Nyt fra tidsskrifterne

Robert A. Lewis, Christopher S. Johns, Marcella Cogliano, David Capener, Euan Tubman, Charlie A. Elliot, Athanasios Charalampopoulos, Ian Sabroe, A. A. Roger Thompson, Catherine G. Billings, Neil Hamilton, Kathleen Baster, Peter J. Laud, Peter M. Hickey, Jennifer Middleton, Iain J. Armstrong, Judith A. Hurdman, Allan Lawrie, Alexander M. K. Rothman, Jim M. Wild, Robin Condliffe, Andrew J. Swift, David G. Kiely

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 458-468, February 15, 2020. …

Taylor W. Foreman, Allison N. Bucşan, Smriti Mehra, Charles Peloquin, Lara A. Doyle, Kasi Russell-Lodrigue, Neel R. Gandhi, John Altman, Cheryl L. Day, Joel D. Ernst, Henry M. Blumberg, Jyothi Rengarajan, Deepak Kaushal

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 469-477, February 15, 2020. …

Ken Stern, Shyam Rao, Timmy Cheng, Huawei Dong

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 478-480, February 15, 2020. …

Monica A. Lu, Nicholas A. Jabre, Peter J. Mogayzel

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 481-482, February 15, 2020. …

David M. Becnel, Michael A. Jantz, Hiren J. Mehta

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page e10-e11, February 15, 2020. …

Akihito Okazaki, Yoshihiro Takeda, Yasuhiko Matsuda, Kazuhiko Shibata, Kazuo Kasahara

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page e12-e12, February 15, 2020. …

Deena Kelly Costa, Haiyin Liu, Emily M. Boltey, Olga Yakusheva

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 483-485, February 15, 2020. …

Maaike de Vries, Diana A. van der Plaat, Ivana Nedeljkovic, K. Joeri van der Velde, Najaf Amin, Cornelia M. van Duijn, Judith M. Vonk, H. Marike Boezen, Cleo C. van Diemen

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 485-488, February 15, 2020. …

Sarath Raju, Emily P. Brigham, Laura M. Paulin, Nirupama Putcha, Aparna Balasubramanian, Nadia N. Hansel, Meredith C. McCormack

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 488-491, February 15, 2020. …

Charles Langelier, Monica Fung, Saharai Caldera, Thomas Deiss, Amy Lyden, Brian C. Prince, Paula Hayakawa Serpa, Farzad Moazed, Peter Chin-Hong, Joseph L. DeRisi, Carolyn S. Calfee

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 491-495, February 15, 2020. …

Randall J. Nett, John M. Wood, David J. Blackley

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 495-496, February 15, 2020. …

Daniel A. Culver, Hyun Kim

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 496-497, February 15, 2020. …

Robert C. Tasker

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 497-497, February 15, 2020. …

François Lellouche, Erwan L’Her

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 498-498, February 15, 2020. …

Edward Palmer, Daniel Martin, Mervyn Singer, Steve Harris

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 499-499, February 15, 2020. …

Muddassir Mehmood

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 500-500, February 15, 2020. …

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page 500-501, February 15, 2020. …

W. Graham Carlos, Charles S. Dela Cruz, Bin Cao, Susan Pasnick, Shazia Jamil

American Journal of Respiratory and Critical Care Medicine, Volume 201, Issue 4, Page P7-P8, February 15, 2020. …

Abstract Purpose Evidence supports the implementation of outpatient parenteral antimicrobial therapy (OPAT) as standard of care. Until 2015 the overall experience with OPAT in Belgium remained limited. The aim of this study was to evaluate the efficacy and safety of a Belgian ‘OPAT at home’ program, which was implemented in University Hospitals Leuven starting from January 2017. Methods A mono-centric, prospective, observational study was carried out. All OPAT cases discharged between 10 January 2017 and 10 January 2019 were included in the study. Relevant demographic and clinical patient data were collected. The outcomes were clinical cure rate, OPAT related readmission rate, adverse event rate and patients’ satisfaction. Results Over the two-year study period, 152 OPAT episodes were started in 130 patients, resulting in 3153 avoided hospitalization days which corresponds to 5.4 freed hospital beds. Urinary tract infections accounted for 40.8% of OPAT courses and temocillin was the most frequently used antibiotic (24.3%). Cure was achieved in 97.9% of the OPAT episodes. During 22 (14.5%) OPAT episodes, patients experienced adverse events, including line related adverse events (7.9%) and adverse drug events (6.6%). An OPAT related readmission rate of 9.2% was observed, mostly related to line-associated adverse events. All patients who completed the satisfaction survey (n = 23) were very satisfied with their OPAT course. Conclusion The University Hospitals Leuven OPAT program is associated with a high level of clinical cure and low all-cause readmission and adverse event rates. Improvement actions are described to further reduce the readmission rate to less than 5.0%.…

Rémi Denise, Sophie S. Abby, Eduardo P.C. Rocha

Protein secretion is important for many biotic and abiotic interactions. The evolution of protein secretion systems of bacteria, and related nanomachines, occurred by the co-option of machineries for motility, conjugation, injection, or adhesion. Some of these secretion systems emerged many times, whereas others are unique. In most cases, their evolution occurred by successive rounds of gene accretion, deletion, and horizontal transfer, resulting in machines that can be very different from the original ones.

Dominik Ternes, Jessica Karta, Mina Tsenkova, Paul Wilmes, Serge Haan, Elisabeth Letellier

Mounting evidence from metagenomic analyses suggests that a state of pathological microbial imbalance or dysbiosis is prevalent in the gut of patients with colorectal cancer. Several bacterial taxa have been identified of which representative isolate cultures interact with human cancer cells in vitro and trigger disease pathways in animal models. However, how the complex interrelationships in dysbiotic communities may be involved in cancer pathogenesis remains a crucial question. Here, we provide a survey of current knowledge of the gut microbiome in colorectal cancer.

McKinnon, W. B., Richardson, D. C., Marohnic, J. C., Keane, J. T., Grundy, W. M., Hamilton, D. P., Nesvorny, D., Umurhan, O. M., Lauer, T. R., Singer, K. N., Stern, S. A., Weaver, H. A., Spencer, J. R., Buie, M. W., Moore, J. M., Kavelaars, J. J., Lisse, C. M., Mao, X., Parker, A. H., Porter, S. B., Showalter, M. R., Olkin, C. B., Cruikshank, D. P., Elliott, H. A., Gladstone, G. R., Parker, J. W., Verbiscer, A. J., Young, L. A., the New Horizons Science Team

The New Horizons spacecraft’s encounter with the cold classical Kuiper Belt object (486958) Arrokoth (provisional designation 2014 MU69) revealed a contact-binary planetesimal. We investigate how Arrokoth formed, finding it is the product of a gentle, low-speed merger in the early Solar System. Its two lenticular lobes suggest low-velocity accumulation of numerous smaller planetesimals within a gravitationally collapsing cloud of solid particles. The geometric alignment of the lobes indicates they were a co-orbiting binary that experienced angular momentum loss and subsequent merger, possibly due to dynamical friction and collisions within the cloud or later gas drag. Arrokoth’s contact-binary shape was preserved by the benign dynamical and collisional environment of the cold classical Kuiper Belt, so informs the accretion processes that operated in the early Solar System.…

Spencer, J. R., Stern, S. A., Moore, J. M., Weaver, H. A., Singer, K. N., Olkin, C. B., Verbiscer, A. J., McKinnon, W. B., Parker, J. W., Beyer, R. A., Keane, J. T., Lauer, T. R., Porter, S. B., White, O. L., Buratti, B. J., El-Maarry, M. R., Lisse, C. M., Parker, A. H., Throop, H. B., Robbins, S. J., Umurhan, O. M., Binzel, R. P., Britt, D. T., Buie, M. W., Cheng, A. F., Cruikshank, D. P., Elliott, H. A., Gladstone, G. R., Grundy, W. M., Hill, M. E., Horanyi, M., Jennings, D. E., Kavelaars, J. J., Linscott

The Cold Classical Kuiper Belt, a class of small bodies in undisturbed orbits beyond Neptune, are primitive objects preserving information about Solar System formation. In January 2019, the New Horizons spacecraft flew past one of these objects, the 36-km long contact binary (486958) Arrokoth (provisional designation 2014 MU69). Images from the flyby show that Arrokoth has no detectable rings, and no satellites (larger than 180 m diameter) within a radius of 8000 km. Arrokoth has a lightly-cratered smooth surface with complex geological features, unlike those on previously visited Solar System bodies. The density of impact craters indicates the surface dates from the formation of the Solar System. The two lobes of the contact binary have closely aligned poles and equators, constraining their accretion mechanism.…

Grundy, W. M., Bird, M. K., Britt, D. T., Cook, J. C., Cruikshank, D. P., Howett, C. J. A., Krijt, S., Linscott, I. R., Olkin, C. B., Parker, A. H., Protopapa, S., Ruaud, M., Umurhan, O. M., Young, L. A., Dalle Ore, C. M., Kavelaars, J. J., Keane, J. T., Pendleton, Y. J., Porter, S. B., Scipioni, F., Spencer, J. R., Stern, S. A., Verbiscer, A. J., Weaver, H. A., Binzel, R. P., Buie, M. W., Buratti, B. J., Cheng, A., Earle, A. M., Elliott, H. A., Gabasova, L., Gladstone, G. R., Hill, M. E., Horanyi, M., Jenn

The outer Solar System object (486958) Arrokoth (provisional designation 2014 MU69) has been largely undisturbed since its formation. We study its surface composition using data collected by the New Horizons spacecraft. Methanol ice is present along with organic material, which may have formed through irradiation of simple molecules. H2O ice is not detected. This composition indicates hydrogenation of CO-rich ice and/or energetic processing of CH4+H2O ices in the cold, outer edge of the early Solar System. There are only small regional variations in color and spectra across the surface, suggesting Arrokoth formed from a homogeneous or well-mixed reservoir of solids. Microwave thermal emission from the winter night side is consistent with a mean brightness temperature of 29 ± 5 K.…

Nagaoka, S. I., Nakaki, F., Miyauchi, H., Nosaka, Y., Ohta, H., Yabuta, Y., Kurimoto, K., Hayashi, K., Nakamura, T., Yamamoto, T., Saitou, M.

Mammalian sexual reproduction relies on the dichotomy of male and female germ cell development. However, the underlying mechanisms remain unclear. Here, we show that ZGLP1, a conserved transcriptional regulator with GATA-like zinc fingers, determines the oogenic fate in mice. ZGLP1 acts downstream of bone morphogenetic protein (BMP), but not retinoic acid (RA), and is essential for the oogenic program and meiotic entry. ZGLP1 overexpression induces differentiation of in vitro primordial germ cell-like cells (PGCLCs) into fetal oocytes by activating the oogenic programs repressed by Polycomb activities, whereas RA signaling contributes to the oogenic program maturation and PGC program repression. Our findings elucidate the mechanism for mammalian oogenic fate determination, providing a foundation for promoting in vitro gametogenesis and reproductive medicine.…

Liao, Y., Koelewijn, S.-F., Van den Bossche, G., Van Aelst, J., Van den Bosch, S., Renders, T., Navare, K., Nicolaï, T., Van Aelst, K., Maesen, M., Matsushima, H., Thevelein, J., Van Acker, K., Lagrain, B., Verboekend, D., Sels, B. F.

Profitability and sustainability of future biorefineries are dependent on efficient feedstock utilization. It is essential to valorize lignin when using wood. We have developed an integrated biorefinery that converts 78 wt.% of birch into xylochemicals. Reductive catalytic fractionation of wood gives a carbohydrate pulp amenable to bioethanol production and a lignin oil. After extraction of lignin oil, the crude, unseparated mixture of phenolic monomers is catalytically funneled into 20 wt.% of phenol and 9 wt.% of propylene (on lignin basis) by gas-phase hydroprocessing/dealkylation, whereas the residual phenolic oligomers (30 wt.%) are used in printing ink as replacements for controversial para-nonylphenol. Techno-economic analysis predicts an economically competitive production, and life-cycle assessment estimates a lower CO2 footprint relative to fossil-based production.…

Jewitt, D. C.

The flyby of the Kuiper Belt object Arrokoth provides quick and tantalizing observations…

Abstract Background Naphthoquine (NQ) is a suitable partner anti-malarial for the artemisinin-based combination therapy (ACT), which is recommended to be taken orally as a single-dose regimen. The metabolism of NQ was mainly mediated by CYP2D6, which is well-known to show gender-specific differences in its expression. In spite of its clinical use, there is limited information on the pharmacokinetics of NQ, and no data are available for females. In this study, the effect of gender on the pharmacokinetics and antiplasmodial efficacy of NQ in rodents was evaluated. The underlying factors leading to the potential gender difference, i.e., plasma protein binding and metabolic clearance, were also evaluated. Methods The pharmacokinetic profiles of NQ were investigated in healthy male or female rats after a single oral administration of NQ. The antiplasmodial efficacy of NQ was studied in male or female mice infected with Plasmodium yoelii. The recrudescence and survival time of infected mice were also recorded after drug treatment. Plasma protein binding of NQ was determined in pooled plasma collected from male or female mice, rat or human. In vitro metabolism experiments were performed in the liver microsomes of male or female mice, rat or human. Results The results showed that the gender of rats did not affect NQ exposure (AUC0–t and Cmax) significantly (P > 0.05). However, a significant (P  0.05) antiplasmodial activity was found for NQ in male mice (ED90, 1.10 mg/kg) infected with P. yoelii, compared with female mice (ED90, 1.67 mg/kg). The binding rates of NQ to plasma protein were similar in males and females. There was no metabolic difference for NQ in male and female mice, rat or human liver microsomes. Conclusions These results indicated that the pharmacokinetic profiles of NQ were similar between male and female rats, except for a longer t1/2 in male rats. The difference was not associated with plasma protein binding or hepatic metabolic clearance. Equivalent antiplasmodial activity was found for NQ in male and female mice infected with P. yoelii. This study will be helpful for the rational design of clinical trials for NQ.…

Marco De Ambrogi

The relationship that we have with our parents is complex, shapes who we are, and inevitably undergoes changes with time and age. As children, it might be difficult to realise and accept that our parents cannot be the idealised reference figures that we want them to be. But growing up and facing our disappointments, difficult life choices, and responsibilities should help us to appreciate that our parents have been in the same position and have also struggled to know what was right to do. Thus, any opportunity to open a window on the past and learn more about our parents' youth and the path they took to become the people we know could be a way to understand something of ourselves.

The Lancet

Clinicians and health-care managers displayed “a capacity for wilful blindness” that allowed Ian Paterson to hide in plain sight—that is the uncomfortable opening statement of the independent inquiry into Paterson's malpractice, published on Feb 4, 2020. Paterson worked as a consultant surgeon from 1993 to 2011 in both private and National Health Service hospitals in West Midlands, UK. During that period, he treated thousands of patients, many of whom had surgery. Paterson demonstrated an array of abhorrent and unsafe activities over this time, including exaggerating patients' diagnoses to coerce them into having surgery, performing his own version of a mastectomy, which goes against internationally agreed oncological principles, and inappropriate conduct towards patients and staff.

The Lancet

Last week, a campaign was jointly launched by the Brazilian Ministry of Health and the Ministry of Women, Family and Human Rights to reduce the country's high teenage pregnancy rate. Under the slogan “adolescence first, pregnancy later”, the campaign aims to make adolescents and their parents aware, via television, billboards, and social media, of the risks and consequences of teenage pregnancies. One of the messages emphasised by Damares Alves, an evangelical pastor who leads the Ministry of Women, Family and Human Rights, is to delay the start of sexual relationships—an approach that is widely regarded as completely ineffective.

The Lancet

On Feb 10, new WHO guidelines were released for the management of pregnant and breastfeeding women in the context of Ebola virus disease, outlining appropriate steps for clinicians to take in DR Congo. The country has had 3428 confirmed cases of Ebola over the past 18 months, the second worst outbreak after the 2014–16 west Africa outbreak of around 28 000 cases.

Kabir Sheikh, Irene Agyepong, Manoj Jhalani, Walid Ammar, Assad Hafeez, Sushil Pyakuryal, Seye Abimbola, Abdul Ghaffar, Soumya Swaminathan

Institutions in high-income countries (HICs) are the main funders and generators of academic knowledge on health systems in low-income and middle-income countries (LMICs), and much too often this knowledge reflects their priorities rather than the needs of health systems in LMICs.1,2 This power imbalance between HICs and LMICs has been the focus of calls for reforms to global and HIC institutions.3,4 However, change must also come from within LMICs. To address this power imbalance, learning must be prioritised as a core part of strengthening health systems in LMICs.

Adnan A Hyder

The 3rd Global Ministerial Conference on Road Safety will be held in Stockholm, Sweden, on Feb 19–20, 2020, as the Decade of Action 2011–20 for global road safety comes to an end. Such summits are important for global road safety in many ways. First, they can bring political attention to road traffic injuries. Second, they can provide a stimulus for countries to assess their own situations and take action. Finally, they present an opportunity for the global community to track progress of road safety efforts over time.

Richard Horton

Here is US President Donald Trump last week in his State of the Union Address: “A good life for American families also requires the most affordable, innovative, and high-quality healthcare system on Earth...Over 130 legislators in this chamber have endorsed legislation that would bankrupt our nation by providing free taxpayer-funded healthcare to millions of illegal aliens, forcing taxpayers to subsidise free care for anyone in the world who unlawfully crosses our borders...If forcing American taxpayers to provide unlimited free healthcare to illegal aliens sounds fair to you, then stand with the radical left.

Rob Hyde

Pharmacists across Europe have seen patients affected by shortages of hundreds of medicines. Rob Hyde reports.

Munyaradzi Makoni

With cases of novel coronavirus spreading worldwide, governments and institutions are getting ready for the first cases in Africa. Munyaradzi Makoni reports from Cape Town.

Talha Burki

The two agencies have announced plans to work together to expand services, train health workers, and raise awareness. Talha Burki reports.

Tyler M Berzin, Eric J Topol

Today gastroenterologists face the challenge of how to perceive and interpret the high volume—about 30 high-definition frames per s—of rich visual data presented in real time during an endoscopy. Unlike many other medical image scenarios, gastroenterologists must make diagnostic decisions in real time since procedures, such as taking a biopsy or removing a polyp, are immediately influenced by the visual findings. Computer vision applied to endoscopy has the potential to improve interpretation of images.

Geoff Watts

When it comes to research, Giovanna Mallucci, an Associate Director of Cambridge University's UK Dementia Research Institute (DRI) and van Geest Professor of Clinical Neuroscience, has a guiding maxim: let the data speak to you. “You might start with one idea”, she says. “But when the data don't agree with it, that's the truth and that's what you have to follow.” If this means a change of direction, with new thinking, so be it. A lot of what Mallucci herself has come up with, she admits, started out as an attempt to answer a different question.

Tania Glyde

Menopause sits at the intersection of ageism, ableism, and misogyny, which is why, particularly in western culture, it is still held in shadow, and treated as comedic and shameful. The cartoonish portrayal of the menopausal woman is typically someone who is overweight, sweaty, raging, and desexed, segueing from pitiful to invisible (particularly to men) in a few short years. In this well written memoir, Flash Count Diary: A New Story About the Menopause, Darcey Steinke states: “Many online essays urge me to laugh at myself more and complain less.

Chris Beyrer

Losing any loved one is painful. Part, taught the Buddha, of the inescapable fate of us all. But losing a spouse, a life partner, is different—these are the people with whom we are most intimate, who we've chosen, who have chosen us to share the joys and burdens of life's journey. And, if we are blessed with mutual long lives, to share the wisdom, the pleasures and pains of ageing together. Medicine has known since antiquity that the loss of a spouse can have profound consequences for the surviving member of a couple.

Andrew Green

Medical epidemiologist and Executive Director of WHO's Division for Universal Health Coverage. Born in Melbourne, VIC, Australia, on Dec 22, 1968, he died of a suspected heart attack in Geneva, Switzerland, on Jan 23, 2020, aged 51 years.

Anna E Thorson, Megan Foeller, Pura Rayco-Solon, Zita Weise Prinzo, João Paulo Souza, Juan Pablo Peña-Rosas

We commend Mija Ververs and Akanksha Arya1 for highlighting an urgent need for evidence-based breastfeeding guidance in the context of Ebola virus disease. In response to the ongoing Ebola outbreak, WHO assembled an expert panel to create recommendations and implementation guidance on breastfeeding, as informed by a systematic review of evidence. On Feb 10, 2020, WHO published recommendations for the management of pregnant and breastfeeding women in the context of Ebola virus disease.2…

Shaohua Guo, Gary Tse, Tong Liu

We read with great interest the outcomes of the PERSEPHONE trial by Helena Earl and colleagues,1 reporting less cardiotoxicity in 6-month treatment with adjuvant trastuzumab than in 12-month treatment. The cardiotoxicity of trastuzumab has been evaluated in several studies. Chang and colleagues2 summarised that 1·7–4·1% of patients treated with trastuzumab developed heart failure when anthracycline was not part of the therapeutic regimen. In the clinical setting, trastuzumab provides substantial benefit to survival and reduction of cancer recurrence in patients with HER2-positive breast cancer.

Helena M Earl, Louise Hiller, Chris Plummer, David Miles, Andrew M Wardley, David A Cameron, Janet A Dunn

We thank Tong Liu and colleagues for their interest in our publication of the primary endpoint results of the PERSEPHONE trial.1 Liu and colleagues draw attention to reports of prophylactic cardiac medication to modify reductions in left ventricular ejection fraction (LVEF) from anthracyclines2 and trastuzumab3 therapy. These drugs will remain standard for many patients with HER2-positive, early breast cancer. Therefore, the possibility of cardioprotection with prophylactic cardiac medication is an important development.

Machteld MHT van Egmond, Maroeska M Rovers, Gerjon Hannink, Carine TM Hendriks, Niels van Heerbeek

We thank Alfonso Pendolino and colleagues, Neil Tan and Samuel Leong, and Basile Landis and Abel-Jan Tasman for the interest in our study, and welcome the opportunity to reply.

Barbara Gomes, Maja de Brito, Ana Forjaz de Lacerda, Duarte Soares

End-of-life care is one of the most neglected areas in Portugal's health system.1 In adults and children, deaths caused by conditions requiring palliative care are rising,2,3 and this aligns with global projections.4 Portugal has the fourth highest aged population in the world, and is predicted to have the third by 2050.5 There is a continuing trend towards dying in hospital,2,3 which is often against people's preferences.6 Falling investment in end-of-life care will diminish the chances of reversing this trend and affect the conditions in which people die in hospitals.

Amy Alpert, Maxine Fookson, Seth Komarovsky, Alan F Meyers, Alice Rothchild, Rachel Rubin, Peter Sporn

As members of the health-care community, all of us Jewish, we disagree with the comments made by Julio Rosenstock and colleagues1 about the Correspondence by Paola Manduca and colleagues2 representing “a clear manifestation of anti-Semitism”.1 This accusation is commonly wielded as a means of foreclosing critical discussion of the behaviour of the state of Israel, conflating such criticism with anti-Semitism, meaning anti-Jewish.

Yuchen Xue

The Editors1 discuss China's commitment to improving the occupational health of its 776 million workers and outline a range of important health risks faced by this population (eg, dust, chemicals, and poison); however, they forget to mention one of the most critical hazards that they endure: smoking in the workplace.