Browsing by Author "Zhang, Chi"
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Item Open Access Reciprocity in Quarantine: Observations from Wuhan's COVID-19 Digital Landscapes.(Asian bioethics review, 2020-11-20) Ni, Yanping; Fabbri, Morris; Zhang, Chi; Stewart, Kearsley AThe 2003 SARS pandemic heralded the return of quarantine as a vital part of twenty-first century public health practice. Over the last two decades, MERS, Ebola, and other emerging infectious diseases each posed unique challenges for applying quarantine ethics lessons learned from the 2003 SARS-CoV-1 outbreak. In an increasingly interdependent and connected global world, the use of quarantine to contain the spread of SARS-CoV-2, or COVID-19, similarly poses new and unexpected ethical challenges. In this essay, we look beyond standard debates about the ethics of quarantine and state power to explore a key quarantine principle, Reciprocity, and how it is being negotiated by healthcare workers, volunteers, and citizens in the context of the Wuhan, China, quarantine. We analyze Reciprocity through the lens of two Wuhan case studies: (1) healthcare workers, particularly nurses, who are simultaneously essential workers and quarantined citizens, asked by their hospital administration to shave their heads because adequate PPE was not available, and (2) citizen-to-citizen mutual aid societies attempting to fill gaps in essential supplies left unfilled by the state. We analyze social media and video-blogs from Wuhan, on the platforms of Douyin and Sina Weibo, to understand how people define and respond to ethical and legal obligations in the wake of COVID-19. It is no surprise that quarantine principles from the 2003 SARS outbreak are inadequate for COVID-19 and that both infectious disease outbreak responses and ethics must adapt to the virtual age. We offer ideas to strengthen and clarify Reciprocal obligations for the state, hospital administrators, and citizens as the globe prepares for the next wave of COVID-19 circulating now.Item Open Access Retinal Ganglion Cells With a Glaucoma OPTN(E50K) Mutation Exhibit Neurodegenerative Phenotypes when Derived from Three-Dimensional Retinal Organoids.(Stem cell reports, 2020-07) VanderWall, Kirstin B; Huang, Kang-Chieh; Pan, Yanling; Lavekar, Sailee S; Fligor, Clarisse M; Allsop, Anna R; Lentsch, Kelly A; Dang, Pengtao; Zhang, Chi; Tseng, Henry C; Cummins, Theodore R; Meyer, Jason SRetinal ganglion cells (RGCs) serve as the connection between the eye and the brain, with this connection disrupted in glaucoma. Numerous cellular mechanisms have been associated with glaucomatous neurodegeneration, and useful cellular models of glaucoma allow for the precise analysis of degenerative phenotypes. Human pluripotent stem cells (hPSCs) serve as powerful tools for studying human disease, particularly cellular mechanisms underlying neurodegeneration. Thus, efforts focused upon hPSCs with an E50K mutation in the Optineurin (OPTN) gene, a leading cause of inherited forms of glaucoma. CRISPR/Cas9 gene editing introduced the OPTN(E50K) mutation into existing lines of hPSCs, as well as generating isogenic controls from patient-derived lines. RGCs differentiated from OPTN(E50K) hPSCs exhibited numerous neurodegenerative deficits, including neurite retraction, autophagy dysfunction, apoptosis, and increased excitability. These results demonstrate the utility of OPTN(E50K) RGCs as an in vitro model of neurodegeneration, with the opportunity to develop novel therapeutic approaches for glaucoma.Item Open Access Streptococcus Pneumoniae Colonization among Children in Galle, Sri Lanka: A Cross-Sectional Study(2020) Zhang, ChiBackground: Streptococcus pneumoniae, a Gram-positive bacterium that is found in the human respiratory tract, is the most common cause of bacterial pneumonia globally. Pneumococcal pneumonia can be effectively prevented by administering pneumococcal vaccines but pneumococcal vaccination is not provided through the public healthcare sector in Sri Lanka at present. This study will serve as evidence instructing future decisions regarding the utility of vaccination.
Methods: A cross-sectional survey was conducted in Galle, Sri Lanka from July to September 2019 . Eleven Medical Officer of Health (MOH) clinics, which provide routine vaccinations to infants and children through the public health sector, were selected as the study setting. The parents of consecutive children ≤5 years of age were approached for consent. A nasopharyngeal sample was collected from each enrolled child and socio-demographic and clinical data were obtained by interviewing the parents. Routine microbiological testing was conducted to confirm the presence of S. pneumoniae isolates. Antibiotic susceptibility testing was performed on confirmed isolates using Kirby-Bauer disc diffusion. Sociodemographic and clinical characteristics associated with S. pneumoniae colonization were assessed using bivariable and multivariable logistic regression in R.
Results: Among 123 enrolled patients, 26 (21.1%) were found to be colonized with S. pneumoniae. Higher risk of S. pneumoniae colonization was found to be associated with living with other children <5 years (Unadjusted OR=4.58, 95%CI: 1.69-12.83); Adjusted OR=3.99, 95%CI: 1.19-13.39) in both bivariate and multivariate analysis. With age >2 years was found to be associated with lower risk of being infected (Unadjusted OR=0.19, 95%CI: 0.02-0.84) in bivariate analysis, and drinking boiled water was found protective to the carriage than no treatment (Adjusted OR=0.11, 95%CI: 0.02-0.65) in multivariate analysis. For antibiotic resistance, the non-susceptible prevalence was 94.4% to oxacillin/penicillin, 72.2% to erythromycin, and 44.4% to clindamycin. All isolates were susceptible to levofloxacin.
Discussion: This is the first report of S. pneumoniae colonization prevalence among children in Southern Province, Sri Lanka. One-fifth of children were found to be colonized with S. pneumoniae, and oxacillin non-susceptibility prevalence was high. Further characterization must be performed to identify serotypes of colonizing strains and to correlate with serotypes present in available vaccines. Our results provide evidence regarding burden of pneumococcal colonization in Sri Lanka, and may help guide pneumococcal vaccine decisions in Sri Lanka.