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Elizabeth K. Serafin, Judy J. Yoo, Jie Li, Xinzhong Dong, Mark L. Baccei
PLoS One Infectious Diseases, 15.03.2024
Tilføjet 15.03.2024
by Elizabeth K. Serafin, Judy J. Yoo, Jie Li, Xinzhong Dong, Mark L. Baccei Recent transcriptomic studies identified Gucy2d (encoding guanylate cyclase D) as a highly enriched gene within inhibitory dynorphin interneurons in the mouse spinal dorsal horn. To facilitate investigations into the role of the Gucy2d+ population in somatosensation, Gucy2d-cre transgenic mice were created to permit chemogenetic or optogenetic manipulation of this subset of spinal neurons. Gucy2d-cre mice created via CRISPR/Cas9 genomic knock-in were bred to mice expressing a cre-dependent reporter (either tdTomato or Sun1.GFP fusion protein), and the resulting offspring were characterized. Surprisingly, a much wider population of spinal neurons was labeled by cre-dependent reporter expression than previous mRNA-based studies would suggest. Although the cre-dependent reporter expression faithfully labeled ~75% of cells expressing Gucy2d mRNA in the adult dorsal horn, it also labeled a substantial number of additional inhibitory neurons in which no Gucy2d or Pdyn mRNA was detected. Moreover, cre-dependent reporter was also expressed in various regions of the brain, including the spinal trigeminal nucleus, cerebellum, thalamus, somatosensory cortex, and anterior cingulate cortex. Injection of AAV-CAG-FLEX-tdTomato viral vector into adult Gucy2d-cre mice produced a similar pattern of cre-dependent reporter expression in the spinal cord and brain, which excludes the possibility that the unexpected reporter-labeling of cells in the deep dorsal horn and brain was due to transient Gucy2d expression during early stages of development. Collectively, these results suggest that Gucy2d is expressed in a wider population of cells than previously thought, albeit at levels low enough to avoid detection with commonly used mRNA-based assays. Therefore, it is unlikely that these Gucy2d-cre mice will permit selective manipulation of inhibitory signaling mediated by spinal dynorphin interneurons, but this novel cre driver line may nevertheless be useful to target a broader population of inhibitory spinal dorsal horn neurons.
Læs mere Tjek på PubMedAref Andishgar, Sina Bazmi, Reza Tabrizi, Maziyar Rismani, Omid Keshavarzian, Babak Pezeshki, Fariba Ahmadizar
PLoS One Infectious Diseases, 15.03.2024
Tilføjet 15.03.2024
by Aref Andishgar, Sina Bazmi, Reza Tabrizi, Maziyar Rismani, Omid Keshavarzian, Babak Pezeshki, Fariba Ahmadizar Background Factors contributing to the development of hypertension exhibit significant variations across countries and regions. Our objective was to predict individuals at risk of developing hypertension within a 5-year period in a rural Middle Eastern area. Methods This longitudinal study utilized data from the Fasa Adults Cohort Study (FACS). The study initially included 10,118 participants aged 35–70 years in rural districts of Fasa, Iran, with a follow-up of 3,000 participants after 5 years using random sampling. A total of 160 variables were included in the machine learning (ML) models, and feature scaling and one-hot encoding were employed for data processing. Ten supervised ML algorithms were utilized, namely logistic regression (LR), support vector machine (SVM), random forest (RF), Gaussian naive Bayes (GNB), linear discriminant analysis (LDA), k-nearest neighbors (KNN), gradient boosting machine (GBM), extreme gradient boosting (XGB), cat boost (CAT), and light gradient boosting machine (LGBM). Hyperparameter tuning was performed using various combinations of hyperparameters to identify the optimal model. Synthetic Minority Over-sampling Technology (SMOTE) was used to balance the training data, and feature selection was conducted using SHapley Additive exPlanations (SHAP). Results Out of 2,288 participants who met the criteria, 251 individuals (10.9%) were diagnosed with new hypertension. The LGBM model (determined to be the optimal model) with the top 30 features achieved an AUC of 0.67, an f1-score of 0.23, and an AUC-PR of 0.26. The top three predictors of hypertension were baseline systolic blood pressure (SBP), gender, and waist-to-hip ratio (WHR), with AUCs of 0.66, 0.58, and 0.63, respectively. Hematuria in urine tests and family history of hypertension ranked fourth and fifth. Conclusion ML models have the potential to be valuable decision-making tools in evaluating the need for early lifestyle modification or medical intervention in individuals at risk of developing hypertension.
Læs mere Tjek på PubMedDebora Glenda Lima de La‐Roque, Elaine Vieira Santos, Renata Aparecida Machado Oliveira, Svetoslav Nanev Slavov, Evandra S. Rodrigues, Vagner Fonseca, Antonio Jorge Martins, Denise Bergamaschi Giomo, Paula Marilia Afonso Torres, Danielle Cristina Dacanal Gentil, Erika Aparecida Catoia, Natalia do Carmo Chiquito, Alessandra Paula Silva Soares Medeiros, Aparecida Y. Yamamoto, Luzia Márcia Romanholi Passos, Rodrigo Tocantins Calado, Claudia Renata Dos Santos Barros, Maria Carolina Elias, Sandra Coccuzzo Sampaio, Marta Giovanetti, Luiz Carlos Junior Alcantara, Dimas T. Covas, Simone Kashima
Journal of Medical Virology, 14.03.2024
Tilføjet 14.03.2024
Infection, 14.03.2024
Tilføjet 14.03.2024
Abstract Purpose Group B streptococcus (GBS) colonizes the gastrointestinal and vaginal mucosa in healthy adults, but has also become an increasing cause of invasive infection. The aims of this study were to describe the incidence and factors associated with the occurrence of invasive GBS disease in adults in Norway. Methods We performed a nationwide retrospective case–control study of invasive GBS infections during 1996–2019, with two control groups; invasive Group A streptococcal disease (GAS) to control for changes in surveillance and diagnostics, and a second representing the general population. Results A total of 3710 GBS episodes were identified. The age-standardized incidence rate increased steadily from 1.10 (95% CI 0.80–1.50) in 1996 to 6.70 (95% CI 5.90–7.50) per 100,000 person-years in 2019. The incidence rate had an average annual increase of 6.44% (95% CI 5.12–7.78). Incidence rates of GAS varied considerably, and there was no evidence of a consistent change over the study period. GBS incidence was highest among adults > 60 years of age. Cardiovascular disease, cancer, and diabetes were the most common comorbid conditions. There was a shift in the distribution of capsular serotypes from three dominant types to more equal distribution among the six most common serotypes. Conclusions The incidence of invasive GBS disease in adults increased significantly from 1996 to 2019. The increasing age of the population with accompanying underlying comorbid conditions might contribute to the increasing burden of invasive GBS disease. Interestingly, type 1 diabetes was also associated with the occurrence of invasive GBS disease.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
Abstract Background Escherichia coli is a common fecal coliform, facultative aerobic, gram-negative bacterium. Pathogenic strains of such microbes have evolved to cause diarrhea, urinary tract infections, and septicemias. The emergence of antibiotic resistance urged the identification of an alternative strategy. The use of lytic bacteriophages against the control of pathogenic E. coli in clinics and different environmental setups (waste and drink water management) has become an alternative therapy to antibiotic therapy. Thus, this study aimed to isolate and characterize lytic bacteriophage from various sources in Addis Ababa, tested them against antimicrobial-resistant diarrheagenic E. coli strains and evaluated their therapeutic potential under in vitro conditions. Methods A total of 14 samples were processed against six different diarrheagenic E. coli strains. The conventional culture and plaque analysis agar overlay method was used to recover lytic bacteriophage isolates. The phage isolates were characterized to determine their lytic effect, growth characteristics, host range activity, and stability under different temperature and pH conditions. Phage isolates were identified by scanning electron microscope (SEM), and molecular techniques (PCR). Results In total, 17 phages were recovered from 84 tested plates. Of the 17 phage isolates, 11 (65%) were Myoviridae-like phages, and 6 (35%) phage isolates were Podoviridae and Siphoviridae by morphology and PCR identification. Based on the host range test, growth characteristics, and stability test 7 potent phages were selected. These phages demonstrated better growth characteristics, including short latent periods, highest burst sizes, and wider host ranges, as well as thermal stability and the ability to survive in a wide range of pH levels. Conclusions The promising effect of the phages isolated in this study against AMR pathogenic E. coli has raised the possibility of their use in the future treatment of E. coli infections.
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
Abstract Background Bats are a reservoir for many viruses causing haemorrhagic fevers. Proximity to bats is a risk factor for virus spillover to animals and humans. We conducted this study to assess knowledge, perceptions, and exposure to bats in communities living near bat roosts in Bundibugyo District, Uganda. Methods A cross-sectional study using mixed methods with both quantitative and qualitative data was conducted between September and December 2022. Participants for the quantitative data (survey) (n = 384) resided near bat caves and/or roost sites and were selected using multistage random sampling. The survey investigated participants’ prior exposure to bats, as well as knowledge and perceptions of bat exposure. Logistic regression was used to determine factors associated with bat exposure. Participants for the qualitative data (focus group discussions) (n = 10, 6–8 participants each) were purposely selected based on engagement in guano mining, hunting, and farming activities. Perceived risk associated with bat-related activities were identified and ranked in the focus group discussions using participatory epidemiology tools. Results In total, (214/384, 55.7%) had a history of bat exposure and (208/384, 54.2%) had poor knowledge of risk factors associated with bat exposure. Increased exposure to bats was associated with being male (OR = 1.6; 95% CI: 1.0, 2.4 p-value = 0.038), staying in urban areas (OR = 1.9; p-value = 0.010), hunting (OR = 10.9; p-value = 0.024), and positive perception to bat guano being safe as fertiliser (OR = 2.5; p-value = 0.045). During the proportional piling process, a total of 7 risk factors were identified by 10 groups with hunting during an outbreak and consumption of bats being the most frequently identified. Overall, there was a strong statistical agreement in the ranking across the 10 focus groups (W = 0.52; p
Læs mere Tjek på PubMedBMC Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
Abstract Background Early during the COVID-19 pandemic, it was important to better understand transmission dynamics of SARS-CoV-2, the virus that causes COVID-19. Household contacts of infected individuals are particularly at risk for infection, but delays in contact tracing, delays in testing contacts, and isolation and quarantine posed challenges to accurately capturing secondary household cases. Methods In this study, 346 households in the Seattle region were provided with respiratory specimen collection kits and remotely monitored using web-based surveys for respiratory illness symptoms weekly between October 1, 2020, and June 20, 2021. Symptomatic participants collected respiratory specimens at symptom onset and mailed specimens to the central laboratory in Seattle. Specimens were tested for SARS-CoV-2 using RT-PCR with whole genome sequencing attempted when positive. SARS-CoV-2-infected individuals were notified, and their household contacts submitted specimens every 2 days for 14 days. Results In total, 1371 participants collected 2029 specimens that were tested; 16 individuals (1.2%) within 6 households tested positive for SARS-CoV-2 during the study period. Full genome sequences were generated from 11 individuals within 4 households. Very little genetic variation was found among SARS-CoV-2 viruses sequenced from different individuals in the same household, supporting transmission within the household. Conclusions This study indicates web-based surveillance of respiratory symptoms, combined with rapid and longitudinal specimen collection and remote contact tracing, provides a viable strategy to monitor households and detect household transmission of SARS-CoV-2. Trial registration identifier NCT04141930, Date of registration 28/10/2019.
Læs mere Tjek på PubMedJournal of the American Medical Association, 14.03.2024
Tilføjet 14.03.2024
With recent advances in endovascular devices and techniques for the treatment of large-vessel occlusion (LVO) stroke, rates of successful recanalization are as high as 90%. While technologies may continue to improve, it would be unreasonable to anticipate significant gains in this measure of macroperfusion. Instead, efforts are increasingly turned toward neuroprotection and augmenting the microcirculation to promote tissue viability during acute cerebral ischemia. Adjunctive intra-arterial thrombolysis and the recombinant variant of human activated protein C (3K3A-APC) have shown promising preliminary results, but warrant additional validation. Inflammatory mechanisms following acute cerebral infarction are also the subject of much clinical research. Following acute ischemic stroke, there is robust activation of peripherally circulating and central immune cells that contribute to cytotoxic and vasogenic edema, leading to progressive tissue injury, hemorrhagic transformation, and ultimately poorer clinical outcomes. The evidence that heightened acute inflammation mediates poor outcomes following infarction is also supported by evidence suggesting potential benefit of anti-inflammatory treatments including the toll-like receptor 4 antagonist ApTOLL, and the combination antioxidant/anti-inflammatory compound edaravone dexborneol in acute cerebral infarction; however, more research is needed.
Læs mere Tjek på PubMedMovahedi Nia, Z., Prescod, C., Westin, M., Perkins, P., Goitom, M., Fevrier, K., Bawa, S., Kong, J.
BMJ Open, 14.03.2024
Tilføjet 14.03.2024
ObjectivesThe COVID-19 pandemic disrupted healthcare services, leading to the cancellation of non-urgent tests, screenings and procedures, a shift towards remote consultations, stalled childhood immunisations and clinic closures which had detrimental effects across the healthcare system. This study investigates the impact of the COVID-19 pandemic on clinical admissions and healthcare quality in the Peel, York and Toronto regions within the Greater Toronto Area (GTA). DesignIn a cross-sectional study, the negative impact of the pandemic on various healthcare sectors, including preventive and primary care (PPC), the emergency department (ED), alternative level of care (ALC) and imaging, procedures and surgeries is investigated. Study questions include assessing impairments caused by the COVID-19 pandemic and discovering hotspots and critical subregions that require special attention to recover. The measuring technique involves comparing the number of cases during the COVID-19 pandemic with before that, and determining the difference in percentage. Statistical analyses (Mann-Whitney U test, analysis of variance, Dunn’s test) is used to evaluate sector-specific changes and inter-relationships. SettingThis work uses primary data which were collected by the Black Creek Community Health Centre. The study population was from three regions of GTA, namely, the city of Toronto, York and Peel. For all health sectors, the sample size was large enough to have a statistical power of 0.95 to capture 1% variation in the number of cases during the COVID-19 pandemic compared with before that. ResultsAll sectors experienced a significant decline in patient volume during the pandemic. ALC admissions surged in some areas, while IPS patients faced delays. Surgery waitlists increased by an average of 9.75%, and completed IPS procedures decreased in several subregions. ConclusionsThe COVID-19 pandemic had a universally negative impact on healthcare sectors across various subregions. Identification of the hardest-hit subregions in each sector can assist health officials in crafting recovery policies.
Læs mere Tjek på PubMedHiluf Ebuy Abraha, Hale Teka, Awol Yemane Legesse, Mohamedawel Mohamedniguss Ebrahim, Mache Tsadik, Girmatsion Fisseha, Bereket Berhe, Brhane Ayele, Gebrehaweria Gebrekurstos, Tesfit Gebremeskel, Tsega Gebremariam, Martha Yemane Hadush, Tigist Hagos, Abraha Gebreegziabher, Kibrom Muez, Haile Tesfay, Hagos Godefay, Afework Mulugeta
PLoS One Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
by Hiluf Ebuy Abraha, Hale Teka, Awol Yemane Legesse, Mohamedawel Mohamedniguss Ebrahim, Mache Tsadik, Girmatsion Fisseha, Bereket Berhe, Brhane Ayele, Gebrehaweria Gebrekurstos, Tesfit Gebremeskel, Tsega Gebremariam, Martha Yemane Hadush, Tigist Hagos, Abraha Gebreegziabher, Kibrom Muez, Haile Tesfay, Hagos Godefay, Afework Mulugeta Background In resource-limited countries with weak healthcare systems, women of reproductive age are particularly vulnerable during times of conflict. In Tigray, Ethiopia, where a war broke out on 04 November 2020, there is a lack of information on causes of death (CoD) among women of reproductive age. This study aims to determine the underlying CoD among women of reproductive age during the armed conflict in Tigray. Methods This community-based survey was carried out in six Tigray zones, excluding the western zone for security reasons. We used a multistage stratified cluster sampling method to select the smallest administrative unit known as Tabiya. Data were collected using a standardized 2022 WHO Verbal Autopsy (VA) tool. The collected data were analyzed using the InterVA model using R analytic software. The study reported both group-based and cause-specific mortality fractions. Results A total of 189,087 households were screened and 832 deaths were identified among women of reproductive age. The Global Burden of Disease classification showed that infectious and maternal disorders were the leading CoD, accounting for 42.9% of all deaths. External causes contributed to 26.4% of fatalities, where assault accounted for 13.2% of the deaths. Maternal deaths made up 30.0% of the overall mortality rate. HIV/AIDS was the primary CoD, responsible for 13.2% of all deaths and 54.0% of infectious causes. Other significant causes included obstetric hemorrhage (11.7%) and other and unspecified cardiac disease (6.6%). Conclusions The high proportion of infectious diseases related CoD, including HIV/AIDS, as well as the occurrence of uncommon external CoD among women, such as assault, and a high proportion of maternal deaths are likely the result of the impact of war in the region. This highlights the urgent need for targeted interventions to address these issues and prioritize sexual and reproductive health as well as maternal health in Tigray.
Læs mere Tjek på PubMedMikael Rubin, Caitlin M. Fischer, Michael J. Telch
PLoS One Infectious Diseases, 14.03.2024
Tilføjet 14.03.2024
by Mikael Rubin, Caitlin M. Fischer, Michael J. Telch Loneliness, perceived stress, depression, and anxiety have increased during the COVID-19 pandemic. Many of existing mindfulness and compassion-based intervention are effective, but are time-intensive, decreasing overall accessibility and scalability. Single-session interventions (SSIs) serve as a promising alternative. The current pre-registered randomized clinical trial evaluated a newly developed, manualized, mindfulness-based single-session intervention. 91 adults were randomly assigned to one of three conditions: (1) one-hour mindfulness only telehealth intervention; (b) one-hour mindfulness and compassion telehealth intervention; or (c) one-week waitlist control (before randomization to an active intervention). Intervention sessions were conducted by graduate students in clinical psychology. The primary outcome was self-reported loneliness; secondary outcomes were self-reported perceived stress, depression, and anxiety. Using Bayesian multilevel models, we found that compared to the waitlist-control, the inclusion of a compassion component led to meaningful reductions in perceived stress b = -3.75, 95% HDI [-6.95, -0.59], anxiety b = -3.79, 95% HDI [-6.99, -0.53], and depression b = -3.01, 95% HDI [-5.22, -0.78], but not loneliness at the 1-week follow-up. Results suggest that a single-session mindfulness and compassion intervention may lead to meaningful reductions in perceived stress, symptoms of anxiety, and symptoms of depression, but not loneliness. Implications of these findings are discussed.
Læs mere Tjek på PubMedMalaria Journal, 14.03.2024
Tilføjet 14.03.2024
Abstract Background The Great Mekong Subregion has attained a major decline in malaria cases and fatalities over the last years, but residual transmission hotspots remain, supposedly fueled by forest workers and migrant populations. This study aimed to: (i) characterize the fine-scale mobility of forest-goers and understand links between their daily movement patterns and malaria transmission, using parasites detection via real time polymerase chain reaction (RT PCR) and the individual exposure to Anopheles bites by quantification of anti-Anopheles saliva antibodies via enzyme-linked immunosorbent assay; (ii) assess the concordance of questionnaires and Global Positioning System (GPS) data loggers for measuring mobility. Methods Two 28 day follow-ups during dry and rainy seasons, including a GPS tracking, questionnaires and health examinations, were performed on male forest goers representing the population at highest risk of infection. Their time spent in different land use categories and demographic data were analyzed in order to understand the risk factors driving malaria in the study area. Results Malaria risk varied with village forest cover and at a resolution of only a few kilometers: participants from villages outside the forest had the highest malaria prevalence compared to participants from forest fringe’s villages. The time spent in a specific environment did not modulate the risk of malaria, in particular the time spent in forest was not associated with a higher probability to detect malaria among forest-goers. The levels of antibody response to Anopheles salivary peptide among participants were significantly higher during the rainy season, in accordance with Anopheles mosquito density variation, but was not affected by sociodemographic and mobility factors. The agreement between GPS and self-reported data was only 61.9% in reporting each kind of visited environment. Conclusions In a context of residual malaria transmission which was mainly depicted by P. vivax asymptomatic infections, the implementation of questionnaires, GPS data-loggers and quantification of anti-saliva Anopheles antibodies on the high-risk group were not powerful enough to detect malaria risk factors associated with different mobility behaviours or time spent in various environments. The joint implementation of GPS trackers and questionnaires allowed to highlight the limitations of both methodologies and the benefits of using them together. New detection and follow-up strategies are still called for.
Læs mere Tjek på PubMedBMC Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
Abstract Background Early during the COVID-19 pandemic, it was important to better understand transmission dynamics of SARS-CoV-2, the virus that causes COVID-19. Household contacts of infected individuals are particularly at risk for infection, but delays in contact tracing, delays in testing contacts, and isolation and quarantine posed challenges to accurately capturing secondary household cases. Methods In this study, 346 households in the Seattle region were provided with respiratory specimen collection kits and remotely monitored using web-based surveys for respiratory illness symptoms weekly between October 1, 2020, and June 20, 2021. Symptomatic participants collected respiratory specimens at symptom onset and mailed specimens to the central laboratory in Seattle. Specimens were tested for SARS-CoV-2 using RT-PCR with whole genome sequencing attempted when positive. SARS-CoV-2-infected individuals were notified, and their household contacts submitted specimens every 2 days for 14 days. Results In total, 1371 participants collected 2029 specimens that were tested; 16 individuals (1.2%) within 6 households tested positive for SARS-CoV-2 during the study period. Full genome sequences were generated from 11 individuals within 4 households. Very little genetic variation was found among SARS-CoV-2 viruses sequenced from different individuals in the same household, supporting transmission within the household. Conclusions This study indicates web-based surveillance of respiratory symptoms, combined with rapid and longitudinal specimen collection and remote contact tracing, provides a viable strategy to monitor households and detect household transmission of SARS-CoV-2. Trial registration identifier NCT04141930, Date of registration 28/10/2019.
Læs mere Tjek på PubMedBMC Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
Abstract Background Influenza viruses cause pneumonia in approximately one-third of cases, and pneumonia is an important cause of death. The aim was to identify risk factors associated with severity and those that could predict the development of pneumonia. Methods This retrospective, observational study included all adult patients with confirmed influenza virus infection admitted to Son Espases University Hospital during four influenza seasons in Spain (October to May) from to 2012–2016. Results Overall, 666 patients with laboratory-confirmed influenza were included, 93 (14%) of which were severe; 73 (10.9%) were admitted to Intensive Care Unit (ICU), 39 (5.8%) died, and 185 (27.7%) developed pneumonia. Compared to less severe cases, patients with severe disease: were less vaccinated (40% vs. 28%, p = 0.021); presented with more confusion (26.9% vs. 6.8%), were more hypoxemic (Horowitz index (PaO2/FiO2) 261 vs. 280), had higher C-reactive protein (CRP) (12.3 vs. 4.0), had more coinfections (26.8% vs. 6.3%) and had more pleural effusion (14% vs. 2.6%) (last six all p
Læs mere Tjek på PubMedSusana Rojo‐Alba, Zulema Pérez Martínez, José María González‐Alba, José Antonio Boga, Cristina Ochoa Varela, Maria Agustina Alonso Álvarez, Carmen Pérez Fonseca, Marta María García Clemente, José Gutierrez Rodriguez, Estibaliz Garrido García, Mercedes Rodríguez Pérez, Santiago Melón García, Marta Elena Álvarez‐Argüelles
Journal of Medical Virology, 13.03.2024
Tilføjet 13.03.2024
Jiezuan Yang, Shaoyan Xu, Jinlin Cheng, Xuying Yin, Dong Yan, Xuefen Li
Journal of Medical Virology, 13.03.2024
Tilføjet 13.03.2024
Moses J Bockarie, Rashid Ansumana, Shingai Grace Machingaidze, Dziedzom K. de Souza, Patrick Fatoma, Alimuddin Zumla, Shui-Shan Lee
International Journal of Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
The rise of Artificial Intelligence (AI) stands out as a revolutionary technological force, surpassing the transformative impact observed during the transition to web and mobile technologies.[1,2] Advances in technology present opportunities for enhancing scientific discovery, accelerating human progress, and improving quality of life. AI, a broad term covering machine and deep learning algorithms emulating human intelligence, has led to the development of various algorithms aiding tasks in public health, from workflow optimization to diagnostics and forecasting.
Læs mere Tjek på PubMedAndersson, C., Berman, A. H., Lindfors, P., Bendtsen, M.
BMJ Open, 13.03.2024
Tilføjet 13.03.2024
ObjectiveThis study used causal inference to estimate the longitudinal effects of contagion in cohabitants and family members on university students’ mental health and academic self-efficacy during the COVID-19 pandemic. DesignA prospective longitudinal study including a baseline online measurement in May 2020, and online follow-ups after 5 months and 10 months. Participants were recruited through open-access online advertising. SettingPublic universities and university colleges in Sweden. ParticipantsThe analytical sample included 2796 students. Outcome measuresContagion in cohabitants and in family members was assessed at baseline and at the 5-month follow-up. Mental health and academic self-efficacy were assessed at the 5-month and 10-month follow-ups. ResultsMild symptoms reported in cohabitants at baseline resulted in negative mental health effects at follow-up 5 months later, and mild baseline symptoms in family members resulted in negative effects on academic self-efficacy at follow-ups both 5 and 10 months later. ConclusionsNotwithstanding the lack of precision in estimated effects, the findings emphasise the importance of social relationships and the challenges of providing students with sufficient support in times of crisis.
Læs mere Tjek på PubMedMoreno, M., Barry, A., Gmeiner, M., Yaro, J. B., Serme, S. S., Byrne, I., Ramjith, J., Ouedraogo, A., Soulama, I., Grignard, L., Soremekun, S., Koele, S., ter Heine, R., Ouedraogo, A. Z., Sawadogo, J., Sanogo, E., Ouedraogo, I. N., Hien, D., Sirima, S. B., Bradley, J., Bousema, T., Drakeley, C., Tiono, A. B.
BMJ Open, 13.03.2024
Tilføjet 13.03.2024
IntroductionSeasonal malaria chemoprevention (SMC) involves repeated administrations of sulfadoxine-pyrimethamine plus amodiaquine to children below the age of 5 years during the peak transmission season in areas of seasonal malaria transmission. While highly impactful in reducing Plasmodium falciparum malaria burden in controlled research settings, the impact of SMC on infection prevalence is moderate in real-life settings. It remains unclear what drives this efficacy decay. Recently, the WHO widened the scope for SMC to target all vulnerable populations. The Ministry of Health (MoH) in Burkina Faso is considering extending SMC to children below 10 years old. We aim to assess the impact of SMC on clinical incidence and parasite prevalence and quantify the human infectious reservoir for malaria in this population. Methods and analysisWe will perform a cluster randomised trial in Saponé Health District, Burkina Faso, with three study arms comprising 62 clusters of three compounds: arm 1 (control): SMC in under 5-year-old children, implemented by the MoH without directly observed treatment (DOT) for the full course of SMC; arm 2 (intervention): SMC in under 5-year-old children, with DOT for the full course of SMC; arm 3 (intervention): SMC in under 10-year-old children, with DOT for the full course of SMC. The primary endpoint is parasite prevalence at the end of the malaria transmission season. Secondary endpoints include the impact of SMC on clinical incidence. Factors affecting SMC uptake, treatment adherence, drug concentrations, parasite resistance markers and transmission of parasites will be determined. Ethics and disseminationThe London School of Hygiene & Tropical Medicine’s Ethics Committee (29193) and the Burkina Faso National Medical Ethics Committee (Deliberation No 2023-05-104) approved this study. The findings will be presented to the community; disease occurrence data and study outcomes will also be shared with the Burkina Faso MoH. Findings will be published irrespective of their results. Trial registration numberNCT05878366.
Læs mere Tjek på PubMedZhu, T., Chen, C., Zhang, X., Yang, Q., Hu, Y., Liu, R., Zhang, X., Dong, Y.
BMJ Open, 13.03.2024
Tilføjet 13.03.2024
ObjectivesThis study measures the differences in inpatient performance after a points-counting payment policy based on diagnosis-related group (DRG) was implemented. The point value is dynamic; its change depends on the annual DRGs’ cost settlements and points of the current year, which are calculated at the beginning of the following year. DesignA longitudinal study using a robust multiple interrupted time series model to evaluate service performance following policy implementation. SettingTwenty-two public general hospitals (8 tertiary institutions and 14 secondary institutions) in Wenzhou, China. InterventionThe intervention was implemented in January 2020. Outcome measuresThe indicators were case mix index (CMI), cost per hospitalisation (CPH), average length of stay (ALOS), cost efficiency index (CEI) and time efficiency index (TEI). The study employed the means of these indicators. ResultsThe impact of COVID-19, which reached Zhejiang Province at the end of January 2020, was temporary given rapid containment following strict control measures. After the intervention, except for the ALOS mean, the change-points for the other outcomes (p
Læs mere Tjek på PubMedJulian Heidecke, Jan Fuhrmann, Maria Vittoria Barbarossa
PLoS One Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
by Julian Heidecke, Jan Fuhrmann, Maria Vittoria Barbarossa Diagnostic testing followed by isolation of identified cases with subsequent tracing and quarantine of close contacts—often referred to as test-trace-isolate-and-quarantine (TTIQ) strategy—is one of the cornerstone measures of infectious disease control. The COVID-19 pandemic has highlighted that an appropriate response to outbreaks of infectious diseases requires a firm understanding of the effectiveness of such containment strategies. To this end, mathematical models provide a promising tool. In this work, we present a delay differential equation model of TTIQ interventions for infectious disease control. Our model incorporates the assumption of limited TTIQ capacities, providing insights into the reduced effectiveness of testing and tracing in high prevalence scenarios. In addition, we account for potential transmission during the early phase of an infection, including presymptomatic transmission, which may be particularly adverse to a TTIQ based control. Our numerical experiments inspired by the early spread of COVID-19 in Germany demonstrate the effectiveness of TTIQ in a scenario where immunity within the population is low and pharmaceutical interventions are absent, which is representative of a typical situation during the (re-)emergence of infectious diseases for which therapeutic drugs or vaccines are not yet available. Stability and sensitivity analyses reveal both disease-dependent and disease-independent factors that impede or enhance the success of TTIQ. Studying the diminishing impact of TTIQ along simulations of an epidemic wave, we highlight consequences for intervention strategies.
Læs mere Tjek på PubMedKyu Jin Lee, Yong Kyun Kim, Kyeongman Jeon, Ryoung-Eun Ko, Gee Young Suh, Dong Kyu Oh, Sung Yoon Lim, Yeon Joo Lee, Su Yeon Lee, Mi-Hyeon Park, Chae-Man Lim, Sunghoon Park, on behalf of the Korean Sepsis Alliance (KSA) investigators
PLoS One Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
by Kyu Jin Lee, Yong Kyun Kim, Kyeongman Jeon, Ryoung-Eun Ko, Gee Young Suh, Dong Kyu Oh, Sung Yoon Lim, Yeon Joo Lee, Su Yeon Lee, Mi-Hyeon Park, Chae-Man Lim, Sunghoon Park, on behalf of the Korean Sepsis Alliance (KSA) investigators Background The understanding of shock indices in patients with septic shock is limited, and their values may vary depending on cardiac function. Methods This prospective cohort study was conducted across 20 university-affiliated hospitals (21 intensive care units [ICUs]). Adult patients (≥19 years) with septic shock admitted to the ICUs during a 29-month period were included. The shock index (SI), diastolic shock index (DSI), modified shock index (MSI), and age shock index (Age-SI) were calculated at sepsis recognition (time zero) and ICU admission. Left ventricular (LV) function was categorized as either normal LV ejection fraction (LVEF ≥ 50%) or decreased LVEF (
Læs mere Tjek på PubMedPrabhjot Kaur Juttla, Moses Ndiritu, Ferdinand Milliano, Alfred Owino Odongo, Magoma Mwancha-Kwasa
PLoS One Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
by Prabhjot Kaur Juttla, Moses Ndiritu, Ferdinand Milliano, Alfred Owino Odongo, Magoma Mwancha-Kwasa Background The knowledge possessed by healthcare workers (HCWs), along with their attitudes and practices play a vital role in effectively managing a pandemic. This is crucial considering that HCWs are exposed to great risk at the forefront of such crises. We aimed to describe the knowledge, attitude, and practices (KAP) of HCWs during the COVID-19 pandemic in Kiambu county, Kenya. Methods A cross-sectional study using a structured questionnaire was conducted from 11th March 2021 to 12th August 2021. Bloom’s cutoff points were used to determine KAP scores (>80%: good, 60–79%: medium and
Læs mere Tjek på PubMedJournal of Infectious Diseases, 13.03.2024
Tilføjet 13.03.2024
Abstract Background Despite vaccination, influenza and otitis media (OM) remain leading causes of illness. We previously found that the human respiratory commensal Haemophilus haemolyticus prevents bacterial infection in vitro and that the related murine commensal Muribacter muris delays OM development in mice. The observation that M muris pretreatment reduced lung influenza titer and inflammation suggests that these bacteria could be exploited for protection against influenza/OM.Methods Safety and efficacy of intranasal H haemolyticus at 5 × 107 colony-forming units (CFU) was tested in female BALB/cARC mice using an influenza model and influenza-driven nontypeable Haemophilus influenzae (NTHi) OM model. Weight, symptoms, viral/bacterial levels, and immune responses were measured.Results Intranasal delivery of H haemolyticus was safe and reduced severity of influenza, with quicker recovery, reduced inflammation, and lower lung influenza virus titers (up to 8-fold decrease vs placebo; P ≤ .01). Haemophilus haemolyticus reduced NTHi colonization density (day 5 median NTHi CFU/mL = 1.79 × 103 in treatment group vs 4.04 × 104 in placebo, P = .041; day 7 median NTHi CFU/mL = 28.18 vs 1.03 × 104; P = .028) and prevented OM (17% OM in treatment group, 83% in placebo group; P = .015).Conclusions Haemophilus haemolyticus has potential as a live biotherapeutic for prevention or early treatment of influenza and influenza-driven NTHi OM. Additional studies will deem whether these findings translate to humans and other respiratory infections.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.03.2024
Tilføjet 12.03.2024
Abstract Background Influenza viruses cause pneumonia in approximately one-third of cases, and pneumonia is an important cause of death. The aim was to identify risk factors associated with severity and those that could predict the development of pneumonia. Methods This retrospective, observational study included all adult patients with confirmed influenza virus infection admitted to Son Espases University Hospital during four influenza seasons in Spain (October to May) from to 2012–2016. Results Overall, 666 patients with laboratory-confirmed influenza were included, 93 (14%) of which were severe; 73 (10.9%) were admitted to Intensive Care Unit (ICU), 39 (5.8%) died, and 185 (27.7%) developed pneumonia. Compared to less severe cases, patients with severe disease: were less vaccinated (40% vs. 28%, p = 0.021); presented with more confusion (26.9% vs. 6.8%), were more hypoxemic (Horowitz index (PaO2/FiO2) 261 vs. 280), had higher C-reactive protein (CRP) (12.3 vs. 4.0), had more coinfections (26.8% vs. 6.3%) and had more pleural effusion (14% vs. 2.6%) (last six all p
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.03.2024
Tilføjet 12.03.2024
Abstract Background Globally, 80 million people are suffering from chronic Hepatitis C virus (HCV) infection. Sofosbuvir ribavirin-based anti-HCV therapy is associated with anemia and other adverse effects. Polymorphisms of Inosine triphosphatase (ITPA) gene may cause functional impairment in the Inosine triphosphate pyrophosphatase enzyme, resulting in enhanced sustained viral response (SVR) and protection from ribavirin-associated anemia in patients on therapy. The study objective was to investigate the effect of Inosine triphosphatase gene polymorphism on SVR achievement, hemoglobin decline and ribavirin dose reduction in patients on therapy. Methods This prospective cohort study was of 170 hepatitis C infected patients received 6-month sofosbuvir ribavirin therapy. Patient viral load, reduction in ribavirin amount, liver function test, and complete blood count were noted monthly. Inosine triphosphatase variants rs1127354 and rs7270101 were assessed through the restriction fragment length polymorphism and confirmed using Sanger sequencing. The impact of polymorphism on cumulative reduction of ribavirin, and anti-HCV therapy outcome were studied. Results A total of 74.3% of patients had ITPA rs1127354 CC genotype, 25.7% were CA and AA 0%. The frequency of ITPA genotype rs7270101-AA was 95%, AC 5%, and CC was 0%. ITPA rs1127354-CA had a notably positive impact on SVR achievement with a zero-relapse rate. ITPA rs1127354-CA genotype was significantly (P ˂0.05) protective against ≥ 2 g/dl Hb reduction from baseline to 1st, 2nd and 6th months of therapy. During treatment, Hb reduction ≥ 10 g/dl was frequently observed in rs1127354-CC genotype and rs7270101-AA genotype patients. Ribavirin dose reduction was significantly (P ˂0.05) high in rs1127354-CC genotype as compared to genotype CA whereas no significant difference was observed in ribavirin dose reduction in rs7270101 AA and non-AA genotype. Patient baseline characteristics such as age, body mass index, rs1127354-CC genotype, and baseline Hb were significantly associated with significant Hb reduction. Conclusion Pretreatment evaluation of ITPA polymorphism can be a diagnostic tool to find out patients at risk of anemia and improve treatment adherence. ITPA genotype rs1127354-CA contributes to improved compliance with ribavirin dose and protects against hemoglobin decline in HCV patients while taking ribavirin-based therapy. However, ITPA rs1127354, rs7270101 polymorphism have no significant impact on SVR achievement.
Læs mere Tjek på PubMedYao, A., Zhu, M., Li, L.
BMJ Open, 12.03.2024
Tilføjet 12.03.2024
ObjectiveTo explore the psychological experiences of university students in prolonged quarantine during the COVID-19 pandemic. DesignA qualitative descriptive study based on semistructured interviews; data were analysed using a thematic topic analysis approach. SettingInterviews were conducted via WeChat video. Participants20 full-time undergraduate students from seven districts in Shanghai Province who experienced prolonged quarantine were interviewed from June to August 2022. ResultsThe data analysis revealed three themes with corresponding subthemes related to the psychological experiences of university students during prolonged quarantine: (1) dynamic and complex psychological experiences, encompassing the feelings of relief, confusion, anxiety, insecurity, loneliness, craving for catharsis and emotional numbness; (2) desire for diverse support; and (3) self-reflection and growth, mainly including learning to be grateful, self-efficacy enhancement, reconsideration of the meaning of life and restructuring of future planning. ConclusionThis study explored the psychological experiences of university students in prolonged quarantine through qualitative interviews, which contributed to our understanding of their emotions, needs and conceptual changes during quarantine. Combined with the experiences of university students in quarantine, they reported complex emotional changes and diverse needs, as well as the impact of prolonged quarantine on their outlook on life. These findings can serve as a reference and basis for the development of future psychological intervention measures in line with national conditions.
Læs mere Tjek på PubMedYudianto, B., Jaure, A., Shen, J., Cho, Y., Brown, E., Dong, J., Dunning, T., Mehrotra, R., Naicker, S., Pecoits-Filho, R., Perl, J., Wang, A. Y.-M., Wilkie, M., Guha, C., Scholes-Robertson, N., Craig, J., Johnson, D., Manera, K.
BMJ Open, 12.03.2024
Tilføjet 12.03.2024
ObjectivesPeritoneal dialysis (PD) allows patients increased autonomy and flexibility; however, both infectious and non-infectious complications may lead to technique failure, which shortens treatment longevity. Maintaining patients on PD remains a major challenge for nephrologists. This study aims to describe nephrologists’ perspectives on technique survival in PD. DesignQualitative semistructured interview study. Transcripts were thematically analysed. Setting and participants30 nephrologists across 11 countries including Australia, the USA, the UK, Hong Kong, Canada, Singapore, Japan, New Zealand, Thailand, Colombia and Uruguay were interviewed from April 2017 to November 2019. ResultsWe identified four themes: defining patient suitability (confidence in capacity for self-management, ensuring clinical stability and expected resilience), building endurance (facilitating access to practical support, improving mental well-being, optimising quality of care and training to reduce risk of complications), establishing rapport through effective communications (managing expectations to enhance trust, individualising care and harnessing a multidisciplinary approach) and confronting fear and acknowledging barriers to haemodialysis (preventing crash landing to haemodialysis, facing concerns of losing independence and positive framing of haemodialysis). ConclusionNephrologists reported that technique survival in PD is influenced by patients’ medical circumstances, psychological motivation and positively influenced by the education and support provided by treating clinicians and families. Strategies to enhance patients’ knowledge on PD and communication with patients about technique survival in PD are needed to build trust, set patient expectations of treatment and improve the process of transition off PD.
Læs mere Tjek på PubMedLars Hulstaert, Isabell Twick, Khaled Sarsour, Hans Verstraete
PLoS One Infectious Diseases, 12.03.2024
Tilføjet 12.03.2024
by Lars Hulstaert, Isabell Twick, Khaled Sarsour, Hans Verstraete Slow patient enrollment or failing to enroll the required number of patients is a disruptor of clinical trial timelines. To meet the planned trial recruitment, site selection strategies are used during clinical trial planning to identify research sites that are most likely to recruit a sufficiently high number of subjects within trial timelines. We developed a machine learning approach that outperforms baseline methods to rank research sites based on their expected recruitment in future studies. Indication level historical recruitment and real-world data are used in the machine learning approach to predict patient enrollment at site level. We define covariates based on published recruitment hypotheses and examine the effect of these covariates in predicting patient enrollment. We compare model performance of a linear and a non-linear machine learning model with common industry baselines that are constructed from historical recruitment data. Performance of the methodology is evaluated and reported for two disease indications, inflammatory bowel disease and multiple myeloma, both of which are actively being pursued in clinical development. We validate recruitment hypotheses by reviewing the covariates relationship with patient recruitment. For both indications, the non-linear model significantly outperforms the baselines and the linear model on the test set. In this paper, we present a machine learning approach to site selection that incorporates site-level recruitment and real-world patient data. The model ranks research sites by predicting the number of recruited patients and our results suggest that the model can improve site ranking compared to common industry baselines.
Læs mere Tjek på PubMedJosé Luis Martínez-Sánchez, Carolina Zequeira Larios, Florisel Hernandez Ramirez
PLoS One Infectious Diseases, 12.03.2024
Tilføjet 12.03.2024
by José Luis Martínez-Sánchez, Carolina Zequeira Larios, Florisel Hernandez Ramirez Southern Mexico is particularly rich in natural resources, yet unemployment has risen to 8% during the COVID-19 pandemic. The effect of the pandemic on the use and abundance of Tabasco’s wild resources was examined through personal surveys. By using Microsoft Forms® with cell phones 1,963 surveys were collected. Cronbach’s alpha, Z-value, and chi2 were calculated using the MAXQDA Analytics Pro program. A higher abundance of wild resources before the pandemic than today (57% vs. 11%) was observed. During the pandemic, people referred more to a high use (28%) of resources than to a low use (20%). This caused the low abundance or scarcity of wild products to be greater during the pandemic than before the pandemic (43% vs. 4%). Wild foods and timber were the most used products. The pandemic has produced a greater use of natural resources probably due to the high unemployment rate in rural areas. Future studies of wild products should address the relevant products in the locality and their even sampling. Finding suitable respondents is highly recommended.
Læs mere Tjek på PubMedPol Ezquerra Condeminas, Milos Mallol, Roger Font, Victor Tremps, Jose Antonio Gutiérrez, Gil Rodas, Alexandre Perera Lluna, José Manuel Soria
PLoS One Infectious Diseases, 12.03.2024
Tilføjet 12.03.2024
by Pol Ezquerra Condeminas, Milos Mallol, Roger Font, Victor Tremps, Jose Antonio Gutiérrez, Gil Rodas, Alexandre Perera Lluna, José Manuel Soria Objective This study aims to comprehend the impact of handball practice on sub-elite athletes by investigating transcriptomic changes that occur during a match. The primary focus encompasses a dual objective: firstly, to identify and characterize these transcriptomic alterations, and secondly, to establish correlations between internal factors (gene expression), and external loads measured through Electronic Performance and Tracking Systems (EPTS variables). Ultimately, this comprehensive analysis seeks to evaluate both acute and chronic responses to exercise within the context of handball training. Methods The study included sixteen elite male athletes from the FC Barcelona handball second team. Blood samples were extracted at three different time points: before the match at baseline levels (T1), immediately upon completion (T2), and 24 hours after completion (T3). Differential gene expression, Gene Ontology Term and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses were conducted in two comparisons: Comparison 1 (T1 vs T2) and Comparison 2 (T1 vs T3). Further, the correlation between gene expression levels and training variables (external load) was conducted. Results In T1 vs T2, 3717 of the 14632 genes detected were differentially expressed (adjusted p-value < 0.05), and enrichment of terms related to the immune system, mitochondria, and metabolic processes was found. Further, significant linear correlations were obtained between High-Speed running (HSR) and high-intensity variables such as acceleration ACC and deceleration DEC values with amino acids, and inflammatory and oxidative environment-related pathways, both in chronic and acute response. Conclusions This research highlights the effects of external workload on elite athletes during a handball match and throughout the season. The study identifies deregulation in the immune system, mitochondrial functions, and various metabolic pathways during the match. Additionally, it establishes correlations between the external load and pathways associated with amino acids, inflammation, oxidative environment, and regulation. These findings offer insights into the immediate and chronic responses of athletes to physical effort.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 12.03.2024
Tilføjet 12.03.2024
Abstract Background In addition to preventing pneumococcal disease, emerging evidence indicates that pneumococcal conjugate vaccines (PCVs) might indirectly reduce viral respiratory tract infections (RTI) by affecting pneumococcal-viral interactions.Methods We performed a systematic review of interventional and observational studies published during 2000-2022 on vaccine efficacy/adjusted effectiveness (VE) and overall effect of PCV7, PCV9, PCV10, or PCV13 against viral RTI.Results Sixteen of 1671 records identified were included. Thirteen publications described effects of PCVs against viral RTIs in children. VE against influenza ranged between 41-86% (n=4), except for the 2010-2011 influenza season. In a randomized controlled trial, PCV9 displayed efficacy against any viral RTI, human seasonal coronavirus, parainfluenza, and human metapneumovirus. Data in adults were limited (n=3). PCV13 VE ranged between 4-25% against viral lower RTI, 32-35% against COVID-19 outcomes, 24-51% against human seasonal coronavirus, and 13-36% against influenza A lower RTI, with some 95%CI spanning zero. No protection was found against adenovirus or rhinovirus in children or adults.Conclusions PCVs were associated with protection against some viral RTI, with the strongest evidence for influenza in children. Limited evidence for adults was generally consistent with pediatric data. Restricting public health evaluations to confirmed pneumococcal outcomes may underestimate the full impact of PCVs.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.03.2024
Tilføjet 12.03.2024
Abstract Background Globally, 80 million people are suffering from chronic Hepatitis C virus (HCV) infection. Sofosbuvir ribavirin-based anti-HCV therapy is associated with anemia and other adverse effects. Polymorphisms of Inosine triphosphatase (ITPA) gene may cause functional impairment in the Inosine triphosphate pyrophosphatase enzyme, resulting in enhanced sustained viral response (SVR) and protection from ribavirin-associated anemia in patients on therapy. The study objective was to investigate the effect of Inosine triphosphatase gene polymorphism on SVR achievement, hemoglobin decline and ribavirin dose reduction in patients on therapy. Methods This prospective cohort study was of 170 hepatitis C infected patients received 6-month sofosbuvir ribavirin therapy. Patient viral load, reduction in ribavirin amount, liver function test, and complete blood count were noted monthly. Inosine triphosphatase variants rs1127354 and rs7270101 were assessed through the restriction fragment length polymorphism and confirmed using Sanger sequencing. The impact of polymorphism on cumulative reduction of ribavirin, and anti-HCV therapy outcome were studied. Results A total of 74.3% of patients had ITPA rs1127354 CC genotype, 25.7% were CA and AA 0%. The frequency of ITPA genotype rs7270101-AA was 95%, AC 5%, and CC was 0%. ITPA rs1127354-CA had a notably positive impact on SVR achievement with a zero-relapse rate. ITPA rs1127354-CA genotype was significantly (P ˂0.05) protective against ≥ 2 g/dl Hb reduction from baseline to 1st, 2nd and 6th months of therapy. During treatment, Hb reduction ≥ 10 g/dl was frequently observed in rs1127354-CC genotype and rs7270101-AA genotype patients. Ribavirin dose reduction was significantly (P ˂0.05) high in rs1127354-CC genotype as compared to genotype CA whereas no significant difference was observed in ribavirin dose reduction in rs7270101 AA and non-AA genotype. Patient baseline characteristics such as age, body mass index, rs1127354-CC genotype, and baseline Hb were significantly associated with significant Hb reduction. Conclusion Pretreatment evaluation of ITPA polymorphism can be a diagnostic tool to find out patients at risk of anemia and improve treatment adherence. ITPA genotype rs1127354-CA contributes to improved compliance with ribavirin dose and protects against hemoglobin decline in HCV patients while taking ribavirin-based therapy. However, ITPA rs1127354, rs7270101 polymorphism have no significant impact on SVR achievement.
Læs mere Tjek på PubMedBMC Infectious Diseases, 12.03.2024
Tilføjet 12.03.2024
Abstract Background Symptoms of COVID-19 including fatigue and dyspnea, may persist for weeks to months after SARS-CoV-2 infection. This study compared self-reported disability among SARS-CoV-2-positive and negative persons with mild to moderate COVID-19-like illness who presented for outpatient care before widespread COVID-19 vaccination. Methods Unvaccinated adults with COVID-19-like illness enrolled within 10 days of illness onset at three US Flu Vaccine Effectiveness Network sites were tested for SARS-CoV-2 by molecular assay. Enrollees completed an enrollment questionnaire and two follow-up surveys (7–24 days and 2–7 months after illness onset) online or by phone to assess illness characteristics and health status. The second follow-up survey included questions measuring global health, physical function, fatigue, and dyspnea. Scores in the four domains were compared by participants’ SARS-CoV-2 test results in univariate analysis and multivariable Gamma regression. Results During September 22, 2020 – February 13, 2021, 2712 eligible adults were enrolled, 1541 completed the first follow-up survey, and 650 completed the second follow-up survey. SARS-CoV-2-positive participants were more likely to report fever at acute illness but were otherwise comparable to SARS-CoV-2-negative participants. At first follow-up, SARS-CoV-2-positive participants were less likely to have reported fully or mostly recovered from their illness compared to SARS-CoV-2-negative participants. At second follow-up, no differences by SARS-CoV-2 test results were detected in the four domains in the multivariable model. Conclusion Self-reported disability was similar among outpatient SARS-CoV-2-positive and -negative adults 2–7 months after illness onset.
Læs mere Tjek på PubMedMalaria Journal, 11.03.2024
Tilføjet 11.03.2024
Abstract Background Delays in malaria treatment can not only lead to severe and even life-threatening complications, but also foster transmission, putting more people at risk of infection. This study aimed to investigate the factors influencing treatment delays among malaria patients and their health-seeking behaviour. Methods The medical records of 494 patients diagnosed with malaria from 6 different malaria-endemic provinces in China were analysed. A bivariate and multivariable regression model was used to investigate the association between delays in seeking treatment and various factors. A Sankey diagram was used to visualize the trajectories of malaria patients seeking medical care. Total treatment delays were categorized as patient delays and doctor delays. Results The incidence of total delays in seeking malaria treatment was 81.6%, of which 28.4% were delayed by patients alone and 34.8% by doctors alone. The median time from the onset of symptoms to the initial healthcare consultation was 1 day. The median time from the initial healthcare consultation to the conclusive diagnosis was 2 day. After being subjected to multiple logistic regression analysis, living in central China was less likely to experience patient delays (OR = 0.43, 95% CI 0.24–0.78). The factors significantly associated with the lower likelihood of doctor delays included: age between 30 to 49 (OR = 0.43, 95% CI 0.23–0.81), being single/divorce/separated (OR = 0.48, 95% CI 0.24–0.95), first visiting a county-level health institution (OR = 0.25, 95% CI 0.14–0.45), first visiting a prefectural health institution (OR = 0.06, 95% CI 0.03–0.12) and first visiting a provincial health institution (OR = 0.05, 95%CI 0.02–0.12). Conversely, individuals with mixed infections (OR = 2.04, 95% CI 1.02–4.08) and those experiencing periodic symptoms (OR = 1.71, 95% CI 1.00–2.92) might face increased doctor delays. Furthermore, higher financial burden and complications were found to be associated with patient delays. Doctor delays, in addition to incurring these two consequences, were associated with longer hospital stays. Conclusion There was a substantial delay in access to health care for malaria patients before China was certified malaria free. Region, marital status, periodic symptoms and the level of health institutions were factors contributing to delays in treatment-seeking among malaria patients.
Læs mere Tjek på PubMedMalaria Journal, 11.03.2024
Tilføjet 11.03.2024
Abstract Background Therapeutic efficacy studies (TESs) and detection of molecular markers of drug resistance are recommended by the World Health Organization (WHO) to monitor the efficacy of artemisinin-based combination therapy (ACT). This study assessed the trends of molecular markers of artemisinin resistance and/or reduced susceptibility to lumefantrine using samples collected in TES conducted in Mainland Tanzania from 2016 to 2021. Methods A total of 2,015 samples were collected during TES of artemether-lumefantrine at eight sentinel sites (in Kigoma, Mbeya, Morogoro, Mtwara, Mwanza, Pwani, Tabora, and Tanga regions) between 2016 and 2021. Photo-induced electron transfer polymerase chain reaction (PET-PCR) was used to confirm presence of malaria parasites before capillary sequencing, which targeted two genes: Plasmodium falciparum kelch 13 propeller domain (k13) and P. falciparum multidrug resistance 1 (pfmdr1). Results Sequencing success was ≥ 87.8%, and 1,724/1,769 (97.5%) k13 wild-type samples were detected. Thirty-seven (2.1%) samples had synonymous mutations and only eight (0.4%) had non-synonymous mutations in the k13 gene; seven of these were not validated by the WHO as molecular markers of resistance. One sample from Morogoro in 2020 had a k13 R622I mutation, which is a validated marker of artemisinin partial resistance. For pfmdr1, all except two samples carried N86 (wild-type), while mutations at Y184F increased from 33.9% in 2016 to about 60.5% in 2021, and only four samples (0.2%) had D1246Y mutations. pfmdr1 haplotypes were reported in 1,711 samples, with 985 (57.6%) NYD, 720 (42.1%) NFD, and six (0.4%) carrying minor haplotypes (three with NYY, 0.2%; YFD in two, 0.1%; and NFY in one sample, 0.1%). Between 2016 and 2021, NYD decreased from 66.1% to 45.2%, while NFD increased from 38.5% to 54.7%. Conclusion This is the first report of the R622I (k13 validated mutation) in Tanzania. N86 and D1246 were nearly fixed, while increases in Y184F mutations and NFD haplotype were observed between 2016 and 2021. Despite the reports of artemisinin partial resistance in Rwanda and Uganda, this study did not report any other validated mutations in these study sites in Tanzania apart from R622I suggesting that intensified surveillance is urgently needed to monitor trends of drug resistance markers and their impact on the performance of ACT.
Læs mere Tjek på PubMedAurélien Saghaï, Sara Hallin
Trends in Microbiology, 10.03.2024
Tilføjet 10.03.2024
Nitrate ammonifiers are a taxonomically diverse group of microorganisms that reduce nitrate to ammonium, which is released, and thereby contribute to the retention of nitrogen in ecosystems. Despite their importance for understanding the fate of nitrate, they remain a largely overlooked group in the nitrogen cycle. Here, we present the latest advances on free-living microorganisms using NrfA to reduce nitrite during ammonification. We describe their diversity and ecology in terrestrial and aquatic environments, as well as the environmental factors influencing the competition for nitrate with denitrifiers that reduce nitrate to gaseous nitrogen species, including the greenhouse gas nitrous oxide (N2O). We further review the capacity of ammonifiers for other redox reactions, showing that they likely play multiple roles in the cycling of elements.
Læs mere Tjek på PubMedMalaria Journal, 9.03.2024
Tilføjet 9.03.2024
Abstract Background Birds chronically infected with avian malaria parasites often show relapses of parasitaemia after latent stages marked by absence of parasites in the peripheral circulation. These relapses are assumed to result from the activation of dormant exo-erythrocytic stages produced during secondary (post-erythrocytic) merogony of avian Plasmodium spp. Yet, there is no morphological proof of persistent or dormant tissue stages in the avian host during latent infections. This study investigated persistence of Plasmodium relictum pSGS1 in birds with latent infections during winter, with the goal to detect presumed persisting tissue stages using a highly sensitive RNAscope® in situ hybridization technology. Methods Fourteen domestic canaries were infected with P. relictum pSGS1 by blood-inoculation in spring, and blood films examined during the first 4 months post infection, and during winter and spring of the following year. After parasitaemia was no longer detectable, half of the birds were dissected, and tissue samples investigated for persisting tissue stages using RNAscope ISH and histology. The remaining birds were blood-checked and dissected after re-appearance of parasitaemia, and their tissues equally examined. Results Systematic examination of tissues showed no exo-erythrocytic stages in birds exhibiting latent infections by blood-film microscopy, indicating absence of dormant tissue stages in P. relictum pSGS1-infected canaries. Instead, RNAscope ISH revealed rare P. relictum blood stages in capillaries of various tissues and organs, demonstrating persistence of the parasites in the microvasculature. Birds examined after re-appearance of parasitemia showed higher numbers of P. relictum blood stages in both capillaries and larger blood vessels, indicating replication during early spring and re-appearance in the peripheral circulation. Conclusions The findings suggest that persistence of P. relictum pSGS1 during latent infection is mediated by continuous low-level erythrocytic merogony and possibly tissue sequestration of infected blood cells. Re-appearance of parasitaemia in spring seems to result from increased erythrocytic merogony, therefore representing recrudescence and not relapse in blood-inoculated canaries. Further, the study highlights strengths and limitations of the RNAscope ISH technology for the detection of rare parasite stages in tissues, providing directions for future research on persistence and tissue sequestration of avian malaria and related haemosporidian parasites.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 9.03.2024
Tilføjet 9.03.2024
Abstract Determining pneumococcal pneumonia (PP) burden in the elderly population is challenging due to limited data on invasive PP (IPP) and, in particular, noninvasive PP (NIPP) incidence. Using retrospective cohorts of adults aged ≥50 years in Denmark (2 782 303) and the Valencia region, Spain (2 283 344), we found higher IPP hospitalization rates in Denmark than Valencia (18.3 vs 9/100 000 person-years [PY], respectively). Conversely, NIPP hospitalization rates were higher in Valencia (48.2 vs 7.2/100 000 PY). IPP and NIPP rates increased with age and comorbidities in both regions, with variations by sex and case characteristics (eg, complications, mortality). The burden of PP in adults is substantial, yet its true magnitude remains elusive. Discrepancies in clinical practices impede international comparisons; for instance, Valencia employed a higher frequency of urinary antigen tests compared to Denmark. Additionally, coding practices and prehospital antibiotic utilization may further influence these variations. These findings could guide policymakers and enhance the understanding of international disparities in disease burden assessments.
Læs mere Tjek på PubMedPlüss-Suard Catherine, Mueller Yolanda, Plate Andreas, Senn Oliver, Kronenberg Andreas
Clinical Microbiology and Infection, 9.03.2024
Tilføjet 9.03.2024
We have read with great interest the article published by Aghlmandi S. et al. regarding the \'Impact of the COVID-19 pandemic on antibiotic prescribing in high-prescribing primary care physicians in Switzerland\' [1]. This study presents the findings of a follow-up investigation following a national intervention trial on antibiotic prescription audit and feedback during the initial year of the SARS-CoV-2 pandemic, compared with the pre-pandemic years (2017-2019). The authors utilized claims data from 2945 physicians, representing the upper 75% of antibiotic prescribers, in an interrupted time series analysis.
Læs mere Tjek på PubMedChen, X., Norris, C., Whitten, T., Ho, C., Mann, B., Bakal, J.
BMJ Open, 9.03.2024
Tilføjet 9.03.2024
ObjectiveFatigue, headache, problems sleeping and numerous other symptoms have been reported to be associated with long COVID. However, many of these symptoms coincide with symptoms reported by the general population, possibly exacerbated by restrictions/precautions experienced during the COVID-19 pandemic. This study examines the symptoms reported by individuals who tested positive for COVID-19 compared with those who tested negative. DesignObservational study. SettingThe study was conducted on adult residents in Alberta, Canada, from October 2021 to February 2023. ParticipantsWe evaluated self-reported symptoms in 7623 adults with positive COVID-19 tests and 1520 adults who tested negative, using surveys adapted from the internationally standardised International Severe Acute Respiratory and emerging Infection Consortium (ISARIC)-developed COVID-19 long-term follow-up tools. These individuals had an index COVID-19 test date between 1 March 2020 and 31 December 2022 and were over 28 days post-COVID-19 testing. Primary outcome measuresThe primary outcomes were to identify the symptoms associated with COVID-19 positivity and risk factors for reporting symptoms. ResultsFatigue was the top reported symptom (42%) among COVID-19-positive respondents, while headache was the top reported symptom (32%) in respondents who tested negative. Compared with those who tested negative, COVID-19-positive individuals reported 1.5 times more symptoms and had higher odds of experiencing 31 out of the 40 listed symptoms during the postinfectious period. These symptoms included olfactory dysfunction, menstruation changes, cardiopulmonary and neurological symptoms. Female sex, middle age (41–55 years), Indigeneity, unemployment, hospital/intensive care unit (ICU) admission at the time of testing and pre-existing health conditions independently predicted a greater number and variety of symptoms. ConclusionsOur results provide evidence that COVID-19 survivors continue to experience a significant number and variety of symptoms. These findings can help inform targeted strategies for the unequally affected population. It is important to offer appropriate management for symptom relief to those who have survived the acute COVID-19 illness.
Læs mere Tjek på PubMedYuan, H.-Y., Wong, W. H., Khairunnasa, F., Ho, H. C., Chung, G. K.-K.
BMJ Open, 9.03.2024
Tilføjet 9.03.2024
ObjectiveTo estimate the impacts of demographic factors and income disparities on the case fatality rate (CFR) of COVID-19 in Hong Kong, taking into account the influence of reporting delays (ie, the duration between symptom onset and case confirmation). DesignRetrospective observational longitudinal study. ParticipantsA total of 7406 symptomatic patients with residence information reported between 23 January 2020 and 2 October 2021. Main outcome measuresThe study examined the disparity in COVID-19 deaths associated with the factors such as age (≥65 vs 0–64 years old groups), gender and the income level of districts (low income vs non-low income). The severe reporting delay (>10 days) was considered as the mediator for mediation analysis. A Cox proportional hazards regression model was constructed. ResultsWe found that CFR was 3.07% in the low-income region, twofold higher than 1.34% in the other regions. Although the severe reporting delay was associated with a hazard ratio (HR) of about 1.9, its mediation effect was only weakly present for age, but not for gender or income level. Hence, high CFR in Hong Kong was largely attributed to the direct effects of the elderly (HR 25.967; 95% CI 14.254 to 47.306) and low income (HR 1.558; 95% CI 1.122 to 2.164). ConclusionThe disparity in COVID-19 deaths between income regions is not due to reporting delays, but rather to health inequities in Hong Kong. These risks may persist after the discontinuation of test-and-trace measures and extend to other high-threat respiratory pathogens. Urgent actions are required to identify vulnerable groups in low-income regions and understand the underlying causes of health inequities.
Læs mere Tjek på PubMedReder, S. R., Herrlich, N., Grauhan, N. F., Othman, A. E., Müller-Eschner, M., Brockmann, C., Brockmann, M. A.
BMJ Open, 9.03.2024
Tilføjet 9.03.2024
ObjectivesA hard lockdown was presumed to lead to delayed diagnosis and treatment of serious diseases, resulting in higher acuity at admission. This should be elaborated based on the estimated acuity of the cases, changes in findings during hospitalisation, age structure and biological sex. DesignRetrospective monocentric cross-sectional study. SettingGerman Neuroradiology Department at a . ParticipantsIn 2019, n=1158 patients were admitted in contrast to n=884 during the first hard lockdown in 2020 (11th–13th week). Main outcome measuresThree radiologists evaluated the initial case acuity, classified them into three groups (not acute, subacute and acute), and evaluated if there was a relevant clinical deterioration. The data analysis was conducted using non-parametric methods and multivariate regression analysis. ResultsA 24% decrease in the number of examinations from 2019 to 2020 (p=0.025) was revealed. In women, the case acuity increased by 21% during the lockdown period (p=0.002). A 30% decrease in acute cases in men was observable (in women 5% decrease). Not acute cases decreased in both women and men (47%; 24%), while the subacute cases remained stable in men (0%) and decreased in women (28%). Regression analysis revealed the higher the age, the higher the acuity (p
Læs mere Tjek på PubMedGonzalez Bravo, C., Sabree, S. A., Dukes, K., Adeagbo, M. J., Edwards, S., Wainwright, K., Schaeffer, S. E., Villa, A., Wilks, A. D., Carvour, M. L.
BMJ Open, 9.03.2024
Tilføjet 9.03.2024
ObjectivesTo understand patients’ experiences with diabetes care during the COVID-19 pandemic, with an emphasis on rural, medically underserved, and/or minoritised racial and ethnic groups in the Midwestern USA. DesignCommunity-engaged, semi-structured interviews were conducted by medical student researchers trained in qualitative interviewing. Transcripts were prepared and coded in the language in which the interview was conducted (English or Spanish). Thematic analysis was conducted, and data saturation was achieved. SettingThe study was conducted in communities in Eastern and Western Iowa. ParticipantsAdults with diabetes (n=20) who were fluent in conversational English or Spanish were interviewed. One-third of participants were residents of areas designated as federal primary healthcare professional shortage areas and/or medically underserved areas, and more than half were recruited from medical clinics that offer care at no cost. ResultsThemes across both English and Spanish transcripts included: (1) perspectives of diabetes, care providers and care management; (2) challenges and barriers affecting diabetes care; and (3) participant feedback and recommendations. Participants reported major constraints related to provider availability, costs of care, access to nutrition counselling and mental health concerns associated with diabetes care during the pandemic. Participants also reported a lack of shared decision-making regarding some aspects of care, including amputation. Finally, participants recognised systems-level challenges that affected both patients and providers and expressed a preference for proactive collaboration with healthcare teams. ConclusionsThese findings support enhanced engagement of rural, medically underserved and minoritised groups as stakeholders in diabetes care, diabetes research and diabetes provider education.
Læs mere Tjek på PubMedCurtis, E., Jaung, R., Paine, S.-J., McLeod, M., Tamatea, J., Atkinson, J., Jiang, Y., Robson, B., Reid, P., Harris, R. B.
BMJ Open, 9.03.2024
Tilføjet 9.03.2024
IntroductionThe COVID-19 pandemic has had both direct and indirect impacts on the health of populations worldwide. While racial/ethnic health inequities in COVID-19 infection are now well known (and ongoing), knowledge about the impact of COVID-19 pandemic management on non-COVID-19-related outcomes for Indigenous peoples is less well understood. This article presents the study protocol for the Health Research Council of New Zealand funded project ‘Mā te Mōhio ka Mārama: Impact of COVID-19 on Māori:non-Māori inequities’. The study aims to explore changes in access to healthcare, quality of healthcare and health outcomes for Māori, the Indigenous peoples of Aotearoa New Zealand (NZ) and non-Māori during the COVID-19 outbreak period across NZ. Methods and analysisThis observational study is framed within a Kaupapa Māori research positioning that includes Kaupapa Māori epidemiology. National datasets will be used to report on access to healthcare, quality of healthcare and health outcomes between Māori and non-Māori during the COVID-19 pandemic in NZ. Study periods are defined as (a) prepandemic period (2015–2019), (b) first pandemic year without COVID-19 vaccines (2020) and (c) pandemic period with COVID-19 vaccines (2021 onwards). Regional and national differences between Māori and non-Māori will be explored in two phases focused on identified health priority areas for NZ including (1) mortality, cancer, long-term conditions, first 1000 days, mental health and (2) rheumatic fever. Ethics and disseminationThis study has ethical approval from the Auckland Health Research Ethics Committee (AHREC AH26253). An advisory group will work with the project team to disseminate the findings of this project via project-specific meetings, peer-reviewed publications and a project-specific website. The overall intention of the project is to highlight areas requiring health policy and practice interventions to address Indigenous inequities in health resulting from COVID-19 pandemic management (both historical and in the future).
Læs mere Tjek på PubMedPuoza Deo Gracious, Jerry Armah, Edward Appiah Boateng, Victoria Bam, Veronica Dzomeku, Joana Kyei-Dompim, Ampem Darko Oklodu-Abbey, Abigail Kusi Amponsah
PLoS One Infectious Diseases, 8.03.2024
Tilføjet 8.03.2024
by Puoza Deo Gracious, Jerry Armah, Edward Appiah Boateng, Victoria Bam, Veronica Dzomeku, Joana Kyei-Dompim, Ampem Darko Oklodu-Abbey, Abigail Kusi Amponsah Background The COVID-19 pandemic caused several higher educational institutions to switch from traditional face-to-face to virtual learning medium. This abrupt shift came with new expectations, experiences and challenges to nursing/ midwifery students, particularly new users, and even more so when preparation, orientation, and support were lacking or ineffective. The present study therefore aimed at exploring the expectations, experiences and challenges of nursing students using the virtual learning medium during the COVID-19 pandemic. Methods This was a descriptive phenomenological design using 12 purposively sampled nursing and midwifery students from a public university in Ghana. With the aid of a semi-structured guide, individual face-to-face interviews were audiotaped, transcribed verbatim at a later time and deductively analyzed into themes using the customer experience execution model. Results Participants were aged 22–36 years and involved equal number of males and females (n = 6), with majority being Christians (n = 11). Six themes were generated from the study: (1) “Initial thoughts and emotions” described participants initial reactions to the virtual educational medium during the pandemic; (2) \'Expectations with the virtual medium\' referred to the participants’ anticipations regarding the convenience offered by the virtual medium; (3) \'Experiences with the virtual medium\' depicted the participants’ recognition of both positive and negative encounters while using the virtual learning platform; (4) “Evaluation and recommendation” described participants’ reports of meeting expectations and recommendations they made to enhance virtual learning; (5) \'Challenges and limitations of the virtual medium\' typically represented the obstacles encountered by nursing/ midwifery students when they embraced the virtual medium; (6) “Prospects of the virtual medium” referred to participants’ views on the future of the virtual medium. Conclusion The study has brought to light that the virtual education environment comes with its own expectations, experiences and challenges to students. Provision of adequate support such as orientation and simulation laboratories by higher education institutions to satisfy students’ needs is necessary to enhance nursing education.
Læs mere Tjek på PubMedIan S. Hines, Tom Jurkiw, Emily Nguyen, Martine Ferguson, Sultana Solaiman, Elizabeth Reed, Maria Hoffmann, Jie Zheng
PLoS One Infectious Diseases, 8.03.2024
Tilføjet 8.03.2024
by Ian S. Hines, Tom Jurkiw, Emily Nguyen, Martine Ferguson, Sultana Solaiman, Elizabeth Reed, Maria Hoffmann, Jie Zheng Foodborne outbreaks associated with Shiga toxin-producing Escherichia coli (STEC) contaminated wheat flour have been an increasing food safety concern in recent decades. However, there is little literature aimed at investigating the impact of different flour types on the persistence of STEC during storage and thermal inactivation. Therefore, two serovars of STEC, O121 and O157, were selected to inoculate each of five different types of common wheat flours: whole wheat, bleached, unbleached, bread, and self-rising. Inoculated flours were examined for the stability of STEC during storage for up to 42 days at room temperature (RT) and aw ~0.56. Additionally, the thermal resistance of O121 and O157 under isothermal conditions at 60, 70, 80, and 90°C was analyzed for the inoculated flours. STEC storage persistence at RT was generally not affected by flour type, however, decreases of 1.2 and 2.4 log CFU/day within whole wheat flour for O121 and O157, respectively, were significantly lower than other flours. Though few differences were identified in relation to flour type, O121 exhibited significantly better survival rates than O157 during both equilibrium and storage periods. Compared to an approximate 6 log reduction in the population of O157, O121 population levels were reduced by a significantly lower amount (~3 log) during the entire storage period at RT. At each isothermal temperature, the impact of flour type on the thermal resistance capabilities of O121 or O157 was not a significant factor and resulted in similar survival curves regardless of serovar. Instead of exhibiting linear survival curves, both O121 and O157 displayed nonlinear curves with some shoulder/tail effect. Similar for both O121 and O157, the predicted decimal reduction time (D-value) decreased from approximately 25 min to around 8 min as the isothermal temperature increased from 60°C to 90°C. Results reported here can contribute to risk assessment models concerning contamination of STEC in wheat flour and add to our understanding of the impacts of flour type and STEC serovar on desiccation stability during storage and isothermal inactivation during thermal treatment.
Læs mere Tjek på PubMedSunpeng Duan, Yuedong Wang, Peter Kotanko, Hanjie Zhang
PLoS One Infectious Diseases, 8.03.2024
Tilføjet 8.03.2024
by Sunpeng Duan, Yuedong Wang, Peter Kotanko, Hanjie Zhang Background In-center hemodialysis entails repeated interactions between patients and clinic staff, potentially facilitating the spread of COVID-19. We examined if in-center hemodialysis is associated with the spread of SARS-CoV-2 between patients. Methods Our retrospective analysis comprised all patients receiving hemodialysis in four New York City clinics between March 12th, 2020, and August 31st, 2022. Treatment-level clinic ID, dialysis shift, dialysis machine station, and date of COVID-19 diagnosis by RT-PCR were documented. To estimate the donor-to-potential recipient exposure (“donor” being the COVID-19 positive patient denoted as “COV-Pos”; “potential recipient” being other susceptible patients in the same shift), we obtained the spatial coordinates of each dialysis station, calculated the Euclidean distances between stations and weighted the exposure by proximity between them. For each donor, we estimated the donor-to-potential recipient exposure of all potential recipients dialyzed in the same shift and accumulated the exposure over time within the ‘COV-Pos infectious period’ as cumulative exposures. The ‘COV-Pos infectious period’ started 5 days before COVID-19 diagnosis date. We deployed network analysis to assess these interactions and summarized the donor-to-potential recipient exposure in 193 network diagrams. We fitted mixed effects logistic regression models to test whether more donor-to-potential recipient exposure conferred a higher risk of SARS-CoV-2 infection. Results Out of 978 patients, 193 (19.7%) tested positive for COVID-19 and had contact with other patients during the COV-Pos infectious period. Network diagrams showed no evidence that more exposed patients would have had a higher chance of infection. This finding was corroborated by logistic mixed effect regression (donor-to-potential recipient exposure OR: 0.63; 95% CI 0.32 to 1.17, p = 0.163). Separate analyses according to vaccination led to materially identical results. Conclusions Transmission of SARS-CoV-2 between in-center hemodialysis patients is unlikely. This finding supports the effectiveness of non-pharmaceutical interventions, such as universal masking and other procedures to control spread of COVID-19.
Læs mere Tjek på PubMedRebecca Rodin, Thérèse A. Stukel, Hannah Chung, Chaim M. Bell, Allan S. Detsky, Sarina Isenberg, Kieran L. Quinn
PLoS One Infectious Diseases, 8.03.2024
Tilføjet 8.03.2024
by Rebecca Rodin, Thérèse A. Stukel, Hannah Chung, Chaim M. Bell, Allan S. Detsky, Sarina Isenberg, Kieran L. Quinn Importance Physicians and their practice behaviors influence access to healthcare and may represent potentially modifiable targets for practice-changing interventions. Use of virtual care at the end-of-life significantly increased during the COVID-19 pandemic, but its association with physician practice behaviors, (e.g., annual service volume) is unknown. Objective Measure the association of physicians’ annual service volume with their use of virtual end-of-life care (EOLC) and the magnitude of physician-attributable variation in its use, before and during the pandemic. Design, setting and participants Population-based cohort study using administrative data of all physicians in Ontario, Canada who cared for adults in the last 90 days of life between 01/25/2018-12/31/2021. Multivariable modified Poisson regression models measured the association between attending physicians’ use of virtual EOLC and their annual service volume. We calculated the variance partition coefficients for each regression and stratified by time period before and during the pandemic. Exposure Annual service volume of a person’s attending physician in the preceding year. Main outcomes and measures Delivery of ≥1 virtual EOLC visit by a person’s attending physician and the proportion of variation in its use attributable to physicians. Results Among the 35,825 unique attending physicians caring for 315,494 adults, use of virtual EOLC was associated with receiving care from a high compared to low service volume attending physician; the magnitude of this association diminished during the pandemic (adjusted RR 1.25 [95% CI 1.14, 1.37] pre-pandemic;1.10 (95% CI 1.08, 1.12) during the pandemic). Physicians accounted for 36% of the variation in virtual EOLC use pre-pandemic and 12% of this variation during the pandemic. Conclusions and relevance Physicians’ annual service volume was associated with use of virtual EOLC and physicians accounted for a substantial proportion of the variation in its use. Physicians may be appropriate and potentially modifiable targets for interventions to modulate use of EOLC delivery.
Læs mere Tjek på PubMedEthan Simpson, William C. Miller, Julia Schmidt, Jaimie Borisoff, W. Ben Mortenson
PLoS One Infectious Diseases, 8.03.2024
Tilføjet 8.03.2024
by Ethan Simpson, William C. Miller, Julia Schmidt, Jaimie Borisoff, W. Ben Mortenson Study design Single-cohort longitudinal survey design. Objectives To identify what ongoing impact the COVID-19 pandemic has on functioning and health in individuals with SCI. Using the ICF model as a guide, outcome measures were chosen to explore potential constructs and aspects of health and functioning which may have been affected by regulations. Setting Online, Canada. Methods Participants provided demographic and clinical characteristics at baseline. They completed standardized online measures at three time points, each roughly one month apart (June, July, and August of 2020). The measures assessed mental health, resilience, boredom, social support, technology use, life space, and participation. Repeated measures ANOVAs were used to identify longitudinal changes for each measure. Results We collected data from 21 participants with SCI (mean age 54 years, 12 male). We found a large effect size for participation (η2 = 0.20), which increased over time. We also found medium effect sizes in both anxiety (η2 = 0.12) and social network usage (η2 = 0.12). Anxiety decreased over time and social networking usage fluctuated slightly but with an increase from time point one to time point two. Conclusion The results indicate that individuals with spinal cord injury appear to be staying relatively stable during the pandemic with improvements in a few key aspects, such as potentially increased participation and decreased anxiety. The results also suggest that it is important to continue fostering ways for individuals with spinal cord injury to stay connected, engaged, and informed.
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