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47 ud af 47 tidsskrifter valgt, ingen søgeord valgt, emner højest 7 dage gamle, sorteret efter nyeste først.
185 emner vises.
Jean-Laurent Casanova, John D. MacMicking, Carl F. Nathan
Science, 18.04.2024
Tilføjet 18.04.2024
Jon Cohen
Science, 18.04.2024
Tilføjet 18.04.2024
Catherine Offord
Science, 18.04.2024
Tilføjet 18.04.2024
Daniel G. Streicker, Megan E. Griffiths, Rustom Antia, Laura Bergner, Peter Bowman, Maria Vitoria dos Santos de Moraes, Kevin Esvelt, Mike Famulare, Amy Gilbert, Biao He, Michael A. Jarvis, David A. Kennedy, Jennifer Kuzma, Carolyne Nasimiyu Wanyonyi, Christopher Remien, Tonie Rocke, Kyle Rosenke, Courtney Schreiner, Justin Sheen, David Simons, Ivet A. Yordanova, James J. Bull, and Scott L. Nuismer
Science, 18.04.2024
Tilføjet 18.04.2024
Yingying YangShiyu XieFangjing HeYindi XuZhifang WangAwais IhsanXu Wang1National Reference Laboratory of Veterinary Drug Residues (HZAU), Huazhong Agricultural University, Wuhan, Hubei, China2MAO Key Laboratory for Detection of Veterinary Drug Residues, Huazhong Agricultural University, Wuhan, Hubei, China3MOA Laboratory for Risk Assessment of Quality and Safety of Livestock and Poultry Products, Huazhong Agricultural University, Wuhan, Hubei, China4Institute of Animal Husbandry Research, Henan Academy of Agricultural Sciences, Zhengzhou, Henan, China5Department of Biosciences, COMSATS University Islamabad, Sahiwal campus, Islamabad, Pakistan, Graeme N. Forrest
Clinical Microbiology Reviews, 18.04.2024
Tilføjet 18.04.2024
Amit Saraf, Rohan Gurjar, Swarnendu Kaviraj, Aishwarya Kulkarni, Durgesh Kumar, Ruta Kulkarni, Rashmi Virkar, Jayashri Krishnan, Anjali Yadav, Ekta Baranwal, Ajay Singh, Arjun Raghuwanshi, Praveen Agarwal, Laxman Savergave, Sanjay Singh, Himanshu Pophale, Prakash Shende, Ravindra Baban Shinde, Vikram Vikhe, Abhishek Karmalkar, Bhaskar Deshmukh, Krishna Giri, Shrikant Deshpande, Ajay Bulle, Md. Sabah Siddiqui, Swapnav Borthakur, V. Reddy Tummuru, A. Venkateshwar Rao, Dhaiwat Shukla, Manish Kumar Jain, Pankaj Bhardwaj, Pravin Dinkar Supe, Manoja Kumar Das, Manoj Lahoti, Vijaykumar Barge
Nature, 18.04.2024
Tilføjet 18.04.2024
Clinical Infectious Diseases, 18.04.2024
Tilføjet 18.04.2024
Clinical Infectious Diseases, 18.04.2024
Tilføjet 18.04.2024
Clinical Infectious Diseases, 18.04.2024
Tilføjet 18.04.2024
Abstract Background The treatment of carbapenem-resistant Acinetobacter baumannii/calcoaceticus complex (CRAB) presents significant treatment challenges.Methods We report the case of a 42-year-old woman with CRAB meningitis who experienced persistently positive cerebrospinal fluid (CSF) cultures for 13 days despite treatment with high-dose ampicillin-sulbactam and cefiderocol. On day 13, she was transitioned to sulbactam-durlobactam and meropenem; four subsequent CSF cultures remained negative. After 14 days of sulbactam-durlobactam, she was cured of infection. Whole genome sequencing investigations identified putative mechanisms that contributed to reduced cefiderocol susceptibility observed during cefiderocol therapy. Blood and CSF samples were collected pre-dose and 3-hours post initiation of a sulbactam-durlobactam infusion.Results The CRAB isolate belonged to sequence type 2. An acquired blaOXA-23 and an intrinsic blaOXA-51-like (i.e., blaOXA-66) carbapenemase gene were identified. The paradoxical effect (i.e., no growth at lower cefiderocol dilutions but growth at higher dilutions) was observed by broth microdilution after 8 days of cefiderocol exposure but not by disk diffusion. Potential markers of resistance to cefiderocol included mutations in the start codon of piuA and piuC iron transport genes and a A515V substitution in PBP3, the primary target of cefiderocol. Sulbactam and durlobactam were detected in CSF at both timepoints, indicating CSF penetration.Conclusions This case describes successful treatment of refractory CRAB meningitis with the administration of sulbactam-durlobactam and meropenem and highlights the need to be cognizant of the paradoxical effect that can be observed with broth microdilution testing of CRAB isolates with cefiderocol.
Læs mere Tjek på PubMedClinical Infectious Diseases, 18.04.2024
Tilføjet 18.04.2024
Abstract Background Virtually all cases of hepatitis C virus (HCV) infection in children in the United States occur through vertical transmission, but it is unknown how many children are infected. Cases of maternal HCV infection have increased in the United States, which may increase the number of children vertically infected with HCV. Infection has long-term consequences for a child\'s health, but treatment options are now available for children ≥3 years old. Reducing HCV infections in adults could decrease HCV infections in children.Methods Using a stochastic compartmental model, we forecasted incidence of HCV infections in children in the United States from 2022 through 2027. The model considered vertical transmission to children
Læs mere Tjek på PubMedClinical Infectious Diseases, 18.04.2024
Tilføjet 18.04.2024
Abstract Background Outbreaks of vaccine preventable diseases (VPDs) in health care workers (HCWs) can result in morbidity and mortality and cause significant disruptions to health care services, patients and visitors as well as an added burden on the health system. This scoping review is aimed to describe the epidemiology of VPD outbreaks in HCW, caused by diseases which are prevented by the ten vaccines recommended by World Health Organization (WHO) for HCWs.Methods In April 2022 CINAHL, MEDLINE, Global Health and EMBASE were searched for all articles reporting on VPD outbreaks in HCWs since the year 2000. Articles were included regardless of language and study type. Clinical and epidemiological characteristics of VPD outbreaks were described.Results Our search found 9363 articles, of which 216 met inclusion criteria. Studies describing six of the ten VPDs were found: influenza, measles, varicella, tuberculosis, pertussis and rubella. Most articles (93%) were from high- and upper middle-income countries. While most outbreaks occurred in hospitals, several influenza outbreaks were reported in long term care facilities. Based on available data, vaccination rates amongst HCWs were rarely reported.Conclusion We describe several VPD outbreaks in HCWs from 2000 to April 2022. The review emphasises the need to understand the factors influencing outbreaks in HCWs and highlight importance of vaccination amongst HCWs.
Læs mere Tjek på PubMedJurre Y. SiegersMichelle WilleSokhoun YannSongha TokSarath SinSokha CheaAlice PorcoSreyem SoursVutha ChimSamban CheaKimtuo ChhelSothyra TumSan SornMakara HakPeter ThielenVijaykrishna DhanasekaranErik A. Karlssona Virology Unit, Institute Pasteur du Cambodge, Phnom Penh, Cambodiab Centre for Pathogen Genomics, Department of Microbiology and Immunology, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australiac WHO Collaborating Centre for Reference and Research on Influenza, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Australiad Wildlife Conservation Society, Phnom Penh, Cambodiae National Animal Health and Production Research Institute, Phnom Penh, Cambodiaf Food and Agriculture Organization of the United Nations Country Office, Phnom Penh, Cambodiag Johns Hopkins University Applied Physics Laboratory, Laurel, MD, USAh School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, People’s Republic of Chinai HKU-Pasteur Research Pole, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, People’s Republic of China
Emerg Microbes Infect, 18.04.2024
Tilføjet 18.04.2024
Keyvan Razazi, Enora Berti, Jerome Cecchini, Guillaume Carteaux, Anoosha Habibi, Pablo Bartolucci, Romain Arrestier, Ségolène Gendreau, Nicolas de Prost, Anne Hulin, Armand Mekontso Dessap
PLoS One Infectious Diseases, 18.04.2024
Tilføjet 18.04.2024
by Keyvan Razazi, Enora Berti, Jerome Cecchini, Guillaume Carteaux, Anoosha Habibi, Pablo Bartolucci, Romain Arrestier, Ségolène Gendreau, Nicolas de Prost, Anne Hulin, Armand Mekontso Dessap Objective Underdosing of antibiotics is common in patients with sickle cell disease (SCD). We hypothesized that in critically-ill patients with SCD receiving cefotaxime during acute chest syndrome, the continuous infusion may outperform the intermittent administration in achieving pharmacokinetic/pharmacodynamic targets. Design Prospective before-after study. Settings Intensive-care unit of a French teaching hospital and sickle cell disease referral center. Patients Sixty consecutive episodes of severe acute chest syndrome in 58 adult patients with sickle cell disease. Interventions Patients were treated with intermittent administration during the first period (April 2016 –April 2018) and with continuous infusion during the second period (May 2018 –August 2019). Measurements and main results We included 60 episodes of acute chest syndrome in 58 patients (29 [25–34] years, 37/58 (64%) males). Daily dose of cefotaxime was similar between groups (59 [48–88] vs. 61 [57–64] mg/kg/day, p = 0.84). Most patients (>75%) presented a glomerular hyperfiltration with no difference between groups (p = 0.25). More patients had a cefotaxime trough level ≥2 mg/L with continuous infusion than intermittent administration: 28 (93%) vs. 5 (16%), p
Læs mere Tjek på PubMedKazushi Hirono, Maiko Maruyama-Inoue, Yasuo Yanagi, Kazuaki Kadonosono
PLoS One Infectious Diseases, 18.04.2024
Tilføjet 18.04.2024
by Kazushi Hirono, Maiko Maruyama-Inoue, Yasuo Yanagi, Kazuaki Kadonosono Purpose This study investigates the visual outcomes of neovascular age-related macular degeneration (nAMD) patients who developed intraocular inflammation (IOI) after intravitreal brolucizumab injection (IVBr). Methods We studied 285 eyes of 279 cases diagnosed with nAMD and focused on 18 eyes (6.3%) of 17 cases which developed IOI after IVBr. IVBr was performed either on the initial treatment or for switching of other anti-vascular endothelial growth factor agents during January 2020 to December 2021. We evaluated clinical features and the course of treatment of a 6-month follow-up after IOI occurred. Results Of 17 cases, 9 cases were male, 8 cases were female. Baseline logarithm of the minimum angle of resolution(logMAR) best-corrected visual acuity (BCVA) was 0.36, BCVA before IOI occurred was 0.30, and BCVA when IOI occurred was 0.43. 16 eyes (88.9%) had symptoms such as visual loss or floaters when IOI occurred. On the other hand, the remaining 2 eyes (11.1%) had no symptoms. 11 eyes (61.1%) had only IOI, while the remaining 7 eyes (38.9%) had IOI and perivascular sheathing. Steroid sub-tenon injection was performed on 1 eye (5.6%), steroid eye drops were used in 11 eyes (61.1%), and 6 eyes (33.3%) were followed-up without treatment. Neovascular AMD recurred in 16 eyes (88.9%) after IOI occurred and were treated with aflibercept. VA at 3 and 6 months after IOI occurred were significantly improved to 0.34 and 0.30, respectively (P = 0.09 at 3 months and P = 0.02 at 6 months). The symptoms of patients were improved in all cases. We were able to stop steroid treatment in all cases. Conclusions IOI occurred in 6.3% of nAMD patients after IVBr treatment. All of which showed significant improvement from logMAR of 0.43 to 0.30 with steroid treatment or without any treatment. We should consider the possibility of IOI after IVBr as a complication, however, they have a relatively good prognosis if treated at an early stage.
Læs mere Tjek på PubMedJeremy Garb, Gil Amitai, Allen Lu, Gal Ofir, Alexander Brandis, Tevie Mehlman, Philip J. Kranzusch, Rotem Sorek
PLoS One Infectious Diseases, 18.04.2024
Tilføjet 18.04.2024
by Jeremy Garb, Gil Amitai, Allen Lu, Gal Ofir, Alexander Brandis, Tevie Mehlman, Philip J. Kranzusch, Rotem Sorek Sterile alpha and TIR motif-containing 1 (SARM1) is a protein involved in programmed death of injured axons. Following axon injury or a drug-induced insult, the TIR domain of SARM1 degrades the essential molecule nicotinamide adenine dinucleotide (NAD+), leading to a form of axonal death called Wallerian degeneration. Degradation of NAD+ by SARM1 is essential for the Wallerian degeneration process, but accumulating evidence suggest that other activities of SARM1, beyond the mere degradation of NAD+, may be necessary for programmed axonal death. In this study we show that the TIR domains of both human and fruit fly SARM1 produce 1′′–2′ and 1′′–3′ glycocyclic ADP-ribose (gcADPR) molecules as minor products. As previously reported, we observed that SARM1 TIR domains mostly convert NAD+ to ADPR (for human SARM1) or cADPR (in the case of SARM1 from Drosophila melanogaster). However, we now show that human and Drosophila SARM1 additionally convert ~0.1–0.5% of NAD+ into gcADPR molecules. We find that SARM1 TIR domains produce gcADPR molecules both when purified in vitro and when expressed in bacterial cells. Given that gcADPR is a second messenger involved in programmed cell death in bacteria and likely in plants, we propose that gcADPR may play a role in SARM1-induced programmed axonal death in animals.
Læs mere Tjek på PubMedYuichiro Miki, Satoshi Nishi, Tatsuro Tamura, Takumi Imai, Mikio Nambara, Tatsunari Fukuoka, Mami Yoshii, Takahiro Toyokawa, Shigeru Lee, Hisako Fujii, Hisako Yoshida, Mitsuhiko Ikebuchi, Kiyoshi Maeda
PLoS One Infectious Diseases, 18.04.2024
Tilføjet 18.04.2024
by Yuichiro Miki, Satoshi Nishi, Tatsuro Tamura, Takumi Imai, Mikio Nambara, Tatsunari Fukuoka, Mami Yoshii, Takahiro Toyokawa, Shigeru Lee, Hisako Fujii, Hisako Yoshida, Mitsuhiko Ikebuchi, Kiyoshi Maeda Background Subtotal esophagectomy with lymph node dissection followed by neoadjuvant chemotherapy (NAC) is the standard treatment for stage II–III esophageal cancer. Esophagectomy is still associated with high morbidity rates, and reducing these rates remains challenging. Among several complications, postoperative pneumonia (PP) is sometimes fatal, which has been reportedly caused by sarcopenia. Thus, nutritional support and rehabilitation may be promising for preventing skeletal muscle mass loss and reduce the incidence of PP. Methods This single-center, randomized, open-label, pilot trial will randomize a total of 40 patients with esophageal cancer in a 1:1 ratio either to ISOCAL Clear + rehabilitation arm or only rehabilitation arm. Although all patients will be educated about rehabilitation by a specialized physician and will be asked to undergo the prespecified rehabilitation program, patients treated with ISOCAL Clear + rehabilitation arm will be supplemented by 400 mL of ISOCAL Clear (Nestlé Japan Ltd, Tokyo, Japan) per day during two courses of NAC with docetaxel, cisplatin, and fluorouracil. Body composition will be assessed using Inbody (Inbody Co., Ltd., Tokyo, Japan) just before starting NAC and surgery. The primary endpoint is the change of skeletal muscle index (SMI) during NAC. Secondary endpoints include (i) body weight, total skeletal muscle mass, appendicular skeletal muscle mass, and lean body mass index changes; (ii) the percentage of ISOCAL Clear continuation; (iii) appetite evaluation; (iv) the percentage of targeted calorie achievement; (v) adverse events of NAC; (vi) postoperative complication rates; and (vii) postoperative hospital stay. Discussion This prospective trial assesses the efficacy of nutritional support in addition to rehabilitation during NAC for patients with esophageal cancer. The results will be utilized in assessing whether the effects of nutritional support by ISOCAL Clear are promising or not and in planning future larger clinical trials.
Læs mere Tjek på PubMedMalaria Journal, 18.04.2024
Tilføjet 18.04.2024
Abstract Background Conventional natural killer (cNK) cells play an important role in the innate immune response by directly killing infected and malignant cells and by producing pro- and anti-inflammatory cytokines. Studies on their role in malaria and its complications have resulted in conflicting results. Methods Using the commonly used anti-NK1.1 depletion antibodies (PK136) in an in-house optimized experimental model for malaria-associated acute respiratory distress syndrome (MA-ARDS), the role of cNK cells was investigated. Moreover, flow cytometry was performed to characterize different NK cell populations. Results While cNK cells were found to be dispensable in the development of MA-ARDS, the appearance of a NK1.1+ cell population was observed in the lungs upon infection despite depletion with anti-NK1.1. Detailed characterization of the unknown population revealed that this population consisted of a mixture of monocytes and macrophages that bind the anti-NK1.1 antibody in an aspecific way. This aspecific binding may occur via Fcγ receptors, such as FcγR4. In contrast, in vivo depletion using anti-NK1.1 antibodies was proved to be specific for cNK cells. Conclusion cNK cells are dispensable in the development of experimental MA-ARDS. Moreover, careful flow cytometric analysis, with a critical mindset in relation to potential aspecific binding despite the use of commercially available Fc blocking reagents, is critical to avoid misinterpretation of the results.
Læs mere Tjek på PubMedSuzy E. Meijer, Yael Paran, Ana Belkin, Ronen Ben-Ami, Yasmin Maor, Lior Nesher, Khetam Hussein, Galia Rahav, Tal Brosh-Nissimov
Clinical Microbiology and Infection, 18.04.2024
Tilføjet 18.04.2024
Immunocompromised patients with impaired humoral immunity are at risk for persistent COVID-19 (pCOVID), a protracted symptomatic disease with active viral replication.
Læs mere Tjek på PubMedSouheil Zayet, Timothée Klopfenstein
Clinical Microbiology and Infection, 18.04.2024
Tilføjet 18.04.2024
We have read with interest the paper by Garzoni et al (1).The authors observed un unexpected increase of the number of cases of severe pneumonia due to M. pneumoniae in adults since November 2023.
Læs mere Tjek på PubMedHinh LyDepartment of Veterinary & Biomedical Sciences, College of Veterinary Medicine, University of Minnesota, Twin Cities, MN, USA
Virulence, 18.04.2024
Tilføjet 18.04.2024
Wyatt, N. J., Watson, H., Anderson, C. A., Kennedy, N. A., Raine, T., Ahmad, T., Allerton, D., Bardgett, M., Clark, E., Clewes, D., Cotobal Martin, C., Doona, M., Doyle, J. A., Frith, K., Hancock, H. C., Hart, A. L., Hildreth, V., Irving, P. M., Iqbal, S., Kennedy, C., King, A., Lawrence, S., Lees, C. W., Lees, R., Letchford, L., Liddle, T., Lindsay, J. O., Maier, R. H., Mansfield, J. C., Marchesi, J. R., McGregor, N., McIntyre, R. E., Ostermayer, J., Osunnuyi, T., Powell, N., Prescott, N. J., Satsangi, J., Sharma, S., Shrestha, T., Speight, A., Strickland, M., Wason, J. M., Whelan, K., Wood, R., Young, G. R., Zhang, X., Parkes, M., Stewart, C. J., Jostins-Dean, L., Lamb, C. A.
BMJ Open, 18.04.2024
Tilføjet 18.04.2024
IntroductionCharacterised by chronic inflammation of the gastrointestinal tract, inflammatory bowel disease (IBD) symptoms including diarrhoea, abdominal pain and fatigue can significantly impact patient’s quality of life. Therapeutic developments in the last 20 years have revolutionised treatment. However, clinical trials and real-world data show primary non-response rates up to 40%. A significant challenge is an inability to predict which treatment will benefit individual patients. Current understanding of IBD pathogenesis implicates complex interactions between host genetics and the gut microbiome. Most cohorts studying the gut microbiota to date have been underpowered, examined single treatments and produced heterogeneous results. Lack of cross-treatment comparisons and well-powered independent replication cohorts hampers the ability to infer real-world utility of predictive signatures. IBD-RESPONSE will use multi-omic data to create a predictive tool for treatment response. Future patient benefit may include development of biomarker-based treatment stratification or manipulation of intestinal microbial targets. IBD-RESPONSE and downstream studies have the potential to improve quality of life, reduce patient risk and reduce expenditure on ineffective treatments. Methods and analysisThis prospective, multicentre, observational study will identify and validate a predictive model for response to advanced IBD therapies, incorporating gut microbiome, metabolome, single-cell transcriptome, human genome, dietary and clinical data. 1325 participants commencing advanced therapies will be recruited from ~40 UK sites. Data will be collected at baseline, week 14 and week 54. The primary outcome is week 14 clinical response. Secondary outcomes include clinical remission, loss of response in week 14 responders, corticosteroid-free response/remission, time to treatment escalation and change in patient-reported outcome measures. Ethics and disseminationEthical approval was obtained from the Wales Research Ethics Committee 5 (ref: 21/WA/0228). Recruitment is ongoing. Following study completion, results will be submitted for publication in peer-reviewed journals and presented at scientific meetings. Publications will be summarised at www.ibd-response.co.uk. Trial registration number ISRCTN96296121.
Læs mere Tjek på PubMedCheema, H. A., Jafar, U., Shahid, A., Masood, W., Usman, M., Hermis, A. H., Naseem, M. A., Sahra, S., Sah, R., Lee, K. Y.
BMJ Open, 18.04.2024
Tilføjet 18.04.2024
ObjectivesWe conducted an updated systematic review and meta-analysis to investigate the effect of colchicine treatment on clinical outcomes in patients with COVID-19. DesignSystematic review and meta-analysis. Data sourcesWe searched PubMed, Embase, the Cochrane Library, medRxiv and ClinicalTrials.gov from inception to January 2023. Eligibility criteriaAll randomised controlled trials (RCTs) that investigated the efficacy of colchicine treatment in patients with COVID-19 as compared with placebo or standard of care were included. There were no language restrictions. Studies that used colchicine prophylactically were excluded. Data extraction and synthesisWe extracted all information relating to the study characteristics, such as author names, location, study population, details of intervention and comparator groups, and our outcomes of interest. We conducted our meta-analysis by using RevMan V.5.4 with risk ratio (RR) and mean difference as the effect measures. ResultsWe included 23 RCTs (28 249 participants) in this systematic review. Colchicine did not decrease the risk of mortality (RR 0.99; 95% CI 0.93 to 1.05; I2=0%; 20 RCTs, 25 824 participants), with the results being consistent among both hospitalised and non-hospitalised patients. There were no significant differences between the colchicine and control groups in other relevant clinical outcomes, including the incidence of mechanical ventilation (RR 0.75; 95% CI 0.48 to 1.18; p=0.22; I2=40%; 8 RCTs, 13 262 participants), intensive care unit admission (RR 0.77; 95% CI 0.49 to 1.22; p=0.27; I2=0%; 6 RCTs, 961 participants) and hospital admission (RR 0.74; 95% CI 0.48 to 1.16; p=0.19; I2=70%; 3 RCTs, 8572 participants). ConclusionsThe results of this meta-analysis do not support the use of colchicine as a treatment for reducing the risk of mortality or improving other relevant clinical outcomes in patients with COVID-19. However, RCTs investigating early treatment with colchicine (within 5 days of symptom onset or in patients with early-stage disease) are needed to fully elucidate the potential benefits of colchicine in this patient population. PROSPERO registration numberCRD42022369850.
Læs mere Tjek på PubMedRockwell, M. S., Oyese, E. G., Singh, E., Vinson, M., Yim, I., Turner, J. K., Epling, J. W.
BMJ Open, 18.04.2024
Tilføjet 18.04.2024
ObjectivesPotentially harmful non-steroidal anti-inflammatory drugs (NSAIDs) utilisation persists at undesirable rates worldwide. The purpose of this paper is to review the literature on interventions to de-implement potentially harmful NSAIDs in healthcare settings and to suggest directions for future research. DesignScoping review. Data sourcesPubMed, CINAHL, Embase, Cochrane Central and Google Scholar (1 January 2000 to 31 May 2022). Study selectionStudies reporting on the effectiveness of interventions to systematically reduce potentially harmful NSAID utilisation in healthcare settings. Data extractionUsing Covidence systematic review software, we extracted study and intervention characteristics, including the effectiveness of interventions in reducing NSAID utilisation. ResultsFrom 7818 articles initially identified, 68 were included in the review. Most studies took place in European countries (45.6%) or the USA (35.3%), with randomised controlled trial as the most common design (55.9%). Interventions were largely clinician-facing (76.2%) and delivered in primary care (60.2%) but were rarely (14.9%) guided by an implementation model, framework or theory. Academic detailing, clinical decision support or electronic medical record interventions, performance reports and pharmacist review were frequent approaches employed. NSAID use was most commonly classified as potentially harmful based on patients’ age (55.8%), history of gastrointestinal disorders (47.1%), or history of kidney disease (38.2%). Only 7.4% of interventions focused on over-the-counter (OTC) NSAIDs in addition to prescription. The majority of studies (76.2%) reported a reduction in the utilisation of potentially harmful NSAIDs. Few studies (5.9%) evaluated pain or quality of life following NSAIDs discontinuation. ConclusionMany varied interventions to de-implement potentially harmful NSAIDs have been applied in healthcare settings worldwide. Based on these findings and identified knowledge gaps, further efforts to comprehensively evaluate the effectiveness of interventions and the combination of intervention characteristics associated with effective de-implementation are needed. In addition, future work should be guided by de-implementation theory, focus on OTC NSAIDs and incorporate patient-focused strategies and outcomes, including the evaluation of unintended consequences of the intervention.
Læs mere Tjek på PubMedHansen, M. A., Lekodeba, N. A., Chevalier, J. M., Ockhuisen, T., del Rey-Puech, P., Marban-Castro, E., Martinez-Perez, G. Z., Shilton, S., Radzi Abu Hassan, M., Getia, V., Weinert-Mizuschima, C., Tenorio Bezerra, M. I., Chala, L., Leong, R., Peregino, R., Keller, S., Spruijt, I., Johnson, C. C., Girdwood, S. J., Nichols, B. E.
BMJ Open, 18.04.2024
Tilføjet 18.04.2024
ObjectiveDiagnostic testing is an important tool to combat the COVID-19 pandemic, yet access to and uptake of testing vary widely 3 years into the pandemic. The WHO recommends the use of COVID-19 self-testing as an option to help expand testing access. We aimed to calculate the cost of providing COVID-19 self-testing across countries and distribution modalities. DesignWe estimated economic costs from the provider perspective to calculate the total cost and the cost per self-test kit distributed for three scenarios that differed by costing period (pilot, annual), the number of tests distributed (actual, planned, scaled assuming an epidemic peak) and self-test kit costs (pilot purchase price, 50% reduction). SettingWe used data collected between August and December 2022 in Brazil, Georgia, Malaysia, Ethiopia and the Philippines from pilot implementation studies designed to provide COVID-19 self-tests in a variety of settings—namely, workplace and healthcare facilities. ResultsAcross all five countries, 173 000 kits were distributed during pilot implementation with the cost/test distributed ranging from $2.44 to $12.78. The cost/self-test kit distributed was lowest in the scenario that assumed implementation over a longer period (year), with higher test demand (peak) and a test kit price reduction of 50% ($1.04–3.07). Across all countries and scenarios, test procurement occupied the greatest proportion of costs: 58–87% for countries with off-site self-testing (outside the workplace, for example, home) and 15–50% for countries with on-site self-testing (at the workplace). Staffing was the next key cost driver, particularly for distribution modalities that had on-site self-testing (29–35%) versus off-site self-testing (7–27%). ConclusionsOur results indicate that it is likely to cost between $2.44 and $12.78 per test to distribute COVID-19 self-tests across common settings in five heterogeneous countries. Cost-effectiveness analyses using these results will allow policymakers to make informed decisions on optimally scaling up COVID-19 self-test distribution programmes across diverse settings and evolving needs.
Læs mere Tjek på PubMedGonzalez-Jaramillo, N., Abbühl, D., Roa-Diaz, Z. M., Kobler-Betancourt, C., Frahsa, A.
BMJ Open, 18.04.2024
Tilføjet 18.04.2024
ObjectiveTo compare vaccination willingness before rollout and 1 year post-rollout uptake among the general population and under-resourced communities in high-income countries. DesignA realist review. Data sourcesEmbase, PubMed, Dimensions ai and Google Scholar. SettingHigh-income countries. DefinitionsWe defined vaccination willingness as the proportion of participants willing or intending to receive vaccines prior to availability. We defined vaccine uptake as the real proportion of the population with complete vaccination as reported by each country until November 2021. ResultsWe included data from 62 studies and 18 high-income countries. For studies conducted among general populations, the proportion of vaccination willingness was 67% (95% CI 62% to 72%). In real-world settings, the overall proportion of vaccine uptake among those countries was 73% (95% CI 69% to 76%). 17 studies reported pre-rollout willingness for under-resourced communities. The summary proportion of vaccination willingness from studies reporting results among people from under-resourced communities was 52% (95% CI 0.46% to 0.57%). Real-world evidence about vaccine uptake after rollout among under-resourced communities was limited. ConclusionOur review emphasises the importance of realist reviews for assessing vaccine acceptance. Limited real-world evidence about vaccine uptake among under-resourced communities in high-income countries is a call to context-specific actions and reporting.
Læs mere Tjek på PubMedBMC Infectious Diseases, 18.04.2024
Tilføjet 18.04.2024
Abstract Toxoplasmosis is a frequent infection among the human population. The infection can cause devastating complications for the fetus during pregnancy. The present study aimed to determine the serological and molecular prevalence of the infection and molecular characterization of Toxoplasma gondii isolates among pregnant women referred to Kowsar Hospital, Urmia, Iran. In a cross-sectional study, 340 blood samples were collected from pregnant women referred to Kowsar Hospital, Urmia, Iran from May to July 2022. Anti-T. gondii IgG and IgM seropositivity were determined by enzyme-linked immunosorbent assay. PCR was carried out by targeting the GRA6 gene of the parasite on all patients’ buffy coats. Anti-T. gondii IgG and IgM antibodies were positive in two (0.6%) women, and 101 (29.7%) women had anti-T. gondii IgG and 70.3% were seronegative. PCR was positive in two IgM-positive women, and both isolates belonged to T. gondii carrying the GRA6 allele of lineage I. The risk of infection was significantly higher in women who had constant contact with cats and soil, and who were residents of rural areas. The two IgM-positive women were asymptomatic regarding acute toxoplasmosis. According to the results of the present study, the prevalence of toxoplasmosis in pregnant women in Urmia is similar to its prevalence in other areas in northwestern Iran, and despite the low prevalence of acute infection, it should not be ignored.
Læs mere Tjek på PubMedBMC Infectious Diseases, 18.04.2024
Tilføjet 18.04.2024
Abstract Background Metagenomic next-generation sequencing (mNGS) has been increasingly applied in sepsis. We aimed to evaluate the diagnostic and therapeutic utility of mNGS of paired plasma and peritoneal drainage (PD) fluid samples in comparison to culture-based microbiological tests (CMTs) among critically ill patients with suspected acute intra-abdominal infections (IAIs). Methods We conducted a prospective study from October 2021 to December 2022 enrolling septic patients with suspected IAIs (n = 111). Pairwise CMTs and mNGS of plasma and PD fluid were sent for pathogen detection. The mNGS group underwent therapeutic regimen adjustment based on mNGS results for better treatment. The microbial community structure, clinical features, antibiotic use and prognoses of the patients were analyzed. Results Higher positivity rates were observed with mNGS versus CMTs for both PD fluid (90.0% vs. 48.3%, p
Læs mere Tjek på PubMedJiong Yang, Shaojun Long, Geoff Hide, Zhao-Rong Lun, De-Hua Lai
Trends in Parasitology, 18.04.2024
Tilføjet 18.04.2024
The micropore, a mysterious structure found in apicomplexan species, was recently shown to be essential for nutrient acquisition in Plasmodium falciparum and Toxoplasma gondii. However, the differences between the micropores of these two parasites questions the nature of a general apicomplexan micropore structure and whether the formation process model from Plasmodium can be applied to other apicomplexans. We analyzed the literature on different apicomplexan micropores and found that T. gondii probably harbors a more representative micropore type than the more widely studied ones in Plasmodium. Using recent knowledge of the Kelch 13 (K13) protein interactome and gene depletion phenotypes in the T. gondii micropore, we propose a model of micropore formation, thus enriching our wider understanding of micropore protein function.
Læs mere Tjek på PubMedEchuan Tan, Tao Wan, Qi Pan, Jianan Duan, Song Zhang, Ruijue Wang, Peng Gao, Jia Lv, Hui Wang, Dali Li, Yuan Ping, Yiyun Cheng
Science Advances, 18.04.2024
Tilføjet 18.04.2024
Clinical Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
Abstract Retrospective surveillance leveraging male rectal swab sample remnants from I Want The Kit from July 2021 through October 2023, identified one symptomatic and one asymptomatic mpox case at the peak of transmission in 2022. Although sporadic cases continue to be reported in Maryland, additional asymptomatic cases were not identified in this leveraged surveillance.
Læs mere Tjek på PubMedClinical Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
Abstract Relatively low salaries in ID compared to other medical specialties in a world where cost of living is skyrocketing are an easy explanation for unmet needs of ID training programs to fill their positions. However, the interest in ID falling short of expectations may reflect that some features of the ID specialty are counter to select pervasive tendencies of modern culture, including i) slow uptake of innovation into daily routines of ID practioners, ii) the emphasis of clinical mastery of ID practioners in an environment of medical corporatization and increased focus on revenue generation, and iii) the fact that ID practice takes societal interests into consideration (eg. prevention of antibiotic resistance) in a world dominated by rights of individuals frequently at the expense of the common good. This article reflects on these possibilities in order to determine what steps can be taken to resurrect interest in our specialty.
Læs mere Tjek på PubMedClinical Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
Abstract Amoxicillin-clavulanate (AMC) is among the most frequently prescribed antibiotics globally. It has broad antibacterial activity against gram-positive, gram-negative, and anaerobic bacteria, and has been utilized to treat infections caused by a broad range of pathogens. AMC breakpoints against Enterobacterales were initially set in the 1980s but since then increases in antibiotic resistance, advances in pharmacokinetic (PK)/pharmacodynamic (PD) analyses, and publication of additional clinical data prompted a reassessment by the Clinical and Laboratory Standards Institute (CLSI) Subcommittee on Antimicrobial Susceptibility Testing. Based on this contemporary reappraisal, the CLSI retained the Enterobacterales breakpoints but revised comments regarding dosing associated with use of the AMC breakpoints in the 2022 supplement of M100. This viewpoint provides insight into the CLSI breakpoint reevaluation process and summarizes the data and rationale used to support these revisions to the AMC Enterobacterales breakpoint.
Læs mere Tjek på PubMedClinical Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
The Publisher is retracting the following article: [Kosumi H, Natsuga K, Takashima S et al. Two Cases of Interleukin-7-Deficient Generalized Verrucosis. Clinical Infectious Diseases, Volume 71, Issue 6, Pages 1561-1563, September 15 2020, https://doi.org/10.1093/cid/ciz1240]. The authors of this article were made aware of an error and on further investigation, determined that a key finding in the article resulted from contamination which compromised the authors’ conclusions.
Læs mere Tjek på PubMedQiucheng ShiHuangdu HuQian YuWeiyi HuangYinping WangJingjing QuanJunxin ZhouRui WengPing ZhangYan MengHaiyang LiuYan JiangYunsong YuXiaoxing Dua Department of Infectious Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of Chinab Key Laboratory of Microbial Technology and Bioinformatics of Zhejiang Province, Hangzhou, People’s Republic of Chinac Regional Medical Center for National Institute of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of Chinad Center for General Practice Medicine, Department of Infectious Diseases, Zhejiang Provincial People’s Hospital, Hangzhou Medical College Affiliated People’s Hospital, Hangzhou, People’s Republic of Chinae Department of Clinical Laboratory, Zhejiang Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of Chinaf Center of Laboratory Medicine, Zhejiang Provincial People’s Hospital, Hangzhou Medical College Affiliated People’s Hospital, Hangzhou, People’s Republic of China
Emerg Microbes Infect, 17.04.2024
Tilføjet 17.04.2024
Jian WangLi ZhuShaoqiu ZhangZhiyi ZhangTao FanFei CaoYe XiongYifan PanYuanyuan LiChao JiangShengxia YinXin TongYali XiongJuan XiaXiaomin YanYong LiuXingxiang LiuYuxin ChenJie LiChuanwu ZhuChao WuRui Huanga Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People’s Republic of Chinab Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, People’s Republic of Chinac Department of Infectious Diseases, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou, People’s Republic of Chinad Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of Chinae Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, People’s Republic of Chinaf Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, People’s Republic of Chinag Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People's Republic of Chinah Department of Clinical Laboratory, Huai’an No. 4 People’s Hospital, Huai’an, People’s Republic of China
Emerg Microbes Infect, 17.04.2024
Tilføjet 17.04.2024
Siti Nur Aisyah Zaid, Azidah Abdul Kadir, Norhayati Mohd Noor, Basaruddin Ahmad, Muhamad Saiful Bahri Yusoff, Anis Safura Ramli, Jasy Liew Suet Yan
PLoS One Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
by Siti Nur Aisyah Zaid, Azidah Abdul Kadir, Norhayati Mohd Noor, Basaruddin Ahmad, Muhamad Saiful Bahri Yusoff, Anis Safura Ramli, Jasy Liew Suet Yan Introduction Healthcare workers play a crucial role in supporting COVID-19 vaccination as they are the most trusted source of information to the public population. Assessing the healthcare workers’ hesitancy towards COVID-19 vaccination is pertinent, however, there are limited validated tools to measure their hesitancy on COVID-19 vaccines. This study aims to adapt and validate the first COVID-19 hesitancy scale among healthcare workers in Malaysia. Materials and methods This study adapted and translated the Vaccine Hesitancy Scale (VHS) developed by the WHO SAGE Working Group. The scale underwent a sequential validation process, including back-back translation, content, face, and construct validity for Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). The reliability was tested using internal consistency (Cronbach’s alpha composite reliability (CR) and average variance extracted (AVE)). Results The data for EFA and CFA were completed by a separate sample of 125 and 300 HCWs, respectively. The EFA analysis of the C19-VHS-M scale was unidimensional with 10 items. A further CFA analysis revealed a uniform set of nine items with acceptable goodness fit indices (comparative fit index = 0.997, Tucker-Lewis index = 0.995, incremental fit index = 0.997, chi-squared/degree of freedom = 1.352, and root mean square error of approximation = 0.034). The Cronbach’s alpha, CR and AVE results were 0.953, 0.95 and 0.70, respectively. Conclusions The questionnaire was valid and reliable for use in the Malay language.
Læs mere Tjek på PubMedKarolina Pawlak, Agata Malak-Rawlikowska, Mariusz Hamulczuk, Marta Skrzypczyk
PLoS One Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
by Karolina Pawlak, Agata Malak-Rawlikowska, Mariusz Hamulczuk, Marta Skrzypczyk The aim of the paper is to provide an ex-post assessment of the impact of the COVID-19 pandemic on food insecurity in the EU-27 countries expressed by physical and economic food access. We analysed trade and price effects, together with food insecurity and malnutrition indicators. Actual levels of the indicators were compared with their pre-pandemic magnitudes and/or with counterfactual levels derived from predictive models. We also aimed to compare the objective statistics with the subjective consumers’ perception of their households’ food security. Our research indicates that the EU food trade was more resilient to COVID-19 impacts than the trade in non-food products, while food trade decreases were of a temporary nature. This did not affect the trade balance significantly; however, the import reduction threatened the physical food access in most EU countries. Regarding economic food access, the results indicate that the increase in food prices was offset by the increase in disposable income. It may suggest that the COVID-19 pandemic did not significantly affect the deterioration of economic access to food in the EU countries. However, the prevalence of severe food insecurity in the total population or the proportion of households reporting inability to afford a meal with meat, chicken, fish, or a vegetarian equivalent increased in 2020–2021 compared to 2019. This means that the comparative analysis of the real data on prices and households’ income, as well as consumer financial situation and food consumption affordability, does not offer a clear answer concerning the impact of the COVID-19 pandemic on the food security of EU households.
Læs mere Tjek på PubMedAaron M. Eisen, Gregory N. Bratman, Hector A. Olvera-Alvarez
PLoS One Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
by Aaron M. Eisen, Gregory N. Bratman, Hector A. Olvera-Alvarez Background Emerging epidemiological evidence indicates nature exposure could be associated with greater health benefits among groups in lower versus higher socioeconomic positions. One possible mechanism underpinning this evidence is described by our framework: (susceptibility) adults in low socioeconomic positions face higher exposure to persistent psychosocial stressors in early life, inducing a pro-inflammatory phenotype as a lifelong susceptibility to stress; (differential susceptibility) susceptible adults are more sensitive to the health risks of adverse (stress-promoting) environments, but also to the health benefits of protective (stress-buffering) environments. Objective Experimental investigation of a pro-inflammatory phenotype as a mechanism facilitating greater stress recovery from nature exposure. Methods We determined differences in stress recovery (via heart rate variability) caused by exposure to a nature or office virtual reality environment (10 min) after an acute stressor among 64 healthy college-age males with varying levels of susceptibility (socioeconomic status, early life stress, and a pro-inflammatory state [inflammatory reactivity and glucocorticoid resistance to an in vitro bacterial challenge]). Results Findings for inflammatory reactivity and glucocorticoid resistance were modest but consistently trended towards better recovery in the nature condition. Differences in recovery were not observed for socioeconomic status or early life stress. Discussion Among healthy college-age males, we observed expected trends according to their differential susceptibility when assessed as inflammatory reactivity and glucocorticoid resistance, suggesting these biological correlates of susceptibility could be more proximal indicators than self-reported assessments of socioeconomic status and early life stress. If future research in more diverse populations aligns with these trends, this could support an alternative conceptualization of susceptibility as increased environmental sensitivity, reflecting heightened responses to adverse, but also protective environments. With this knowledge, future investigators could examine how individual differences in environmental sensitivity could provide an opportunity for those who are the most susceptible to experience the greatest health benefits from nature exposure.
Læs mere Tjek på PubMedMariko I. Ito, Yudai Honma, Takaaki Ohnishi, Tsutomu Watanabe, Kazuyuki Aihara
PLoS One Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
by Mariko I. Ito, Yudai Honma, Takaaki Ohnishi, Tsutomu Watanabe, Kazuyuki Aihara Transactions in financial markets are not evenly spaced but can be concentrated within a short period of time. In this study, we investigated the factors that determine the transaction frequency in financial markets. Specifically, we employed the Hawkes process model to identify exogenous and endogenous forces governing transactions of individual stocks in the Tokyo Stock Exchange during the COVID-19 pandemic. To enhance the accuracy of our analysis, we introduced a novel EM algorithm for the estimation of exogenous and endogenous factors that specifically addresses the interdependence of the values of these factors over time. We detected a substantial change in the transaction frequency in response to policy change announcements. Moreover, there is significant heterogeneity in the transaction frequency among individual stocks. We also found a tendency where stocks with high market capitalization tend to significantly respond to external news, while their excitation relationship between transactions is weak. This suggests the capability of quantifying the market state from the viewpoint of the exogenous and endogenous factors generating transactions for various stocks.
Læs mere Tjek på PubMedMalaria Journal, 17.04.2024
Tilføjet 17.04.2024
Abstract Background To gain a deeper understanding of protective immunity against relapsing malaria, this study examined sporozoite-specific T cell responses induced by a chemoprophylaxis with sporozoite (CPS) immunization in a relapsing Plasmodium cynomolgi rhesus macaque model. Methods The animals received three CPS immunizations with P. cynomolgi sporozoites, administered by mosquito bite, while under two anti-malarial drug regimens. Group 1 (n = 6) received artesunate/chloroquine (AS/CQ) followed by a radical cure with CQ plus primaquine (PQ). Group 2 (n = 6) received atovaquone-proguanil (AP) followed by PQ. After the final immunization, the animals were challenged with intravenous injection of 104 P. cynomolgi sporozoites, the dose that induced reliable infection and relapse rate. These animals, along with control animals (n = 6), were monitored for primary infection and subsequent relapses. Immunogenicity blood draws were done after each of the three CPS session, before and after the challenge, with liver, spleen and bone marrow sampling and analysis done after the challenge. Results Group 2 animals demonstrated superior protection, with two achieving protection and two experiencing partial protection, while only one animal in group 1 had partial protection. These animals displayed high sporozoite-specific IFN-γ T cell responses in the liver, spleen, and bone marrow after the challenge with one protected animal having the highest frequency of IFN-γ+ CD8+, IFN-γ+ CD4+, and IFN-γ+ γδ T cells in the liver. Partially protected animals also demonstrated a relatively high frequency of IFN-γ+ CD8+, IFN-γ+ CD4+, and IFN-γ+ γδ T cells in the liver. It is important to highlight that the second animal in group 2, which experienced protection, exhibited deficient sporozoite-specific T cell responses in the liver while displaying average to high T cell responses in the spleen and bone marrow. Conclusions This research supports the notion that local liver T cell immunity plays a crucial role in defending against liver-stage infection. Nevertheless, there is an instance where protection occurs independently of T cell responses in the liver, suggesting the involvement of the liver\'s innate immunity. The relapsing P. cynomolgi rhesus macaque model holds promise for informing the development of vaccines against relapsing P. vivax.
Læs mere Tjek på PubMedMalaria Journal, 17.04.2024
Tilføjet 17.04.2024
Abstract Background Malaria remains a significant global health burden affecting millions of people, children under 5 years and pregnant women being most vulnerable. In 2019, the World Health Organization (WHO) endorsed the introduction of RTS,S/AS01 malaria vaccine as Phase IV implementation evaluation in three countries: Malawi, Kenya and Ghana. Acceptability and factors influencing vaccination coverage in implementing areas is relatively unknown. In Malawi, only 60% of children were fully immunized with malaria vaccine in Nsanje district in 2021, which is below 80% WHO target. This study aimed at exploring factors influencing uptake of malaria vaccine and identify approaches to increase vaccination. Methods In a cross-sectional study conducted in April–May, 2023, 410 mothers/caregivers with children aged 24–36 months were selected by stratified random sampling and interviewed using a structured questionnaire. Vaccination data was collected from health passports, for those without health passports, data was collected using recall history. Regression analyses were used to test association between independent variables and full uptake of malaria vaccine. Results Uptake of malaria vaccine was 90.5% for dose 1, but reduced to 87.6%, 69.5% and 41.2% for dose 2, 3, and 4 respectively. Children of caregivers with secondary or upper education and those who attended antenatal clinic four times or more had increased odds of full uptake of malaria vaccine [OR: 2.43, 95%CI 1.08–6.51 and OR: 1.89, 95%CI 1.18–3.02], respectively. Children who ever suffered side-effects following immunization and those who travelled long distances to reach the vaccination centre had reduced odds of full uptake of malaria vaccine [OR: 0.35, 95%CI 0.06–0.25 and OR: 0.30, 95%CI 0.03–0.39] respectively. Only 17% (n = 65) of mothers/caregivers knew the correct schedule for vaccination and 38.5% (n = 158) knew the correct number of doses a child was to receive. Conclusion Only RTS,S dose 1 and 2 uptake met WHO coverage targets. Mothers/caregivers had low level of information regarding malaria vaccine, especially on numbers of doses to be received and dosing schedule. The primary modifiable factor influencing vaccine uptake was mother/caregiver knowledge about the vaccine. Thus, to increase the uptake Nsanje District Health Directorate should strengthen communities’ education about malaria vaccine. Programmes to strengthen mother/caregiver knowledge should be included in scale-up of the vaccine in Malawi and across sub-Saharan Africa.
Læs mere Tjek på PubMedMalaria Journal, 17.04.2024
Tilføjet 17.04.2024
Abstract Background Malaria remains a burden globally, with the African region accounting for 94% of the overall disease burden and deaths in 2019. It is the major cause of morbidity and mortality among children in Nigeria. Though different environmental factors have been assessed to influence the distribution and transmission of malaria vectors, there is a shortage of information on how they may influence malaria transmission among under-fives in Nigeria. Methods This study was based on the secondary data analysis of the Nigeria Malaria Indicator Survey 2021. The study sample comprised 10,645 women (aged 15–49) who delivered a child in the 2 years preceding the survey. The study was restricted to under-fives. Logistic regression was used to identify factors associated with the risk of malaria. Results There was a positive association between the risk of malaria and heard/seen malaria messages in the last 6 months (AOR 1.39, 95% CI 1.19–1.62), houses with walls built using rudimentary materials (AOR = 1.38, 95% CI 1.04–1.83), at least 6 children living in the house (AOR 1.22, 95% CI 1.00–1.49), children being 1 or 2 years old was associated with increased odds (AOR 1.89, 95% CI 1.50–2.34 and AOR 1.89, 95% CI 1.52–2.36), children from households with only treated nets (AOR 1.23, 95% CI 1.04–1.46) and those from the North West or South East regions (AOR 1.50, 95% CI 1.10–2.05 and AOR 1.48, 95% CI 1.01–2.16), respectively. All other predictors were not associated with the risk of malaria. Conclusion The factors associated with the risk of malaria in this study included sleeping under treated mosquito nets, the age of the children, residing in the northwest and southeast regions, wall construction material, 6 children and above in the household and hearing/seen malaria messages in the last 6 months. Continuous health education and public health interventions, such as the provision of LLITNs, will reduce the risk of malaria and improve the health and well-being of children under 5 years of age.
Læs mere Tjek på PubMedMalaria Journal, 17.04.2024
Tilføjet 17.04.2024
Abstract Background Achieving effective control and elimination of malaria in endemic regions necessitates a comprehensive understanding of local mosquito species responsible for malaria transmission and their susceptibility to insecticides. Methods The study was conducted in the highly malaria prone Ujina Primary Health Center of Nuh (Mewat) district of Haryana state of India. Monthly entomological surveys were carried out for adult mosquito collections via indoor resting collections, light trap collections, and pyrethrum spray collections. Larvae were also collected from different breeding sites prevalent in the region. Insecticide resistance bioassay, vector incrimination, blood meal analysis was done with the collected vector mosquitoes. Results A total of 34,974 adult Anopheles mosquitoes were caught during the survey period, out of which Anopheles subpictus was predominant (54.7%). Among vectors, Anopheles stephensi was predominant (15.5%) followed by Anopheles culicifacies (10.1%). The Human Blood Index (HBI) in the case of An. culicifacies and An. stephensi was 6.66 and 9.09, respectively. Vector incrimination results revealed Plasmodium vivax positivity rate of 1.6% for An. culicifacies. Both the vector species were found resistant to DDT, malathion and deltamethrin. Conclusion The emergence of insecticide resistance in both vector species, compromises the effectiveness of commonly used public health insecticides. Consequently, the implementation of robust insecticide resistance management strategies becomes imperative. To effectively tackle the malaria transmission, a significant shift in vector control strategies is warranted, with careful consideration and adaptation to address specific challenges encountered in malaria elimination efforts.
Læs mere Tjek på PubMedMalaria Journal, 17.04.2024
Tilføjet 17.04.2024
Abstract Background Rapid diagnostic tests (RDTs) play a significant role in expanding case management in peripheral healthcare systems. Histidine-rich protein-2 (HRP2) antigen detection RDTs are predominantly used to diagnose Plasmodium falciparum infection. However, the evolution and spread of P. falciparum parasite strains with deleted hrp2/3 genes, causing false-negative results, have been reported. This study assessed the diagnostic performance of HRP2-detecting RDTs for P. falciparum cases and the prevalence of pfhrp2/3 deletions among symptomatic patients seeking malaria diagnosis at selected health facilities in southern Ethiopia. Methods A multi-health facilities-based cross-sectional study was conducted on self-presenting febrile patients seeking treatment in southern Ethiopia from July to September 2022. A purposive sampling strategy was used to enroll patients with microscopically confirmed P. falciparum infections. A capillary blood sample was obtained to prepare a blood film for microscopy and a RDT using the SD Bioline™ Malaria Pf/Pv Test. Dried blood spot samples were collected for further molecular analysis. DNA was extracted using gene aid kits and amplification was performed using nested PCR assay. Exon 2 of hrp2 and hrp3, which are the main protein-coding regions, was used to confirm its deletion. The diagnostic performance of RDT was evaluated using PCR as the gold standard test for P. falciparum infections. Results Of 279 P. falciparum PCR-confirmed samples, 249 (89.2%) had successful msp-2 amplification, which was then genotyped for hrp2/3 gene deletions. The study revealed that pfhrp2/3 deletions were common in all health centres, and it was estimated that 144 patients (57.8%) across all health facilities had pfhrp2/3 deletions, leading to false-negative PfHRP2 RDT results. Deletions spanning exon 2 of hrp2, exon 2 of hrp3, and double deletions (hrp2/3) accounted for 68 (27.3%), 76 (30.5%), and 33 (13.2%) of cases, respectively. The study findings revealed the prevalence of P. falciparum parasites lacking a single pfhrp2-/3-gene and that both genes varied across the study sites. This study also showed that the sensitivity of the SD Bioline PfHRP2-RDT test was 76.5% when PCR was used as the reference test. Conclusion This study confirmed the existence of widespread pfhrp2/3- gene deletions, and their magnitude exceeded the WHO-recommended threshold (> 5%). False-negative RDT results resulting from deletions in Pfhrp2/3- affect a country’s attempts at malaria control and elimination. Therefore, the adoption of non-HRP2-based RDTs as an alternative measure is required to avoid the consequences associated with the continued use of HRP-2-based RDTs, in the study area in particular and in Ethiopia in general.
Læs mere Tjek på PubMedJia Mun ChanElisa Ramos-SevillanoModupeh BettsHolly U. WilsonCaroline M. WeightAmbrine Houhou-OusalahGabriele PollaraJeremy S. BrownRobert S. Heyderman1Research Department of Infection, Division of Infection and Immunity, University College London, London, United Kingdom2UCL Respiratory, Division of Medicine, University College London, London, United Kingdom, Nancy E. Freitag
Infection and Immunity, 17.04.2024
Tilføjet 17.04.2024
Manmeet BhallaSydney HerringAlexsandra LenhardJoshua R. WheelerFred AswadKlaus KlumppJustin ReboYan WangKevin WilhelmsenKristen FortneyElsa N. Bou Ghanem1Department of Microbiology and Immunology, School of Medicine, University at Buffalo, Buffalo, New York, USA2Department of Pathology, Stanford University, Stanford, California, USA3BIOAGE Labs Inc., Richmond, California, USA, Nancy E. Freitag
Infection and Immunity, 17.04.2024
Tilføjet 17.04.2024
Kevin C. JenningsKaitlin E. JohnsonMichael A. HaywardChristopher J. KristichNita H. Salzman1Department of Pediatrics, Division of Gastroenterology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA2Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA3Center for Microbiome Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA4Center for Infectious Disease Research, Medical College of Wisconsin, Milwaukee, Wisconsin, USA, Nancy E. Freitag
Infection and Immunity, 17.04.2024
Tilføjet 17.04.2024
Infection, 17.04.2024
Tilføjet 17.04.2024
Abstract Purpose Sepsis is a life-threatening organ dysfunction caused by dysregulated host response to infection. The purpose of the study was to measure the associations of specific exposures (deprivation, ethnicity, and clinical characteristics) with incident sepsis and case fatality. Methods Two research databases in England were used including anonymized patient-level records from primary care linked to hospital admission, death certificate, and small-area deprivation. Sepsis cases aged 65–100 years were matched to up to six controls. Predictors for sepsis (including 60 clinical conditions) were evaluated using logistic and random forest models; case fatality rates were analyzed using logistic models. Results 108,317 community-acquired sepsis cases were analyzed. Severe frailty was strongly associated with the risk of developing sepsis (crude odds ratio [OR] 14.93; 95% confidence interval [CI] 14.37–15.52). The quintile with most deprived patients showed an increased sepsis risk (crude OR 1.48; 95% CI 1.45–1.51) compared to least deprived quintile. Strong predictors for sepsis included antibiotic exposure in prior 2 months, being house bound, having cancer, learning disability, and diabetes mellitus. Severely frail patients had a case fatality rate of 42.0% compared to 24.0% in non-frail patients (adjusted OR 1.53; 95% CI 1.41–1.65). Sepsis cases with recent prior antibiotic exposure died less frequently compared to non-users (adjusted OR 0.7; 95% CI 0.72–0.76). Case fatality strongly decreased over calendar time. Conclusion Given the variety of predictors and their level of associations for developing sepsis, there is a need for prediction models for risk of developing sepsis that can help to target preventative antibiotic therapy.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
Journal of Infectious Diseases, 17.04.2024
Tilføjet 17.04.2024
Abstract Background Observational evidence suggests the 4CMenB meningococcal vaccine may partially protect against gonorrhea, with one dose being two-thirds as protective as two. We examined the cost-effectiveness of vaccinating men-who-have-sex-with-men (MSM) in England, with one- or two-dose primary vaccination.Methods Integrated transmission-dynamic health-economic modeling explored the effects of targeting strategy, first- and second-dose uptake levels, and duration of vaccine protection, using observational estimates of vaccine protection.Results Vaccination with one or two primary doses is always cost-saving, irrespective of uptake, although vaccine sentiment is an important determinant of impact and cost-effectiveness. The most impactful and cost-effective targeting is offering “Vaccination-according-to-Risk” (VaR), to all patients with gonorrhea plus those reporting high numbers of sexual partners. If VaR is not feasible to implement then the more-restrictive strategy of “Vaccination-on-Diagnosis” (VoD) with gonorrhea is cost-effective, but much less impactful. Under conservative assumptions, VaR(2-dose) saves £7.62M(95%CrI:1.15-17.52) and gains 81.41(28.67-164.23) QALYs over 10 years; VoD(2-dose) saves £3.40M(0.48-7.71) and gains 41.26(17.52-78.25) QALYs versus no vaccination. Optimistic versus pessimistic vaccine-sentiment assumptions increase net benefits by ∼30%(VoD) or ∼60%(VaR).Conclusions At UK costs, targeted 4CMenB vaccination of MSM gains QALYs and is cost-saving at any uptake level. Promoting uptake maximizes benefits and is an important role for behavioral science.
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