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BMC Infectious Diseases, 14.10.2021
Tilføjet 14.10.2021
Abstract
Background
Transgender and gender diverse individuals often face structural barriers to health care because of their gender minority status. The aim of this study was to examine the association between gender minority stress and access to specific health care services among transgender women and transfeminine people in China.
Methods
This multicenter cross-sectional study recruited participants between January 1st and June 30th 2020. Eligible participants were 18 years or older, assigned male at birth, not currently identifying as male, and living in China. Gender minority stress was measured using 45 items adapted from validated subscales. We examined access to health care services and interventions relevant to transgender and gender diverse people, including gender affirming interventions (hormones, surgeries), human immunodeficiency virus (HIV) and sexually transmitted infections (STIs) testing, pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP). Multivariable regression was used to measure correlations between gender minority stress and access to health care service.
Results
Three hundred and twenty-four people completed a survey and data from 277 (85.5%) people were analyzed. The mean age was 29 years old (standard deviation [SD] = 8). Participants used hormones (118/277, 42.6%), gender affirming surgery (26/277, 9.4%), HIV testing (220/277, 79.4%), STI testing (132/277, 47.7%), PrEP (24/276, 8.7%), and PEP (29/267, 10.9%). Using gender affirming hormones was associated with higher levels of discrimination (adjusted odds ratio [aOR] 1.41, 95% confidence interval [CI] 1.17–1.70) and internalized transphobia (aOR 1.06, 95%CI 1.00–1.12). STI testing was associated with lower levels of internalized transphobia (aOR 0.91, 95%CI 0.84–0.98).
Conclusions
Our data suggest that gender minority stress is closely related to using health services. Stigma reduction interventions and gender-affirming medical support are needed to improve transgender health.
Læs mere Tjek på PubMedKoen B. Pouwels, Emma Pritchard, Philippa C. Matthews, Nicole Stoesser, David W. Eyre, Karina-Doris Vihta, Thomas House, Jodie Hay, John I. Bell, John N. Newton, Jeremy Farrar, Derrick Crook, Duncan Cook, Emma Rourke, Ruth Studley, Tim E. A. Peto, Ian Diamond, A. Sarah Walker
Nature, 14.10.2021
Tilføjet 14.10.2021
Nature Medicine, Published online: 14 October 2021; doi:10.1038/s41591-021-01548-7
A large, community-based study in the United Kingdom indicates that the effectiveness of BNT162b2 and ChAdOx1 vaccines against SARS-CoV-2 infections with symptoms or high viral burden is reduced with the Delta variant compared to the Alpha variant.
Læs mere Tjek på PubMedTerence Nolan, Alexandre C. Fortanier, Brett Leav, Airi Põder, Lulu C. Bravo, Henryk T. Szymański, Marten Heeringa, Wim Vermeulen, Vince Matassa, Igor Smolenov, Jonathan M. Edelman
New England Journal of Medicine, 13.10.2021
Tilføjet 14.10.2021
New England Journal of Medicine, Volume 385, Issue 16, Page 1485-1495, October 2021.
Læs mere Tjek på PubMedGeorge R. Thompson, Jo-Anne H. Young
New England Journal of Medicine, 13.10.2021
Tilføjet 14.10.2021
New England Journal of Medicine, Volume 385, Issue 16, Page 1496-1509, October 2021.
Læs mere Tjek på PubMedEric J. Rubin, Lindsey R. Baden, Katherine J. Wu, Stephen Morrissey
New England Journal of Medicine, 13.10.2021
Tilføjet 14.10.2021
New England Journal of Medicine, 13.10.2021
Tilføjet 14.10.2021
New England Journal of Medicine, 13.10.2021
Tilføjet 14.10.2021
Shuyi Fang, Sheng Liu, Jikui Shen, Alex Z Lu, Audrey K. Y. Wang, Yucheng Zhang, Kailing Li, Juli Liu, Lei Yang, Chang‐Deng Hu, Jun Wan
Journal of Medical Virology, 13.10.2021
Tilføjet 14.10.2021
Saverio Marchi, Gianluca Morroni, Paolo Pinton, Lorenzo Galluzzi
Trends in Microbiology, 13.10.2021
Tilføjet 14.10.2021
Mitochondria control various processes that are integral to cellular and organismal homeostasis, including Ca2+ fluxes, bioenergetic metabolism, and cell death. Perhaps not surprisingly, multiple pathogenic bacteria have evolved strategies to subvert mitochondrial functions in support of their survival and dissemination. Here, we discuss nonimmunological pathogenic mechanisms that converge on the ability of bacteria to control the mitochondrial compartment of host cells.
Læs mere Tjek på PubMedMalaria Journal, 13.10.2021
Tilføjet 14.10.2021
Abstract
Background
Despite the growing evidence that malaria and anaemia are two interlinked health problems of school-aged children (SAC) in developing countries, there is scarce information about malaria among SAC in Ethiopia. Moreover, anaemia-related studies were more concentrated in easily accessible areas. This study aimed to assess the prevalence of malaria and anaemia and corresponding risk factors among SAC in Dara Mallo and Uba Debretshay districts, in hard to reach areas, so as to inform appropriate integrated interventions for both diseases.
Methods
This study was part of baseline data collected for a cluster-randomized trial registered in Pan African Clinical Trials Registry (PACTR202001837195738). Data were collected from 2167 SAC and their households through face-to-face interview; malaria was diagnosed by using rapid diagnostic test (RDT); haemoglobin concentration was determined using hemoCue hb 301 and adjusted for altitude to determine anaemic status; helminth infections were determined by using kato-katz, and anthropometric measurements were made to determine nutritional status of children. Generalized mixed effects logistic regression model was used to assess the association between predictor variables and malaria and anaemia using school as a random variable.
Results
The overall prevalence of malaria was 1.62% (95% CI 1.15–2.27%) (35/2167). Of the 35 children positive for malaria, 20 (57.14%), 3 (8.57%) and 12 (34.29%) were due to Plasmodium falciparum, Plasmodium vivax and mixed infections of P. falciparum and P. vivax, respectively. Malaria was significantly lower among children from literate household head (Adjusted OR = 0.38; 95% CI 0.15–0.95) and residence house located at an altitude range above 1100 masl (AOR = 0.40; 95% CI 0.17–0.94). The prevalence of anaemia was 22.00% (95% CI 20.3–23.8%) (477/2167) and was significantly reduced by eating legumes, nuts or seed group of food in their 24-h dietary diversity recall (AOR = 0.64; 95% CI 0.41–0.99).
Conclusions
The prevalence of malaria was low and unevenly distributed per school while the overall prevalence of anaemia was moderate. It is important to implement integrated interventions targeting both malaria and anaemia, with special emphasis given to children from illiterate households and living at an altitude below 1100 masl. The micronutrient content of locally grown legumes should be further investigated to recommend specific interventions to overcome anaemia.
Læs mere Tjek på PubMedMalaria Journal, 13.10.2021
Tilføjet 14.10.2021
Abstract
Artemisinin resistance has emerged and spread in the Greater Mekong Sub-region (GMS), followed by artemisinin-based combination therapy failure, due to both artemisinin and partner drug resistance. More worrying, artemisinin resistance has been recently reported and confirmed in Rwanda. Therefore, there is an urgent need to strengthen surveillance systems beyond the GMS to track the emergence or spread of artemisinin and partner drug resistance in other endemic settings. Currently, anti-malarial drug efficacy is monitored primarily through therapeutic efficacy studies (TES). Even though essential for anti-malarial drug policy change, these studies are difficult to conduct, expensive, and may not detect the early emergence of resistance. Additionally, results from TES may take years to be available to the stakeholders, jeopardizing their usefulness. Molecular markers are additional and useful tools to monitor anti-malarial drug resistance, as samples collected on dried blood spots are sufficient to monitor known and validated molecular markers of resistance, and could help detecting and monitoring the early emergence of resistance. However, molecular markers are not monitored systematically by national malaria control programmes, and are often assessed in research studies, but not in routine surveillance. The implementation of molecular markers as a routine tool for anti-malarial drug resistance surveillance could greatly improve surveillance of anti-malarial drug efficacy, making it possible to detect resistance before it translates to treatment failures. When possible, ex vivo assays should be included as their data could be useful complementary, especially when no molecular markers are validated.
Læs mere Tjek på PubMedTessel M. van Rossen, Rogier E. Ooijevaar, Christina M.J.E. Vandenbroucke-Grauls, Olaf M. Dekkers, Ed.J. Kuijper, Josbert J. Keller, Joffrey van Prehn
Clinical Microbiology and Infection, 13.10.2021
Tilføjet 13.10.2021
Clostridioides difficile infection (CDI), its subsequent recurrences (rCDI), and severe CDI (sCDI) provide a significant burden for both patients and the healthcare system. Identifying patients diagnosed with initial CDI who are at increased risk of developing sCDI/rCDI could lead to more cost-effective therapeutic choices.
Læs mere Tjek på PubMedTiina Savikangas, Timo Törmäkangas, Anna Tirkkonen, Markku Alen, Roger A. Fielding, Miia Kivipelto, Timo Rantalainen, Anna Stigsdotter Neely, Sarianna Sipilä
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Tiina Savikangas, Timo Törmäkangas, Anna Tirkkonen, Markku Alen, Roger A. Fielding, Miia Kivipelto, Timo Rantalainen, Anna Stigsdotter Neely, Sarianna Sipilä
Background Executive functions underlie self-regulation and are thus important for physical activity and adaptation to new situations. The aim was to investigate, if yearlong physical and cognitive training (PTCT) had greater effects on physical activity among older adults than physical training (PT) alone, and if executive functions predicted physical activity at baseline, after six (6m) and twelve months (12m) of the interventions, one-year post-intervention follow-up and an extended follow-up during COVID-19 lockdown.
Methods Data from a single-blinded, parallel-group randomized controlled trial (PASSWORD-study, ISRCTN52388040) were utilized. Participants were 70–85 years old community-dwelling men and women from Jyväskylä, Finland. PT (n = 159) included supervised resistance, walking and balance training, home-exercises and self-administered moderate activity. PTCT (n = 155) included PT and cognitive training targeting executive functions on a computer program. Physical activity was assessed with a one-item, seven-scale question. Executive functions were assessed with color-word Stroop, Trail Making Test (TMT) B-A and Letter Fluency. Changes in physical activity were modeled with multinomial logistic models and the impact of executive functions on physical activity with latent change score models.
Results No significant group-by-time interaction was observed for physical activity (p>0.1). The subjects were likely to select an activity category higher than baseline throughout the study (pooled data: B = 0.720–1.614, p<0.001–0.046). Higher baseline Stroop predicted higher physical activity through all subsequent time-points (pooled data: B = 0.011–0.013, p = 0.015–0.030). Higher baseline TMT B–A predicted higher physical activity at 6m (pooled data: B = 0.007, p = 0.006) and during COVID-19 (B = 0.005, p = 0.030). In the PT group, higher baseline Letter Fluency predicted higher physical activity at 12m (B = -0.028, p = 0.030) and follow-up (B = -0.042, p = 0.002).
Conclusions Cognitive training did not have additive effects over physical training alone on physical activity, but multicomponent training and higher executive function at baseline may support adaptation to and maintenance of a physically active lifestyle among older adults.
Læs mere Tjek på PubMedSayuri Herath, Thivya Balendran, Akila Herath, Devika Iddawela, Susiji Wickramasinghe
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Sayuri Herath, Thivya Balendran, Akila Herath, Devika Iddawela, Susiji Wickramasinghe
Background Trichomonas vaginalis infection is underreported due to nonspecific clinical presentation and the nonavailability of sensitive laboratory diagnostic tests at the clinical setup. Hence, this study was designed to compare the sensitivity and specificity of microscopy and culture methods with polymerase chain reaction (PCR). The socio-demographic factors associated with the infection were explored.
Methods The study was carried out at the National Sexually Transmitted Diseases and Acquired Immuno Deficiency Syndrome Control Programme in Colombo and Sexually Transmitted Diseases and Acquired Immuno Deficiency Syndrome Control Programme in Kandy. Samples were collected from a total of 385 patients including, 272 females (70.7%) and 113 males (29.3%), and tested using microscopy (wet mount and Giemsa staining), culture, and PCR. Genus-specific primer set (TFR1/TFR2) that amplifies 5.8S rRNA and species-specific primer sets (TV16Sf-2/TV16Sr-2 and TVK3/7) that amplifies 18S rRNA and repetitive DNA, respectively, were used. Patient’s socio-demographic and sexual behaviour data were obtained using a standard interviewer-administered questionnaire. Data were analyzed with R statistical software Version 3.6.3.
Results The overall prevalence of trichomoniasis was 4.4% (17/385). Of these, six (1.6%) were positive for microscopic examination, 7 (1.8%) were positive for culture, and 13 (3.4%) for TVK3/7, 15 (3.9%) for TV16Sf/r, and TFR1/2 17 (4.4%) were positive for PCR. Sensitivities of PCR using TFR1/2, TV16Sf/r, and TVK3/7 primer sets were 100%, 88.20%, and 76.50%, respectively, against the expanded gold standard. Trichomoniasis was associated with age above 36 (p = 0.033), not using condoms in last three months (p = 0.016), multiple sex partners (p = 0.001), reason for attendance (p = 0.027), symptomatic nature (p = 0.015), and the presence of other sexually transmitted diseases (p = 0.001).
Conclusions The study highlighted that age over 36 years, multiple sex partners, not using condoms, reason for attendance, symptomatic nature, and having other sexually transmitted diseases can increase the risk of acquiring trichomoniasis. Furthermore, this study confirmed PCR as highly sensitive and specific diagnostic test for the diagnosis of trichomoniasis in comparison to microscopy and culture methods.
Læs mere Tjek på PubMedEd Giesbrecht, Julie Faieta, Krista Best, François Routhier, William C. Miller, Maude Laberge
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Ed Giesbrecht, Julie Faieta, Krista Best, François Routhier, William C. Miller, Maude Laberge
Background Variable, and typically inadequate, delivery of skills training following manual wheelchair (MWC) provision has a detrimental impact on user mobility and participation. Traditional in-person delivery of training by rehabilitation therapists has diminished due to cost, travel time, and most recently social distancing restrictions due to COVID-19. Effective alternative training approaches include eHealth home training applications and interactive peer-led training using experienced and proficient MWC users. An innovative TEAM Wheels program integrates app-based self-training and teleconference peer-led training using a computer tablet platform.
Objective This protocol outlines implementation and evaluation of the TEAM Wheels training program in a randomized control trial using a wait-list control group.
Setting The study will be implemented in a community setting in three Canadian cities.
Participants Individuals ≥ 18 years of age within one year of transitioning to use of a MWC.
Intervention Using a computer tablet, participants engage in three peer-led teleconference training sessions and 75–150 minutes of weekly practice using a video-based training application over 4 weeks. Peer trainers individualize the participants’ training plans and monitor their tablet-based training activity online. Control group participants also receive the intervention following a 1-month wait-list period and data collection.
Measurements Outcomes assessing participation; skill capacity and performance; self-efficacy; mobility; and quality of life will be measured at baseline and post-treatment, and at 6-month follow-up for the treatment group.
Impact statement We anticipate that TEAM Wheels will be successfully carried out at all sites and participants will demonstrate statistically significant improvement in the outcome measures compared with the control group.
Læs mere Tjek på PubMedBrittany A. Seibert, Michael K. Keel, Terra R. Kelly, Roger A. Nilsen, Paula Ciembor, Denise Pesti, Christopher R. Gregory, Branson W. Ritchie, Michelle G. Hawkins
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Brittany A. Seibert, Michael K. Keel, Terra R. Kelly, Roger A. Nilsen, Paula Ciembor, Denise Pesti, Christopher R. Gregory, Branson W. Ritchie, Michelle G. Hawkins
Chlamydial infections, caused by a group of obligate, intracellular, gram-negative bacteria, have health implications for animals and humans. Due to their highly infectious nature and zoonotic potential, staff at wildlife rehabilitation centers should be educated on the clinical manifestations, prevalence, and risk factors associated with Chlamydia spp. infections in raptors. The objectives of this study were to document the prevalence of chlamydial DNA shedding and anti-chlamydial antibodies in raptors admitted to five wildlife rehabilitation centers in California over a one-year period. Chlamydial prevalence was estimated in raptors for each center and potential risk factors associated with infection were evaluated, including location, species, season, and age class. Plasma samples and conjunctiva/choana/cloaca swabs were collected for serology and qPCR from a subset of 263 birds of prey, representing 18 species. Serologic assays identified both anti-C. buteonis IgM and anti-chlamydial IgY antibodies. Chlamydial DNA and anti-chlamydial antibodies were detected in 4.18% (11/263) and 3.14% (6/191) of patients, respectively. Chamydial DNA was identified in raptors from the families Accipitridae and Strigidae while anti-C.buteonis IgM was identified in birds identified in Accipitridae, Falconidae, Strigidae, and Cathartidae. Two of the chlamydial DNA positive birds (one Swainson’s hawk (Buteo swainsoni) and one red-tailed hawk (Buteo jamaicensis)) were necropsied, and tissues were collected for culture. Sequencing of the cultured elementary bodies revealed a chlamydial DNA sequence with 99.97% average nucleotide identity to the recently described Chlamydia buteonis. Spatial clusters of seropositive raptors and raptors positive for chlamydial DNA were detected in northern California. Infections were most prevalent during the winter season. Furthermore, while the proportion of raptors testing positive for chlamydial DNA was similar across age classes, seroprevalence was highest in adults. This study questions the current knowledge on C. buteonis host range and highlights the importance of further studies to evaluate the diversity and epidemiology of Chlamydia spp. infecting raptor populations.
Læs mere Tjek på PubMedAdriana Rezende Lopes, Oscar Kenji Nihei
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Adriana Rezende Lopes, Oscar Kenji Nihei
Background The COVID-19 pandemic raises concerns about the mental health of the world population. Protection measures to prevention the disease impacted education and undergraduate students were exposed to additional stressors.
Objectives Analyze depression, anxiety and stress symptoms in undergraduates, their respective predictors and the association with satisfaction with life, psychological well-being and coping strategies.
Methods An online cross-sectional study was conducted from September 14 to October 19, 2020, involving undergraduate students enrolled in 33 courses from 5 public university campuses in the state of Parana, Brazil, using: questionnaire with sociodemographic, academic, health and pandemic effects variables; Depression, Anxiety and Stress Scale-21 (DASS-21); Satisfaction with Life Scale (SWLS); Psychological Well-Being (PWB); BriefCOPE. The convenience sample was composed of 1,224 participants, with 18 years old or older, that completed all research instruments. Spearman correlation and logistic analysis (univariate and multivariate) were applied to the collected data.
Results Most of the undergraduates presented symptoms of depression (60.5%), anxiety (52.5%) and stress (57.5%). Depression, anxiety and stress presented significant correlations in common: negative with satisfaction with life, all dimensions of psychological well-being, and 3 adaptive copings (active coping, planning, positive reframing); positive with 5 maladaptive copings (behavioral disengagement, denial, self-blame, self-distraction, substance use). In addition, there were 7 common predictors for symptoms of depression, anxiety and stress: female; age 18–24 years old; having a chronic disease; lower scores in 2 dimensions of psychological well-being (positive relations with others, self-acceptance); higher scores in 2 maladaptive copings (self-blame, substance use).
Conclusions The data indicate a high prevalence of symptoms of depression, anxiety and stress, and suggest that higher scores of satisfaction with life, psychological well-being dimensions and adaptive copings may present protective effects in undergraduates during a pandemic crisis.
Læs mere Tjek på PubMedRhiannon Phillips, Khadijeh Taiyari, Anna Torrens-Burton, Rebecca Cannings-John, Denitza Williams, Sarah Peddle, Susan Campbell, Kathryn Hughes, David Gillespie, Paul Sellars, Bethan Pell, Pauline Ashfield-Watt, Ashley Akbari, Catherine Heidi Seage, Nick Perham, Natalie Joseph-Williams, Emily Harrop, James Blaxland, Fiona Wood, Wouter Poortinga, Karin Wahl-Jorgensen, Delyth H. James, Diane Crone, Emma Thomas-Jones, Britt Hallingberg
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Rhiannon Phillips, Khadijeh Taiyari, Anna Torrens-Burton, Rebecca Cannings-John, Denitza Williams, Sarah Peddle, Susan Campbell, Kathryn Hughes, David Gillespie, Paul Sellars, Bethan Pell, Pauline Ashfield-Watt, Ashley Akbari, Catherine Heidi Seage, Nick Perham, Natalie Joseph-Williams, Emily Harrop, James Blaxland, Fiona Wood, Wouter Poortinga, Karin Wahl-Jorgensen, Delyth H. James, Diane Crone, Emma Thomas-Jones, Britt Hallingberg
Public perceptions of pandemic viral threats and government policies can influence adherence to containment, delay, and mitigation policies such as physical distancing, hygienic practices, use of physical barriers, uptake of testing, contact tracing, and vaccination programs. The UK COVID-19 Public Experiences (COPE) study aims to identify determinants of health behaviour using the Capability, Opportunity, Motivation (COM-B) model using a longitudinal mixed-methods approach. Here, we provide a detailed description of the demographic and self-reported health characteristics of the COPE cohort at baseline assessment, an overview of data collected, and plans for follow-up of the cohort. The COPE baseline survey was completed by 11,113 UK adult residents (18+ years of age). Baseline data collection started on the 13th of March 2020 (10-days before the introduction of the first national COVID-19 lockdown in the UK) and finished on the 13th of April 2020. Participants were recruited via the HealthWise Wales (HWW) research registry and through social media snowballing and advertising (Facebook®, Twitter®, Instagram®). Participants were predominantly female (69%), over 50 years of age (68%), identified as white (98%), and were living with their partner (68%). A large proportion (67%) had a college/university level education, and half reported a pre-existing health condition (50%). Initial follow-up plans for the cohort included in-depth surveys at 3-months and 12-months after the first UK national lockdown to assess short and medium-term effects of the pandemic on health behaviour and subjective health and well-being. Additional consent will be sought from participants at follow-up for data linkage and surveys at 18 and 24-months after the initial UK national lockdown. A large non-random sample was recruited to the COPE cohort during the early stages of the COVID-19 pandemic, which will enable longitudinal analysis of the determinants of health behaviour and changes in subjective health and well-being over the course of the pandemic.
Læs mere Tjek på PubMedJ. E. Meca-Lallana, C. Oreja-Guevara, D. Muñoz, J. Olascoaga, A. Pato, L. Ramió-Torrentà, V. Meca-Lallana, M. A. Hernández, M. E. Marzo, J. C. Álvarez- Cermeño, A. Rodríguez-Antigüedad, X. Montalbán, O. Fernández, on behalf of the Spanish GILENYA Registry Investigators
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by J. E. Meca-Lallana, C. Oreja-Guevara, D. Muñoz, J. Olascoaga, A. Pato, L. Ramió-Torrentà, V. Meca-Lallana, M. A. Hernández, M. E. Marzo, J. C. Álvarez- Cermeño, A. Rodríguez-Antigüedad, X. Montalbán, O. Fernández, on behalf of the Spanish GILENYA Registry Investigators
Objective To describe the profile of patients with multiple sclerosis (MS) treated with fingolimod in Spain and to assess the effectiveness and safety of fingolimod after 4 years of inclusion in the Spanish Gilenya Registry.
Methods An observational, retrospective/prospective, multicenter case registry, including all patients with relapsing-remitting MS (RRMS) starting treatment with fingolimod in 43 centers in Spain. Analyses were performed in the overall population and in subgroups according to prior disease-modifying therapy (DMT): glatiramer acetate/interferon beta-1 (BRACE), natalizumab, other treatment, or naïve.
Results Six hundred and sixty-six evaluable patients were included (91.1% previously treated with at least one DMT). The mean annualized relapse rate (ARR) prior to fingolimod was 1.12, and the mean EDSS at fingolimod initiation was 3.03. Fingolimod reduced the ARR by 71.4%, 75%, 75.5%, and 80.3%, after 1, 2, 3 and 4 years, respectively (p<0.001). This significant reduction in the ARR continued to be observed in all subgroups. After 4 years, the EDSS showed a minimal deterioration, with the EDSS scores from year 1 to year 4 remaining mostly stable. The percentage of patients without T1 Gd+ lesions progressively increased from 45.6% during the year prior to fingolimod initiation to 88.2% at year 4. The proportion of patients free from new/enlarged T2 lesions after 4 years of fingolimod treatment was 80.3%. This trend in both radiological measures was also observed in the subgroups. Adverse events (AEs) were experienced by up to 41.6% of patients (most commonly: lymphopenia [12.5%] and urinary tract infection [3.7%]). Most AEs were mild in severity, 3.6% of patients had serious AEs.
Conclusions The patient profile was similar to other observational studies. The results obtained from the long-term use of fingolimod showed that it was effective, regardless of prior DMT, and it had adequate safety results, with a positive benefit-risk balance.
Læs mere Tjek på PubMedVinicius S. Michaelsen, Rafaela V. P. Ribeiro, Edson Brambate, Aadil Ali, Aizhou Wang, Layla Pires, Mitsuaki Kawashima, Yu Zhang, Anajara Gazzalle, Shaf Keshavjee, Lorenzo Del Sorbo, Marcelo Cypel
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Vinicius S. Michaelsen, Rafaela V. P. Ribeiro, Edson Brambate, Aadil Ali, Aizhou Wang, Layla Pires, Mitsuaki Kawashima, Yu Zhang, Anajara Gazzalle, Shaf Keshavjee, Lorenzo Del Sorbo, Marcelo Cypel
Effective treatment of respiratory infections continues to be a major challenge. In high doses (≥160 ppm), inhaled Nitric Oxide (iNO) has been shown to act as a broad-spectrum antimicrobial agent, including its efficacy in vitro for coronavirus family. However, the safety of prolonged in vivo implementation of high-dose iNO therapy has not been studied. Herein we aim to explore the feasibility and safety of delivering continuous high-dose iNO over an extended period of time using an in vivo animal model. Yorkshire pigs were randomized to one of the following two groups: group 1, standard ventilation; and group 2, standard ventilation + continuous iNO 160 ppm + methylene blue (MB) as intravenous bolus, whenever required, to maintain metHb
Læs mere Tjek på PubMedJavier Barbero, Juan José de Lucio, Ernesto Rodríguez-Crespo
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Javier Barbero, Juan José de Lucio, Ernesto Rodríguez-Crespo
This paper examines the impact of COVID-19 on bilateral trade flows using a state-of-the-art gravity model of trade. Using the monthly trade data of 68 countries exporting across 222 destinations between January 2019 and October 2020, our results are threefold. First, we find a greater negative impact of COVID-19 on bilateral trade for those countries that were members of regional trade agreements before the pandemic. Second, we find that the impact of COVID-19 is negative and significant when we consider indicators related to governmental actions. Finally, this negative effect is more intense when exporter and importer country share identical income levels. In the latter case, the highest negative impact is found for exports between high-income countries.
Læs mere Tjek på PubMedPhoebe E. McKenna-Plumley, Lisa Graham-Wisener, Emma Berry, Jenny M. Groarke
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Phoebe E. McKenna-Plumley, Lisa Graham-Wisener, Emma Berry, Jenny M. Groarke
The COVID-19 pandemic has necessitated physical distancing which is expected to continue in some form for the foreseeable future. Physical distancing policies have increased reliance on digital forms of social connection and there are widespread concerns about social isolation and mental health in this context. This qualitative study sought to understand how loneliness was experienced during physical distancing in the initial national UK COVID-19 lockdown. Eight individuals who reported feeling lonely during the initial lockdown were interviewed in May 2020. Interviews were analysed using reflexive thematic analysis. Four main themes were identified: (1) Loss of in-person interaction causing loneliness, (2) Constrained freedom, (3) Challenging emotions, and (4) Coping with loneliness. The loss of in-person interaction contributed to feelings of loneliness and digital interaction was viewed as an insufficient alternative. Social freedom could be constrained by distancing policies and by social contacts, contributing to strained personal relationships and feelings of frustration as part of loneliness. Fluctuations in mood and difficult emotions were experienced alongside loneliness, and distraction and seeking reconnection were commonly reported methods of coping, although they were less accessible. These findings indicate that physical distancing measures can impact loneliness due to the limitations they impose on in-person social contact and the perceived insufficiency of digital contact as a substitute.
Læs mere Tjek på PubMedJacquelyn Jacobs, Amy K. Johnson, Arianna Boshara, Bijou Hunt, Christina Khouri, Javier Cruz, Nancy Glick
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Jacquelyn Jacobs, Amy K. Johnson, Arianna Boshara, Bijou Hunt, Christina Khouri, Javier Cruz, Nancy Glick
Millions of Americans have been infected with COVID-19 and communities of color have been disproportionately burdened. We investigated the relationship between demographic characteristics and COVID-19 positivity, and comorbidities and severe COVID-19 illness (use of mechanical ventilation and length of stay) within a racial/ethnic minority population. Patients tested for COVID-19 between March 2020 and January 2021 (N = 14171) were 49.9% (n = 7072) female; 50.1% (n = 7104) non-Hispanic Black; 33.2% (n = 4698) Hispanic; and 23.6% (n = 3348) aged 65+. Overall COVID-19 positivity was 16.1% (n = 2286). Compared to females, males were 1.1 times more likely to test positive (p = 0.014). Compared to non-Hispanic Whites, non-Hispanic Black and Hispanic persons were 1.4 (p = 0.003) and 2.4 (p<0.001) times more likely, respectively, to test positive. Compared to persons ages 18–24, the odds of testing positive were statistically significantly higher for every age group except 25–34, and those aged 65+ were 2.8 times more likely to test positive (p<0.001). Adjusted for race, sex, and age, COVID-positive patients with chronic obstructive pulmonary disease were 1.9 times more likely to require a ventilator compared to those without chronic obstructive pulmonary disease (p = 0.001). Length of stay was not statistically significantly associated with any of the comorbidity variables. Our findings emphasize the importance of documenting COVID-19 disparities in marginalized populations.
Læs mere Tjek på PubMedShaima A. Alothman, Abdullah F. Alghannam, Alaa A. Almasud, Arwa S. Altalhi, Hazzaa M. Al-Hazzaa
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Shaima A. Alothman, Abdullah F. Alghannam, Alaa A. Almasud, Arwa S. Altalhi, Hazzaa M. Al-Hazzaa
Introduction COVID-19 pandemic cautionary measures have affected the daily life of people around the globe. Further, understanding the complete lifestyle behaviors profile can help healthcare providers in designing effective interventions and assessing overall health impact on risk of disease development. Thus, this study aims to assess the complete spectrum of lifestyle behaviors (physical activity, sedentary behavior, sleep, distress, social support, dietary habits, and smoking) prevalence and its association with fear of COVID-19 in people living in Saudi Arabia.
Methods Self-administered survey consisted of seven sections was used to collect data on fear of COVID-19 using Fear of COVID-19 Scale (FCV-19S), physical activity and sedentary behavior using the Global Physical Activity Questionnaire (GPAQ), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), psychosocial distress using Kessler Psychological Distress Scale (K-10), social support using the MOS social support survey, and dietary habits using a short version of food frequency questionnaire (FFQ). The online survey was distributed via social media platforms during lockdown period of COVID-19 pandemic (May–June 2020). Each section consisted of validated questionnaire examining one of aforementioned lifestyle behaviors. Associations were analyzed using multiple linear regression.
Results A total of 669 individuals attempted to complete the online survey, 554 participants completed at least 2 sections of the survey (82.8%), and 41.3% (n = 276) completed the whole online survey. The majority of the sample were female (83%), not smokers (86.5%), had sufficient sleep duration (7.5 hrs ± 2.1), and only indicated mild level of distress (21.4 ± 8.9); they also reported high level of sedentary behavior (7.7 hrs ± 4.5), poor sleep quality (5.4 ± 2.4), were not engaged in healthy eating habits, and moderate level of perceived social support (62.0% ± 27). Only physical activity results indicated that about half of the sample were engaged in moderate to vigorous level of physical activity (54.3%). Further, being female (β = 0.12; 95% CI: 0.45, 2.94) and married (β = 0.13; 95% CI: 0.3, 2.63) were associated with fear of COVID-19 level (β = 0.21; 95% IC: 0.05, 0.19) with a confidence interval level of 95%. In addition, distress was associated with fear.
Conclusion The trend of lifestyle behaviors measured during lockdown period changed from previously published rates. Future research needs to establish the short-term and long-term effect of lifestyle behaviors complete profile on physical and mental health.
Læs mere Tjek på PubMedLovisa Sjögren, Erik Stenberg, Meena Thuccani, Jari Martikainen, Christian Rylander, Ville Wallenius, Torsten Olbers, Jenny M. Kindblom
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Lovisa Sjögren, Erik Stenberg, Meena Thuccani, Jari Martikainen, Christian Rylander, Ville Wallenius, Torsten Olbers, Jenny M. Kindblom
Background Previous studies have shown that a high body mass index (BMI) is a risk factor for severe COVID-19. The aim of the present study was to assess whether a high BMI affects the risk of death or prolonged length of stay (LOS) in patients with COVID-19 during intensive care in Sweden.
Methods and findings In this observational, register-based study, we included patients with COVID-19 from the Swedish Intensive Care Registry admitted to intensive care units (ICUs) in Sweden. Outcomes assessed were death during intensive care and ICU LOS ≥14 days. We used logistic regression models to evaluate the association (odds ratio [OR] and 95% confidence interval [CI]) between BMI and the outcomes. Valid weight and height information could be retrieved in 1,649 patients (1,227 (74.4%) males) with COVID-19. We found a significant association between BMI and the risk of the composite outcome death or LOS ≥14 days in survivors (OR per standard deviation [SD] increase 1.30, 95%CI 1.16–1.44, adjusted for sex, age and comorbidities), and this association remained after further adjustment for severity of illness (simplified acute physiology score; SAPS3) at ICU admission (OR 1.30 per SD, 95%CI 1.17–1.45). Individuals with a BMI ≥ 35 kg/m2 had a doubled risk of the composite outcome. A high BMI was also associated with death during intensive care and a prolonged LOS in survivors assessed as separate outcomes.The main limitations were the restriction to the first wave of the pandemic, and the lack of information on socioeconomic status as well as smoking.
Conclusions In this large cohort of Swedish ICU patients with COVID-19, a high BMI was associated with increasing risk of death and prolonged length of stay in the ICU. Based on our findings, we suggest that individuals with obesity should be more closely monitored when hospitalized for COVID-19.
Læs mere Tjek på PubMedUjjala Ghoshal, Atul Garg, Shruthi Vasanth, Akshay K. Arya, Ankita Pandey, Nidhi Tejan, Vikas Patel, Vikram P. Singh
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Ujjala Ghoshal, Atul Garg, Shruthi Vasanth, Akshay K. Arya, Ankita Pandey, Nidhi Tejan, Vikas Patel, Vikram P. Singh
COVID-19 testing is required before admission of a patient in the hospitals, invasive procedures, major and minor surgeries etc. Real Time Polymerase chain reaction is the gold standard test for the diagnosis, but requires well equipped biosafety laboratory along with trained manpower. In this study we have evaluated the diagnostic accuracy of novel TrueNat molecular assay for detecting SARS CoV-2. TrueNat is a chip-based real time PCR test and works on portable, light weight, battery powered equipment and can be used in remote areas with poor infrastructure. In this study 1807 patients samples were collected for both TrueNat and RTPCR COVID-19 testing during study period. Of these 174 (9.7%) and 174 (15%) were positive by RTPCR and TrueNat respectively and taking results of RTPCR as gold standard TrueNat test showed a sensitivity, specificity and diagnostic accuracy of 69.5, 90.9% and 89.2% respectively. It can be concluded that TrueNat is a simple, easy to use, good rapid molecular diagnostic test for diagnosis of COVID-19 especially in resource limited settings and will prove to be a game changer of molecular diagnostics in future.
Læs mere Tjek på PubMedKathryn Buchanan, Lara B. Aknin, Shaaba Lotun, Gillian M. Sandstrom
PLoS One Infectious Diseases, 13.10.2021
Tilføjet 13.10.2021
by Kathryn Buchanan, Lara B. Aknin, Shaaba Lotun, Gillian M. Sandstrom
People often seek out information as a means of coping with challenging situations. Attuning to negative information can be adaptive because it alerts people to the risks in their environment, thereby preparing them for similar threats in the future. But is this behaviour adaptive during a pandemic when bad news is ubiquitous? We examine the emotional consequences of exposure to brief snippets of COVID-related news via a Twitter feed (Study 1), or a YouTube reaction video (Study 2). Compared to a no-information exposure group, consumption of just 2–4 minutes of COVID-related news led to immediate and significant reductions in positive affect (Studies 1 and 2) and optimism (Study 2). Exposure to COVID-related kind acts did not have the same negative consequences, suggesting that not all social media exposure is detrimental for well-being. We discuss strategies to counteract the negative emotional consequences of exposure to negative news on social media.
Læs mere Tjek på PubMedInfection, 12.10.2021
Tilføjet 13.10.2021
Abstract
Purpose
Over the course of COVID-19 pandemic, evidence has accumulated that SARS-CoV-2 infections may affect multiple organs and have serious clinical sequelae, but on-site clinical examinations with non-hospitalized samples are rare. We, therefore, aimed to systematically assess the long-term health status of samples of hospitalized and non-hospitalized SARS-CoV-2 infected individuals from three regions in Germany.
Methods
The present paper describes the COVIDOM-study within the population-based cohort platform (POP) which has been established under the auspices of the NAPKON infrastructure (German National Pandemic Cohort Network) of the national Network University Medicine (NUM). Comprehensive health assessments among SARS-CoV-2 infected individuals are conducted at least 6 months after the acute infection at the study sites Kiel, Würzburg and Berlin. Potential participants were identified and contacted via the local public health authorities, irrespective of the severity of the initial infection. A harmonized examination protocol has been implemented, consisting of detailed assessments of medical history, physical examinations, and the collection of multiple biosamples (e.g., serum, plasma, saliva, urine) for future analyses. In addition, patient-reported perception of the impact of local pandemic-related measures and infection on quality-of-life are obtained.
Results
As of July 2021, in total 6813 individuals infected in 2020 have been invited into the COVIDOM-study. Of these, about 36% wished to participate and 1295 have already been examined at least once.
Conclusion
NAPKON-POP COVIDOM-study complements other Long COVID studies assessing the long-term consequences of an infection with SARS-CoV-2 by providing detailed health data of population-based samples, including individuals with various degrees of disease severity.
Trial registration
Registered at the German registry for clinical studies (DRKS00023742).
Læs mere Tjek på PubMedFalk, R. S., Mariampillai, J. E., Prestgaard, E. E., Heir, T., Bodegard, J., Robsahm, T. E., Grundvold, I., Skretteberg, P. T., Engeseth, K., Bjornholt, J. V., Stavem, K., Liestol, K., Sandvik, L., Thaulow, E., Erikssen, G., Kjeldsen, S. E., Gjesdal, K., Erikssen, J. E.
BMJ Open, 13.10.2021
Tilføjet 13.10.2021
Purpose
The Oslo Ischaemia Study was designed to investigate the prevalence and predictors of silent coronary disease in Norwegian middle-aged men, specifically validating exercise electrocardiography (ECG) findings compared with angiography. The study has been important in investigating long-term predictors of cardiovascular morbidity and mortality, as well as investigating a broad spectrum of epidemiological and public health perspectives.
Participants
In 1972–1975, 2014 healthy men, 40–59 years old, were enrolled in the study. Comprehensive clinical examination included an ECG-monitored exercise test at baseline and follow-ups. The cohort has been re-examined four times during 20 years. Linkage to health records and national health registries has ensured complete endpoint registration of morbidity until the end of 2006, and cancer and mortality until the end of 2017.
Findings to date
The early study results provided new evidence, as many participants with a positive exercise ECG, but no chest pain (‘silent ischaemia’), did not have significant coronary artery stenosis after all. Still, they were over-represented with coronary disease after years of follow-up. Furthermore, participants with the highest physical fitness had lower risk of cardiovascular disease, and the magnitude of blood pressure responses to moderate exercise was shown to influence the risk of cardiovascular disease and mortality. With time, follow-up data allowed the scope of research to expand into other fields of medicine, with the aim of investigating predictors and the importance of lifestyle and risk factors.
Future plans
Recently, the Oslo Ischaemia Study has been found worthy, as the first scientific study, to be preserved by The National Archives of Norway. All the study material will be digitised, free to use and accessible for all. In 2030, the Oslo Ischaemia Study will be linked to the Norwegian Cause of Death Registry to obtain complete follow-up to death. Thus, a broad spectrum of additional opportunities opens.
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