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Journal of Infectious Diseases, 19.06.2024
Tilføjet 19.06.2024
Abstract Background Young children and older adults are susceptible for invasive pneumococcal disease (IPD) caused by Streptococcus pneumoniae. Pneumococcal protein-specific antibodies play a protective role against IPD; however, not much is known about the pace of acquisition, maturation, and maintenance of these antibodies throughout life.Methods Immunoglobulin G (IgG) and IgA levels, avidity, and/or specificity to the pneumococcal proteome in serum and saliva from healthy young children, adults, and older adults, with known carriage status, were measured by enzyme-linked immunosorbent assay (ELISA) and 2-dimensional western blotting against ΔcpsTIGR4.Results Eleven-month-old children, the youngest age group tested, had the lowest pneumococcal proteome-specific IgG and IgA levels and avidity in serum and saliva, followed by 24-month-old children and were further elevated in adult groups. Among adult groups, the parents had the highest serum and saliva IgG and IgA antibody levels. In children, antibody levels and avidity correlated with daycare attendance and presence of siblings, posing as proxy for exposure and immunization. Immunodominance patterns slightly varied throughout life.Conclusions Humoral immunity against the pneumococcal proteome is acquired through multiple episodes of pneumococcal exposure. Low-level and low-avidity antiproteome antibody profiles in young children may contribute to their IPD susceptibility, while in overall antiproteome antibody-proficient older adults other factors likely play a role.
Læs mere Tjek på PubMedMartin Šmíd, Vít Tuček, Rastislav Madar, Ruth Tachezy, Zdenek Hel
International Journal of Infectious Diseases, 19.06.2024
Tilføjet 19.06.2024
With great concern, we read the manuscript “Does the healthy vaccinee bias rule them all?” by Fürst et al. [1]. The existence of a potential bias in the characteristics of target populations in observational studies is routinely considered in studies addressing vaccine effectivity. However, the claims by Fürst et al. are not substantiated by any valid statistical analysis and are based primarily on speculation. The authors rely on simple descriptive statistics and do not provide any valid statistical quantification of individual contributing factors or comorbidity analysis of target populations.
Læs mere Tjek på PubMedAnne J. Huiberts, Susan van den Hof, Mirjam J. Knol
International Journal of Infectious Diseases, 19.06.2024
Tilføjet 19.06.2024
We send this letter regarding our article “Vaccine effectiveness of primary and booster COVID-19 vaccinations against SARS-CoV-2 infection in the Netherlands from July 12, 2021 to June 6, 2022: A prospective cohort study” published in International Journal of Infectious Diseases [1]. With this letter we present updated results of the previously published vaccine effectiveness estimates because of newly collected data on vaccination status.
Læs mere Tjek på PubMedChristoph Lange, Yousra Kherabi, Lorenzo Guglielmetti, Raquel Duarte, Gunar Günther, Tuberculosis Network European Trialsgroup
Clinical Microbiology and Infection, 19.06.2024
Tilføjet 19.06.2024
In the recent manuscript by Günther G. et al. “Availability of drugs and resistance testing for BPaLM regimen for rifampicin-resistant tuberculosis in Europe”, published in this journal (1) we described the availability of medicines and drug susceptibility testing (DST) for the medicines composing the bedaquiline-pretomanid-linezolid-(moxifloxacin) (BPaL[M]) regimen for individuals affected by multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) in the World Health Organization (WHO) Europe Region as of November 2023, one year after the WHO recommendation for this 6-month duration regimen for the treatment of patients affected by MDR/RR-TB (BPaLM) or pre-extensively drug-resistant tuberculosis (pre-XDR-TB; BPaL) (2).
Læs mere Tjek på PubMedGoldenberg, J. Z., Wright, T. J., Batson, R. D., Wexler, R. S., McGovern, K. A., Venugopal, N. K., Ward, W. W., Randolph, K. M., Urban, R. J., Pyles, R. B., Sheffield-Moore, M.
BMJ Open, 19.06.2024
Tilføjet 19.06.2024
IntroductionCognitive impairment is reported in a variety of clinical conditions including Alzheimer’s disease, Parkinson’s and ‘long-COVID’. Interestingly, many of these clinical conditions are also associated with microbial dysbiosis. This comanifestation of cognitive and microbiome findings in seemingly unrelated maladies suggests that they could share a common mechanism and potentially presents a treatment target. Although a rapidly growing body of literature has documented this comorbid presentation within specific conditions, an overview highlighting potential parallels across healthy and clinical populations is lacking. The objective of this umbrella review, therefore, is to summarise and synthesise the findings of these systematic reviews. Methods and analysisOn 2 April 2023, we searched MEDLINE (Pubmed), Embase (Ovid), the Web of Science (Core Collection), the Cochrane Library of Systematic Reviews and Epistemonikos as well as grey literature sources, for systematic reviews on clinical conditions and interventions where cognitive and microbiome outcomes were coreported. An updated search will be conducted before completion of the project if the search-to-publication date is >1 year old. Screening, data abstraction and quality assessment (AMSTAR 2, A MeaSurement Tool to Assess systematic Reviews) will be conducted independently and in duplicate, with disagreements resolved by consensus. Evidence certainty statements for each review’s conclusions (eg, Grading of Recommendations Assessment, Development and Evaluation (GRADE)) will be extracted or constructed de novo. A narrative synthesis will be conducted and delineated by the review question. Primary study overlap will be visualised using a citation matrix as well as calculated using the corrected covered area method. Ethics and disseminationNo participant-identifying information will be used in this review. No ethics approval was required due to our study methodology. Our findings will be presented at national and international conferences and disseminated via social media and press releases. We will recruit at least one person living with cognitive impairment to collaborate on writing the plain language summary for the review. PROSPERO registration numberCRD42023412903
Læs mere Tjek på PubMedMachumu, N., Frumence, G., Anaeli, A.
BMJ Open, 19.06.2024
Tilføjet 19.06.2024
ObjectivesAimed at determining facilitators and barriers to optimum uptake of multimonth dispensing (MMD) of antiretroviral treatment (ART). DesignQualitative study conducted through in-depth interviews. SettingAn explorative qualitative approach conducted at three high-volume care and treatment clinics in Morogoro Municipality, Tanzania. ParticipantsData were collected from a purposefully selected sample of 22 participants. Of them, 9 were healthcare providers and 12 were clients on ART receiving MMD. Audio records from the interviews were transcribed, translated, and thematically analysed. ResultsEvidence showed that multimonth dispensing can be improved through strengthened health system barriers such as having proper guidelines and involving stakeholders. Other facilitators included service providers’ ability to identify eligible clients, fast-tracking of services, quality improvement implementation, peer-to-peer inspiration and clients’ satisfaction and awareness. Identified barriers to effective multimonth dispensing included inadequate drug supply, prolonged turn-around time of HIV viral load results, delayed integrated Tuberculosis (TB) preventive therapy initiation, stigma and retention challenges. ConclusionMultimonth dispensing has the potential to address the health system challenges in Tanzania if guidelines are well informed to stakeholders, and facets of quality of care are improved. Addressing the earmarked barriers such as ensuring medicine, supplies and diagnostics, while addressing retention challenges and stigma.
Læs mere Tjek på PubMedYilin Zhong Juan Guo Ziyi Zhang Yu Zheng Manjun Yang Yubin Su a Department of Cell Biology & Institute of Biomedicine, National Engineering Research Center of Genetic Medicine, MOE Key Laboratory of Tumor Molecular Biology, Guangdong Provincial Key Laboratory of Bioengineering Medicine, College of Life Science and Technology, Jinan University, Guangzhou, People’s Republic of Chinab Xizang Key Laboratory of Veterinary Drug, Xizang Vocational Technical College, Lasa, Xizang, People’s Republic of China
Virulence, 19.06.2024
Tilføjet 19.06.2024
Yahan Wei, Dennise Palacios Araya, Kelli L. Palmer
Nat Rev Microbiol, 19.06.2024
Tilføjet 19.06.2024
Ruiwen Hu, Zhili He, Cheng Wang
Trends in Microbiology, 19.06.2024
Tilføjet 19.06.2024
Mangrove wetlands contribute to climate change mitigation through efficient carbon burial, yet microbial methanogenesis offsets these climate benefits. We review the diversity of methanogenic microorganisms in mangrove sediments, present the unrecognized role of bacteria on methanogenesis, and highlight the significance of distinguishing various methanogenic pathways to assess mangrove climate benefits.
Læs mere Tjek på PubMedTalia Backman, Hernán A. Burbano, Talia L. Karasov
Trends in Microbiology, 19.06.2024
Tilføjet 19.06.2024
Phage tail-like bacteriocins (tailocins) are protein complexes produced by bacteria with the potential to kill their neighbors. Widespread throughout Gram-negative bacteria, tailocins exhibit extreme specificity in their targets, largely killing closely related strains. Despite their presence in diverse bacteria, the impact of these competitive weapons on the surrounding microbiota is largely unknown. Recent studies revealed the rapid evolution and genetic diversity of tailocins in microbial communities and suggest that there are constraints on the evolution of specificity and resistance. Given the precision of their targeted killing and the ease of engineering new specificities, understanding the evolution and ecological impact of tailocins may enable the design of promising candidates for novel targeted antibiotics.
Læs mere Tjek på PubMedRoger Li, Paras H. Shah, Tyler F. Stewart, Jong Kil Nam, Trinity J. Bivalacqua, Donald L. Lamm, Edward M. Uchio, Daniel M. Geynisman, Joseph M. Jacob, Joshua J. Meeks, Rian Dickstein, Shane M. Pearce, Seok Ho Kang, Seung Il Jung, Ashish M. Kamat, James M. Burke, Kirk A. Keegan, Gary D. Steinberg
Nature, 19.06.2024
Tilføjet 19.06.2024
Xiao Heng, Amanda Paz Herrera, Zhenwei Song and Kathleen Boris-Lawrie
Retrovirology, 19.06.2024
Tilføjet 19.06.2024
An essential regulatory hub for retroviral replication events, the 5’ untranslated region (UTR) encodes an ensemble of cis-acting replication elements that overlap in a logical manner to carry out divergent RN...
Læs mere Tjek på PubMedMariya Akter, A. S. M. Roknuzzaman, Mohammad Shahriar, Sardar Mohammad Ashraful Islam, Mohiuddin Ahmed Bhuiyan, M. M. A. Shalahuddin Qusar, Eva Rahman Kabir, Rabiul Islam
PLoS One Infectious Diseases, 19.06.2024
Tilføjet 19.06.2024
by Mariya Akter, A. S. M. Roknuzzaman, Mohammad Shahriar, Sardar Mohammad Ashraful Islam, Mohiuddin Ahmed Bhuiyan, M. M. A. Shalahuddin Qusar, Eva Rahman Kabir, Rabiul Islam Background Major depressive disorder (MDD) is a common and debilitating mental illness characterized by persistent feelings of sadness, hopelessness, and a lack of interest in daily activities. The objective of this study was to investigate whether levels of macrophage inflammatory protein-1β (MIP-1β) and macrophage chemoattractant protein-2 (MCP-2) in the blood were associated with the pathophysiology and development of MDD compared to healthy controls (HCs). Methods This case-control study was conducted involving 50 MDD patients and 38 HCs. We performed a comprehensive assessment to match age, sex, BMI, and socio-demographic profile between the groups. The study excluded participants with chronic infection, inflammatory diseases, coexisting psychiatric disorder, history of liver and kidney diseases, and individuals who are under antipsychotic medications. A professional psychiatrist diagnosed MDD patients and evaluated HCs based on the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) criteria. The severity of depression was assessed using the Hamilton Depression (Ham-D) rating scale. Commercially available enzyme-linked immunosorbent assay (ELISA) kits were used to quantify the serum MIP-1β and MCP-2 levels. Results The results indicated elevated serum MIP-1β levels (207.73±24.24 pg/ml) in MDD patients compared to HCs (58.77±9.14 pg/ml). This difference in concentration is positively correlated with severity of disease symptoms (r = 0.451; p
Læs mere Tjek på PubMedNattawet Sriwichai, Rutrawee Sangcharoen, Treenut Saithong, David Simpson, Igor Goryanin, Nimaradee Boonapatcharoen, Saowalak Kalapanulak, Pornpan Panichnumsin
PLoS One Infectious Diseases, 19.06.2024
Tilføjet 19.06.2024
by Nattawet Sriwichai, Rutrawee Sangcharoen, Treenut Saithong, David Simpson, Igor Goryanin, Nimaradee Boonapatcharoen, Saowalak Kalapanulak, Pornpan Panichnumsin Microbial fuel cells (MFCs) are innovative eco-friendly technologies that advance a circular economy by enabling the conversion of both organic and inorganic substances in wastewater to electricity. While conceptually promising, there are lingering questions regarding the performance and stability of MFCs in real industrial settings. To address this research gap, we investigated the influence of specific operational settings, regarding the hydraulic retention time (HRT) and organic loading rate (OLR) on the performance of MFCs used for treating sulfide-rich wastewater from a canned pineapple factory. Experiments were performed at varying hydraulic retention times (2 days and 4 days) during both low and high seasonal production. Through optimization, we achieved a current density generation of 47±15 mA/m2, a COD removal efficiency of 91±9%, and a sulfide removal efficiency of 86±10%. Microbiome analysis revealed improved MFC performance when there was a substantial presence of electrogenic bacteria, sulfide-oxidizing bacteria, and methanotrophs, alongside a reduced abundance of sulfate-reducing bacteria and methanogens. In conclusion, we recommend the following operational guidelines for applying MFCs in industrial wastewater treatment: (i) Careful selection of the microbial inoculum, as this step significantly influences the composition of the MFC microbial community and its overall performance. (ii) Initiating MFC operation with an appropriate OLR is essential. This helps in establishing an effective and adaptable microbial community within the MFCs, which can be beneficial when facing variations in OLR due to seasonal production changes. (iii) Identifying and maintaining MFC-supporting microbes, including those identified in this study, should be a priority. Keeping these microbes as an integral part of the system’s microbial composition throughout the operation enhances and stabilizes MFC performance.
Læs mere Tjek på PubMedVitalii Timofeev, Irina Bakhteeva, Galina Titareva, Raisa Mironova, Vera Evseeva, Tatiana Kravchenko, Angelika Sizova, Alexander Borzilov, Natalia Pavlovich, Alexander Mokrievich, Ivan Dyatlov, Gilles Vergnaud
PLoS One Infectious Diseases, 19.06.2024
Tilføjet 19.06.2024
by Vitalii Timofeev, Irina Bakhteeva, Galina Titareva, Raisa Mironova, Vera Evseeva, Tatiana Kravchenko, Angelika Sizova, Alexander Borzilov, Natalia Pavlovich, Alexander Mokrievich, Ivan Dyatlov, Gilles Vergnaud Francisella tularensis, the causative agent of tularemia, is divided into three subspecies. Two of these, subspecies holarctica and tularensis, are highly pathogenic to humans and consequently relatively well studied. The third subspecies, mediasiatica, is rarely isolated and remains poorly studied. It is distributed in the sparsely populated regions of Central Asia and Siberia. Curently this subspecies is not known to have been responsible for human infections in spite of its high virulence in laboratory animals. Subspecies mediasiatica is currently divided into three subgroups—MI, present in Central Asia, MII, present in southern Siberia, and MIII represented by a unique strain, 60(B)57, isolated in Uzbekistan in 1960. We describe here the unexpected observation that MIII strain 60(B)57 is avirulent and immunogenic. We observed that infection with this strain protected mice from challenge 21 days later with a virulent subsp. mediasiatica strain. With an increase of this interval, the protection for mice was significantly reduced. In contrast, guinea pigs were protected from challenge with strains of the subspecies holarctica and mediasiatica (but not subsp. tularensis) 90 days after infection with 60(B)57. We performed genome assembly based on whole genome sequencing data obtained using the Nanopore MinION for strain 60(B)57 and two subsp. mediasiatica strains representing the Central Asian MI and Siberian MII phylogenetic subgroups. The prmA gene is truncated due to a nonsense mutation in strain 60(B)57. The deletion of gene prmA has previously been shown to induce a loss of virulence in Francisella novicida the closest model organism suggesting that the observed mutation might the cause of the avirulence of strain 60(B)57.
Læs mere Tjek på PubMedDaniel Haile Chercos, Solomon T. Wafula, John P. A. Lusingu, Daniel T. R. Minja, Samwel Gesase, Joyce R. Mbwana, Ulrich Schotte, Jürgen May, Lea Mardeis, Anna Jaeger, Sandra Rojak, Maike Lamshöft, Joseph Kaseka, Eva Lorenz, Hagen Frickmann, Denise Dekker
PLoS One Infectious Diseases, 19.06.2024
Tilføjet 19.06.2024
by Daniel Haile Chercos, Solomon T. Wafula, John P. A. Lusingu, Daniel T. R. Minja, Samwel Gesase, Joyce R. Mbwana, Ulrich Schotte, Jürgen May, Lea Mardeis, Anna Jaeger, Sandra Rojak, Maike Lamshöft, Joseph Kaseka, Eva Lorenz, Hagen Frickmann, Denise Dekker Diarrheal diseases are important causes of morbidity and mortality, worldwide. The occurrence of multiple pathogens in stool samples of symptomatic and asymptomatic individuals in resource-limited countries have been repeatedly described. In this study, we assessed the differentiated effects of combined pathogen detections on recorded symptoms. A case-control study was conducted among 620 under-five-year-old children in rural northeastern Tanzania with emphasis of multiple detection. The median age of children was 11 months (IQR = 7, 20), and 52.1% were male. Cases (50.2%, n = 157) were less likely than controls (64.5%, n = 198) to have multiple colonization with gastrointestinal tract (GIT) pathogens. The children’s age was positively associated with the likelihood of harboring multiple GIT pathogens [OR, 1.02, 95% CI = 1.01, 1.04]. Shigella spp./enteroinvasive Escherichia coli (EIEC) [OR = 2.80, 95% CI 1.62, 4.83] and norovirus [OR = 2.04, 95% CI 1.23, 3.39] were more common in cases and were strongly associated with diarrhea, while enteroaggregative E. coli (EAEC) [OR = 0.23, 95%CI 0.17–0.33] were more common in controls. Diarrheal diseases in under-five children from rural Tanzania are likely to be due to infections with Shigella spp./EIEC, and norovirus with strongly age-dependent associations.
Læs mere Tjek på PubMedPriscilla Guimarães Silva Vasconcelos, Gabriel Flores Abuna, Joanda Paolla Raimundo e Silva, Josean Fechine Tavares, Edja Maria Melo de Brito Costa, Ramiro Mendonça Murata
PLoS One Infectious Diseases, 19.06.2024
Tilføjet 19.06.2024
by Priscilla Guimarães Silva Vasconcelos, Gabriel Flores Abuna, Joanda Paolla Raimundo e Silva, Josean Fechine Tavares, Edja Maria Melo de Brito Costa, Ramiro Mendonça Murata Syzigium aromaticum essential oil (EO), eugenol, and β-caryophyllene were evaluated regarding antifungal, antibiofilm, and in vitro toxicity. Additionally, in vivo toxicity of EO was observed. Anti-Candida activity was assessed through broth microdilution assay for all compounds. Time-kill assay (0, 1, 10, 30 min, 1, 2, and 4 h) was used to determine the influence of EO and eugenol on Candida Growth kinetics. Thereafter, both compounds were evaluated regarding their capacity to act on a biofilm formation and on mature biofilm, based on CFU/ml/g of dry weight. Cell Titer Blue Viability Assay was used for in vitro cytotoxicity, using oral epithelial cells (TR146) and human monocytes (THP-1). Lastly, Galleria mellonella model defined the EO in vivo acute toxicity. All compounds, except β-cariofilene (MIC > 8000 μg/ml), presented antifungal activity against Candida strains (MIC 500–1000 μg/ml). The growth kinetics of Candida was affected by the EO (5xMIC 30 min onward; 10xMIC 10 min onward) and eugenol (5xMIC 10 min onward; 10xMIC 1 min onward). Fungal viability was also affected by 5xMIC and 10xMIC of both compounds during biofilm formation and upon mature biofilms. LD50 was defined for TR146 and THP1 cells at, respectively, 59.37 and 79.54 μg/ml for the EO and 55.35 and 84.16 μg/ml for eugenol. No sign of toxicity was seen in vivo up to 10mg/ml (20 x MIC) for the EO. S. aromaticum and eugenol presented antifungal and antibiofilm activity, with action on cell growth kinetics. In vivo acute toxicity showed a safe parameter for the EO up to 10 mg/ml.
Læs mere Tjek på PubMedA. K. M. Sahfiqul Islam, Rejwan Bhuiyan, Sheikh Arafat Islam Nihad, Rumana Akter, Mohammad Ashik Iqbal Khan, Shamima Akter, Md. Rashidul Islam, Md. Atiqur Rahman Khokon, Mohammad Abdul Latif
PLoS One Infectious Diseases, 19.06.2024
Tilføjet 19.06.2024
by A. K. M. Sahfiqul Islam, Rejwan Bhuiyan, Sheikh Arafat Islam Nihad, Rumana Akter, Mohammad Ashik Iqbal Khan, Shamima Akter, Md. Rashidul Islam, Md. Atiqur Rahman Khokon, Mohammad Abdul Latif Rice (Oryza sativa) stands as a crucial staple food worldwide, especially in Bangladesh, where it ranks as the third-largest producer. However, intensified cultivation has made high-yielding rice varieties susceptible to various biotic stresses, notably sheath blight caused by Rhizoctonia solani, which inflicts significant yield losses annually. Traditional fungicides, though effective, pose environmental and health risks. To address this, nanotechnology emerges as a promising avenue, leveraging the antimicrobial properties of nanoparticles like silver nanoparticles (AgNPs). This study explored the green synthesis of AgNPs using Ipomoea carnea leaf extract and silver nitrate (AgNO3), and also examined their efficacy against sheath blight disease in rice. The biosynthesized AgNPs were characterized through various analytical techniques such as UV-vis spectrophotometer, X-ray Diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), Particle size analyzer, Zeta potential, Scanning Electron Microscope (SEM), Field Emission Scanning Electron Microscope (FESEM), Transmission Electron Microscope (TEM) for confirming their successful production and crystalline nature of nanoparticles. The results of UV-visible spectrophotometers revealed an absorption peak ranging from 421 to 434 nm, validated the synthesis of AgNPs in the solution. XRD, DLS, and TEM estimated AgNPs sizes were ~45 nm, 66.2nm, and 46.38 to 73.81 nm, respectively. SEM and FESEM demonstrated that the synthesized AgNPs were spherical in shape. In vitro assays demonstrated the significant inhibitory effects of AgNPs on mycelial growth of Rhizoctonia solani, particularly at higher concentrations and pH levels. Further greenhouse and field experiments validated the antifungal efficacy of AgNPs against sheath blight disease in rice, exhibiting comparable effectiveness to commercial fungicides. The findings highlight the potential of AgNPs as a sustainable and effective alternative for managing rice sheath blight disease, offering a safer solution amidst environmental concerns associated with conventional fungicides.
Læs mere Tjek på PubMedChloe Brown, Colette S. M. Bilynsky, Melanie Gainey, Sarah Young, John Kitchin, Elizabeth C. Wayne
PLoS One Infectious Diseases, 19.06.2024
Tilføjet 19.06.2024
by Chloe Brown, Colette S. M. Bilynsky, Melanie Gainey, Sarah Young, John Kitchin, Elizabeth C. Wayne The role of macrophages in regulating the tumor microenvironment has spurned the exponential generation of nanoparticle targeting technologies. With the large amount of literature and the speed at which it is generated it is difficult to remain current with the most up-to-date literature. In this study we performed a topic modeling analysis of 854 abstracts of peer-reviewed literature for the most common usages of nanoparticle targeting of tumor associated macrophages (TAMs) in solid tumors. The data spans 20 years of literature, providing a broad perspective of the nanoparticle strategies. Our topic model found 6 distinct topics: Immune and TAMs, Nanoparticles, Imaging, Gene Delivery and Exosomes, Vaccines, and Multi-modal Therapies. We also found distinct nanoparticle usage, tumor types, and therapeutic trends across these topics. Moreover, we established that the topic model could be used to assign new papers into the existing topics, thereby creating a Living Review. This type of “birds-eye-view” analysis provides a useful assessment tool for exploring new and emerging themes within a large field.
Læs mere Tjek på PubMedMalaria Journal, 18.06.2024
Tilføjet 18.06.2024
Abstract Background Effective testing for malaria, including the detection of infections at very low densities, is vital for the successful elimination of the disease. Unfortunately, existing methods are either inexpensive but poorly sensitive or sensitive but costly. Recent studies have shown that mid-infrared spectroscopy coupled with machine learning (MIRs-ML) has potential for rapidly detecting malaria infections but requires further evaluation on diverse samples representative of natural infections in endemic areas. The aim of this study was, therefore, to demonstrate a simple AI-powered, reagent-free, and user-friendly approach that uses mid-infrared spectra from dried blood spots to accurately detect malaria infections across varying parasite densities and anaemic conditions. Methods Plasmodium falciparum strains NF54 and FCR3 were cultured and mixed with blood from 70 malaria-free individuals to create various malaria parasitaemia and anaemic conditions. Blood dilutions produced three haematocrit ratios (50%, 25%, 12.5%) and five parasitaemia levels (6%, 0.1%, 0.002%, 0.00003%, 0%). Dried blood spots were prepared on Whatman™ filter papers and scanned using attenuated total reflection-Fourier Transform Infrared (ATR-FTIR) for machine-learning analysis. Three classifiers were trained on an 80%/20% split of 4655 spectra: (I) high contrast (6% parasitaemia vs. negative), (II) low contrast (0.00003% vs. negative) and (III) all concentrations (all positive levels vs. negative). The classifiers were validated with unseen datasets to detect malaria at various parasitaemia levels and anaemic conditions. Additionally, these classifiers were tested on samples from a population survey in malaria-endemic villages of southeastern Tanzania. Results The AI classifiers attained over 90% accuracy in detecting malaria infections as low as one parasite per microlitre of blood, a sensitivity unattainable by conventional RDTs and microscopy. These laboratory-developed classifiers seamlessly transitioned to field applicability, achieving over 80% accuracy in predicting natural P. falciparum infections in blood samples collected during the field survey. Crucially, the performance remained unaffected by various levels of anaemia, a common complication in malaria patients. Conclusion These findings suggest that the AI-driven mid-infrared spectroscopy approach holds promise as a simplified, sensitive and cost-effective method for malaria screening, consistently performing well despite variations in parasite densities and anaemic conditions. The technique simply involves scanning dried blood spots with a desktop mid-infrared scanner and analysing the spectra using pre-trained AI classifiers, making it readily adaptable to field conditions in low-resource settings. In this study, the approach was successfully adapted to field use, effectively predicting natural malaria infections in blood samples from a population-level survey in Tanzania. With additional field trials and validation, this technique could significantly enhance malaria surveillance and contribute to accelerating malaria elimination efforts.
Læs mere Tjek på PubMedMalaria Journal, 18.06.2024
Tilføjet 18.06.2024
Abstract The recently released 2023 World Malaria Report sheds light on an alarming reality: despite preventive measures, malaria remains a severe issue in Burkina Faso. As researchers in the field working on malaria in Burkina Faso, the assessment suggests significant underreporting, especially in remote areas with limited healthcare access. In addition, the confusion arising from similar diseases, such as dengue, further complicates the situation. Aligning with the 2023 World Health Organization recommendations, it is time to advocate for tailored strategies in high-burden areas by emphasizing community involvement in data collection awareness campaigns for effective disease management to combat the invisible crisis lurking within communities.
Læs mere Tjek på PubMedMalaria Journal, 18.06.2024
Tilføjet 18.06.2024
Abstract Background Well-built housing limits mosquito entry and can reduce malaria transmission. The association between community-level housing and malaria burden in Uganda was assessed using data from randomly selected households near 64 health facilities in 32 districts. Methods Houses were classified as ‘improved’ (synthetic walls and roofs, eaves closed or absent) or ‘less-improved’ (all other construction). Associations between housing and parasitaemia were made using mixed effects logistic regression (individual-level) and multivariable fractional response logistic regression (community-level), and between housing and malaria incidence using multivariable Poisson regression. Results Between November 2021 and March 2022, 4.893 children aged 2–10 years were enrolled from 3.518 houses; of these, 1.389 (39.5%) were classified as improved. Children living in improved houses had 58% lower odds (adjusted odds ratio = 0.42, 95% CI 0.33–0.53, p 67% of houses improved had a 63% lower parasite prevalence (adjusted prevalence ratio 0.37, 95% CI 0.19–0.70, p
Læs mere Tjek på PubMedMalaria Journal, 18.06.2024
Tilføjet 18.06.2024
Abstract Background Malaria, a prominent vector borne disease causing over a million annual cases worldwide, predominantly affects vulnerable populations in the least developed regions. Despite their preventable and treatable nature, malaria remains a global public health concern. In the last decade, India has faced a significant decline in malaria morbidity and mortality. As India pledged to eliminate malaria by 2030, this study examined a decade of surveillance data to uncover space–time clustering and seasonal trends of Plasmodium vivax and Plasmodium falciparum malaria cases in West Bengal. Methods Seasonal and trend decomposition using Loess (STL) was applied to detect seasonal trend and anomaly of the time series. Univariate and multivariate space–time cluster analysis of both malaria cases were performed at block level using Kulldorff’s space–time scan statistics from April 2011 to March 2021 to detect statistically significant space–time clusters. Results From the time series decomposition, a clear seasonal pattern is visible for both malaria cases. Statistical analysis indicated considerable high-risk P. vivax clusters, particularly in the northern, central, and lower Gangetic areas. Whereas, P. falciparum was concentrated in the western region with a significant recent transmission towards the lower Gangetic plain. From the multivariate space–time scan statistics, the co-occurrence of both cases were detected with four significant clusters, which signifies the regions experiencing a greater burden of malaria cases. Conclusions Seasonal trends from the time series decomposition analysis show a gradual decline for both P. vivax and P. falciparum cases in West Bengal. The space–time scan statistics identified high-risk blocks for P. vivax and P. falciparum malaria and its co-occurrence. Both malaria types exhibit significant spatiotemporal variations over the study area. Identifying emerging high-risk areas of P. falciparum malaria over the Gangetic belt indicates the need for more research for its spatial shifting. Addressing the drivers of malaria transmission in these diverse clusters demands regional cooperation and strategic strategies, crucial steps towards overcoming the final obstacles in malaria eradication.
Læs mere Tjek på PubMedToshihiko HanadaMaulana A. EmpituGregory I. MinesQianni MaIziegbe L. OmorodionAnsel LinkChristopher J. SchwakeRachel M. KruegerNicholas S. DaRosaAndrew E. LevinEdouard VannierAthar H. Chishti1Department of Developmental, Molecular, and Chemical Biology, Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA2Program in Pharmacology and Drug Development, Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA3Cellular, Molecular and Developmental Biology, Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USA4Kephera Diagnostics, Framingham, Massachusetts, USA5Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA6Molecular Microbiology, Graduate School of Biomedical Sciences, Tufts University School of Medicine, Boston, Massachusetts, USAJeroen P. J. Saeij
Infection and Immunity, 18.06.2024
Tilføjet 18.06.2024
Christian XanderSaranathan RajagopalanWilliam R. JacobsMiriam Braunstein1Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA2Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, New York, USA3Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado, USAAndreas J. Bäumler
Infection and Immunity, 18.06.2024
Tilføjet 18.06.2024
Ting Zhang, Yang Han, Weijuan Huang, Hejiang Wei, Yingze Zhao, Liumei Shu, Yaxin Guo, Beiwei Ye, Jianfang Zhou, Jun Liu
Journal of Medical Virology, 18.06.2024
Tilføjet 18.06.2024
Guixin Li, Xin Liu, Fengmin Lu
Journal of Medical Virology, 18.06.2024
Tilføjet 18.06.2024
Michael Karbiener, Gerhard Kindle, Isabelle Meyts, Mikko R. J. Seppänen, Fabio Candotti, Marta Kamieniak, Reinhard Ilk, Thomas R. Kreil, Markus G. Seidel, ESID‐COVID Consortium
Journal of Medical Virology, 18.06.2024
Tilføjet 18.06.2024
Wentao Zhu, Li Gu
Journal of Medical Virology, 18.06.2024
Tilføjet 18.06.2024
Ngoc Ha Tran, Dayna Sais, Nham Tran
Journal of Medical Virology, 18.06.2024
Tilføjet 18.06.2024
Teboho Mooko, Feziwe Busiswa Bisiwe, Perpertual Chikobvu, Molefi Daniel Morobadi, Thabiso Rafaki Petrus Mofokeng, Martin Munene Nyaga, Gabre Kemp, Dominique Goedhals, Kwazi Celani Zwakele Ndlovu
Journal of Medical Virology, 18.06.2024
Tilføjet 18.06.2024
Ji Eun SonSi Hyoung ParkUmji ChoiChang-Ro Lee1Department of Biological Sciences, Myongji University, Yongin, Gyeonggido, Republic of KoreaLaurent Poirel
Antimicrobial Agents And Chemotherapy, 18.06.2024
Tilføjet 18.06.2024
Journal of Infectious Diseases, 18.06.2024
Tilføjet 18.06.2024
Abstract Background The global resurgence of syphilis necessitates vaccine development.Methods We collected ulcer exudates and blood from 17 primary syphilis (PS) participants and skin biopsies and blood from 51 secondary syphilis (SS) participants in Guangzhou, China for Treponema pallidum subsp. pallidum (TPA) qPCR, whole genome sequencing (WGS), and isolation of TPA in rabbits.Results TPA DNA was detected in 15 of 17 ulcer exudates and 3 of 17 blood PS specimens. TPA DNA was detected in 50 of 51 SS skin biopsies and 27 of 51 blood specimens. TPA was isolated from 47 rabbits with success rates of 71% (12/17) and 69% (35/51), respectively, from ulcer exudates and SS bloods. We obtained paired genomic sequences from 24 clinical samples and corresponding rabbit isolates. Six SS14- and two Nichols-clade genome pairs contained rare discordances. Forty-one of the 51 unique TPA genomes clustered within SS14 subgroups largely from East Asia, while 10 fell into Nichols C and E subgroups.Conclusions Our TPA detection rate was high from PS ulcer exudates and SS skin biopsies and over 50% from SS blood, with TPA isolation in over two-thirds of samples. Our results support the use of WGS from rabbit isolates to inform vaccine development.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 18.06.2024
Tilføjet 18.06.2024
Abstract While ceftriaxone remains the first-line treatment for gonorrhoea, the US CDC recommended cefixime as a second-line treatment in 2021. We tested 1176 Neisseria gonorrhoeae isolates among clients attending the Melbourne Sexual Health Centre in 2021-2022. The prevalence of cefixime resistance was 6.3% (74/1176), azithromycin resistance was 4.9% (58/1176) and ceftriaxone resistance was 0% (0/1176). Cefixime resistance was the highest among women (16.4%, 10/61), followed by men-who-have-sex-with-women (6.4%, 7/109), and men-who-have-sex-with-men (5.8%, 57/982). The prevalence of cefixime-resistant N. gonorrhoeae exceeds the threshold of the 5% resistance level recommended by the World Health Organization; and thus, cefixime treatment would have limited benefits in Australia.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 18.06.2024
Tilføjet 18.06.2024
Abstract In IMPAACT 2010/VESTED, pregnant women were randomized to initiate dolutegravir (DTG)+emtricitabine (FTC)/tenofovir alafenamide (TAF), DTG+FTC/tenofovir disoproxil fumarate (TDF), or efavirenz (EFV)/FTC/TDF. We assessed red blood cell folate concentrations (RBC-folate) at maternal study entry and delivery, and infant birth. RBC-folate outcomes were: 1) maternal change entry to delivery (trajectory), 2) infant, 3) ratio of infant-to-maternal delivery. Generalized estimating equation models for each log(folate) outcome were fit to estimate adjusted geometric mean ratio (Adj-GMR)/GMR trajectories (Adj-GMRT) of each arm comparison in 340 mothers and 310 infants. Overall, 90% of mothers received folic acid supplements and 78% lived in Africa. At entry, median maternal age was 25 years, gestational age was 22 weeks, CD4 count was 482 cells/mm3 and log10HIV RNA was 3 copies/mL. Entry RBC-folate was similar across arms. Adj-GMRT of maternal folate was 3% higher in the DTG+FTC/TAF versus EFV/FTC/TDF arm (1.03, 95%CI 1.00, 1.06). The DTG+FTC/TAF arm had an 8% lower infant-maternal folate ratio (0.92, 95%CI 0.78, 1.09) versus EFV/FTC/TDF. Results are consistent with no clinically meaningful differences between arms for all RBC-folate outcomes and they suggest that cellular uptake of folate and folate transport to the infant do not differ in pregnant women starting DTG- vs. EFV-based ART.
Læs mere Tjek på PubMedAmanda de la Fuente, Jaime López-Sánchez, Luis Mario Vaquero-Roncero, María Merino García, María Elisa Sánchez Barrado, Miguel Vicente Sánchez-Hernández, Nadia Garcia-Mateo, Jesús Rico-Feijoo, Luis Muñoz-Bellvís, Rafael González de Castro, Ana P. Tedim, Alicia Ortega, Omar Abdel-lah Fernández, Alejandro Suárez-de-la-Rica, Emilio Maseda, Ignacio Trejo González, Geovanna Liszeth García Carrera, José Miguel Marcos-Vidal, Juan Manuel Nieto Arranz, Luis Chiscano-Camón, Ricard Ferrer, Juan Carlos Ruiz-Rodríguez, Juan José González-López, José Alberto Vila Fernández, Regina Prieto Carballo, Raul Lopez-Izquierdo, Sonsoles Garrosa, Beatriz Barón, Carmen Esteban-Velasco, César Aldecoa, Jesús F Bermejo-Martin
International Journal of Infectious Diseases, 18.06.2024
Tilføjet 18.06.2024
The emergence of organ failure is a major complication of an infection, leading to sepsis, septic shock or even death in some cases [1]. For clinical operationalization, the degree of organ failure during an infection is typically evaluated using the Sequential Organ Failure Assessment (SOFA) score, which includes parameters of six different organs and systems: the liver, kidneys, lungs, the coagulation system, the central nervous system, and the cardiovascular system [2].
Læs mere Tjek på PubMedMuhammad Asif Syed, Muhammad Ilyas Siddiqui, Ishfaque Hussain Memon, Kishwar Jehandad, Nayyar Nawaz Baloch, Hamza Jamal, Aamir Hussain, Naveed Masood Memon, Masroor Hussain Syed, Zeeshan Ansar Ahmed, Robert Fontaine, Paola Rullán-Oliver
International Journal of Infectious Diseases, 18.06.2024
Tilføjet 18.06.2024
Crimean-Congo hemorrhagic fever (CCHF) virus (CCHFV) is enzootic in wildlife and livestock throughout Africa, southeast Europe, the Middle East, Central Asia, and South Asia[1]. Humans are accidental hosts and are infected through contact with the blood or secretions of infected livestock, bites from reservoir and vector tick species (Hyalomma), and exposure to blood or secretions from infected patients in the healthcare setting [1]. Accordingly, working in these situations carries the highest risk to humans.
Læs mere Tjek på PubMedZacharia, A., Makene, T., Haule, S., Lukumay, G., Omary, H., Shabani, M., Ngasala, B.
BMJ Open, 18.06.2024
Tilføjet 18.06.2024
BackgroundUrogenital schistosomiasis (UGS) caused by Schistosoma haematobium is endemic in Southern Tanzania. The disease has significant implications for both socioeconomic and public health. Because infections with S. haematobium usually peak in childhood, the majority of studies have concentrated on school-aged children leaving other groups such as males which might be continuous reservoir of infection transmission. However, despite its chronic consequences in the male population, the disease has received insufficient attention, especially in sub-Saharan Africa. This study was conducted to describe the previous and current schistosomiasis status among adult males living in high-endemic areas of southern Tanzania Design, setting and participantsA descriptive cross-sectional study was employed to gather data on the prevalence of UGS among adult men residing at schistosomiasis endemic in the Mtama District Council. Quantitative methods of data collection which included questionnaire and laboratory procedures were used. ResultsOut of 245 participants, macrohaematuria and microhaematuria were found in 12 (4.9%, 95% CI 2.4% to 7.8%) and 66 (26.9%, 95% CI 21.6% to 32.7%) participants, respectively. S. haematobium ova were recovered from the urine samples of 54 (22.0%, 95% CI 16.7% to 27.3%) participants. The median intensity of infection was 20 eggs per 10 mL of urine ranging from 1 to 201 eggs per 10 mL of urine (IQR) 60.5). Out of 245 participants 33 (13.5% 95% CI 9.0% to 17.6%) had light intensity of infection and 21 (38.9%, 95% CI; 25.0% to 52.5%) had heavy intensity of infection. Overall, the prevalence of heavy intensity of infection was 8.6% (95% CI 4.9% to 12.6%). The prevalence and intensity of UGS varied significantly by age, marital status and village of residence. ConclusionThis study sheds light on the prevalence of UGS among adult males in endemic areas of southern Tanzania. The results highlight the urgent need for comprehensive intervention strategies to address the burden of the disease.
Læs mere Tjek på PubMedAadal, L., Holst, M., Poulsen, I., Siig, M., Odgaard, L.
BMJ Open, 18.06.2024
Tilføjet 18.06.2024
IntroductionPatients with an acquired brain injury (ABI) are at an increased risk of undernutrition due to the disease-related inflammation and other numerous symptoms that impact their nutrition. Unfortunately, recommendations related to nutritional interventions and related efforts vary. The objective of this scoping review is to map the body of literature on nutritional interventions and related efforts provided by health professionals, such as screening or assessments, addressing undernutrition in adults with a moderate to severe ABI during the subacute rehabilitation pathway. Methods and analysisThe review follows the Joanna Briggs Institute methodology for scoping reviews. The librarian-assisted search strategy will be conducted in the bibliographical databases: MEDLINE (PubMed), Embase, CINAHL, Web of Science and OpenGrey. Indexed and grey literature in English, German or Scandinavian languages from January 2010 will be considered for inclusion. Two independent reviewers will conduct the iterative process of screening the identified literature, paper selection and data extraction. Disagreements will be resolved by discussion until a consensus is reached. A template will be used to guide the data extraction. This scoping review will include research articles, methodological papers and clinical guidelines reporting on nutritional interventions or related efforts to prevent or address undernutrition in adult patients (≥18 years) with moderate to severe ABI within the first year after admission to rehabilitation hospital. We will map all kinds of nutritional efforts provided by professionals in different settings within high-income countries, including interventions targeting relatives. Ethics and disseminationThis review will involve the collection and analysis of secondary sources that have been published and/or are publicly available. Therefore, ethics approval is not required. The results will be published in an international peer-reviewed journal, presented at scientific conferences and disseminated through digital science communication platforms. Study registrationOpen Science Framework: https://doi.org/10.17605/OSF.IO/H5GJX.
Læs mere Tjek på PubMedAllel, K., Fernandez-Miyakawa, M., Gaze, W., Petroni, A., Corso, A., Luna, F., Barcelona, L., Boden, L., Pitchforth, E., AMR Policy Research Group Argentina, Sota, Gomez, Bruni, Reyher, West, Davies, Moran
BMJ Open, 18.06.2024
Tilføjet 18.06.2024
IntroductionGaps in antimicrobial resistance (AMR) surveillance and control, including implementation of national action plans (NAPs), are evident internationally. Countries’ capacity to translate political commitment into action is crucial to cope with AMR at the human–animal–environment interface. MethodsWe employed a two-stage process to understand opportunities and challenges related to AMR surveillance and control at the human–animal interface in Argentina. First, we compiled the central AMR policies locally and mapped vital stakeholders around the NAP and the national commission against bacterial resistance. Second, we conducted qualitative interviews using a semistructured questionnaire covering stakeholders’ understanding and progress towards AMR and NAP. We employed a mixed deductive–inductive approach and used the constant comparative analysis method. We created categories and themes to cluster subthemes and determined crucial relationships among thematic groups. ResultsCrucial AMR policy developments have been made since 1969, including gradually banning colistin in food-producing animals. In 2023, a new government decree prioritised AMR following the 2015 NAP launch. Our qualitative analyses identified seven major themes for tackling AMR: (I) Cultural factors and sociopolitical country context hampering AMR progress, (II) Fragmented governance, (III) Antibiotic access and use, (IV) AMR knowledge and awareness throughout stakeholders, (V) AMR surveillance, (VI) NAP efforts and (VII) External drivers. We identified a fragmented structure of the food production chain, poor cross-coordination between stakeholders, limited surveillance and regulation among food-producing animals and geographical disparities over access, diagnosis and treatment. The country is moving to integrate animal and food production into its surveillance system, with most hospitals experienced in monitoring AMR through antimicrobial stewardship programmes. ConclusionAMR accountability should involve underpinning collaboration at different NAP implementation levels and providing adequate resources to safeguard long-term sustainability. Incorporating a multisectoral context-specific approach relying on different One Health domains is crucial to strengthening local AMR surveillance.
Læs mere Tjek på PubMedFonseka, N., Khan, Z., Lewis, M., Kibria, Z., Ahmad, F., Khan, M. F., Ul-Haq, M., Ul-Haq, Z., Sanauddin, N., Majid, M., Rahim, M., Naeem, F., Butt, M., Ashraf, S., Komproe, I., Mallen, C., Kellar, I., Yadegarfar, G., Milner, A., Sheikh, S., Farooq, S.
BMJ Open, 18.06.2024
Tilføjet 18.06.2024
Introduction and objectivesThere is an unmet need to develop high-quality evidence addressing tuberculosis (TB)-related mental health comorbidity, particularly in the context of lower-middle-income countries. This study aims to examine the effectiveness and cost-effectiveness of cognitive behavioural therapy (CBT) versus enhanced treatment as usual (ETAU) in improving depressive symptoms in people with TB and comorbid depression, enhancing adherence with anti-TB treatment (ATT) and its implementation in the real-world setting of Pakistan. MethodsWe will conduct a pragmatic parallel arm randomised control trial with an internal pilot. A brief psychological intervention based on CBT has been developed using a combination of qualitative and ethnographic studies. The inbuilt pilot trial will have a sample size of 80, while we plan to recruit 560 (280 per arm) participants in the definitive trial. Participants who started on ATT within 1 month of diagnosis for pulmonary and extrapulmonary TB or multidrug resistant TB (MDR-TB) and meeting the criteria for depression on Patient Health Questionnaire-9 (PHQ-9) will be randomised with 1:1 allocation to receive six sessions of CBT (delivered by TB healthcare workers) or ETAU. Data on the feasibility outcomes of the pilot will be considered to proceed with the definitive trial. Participants will be assessed (by a blinded assessor) for the following main trial primary outcomes: (1) severity of depression using PHQ-9 scale (interviewer-administered questionnaire) at baseline, weeks 8, 24 and 32 postrandomisation and (2) ATT at baseline and week 24 at the end of ATT therapy. Ethics and disseminationEthical approval has been obtained from Keele University Research Ethics Committee (ref: 2023-0599-792), Khyber Medical University Ethical Review Board (ref: DIR/KMU-EB/CT/000990) and National Bioethics Committee Pakistan (ref: No.4–87/NBC-998/23/587). The results of this study will be reported in peer-reviewed journals and academic conferences and disseminated to stakeholders and policymakers. Trial registration numberISRCTN10761003.
Læs mere Tjek på PubMedBlythe, N. M., Coates, K., Benger, J. R., Annaw, A., Banks, J., Clement, C., Clout, M., Edwards, A., Gaunt, D., Kandiyali, R., Lane, J. A., Lecky, F., Maskell, N. A., Metcalfe, C., Platt, M., Rees, S., Taylor, J., Thompson, J., Walker, S., West, D., Carlton, E.
BMJ Open, 18.06.2024
Tilføjet 18.06.2024
IntroductionTraumatic pneumothoraces are present in one of five victims of severe trauma. Current guidelines advise chest drain insertion for most traumatic pneumothoraces, although very small pneumothoraces can be managed with observation at the treating clinician’s discretion. There remains a large proportion of patients in whom there is clinical uncertainty as to whether an immediate chest drain is required, with no robust evidence to inform practice. Chest drains carry a high risk of complications such as bleeding and infection. The default to invasive treatment may be causing potentially avoidable pain, distress and complications. We are evaluating the clinical and cost-effectiveness of an initial conservative approach to the management of patients with traumatic pneumothoraces. Methods and analysisThe CoMiTED (Conservative Management in Traumatic Pneumothoraces in the Emergency Department) trial is a multicentre, pragmatic parallel group, individually randomised controlled non-inferiority trial to establish whether initial conservative management of significant traumatic pneumothoraces is non-inferior to invasive management in terms of subsequent emergency pleural interventions, complications, pain, breathlessness and quality of life. We aim to recruit 750 patients from at least 40 UK National Health Service hospitals. Patients allocated to the control (invasive management) group will have a chest drain inserted in the emergency department. For those in the intervention (initial conservative management) group, the treating clinician will be advised to manage the participant without chest drain insertion and undertake observation. The primary outcome is a binary measure of the need for one or more subsequent emergency pleural interventions within 30 days of randomisation. Secondary outcomes include complications, cost-effectiveness, patient-reported quality of life and patient and clinician views of the two treatment options; participants are followed up for 6 months. Ethics and disseminationThis trial received approval from the Wales Research Ethics Committee 4 (reference: 22/WA/0118) and the Health Research Authority. Results will be submitted for publication in a peer-reviewed journal. Trial registration numberISRCTN35574247.
Læs mere Tjek på PubMedBMC Infectious Diseases, 18.06.2024
Tilføjet 18.06.2024
Abstract Background Intestinal parasitic infections remain a significant global health issue, particularly affecting poor and marginalised populations. These infections significantly contribute to children’s diseases, malnutrition, poor school performance, cognitive disorders, and future economic losses. This study aimed to explore and compare the occurrence of intestinal parasites in early childhood among the group of infants from the Slovak majority population and from marginalised Roma communities (MRCs). Furthermore, it aimed to explore the health complaints of children with and without intestinal parasitic infection in the past month and assess the effect of various risk factors on the occurrence of intestinal parasitic infection in infants from MRCs. Methods We obtained cross-sectional data from mothers and stool samples of their children aged 13–21 months using the first wave of the longitudinal RomaREACH study. A total of 181 stools from infants were analysed: 105 infants from the Slovak majority population and 76 from MRCs. Results Infants from MRCs are significantly more often infected by Ascaris lumbricoides, Trichuris trichiura and Giardia duodenalis than their better-off peers from the majority population. Infection rates are 30% in infants from MRCs vs. 0% in the majority population (p
Læs mere Tjek på PubMedBMC Infectious Diseases, 18.06.2024
Tilføjet 18.06.2024
Abstract Background and purpose The persistent progression of pneumonia is a critical determinant of adverse outcomes in patients afflicted with COVID-19. This study aimed to predict personalized COVID-19 pneumonia progression between the duration of two weeks and 1 month after admission by integrating radiological and clinical features. Methods A retrospective analysis, approved by the Institutional Review Board, encompassed patients diagnosed with COVID-19 pneumonia between December 2022 and February 2023. The cohort was divided into training and validation groups in a 7:3 ratio. A trained multi-task U-Net network was deployed to segment COVID-19 pneumonia and lung regions in CT images, from which quantitative features were extracted. The eXtreme Gradient Boosting (XGBoost) algorithm was employed to construct a radiological model. A clinical model was constructed by LASSO method and stepwise regression analysis, followed by the subsequent construction of the combined model. Model performance was assessed using ROC and decision curve analysis (DCA), while Shapley’s Additive interpretation (SHAP) illustrated the importance of CT features. Results A total of 214 patients were recruited in our study. Four clinical characteristics and four CT features were identified as pivotal components for constructing the clinical and radiological models. The final four clinical characteristics were incorporated as well as the RS_radiological model to construct the combined prediction model. SHAP analysis revealed that CT score difference exerted the most significant influence on the predictive performance of the radiological model. The training group’s radiological, clinical, and combined models exhibited AUC values of 0.89, 0.72, and 0.92, respectively. Correspondingly, in the validation group, these values were observed to be 0.75, 0.72, and 0.81. The DCA curve showed that the combined model exhibited greater clinical utility than the clinical or radiological models. Conclusion Our novel combined model, fusing quantitative CT features with clinical characteristics, demonstrated effective prediction of COVID-19 pneumonia progression from 2 weeks to 1 month after admission. This comprehensive model can potentially serve as a valuable tool for clinicians to develop personalized treatment strategies and improve patient outcomes.
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