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Gagan Kumar, Dhaval Patel, Martin Hererra, David Jefferies, Ankit Sakhuja, Mark Meersman CPA, Drew Dalton, Rahul Nanchal, Achuta Kumar Guddati
Journal of Medical Virology, 24.09.2021
Tilføjet 25.09.2021
Irene Cassaniti, Federica Bergami, Elena Percivalle, Elisa Gabanti, Josè Camilla Sammartino, Alessandro Ferrari, Kodjo Messan Guy Adzasehoun, Federica Zavaglio, Paola Zelini, Giuditta Comolli, Antonella Sarasini, Antonio Piralla, Alessandra Ricciardi, Valentina Zuccaro, Fabrizio Maggi, Federica Novazzi, Luca Simonelli, Luca Varani, Daniele Lilleri, Fausto Baldanti
Clinical Microbiology and Infection, 25.09.2021
Tilføjet 25.09.2021
To assess SARS-CoV-2 humoral and cell-mediated response elicited by mRNA BNT162b2 vaccine in SARS-CoV-2 experienced and naïve subjects against reference strain and SARS-CoV-2 variants.
Læs mere Tjek på PubMedYawei Tang, Ziran Bai, Jingjing Qi, Zhimin Lu, Ahmad, Guan Wang, Minli Jin, Bing Wang, Haifeng Chen, Xia Li
Clinical & Experimental Immunology, 24.09.2021
Tilføjet 25.09.2021
David Horn
Trends in Parasitology, 24.09.2021
Tilføjet 25.09.2021
Genome-scale genetic screens allow researchers to rapidly identify the genes and proteins that impact a particular phenotype of interest. In African trypanosomes, RNA interference (RNAi) knockdown screens have revealed mechanisms underpinning drug resistance, drug transport, prodrug metabolism, quorum sensing, genome replication, and gene expression control. RNAi screening has also been remarkably effective at highlighting promising potential antitrypanosomal drug targets. The first ever RNAi library screen was implemented in African trypanosomes, and genome-scale RNAi screens and other related approaches continue to have a major impact on trypanosomatid research.
Læs mere Tjek på PubMedChristopher P. Reinders Folmer, Megan A. Brownlee, Adam D. Fine, Emmeke B. Kooistra, Malouke E. Kuiper, Elke H. Olthuis, Anne Leonore de Bruijn, Benjamin van Rooij
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Christopher P. Reinders Folmer, Megan A. Brownlee, Adam D. Fine, Emmeke B. Kooistra, Malouke E. Kuiper, Elke H. Olthuis, Anne Leonore de Bruijn, Benjamin van Rooij
A crucial question in the governance of infectious disease outbreaks is how to ensure that people continue to adhere to mitigation measures for the longer duration. The present paper examines this question by means of a set of cross-sectional studies conducted in the United States during the COVID-19 pandemic, in May, June, and July of 2020. Using stratified samples that mimic the demographic characteristics of the U.S. population, it seeks to understand to what extent Americans continued to adhere to social distancing measures in the period after the first lockdown ended. Moreover, it seeks to uncover which variables sustained (or undermined) adherence across this period. For this purpose, we examined a broad range of factors, relating to people’s (1) knowledge and understanding of the mitigation measures, (2) perceptions of their costs and benefits, (3) perceptions of legitimacy and procedural justice, (4) personal factors, (5) social environment, and (6) practical circumstances. Our findings reveal that adherence was chiefly shaped by three major factors: respondents adhered more when they (a) had greater practical capacity to adhere, (b) morally agreed more with the measures, and (c) perceived the virus as a more severe health threat. Adherence was shaped to a lesser extent by impulsivity, knowledge of social distancing measures, opportunities for violating, personal costs, and descriptive social norms. The results also reveal, however, that adherence declined across this period, which was partly explained by changes in people’s moral alignment, threat perceptions, knowledge, and perceived social norms. These findings show that adherence originates from a broad range of factors that develop dynamically across time. Practically these insights help to improve pandemic governance, as well as contributing theoretically to the study of compliance and the way that rules come to shape behavior.
Læs mere Tjek på PubMedAragaw Tesfaw, Getachew Arage, Fentaw Teshome, Wubet Taklual, Tigist Seid, Emaway Belay, Gashaw Mehiret
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Aragaw Tesfaw, Getachew Arage, Fentaw Teshome, Wubet Taklual, Tigist Seid, Emaway Belay, Gashaw Mehiret
Background According to the World Health Organization, viral diseases continue to emerge and represent a serious issue for public health. The elderly and those with underlying chronic diseases are more likely to become severe cases. Our study sets out to present in-depth exploration and analyses of the community’s risk perception and barriers to the practice of COVID-19 prevention measures in South Gondar Zone, Northwest Ethiopia.
Methods A qualitative study was done in three districts of South Gondar Zone. Community key informants and health extension workers were selected purposely for in-depth interviews and focus group discussion. The interviews were conducted by maintaining WHO recommendations for social distancing and use of appropriate personal protective equipment. The sample size for the study depended on the theoretical saturation of the data at the time of data collection. The qualitative data generated from in-depth interviews and focus group discussions was transcribed verbatim and translated into English language and thematically analyzed using open code software version 4.02.
Results Three main themes and five categories emerged from the narrations of the participants regarding the perceived barriers for the practice of COVID-19 prevention measures. A total of 9 community key informants (5 women development armies (HDA), 2 health extension workers (HEW), and 2 religious leaders participated in the in-depth interview, while two focus group discussions (7 participants in each round) were conducted among purposely selected community members. The age of the participants ranged from 24 to 70 years with the median age of 48 years. The major identified barriers for practicing COVID-19 prevention measures were the presence of strong cultural and religious practices, perceiving that the disease does not affect the young, misinformation about the disease, and lack of trust in the prevention measures.
Conclusions Socio-cultural, religious, and economic related barriers were identified from the participant’s narratives for the practice of COVID-19 prevention measures in south Gondar Zone. Our findings suggest the need to strengthen community awareness and education programs about the prevention measures of COVID-19 and increase diagnostic facilities with strong community-based surveillance to control the transmission of the pandemic.
Læs mere Tjek på PubMedFathmawati Fathmawati, Saidah Rauf, Braghmandita Widya Indraswari
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Fathmawati Fathmawati, Saidah Rauf, Braghmandita Widya Indraswari
Various factors associated with Acute Respiratory Infections (ARI) in toddlers have been widely observed, but there are no studies using data from the Sleman Health and Demographic Surveillance System (HDSS). This study aimed to determine the factors associated with ARI in children under five in Sleman, Yogyakarta, Indonesia. This research was an observational analytic study with a cross-sectional design, using secondary data from the Sleman HDSS. Data of 463 children under five who met the inclusion and exclusion criteria were used in this study. Inclusion criteria were toddlers who have complete observed variable data. The variables observed were the characteristics of children under five, the attributes of the mother, the physical condition of the house, the use of mosquito coils, sanitation facilities, and sources of drinking water. The exclusion criteria were toddlers with pulmonary tuberculosis in the past year. Data analysis used chi-squared tests for bivariate analysis and multivariate logistic regression analysis. The results showed that working mothers had a greater risk of ARI under five children with OR 1.46 (95% CI = 1.01–2.11), and groundwater as a water source was a protective factor against the occurrence of ARI in toddlers with OR 0.46 (95% CI = 0.26–0.81). After a logistic regression analysis was performed, only the drinking water source variable had a statistically significant relationship with the incidence of ARI in children under five with OR = 0.47 (95% CI = 0.268–0.827). Research on the relationship between water quality and the incidence of ARI in children under five is needed to follow up on these findings.
Læs mere Tjek på PubMedJoanna Konopińska, Iwona Obuchowska, Łukasz Lisowski, Natalia Dub, Diana Anna Dmuchowska, Marek Rękas
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Joanna Konopińska, Iwona Obuchowska, Łukasz Lisowski, Natalia Dub, Diana Anna Dmuchowska, Marek Rękas
The aim of this study was to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on ophthalmology residency training in Poland. An anonymous self-administered online survey involving polish ophthalmology residents was conducted between February 15 and 28, 2021. Of the 126 residents who completed the survey, 88.9% (n = 112) and 89.7% (n = 113) felt that the COVID-19 pandemic had negatively impacted their surgical training and overall training programs, respectively. Trainees providing care to patients with COVID-19 and female trainees indicated a greater negative impact of the pandemic on the implementation of the specialization program (p = 0.008 and p = 0.015, respectively) and on the acquisition of practical skills (p = 0.014 and p = 0.021, respectively). Approximately 94% (n = 118) of the residents surveyed participated in virtual training during the pandemic, and 99.2% (n = 124) positively assessed the content and usefulness of online teaching in everyday clinical practice. The most common platforms used for online meetings were Zoom (62.7%, n = 79) and Microsoft Teams (50.8%, n = 64). Approximately 79% (n = 99) of residents believed that, after the pandemic is over, at least some of the training courses and conferences should be conducted online. In addition, 13.5% (n = 17) of residents reported that they would like to undergo training and specialization courses in virtual form only after the pandemic is over. In summary, the present findings indicate that the COVID-19 pandemic negatively impacted the implementation of the ophthalmology specialization program in Poland, with the greatest impact on surgical training. Trainees providing care to patients with COVID-19 are more likely to negatively assess the impact of the pandemic on the training process. Replacing traditional training with virtual methods was positively received by residents and considered very useful, and most residents reported a desire to maintain virtual training in ophthalmology in the future.
Læs mere Tjek på PubMedJagadeesan M., Polani Rubeshkumar, Mohankumar Raju, Manikandanesan Sakthivel, Sharan Murali, Ramya Nagarajan, Muthappan Sendhilkumar, Irene Sambath, Kumaravel Ilangovan, Dineshkumar Harikrishnan, Vettrichelvan Venkatasamy, Parasuraman Ganeshkumar, Madhusudhan Reddy, Prabhdeep Kaur
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Jagadeesan M., Polani Rubeshkumar, Mohankumar Raju, Manikandanesan Sakthivel, Sharan Murali, Ramya Nagarajan, Muthappan Sendhilkumar, Irene Sambath, Kumaravel Ilangovan, Dineshkumar Harikrishnan, Vettrichelvan Venkatasamy, Parasuraman Ganeshkumar, Madhusudhan Reddy, Prabhdeep Kaur
Purpose Government of Tamil Nadu, India, mandated the face mask wearing in public places as one of the mitigation measures of COVID-19. We established a surveillance system for monitoring the face mask usage. This study aimed to estimate the proportion of the population who wear face masks appropriately (covering nose, mouth, and chin) in the slums and non-slums of Chennai at different time points.
Methods We conducted cross-sectional surveys among the residents of Chennai at two-time points of October and December 2020. The sample size for outdoor mask compliance for the first and second rounds of the survey was 1800 and 1600, respectively, for each of the two subgroups–slums and non-slums. In the second round, we included 640 individuals each in the slums and non-slums indoor public places and 1650 individuals in eleven shopping malls. We calculated the proportions and 95% confidence interval (95%CI) for the mask compliance outdoors and indoors by age, gender, region, and setting (slum and non-slum).
Results We observed 3600 and 3200 individuals in the first and second surveys, respectively, for outdoor mask compliance. In both rounds, the prevalence of appropriate mask use outdoors was significantly lower in the slums (28%-29%) than non-slum areas (36%-35%) of Chennai (p<0.01). Outdoor mask compliance was similar within slum and non-slum subgroups across the two surveys. Lack of mask use was higher in the non-slums in the second round (50%) than in the first round of the survey (43%) (p<0.05). In the indoor settings in the 2nd survey, 10%-11% among 1280 individuals wore masks appropriately. Of the 1650 observed in the malls, 947 (57%) wore masks appropriately.
Conclusion Nearly one-third of residents of Chennai, India, correctly wore masks in public places. We recommend periodic surveys, enforcement of mask compliance in public places, and mass media campaigns to promote appropriate mask use.
Læs mere Tjek på PubMedJonathan M. Wortham, Seth A. Meador, James L. Hadler, Kimberly Yousey-Hindes, Isaac See, Michael Whitaker, Alissa O’Halloran, Jennifer Milucky, Shua J. Chai, Arthur Reingold, Nisha B. Alden, Breanna Kawasaki, Evan J. Anderson, Kyle P. Openo, Andrew Weigel, Maya L. Monroe, Patricia A. Ryan, Sue Kim, Libby Reeg, Ruth Lynfield, Melissa McMahon, Daniel M. Sosin, Nancy Eisenberg, Adam Rowe, Grant Barney, Nancy M. Bennett, Sophrena Bushey, Laurie M. Billing, Jess Shiltz, Melissa Sutton, Nicole West, H. Keipp Talbot, William Schaffner, Keegan McCaffrey, Melanie Spencer, Anita K. Kambhampati, Onika Anglin, Alexandra M. Piasecki, Rachel Holstein, Aron J. Hall, Alicia M. Fry, Shikha Garg, Lindsay Kim
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Jonathan M. Wortham, Seth A. Meador, James L. Hadler, Kimberly Yousey-Hindes, Isaac See, Michael Whitaker, Alissa O’Halloran, Jennifer Milucky, Shua J. Chai, Arthur Reingold, Nisha B. Alden, Breanna Kawasaki, Evan J. Anderson, Kyle P. Openo, Andrew Weigel, Maya L. Monroe, Patricia A. Ryan, Sue Kim, Libby Reeg, Ruth Lynfield, Melissa McMahon, Daniel M. Sosin, Nancy Eisenberg, Adam Rowe, Grant Barney, Nancy M. Bennett, Sophrena Bushey, Laurie M. Billing, Jess Shiltz, Melissa Sutton, Nicole West, H. Keipp Talbot, William Schaffner, Keegan McCaffrey, Melanie Spencer, Anita K. Kambhampati, Onika Anglin, Alexandra M. Piasecki, Rachel Holstein, Aron J. Hall, Alicia M. Fry, Shikha Garg, Lindsay Kim
Objectives Some studies suggested more COVID-19-associated hospitalizations among racial and ethnic minorities. To inform public health practice, the COVID-19-associated Hospitalization Surveillance Network (COVID-NET) quantified associations between race/ethnicity, census tract socioeconomic indicators, and COVID-19-associated hospitalization rates.
Methods Using data from COVID-NET population-based surveillance reported during March 1–April 30, 2020 along with socioeconomic and denominator data from the US Census Bureau, we calculated COVID-19-associated hospitalization rates by racial/ethnic and census tract-level socioeconomic strata.
Results Among 16,000 COVID-19-associated hospitalizations, 34.8% occurred among non-Hispanic White (White) persons, 36.3% among non-Hispanic Black (Black) persons, and 18.2% among Hispanic or Latino (Hispanic) persons. Age-adjusted COVID-19-associated hospitalization rate were 151.6 (95% Confidence Interval (CI): 147.1–156.1) in census tracts with >15.2%–83.2% of persons living below the federal poverty level (high-poverty census tracts) and 75.5 (95% CI: 72.9–78.1) in census tracts with 0%–4.9% of persons living below the federal poverty level (low-poverty census tracts). Among White, Black, and Hispanic persons living in high-poverty census tracts, age-adjusted hospitalization rates were 120.3 (95% CI: 112.3–128.2), 252.2 (95% CI: 241.4–263.0), and 341.1 (95% CI: 317.3–365.0), respectively, compared with 58.2 (95% CI: 55.4–61.1), 304.0 (95%: 282.4–325.6), and 540.3 (95% CI: 477.0–603.6), respectively, in low-poverty census tracts.
Conclusions Overall, COVID-19-associated hospitalization rates were highest in high-poverty census tracts, but rates among Black and Hispanic persons were high regardless of poverty level. Public health practitioners must ensure mitigation measures and vaccination campaigns address needs of racial/ethnic minority groups and people living in high-poverty census tracts.
Læs mere Tjek på PubMedWillem Esterhuizen, Jean Lévine, Stefan Streif
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Willem Esterhuizen, Jean Lévine, Stefan Streif
We present a detailed set-based analysis of the well-known SIR and SEIR epidemic models subjected to hard caps on the proportion of infective individuals, and bounds on the allowable intervention strategies, such as social distancing, quarantining and vaccination. We describe the admissible and maximal robust positively invariant (MRPI) sets of these two models via the theory of barriers. We show how the sets may be used in the management of epidemics, for both perfect and imperfect/uncertain models, detailing how intervention strategies may be specified such that the hard infection cap is never breached, regardless of the basic reproduction number. The results are clarified with detailed examples.
Læs mere Tjek på PubMedMelanie Etti, Jackeline Alger, Sofía P. Salas, Robin Saggers, Tanusha Ramdin, Margit Endler, Kristina Gemzell-Danielsson, Tobias Alfvén, Yusuf Ahmed, Allison Callejas, Deborah Eskenazi, Asma Khalil, Kirsty Le Doare, On behalf of the Maternal, Newborn and Child Health Working Group of the COVID-19 Clinical Research Coalition
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Melanie Etti, Jackeline Alger, Sofía P. Salas, Robin Saggers, Tanusha Ramdin, Margit Endler, Kristina Gemzell-Danielsson, Tobias Alfvén, Yusuf Ahmed, Allison Callejas, Deborah Eskenazi, Asma Khalil, Kirsty Le Doare, On behalf of the Maternal, Newborn and Child Health Working Group of the COVID-19 Clinical Research Coalition
Background The World Health Organization’s “Coordinated Global Research Roadmap: 2019 Novel Coronavirus” outlined the need for research that focuses on the impact of COVID-19 on pregnant women and children. More than one year after the first reported case significant knowledge gaps remain, highlighting the need for a coordinated approach. To address this need, the Maternal, Newborn and Child Health Working Group (MNCH WG) of the COVID-19 Clinical Research Coalition conducted an international survey to identify global research priorities for COVID-19 in maternal, reproductive and child health.
Method This project was undertaken using a modified Delphi method. An electronic questionnaire was disseminated to clinicians and researchers in three different languages (English, French and Spanish) via MNCH WG affiliated networks. Respondents were asked to select the five most urgent research priorities among a list of 17 identified by the MNCH WG. Analysis of questionnaire data was undertaken to identify key similarities and differences among respondents according to questionnaire language, location and specialty. Following elimination of the seven lowest ranking priorities, the questionnaire was recirculated to the original pool of respondents. Thematic analysis of final questionnaire data was undertaken by the MNCH WG from which four priority research themes emerged.
Results Questionnaire 1 was completed by 225 respondents from 29 countries. Questionnaire 2 was returned by 49 respondents. The four priority research themes which emerged from the analysis were 1) access to healthcare during the COVID-19 pandemic, 2) the direct and 3) indirect effects of COVID-19 on pregnant and breastfeeding women and children and 4) the transmission of COVID-19 and protection from infection.
Conclusion The results of these questionnaires indicated a high level of concordance among continents and specialties regarding priority research themes. This prioritized list of research uncertainties, developed to specifically highlight the most urgent clinical needs as perceived by healthcare professionals and researchers, could help funding organizations and researchers to answer the most pressing questions for clinicians and public health professionals during the pandemic. It is hoped that these identified priority research themes can help focus the discussion regarding the allocation of limited resources to enhance COVID-19 research in MNCH globally.
Læs mere Tjek på PubMedAndrea Hernandez-Bures, Jason B. Pieper, Willie A. Bidot, Miranda O’Dell, William E. Sander, Carol W. Maddox
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Andrea Hernandez-Bures, Jason B. Pieper, Willie A. Bidot, Miranda O’Dell, William E. Sander, Carol W. Maddox
Dermatophytosis is a common and highly contagious zoonotic skin disease in companion animals. This disease is a major concern in geographical areas that contain large numbers of stray animal populations. Numerous surveys on dermatophytosis among stray animal populations worldwide range between 27% to 50%. In recent years, the US territory of Puerto Rico was impacted by several natural disasters such as hurricanes, which has led to a large increase of abandonment cases and an increase in the stray animal population. Due to this, large low-cost spay/neuter clinics and trap-neuter-release programs have become a more common practice on the island. During these events, veterinary staff are exposed to multiple animals with no health history, and therefore, zoonotic diseases are of concern. The aim of this study was to provide information regarding the presence of dermatophyte species in symptomatic and asymptomatic stray dogs and cats in a region of Puerto Rico. Hair samples were collected from 99 stray animals with and without dermatological clinical signs. The hair samples were cultured on plates containing rapid sporulation medium and dermatophyte test medium. All cultures were evaluated microscopically to confirm the presence of dermatophytes. Then, all dermatophytes were further evaluated with MALDI-TOF MS to compare both diagnostic tests. A total of 19 animals (19%) were positive for dermatophyte growth. Of these animals, 18/19 were infected with M. canis and 1/19 with Trichophyton spp. Animals with clinical lesions were positive only 13.5% of the time compared to asymptomatic animals, who were positive in 36% of the sample population. All 19 dermatophytes (100%) diagnosed with microscopic evaluation were confirmed with MALDI-TOF MS. Our results indicate that there is a prevalence of 19% of dermatophytosis among the stray dog and cat population of the southeastern coast of the island.
Læs mere Tjek på PubMedŁukasz Kołodziej, Dawid Ciechanowicz, Hubert Rola, Szymon Wołyński, Hanna Wawrzyniak, Kamila Rydzewska, Konrad Podsiadło
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Łukasz Kołodziej, Dawid Ciechanowicz, Hubert Rola, Szymon Wołyński, Hanna Wawrzyniak, Kamila Rydzewska, Konrad Podsiadło
The Coronovirus Disease 2019 –(COVID-19) pandemic had a significant impact on the health care system and medical staff around the world. The orthopedic units were also subject to new restrictions and regulations. Therefore, the aim of our research was to assess how the COVID-19 pandemic affected orthopedic wards in the last year in Poland. We created an online survey, which was sent to 273 members of the Polish Society of Orthopedics and Traumatology. The survey contained 51 questions and was divided into main sections: Preparedness, Training, Stress, Reduction, Awareness. A total of 80 responses to the survey were obtained. In Preparedness section the vast majority of respondents (90%) replied, that they used personal protective equipment during the pandemic, however only 50% of the respondents indicated that their facility received a sufficient amount of personal protective equipment. Most of the respondents indicated that the pandemic negatively affected the quality of training of future orthopedists (69.4%) and that pandemic has had a negative impact on their operating skills (66,7%). In Reduction section most of the doctors indicated that the number of patients hospitalized in their departments decreased by 20–60% (61,2% respondents), while the number of operations performed decreased by 60–100% (60% respondents). The negative impact of pandemic on education was noticeable especially in the group of young orthopedic surgeons: 0–5 years of work experience (p = 0,029). Among the respondents, the level of stress increased over the last year from 4.8 to 6.9 (p
Læs mere Tjek på PubMedDavid Wurzer, Paul Spielhagen, Adonia Siegmann, Ayca Gercekcioglu, Judith Gorgass, Simone Henze, Yuron Kolar, Felix Koneberg, Sari Kukkonen, Hannah McGowan, Stefanie Schmid-Eisinger, Alexander Steger, Michael Dommasch, Hans Ulrich Haase, Alexander Müller, Eimo Martens, Bernhard Haller, Katharina M. Huster, Georg Schmidt
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by David Wurzer, Paul Spielhagen, Adonia Siegmann, Ayca Gercekcioglu, Judith Gorgass, Simone Henze, Yuron Kolar, Felix Koneberg, Sari Kukkonen, Hannah McGowan, Stefanie Schmid-Eisinger, Alexander Steger, Michael Dommasch, Hans Ulrich Haase, Alexander Müller, Eimo Martens, Bernhard Haller, Katharina M. Huster, Georg Schmidt
Background If a COVID-19 patient develops a so-called severe course, he or she must be taken to hospital as soon as possible. This proves difficult in domestic isolation, as patients are not continuously monitored. The aim of our study was to establish a telemonitoring system in this setting.
Methods Oxygen saturation, respiratory rate, heart rate and temperature were measured every 15 minutes using an in-ear device. The data was transmitted to the Telecovid Centre via mobile network or internet and monitored 24/7 by a trained team. The data were supplemented by daily telephone calls. The patients´ individual risk was assessed using a modified National Early Warning Score. In case of a deterioration, a physician initiated the appropriate measures. Covid-19 Patients were included if they were older than 60 years or fulfilled at least one of the following conditions: pre-existing disease (cardiovascular, pulmonary, immunologic), obesity (BMI >35), diabetes mellitus, hypertension, active malignancy, or pregnancy.
Findings 153 patients (median age 59 years, 77 female) were included. Patients were monitored for 9 days (median, IQR 6–13 days) with a daily monitoring time of 13.3 hours (median, IQR 9.4–17.0 hours). 20 patients were referred to the clinic by the Telecovid team. 3 of these required intensive care without invasive ventilation, 4 with invasive ventilation, 1 of the latter died. All patients agreed that the device was easy to use. About 90% of hospitalised patients indicated that they would have delayed hospitalisation further if they had not been part of the study.
Interpretation Our study demonstrates the successful implementation of a remote monitoring system in a pandemic situation. All clinically necessary information was obtained and adequate measures were derived from it without delay.
Læs mere Tjek på PubMedLakshya Singhal, Yash Garg, Philip Yang, Azade Tabaie, A. Ian Wong, Akram Mohammed, Lokesh Chinthala, Dipen Kadaria, Amik Sodhi, Andre L. Holder, Annette Esper, James M. Blum, Robert L. Davis, Gari D. Clifford, Greg S. Martin, Rishikesan Kamaleswaran
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Lakshya Singhal, Yash Garg, Philip Yang, Azade Tabaie, A. Ian Wong, Akram Mohammed, Lokesh Chinthala, Dipen Kadaria, Amik Sodhi, Andre L. Holder, Annette Esper, James M. Blum, Robert L. Davis, Gari D. Clifford, Greg S. Martin, Rishikesan Kamaleswaran
We present an interpretable machine learning algorithm called ‘eARDS’ for predicting ARDS in an ICU population comprising COVID-19 patients, up to 12-hours before satisfying the Berlin clinical criteria. The analysis was conducted on data collected from the Intensive care units (ICU) at Emory Healthcare, Atlanta, GA and University of Tennessee Health Science Center, Memphis, TN and the Cerner® Health Facts Deidentified Database, a multi-site COVID-19 EMR database. The participants in the analysis consisted of adults over 18 years of age. Clinical data from 35,804 patients who developed ARDS and controls were used to generate predictive models that identify risk for ARDS onset up to 12-hours before satisfying the Berlin criteria. We identified salient features from the electronic medical record that predicted respiratory failure among this population. The machine learning algorithm which provided the best performance exhibited AUROC of 0.89 (95% CI = 0.88–0.90), sensitivity of 0.77 (95% CI = 0.75–0.78), specificity 0.85 (95% CI = 085–0.86). Validation performance across two separate health systems (comprising 899 COVID-19 patients) exhibited AUROC of 0.82 (0.81–0.83) and 0.89 (0.87, 0.90). Important features for prediction of ARDS included minimum oxygen saturation (SpO2), standard deviation of the systolic blood pressure (SBP), O2 flow, and maximum respiratory rate over an observational window of 16-hours. Analyzing the performance of the model across various cohorts indicates that the model performed best among a younger age group (18–40) (AUROC = 0.93 [0.92–0.94]), compared to an older age group (80+) (AUROC = 0.81 [0.81–0.82]). The model performance was comparable on both male and female groups, but performed significantly better on the severe ARDS group compared to the mild and moderate groups. The eARDS system demonstrated robust performance for predicting COVID19 patients who developed ARDS at least 12-hours before the Berlin clinical criteria, across two independent health systems.
Læs mere Tjek på PubMedDuika L. Burges Watson, Miglena Campbell, Claire Hopkins, Barry Smith, Chris Kelly, Vincent Deary
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Duika L. Burges Watson, Miglena Campbell, Claire Hopkins, Barry Smith, Chris Kelly, Vincent Deary
Background Qualitative olfactory (smell) dysfunctions are a common side effect of post-viral illness and known to impact quality of life and health status. Evidence is emerging that taste and smell loss are common symptoms of Covid-19 that may emerge and persist long after initial infection. The aim of the present study was to document the impact of post Covid-19 alterations to taste and smell.
Methods We conducted exploratory thematic analysis of user-generated text from 9000 users of the AbScent Covid-19 Smell and Taste Loss moderated Facebook support group from March 24 to 30th September 2020.
Results Participants reported difficulty explaining and managing an altered sense of taste and smell; a lack of interpersonal and professional explanation or support; altered eating; appetite loss, weight change; loss of pleasure in food, eating and social engagement; altered intimacy and an altered relationship to self and others.
Conclusions Our findings suggest altered taste and smell with Covid-19 may lead to severe disruption to daily living that impacts on psychological well-being, physical health, relationships and sense of self. More specifically, participants reported impacts that related to reduced desire and ability to eat and prepare food; weight gain, weight loss and nutritional insufficiency; emotional wellbeing; professional practice; intimacy and social bonding; and the disruption of people’s sense of reality and themselves. Our findings should inform further research and suggest areas for the training, assessment and treatment practices of health care professionals working with long Covid.
Læs mere Tjek på PubMedRoberto Galbiati, Emeric Henry, Nicolas Jacquemet, Max Lobeck
PLoS One Infectious Diseases, 24.09.2021
Tilføjet 24.09.2021
by Roberto Galbiati, Emeric Henry, Nicolas Jacquemet, Max Lobeck
Laws not only affect behavior due to changes in material payoffs, but they may also change the perception individuals have of social norms, either by shifting them directly or by providing information on these norms. Using detailed daily survey data and exploiting the introduction of lockdown measures in the UK in the context of the COVID-19 health crisis, we provide causal evidence that the law drastically changed the perception of the norms regarding social distancing behaviors. We show that this effect of laws on perceived norms is mostly driven by an informational channel and that the intervention made perceptions of social norms converge to the actual prevalent norm.
Læs mere Tjek på PubMedMalaria Journal, 24.09.2021
Tilføjet 24.09.2021
Abstract
Background
The diagnosis of malaria, using microscopy or rapid diagnostic tests (RDTs), requires the collection of capillary blood. This procedure is relatively simple to perform but invasive and poses potential risks to patients and health workers, arising from the manipulation of potentially infectious bodily fluids. Less or non-invasive diagnostic tests, based on urine, saliva or requiring no sampling, have the potential to generate less discomfort for the patient and to offer simpler and less risky testing procedures that could be safely performed by untrained staff or even self-performed. To explore the potential acceptance and perceived value of such non-invasive tests, an online, international survey was conducted to gather feedback from National Malaria Control Programme (NMCP) representatives.
Methods
An online survey comprising nineteen questions, available in English, French or Spanish, was emailed to 300 individuals who work with NMCPs in malaria-endemic countries. Answers were collected between November and December 2017; responses were qualitatively analysed to identify key themes and trends and quantitatively analysed to determine average values stratified by region.
Results
Responses were received from 70 individuals, from 33 countries. Approximately half of the respondents (52 %) considered current blood-based tests for malaria to be minimally invasive and non-problematic in their setting. For these participants, non-invasive tests would only be of interest if they brought additional performance improvements, as compared with the performance of microscopy and RDTs. Most respondents were of the view that saliva-based (80 %) and urine-based (66 %) tests would be more readily acceptable among children than blood-based tests. Potential use-case scenarios of interest for both saliva- and urine-based tests were ease-of-testing by community health workers, additional surveillance, self-testing, and outbreak investigation. Many respondents (41 %) thought that if saliva-based tests retailed at <$0.50 per unit they could largely replace conventional RDTs, whereas only 25 % of respondents thought a similarly priced urine-based test would do so.
Conclusions
Although limited to NMCP stakeholders, this survey indicated that current tests for malaria, based on capillary blood, are generally perceived to be minimally invasive and non-problematic. Non-invasive tests, especially if saliva-based, would be welcome if they could match or out-perform the price and performance of current blood-based tests.
Læs mere Tjek på PubMedMalaria Journal, 23.09.2021
Tilføjet 24.09.2021
Abstract
Background
Plasmodium spp. sporozoite rates in mosquitoes are used to better understand malaria transmission intensity, the relative importance of vector species and the impact of interventions. These rates are typically estimated using an enzyme-linked immunosorbent assay (ELISA) utilizing antibodies against the circumsporozoite protein of Plasmodium falciparum, Plasmodium vivax VK210 (P. vivax210) or P. vivax VK247 (P. vivax247), employing assays that were developed over three decades ago. The ELISA method requires a separate assay plate for each analyte tested and can be time consuming as well as requiring sample volumes not always available. The bead-based multiplex platform allows simultaneous measurement of multiple analytes and may improve the lower limit of detection for sporozoites.
Methods
Recombinant positive controls for P. falciparum, P. vivax210 and P. vivax247 and previously developed circumsporozoite (cs) ELISA antibodies were used to optimize conditions for the circumsporozoite multiplex bead assay (csMBA) and to determine the detection range of the csMBA. After optimizing assay conditions, known amounts of sporozoites were used to determine the lower limit of detection for the csELISA and csMBA and alternate cut-off measures were applied to demonstrate how cut-off criteria can impact lower limits of detection. Sporozoite rates from 1275 mosquitoes collected in Madagascar and 255 mosquitoes collected in Guinea were estimated and compared using the established csELISA and newly optimized csMBA. All mosquitoes were tested (initial test), and those that were positive were retested (retest). When sufficient sample volume remained, an aliquot of homogenate was boiled and retested (boiled retest), to denature any heat-unstable cross-reactive proteins.
Results
Following optimization of the csMBA, the lower limit of detection was 25 sporozoites per mosquito equivalent for P. falciparum, P. vivax210 and P. vivax247 whereas the lower limits of detection for csELISA were found to be 1400 sporozoites for P. falciparum, 425 for P. vivax210 and 1650 for P. vivax247. Combined sporozoite rates after re-testing of samples that initially tested positive for Madagascar mosquitoes by csELISA and csMBA were 1.4 and 10.3%, respectively, and for Guinea mosquitoes 2% by both assays. Boiling of samples followed by csMBA resulted in a decrease in the Madagascar sporozoite rate to 2.8–4.4% while the Guinea csMBA sporozoite rate remained at 2.0%. Using an alternative csMBA cut-off value of median fluorescence intensity (MFI) of 100 yielded a sporozoite rate after confirmational testing of 3.7% for Madagascar samples and 2.0% for Guinea samples. Whether using csMBA or csELISA, the following steps may help minimize false positives: specimens are appropriately stored and bisected anterior to the thorax-abdomen junction, aliquots of homogenate are boiled and retested following initial testing, and an appropriate cut-off value is determined.
Conclusions
The csMBA is a cost-comparable and time saving alternative to the csELISA and may help eliminate false negatives due to a lower limit of detection, thus increasing sensitivity over the csELISA. The csMBA expands the potential analyses that can be done with a small volume of sample by allowing multiplex testing where analytes in addition to P. falciparum, P. vivax210 and P. vivax247 can be added following optimization.
Læs mere Tjek på PubMedMalaria Journal, 23.09.2021
Tilføjet 24.09.2021
Abstract
Background
Screening malaria-specific antibody responses on protein microarrays can help identify immune factors that mediate protection against malaria infection, disease, and transmission, as well as markers of past exposure to both malaria parasites and mosquito vectors. Most malaria protein microarray work has used serum as the sample matrix, requiring prompt laboratory processing and a continuous cold chain, thus limiting applications in remote locations. Dried blood spots (DBS) pose minimal biohazard, do not require immediate laboratory processing, and are stable at room temperature for transport, making them potentially superior alternatives to serum. The goals of this study were to assess the viability of DBS as a source for antibody profiling and to use DBS to identify serological signatures of low-density Plasmodium falciparum infections in malaria-endemic regions of Myanmar.
Methods
Matched DBS and serum samples from a cross-sectional study in Ingapu Township, Myanmar were probed on protein microarrays populated with P. falciparum antigen fragments. Signal and trends in both sample matrices were compared. A case-control study was then performed using banked DBS samples from malaria-endemic regions of Myanmar, and a regularized logistic regression model was used to identify antibody signatures of ultrasensitive PCR-positive P. falciparum infections.
Results
Approximately 30% of serum IgG activity was recovered from DBS. Despite this loss of antibody activity, antigen and population trends were well-matched between the two sample matrices. Responses to 18 protein fragments were associated with the odds of asymptomatic P. falciparum infection, albeit with modest diagnostic characteristics (sensitivity 58%, specificity 85%, negative predictive value 88%, and positive predictive value 52%).
Conclusions
Malaria-specific antibody responses can be reliably detected, quantified, and analysed from DBS, opening the door to serological studies in populations where serum collection, transport, and storage would otherwise be impossible. While test characteristics of antibody signatures were insufficient for individual diagnosis, serological testing may be useful for identifying exposure to asymptomatic, low-density malaria infections, particularly if sero-surveillance strategies target individuals with low previous exposure as sentinels for population exposure.
Læs mere Tjek på PubMedJavaudin, F., Marjanovic, N., de Carvalho, H., Gaborit, B., Le Bastard, Q., Boucher, E., Haroche, D., Montassier, E., Le Conte, P.
BMJ Open, 24.09.2021
Tilføjet 24.09.2021
Lung ultrasound (LUS) can help clinicians make a timely diagnosis of community-acquired pneumonia (CAP).
Objectives
To assess if LUS can improve diagnosis and antibiotic initiation in emergency department (ED) patients with suspected CAP.
Design
A prospective observational study.
Settings
Four EDs.
Participants
The study included 150 patients older than 18 years with a clinical suspicion of CAP, of which 2 were subsequently excluded (incorrect identification), leaving 148 patients (70 women and 78 men, average age 72±18 years). Exclusion criteria included a life-threatening condition with do-not-resuscitate-order or patient requiring immediate intensive care.
Interventions
After routine diagnostic procedure (clinical, radiological and laboratory tests), the attending emergency physician established a clinical CAP probability according to a four-level Likert scale (definite, probable, possible and excluded). An LUS was then performed, and another CAP probability was established based on the ultrasound result. An adjudication committee composed of three independent experts established the final CAP probability at hospital discharge.
Primary and secondary outcome measures
Primary objective was to assess concordance rate of CAP diagnostic probabilities between routine diagnosis procedure or LUS and the final probability of the adjudication committee. Secondary objectives were to assess changes in CAP probability induced by LUS, and changes in antibiotic treatment initiation.
Results
Overall, 27% (95% CI 20 to 35) of the routine procedure CAP classifications and 77% (95% CI 71 to 84) of the LUS CAP classifications were concordant with the adjudication committee classifications. Cohen’s kappa coefficients between routine diagnosis procedure and LUS, according to adjudication committee, were 0.07 (95% CI 0.04 to 0.11) and 0.61 (95% CI 0.55 to 0.66), respectively. The modified probabilities for the diagnosis of CAP after LUS resulted in changes in antibiotic prescriptions in 32% (95% CI 25 to 40) of the cases.
Conclusion
In our study, LUS was a powerful tool to improve CAP diagnosis in the ED, reducing diagnostic uncertainty from 73% to 14%.
Trial registration number
NCT03411824.
Læs mere Tjek på PubMedZhou, Q., Dong, J., Sun, Q., Lu, N., Pan, Y., Han, X.
BMJ Open, 24.09.2021
Tilføjet 24.09.2021
Objective
The neutrophil-to-lymphocyte ratio (NLR) is recognised as a suitable prognostic biomarker in patients with breast cancer. Nevertheless, the efficacy of this biomarker in predicting the pathological complete response (pCR) and survival in patients with breast cancer receiving neoadjuvant chemotherapy (NACT) is still controversial. This meta-analysis aimed to identify the association between baseline NLR and the prognosis of patients with breast cancer treated with NACT.
Design
Meta-analysis.
Data sources
Relevant literature published before 1 May 2021 was searched using the Cochrane Library, Embase, PubMed and the Web of Science databases.
Eligibility criteria
All studies involving patients with breast cancer treated with NACT and peripheral blood pretreatment NLR recorded as a dichotomous variable were included.
Data extraction and synthesis
Two researchers independently extracted and evaluated OR/HR and its 95% CIs of survival outcomes and clinicopathological parameters.
Results
A total of 19 studies were identified. From each study, the impact of NLR on the pCR, OR and HR, with their 95% CIs were extracted and combined using either a random or fixed-effects model. The results indicate that a higher pCR in patients with a low NLR (OR 1.620, 95% CI 1.209 to 2.169, p<0.001). In addition, an elevated NLR predicted lower disease-free survival (HR 2.269, 95% CI 1.557 to 3.307, p<0.001) and overall survival (HR 1.691, 95% CI 1.365 to 2.096, p<0.001) in patients with breast cancer treated with NACT.
Conclusions
NLR is a suitable biomarker for predicting pCR and survival in patients with breast cancer receiving NACT.
Læs mere Tjek på PubMedFeroz, A. S., Valliani, K., Khwaja, H., Karim, S.
BMJ Open, 24.09.2021
Tilføjet 24.09.2021
Introduction
COVID-19 has significantly affected community health workers’ (CHWs) performance as they are expected to perform pandemic-related tasks along with routine essential healthcare services. A plausible way to optimise CHWs’ functioning during this pandemic is to couple the efforts of CHWs with digital tools. So far, no systematic evidence is available on the use of digital health interventions to support CHWs in low-middle-income countries (LMICs) amid the COVID-19 pandemic. The article describes a protocol for a scoping review of primary research studies that aim to map evidence on the use of unique digital health interventions to support CHWs during COVID-19 in LMICs.
Methods and analysis
Our methodology has been adapted from scoping review guidelines provided by Arksey and O’Malley, Levac et al. and the Joanna Briggs Institute. Our search strategy has been developed for the following four main electronic databases: Excerpta Medica Database, Medical Literature Analysis and Retrieval System Online, Cochrane Central Register of Controlled Trials and Cumulated Index to Nursing and Allied Health Literature. Google Scholar and reference tracking will be used for supplementary searches. Each article will be screened against eligibility criteria by two independent researchers at the title and abstract and full-text level. The review will include studies that targeted digital health interventions at CHWs’ level to provide support in delivering COVID-19-related and other essential healthcare services. A date limit of 31 December 2019 to the present date will be placed on the search and English language articles will be included.
Ethics and dissemination
Formal ethical approval is not required, as primary data will not be collected in this study. The results from our scoping review will provide valuable insight into the use of digital health interventions to optimise CHWs’ functioning and will reveal current knowledge gaps in research. The results will be disseminated through journal publications and conference presentations.
Læs mere Tjek på PubMedRussom, M., Bahta, M., Debesai, M., Bahta, I., Kessete, A., Afendi, A., Fitsum, Y., Nambozi, J., Kidane, S. N., Tesfamariam, E. H.
BMJ Open, 24.09.2021
Tilføjet 24.09.2021
Objective
To measure knowledge, attitude and practice of antibiotics and antibiotic resistance (ABR) and their determinants in the Eritrean urban population.
Design
A population-based, nation-wide, cross-sectional study.
Setting
Urban settings of Eritrea.
Participants
Members of the general public aged ≥18 years and living in 13 urban places of Eritrea. Three-stage stratified cluster sampling was used to select the study participants.
Data collection and analysis
Date were collected from July 2019 to September 2019 in a face-to-face interview using a structured questionnaire. The collected data were double entered and analysed using Census and Survey Processing system (V.7.0) and SPSS (V.23), respectively. Descriptive statistics, 2 test, t-tests, analysis of variance, factorial analysis and multivariable logistic regression were performed. All analyses were weighted and p<0.05 was considered significant.
Primary and secondary outcome measures
Main outcome variables were knowledge, attitude and practice of antibiotics and ABR. Secondary outcome measure was the determinants of knowledge, attitude and practice.
Results
A total of 2477 adults were interviewed. The mean score of knowledge and attitude of antibiotics and ABR was 10.36/20 (SD=3.51, minimum=0 and maximum=20) and 22.34/30 (SD=3.59, minimum=6 and maximum=30), respectively. Of those who used antibiotics, the proportion of at least one inappropriate practice (use of antibiotics without prescription and/or discontinuation of prescribed antibiotics before completing the full course) was 23.8%. Young age <24 years (adjusted odds ratio (AOR)=1.61, 95% CI: 1.08 to 2.41), male sex (AOR=1.48, 95% CI: 1.14 to 1.91), higher level of education (AOR=1.76, 95% CI: 1.08 to 2.88), and negative attitude towards appropriate use of antibiotics (AOR=0.95, 95% CI: 0.92 to 0.97) were found to be the significant determinants of inappropriate practice of antibiotics.
Conclusion
The gap in knowledge and inappropriate practice of antibiotics in the Eritrean urban population was widespread; requiring immediate attention from policy-makers and healthcare professionals.
Læs mere Tjek på PubMedSabrina Bortoluzzi, Nyambayar Dashtsoodol, Thomas Engleitner, Christoph Drees, Sabine Helmrath, Jonas Mir, Albulena Toska, Michael Flossdorf, Rupert Öllinger, Maria Solovey, Maria Colomé-Tatché, Bahire Kalfaoglu, Masahiro Ono, Thorsten Buch, Tim Ammon, Roland Rad, Marc Schmidt-Supprian
Immunity, 24.09.2021
Tilføjet 24.09.2021
Innate-like T cells undergo effector differentiation in absence of infection. Leveraging a genetically induced wave of iNKT cell development, Bortoluzzi et al. reveal that early TCR signaling instructs a common progenitor state, while effector subsets emerge later without further TCR input. The precise timing of these events suggests a distinct two-step process for iNKT cell differentiation.
Læs mere Tjek på PubMedChunxu Gao, Debra Gardner, Marie‐Clare Theobalds, Shannon Hitchcock, Heather Deutsch, Chidozie Amuzie, Matteo Cesaroni, Davit Sargsyan, Tadimeti S. Rao, Ravi Malaviya
Clinical & Experimental Immunology, 23.09.2021
Tilføjet 24.09.2021