存在,提示其为维持胚胎的正常发育发挥重要作用。

考虑热湿影响的氯盐侵蚀下混凝土中多相传输与相变模拟

在富含氯化物的环境中,氯离子引起的钢筋锈蚀是导致钢筋混凝土结构性能退化的主要原因之一。如何预测氯离子侵蚀过程以及提高结构抗侵蚀能力是混凝土结构工程师所必须面临的最严峻挑战。为此,本实验建立了一个用于数值分析混凝土中氯离子传输过程的计算模型。为能再现混凝土结构在非饱和、非等温条件下的真实状况,模型控制方程中考虑了氯离子、湿分、空气、热量在混凝土中的耦合传输过程,以及相互间的耦合作用。控制方程中所涉及的耦合系数均来自已有的材料模型和实验数据,而方程的数值求解使用了有限单元法。模型计算结果与试验数据显示出良好的吻合度,研究结果可为混凝土结构的减防腐蚀灾害设计提供重要的参考。