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A 66-year-old female presented with a 2-month history of sinus tracts of the left lower leg and heel with discharge of pus. Her medical history included nephrotic syndrome, avascular necrosis of the femoral head, and primary hypothyroidism. The patient complained of leg pain when walking and standing. The nutritional status of the patient was poor. Laboratory test results included: white blood cell count, 13.77 ×  109/L (normal range, 3.5–9.5 ×  109/L); absolute neutrophil count, 12.49 ×  109/L (normal range, 1.8–6.3 ×  109/L); and percent of neutrophils, 90.7% (normal range, 40%–75%).

Therapeutic drug management (TDM) and model-informed precision dosing (MIPD) allow dose individualisation to increase drug effectivity and reduce toxicity.

Background: There is limited understanding of the pre-exposure prophylaxis (PrEP) care continuum specific to Latino/x gay, bisexual, and other sexual minority men (SMM) that encompasses the population residing outside of large metropolitan or urban areas.Setting: We examined trends and characteristics associated with the PrEP care continuum with data from the 2014-2020 cycles of the American Men’s Internet Survey, an annual online cross-sectional behavioral survey of cisgender SMM in the U.S.Methods: We calculated PrEP continuum outcomes overall and by year among Hispanic/Latino SMM (n=9,010). We used generalized estimating equations with Poisson links to examine (1) temporal trends (2014-2020) in each step of the PrEP continuum and PrEP use in the past year stratified by PrEP eligibility and (2) correlates of each step of the PrEP continuum in 2020 using multivariable models.Results: Among 2,283 Latino SMM in 2020, 84% reported PrEP awareness, 30% discussed PrEP with a provider, 15% used PrEP in the past year, and 12% were currently using PrEP. PrEP awareness increased from 52% in 2014 to 84% in 2020; and PrEP use in past year increased from 4% in 2014 to 15% in 2020. In the multivariable models, age and PrEP eligibility were associated with PrEP use in past year, and urban-rural classification was associated with current PrEP use.Conclusions: While the majority of Latino SMM are aware of PrEP, significant gaps remain in this population in discussing PrEP with a provider and using PrEP that require tailored strategies to enhance access to HIV prevention services.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Background: Despite modern antiretroviral therapy, HIV-1 RNA escape into the cerebrospinal fluid (CSF) may occur. We examined the prevalence of and factors associated with CSF HIV-1 escape among people living with HIV (PLWH) in Switzerland.Setting: The Neurocognitive Assessment in the Metabolic and Aging Cohort (NAMACO) study is an ongoing, prospective, longitudinal, multicenter study within the Swiss HIV Cohort Study. The neuro-HIV platform is a multi-disciplinary, single-day outpatient consultation at Lausanne University Hospital.Methods: We pooled data from the NAMACO study and the neuro-HIV platform participants who underwent lumbar puncture (LP) between 2011 and 2019. Both patient groups had neurocognitive symptoms. CSF HIV-1 escape was defined as the presence of quantifiable CSF HIV-1 RNA when plasma HIV-1 RNA was suppressed or CSF HIV-1 RNA greater than plasma HIV-1 RNA when the latter was detectable.Results: Of 1166 PLWH assessed, 288 underwent LP. CSF HIV-1 escape was observed in 25 PLWH (8.7%) of whom 19 (76%) had supressed plasma HIV-1 RNA. Characteristics of PLWH were comparable whether they had CSF HIV-1 escape or not, including comorbidities, time since HIV diagnosis (15 vs 16 years, p=0.9), median CD4 nadir (158.5/mm3 vs 171/mm3, p=0.6), antiretroviral CSF-Penetration-Effectiveness score (7 vs 7 points, p=0.8), neurocognitive diagnosis based on Frascati criteria and radiological findings.Conclusions: In this large pooled sample of PLWH with neurocognitive symptoms, CSF HIV-1 escape occurred in 8.7% of PLWH. PLWH with CSF HIV-1 escape presented no distinctive clinical or paraclinical characteristics. We conclude that LP is unavoidable in confirming CSF HIV-1 escape.Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

Journal of Medical Virology, Accepted Article.

Journal of Medical Virology, Accepted Article.

Journal of Medical Virology, Accepted Article.

Journal of Medical Virology, Accepted Article.

Journal of Medical Virology, Accepted Article.

Journal of Medical Virology, Accepted Article.

New England Journal of Medicine, Volume 388, Issue 12, Page 1101-1110, March 2023.

New England Journal of Medicine, Volume 388, Issue 12, Page 1139-1141, March 2023.

New England Journal of Medicine, Volume 388, Issue 12, Page 1146-1148, March 2023.

New England Journal of Medicine, Ahead of Print.

New England Journal of Medicine, Ahead of Print.

ObjectivesTo find the optimal treatment duration with antibiotics for community-acquired pneumonia (CAP) in adults.DesignSystematic review and duration-effect meta-analysis.Data sourcesMEDLINE, Embase and CENTRAL through 25 August 2021.Eligibility criteriaAll randomised controlled trials comparing the same antibiotics used at the same daily dosage but for different durations for CAP in adults. Both outpatients and inpatients were included but not those admitted to intensive care units. We imposed no date, language or publication status restriction.Data extraction and synthesisData extraction by two independent reviewers. We conducted a random-effects, one-stage duration-effect meta-analysis with restricted cubic splines. We tested the non-inferiority with the prespecified non-inferiority margin of 10% examined against 10 days . The primary outcome was clinical improvement on day 15 (range 7–45 days). Secondary outcomes: all-cause mortality, serious adverse events and clinical improvement on day 30 (15–60 days).ResultsWe included nine trials (2399 patients with a mean (SD) age of 61.2 (22.1); 39% women). The duration-effect curve was monotonic with longer duration leading to a lower probability of improvement, and shorter treatment duration (3–9 days) was likely to be non-inferior to 10-day treatment. Harmful outcome curves indicated no association. The weighted average percentage of the primary outcome in the 10-day treatment arms was 68%. Using that average, the absolute clinical improvement rates of the following durations were: 3-day treatment 75% (95% CI: 68% to 81%), 5-day treatment 72% (95% CI: 66% to 78%) and 7-day treatment 69% (95% CI: 61% to 76%).ConclusionsShorter treatment duration (3–5 days) probably offers the optimal balance between efficacy and treatment burden for treating CAP in adults if they achieved clinical stability. However, the small number of included studies and the overall moderate-to-high risk of bias may compromise the certainty of the results. Further research on the shorter duration range is required.PROSPERO registration numberCRD 42021273357.…

ObjectiveThis study aimed to assess the knowledge and acceptability of the human papillomavirus (HPV) vaccine and associated factors among female adolescent students in Debre Tabor Town, Ethiopia, 2021.DesignCross-sectional study was done from 9 December 2020 to 28 February 2021.AnalysisThe data were entered into EpiData V.4.2 and analysed with SPSS V.23 software. The OR, 95% CI and p<0.05 were used to determine the bivariable and multivariable statistical association.SettingThree high schools (grades 9 and 10) and six primary schools (grades 7 and 8) were included in the study.ParticipantsAdolescent female students in Debre Tabor Town.ResultsThe overall knowledge score in the questionnaire was six, and it was divided into two groups based on scoring level: poor (score <3) and good (score ≥3). More than half respondents (59.2%) scored good knowledge. The proportion of acceptability of the HPV vaccine was 61.9%. Age (adjusted OR, AOR 1.70, 95% CI 1.17 to 3.88), and having a source of information (AOR 1.94, 95% CI 1.06 to 3.22) were significantly associated with the knowledge of the HPV vaccine. Place of birth (AOR 1.55, 95% CI 1.15 to 1.95), fathers’ educational status (AOR 2.80, 95% CI 1.18 to 5.65), having a source of information (AOR 2.14, 95% CI 1.05 to 4.32) and knowledge about the HPV vaccine (AOR 6.41, 95% CI 3.45 to 11.90) were significantly associated with the acceptance of the female adolescent HPV vaccine.ConclusionIn this study, the knowledge and acceptability of students of the HPV vaccine were low. Health authorities, through the mass media, should strengthen HPV vaccine promotion in schools, religious institutions and health facilities.…

IntroductionThe effectiveness of psychotherapy in depression is subject of an ongoing debate. The mechanisms of change are still underexplored. Research tries to find influencing factors fostering the effect of psychotherapy. In that context, the dose–response relationship should receive more attention. Increasing the frequency from one to two sessions per week seems to be a promising start. Moreover, the concept of expectations and its influence in depression can be another auspicious approach. Dysfunctional expectations and the lack of their modification are central in symptom maintenance. Expectation focused psychological interventions (EFPI) have been investigated, primarily in the field of depression. The aim of this study is to compare cognitive behavioural therapy (CBT) once a week with an intensified version of CBT (two times a week) in depression as well as to include a third proof-of-principle intervention group receiving a condensed expectation focused CBT.Methods and analysisParticipants are recruited through an outpatient clinic in Germany. A current major depressive episode, diagnosed via structured clinical interviews should present as the main diagnosis. The planned randomised-controlled trial will allow comparisons between the following treatment conditions: CBT (one session/week), condensed CBT (two sessions/week) and EFPI (two sessions/week). All treatment arms include a total dose of 24 sessions. Depression severity applies as the outcome variable (Beck Depression Inventory II, Montgomery Asberg Depression Rating Scale). A sample size of n=150 is intended.Ethics and disseminationThe local ethics committee of the Department of Psychology, Philipps-University Marburg approved the study (reference number 2020-68 v). The final research article including the study results is intended to be published in international peer-reviewed journals.Trial registration numberGerman Clinical Trials Registry (DRKS00023203).…

ObjectivesThe non-transfusion-dependent beta-thalassaemia-patient-reported outcome (NTDT-PRO) questionnaire was developed for assessing anaemia-related tiredness/weakness (T/W) and shortness of breath (SoB) among patients with NTDT. Psychometric properties were evaluated using blinded data from the BEYOND trial (NCT03342404).DesignAnalysis of a phase 2, double-blind, randomised, placebo-controlled trial.SettingUSA, Greece, Italy, Lebanon, Thailand and the UK.ParticipantsAdults (≥18 years) (N=145) with NTDT who had not received a red blood cell transfusion within 8 weeks prior to randomisation, with mean baseline haemoglobin level ≤100 g/L.MeasuresNTDT-PRO daily scores from baseline until week 24, and scores at select time points for the 36-Item Short Form Health Survey version 2 (SF-36v2), Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F) and Patient Global Impression of Severity (PGI-S).ResultsCronbach’s alpha at weeks 13–24 was 0.95 and 0.84 for the T/W and SoB domains, respectively, indicating acceptable internal consistency reliability. Among participants self-reporting no change in thalassaemia symptoms via the PGI-S between baseline and week 1, intraclass correlation coefficients were 0.94 and 0.92 for the T/W and SoB domains, respectively, indicating excellent test–retest reliability. In a known-groups validity analysis, least-squares mean T/W and SoB scores at weeks 13–24 were worse in participants with worse scores for the FACIT-F Fatigue Subscale (FS), SF-36v2 vitality or PGI-S. Indicating responsiveness, changes in T/W and SoB domain scores were moderately correlated with changes in haemoglobin levels, and strongly correlated with changes in SF-36v2 vitality, FACIT-F FS, select FACIT-F items and the PGI-S. Improvements in least-squares mean T/W and SoB scores were higher in participants with greater improvements in scores on other PROs measuring similar constructs.ConclusionsThe NTDT-PRO demonstrated adequate psychometric properties to assess anaemia-related symptoms in adults with NTDT and can be used to evaluate treatment efficacy in clinical trials.…

IntroductionPeople with disabilities have a higher prevalence of cigarette smoking than people without disabilities. However, little information exists on smoking cessation interventions tailored to address the unique needs of people with disabilities. This paper describes a systematic review protocol to identify and evaluate tobacco smoking cessation interventions designed to improve outcomes for people with disabilities.Methods and analysisWe will conduct a systematic review of the literature using the procedures outlined by Cochrane. We will search four electronic databases (CINAHL Plus (EBSCO), Embase (Ovid), Medline (Ovid) and PsycINFO (Ovid)) with no date restriction to identify tobacco cessation interventions tailored to meet the needs of people with disabilities. We will extract data and assess risk of bias using the RoB2 and ROBINS-I for included studies using Covidence systematic review software. Quantitative and qualitative syntheses will summarise key study characteristics and outcomes with text, tables and forest plots; a meta-analysis will be conducted, if appropriate.Ethics and disseminationEthical approval is not required as there are no primary data associated with the study. Data will be disseminated through a peer-reviewed articles and conference presentations.PROSPERO registration numberCRD42022337434.…

ObjectivesIncreasingly attention of the COVID-19 pandemic is directed towards its long-term effects, also known as Long-COVID. So far, Long-COVID was examined mainly from a medical perspective, leaving psychosocial effects of Long-COVID understudied. The present study advances the current literature by examining social support in the context of Long-COVID. The study not only examines received support reported by individuals with Long-COVID, but also provided support reported by relatives of individuals with Long-COVID.DesignCross-sectional study.SettingThe study was conducted from June to October 2021 in Austria, Germany and the German-speaking part of Switzerland.ParticipantsWe examined 256 individuals with Long-COVID (MAge=45.05 years, 90.2% women) and 50 relatives of individuals with Long-COVID (MAge=48.34 years, 66.1% female) in two separate online surveys, assessing social support, well-being and distress.Primary outcome measuresPrimary outcomes were positive and negative affect, anxiety and depressive symptoms and perceived stress.ResultsFor individuals with Long-COVID, receiving emotional support was related to higher well-being (positive affect: b=0.29, p<0.01; negative affect: b=–0.31, p<0.05) and less distress (anxiety: b=–1.45, p<0.01; depressive symptoms: b=–1.04, p<0.05; perceived stress: b=–0.21, p<0.05) but no effects emerged for receiving practical support. For relatives of individuals with Long-COVID, providing emotional support was only related to lower depressive symptoms (b=–2.57, p<0.05). Again, provided practical support was unrelated to the outcomes considered.ConclusionsEmotional support is likely to play an important role in well-being and distress of patients and relatives, whereas practical support does not seem to make a difference. Future research should clarify under what conditions different kinds of support unfold their positive effects on well-being and distress in the context of Long-COVID.…

Healthcare staff have been facing particular mental health challenges during the COVID-19-pandemic. Building on a first study at the beginning of the pandemic in March 2020, we aimed to investigate among healthcare professionals in Germany and Austria (1) how mental health may have changed in professionals over the course of the ongoing pandemic, (2) whether there are differences between different professional groups regarding mental health, (3) which stress factors may explain these mental health outcomes and (4) whether help-seeking behaviour is related to caretaker self-image or team climate. Between March and June 2021, N=639 healthcare professionals completed an online survey including the ICD-10 Symptom Rating checklist, event-sampling questions on pandemic-related stressors and self-formulated questions on help-seeking behaviour and team climate. Findings were analysed using t-tests, regressions and comparisons to a sample of healthcare professionals assessed in 2020 as well as to norm samples. Results show that mental health symptoms, particularly for depression and anxiety, persist among healthcare staff in the second pandemic year, that symptom prevalence rates are higher among nursing staff compared with physicians and paramedics and that team climate is associated with mental health outcomes. Implications of these findings in relation to the persisting pandemic and its aftermath are discussed.…

ObjectiveTo assess the prevalence, treatment outcomes and determinants of tuberculosis (TB)–HIV coinfection in Ghana.Study designA retrospective review of TB case register for Kwabre East Municipality was conducted for the period 2010–2020 to identify TB–HIV coinfections.Setting462 patients with TB from four sub-municipal treatment centres were included in the study.Primary outcome measureA logistic regression model was used to investigate the relationship between clinico-demographic factors (age, sex, type of patient, disease classification, treatment category and sputum smear microscopy) and TB–HIV coinfection.ResultsOf the 462 individual TB cases found in the TB register from 2010 to 2020, 286 (61.9%) were screened for HIV and the results showed that 18% had TB–HIV coinfection. TB–HIV coinfection was highest in 2015 with a prevalence of 40% among all registered TB cases. The likelihood of TB–HIV coinfection was highest among patients with TB aged 40–49 years (AOR=3.99, CI=1.3, 12.7). Those who tested negative for TB at the end of their treatment period had lower odds of HIV coinfection (AOR=0.27, CI=0.10, 0.72).ConclusionNearly one out of every five (18%) patients with TB in the municipality were found to be coinfected with HIV. TB–HIV coinfection was significantly associated with patients' age and their TB treatment outcomes. Urgent interventions are needed to address these risk factors to promote optimal health for patients with TB in the municipality.…

Science Advances, Volume 9, Issue 12, March 2023.

Science Advances, Volume 9, Issue 12, March 2023.

Antimicrobial Agents and Chemotherapy, Ahead of Print.

Publication date: Available online 21 March 2023Source: ImmunityAuthor(s): Michaela Seeling, Matthias Pöhnl, Sibel Kara, Nathalie Horstmann, Carolina Riemer, Miriam Wöhner, Chunguang Liang, Christin Brückner, Patrick Eiring, Anja Werner, Markus Biburger, Leon Altmann, Martin Schneider, Lukas Amon, Christian H.K. Lehmann, Sooyeon Lee, Meik Kunz, Diana Dudziak, Georg Schett, Tobias Bäuerle…

Publication date: Available online 21 March 2023Source: ImmunityAuthor(s): Conor M. Finlay, James E. Parkinson, Lili Zhang, Brian H.K. Chan, Jesuthas Ajendra, Alistair Chenery, Anya Morrison, Irem Kaymak, Emma L. Houlder, Syed Murtuza Baker, Ben R. Dickie, Louis Boon, Joanne E. Konkel, Matthew R. Hepworth, Andrew S. MacDonald, Gwendalyn J. Randolph, Dominik Rückerl, Judith E. Allen…

Objectives: Extracorporeal carbon dioxide removal (ECCO2R) devices are effective in reducing hypercapnia and mechanical ventilation support but have not been shown to reduce mortality. This may be due to case selection, device performance, familiarity, or the management. The objective of this study is to investigate the effectiveness and safety of a single ECCO2R device (Hemolung) in patients with acute respiratory failure and identify variables associated with survival that could help case selection in clinical practice as well as future research.Design: Multicenter, multinational, retrospective review.Setting: Data from the Hemolung Registry between April 2013 and June 2021, where 57 ICUs contributed deidentified data.Patients: Patients with acute respiratory failure treated with the Hemolung. The characteristics of patients who survived to ICU discharge were compared with those who died. Multivariable logistical regression analysis was used to identify variables associated with ICU survival.Interventions: None.Measurements and Main Results: Of the 159 patients included, 65 (41%) survived to ICU discharge. The survival was highest in status asthmaticus (86%), followed by acute respiratory distress syndrome (ARDS) (52%) and COVID-19 ARDS (31%). All patients had a significant reduction in Paco2 and improvement in pH with reduction in mechanical ventilation support. Patients who died were older, had a lower Pao2:Fio2 (P/F) and higher use of adjunctive therapies. There was no difference in the complications between patients who survived to those who died. Multivariable regression analysis showed non-COVID-19 ARDS, age less than 65 years, and P/F at initiation of ECCO2R to be independently associated with survival to ICU discharge (P/F 100–200 vs…

by Katriina Willgert, Susie da Silva, Ruoran Li, Premanshu Dandapat, Maroudam Veerasami, Hindol Maity, Mohan Papanna, Sreenidhi Srinivasan, James L. N. Wood, Vivek Kapur, Andrew J. K. ConlanZoonotic tuberculosis in humans is caused by infection with bacteria of the Mycobacterium tuberculosis complex acquired from animals, most commonly cattle. India has the highest burden of human tuberculosis in the world and any zoonotic risk posed by tuberculosis in bovines needs to be managed at the source of infection as a part of efforts to end human tuberculosis. Zoonotic tuberculosis in humans can be severe and is clinically indistinguishable from non-zoonotic tuberculosis. As a consequence, zoonotic tuberculosis remains under-recognised and the significance of its contribution to human tuberculosis is poorly understood. This study aimed to explore any association between bovine density, bovine ownership, and human tuberculosis reporting in India using self-reported tuberculosis data in households and officially reported tuberculosis cases while controlling for common confounders for human tuberculosis. We find an association between human tuberculosis reporting, bovine density and bovine ownership in India. Buffalo density was significantly associated with an increased risk of self-reported tuberculosis in households (odds ratio (OR) = 1.23 (95% credible interval (CI): 1.10–1.39) at household level; incidence rate ratio (IRR) = 1.17 (95% CI: 1.04–1.33) at district level), while cattle density (OR = 0.80, 95% CI: 0.71–0.89; IRR = 0.78, 95% CI: 0.70–0.87) and ownership of bovines in households (OR = 0.94, 95% CI: 0.9–0.99; IRR = 0.67, 95% CI: 0.57–0.79) had a protective association with tuberculosis reporting. It is unclear whether this relates to differences in tuberculosis transmission dynamics, or perhaps an association between bovines and other unexplored confounders for tuberculosis reporting in humans. Our study highlights a need for structured surveillance to estimate the prevalence of tuberculosis in cattle and buffaloes, characterisation of Mycobacterium tuberculosis complex species present in bovines and transmission analyses at the human-animal interface to better assess the burden and risk pathways of zoonotic tuberculosis in India.

by Laura Kananen, Xu Hong, Martin Annetorp, Jonathan K. L. Mak, Juulia Jylhävä, Maria Eriksdotter, Sara Hägg, Dorota ReligaObjective To analyse if the health progression of geriatric Covid-19 survivors three months after an acute Covid-19 infection was worse than in other geriatric patients. Specifically, we wanted to see if we could see distinct health profiles in the flow of re-admitted Covid-19 patients compared to re-admitted non-Covid-19 controls. Design Matched cohort study. Setting and participants Electronic medical records of geriatric patients hospitalised in geriatric clinics in Stockholm, Sweden, between March 2020 and January 2022. Patients readmitted three months after initial admission were selected for the analysis and Covid-19 survivors (n = 895) were compared to age-sex-Charlson comorbidity index (CCI)-matched non-Covid-19 controls (n = 2685). Methods We assessed using binary logistic and Cox regression if a previous Covid-19 infection could be a risk factor for worse health progression indicated by the CCI, hospital frailty risk score (HFRS), mortality and specific comorbidities. Results The patients were mostly older than 75 years and, already at baseline, had typically multiple comorbidities. The Covid-19 patients with readmission had mostly had their acute-phase infection in the 1st or 2nd pandemic waves before the vaccinations. The Covid-19 patients did not have worse health after three months compared to the matched controls according to the CCI (odds ratio, OR[95% confidence interval, CI] = 1.12[0.94–1.34]), HFRS (OR[95%CI] = 1.05[0.87–1.26]), 6-months (hazard ratio, HR[95%CI] = 1.04[0.70–1.52]) and 1-year-mortality risk (HR[95%CI] = 0.89[0.71–1.10]), adjusted for age, sex and health at baseline (the CCI and HFRS). Conclusions and implications The overall health progression of re-hospitalized geriatric Covid-19 survivors did not differ dramatically from other re-hospitalized geriatric patients with similar age, sex and health at baseline. Our results emphasize that Covid-19 was especially detrimental for geriatric patients in the acute-phase, but not in the later phase. Further studies including post-vaccination samples are needed.…

by Cristhian David Perdomo-Gómez, Nancy E. Ruiz-Uribe, John Mario González, Manu Forero-SheltonTrypanosoma cruzi is the etiological agent of Chagas disease, an important cause of infectious chronic myocardiopathy in Latin America. The life cycle of the parasite involves two main hosts: a triatomine (arthropod hematophagous vector) and a mammal. Epimastigotes are flagellated forms inside the triatomine gut; they mature in its intestine into metacyclic trypomastigotes, the infective form for humans. Parasites attach despite the shear stress generated by fluid flow in the intestines of the host, but little is known about the mechanisms that stabilize attachment in these conditions. Here, we describe the effect of varying levels of shear stress on attached T. cruzi epimastigotes using a parallel plate flow chamber. When flow is applied, parasites are partially dragged but maintain a connection to the surface via ~40 nm wide filaments (nanotubules) and the activity of flagella is reduced. When flow stops, parasites return near their original position and flagellar motion resumes. Nanotubule elongation increases with increasing shear stress and is consistent with a model of membrane tether extension under force. Fluorescent probes used to confirm membrane composition also show micron-wide anchoring pads at the distal end of the nanotubules. Multiple tethering accounts for more resistance to large shear stresses and for reduced flagellar movement when flow is stopped. The formation of membrane nanotubules is a possible mechanism to enhance adherence to host cells under shear stress, favoring the continuity of the parasite´s life cycle.

by Soraya C. Trindade, Mabel P. P. Lopes, Tatiane T. M. C. Oliveira, Milca J. Silva, Gerson A. Queiroz, Talita S. Jesus, Ellen K. N. Santos, Paulo C. Carvalho-Filho, Michelle M. L. Falcão, Patrícia M. Miranda, Rebeca P. B. Santos, Camila A. Figueiredo, Álvaro A. Cruz, Gregory J. Seymour, Isaac S. Gomes-FilhoThe Interleukin (IL)-33 is important in several inflammatory diseases and its cellular receptor is the Interleukin 1 receptor-like 1 (IL1RL1), also called suppression of tumorigenicity 2 ligand (ST2L). This study investigated associations between single nucleotide variants (SNVs) in the IL33 gene and in the IL1RL1 (ST2) gene with periodontitis. Additionally, aimed to determine the role of Aggregatibacter actinomycetemcomitans (Aa) relative amount in the subgingival biofilm in these associations. A cross-sectional study was carried out with 506 individuals that answered a structured questionnaire used to collect their health status, socioeconomic-demographic, and behavioral characteristics. Periodontal examination was performed to determine the presence and severity of periodontitis, and subgingival biofilm samples were collected to quantify the relative amount of Aa by real time polymerase chain reaction. Human genomic DNA was extracted from whole blood cells and SNV genotyping was performed. Logistic regression estimated the association measurements, odds ratio (OR), and 95% confidence interval (95%CI), between the IL33 and ST2 genes with periodontitis, and subgroup analyses assessed the relative amount of Aa in these associations. 23% of individuals had periodontitis. Adjusted measurements showed a statistically significant inverse association between two SNVs of the ST2; rs148548829 (C allele) and rs10206753 (G allele). These two alleles together with a third SNV, the rs11693204 (A allele), were inversely associated with moderate periodontitis. One SNV of the IL33 gene also showed a statistically significant inverse association with moderate periodontitis. Nine SNVs of the ST2 gene were inversely associated with the relative amount of Aa. In the high Aa subgroup, there was a direct association between 11 SNVs of the ST2 gene and moderate periodontitis and two SNVs of the ST2 gene and severe periodontitis, and eight SNVs of the ST2 gene and periodontitis. These exploratory findings of genetic variants in IL-33/ST2 axis support the concept that the different tissue responses among individuals with periodontitis may be modulated by the host’s genetics, influencing the physiopathology of the disease.

by Shantanu Dutta, Ashok Kumar, Pushpesh Pant, Caolan Walsh, Moumita DuttaDuring the pandemic era, COVID-related disclosure has become quite critical for shareholders and other market participants to understand the uncertainties and challenges associated with a firm’s operation. However, there is no well-grounded and systematic measure to gauge the intensity of COVID-related disclosure and its plausible impact. Therefore, this study develops and validates various COVID-related disclosure measures. More specifically, using a sample of publicly listed U.S. firms and applying natural language processing (NLP) on 10-K reports, we have developed two types of COVID dictionaries (or COVID-related disclosure measurement tools): (a) overall COVID dictionary (count of all COVID-related words/phrases) and (b) contextual COVID-dictionary (count of COVID related words/phrases preceded or followed by positive, negative tones, or financial constraints words). Subsequently, we have validated both types of COVID dictionaries by investigating their association with corporate liquidity events (e.g., dividend payment, dividend change). We confirm that the overall COVID dictionary effectively predicts a firm’s liquidity event. We find similar results for contextual COVID dictionaries with a negative spin (i.e., COVID disclosures with a negative tone or an indication of financial constraints). Our results further show that better-governed firms (e.g., greater board independence, and more female directors) tend to have more COVID-related disclosures, despite the fact that more COVID-related disclosures suppress a firm’s market-based stock performance (e.g. Tobin’s Q). Our results suggest that better-governed firms prefer greater transparency, even if it may hurt their market performance in the short run.

by María Dolores Cima Cabal, Felipe Molina, José Ignacio López-Sánchez, Efrén Pérez-Santín, María del Mar García-SuárezBackground This systematic review evaluates pneumolysin (PLY) as a target for new treatments against pneumococcal infections. Pneumolysin is one of the main virulence factors produced by all types of pneumococci. This toxin (53 kDa) is a highly conserved protein that binds to cholesterol in eukaryotic cells, forming pores that lead to cell destruction. Methods The databases consulted were MEDLINE, Web of Science, and Scopus. Articles were independently screened by title, abstract, and full text by two researchers, and using consensus to resolve any disagreements that occurred. Articles in other languages different from English, patents, cases report, notes, chapter books and reviews were excluded. Searches were restricted to the years 2000 to 2021. Methodological quality was evaluated using OHAT framework. Results Forty-one articles describing the effects of different molecules that inhibit PLY were reviewed. Briefly, the inhibitory molecules found were classified into three main groups: those exerting a direct effect by binding and/or blocking PLY, those acting indirectly by preventing its effects on host cells, and those whose mechanisms are unknown. Although many molecules are proposed as toxin blockers, only some of them, such as antibiotics, peptides, sterols, and statins, have the probability of being implemented as clinical treatment. In contrast, for other molecules, there are limited studies that demonstrate efficacy in animal models with sufficient reliability. Discussion Most of the studies reviewed has a good level of confidence. However, one of the limitations of this systematic review is the lack of homogeneity of the studies, what prevented to carry out a statistical comparison of the results or meta-analysis. Conclusion A panel of molecules blocking PLY activity are associated with the improvement of the inflammatory process triggered by the pneumococcal infection. Some molecules have already been used in humans for other purposes, so they could be safe for use in patients with pneumococcal infections. These patients might benefit from a second line treatment during the initial stages of the infection preventing acute respiratory distress syndrome and invasive pneumococcal diseases. Additional research using the presented set of compounds might further improve the clinical management of these patients.…

by Ineke R. van Herwijnen, Joanne A. M. van der Borg, Chantal M. Kapteijn, Saskia S. Arndt, Claudia M. VinkeTo examine the dog ownership factors characteristic to a population of dogs confiscated after a human and/ or animal-directed biting incident, we compared bite risk assessment reports of 159 confiscated dogs in the time frame 2008, 2009, 2010 (tf1) and of 215 confiscated dogs in the time frame 2020, 2021, 2022 (until mid-May; tf2). The reports were compiled by the same institute in a standardized format. We studied frequencies and chi-square pairwise comparisons (P…

by Sarah K. Highlander, Jason M. Wood, John D. Gillece, Megan Folkerts, Viacheslav Fofanov, Tara Furstenau, Nitin K. Singh, Lisa Guan, Arman Seuylemezian, James N. Benardini, David M. Engelthaler, Kasthuri Venkateswaran, Paul S. KeimThe National Aeronautics and Space Administration (NASA) has been monitoring the microbial burden of spacecraft since the 1970’s Viking missions. Originally culture-based and then focused 16S sequencing techniques were used, but we have now applied whole metagenomic sequencing to a variety of cleanroom samples at the Jet Propulsion Lab (JPL), including the Spacecraft Assembly Facility (SAF) with the goals of taxonomic identification and for functional assignment. Our samples included facility pre-filters, cleanroom vacuum debris, and surface wipes. The taxonomic composition was carried out by three different analysis tools to contrast marker, k-mer, and true alignment approaches. Hierarchical clustering analysis of the data separated vacuum particles from other SAF DNA samples. Vacuum particle samples were the most diverse while DNA samples from the ISO (International Standards Organization) compliant facilities and the SAF were the least diverse; all three were dominated by Proteobacteria. Wipe samples had higher diversity and were predominated by Actinobacteria, including human commensals Cutibacterium acnes and Corynebacterium spp. Taxa identified by the three methods were not identical, supporting the use of multiple methods for metagenome characterization. Likewise, functional annotation was performed using multiple methods. Vacuum particles and SAF samples contained strong signals of the tricarboxylic acid cycle and of amino acid biosynthesis, suggesting that many of the identified microorganisms have the ability to grow in nutrient-limited environments. In total, 18 samples generated high quality metagenome assembled genomes (MAG), which were dominated by Moraxella osloensis or Malassezia restricta. One M. osloensis MAG was assembled into a single circular scaffold and gene annotated. This study includes a rigorous quantitative determination of microbial loads and a qualitative dissection of microbial composition. Assembly of multiple specimens led to greater confidence for the identification of particular species and their predicted functional roles.

Infection and Immunity, Ahead of Print.