Displaying publications 1 - 20 of 28 in total

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  1. Biomechanical characterisation of ovine spinal facet joint cartilage
    Abd Latif MJ, Jin Z, Wilcox RK
    J Biomech, 2012 May 11;45(8):1346-52.
    PMID: 22483055 DOI: 10.1016/j.jbiomech.2012.03.015
    The spinal facet joints are known to be an important component in the kinematics and the load transmission of the spine. The articular cartilage in the facet joint is prone to degenerative changes which lead to back pain and treatments for the condition have had limited long term success. There is currently a lack of information on the basic biomechanical properties of the facet joint cartilage which is needed to develop tissue substitution or regenerative interventions. In the present study, the thickness and biphasic properties of ovine facet cartilage were determined using a combination of indentation tests and computational modelling. The equilibrium biphasic Young's modulus and permeability were derived to be 0.76±0.35 MPa and 1.61±1.10×10⁻¹⁵ m⁴/(Ns) respectively, which were within the range of cartilage properties characterised from the human synovial joints. The average thickness of the ovine facet cartilage was 0.52±0.10 mm, which was measured using a needle indentation test. These properties could potentially be used for the development of substitution or tissue engineering interventions and for computational modelling of the facet joint. Furthermore, the developed method to characterise the facet cartilage could be used for other animals or human donors.
  2. Membrane separations
    Walter JK, Jin Z, Jornitz MW, Gorrschalk U
    Methods Biochem Anal, 2011;54:281-317.
    PMID: 21954783
  3. Twice evasions of Omicron variants explain the temporal patterns in six Asian and Oceanic countries
    Chen B, Zhao Y, Jin Z, He D, Li H
    BMC Infect Dis, 2023 Jan 13;23(1):25.
    PMID: 36639649 DOI: 10.1186/s12879-023-07984-9
    BACKGROUND: The ongoing coronavirus 2019 (COVID-19) pandemic has emerged and caused multiple pandemic waves in the following six countries: India, Indonesia, Nepal, Malaysia, Bangladesh and Myanmar. Some of the countries have been much less studied in this devastating pandemic. This study aims to assess the impact of the Omicron variant in these six countries and estimate the infection fatality rate (IFR) and the reproduction number [Formula: see text] in these six South Asia, Southeast Asia and Oceania countries.

    METHODS: We propose a Susceptible-Vaccinated-Exposed-Infectious-Hospitalized-Death-Recovered model with a time-varying transmission rate [Formula: see text] to fit the multiple waves of the COVID-19 pandemic and to estimate the IFR and [Formula: see text] in the aforementioned six countries. The level of immune evasion and the intrinsic transmissibility advantage of the Omicron variant are also considered in this model.

    RESULTS: We fit our model to the reported deaths well. We estimate the IFR (in the range of 0.016 to 0.136%) and the reproduction number [Formula: see text] (in the range of 0 to 9) in the six countries. Multiple pandemic waves in each country were observed in our simulation results.

    CONCLUSIONS: The invasion of the Omicron variant caused the new pandemic waves in the six countries. The higher [Formula: see text] suggests the intrinsic transmissibility advantage of the Omicron variant. Our model simulation forecast implies that the Omicron pandemic wave may be mitigated due to the increasing immunized population and vaccine coverage.

  4. Fulltext Palmitic acid- and cysteine-functionalized nanoparticles overcome mucus and epithelial barrier for oral delivery of drug
    Xie Y, Jin Z, Ma D, Yin TH, Zhao K
    Bioeng Transl Med, 2023 May;8(3):e10510.
    PMID: 37206211 DOI: 10.1002/btm2.10510
    Nanoparticles (NPs) used for oral administration have greatly improved drug bioavailability and therapeutic efficacy. Nevertheless, NPs are limited by biological barriers, such as gastrointestinal degradation, mucus barrier, and epithelial barrier. To solve these problems, we developed the PA-N-2-HACC-Cys NPs loaded with anti-inflammatory hydrophobic drug curcumin (CUR) (CUR@PA-N-2-HACC-Cys NPs) by self-assembled amphiphilic polymer, composed of the N-2-Hydroxypropyl trimethyl ammonium chloride chitosan (N-2-HACC), hydrophobic palmitic acid (PA), and cysteine (Cys). After oral administration, the CUR@PA-N-2-HACC-Cys NPs had good stability and sustained release under gastrointestinal conditions, followed by adhering to the intestine to achieve drug mucosal delivery. Additionally, the NPs could penetrate mucus and epithelial barriers to promote cellular uptake. The CUR@PA-N-2-HACC-Cys NPs could open tight junctions between cells for transepithelial transport while striking a balance between mucus interaction and diffusion through mucus. Notably, the CUR@PA-N-2-HACC-Cys NPs improved the oral bioavailability of CUR, which remarkably relieved colitis symptoms and promoted mucosal epithelial repair. Our findings proved that the CUR@PA-N-2-HACC-Cys NPs had excellent biocompatibility, could overcome mucus and epithelial barriers, and had significant application prospects for oral delivery of the hydrophobic drugs.
  5. Molecular cloning and expression of five glutathione S-transferase (GST) genes from Banana (Musa acuminata L. AAA group, cv. Cavendish)
    Wang Z, Huang S, Jia C, Liu J, Zhang J, Xu B, et al.
    Plant Cell Rep, 2013 Sep;32(9):1373-80.
    PMID: 23652818 DOI: 10.1007/s00299-013-1449-7
    KEY MESSAGE: Three tau class MaGSTs responded to abiotic stress, MaGSTF1 and MaGSTL1 responded to signaling molecules, they may play an important role in the growth of banana plantlet. Glutathione S-transferases (GST) are multifunctional detoxification enzymes that participate in a variety of cellular processes, including stress responses. In this study, we report the molecular characteristics of five GST genes (MaGSTU1, MaGSTU2, MaGSTU3, MaGSTF1 and MaGSTL1) cloned from banana (Musa acuminate L. AAA group, cv. Cavendish) using a RACE-PCR-based strategy. The predicted molecular masses of these GSTs range from 23.4 to 27.7 kDa and their pIs are acidic. At the amino acid level, they share high sequence similarity with GSTs in the banana DH-Pahang (AA group) genome. Phylogenetic analysis showed that the deduced amino acid sequences of MaGSTs also have high similarity to GSTs of other plant species. Expression analysis by semi-quantitative RT-PCR revealed that these genes are differentially expressed in various tissues. In addition, their expression is regulated by various stress conditions, including exposure to signaling molecules, cold, salinity, drought and Fusarium oxysporum f specialis(f. Sp) cubense Tropical Race 4 (Foc TR4) infection. The expression of the tau class MaGSTs (MaGSTU1, MaGSTU2 and MaGSTU3) mainly responded to cold, salinity and drought while MaGSTF1 and MaGSTL1 expressions were upregulated by signaling molecules. Our findings suggest that MaGSTs play a key role in both development and abiotic stress responses.
  6. Fulltext What Simon "knows" about cultural differences: The influence of cultural orientation and traffic directionality on spatial compatibility effects
    Baess P, Ecker UKH, Janssen SMJ, Jin Z, Bermeitinger C
    Mem Cognit, 2023 Apr;51(3):526-542.
    PMID: 36180770 DOI: 10.3758/s13421-022-01360-9
    Previous research has suggested that culture influences perception and attention. These studies have typically involved comparisons of Westerners with East Asians, motivated by assumed differences in the cultures' self-concept or position on the individualism-collectivism spectrum. However, other potentially important sources of cultural variance have been neglected, such as differences in traffic directionality shaped by the urban spatial environment (i.e., left-hand vs. right-hand traffic). Thus, existing research may potentially place too much emphasis on self-concepts or the individualism-collectivism dimension in explaining observed cultural differences in cognition. The present study investigated spatial cognition using a Simon task and tested participants from four nations (Australia, China, Germany, and Malaysia) that differ in both cultural orientation (collectivistic vs. individualistic) and traffic directionality (left-hand vs. right-hand traffic). The task used two possible reference frames underlying the Simon effect: a body-centered one based on global stimulus position relative to the screen's center versus an object-centered one based on local stimulus position relative to a context object. As expected, all groups showed a reliable Simon effect for both spatial reference frames. However, the global Simon effect was larger in participants from countries with left-hand traffic. In contrast, the local Simon effect was modulated by differences in cultural orientation, with larger effects in participants from collectivistic cultures. This pattern suggests that both sources of cultural variation, viz. cultural orientation and traffic directionality, contribute to differences in spatial cognition in distinct ways.
  7. MPS-FFA: A multiplane and multiscale feature fusion attention network for Alzheimer's disease prediction with structural MRI
    Liu F, Wang H, Liang SN, Jin Z, Wei S, Li X, et al.
    Comput Biol Med, 2023 May;157:106790.
    PMID: 36958239 DOI: 10.1016/j.compbiomed.2023.106790
    Structural magnetic resonance imaging (sMRI) is a popular technique that is widely applied in Alzheimer's disease (AD) diagnosis. However, only a few structural atrophy areas in sMRI scans are highly associated with AD. The degree of atrophy in patients' brain tissues and the distribution of lesion areas differ among patients. Therefore, a key challenge in sMRI-based AD diagnosis is identifying discriminating atrophy features. Hence, we propose a multiplane and multiscale feature-level fusion attention (MPS-FFA) model. The model has three components, (1) A feature encoder uses a multiscale feature extractor with hybrid attention layers to simultaneously capture and fuse multiple pathological features in the sagittal, coronal, and axial planes. (2) A global attention classifier combines clinical scores and two global attention layers to evaluate the feature impact scores and balance the relative contributions of different feature blocks. (3) A feature similarity discriminator minimizes the feature similarities among heterogeneous labels to enhance the ability of the network to discriminate atrophy features. The MPS-FFA model provides improved interpretability for identifying discriminating features using feature visualization. The experimental results on the baseline sMRI scans from two databases confirm the effectiveness (e.g., accuracy and generalizability) of our method in locating pathological locations. The source code is available at https://github.com/LiuFei-AHU/MPSFFA.
  8. Fulltext Global stability and cost-effectiveness analysis of COVID-19 considering the impact of the environment: using data from Ghana
    Asamoah JKK, Owusu MA, Jin Z, Oduro FT, Abidemi A, Gyasi EO
    Chaos Solitons Fractals, 2020 Nov;140:110103.
    PMID: 32834629 DOI: 10.1016/j.chaos.2020.110103
    COVID-19 potentially threatens the lives and livelihood of people all over the world. The disease is presently a major health concern in Ghana and the rest of the world. Although, human to human transmission dynamics has been established, not much research is done on the dynamics of the virus in the environment and the role human play by releasing the virus into the environment. Therefore, investigating the human-environment-human by use of mathematical analysis and optimal control theory is relatively necessary. The dynamics of COVID-19 for this study is segregated into compartments as: Susceptible (S), Exposed (E), Asymptomatic (A), Symptomatic (I), Recovered (R) and the Virus in the environment/surfaces (V). The basic reproduction number R 0 without controls is computed. The application of Lyapunov's function is used to analyse the global stability of the proposed model. We fit the model to real data from Ghana in the time window 12th March 2020 to 7th May 2020, with the aid of python programming language using the least-squares method. The average basic reproduction number without controls, R 0 a , is approximately 2.68. An optimal control is formulated based on the sensitivity analysis. Numerical simulation of the model is also done to verify the analytic results. The admissible control set such as: effective testing and quarantine when boarders are opened, the usage of masks and face shields through media education, cleaning of surfaces with home-based detergents, practising proper cough etiquette and fumigating commercial areas; health centers is simulated in MATLAB. We used forward-backward sweep Runge-Kutta scheme which gave interesting results in the main text, for example, the cost-effectiveness analysis shows that, Strategy 4 (safety measures adopted by the asymptomatic and symptomatic individuals such as practicing proper coughing etiquette by maintaining a distance, covering coughs and sneezes with disposable tissues or clothing and washing of hands after coughing or sneezing) is the most cost-effective strategy among all the six control intervention strategies under consideration.
  9. Co-encapsulation of curcumin and quercetin with zein/HP-β-CD conjugates to enhance environmental resistance and antioxidant activity
    Qiu C, Zhang Z, Li X, Sang S, McClements DJ, Chen L, et al.
    NPJ Sci Food, 2023 Jun 14;7(1):29.
    PMID: 37316567 DOI: 10.1038/s41538-023-00186-2
    In this study, composite nanoparticles consisting of zein and hydroxypropyl beta-cyclodextrin were prepared using a combined antisolvent co-precipitation/electrostatic interaction method. The effects of calcium ion concentration on the stability of the composite nanoparticles containing both curcumin and quercetin were investigated. Moreover, the stability and bioactivity of the quercetin and curcumin were characterized before and after encapsulation. Fluorescence spectroscopy, Fourier Transform infrared spectroscopy, and X-ray diffraction analyses indicated that electrostatic interactions, hydrogen bonding, and hydrophobic interactions were the main driving forces for the formation of the composite nanoparticles. The addition of calcium ions promoted crosslinking of the proteins and affected the stability of the protein-cyclodextrin composite particles through electrostatic screening and binding effects. The addition of calcium ions to the composite particles improved the encapsulation efficiency, antioxidant activity, and stability of the curcumin and quercetin. However, there was an optimum calcium ion concentration (2.0 mM) that provided the best encapsulation and protective effects on the nutraceuticals. The calcium crosslinked composite particles were shown to maintain good stability under different pH and simulated gastrointestinal digestion conditions. These results suggest that zein-cyclodextrin composite nanoparticles may be useful plant-based colloidal delivery systems for hydrophobic bio-active agents.
  10. An immune-enhanced multivalent DNA nanovaccine to prevent H7 and H9 avian influenza virus in mice
    Xu S, Lan H, Teng Q, Li X, Jin Z, Qu Y, et al.
    Int J Biol Macromol, 2023 Aug 12;251:126286.
    PMID: 37579904 DOI: 10.1016/j.ijbiomac.2023.126286
    H7 avian influenza virus has caused multiple human infections and poses a severe public health threat. In response to the highly variable nature of AIVs, a novel, easily regenerated DNA vaccine has great potential in treating or preventing avian influenza pandemics. Nevertheless, DNA vaccines have many disadvantages, such as weak immunogenicity and poor in vivo delivery. To further characterize and solve these issues and develop a novel H7 AIV DNA vaccine with enhanced stability and immunogenicity, we constructed nine AIV DNA plasmids, and the immunogenicity screened showed that mice immunized with pβH7N2SH9 elicited stronger hemagglutination-inhibiting (HI) antibodies than other eight plasmid DNAs. Then, to address the susceptibility to degradation and low transfection rate of DNA vaccine in vivo, we developed pβH7N2SH9/DGL NPs by encapsulating the pβH7N2SH9 within the dendrigraft poly-l-lysines nanoparticles. As expected, these NPs exhibited excellent physical and chemical properties, were capable of promote lymphocyte proliferation, and induce stronger humoral and cellular responses than the naked pβH7N2SH9, including higher levels of HI antibodies than naked pβH7N2SH9, as well as the production of cytokines, namely, IL-2, IFN-α. Taken together, our results suggest that the construction of an immune-enhanced H7-AIV DNA nanovaccine may be a promising strategy against most influenza viruses.
  11. Health benefits, mechanisms of interaction with food components, and delivery of tea polyphenols: a review
    Niu J, Shang M, Li X, Sang S, Chen L, Long J, et al.
    Crit Rev Food Sci Nutr, 2023 Sep 04.
    PMID: 37665600 DOI: 10.1080/10408398.2023.2253542
    Tea polyphenols (TPs) are the most important active component of tea and have become a research focus among natural products, thanks to their antioxidant, lipid-lowering, liver-protecting, anti-tumor, and other biological activities. Polyphenols can interact with other food components, such as protein, polysaccharides, lipids, and metal ions to further improve the texture, flavor, and sensory quality of food, and are widely used in food fields, such as food preservatives, antibacterial agents and food packaging. However, the instability of TPs under conditions such as light or heat and their low bioavailability in the gastrointestinal environment also hinder their application in food. In this review, we summarized the health benefits of TPs. In order to better use TPs in food, we analyzed the form and mechanism of interaction between TPs and main food components, such as polysaccharides and proteins. Moreover, we reviewed research into optimizing the applications of TPs in food by bio-based delivery systems, such as liposomes, nanoemulsions, and nanoparticles, so as to improve the stability and bioactivity of TPs in food application. As an effective active ingredient, TPs have great potential to be applied in functional food to produce benefits for human health.
  12. Fabrication and characterization of polydopamine-mediated zein-based nanoparticle for delivery of bioactive molecules
    Zhang Z, Jiang H, Chen G, Miao W, Lin Q, Sang S, et al.
    Food Chem, 2024 Apr 24;451:139477.
    PMID: 38678664 DOI: 10.1016/j.foodchem.2024.139477
    In this study, a combination of whey protein (hydrophilic coating) and polydopamine (crosslinking agent) was used to improve the stability and functionality of quercetin-loaded zein nanoparticles. There are two key benefits of the core-shell nanoparticles formed. First, the ability of the polydopamine to bind to both zein and whey protein facilitates the formation of a stable core-shell structure, thereby protecting quercetin from any pro-oxidants in the aqueous surroundings. Second, neutral and hydrophilic whey proteins were used for the surface coating of the nanoparticles to further enhance the sustained and slow release of quercetin, facilitating its sustained release into the body at a slow and steady rate. The results of this study will promote the innovative development of precise nutritional delivery systems for zein and provide a theoretical basis for the design and development of dietary supplements based on hydrophobic food nutrient molecules.
  13. Physicochemical stability, antioxidant activity, and antimicrobial activity of quercetin-loaded zein nanoparticles coated with dextrin-modified anionic polysaccharides
    Zhang Z, Hu Y, Ji H, Lin Q, Li X, Sang S, et al.
    Food Chem, 2023 Jul 30;415:135736.
    PMID: 36863232 DOI: 10.1016/j.foodchem.2023.135736
    Core-shell biopolymer nanoparticles are assembled from a hydrophobic protein (zein) core and a hydrophilic polysaccharide (carboxymethyl dextrin) shell. The nanoparticles were shown to have good stability and the ability to protect quercetin from chemical degradation under long-term storage, pasteurization, and UV irradiation. Spectroscopy analysis shows that electrostatic, hydrogen bonding, and hydrophobic interactions are the main driving forces for the formation of composite nanoparticles. Quercetin coated with nanoparticles significantly enhanced its antioxidant and antibacterial activities and showed good stability and slow release in vitro during simulated gastrointestinal digestion. Furthermore, the encapsulation efficiency of carboxymethyl dextrin-coated zein nanoparticles (81.2%) for quercetin was significantly improved compared with that of zein nanoparticles alone (58.4%). These results indicate that carboxymethyl dextrin-coated zein nanoparticles can significantly improve the bioavailability of hydrophobic nutrient molecules such as quercetin and provide a valuable reference for their application in the field of biological delivery of energy drinks and food.
  14. Preparation of robust, water-resistant, antibacterial, and antioxidant chitosan-based films by incorporation of cinnamaldehyde-tannin acid-zinc acetate nanoparticles
    Yin W, Yan R, Zhou X, Li X, Sang S, Julian McClements D, et al.
    Food Chem, 2023 Mar 24;419:136004.
    PMID: 37054511 DOI: 10.1016/j.foodchem.2023.136004
    Chitosan (CS) films have poor mechanical property, low water-resistance and limited antimicrobial activity, which hinder their application in food preservation industry. Cinnamaldehyde-tannic acid-zinc acetate nanoparticles (CTZA NPs) assembled from edible medicinal plant extracts were successfully incorporated into CS films to solve these issues. The tensile strength and water contact angle of the composite films increased about 5.25-fold and 17.55°. The addition of CTZA NPs reduced the water sensitivity of CS films, which could undergo appreciable stretching in water without breaking. Furthermore, CTZA NPs significantly enhanced the UV adsorption, antibacterial, and antioxidant properties of the films, while reduced their water vapor permeability. Moreover, it was possible to print inks onto the films because the presence of the hydrophobic CTZA NPs facilitated the deposition of carbon powder onto their surfaces. The films with great antibacterial and antioxidant activities can be applied for food packaging application.
  15. Exogenous stromal derived factor-1 releasing silk scaffold combined with intra-articular injection of progenitor cells promotes bone-ligament-bone regeneration
    Hu Y, Ran J, Zheng Z, Jin Z, Chen X, Yin Z, et al.
    Acta Biomater, 2018 04 15;71:168-183.
    PMID: 29524675 DOI: 10.1016/j.actbio.2018.02.019
    Anterior cruciate ligament (ACL) is one of the most difficult tissues to heal once injured. Ligament regeneration and tendon-bone junction healing are two major goals of ACL reconstruction. This study aimed to investigate the synergistic therapeutic effects of Stromal cell-derived factor 1 (SDF-1)-releasing collagen-silk (CSF) scaffold combined with intra-articular injection of ligament-derived stem/progenitor cells (LSPCs) for ACL regeneration and the amelioration in the long-term complication of osteoarthritis (OA). The stem cell recruitment ability of CSF scaffold and the multipotency, particularly the tendon forming ability of LSPCs from rabbits were characterized in vitro, while the synergistic effect of the CSF scaffold and LSPCs for ACL regeneration and OA amelioration were investigated in vivo at 1, 3, and 6 months with a rabbit ACL reconstruction model. The CSF scaffold was used as a substitute for the ACL, and LSPCs were injected into the joint cavity after 7 days of the ACL reconstruction. CSF scaffold displayed a controlled release pattern for the encapsulated protein for up to 7 days with an increased stiffness in the mechanical property. LSPCs, which exhibited highly I Collagen and CXCR4 expression, were attracted by SDF-1 and successfully relocated into the CSF scaffold at 1 month in vivo. At 3 and 6 months post-treatment, the CSF scaffold combined with LSPCs (CSFL group) enhanced the regeneration of ACL tissue, and promoted bone tunnel healing. Furthermore, the OA progression was impeded efficiently. Our findings here provided a new strategy that using stem cell recruiting CSF scaffold with tissue-specific stem cells, could be a promising solution for ACL regeneration.

    STATEMENT OF SIGNIFICANCE: In this study, we developed a silk scaffold with increased stiffness and SDF-1 controlled release capacity for ligament repair. This advanced scaffold transplantation combined with intra-articular injection of LSPCs (which was isolated from rabbit ligament for the first time in this study) promoted the regeneration of both the tendinous and bone tunnel portion of ACL. This therapeutic strategy also ameliorated cartilage degeneration and reduced the severity of arthrofibrosis. Hence, combining LSPCs injection with SDF-1-releasing silk scaffold is demonstrated as a therapeutic strategy for ACL regeneration and OA treatment in the clinic.

  16. Fulltext Collective remembering and future forecasting during the COVID-19 pandemic: How the impact of COVID-19 affected the themes and phenomenology of global and national memories across 15 countries
    Öner S, Watson LA, Adıgüzel Z, Ergen İ, Bilgin E, Curci A, et al.
    Mem Cognit, 2023 Apr;51(3):729-751.
    PMID: 35817990 DOI: 10.3758/s13421-022-01329-8
    The COVID-19 pandemic created a unique set of circumstances in which to investigate collective memory and future simulations of events reported during the onset of a potentially historic event. Between early April and late June 2020, we asked over 4,000 individuals from 15 countries across four continents to report on remarkable (a) national and (b) global events that (i) had happened since the first cases of COVID-19 were reported, and (ii) they expected to happen in the future. Whereas themes of infections, lockdown, and politics dominated global and national past events in most countries, themes of economy, a second wave, and lockdown dominated future events. The themes and phenomenological characteristics of the events differed based on contextual group factors. First, across all conditions, the event themes differed to a small yet significant degree depending on the severity of the pandemic and stringency of governmental response at the national level. Second, participants reported national events as less negative and more vivid than global events, and group differences in emotional valence were largest for future events. This research demonstrates that even during the early stages of the pandemic, themes relating to its onset and course were shared across many countries, thus providing preliminary evidence for the emergence of collective memories of this event as it was occurring. Current findings provide a profile of past and future collective events from the early stages of the ongoing pandemic, and factors accounting for the consistencies and differences in event representations across 15 countries are discussed.
  17. Fulltext Assessing generalisability of deep learning-based polyp detection and segmentation methods through a computer vision challenge
    Ali S, Ghatwary N, Jha D, Isik-Polat E, Polat G, Yang C, et al.
    Sci Rep, 2024 Jan 23;14(1):2032.
    PMID: 38263232 DOI: 10.1038/s41598-024-52063-x
    Polyps are well-known cancer precursors identified by colonoscopy. However, variability in their size, appearance, and location makes the detection of polyps challenging. Moreover, colonoscopy surveillance and removal of polyps are highly operator-dependent procedures and occur in a highly complex organ topology. There exists a high missed detection rate and incomplete removal of colonic polyps. To assist in clinical procedures and reduce missed rates, automated methods for detecting and segmenting polyps using machine learning have been achieved in past years. However, the major drawback in most of these methods is their ability to generalise to out-of-sample unseen datasets from different centres, populations, modalities, and acquisition systems. To test this hypothesis rigorously, we, together with expert gastroenterologists, curated a multi-centre and multi-population dataset acquired from six different colonoscopy systems and challenged the computational expert teams to develop robust automated detection and segmentation methods in a crowd-sourcing Endoscopic computer vision challenge. This work put forward rigorous generalisability tests and assesses the usability of devised deep learning methods in dynamic and actual clinical colonoscopy procedures. We analyse the results of four top performing teams for the detection task and five top performing teams for the segmentation task. Our analyses demonstrate that the top-ranking teams concentrated mainly on accuracy over the real-time performance required for clinical applicability. We further dissect the devised methods and provide an experiment-based hypothesis that reveals the need for improved generalisability to tackle diversity present in multi-centre datasets and routine clinical procedures.
  18. Multinational prospective cohort study over 18 years of the risk factors for ventilator-associated pneumonia in 9 Asian countries: INICC findings
    Rosenthal VD, Yin R, Rodrigues C, Myatra SN, Divatia JV, Biswas SK, et al.
    Am J Infect Control, 2023 Jul;51(7):751-757.
    PMID: 36400318 DOI: 10.1016/j.ajic.2022.11.005
    BACKGROUND: Ventilator associated pneumonia (VAP) rates in Asia are several times above those of US. The objective of this study is to identify VAP risk factors.

    METHODS: We conducted a prospective cohort study, between March 27, 2004 and November 2, 2022, in 279 ICUs of 95 hospitals in 44 cities in 9 Asian countries (China, India, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, Vietnam).

    RESULTS: 153,717 patients, followed during 892,996 patient-days, acquired 3,369 VAPs. We analyzed 10 independent variables. Using multiple logistic regression we identified following independent VAP RFs= Age, rising VAP risk 1% per year (aOR=1.01; 95%CI=1.00-1.01, P

  19. Risk factors for mortality over 18 years in 317 ICUs in 9 Asian countries: The impact of healthcare-associated infections
    Rosenthal VD, Jin Z, Rodrigues C, Myatra SN, Divatia JV, Biswas SK, et al.
    Infect Control Hosp Epidemiol, 2023 Aug;44(8):1261-1266.
    PMID: 36278508 DOI: 10.1017/ice.2022.245
    OBJECTIVE: To identify risk factors for mortality in intensive care units (ICUs) in Asia.

    DESIGN: Prospective cohort study.

    SETTING: The study included 317 ICUs of 96 hospitals in 44 cities in 9 countries of Asia: China, India, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, and Vietnam.

    PARTICIPANTS: Patients aged >18 years admitted to ICUs.

    RESULTS: In total, 157,667 patients were followed during 957,517 patient days, and 8,157 HAIs occurred. In multiple logistic regression, the following variables were associated with an increased mortality risk: central-line-associated bloodstream infection (CLABSI; aOR, 2.36; P < .0001), ventilator-associated event (VAE; aOR, 1.51; P < .0001), catheter-associated urinary tract infection (CAUTI; aOR, 1.04; P < .0001), and female sex (aOR, 1.06; P < .0001). Older age increased mortality risk by 1% per year (aOR, 1.01; P < .0001). Length of stay (LOS) increased mortality risk by 1% per bed day (aOR, 1.01; P < .0001). Central-line days increased mortality risk by 2% per central-line day (aOR, 1.02; P < .0001). Urinary catheter days increased mortality risk by 4% per urinary catheter day (aOR, 1.04; P < .0001). The highest mortality risks were associated with mechanical ventilation utilization ratio (aOR, 12.48; P < .0001), upper middle-income country (aOR, 1.09; P = .033), surgical hospitalization (aOR, 2.17; P < .0001), pediatric oncology ICU (aOR, 9.90; P < .0001), and adult oncology ICU (aOR, 4.52; P < .0001). Patients at university hospitals had the lowest mortality risk (aOR, 0.61; P < .0001).

    CONCLUSIONS: Some variables associated with an increased mortality risk are unlikely to change, such as age, sex, national economy, hospitalization type, and ICU type. Some other variables can be modified, such as LOS, central-line use, urinary catheter use, and mechanical ventilation as well as and acquisition of CLABSI, VAE, or CAUTI. To reduce mortality risk, we shall focus on strategies to reduce LOS; strategies to reduce central-line, urinary catheter, and mechanical ventilation use; and HAI prevention recommendations.

  20. An international prospective study of INICC analyzing the incidence and risk factors for catheter-associated urinary tract infections in 235 ICUs across 8 Asian Countries
    Rosenthal VD, Yin R, Abbo LM, Lee BH, Rodrigues C, Myatra SN, et al.
    Am J Infect Control, 2024 Jan;52(1):54-60.
    PMID: 37499758 DOI: 10.1016/j.ajic.2023.07.007
    BACKGROUND: Identify urinary catheter (UC)-associated urinary tract infections (CAUTI) incidence and risk factors (RF) in 235 ICUs in 8 Asian countries: India, Malaysia, Mongolia, Nepal, Pakistan, the Philippines, Thailand, and Vietnam.

    METHODS: From January 1, 2014, to February 12, 2022, we conducted a prospective cohort study. To estimate CAUTI incidence, the number of UC days was the denominator, and CAUTI was the numerator. To estimate CAUTI RFs, we analyzed 11 variables using multiple logistic regression.

    RESULTS: 84,920 patients hospitalized for 499,272 patient days acquired 869 CAUTIs. The pooled CAUTI rate per 1,000 UC-days was 3.08; for those using suprapubic-catheters (4.11); indwelling-catheters (2.65); trauma-ICU (10.55), neurologic-ICU (7.17), neurosurgical-ICU (5.28); in lower-middle-income countries (3.05); in upper-middle-income countries (1.71); at public-hospitals (5.98), at private-hospitals (3.09), at teaching-hospitals (2.04). The following variables were identified as CAUTI RFs: Age (adjusted odds ratio [aOR] = 1.01; 95% CI = 1.01-1.02; P 

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