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Harry R. KingMark BycroftThanh-Binh NguyenGeoff KellyAlexander A. VinogradovPamela J. E. RowlingKatherine StottDavid B. AscherHiroaki SugaLaura S. ItzhakiKaterina Artavanis-TsakonasaDepartment of Pathology, University of Cambridge, Cambridge CB2 1QP, United KingdombDepartment of Pharmacology, University of Cambridge, Cambridge CB2 1PD, United KingdomcSchool of Chemistry and Molecular Biosciences, University of Queensland, Brisbane QLD 4067, AustraliadNMR Centre, Francis Crick Institute, London NW1 1AT, United KingdomeDepartment of Chemistry, Graduate School of Science, University of Tokyo, Tokyo 113-0033, JapanfDepartment of Biochemistry, University of Cambridge, Cambridge CB2 1GA, United Kingdom
Proceedings of the National Academy of Sciences, 23.05.2024
Tilføjet 23.05.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 21, May 2024.
Læs mere Tjek på PubMedMengzhu ChaiLei LiYong LiYingshuai YangYuting WangXue JiangYameng LuanFangfang LiHongguang CuiAiming WangWensheng XiangXiaoyun WuXiaofei ChengaCollege of Plant Protection, Northeast Agricultural University, Harbin, Heilongjiang 150030, ChinabSchool of Life Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, ChinacState Key Laboratory for Biology of Plant Diseases and Insect Pests, Institute of Plant Protection, Chinese Academy of Agricultural Sciences, Beijing 100193, ChinadCollege of Plant Protection, Hainan University, Haikou 570228, ChinaeLondon Research and Development Centre, Agriculture and Agri-Food Canada, London, ON N5V 4T3, Canada
Proceedings of the National Academy of Sciences, 23.05.2024
Tilføjet 23.05.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 21, May 2024.
Læs mere Tjek på PubMedPriscila M. S. CastanhaPatrick J. McEnaneyYongseok ParkAnthea BouwerElton J. F. ChavesRoberto D. LinsNicholas G. PaciaroniPaige DicksonGraham CarlsonMarli T. CordeiroTereza MagalhaesJodi CraigoErnesto T. A. MarquesThomas KodadekDonald S. BurkeaDepartment of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261bDepartment of Chemistry, The Herbert Wertheim University of Florida Scripps Institute for Biomedical Innovation and Technology, Jupiter, FL 33458cDepartment of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261dDepartment of Microbiology and Molecular Genetics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15219eDepartment of Virology, Aggeu Magalhaes Institute, Oswaldo Cruz Foundation, Cidade Universitearia, Recife, Pernambuco 50740-465, BrazilfDeluge Biotechnologies, Jupiter, FL 33458gDepartment of Entomology, Texas A&M University, College Station, TX 77843hDepartment of Preventive and Social Medicine, School of Medicine, Universidade Federal da Bahia, Bahia 40026-010, BraziliDepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261
Proceedings of the National Academy of Sciences, 23.05.2024
Tilføjet 23.05.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 21, May 2024.
Læs mere Tjek på PubMedAnna E. DewarChunhui HaoLaurence J. BelcherMelanie GhoulStuart A. WestaDepartment of Biology, University of Oxford, Oxford OX1 3SZ, United Kingdom
Proceedings of the National Academy of Sciences, 23.05.2024
Tilføjet 23.05.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 21, May 2024.
Læs mere Tjek på PubMedJingjing QiLichong YanJiping SunChuanxin HuangBing SuJinke ChengLei ShenaCenter for Immune-Related Diseases at Shanghai Institute of Immunology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinabDepartment of Immunology and Microbiology, Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of Education, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinacDepartment of Biochemistry and Molecular Cell Biology, Shanghai Key Laboratory of Tumor Microenvironment and Inflammation, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Proceedings of the National Academy of Sciences: Immunology and Inflammation, 23.05.2024
Tilføjet 23.05.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 22, May 2024.
Læs mere Tjek på PubMedLin GaoTian TianTingrong XiongXiaomei ZhangNing WangLuxuan LiuYun ShiQiang LiuDongshui LuPing LuoWeijun ZhangPing ChengQiang GouYu WangHao ZengXiaokai ZhangQuanming ZouaNational Engineering Research Center of Immunological Products, Department of Microbiology and Biochemical Pharmacy, College of Pharmacy, Third Military Medical University, Chongqing 400038, ChinabDepartment of Medical Engineering, Xinqiao Hospital, Third Military Medical University, Chongqing 400038, ChinacInstitute of Biopharmaceutical Research, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, ChinadDepartment of Basic Courses, Non-Commissioned Officer School, Third Military Medical University, Shijiazhuang 050081, ChinaeState Key Laboratory of Trauma, Burn and Combined Injury, Third Military Medical University, Chongqing 400038, China
Proceedings of the National Academy of Sciences: Immunology and Inflammation, 23.05.2024
Tilføjet 23.05.2024
Proceedings of the National Academy of Sciences, Volume 121, Issue 22, May 2024.
Læs mere Tjek på PubMedMustafa Özçam, Susan V. Lynch
Nat Rev Microbiol, 23.05.2024
Tilføjet 23.05.2024
Trisha GreenhalghC. Raina MacIntyreMichael G. BakerShovon BhattacharjeeAbrar A. ChughtaiDavid FismanMohana KunasekaranAmanda KvalsvigDeborah LuptonMatt OliverEssa TawfiqMark UngrinJoe Vipond1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom2Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, Australia3Department of Public Health, University of Otago, Wellington, New Zealand4School of Mechanical and Manufacturing Engineering, University of New South Wales, Sydney, Australia5School of Population Health, University of New South Wales, Sydney, Australia6Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada7Centre for Social Research in Health and Social Policy Research Centre, Faculty of Arts, Design and Architecture, University of New South Wales, Sydney, Australia8Professional Standards Advocate, Edmonton, Canada9Faculty of Veterinary Medicine; Department of Biomedical Engineering, Schulich School of Engineering; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada10Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada, Ferric C. Fang, Linsey Marr
Clinical Microbiology Reviews, 23.05.2024
Tilføjet 23.05.2024
Tiana Carina Schwab, Lisa Perrig, Pauline Carlotta Göller, Freddy Fernando Guebely De la Hoz, Adrien Philippe Lahousse, Beatrice Minder, Gunar Günther, Orestis Efthimiou, Shaheed Vally Omar, Matthias Egger, Lukas Fenner
Lancet Infectious Diseases, 23.05.2024
Tilføjet 23.05.2024
Targeted NGS is highly sensitive and specific for detecting drug resistance across panels of tuberculosis drugs and can be performed directly on clinical samples. There is a paucity of data on performance for some currently recommended drugs. The barriers preventing the use of targeted NGS to diagnose drug-resistant tuberculosis in high-burden countries need to be addressed.
Læs mere Tjek på PubMedChristine Marie George, Alves Namunesha, Willy Felicien, Kelly Endres, Wensheng Luo, Lucien Bisimwa, Camille Williams, Jean‐Claude Bisimwa, Presence Sanvura, Jamie Perin, Justin Bengehya, Ghislain Maheshe, David A. Sack, Cirhuza Cikomola, Alain Mwishingo
Tropical Medicine & International Health, 23.05.2024
Tilføjet 23.05.2024
Wojciech Trzebiński, Jerzy Trzebiński
PLoS One Infectious Diseases, 23.05.2024
Tilføjet 23.05.2024
Desalegn Girma, Zinie Abita, Lidya Gutema Lemu, Daniel Asmelash, Getachew Mesfin Bambo, Melesew Setegn Alie, Gossa Fetene Abebe
PLoS One Infectious Diseases, 23.05.2024
Tilføjet 23.05.2024
by Desalegn Girma, Zinie Abita, Lidya Gutema Lemu, Daniel Asmelash, Getachew Mesfin Bambo, Melesew Setegn Alie, Gossa Fetene Abebe Background At the end of 2022, globally, only 46% of children (aged 0–14 years) on ART had suppressed viral loads. Viral load suppression is crucial to reduce HIV-related deaths. To suppress the viral load at the expected level, children must be retained in ART treatment. Nevertheless, lost to follow-up from ART treatment continues to be a global challenge, particularly, in developing countries. Previously, primary studies were conducted in Ethiopia to assess the incidence of lost to follow-up among HIV-positive children on ART treatment. However, variations have been seen among the studies. Therefore, this systematic review and meta-analysis aimed to estimate the pooled incidence of lost to follow-up among HIV-positive children on ART and identify its associated factors in Ethiopia. Methods We searched PubMed, HINARI, Science Direct, Google Scholar, and African Journals Online to obtain articles published up to November 20, 2023. Critical appraisal was done using the Joanna Briggs Institute checklist. Heterogeneity was identified using I-square statistics. Funnel plot and Egger’s tests were used to identify publication bias. Data was presented using forest plots and tables. Random and fixed-effect models were used to compute the pooled estimate. Results Twenty-four studies were included in the final analysis. The pooled incidence of lost to follow-up among HIV-positive children on ART was 2.79 (95% CI: 1.99, 3.91) per 100-child-year observations. Advanced HIV disease (HR: 2.20, 95% CI: 1.71, 2.73), having opportunistic infection (HR: 2.59, 95% CI: 1.39; 4.78), fair or poor ART treatment adherence (HR: 2.92, 95% CI: 1.31; 6.54) and children aged between 1–5 years (HR: 2.1,95% CI: 1.44; 2.95) were factors associated with lost to follow up among HIV positive children on ART. Conclusions The overall pooled incidence of lost to follow-up among HIV-positive children on ART is low in Ethiopia. Therefore, counseling on ART drug adherence should be strengthened. Moreover, emphasis has to be given to children with advanced HIV stage and opportunistic infection to reduce the rate of lost to follow up among HIV-positive children on ART. Trial registration Registered in PROSPERO with ID: CRD42024501071.
Læs mere Tjek på PubMedJesús S. Aguilar Díaz de león, Miyuki Thirumurty, Nguyen Ly
PLoS One Infectious Diseases, 23.05.2024
Tilføjet 23.05.2024
by Jesús S. Aguilar Díaz de león, Miyuki Thirumurty, Nguyen Ly Membrane proteins are the main targets of therapeutic drugs and most of them are glycosylated. Glycans play pivotal roles in several biological processes, and glycosylation changes are a well-established hallmark of several types of cancer, including pancreatic cancer, that contribute to tumor growth. Mucin-4 (MUC-4) is a membrane glycoprotein which is associated with pancreatic cancer and metastasis, and it has been targeted as a promising vaccine candidate. In this study, Surface Plasmon Resonance Microscopy (SPRM) was implemented to study complex influences of the native N-glycan cellular environment on binding interactions to the MUC-4 receptor as this is currently the only commercially available label-free technique with high enough sensitivity and resolution to measure binding kinetics and heterogeneity on single cells. Such unique capability enables for a more accurate understanding of the “true” binding interactions on human cancer cells without disrupting the native environment of the target MUC-4 receptor. Removal of N-linked glycans in pancreatic cancer cells using PNGase F exposed heterogeneity in Concanavalin (Con A) binding by revealing three new binding populations with higher affinities than the glycosylated control cells. Anti-MUC-4 binding interactions of enzymatically N-linked deglycosylated pancreatic cancer cells produced a 25x faster association and 37x higher affinity relative to the glycosylated control cells. Lastly, four interaction modes were observed for Helix Pomatia Agglutinin (HPA) binding to the glycosylated control cells, but shifted and increased in activity upon removal of N-linked glycans. These results identified predominant interaction modes of glycan and MUC-4 in pancreatic cancer cells, the kinetics of their binding interactions were quantified, and the influence of N-linked glycans in MUC-4 binding interactions was revealed.
Læs mere Tjek på PubMedEzra Gayawan, Ewan Cameron, Tolu Okitika, Osafu Augustine Egbon, Peter Gething
PLoS One Infectious Diseases, 23.05.2024
Tilføjet 23.05.2024
by Ezra Gayawan, Ewan Cameron, Tolu Okitika, Osafu Augustine Egbon, Peter Gething We assess progress towards improved case management of childhood diarrhea in Nigeria over a period of targeted health systems reform from 2013 to 2018. Individual and community data from three Demographic and Health Survey rounds are leveraged in a geospatial model designed for stratified estimation by venue of treatment seeking and State. Our analysis reveals a highly regionalised health system undergoing rapid change. Nationally, there have been substantial increases in the proportion of children under 5 years old with diarrhea receiving the recommended oral rehydration therapy after seeking treatment at either a health clinic (0.57 [0.44–0.69; 95% CI] in 2008; 0.70 [0.54–0.83] in 2018) or chemist/pharmacy (0.28 [0.17–0.42] in 2008; 0.48 [0.31–0.64] in 2018). Yet State-level variations in venue attendance and performance by venue have conspired to hold the overall proportion receiving this potentially life-saving therapy (0.45 [0.35–0.55] in 2018) to well-below ideal coverage levels. High performing states that have demonstrated significant improvements include Kano, Jigawa and Borno, while under-performing states that have suffered declines in coverage include Kaduna and Taraba. The use of antibiotics is not recommended for mild cases of childhood diarrhea yet remains concerningly high nationally (0.27 [0.19–0.36] in 2018) with negligible variation between venues. Antibiotic use rates are particularly high in Enugu, Kaduna, Taraba, Kano, Niger and Kebbi, yet welcome reductions were identified in Jigawa, Adamawa and Osun. These results support the conclusions of previous studies and build the strength of evidence that urgent action is needed throughout the multi-tiered health system to improve the quality and equity of care for common childhood illnesses in Nigeria.
Læs mere Tjek på PubMedAmit Timilsina, Buna Bhandari, Alexandra Johns, Subash Thapa
PLoS One Infectious Diseases, 23.05.2024
Tilføjet 23.05.2024
by Amit Timilsina, Buna Bhandari, Alexandra Johns, Subash Thapa Introduction Sexual and Reproductive Health and Rights (SRHR) have been promoted globally, yet sexual and reproductive health (SRH) interventions are seldom evaluated from the perspective of service users and service providers. Very little is known about whether and why various target groups including general women are (or are not) practicing SRH -related self-care practices. This study explored SRH self-care practices and facilitators and barriers to the adoption of SRH self-care among reproductive-age women of Nepal. Methods In this descriptive qualitative study, we conducted in-depth interviews in June 2022 with ten married women of reproductive age (service users) and four SRHR service providers (program managers and health service providers) in Nepal. Thematic analysis was conducted for data analysis. Results We found that commonly practiced self-care practices were self-administration of contraceptives, self-management of pain, self-monitoring of pregnancy, self-awareness and seeking medical abortions (tele-abortion), self-medication for pre-exposure prophylaxis for HIV, and self-testing for HIV and pregnancy. The multi-level barriers to SRH self-care were poor knowledge and perceived lack of need for SRH self-care, limited access, and negative behaviors from the service providers. The program-related barriers included lack of evidence, limited financial resources, lack of accountability, and limited knowledge and skills among service providers on SRH self-care measures. Peer support, an increasing number of service sites, and access to and use of digital (health) tools emerged as the facilitators of SRH self-care. Conclusions The findings of this study suggest that addressing barriers such as poor knowledge, limited access, and negative attitudes while leveraging facilitators such as peer support and digital tools is essential for promoting and enabling effective SRH self-care among women. Population-wide awareness programs supplemented by increasing service sites are essential for increasing SRH self-care practices.
Læs mere Tjek på PubMedLi Wang, Fangli Liao, Liping Yang, Linshan Jiang, Liang Duan, Bo Wang, Di Mu, Juan Chen, Ying Huang, Qin Hu, Weixian Chen
PLoS One Infectious Diseases, 23.05.2024
Tilføjet 23.05.2024
by Li Wang, Fangli Liao, Liping Yang, Linshan Jiang, Liang Duan, Bo Wang, Di Mu, Juan Chen, Ying Huang, Qin Hu, Weixian Chen Killer cell lectin-like receptor G1 (KLRG1) has traditionally been regarded as an inhibitory receptor of T cell exhaustion in chronic infection and inflammation. However, its exact role in hepatitis B virus (HBV) infection remains elusive. CD8+ T cells from 190 patients with chronic hepatitis B were analyzed ex vivo for checkpoint and apoptosis markers, transcription factors, cytokines and subtypes in 190 patients with chronic hepatitis B. KLRG1+ and KLRG1− CD8+ T cells were sorted for transcriptome analysis. The impact of the KLRG1-E-cadherin pathway on the suppression of HBV replication mediated by virus-specific T cells was validated in vitro. As expected, HBV-specific CD8+ T cells expressed higher levels of KLRG1 and showed an exhausted molecular phenotype and function. However, despite being enriched for the inhibitory molecules, thymocyte selection-associated high mobility group box protein (TOX), eomesodermin (EOMES), and Helios, CD8+ T cells expressing KLRG1 produced significant levels of tumour necrosis factor (TNF)-α, interferon (IFN)-γ, perforin, and granzyme B, demonstrating not exhausted but active function. Consistent with the in vitro phenotypic assay results, RNA sequencing (RNA-seq) data showed that signature effector T cell and exhausted T cell genes were enriched in KLRG1+ CD8+ T cells. Furthermore, in vitro testing confirmed that KLRG1−E-cadherin binding inhibits the antiviral efficacy of HBV-specific CD8+ T cells. Based on these findings, we concluded that KLRG1+ CD8+ T cells are not only a terminally exhausted subgroup but also exhibit functional diversity, despite inhibitory signs in HBV infection.
Læs mere Tjek på PubMedKatharine J. Looker, Elliot McClenaghan, Alison Judd, Livia Pierotti, Harriet Downing, Jody Phelan, Charlotte Warren-Gash, Kalu Ngozi, Fiona Dawe, Caroline Relton, Hannah Christensen, Alastair D. Hay, Punam Mangtani, Patrick Nguipdop-Djomo, Rachel Denholm
PLoS One Infectious Diseases, 23.05.2024
Tilføjet 23.05.2024
by Katharine J. Looker, Elliot McClenaghan, Alison Judd, Livia Pierotti, Harriet Downing, Jody Phelan, Charlotte Warren-Gash, Kalu Ngozi, Fiona Dawe, Caroline Relton, Hannah Christensen, Alastair D. Hay, Punam Mangtani, Patrick Nguipdop-Djomo, Rachel Denholm Background The symptom profiles of acute SARS-CoV-2 infection and long-COVID in children and young people (CYP), risk factors, and associated healthcare needs, are poorly defined. The Schools Infection Survey 1 (SIS-1) was a nationwide study of SARS-CoV-2 infection in primary and secondary schools in England during the 2020/21 school year. The Covid-19 Mapping and Mitigation in Schools (CoMMinS) study was conducted in schools in the Bristol area over a similar period. Both studies conducted testing to identify current and previous SARS-CoV-2 infection, and recorded symptoms and school attendance. These research data have been linked to routine electronic health record (EHR) data. Aims To better understand the short- and long-term consequences of SARS-CoV-2 infection, and their risk factors, in CYP. Methods Retrospective cohort and nested case-control analyses will be conducted for SIS-1 and CoMMinS data linked to EHR data for the association between (1) acute symptomatic SARS-CoV-2 infection and risk factors; (2) SARS-CoV-2 infection and long-term effects on health: (a) persistent symptoms; (b) any new diagnosis; (c) a new prescription in primary care; (d) health service attendance; (e) a high rate of school absence. Results Our study will improve understanding of long-COVID in CYP by characterising the trajectory of long-COVID in CYP in terms of things like symptoms and diagnoses of conditions. The research will inform which groups of CYP are more likely to get acute- and long-term outcomes of SARS-CoV-2 infection, and patterns of related healthcare-seeking behaviour, relevant for healthcare service planning. Digested information will be produced for affected families, doctors, schools, and the public, as appropriate. Conclusion Linked SIS-1 and CoMMinS data represent a unique and rich resource for understanding the impact of SARS-CoV-2 infection on children’s health, benefiting from enhanced SARS-CoV-2 testing and ability to assess a wide range of outcomes.
Læs mere Tjek på PubMedFrancesca Bianchi, Valentino Le Noci, Giancarla Bernardo, Nicoletta Gagliano, Graziano Colombo, Michele Sommariva, Michele Palazzo, Isabella Dalle-Donne, Aldo Milzani, Serenella Pupa, Elda Tagliabue, Lucia Sfondrini
PLoS One Infectious Diseases, 23.05.2024
Tilføjet 23.05.2024
by Francesca Bianchi, Valentino Le Noci, Giancarla Bernardo, Nicoletta Gagliano, Graziano Colombo, Michele Sommariva, Michele Palazzo, Isabella Dalle-Donne, Aldo Milzani, Serenella Pupa, Elda Tagliabue, Lucia Sfondrini Background It is amply demonstrated that cigarette smoke (CS) has a high impact on lung tumor progression worsening lung cancer patient prognosis and response to therapies. Alteration of immune cell types and functions in smokers’ lungs have been strictly related with smoke detrimental effects. However, the role of CS in dictating an inflammatory or immunosuppressive lung microenvironment still needs to be elucidated. Here, we investigated the effect of in vitro exposure to cigarette smoke extract (CSE) focusing on macrophages. Methods Immortalized murine macrophages RAW 264.7 cells were cultured in the presence of CS extract and their polarization has been assessed by Real-time PCR and cytofluorimetric analysis, viability has been assessed by SRB assay and 3D-cultures and activation by exposure to Poly(I:C). Moreover, interaction with Lewis lung carcinoma (LLC1) murine cell models in the presence of CS extract were analyzed by confocal microscopy. Results Obtained results indicate that CS induces macrophages polarization towards the M2 phenotype and M2-phenotype macrophages are resistant to the CS toxic activity. Moreover, CS impairs TLR3-mediated M2-M1 phenotype shift thus contributing to the M2 enrichment in lung smokers. Conclusions These findings indicate that, in lung cancer microenvironment of smokers, CS can contribute to the M2-phenotype macrophages prevalence by different mechanisms, ultimately, driving an anti-inflammatory, likely immunosuppressive, microenvironment in lung cancer smokers.
Læs mere Tjek på PubMedMalaria Journal, 22.05.2024
Tilføjet 22.05.2024
Abstract Sustainable reductions in African malaria transmission require innovative tools for mosquito control. One proposal involves the use of low-threshold gene drive in Anopheles vector species, where a ‘causal pathway’ would be initiated by (i) the release of a gene drive system in target mosquito vector species, leading to (ii) its transmission to subsequent generations, (iii) its increase in frequency and spread in target mosquito populations, (iv) its simultaneous propagation of a linked genetic trait aimed at reducing vectorial capacity for Plasmodium, and (v) reduced vectorial capacity for parasites in target mosquito populations as the gene drive system reaches fixation in target mosquito populations, causing (vi) decreased malaria incidence and prevalence. Here the scope, objectives, trial design elements, and approaches to monitoring for initial field releases of such gene dive systems are considered, informed by the successful implementation of field trials of biological control agents, as well as other vector control tools, including insecticides, Wolbachia, larvicides, and attractive-toxic sugar bait systems. Specific research questions to be addressed in initial gene drive field trials are identified, and adaptive trial design is explored as a potentially constructive and flexible approach to facilitate testing of the causal pathway. A fundamental question for decision-makers for the first field trials will be whether there should be a selective focus on earlier points of the pathway, such as genetic efficacy via measurement of the increase in frequency and spread of the gene drive system in target populations, or on wider interrogation of the entire pathway including entomological and epidemiological efficacy. How and when epidemiological efficacy will eventually be assessed will be an essential consideration before decisions on any field trial protocols are finalized and implemented, regardless of whether initial field trials focus exclusively on the measurement of genetic efficacy, or on broader aspects of the causal pathway. Statistical and modelling tools are currently under active development and will inform such decisions on initial trial design, locations, and endpoints. Collectively, the considerations here advance the realization of developer ambitions for the first field trials of low-threshold gene drive for malaria vector control within the next 5 years.
Læs mere Tjek på PubMedMalaria Journal, 22.05.2024
Tilføjet 22.05.2024
Abstract Background This study aimed to assess the spatial distribution of Anopheles mosquito larval habitats and the environmental factors associated with them, as a prerequisite for the implementation of larviciding. Methods The study was conducted in December 2021, during the transition period between the end of the short rainy season (September–November) and the short dry season (December-February). Physical, biological, and land cover data were integrated with entomological observations to collect Anopheles larvae in three major towns: Mitzic, Oyem, and Bitam, using the "dipping" method during the transition from rainy to dry season. The collected larvae were then reared in a field laboratory established for the study period. After the Anopheles mosquitoes had emerged, their species were identified using appropriate morphological taxonomic keys. To determine the influence of environmental factors on the breeding of Anopheles mosquitoes, multiple-factor analysis (MFA) and a binomial generalized linear model were used. Results According to the study, only 33.1% out of the 284 larval habitats examined were found to be positive for Anopheles larvae, which were primarily identified as belonging to the Anopheles gambiae complex. The findings of the research suggested that the presence of An. gambiae complex larvae in larval habitats was associated with various significant factors such as higher urbanization, the size and type of the larval habitats (pools and puddles), co-occurrence with Culex and Aedes larvae, hot spots in ambient temperature, moderate rainfall, and land use patterns. Conclusions The results of this research mark the initiation of a focused vector control plan that aims to eradicate or lessen the larval habitats of An. gambiae mosquitoes in Gabon\'s Woleu Ntem province. This approach deals with the root causes of malaria transmission through larvae and is consistent with the World Health Organization\'s (WHO) worldwide objective to decrease malaria prevalence in regions where it is endemic.
Læs mere Tjek på PubMedMalaria Journal, 22.05.2024
Tilføjet 22.05.2024
Abstract Background Primaquine (PQ) is the prototype 8-aminoquinoline drug, a class which targets gametocytes and hypnozoites. The World Health Organization (WHO) recommends adding a single low dose of primaquine to the standard artemisinin-based combination therapy (ACT) in order to block malaria transmission in regions with low malaria transmission. However, the haemolytic toxicity is a major adverse outcome of primaquine in glucose-6-phosphate dehydrogenase (G6PD)-deficient subjects. This study aimed to characterize the pharmacokinetic properties of primaquine and its major metabolites in G6PD-deficient subjects. Methods A single low-dose of primaquine (0.4–0.5 mg/kg) was administered in twenty-eight African males. Venous and capillary plasma were sampled up to 24 h after the drug administration. Haemoglobin levels were observed up to 28 days after drug administration. Only PQ, carboxy-primaquine (CPQ), and primaquine carbamoyl-glucuronide (PQCG) were present in plasma samples and measured using liquid chromatography mass spectrometry. Drug and metabolites’ pharmacokinetic properties were investigated using nonlinear mixed-effects modelling. Results Population pharmacokinetic properties of PQ, CPQ, and PQCG can be described by one-compartment disposition kinetics with a transit-absorption model. Body weight was implemented as an allometric function on the clearance and volume parameters for all compounds. None of the covariates significantly affected the pharmacokinetic parameters. No significant correlations were detected between the exposures of the measured compounds and the change in haemoglobin or methaemoglobin levels. There was no significant haemoglobin drop in the G6PD-deficient patients after administration of a single low dose of PQ. Conclusions A single low-dose of PQ was haematologically safe in this population of G6PD-normal and G6PD-deficient African males without malaria. Trial registration NCT02535767
Læs mere Tjek på PubMedMalaria Journal, 22.05.2024
Tilføjet 22.05.2024
Abstract Background Perennial malaria chemoprevention (PMC) aims to protect children at risk from severe malaria by the administration of anti-malarial drugs to children of defined ages throughout the year. Sulfadoxine-pyrimethamine (SP) has been widely used for chemoprevention in Africa and a child-friendly dispersible tablet formulation has recently become available. Methods This qualitative non-interventional observational study was conducted in Benin, Côte d’Ivoire, and Mozambique between February and June 2022. Prototype blister packs, dispensing boxes and job aids designed to support dispersible SP deployment for PMC were evaluated using focus group discussions (FGD) and semi-structured in-depth individual interviews (IDI) with health authorities, health personnel, community health workers (CHWs) and caregivers. The aim was to evaluate knowledge and perceptions of malaria and chemoprevention, test understanding of the tools and identify gaps in understanding, satisfaction, user-friendliness and acceptability, and assess the potential role of CHWs in PMC implementation. Interviews were transcribed and imported to ATLAS.ti for encoding and categorization. Thematic content analysis used deductive and inductive coding with cross-referencing of findings between countries and participants to enrich data interpretation. Continuous comparison across the IDI and FGD permitted iterative, collaborative development of materials. Results Overall, 106 participants completed IDIs and 70 contributed to FGDs. Malaria was widely recognised as the most common disease affecting children, and PMC was viewed as a positive intervention to support child health. The role of CHWs was perceived differently by the target groups, with caregivers appreciating their trusted status in the community, whereas health authorities preferred clinic-based deployment of PMC by health professionals. Empirical testing of the prototype blister packs, dispensing boxes and job aids highlighted the context-specific expectations of respondents, such as familiar situations and equipment, and identified areas of confusion or low acceptance. A key finding was the need for a clear product identity reflecting malaria. Conclusion Simple modifications profoundly affected the perception of PMC and influenced acceptability. Iterative quantitative investigation resulted in PMC-specific materials suited to the local context and socio-cultural norms of the target population with the aim of increasing access to chemoprevention in children most at risk of severe malaria.
Læs mere Tjek på PubMedGitanjali BhushanVictor CastanoTania Wong Fok LungCourtney ChandlerThomas H. McConvilleRobert K. ErnstAlice S. PrinceDanielle Ahn1Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA2Department of Microbial Pathogenesis, University of Maryland, School of Dentistry, Baltimore, Maryland, USA3Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA, Denise M. Monack
Infection and Immunity, 22.05.2024
Tilføjet 22.05.2024
Ezequiel Lacunza, Anuj Ahuja, Omar A. Coso, Martin Abba, Juan Carlos Ramos, Ethel Cesarman, Enrique A. Mesri, Julian Naipauer
Journal of Medical Virology, 22.05.2024
Tilføjet 22.05.2024
Seyit Ali Büyüktuna, Serra İlayda Yerlitaş, Gözde Ertük Zararsız, Kübra Doğan, Demet Kablan, Gökhan Bağcı, Selda Özer, Cihad Baysal, Yasemin Çakır, Ahu Cephe, Necla Koçhan, Gökmen Zararız, Halef Okan Doğan
Journal of Medical Virology, 22.05.2024
Tilføjet 22.05.2024
Warda Haque, Muhammad Talha, Sezanur Rahman, Mehedi Hasan, Shaheen Alam, Zahid Hassan, Sayra Moni, Sadia H. Khan, Mohammad E. Hossain, Abu S. G. Faruque, S. M. Tafsir Hasan, Soroar H. Khan, Tahmeed Ahmed, Khalequz Zaman, Mustafizur Rahman
Journal of Medical Virology, 22.05.2024
Tilføjet 22.05.2024
Xin Lai, Wenxian OuYang, Shuangjie Li, Jun Qiu, Hui Zhang, Tao Jiang, Xiaomei Qin, Lian Tang, Yingping Gu, Zhenzhen Yao, Songxu Peng
Journal of Medical Virology, 22.05.2024
Tilføjet 22.05.2024
Fang Ren, Shiqiao Zhao, Xin He, Hanghong Lo, Vincent Kam Wai Wong, Betty Yuen Kwan Law, Anguo Wu, Juan Zhang
Journal of Medical Virology, 22.05.2024
Tilføjet 22.05.2024
Noah BrownClemente da SilvaCaroline WebbDaniela MatiasBrigite DiasBeatriz CancioMiguel SilvaRuben ViegasCrizolgo SalvadorNordino ChivaleSonia LuisPaulo ArnaldoJulia ZulawinskaChristopher C. MooreFatima NogueiraJennifer L. Guler1Department of Biology, University of Virginia, Charlottesville, Virginia, USA2Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, UNL, Lisbon, Portugal3Instituto Nacional de Saúde, Maputo (INS), Maputo, Mozambique4Hospital Provincial de Matola, Matola, Mozambique5Division of Infectious Disease and International Health, University of Virginia, Charlottesville, Virginia, USA, Audrey Odom John
Antimicrobial Agents And Chemotherapy, 22.05.2024
Tilføjet 22.05.2024
Md Monzurul Islam AnoyWon-Jun KimSuzanne GelstonDerek FlemingRobin PatelHaluk Beyenal1The Gene and Linda Voiland School of Chemical Engineering and Bioengineering, Washington State University, Pullman, Washington, USA2Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA3Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA, Helen Boucher
Antimicrobial Agents And Chemotherapy, 22.05.2024
Tilføjet 22.05.2024
Gehang Ju, Yan Zhang, Chao Ye, Qiong Liu, Hanzhu Sun, Zhaorui Zhang, Xinyi Huang, Yueping Jiang, Qi Huang
International Journal of Infectious Diseases, 22.05.2024
Tilføjet 22.05.2024
Human infectious diseases are the second leading cause of death worldwide [1]. Staphylococcus aureus (S. aureus) is pathogenic bacteria causing various diseases, including pneumonia, skin and soft tissue infections, bacteremia, and endocarditis [1,2]. China Antimicrobial Resistance Surveillance System (CARSS) reported a 46% detection rate of S. aureus in 2020 [3]. The study showed that MRSA prevalence ranged from 0% to 73% at 19 sites in the Asia-Pacific region from 2000 to 2016 [3]. Recently, the rate of MRSA infection has been increasing sharply[4], posing a challenge to the health system in terms of difficult therapy, extended length of hospital stay, expanded health costs, and high mortality [4,5].
Læs mere Tjek på PubMedDiego Ramonfaur, Nardeen Ayad, Peter Hong Zhi Liu, Jiayan Zhou, Ying Wu, Jinlin Li, Guang Chen
International Journal of Infectious Diseases, 22.05.2024
Tilføjet 22.05.2024
The US National Institute of Health (NIH) launched the RECOVER initiative in 2021, a billion-dollar national research network, aimed at understanding, preventing, and treating long COVID [1]. Also in 2021, UK Research and Innovation (UKRI) and the National Institute for Health Research (NIHR) funded long COVID research studies with £18.5 million, to understand the genetic, biological, social, and environmental signatures and pathways of long COVID [2]. These projects have increased awareness of long COVID throughout the world and instilled a sense of public expectation of treating long COVID successfully.
Læs mere Tjek på PubMedGroot, L., Schers, H., Burgers, J. S., Smalbrugge, M., Uijen, A. A., Hoogland, J., van der Horst, H. E., Maarsingh, O. R.
BMJ Open, 22.05.2024
Tilføjet 22.05.2024
AimTo evaluate the effectiveness, feasibility and acceptability of a multicomponent intervention for improving personal continuity for older patients in general practice. DesignA cluster randomised three-wedged, pragmatic trial during 18 months. Setting32 general practices in the Netherlands. Participants221 general practitioners (GPs), practice assistants and other practice staff were included. Practices were instructed to include a random sample of 1050 patients aged 65 or older at baseline and 12-month follow-up. InterventionThe intervention took place at practice level and included opTimise persOnal cOntinuity for oLder (TOOL)-kit: a toolbox containing 34 strategies to improve personal continuity. OutcomesData were collected at baseline and at six 3-monthly follow-up measurements. Primary outcome measure was experienced continuity of care at the patient level measured by the Nijmegen Continuity Questionnaire (NCQ) with subscales for personal continuity (GP knows me and GP shows commitment) and team/cross-boundary continuity at 12-month follow-up. Secondary outcomes were measured in GPs, practice assistants and other practice staff and included work stress and satisfaction and perceived level of personal continuity. In addition, a process evaluation was undertaken among GPs, practice assistants and other practice staff to assess the acceptability and feasibility of the intervention. ResultsNo significant effect of the intervention was observed on NCQ subscales GP knows me (adjusted mean difference: 0.05 (95% CI –0.05 to 0.15), p=0.383), GP shows commitment (0.03 (95% CI –0.08 to 0.14), p=0.668) and team/cross-boundary (0.01 (95% CI –0.06 to 0.08), p=0.911). All secondary outcomes did not change significantly during follow-up. Process evaluation among GPs, practice assistants and other practice staff showed adequate acceptability of the intervention and partial implementation due to the COVID-19 pandemic and a high perceived workload. ConclusionAlthough participants viewed TOOL-kit as a practical and accessible toolbox, it did not improve personal continuity as measured with the NCQ. The absence of an effect may be explained by the incomplete implementation of TOOL-kit into practice and the choice of general outcome measures instead of outcomes more specific for the intervention. Trial registration numberInternational Clinical Trials registry Platform (ICTRP), trial NL8132 (URL: ICTRP Search Portal (who.int).
Læs mere Tjek på PubMedHuang, J., Zhang, Y., Turhon, M., Zheng, Z., Li, W., Kang, H., Wang, C., Liu, J., Jiang, P.
BMJ Open, 22.05.2024
Tilføjet 22.05.2024
IntroductionIntracranial aneurysm (IA) is a common cerebrovascular disease. Considering the risks and benefits of surgery, a significant proportion of patients with unruptured IA (UIA) choose conservative observation. Previous studies suggest that inflammation of aneurysm wall is a high-risk factor of rupture. Dimethyl fumarate (DMF) acts as an anti-inflammatory agent by activating nuclear factor erythroid 2-related factor 2 (Nrf2) and other pathways. Animal experiments found DMF reduces the formation and rupture of IAs. In this study, DMF will be evaluated for its ability to reduce inflammation of the aneurysm wall in high-resolution vessel wall imaging. Methods and analysisThis is a multi-centre, randomised, controlled, double-blind clinical trial. Three hospitals will enrol a total of 60 patients who have UIA with enhanced wall. Participants will be assigned randomly in a 1:1 proportion, taking either 240 mg DMF or placebo orally every day for 6 months. As the main result, aneurysm wall enhancement will be measured by the signal intensity after 6 months of DMF treatment. Secondary endpoints include morphological changes of aneurysms and factors associated with inflammation. This study will provide prospective data on the reduction of UIA wall inflammation by DMF. Ethics and disseminationThis study has been approved by Medical Ethics Committee of the Beijing Tiantan Hospital, Capital Medical University (approval no: KY2022-064-02). We plan to disseminate our research findings through peer-reviewed journal publication and relevant academic conferences. Trial registration numberNCT05959759.
Læs mere Tjek på PubMedHafid, S., Freeman, K., Aubrey-Bassler, K., Queenan, J., Drummond, N., Lawson, J., Vanstone, M., Nicholson, K., Lussier, M.-T., Mangin, D., Howard, M.
BMJ Open, 22.05.2024
Tilføjet 22.05.2024
ObjectiveThe objective was to analyse how the pandemic affected primary care access and comprehensiveness in chronic disease management by comparing primary care patterns before and during the early COVID-19 pandemic. DesignWe conducted a quasi-experimental pre–post design cohort study and reported indicators for the 21 months before and after the onset of the COVID-19 pandemic. SettingWe used electronic medical record data from primary care clinics enrolled in the Canadian Primary Care Sentinel Surveillance Network from 1 January 2018 to 31 December 2021. PopulationThe study population included patients (n=919 928) aged 18 years or older with at least one primary care contact from 12 March 2018 to 12 March 2020, in Canada. Outcome measuresThe study indicators included three indicators measuring access to primary care (encounters, blood pressure measurements and lab tests) and three for comprehensiveness (diagnoses, non-COVID-19 vaccines administered and referrals). Results67.3% of the cohort was aged ≥40 years, 56.4% were female and 53.5% were from Ontario, Canada. Fewer patients received an encounter during the pandemic (91.5% to 81.5%), while the median (IQR) number of encounters remained the same (5 (2–1)) for those with access. Fewer patients received a blood pressure measurement (47.9% to 31.8%), and patients received fewer measurements during the pandemic (2 (1–4) to 1 (0–2)). ConclusionsEncounters with primary care remained consistent during the pandemic, but in-person care, such as lab tests and blood pressure measurements, decreased. In-person care indicators followed temporally to national COVID-19 case counts during the pandemic.
Læs mere Tjek på PubMedSzaroz, D., Kulkarni, M., Robayo Gonzalez, C. X., Zinszer, K.
BMJ Open, 22.05.2024
Tilføjet 22.05.2024
IntroductionIn the temperate world, Lyme disease (LD) is the most common vector-borne disease affecting humans. In North America, LD surveillance and research have revealed an increasing territorial expansion of hosts, bacteria and vectors that has accompanied an increasing incidence of the disease in humans. To better understand the factors driving disease spread, predictive models can use current and historical data to predict disease occurrence in populations across time and space. Various prediction methods have been used, including approaches to evaluate prediction accuracy and/or performance and a range of predictors in LD risk prediction research. With this scoping review, we aim to document the different modelling approaches including types of forecasting and/or prediction methods, predictors and approaches to evaluating model performance (eg, accuracy). Methods and analysisThis scoping review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review guidelines. Electronic databases will be searched via keywords and subject headings (eg, Medical Subject Heading terms). The search will be performed in the following databases: PubMed/MEDLINE, EMBASE, CAB Abstracts, Global Health and SCOPUS. Studies reported in English or French investigating the risk of LD in humans through spatial prediction and temporal forecasting methodologies will be identified and screened. Eligibility criteria will be applied to the list of articles to identify which to retain. Two reviewers will screen titles and abstracts, followed by a full-text screening of the articles’ content. Data will be extracted and charted into a standard form, synthesised and interpreted. Ethics and disseminationThis scoping review is based on published literature and does not require ethics approval. Findings will be published in peer-reviewed journals and presented at scientific conferences.
Læs mere Tjek på PubMedGrzeskowiak, L. E., Kunnel, A., Crawford, S. B., Cullinane, M., Amir, L. H.
BMJ Open, 22.05.2024
Tilføjet 22.05.2024
ObjectiveTo examine longitudinal trends in clinical management of lactational mastitis in women attending general practice. DesignOpen cohort study. SettingAustralian general practice using data from MedicineInsight. ParticipantsWomen aged 18 to 44 years with one or more clinical encounters for lactational mastitis between January 2011 and July 2022. Primary and secondary outcome measuresThe primary outcome measure was the proportion of prescribed oral antibiotics based on the antibiotic type. Secondary outcome measures were the proportion of women prescribed other medications (eg, antifungals, lactation suppressants) or ordered selected clinical investigations including breast ultrasound, blood test, breast milk culture, nipple swab culture or breast aspirate. Outcomes were examined based on the calendar year and individual- or clinical practice-level characteristics. ResultsAmong 25 002 women who had one or more clinical encounters related to mastitis, 90.9% were prescribed oral antibiotics. While the proportion of women prescribed an oral antibiotic remained consistent from 2011 to 2022 (91.1% vs 92.5%), there were changes in the proportion receiving prescriptions for di/flucloxacillin (46.1% vs 60.4%) and cefalexin (38.6% vs 26.5%). Fewer than 12% of women were clinically investigated for their mastitis encounter, most commonly a breast ultrasound (7.1%), followed by a selected blood test (3.8%). Requests for breast milk cultures, nipple swab cultures or breast aspirates occurred in less than 1.1% of individuals. Significant increases were evident with respect to ordering of all clinical investigations, with rates at least doubling between 2011 and 2022 (6.6% vs 14.7%). Large variability in clinical management was evident according to both individual- (eg, concessional status) and clinical practice-level characteristics (eg, remoteness). ConclusionsAustralian general practitioners commonly prescribe oral antibiotics to women with mastitis and largely in line with clinical guidelines. Their use of clinical investigations as part of mastitis management has increased over the last decade.
Læs mere Tjek på PubMedJackson, M., Ibrahim, Y., Freeland, C., Jacob, S., Zovich, B., Cohen, C.
BMJ Open, 22.05.2024
Tilføjet 22.05.2024
ObjectivesTo collect and document the numerous barriers that people living with hepatitis B (PLHB) encounter when trying to access their hepatitis B virus (HBV) medications. DesignResearchers collected qualitative data through 24 online interviews. The semistructured interview questions focused on the impact that HBV has on different aspects of daily life (physical, emotional and social), personal experiences managing their infection, HBV treatment experiences and interactions with healthcare providers. SettingAll interviews occurred over Zoom. ParticipantsThe participant cohort consisted of 12 males and 12 females. 63% of all participants represented communities of colour (37% white, 17% black/African/African American and 46% Asian/Asian American). Most of the participants were on antiviral treatment at the time of the study (62%). Participants were PLHB (self-reported), ≥18 years old, living in the USA or Canada and spoke English. ResultsParticipants reported several barriers to accessing medicine among PLHB including financial barriers, health insurance and pharmacy preauthorisation process and other intangible barriers like lack of access to reliable patient-friendly information and stigma. The identified barriers to accessing HBV medication impacted patients’ continuity of care. ConclusionsAccess to medicine is essential to improving health outcomes. PLHB experience significant barriers to accessing HBV antivirals at different levels. Patient-related, physician-related and healthcare system barriers were identified as themes contributing to antiviral access challenges. More research is needed to identify strategies to improve access to HBV medications.
Læs mere Tjek på PubMedBraendle, K., Egli, A., Bischoff-Ferrari, H., Freystaetter, G.
BMJ Open, 22.05.2024
Tilføjet 22.05.2024
ObjectivesFalling and living alone have been identified as public health challenges in an ageing society. Our study investigates whether living alone influences fall risk in community-dwelling older adults in Switzerland. Design and methodsSecondary analysis of three randomised controlled trials investigating how different doses of vitamin D and an exercise programme may influence the risk of further falls in people 60+ at risk of falling. We used logistic regression to examine the association between living alone and the odds of becoming a faller, and negative binomial regression to examine the association between living alone and the rate of falls. We assessed both any falls and falls with injury. All analyses were adjusted for sex, body mass index, age, grip strength, comorbidities, use of walking aids, mental health, trial and treatment group. Predefined subgroups were by sex and age. ResultsAmong 494 participants (63% women; mean age was 74.7±7.5 years) 643 falls were recorded over 936.5 person-years, including 402 injurious falls. Living alone was associated with a 1.76-fold higher odds of becoming a faller (OR (95% CI)=1.76 (1.11 to 2.79)). While the odds did not differ by sex, older age above the median age of 74.6 years increased the odds to 2.19-fold (OR (95% CI)=2.19 (1.11 to 4.32)). The rate of total or injurious falls did not differ by living status. ConclusionsCommunity-dwelling older adults living alone have a higher odds of becoming a faller. The increased odds is similar for men and women but accentuated with higher age. Trial registration numbersZDPT: NCT01017354, NFP53: NCT00133640, OA: NCT00599807.
Læs mere Tjek på PubMedHealey, F., Gower, J., Roberts, L., Arya, R., Beresford, M., Fowler, A., Kirkpatrick, G., Oldfield, E., Weaver, R.
BMJ Open, 22.05.2024
Tilføjet 22.05.2024
ObjectivesVenous thromboembolism (VTE) is a major cause of morbidity and mortality globally, with hospital-associated thrombosis (HAT) accounting for at least half of VTE. We set out to understand more about deaths from HAT in England, to focus improvement efforts where they are needed most. DesignA retrospective cohort combining death certification and hospital activity data to identify people with an inpatient or day case hospitalisation where no VTE diagnosis was recorded, and who died from VTE in a hospital or within 90 days of discharge, between April 2017 and March 2020. SettingAll deaths occurring in England and all National Health Service-funded hospital care in England. ParticipantsAfter 0.1% of cases were excluded due to duplicate but conflicting records, a cohort of 13 995 deaths remained; 54% were women, and 26% were aged under 70 years. Outcome measuresAnalysis of age, gender, primary diagnosis, type of admission, specialties and (for day cases) procedure types were preplanned. ResultsOnly 5% of these deaths followed planned inpatient admissions. Day case admissions preceded 7% of VTE deaths. Emergency inpatient admissions, medical specialties and infection-related primary diagnoses predominated in people who died from VTE after hospitalisation where no VTE diagnosis was recorded. Most deaths occurred in a hospital or within 30 days of discharge. ConclusionsInternational efforts to reduce HAT historically focused on planned inpatient admissions. Further initiatives and research to prevent deaths from VTE after hospitalisation should focus on the emergency care pathway where most deaths occurred, with people undergoing day case procedures an important additional focus.
Læs mere Tjek på PubMedSorato, M. M., Alemu, T., Toma, A., Paulos, G., Mekonnen, S.
BMJ Open, 22.05.2024
Tilføjet 22.05.2024
BackgroundSubstance use disorders and HIV infection have a bidirectional relationship. People who use illicit drugs are at increased risk of contracting HIV/AIDS, and people living with HIV/AIDS are at increased risk of using substances due to disease-related complications like depression and HIV-associated dementia. There is no adequate evidence on the effect of HIV/AIDS and substance use disorder comorbidity-related effects on placental, fetal, maternal and neonatal outcomes globally. Methods and analysisWe will search articles written in the English language until 30 January 2024, from PubMed/Medline, Cochrane Library, Embase, Scopus, Web of Sciences, SUMsearch2, Turning Research Into Practice database and Google Scholar. A systematic search strategy involving AND/OR Boolean Operators will retrieve information from these databases and search engines. Qualitative and quantitative analysis methods will be used to report the effect of HIV/AIDS and substance use disorders on placental, fetal and maternal composite outcomes. Descriptive statistics like pooled prevalence mean and SD will be used for qualitative analysis. However, quantitative analysis outcomes will be done by using Comprehensive Meta-Analysis Software for studies that are combinable. The individual study effects and the weighted mean difference will be reported in a forest plot. In addition to this, the presence of multiple morbidities like diabetes, chronic kidney disease and maternal haemoglobin level could affect placental growth, fetal growth and development, abortion, stillbirth, HIV transmission and composite maternal outcomes. Therefore, subgroup analysis will be done for pregnant women with multiple morbidities. Ethics and disseminationSince systematic review and meta-analysis will be conducted by using published literature, ethical approval is not required. The results will be presented in conferences and published in peer-reviewed journals. PROSPERO registration numberCRD42023478360.
Læs mere Tjek på PubMedPoljo, A., Tynes, D. M., Timper, K., Süsstrunk, J., Kraljevic, M., Peterli, R., Billeter, A. T., Müller-Stich, B. P., Klasen, J. M.
BMJ Open, 22.05.2024
Tilføjet 22.05.2024
ObjectiveTelemedicine is becoming an increasingly feasible option for patients with chronic diseases due to its convenience, cost-effectiveness and ease of access. While there are certain limitations, the benefits can be appreciated by those seeking repetitive care. The perception of telemedicine as an alternative to recurrent, in-person appointments for patients with obesity in structured bariatric programmes is still unclear. This content analysis’ primary endpoint was to explore how patients within our bariatric programme perceived telemedicine and virtual consultations as a new way of communication during COVID-19. DesignA qualitative study using semistructured interviews and qualitative content analysis method by Elo and Kyngäs following four steps: data familiarisation, coding and categorising with Quirkos software and final interpretation guided by developed categories. SettingUniversity Hospital, Switzerland. ParticipantsWe conducted 33 interviews with 19 patients from a structured bariatric programme. ResultsMost patients shared positive experiences, acknowledging the convenience and accessibility of virtual appointments. Others voiced concerns, especially regarding telemedicine’s limitations. These reservations centred around the lack of physical examinations, difficulties in fostering connections with healthcare providers, as well as barriers stemming from language and technology. The research identified a spectrum of patient preferences in relation to telemedicine versus in-person visits, shaped by the immediacy of their concerns and their availability. ConclusionWhile telemedicine is increasingly accepted by the public and provides accessible and cost-effective options for routine follow-up appointments, there are still obstacles to overcome, such as a lack of physical examination and technological limitations. However, integrating virtual alternatives, like phone or video consultations, into routine bariatric follow-ups could improve continuity and revolutionise bariatric care.
Læs mere Tjek på PubMedMariano A. Molina, Sneha Biswas, Virginia Núñez-Samudio, Iván Landires
Trends in Microbiology, 22.05.2024
Tilføjet 22.05.2024
Maintaining a healthy cervicovaginal microbiome (CVM) is vital for women\'s wellbeing; it is dependent primarily on Lactobacillus dominance. Microbiome imbalances, driven by Megasphaera species, contribute to infections and disease. Comprehensive research into Megasphaera biology and interventions is crucial for personalized women\'s healthcare, and additional efforts are required to mitigate the risks posed by cervicovaginal dysbiosis.
Læs mere Tjek på PubMedMarlon H. Cardoso, Cesar de la Fuente-Nunez, Nuno C. Santos, Michael A. Zasloff, Octávio L. Franco
Trends in Microbiology, 22.05.2024
Tilføjet 22.05.2024
Many factors contribute to bacterial membrane stabilization, including steric effects between lipids, membrane spontaneous curvature, and the difference in the number of neighboring molecules. This forum provides an overview of the physicochemical properties associated with membrane curvature and how this parameter can be tuned to design more effective antimicrobial peptides.
Læs mere Tjek på PubMedDaniele FocosiMassimo FranchiniFabrizio MaggiShmuel Shoham1North-Western Tuscany Blood Bank, Pisa University Hospital, Pisa, Italy2Division of Hematology and Transfusion Medicine, Carlo Poma Hospital, Mantua, Italy3National Institute for Infectious Diseases “Lazzaro Spallanzani” IRCCS, Rome, Italy4Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA, Graeme N. Forrest
Clinical Microbiology Reviews, 22.05.2024
Tilføjet 22.05.2024
Kami Pekayvaz, Corinna Losert, Viktoria Knottenberg, Christoph Gold, Irene V. van Blokland, Roy Oelen, Hilde E. Groot, Jan Walter Benjamins, Sophia Brambs, Rainer Kaiser, Adrian Gottschlich, Gordon Victor Hoffmann, Luke Eivers, Alejandro Martinez-Navarro, Nils Bruns, Susanne Stiller, Sezer Akgöl, Keyang Yue, Vivien Polewka, Raphael Escaig, Markus Joppich, Aleksandar Janjic, Oliver Popp, Sebastian Kobold, Tobias Petzold, Ralf Zimmer, Wolfgang Enard, Kathrin Saar, Philipp Mertins, Norbert Huebner, Pim van der Harst, Lude H. Franke, Monique G. P. van der Wijst, Steffen Massberg, Matthias Heinig, Leo Nicolai, Konstantin Stark
Nature, 22.05.2024
Tilføjet 22.05.2024
Clinical Infectious Diseases, 22.05.2024
Tilføjet 22.05.2024
Abstract Background We aimed to test the hypothesis that development of metastatic infection represents a distinct clinical endpoint from death due to SAB.Methods We conducted a retrospective observational study of adults with SAB between 20/12/2019 and 23/08/2022 (n=464). Simple logistic regression, odds ratios, and z-scores were used to compare host, clinical and microbiologic features.Results Co-occurrence of attributable mortality and metastatic infection was infrequent. Charlson Comorbidity Index and age were strongly associated with attributable mortality, but not metastatic infection. We compared patients with fatal SAB (without clinically-apparent metastatic complications, 14·4% of cohort), metastatic SAB (without attributable mortality, 22·2%), neither complication (56·7%), and overlapping fatal/metastatic SAB (6·7%). Compared to SAB without complications, fatal SAB was specifically associated with older age and multi-morbidity. Metastatic SAB was specifically associated with community acquisition, persistent fever, persistent bacteraemia, and recurrence. Endocarditis was over-represented in the fatal/metastatic SAB overlap group, which shared patient characteristics with fatal SAB. In contrast to other (predominantly musculoskeletal) metastatic complications, endocarditis was associated with increased mortality, with death occurring in older multi-morbid patients later after SAB onset.Conclusions Patients with SAB experience distinct clinical endpoints: (i) early death, associated with multi-morbidity and age; (ii) metastatic (predominantly musculoskeletal) SAB; (iii) endocarditis, associated with late death occurring in older people with multi-morbidity, and (iv) bacteraemia without complications. These distinctions could be important for selecting appropriate outcomes in clinical trials: different interventions might be required to reduce mortality vs. improve clinical response in patients with metastatic SAB.
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