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48 emner vises.
Erika P. Ong, Frances V. Ho
New England Journal of Medicine, 1.10.2023
Tilføjet 1.10.2023
Geiger, Keri; Patil, Amita; Budhathoki, Chakra; Dooley, Kelly E.; Lowensen, Kelly; Ndjeka, Norbert; Ngozo, Jaqueline; Farley, Jason E.
Journal of Acquired Immune Deficiency Syndromes, 1.10.2023
Tilføjet 1.10.2023
Background Co-infection with multidrug-resistant tuberculosis (MDR-TB) and human immunodeficiency virus (HIV) is common, but few published studies examine how undergoing MDR-TB treatment impacts HIV disease indicators. Methods Using data from a nested, retrospective cohort of people with HIV (PWH) and successful MDR-TB treatment outcomes, we built multivariable regression models to explore correlates of HIV viral suppression at MDR-TB treatment completion. Results Among 532 PWH successfully treated for MDR-TB, mean age was 37.4 years (SD 10.2, IQR 30-43), 271 (50.9%) were male, 396 (74.4%) were virally suppressed at MDR-TB outcome, and 259 (48.7%) took bedaquiline. Older age (aOR 1.04, 95% CI 1.01-1.06) increased odds of viral suppression, while having a prior TB episode (aOR 0.45, 95% CI 0.31-0.64), having a detectable viral load at MDR-TB treatment initiation (aOR 0.17, 95% CI 0.09-0.30), living in a township (aOR 0.49, 95% CI 0.28-0.86), and being changed from efavirenz-based antiretroviral therapy (ART) to a protease inhibitor due to bedaquiline usage (aOR 0.19, 95% CI 0.04-0.81) or not having an ART change while on bedaquiline (aOR 0.29, 95% CI 0.11-0.75) lowered odds of viral suppression. Changing from efavirenz to nevirapine due to bedaquiline usage did not significantly affect odds of viral suppression (aOR 0.40, 95% CI 0.16-1.04). Conclusion Increased pill burden and adverse treatment effects did not significantly affect HIV viral suppression, while switching ART to a protease inhibitor to accommodate bedaquiline or not changing ART while taking bedaquiline did, suggesting that PWH and MDR-TB may benefit from additional support if they must switch ART. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedChi, Benjamin H.; Saidi, Friday; Graybill, Lauren A.; Phanga, Twambilile; Mollan, Katie R.; Amico, K. Rivet; Freeborn, Kellie; Rosenberg, Nora E.; Hill, Lauren M.; Hamoonga, Twaambo; Richardson, Brian; Kalua, Thokozani; Phiri, Sam; Mutale, Wilbroad
Journal of Acquired Immune Deficiency Syndromes, 1.10.2023
Tilføjet 1.10.2023
Background: Daily oral pre-exposure prophylaxis (PrEP) can reduce HIV incidence in pregnant and breastfeeding women, but adherence is essential. Methods: We conducted a pilot randomized trial to evaluate an intervention package to enhance antenatal and postnatal PrEP use in Lilongwe, Malawi. The intervention was based on patient-centered counseling adapted from prior PrEP studies, with the option of a participant-selected adherence supporter. Participants were locally eligible for PrEP and randomized 1:1 to intervention or standard counseling (i.e., control) and followed for six months. Participants received the intervention package or standard counseling at enrollment, one month, three months, and six months. Adherence was measured via plasma and intracellular tenofovir concentrations and scored using a published algorithm. Our primary outcome was retention in care with concentrations consistent with 4-7 doses/week. Results: From June to November 2020, we enrolled 200 pregnant women with median gestational age of 26 (IQR:19-33) weeks. Study retention was high at three months (89.5%) and six months (85.5%). In contrast, across the two timepoints, 32.8% had adherence scores consistent with 2-5 doses/week and 10.3% had scores consistent with daily dosing. For the composite primary endpoint, no substantial differences were observed between the intervention and control groups at three months (28.3% vs. 29.0%, probability difference [PD]:-0.7%, 95%CI:-13.3%, 11.8%) or at six months (22.0% vs. 26.3%, PD:-4.3%, 95%CI:-16.1%, 7.6%). Conclusions: In this randomized trial of PrEP adherence support, retention was high, but less than one-third of participants had pharmacologically confirmed adherence of >4 doses/week. Future research should focus on antenatal and postnatal HIV prevention needs and their alignment across the PrEP continuum, including uptake, persistence, and adherence. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBen Farhat, Jihane; Hessamfar, Mojgan; Farbos, Sophie; Desclaux, Arnaud; Dumondin, Gilles; Ferrand, Hélène; Greib, Carine; Castan, Bernard; Rispal, Patrick; Duffau, Pierre; Leleux, Olivier; Perrier, Adélaïde; Wittkop, Linda; Bonnet, Fabrice; Barger, Diana
Journal of Acquired Immune Deficiency Syndromes, 1.10.2023
Tilføjet 1.10.2023
Objectives: The Covid-19 pandemic’s impact on initiation and effectiveness of antiretroviral therapy (ART) in people diagnosed with HIV remains unclear. We evaluated critical delays in HIV care in people diagnosed before and during the pandemic in ex-Aquitaine, France. Methods: We considered adults diagnosed with HIV-1 in 2018-2021 and enrolled in the ANRS CO3 AQUIVIH-NA and followed them until 10/10/2022 for those diagnosed during the pandemic (1/4/2020 - 31/12/2021) and until 31/03/2020 for historical controls. We compared their characteristics at inclusion and the median time between diagnosis and ART initiation, ART initiation and viral suppression and diagnosis and virological suppression (effective management). Results: 83 individuals were diagnosed during the pandemic versus 188 during the pre-pandemic period. Median follow-up was 549 (IQR: 329-713) days. Populations were similar in terms of sex, age, HIV transmission group, hospital type, and clinical characteristics at diagnosis, however, fewer were foreign-born during the pandemic (15.7% versus 33.5%, p=0.003). The probability of ART initiation, therapeutic success, effective management was higher in PLWH diagnosed during the pandemic in adjusted analyses (HR 2.0 95%CI. 1.5-2.7, HR 1.7 95%CI. 1.2-2.3, HR 1.8 95%CI. 1.3-2.6, respectively). Those diagnosed during the pandemic were 2.3 (95%CI: 1.2-4.1) times more likely to be virologically suppressed within 6 months of diagnosis compared to historical controls. Conclusions: Pandemic-related reorganizations may have resulted in newly diagnosed PLWH being prioritized, however, the lower proportion of foreign-born PLWH diagnosed during the pandemic period, likely due to reduced migration and potential delays in diagnosis, may contribute to these preliminary findings. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedLombardo, Alexandra R; Materi, Joshua; Caturegli, Giorgio; Milovanovic, Minja; Martinson, Neil; Calver, Alistair; Nonyane, Bareng A. S.; Golub, Jonathan; Hoffmann, Christopher J; Variava DTM&H, Ebrahim
Journal of Acquired Immune Deficiency Syndromes, 1.10.2023
Tilføjet 1.10.2023
Background: Elevated HIV-associated mortality persists, despite a notable decline with the expansion of ART. In South Africa, the relative majority of deaths occur in health facilities, providing an opportunity to track decedent characteristics. Setting: We analyzed data from 14,870 adult patients who died between 2008 and 2018 at Klerksdorp/Tshepong Hospital Complex in South Africa. Methods: Recorded data included demographics, causes of death, HIV status, ART, and TB history. We present summary statistics and results from linear, log-binomial, and multinomial regressions to quantify changes over time. Results: Over the study period, the median age of decedents with HIV in the hospital increased from 39.3 to 43.4 years, and there was a switch to male predominance (46% to 54%). Those who died at a younger age (< 40 years) remained more likely to be HIV-positive than the older age group, despite the overall proportion of HIV-positivity decreasing over time. The proportion of decedents with HIV ever started on ART increased from 21% to 67%. The proportion of HIV patients dying from TB and AIDS-defining illnesses decreased from 31% to 22%. Conclusions: We noted a shift in deaths over time to more men and older individuals, while the burden of HIV was heaviest on the younger age groups. Advanced HIV disease remained an important cause of mortality. We also observed an increase in less traditional opportunistic illnesses among those with HIV, including malignancy, cardiovascular disease, and kidney disease. The high proportion of patients on ART who died prematurely requires further research and interventions. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedPoliseno, Mariacristina; Mazzitelli, Maria; Narducci, Arianna; Ferrara, Sergio Maria; Resnati, Chiara; Gervasoni, Cristina; Cattelan, Anna Maria; Lo Caputo, Sergio
Journal of Acquired Immune Deficiency Syndromes, 1.10.2023
Tilføjet 1.10.2023
Background: Few data are available about the efficacy, durability, and tolerability of Doravirine (DOR) + Integrase Strand Inhibitors (INI) as an ART- experienced PLWH switching strategy. Setting: Retrospective, multicenter cohort study investigating the durability, efficacy, and tolerability of two off-label drug associations of DOR+INI among ART-experienced PLWH. Methods: The study included PLWH who switched to DOR combined with either raltegravir (RAL) or dolutegravir (DTG) between June 1st, 2020, and December 31st, 2021, with at least one follow-up (FU) visit. Virologic, biometric, and metabolic parameters were evaluated at baseline (T0) and 1-3 (T1), 6 (T2), and 12 months (T3) visits. Uni- and multivariate survival analysis assessed the 28-week probability of persistence on the regimens. Patient satisfaction was measured using the HIV Treatment Satisfaction Questionnaire (HIVTsQ) Results: 95 PLWH were included, 52 in DOR+RAL, and 43 in DOR+DTG. Six treatment discontinuations were reported during a mean of 37 (±17) weeks of FU (incidence of 2.7 x1000 PWFU). Only two were due to virological failure without resistance mutations. DOR+DTG demonstrated significantly higher 28-week persistence than DOR+RAL (HR 1.90, 95% C.I.1.24-2.90, Log-rank: p=.003). Weight, waist circumference, and fasting lipids reduced considerably at T3 vs T0. Overall, high satisfaction with the new treatment was reported, particularly in the DOR+RAL (68 (64-72)/72), compared to the DOR+DTG group (58 (50-65)/72, p< .001). Conclusions: Our experience revealed few treatment discontinuations, improved metabolic parameters, and high patient satisfaction among ART-experienced PLWH switching to DOR combined with INI, irrespective of the specific INI used. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedBunge, Katherine; Balkus, Jennifer E.; Fairlie, Lee; Mayo, Ashley J.; Nakabiito, Clemensia; Mgodi, Nyaradzo; Gadama, Luis; Matrimbira, Moleen; Chappell, Catherine Anne; Piper, Jeanna; Chakhtoura, Nahida; Szydlo, Daniel w.; Richardson, Barbra; Hillier, Sharon L.
Journal of Acquired Immune Deficiency Syndromes, 1.10.2023
Tilføjet 1.10.2023
Background: Pregnancy represents a period of high HIV acquisition risk. Safety data for the monthly dapivirine vaginal ring (DVR) during pregnancy are limited. Here we report data from the first two cohorts of pregnant participants in MTN-042/DELIVER, a phase 3b, randomized, open-label safety trial of DVR and oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC). MTN-042 is being conducted in three cohorts beginning with later gestational ages when risks of drug exposure are less. Methods: Eligible pregnant individuals aged 18 to 40 in Malawi, South Africa, Uganda, and Zimbabwe were randomized 2:1 to monthly DVR or daily TDF/FTC. Participants in cohort 1 initiated product use between 36 weeks 0 days (36 0/7 weeks) -37 6/7 weeks gestation; participants in cohort 2 initiated product use between 30 0/7- 35 6/7 weeks gestation. All participants continued product use until delivery or 41 6/7 weeks gestation. Pregnancy outcomes and complications were assessed and summarized using descriptive statistics and compared to local background rates obtained through a separate chart review. Results: One-hundred and fifty participants were enrolled into cohort 1 with 101 randomized to DVR and 49 to TDF/FTC. One-hundred and fifty-seven participants were enrolled into cohort 2 with 106 randomized to DVR and 51 to TDF/FTC. In both cohorts, pregnancy complications were rare and similar to local background rates. Conclusion: In this first study of a long-acting HIV prevention agent in pregnancy, adverse pregnancy outcomes and complications were uncommon when DVR and TDF/FTC were used in the third trimester of pregnancy suggesting a favorable safety profile for both prevention products. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Læs mere Tjek på PubMedMasato Inaba, Yukiko Miyake, Kazutaka Yasuda
International Journal of Infectious Diseases, 1.10.2023
Tilføjet 1.10.2023
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is primarily transmitted through respiratory droplets, saliva, fomites, and aerosols resulting from direct or indirect contact with infected individuals. The risk of person-to-person transmission is particularly high in crowded or poorly ventilated spaces, or during prolonged exposure to an infected person [1]. The household environment exemplifies such conditions. When one household member tested positive for SARS-CoV-2, the risk of to family members increased due to their close contact.
Læs mere Tjek på PubMedEdwin Kamau, Risper Maisiba, Nicole Dear, Allahna Esber, Ajay P. Parikh, Michael Iroezindu, Emmanuel Bahemana, Hannah Kibuuka, John Owuoth, Jonah Maswai, Benjamin Opot, Raphael O. Okoth, Farid Abdi, Maureen Mwalo, Dennis Juma, Ben Andagalu, Hoseah M. Akala, Neha Shah, Trevor A. Crowell, Jessica Cowden, Christina S. Polyak, Julie A. Ake, AFRICOS Study Group
International Journal of Infectious Diseases, 1.10.2023
Tilføjet 1.10.2023
Hematological parameters are important indicators of health and disease. In PLHIV with asymptomatic malaria coinfection enrolled across four geographic sites in three African countries, abnormalities in hematologic parameters differ in different malaria transmission settings and are region specific.
Læs mere Tjek på PubMedGordon F. Custer, Luana Bresciani, Francisco Dini-Andreote
Trends in Microbiology, 1.10.2023
Tilføjet 1.10.2023
Community coalescence is defined as the mixing of intact ecological communities. From river confluences to fecal microbiota transplantation, community coalescence constitutes a common ecological occurrence affecting natural and engineered microbial systems. In this opinion article, we propose an integrative framework for microbial community coalescence to guide advances in our understanding of this important – yet underexplored – ecological phenomenon. We start by aligning community coalescence with the unified framework of biological invasion and enumerate commonalities and idiosyncrasies between these two analogous processes. Then, we discuss how organismal interactions and cohesive establishment affect coalescence outcomes with direct implications for community functioning. Last, we propose the use of ecological null modeling to study the interplay of ecological processes structuring community reassembly following coalescence.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.09.2023
Tilføjet 30.09.2023
Abstract Background Risk factors related to mortality due to Acinetobacter baumannii (AB) bacteremia have been unveiled previously, but early clinical manifestations of AB bacteremia based on prognosis remain uncovered. Methods The demographic characteristics, clinical features, antibiotic susceptibility, and outcomes of 37 hospitalized children with laboratory-confirmed AB bacteremia from Suzhou, China, were collected and analyzed retrospectively. Results Of the 37 children with AB bacteremia included in this study, 23 were males and 14 were females, with a median age of 4.83 (0.60 to 10.15) years. Among the children, 18 died (48.65%, 18/37) and 19 survived (51.35%, 19/37). The dead group had a significantly higher incidence of respiratory failure (p = 0.008), shock (P = 0.000), MODS (p = 0.000), neutropenia (
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.09.2023
Tilføjet 30.09.2023
Abstract Background Concurrent non-alcoholic fatty liver disease (NAFLD) is common in patients with chronic HBV infection. But the impact of fatty liver on the histologic progression of HBV infection remains controversial. Methods Consecutive HBV-infected patients who underwent liver biopsy between 2016 and 2021 were included. Alcohol consumption and other types of viral hepatitis were excluded. All biopsies were scored for grading and staging by Scheuer’s score, and the steatosis was scored as an estimate of the percentage of liver parenchyma replaced by fat. Logistic regression analyses were applied to assess the associated factors for significant liver inflammation (G ≥ 2), significant fibrosis (S ≥ 2) and advanced fibrosis (S ≥ 3). Results Among the 871 HBV-infected patients, hepatic steatosis was prevalent in 255 patients (29.28%). Significant liver inflammation was present in 461 patients (52.93%). Significant fibrosis was observed in 527 patients (60.51%), while advanced liver fibrosis was observed in 171 patients (19.63%). Patients with concomitant NAFLD were more likely to have significant liver inflammation and advanced fibrosis. Fatty liver was an independent risk factor for significant liver inflammation (OR: 2.117, 95% CI: 1.500-2.988), but it could not predict the development of fibrosis. Especially, in HBV-infected patients with persistent normal ALT (immune tolerant and inactive carrier phase), the presence of significant liver inflammation was higher in NAFLD than those without NAFLD. The prevalence of advanced liver fibrosis was higher in NAFLD than non-NAFLD only in the immune tolerant phase, while NAFLD did not increase fibrosis burden in other stages of HBV infection. We developed a predictive model for significant liver inflammation with the area under receiver operating characteristic curve (AUROC) of 0.825, and a model for significant fibrosis with the AUROC of 0.760. Conclusions NAFLD is independently associated with significant liver inflammation, and increases the burden of advanced liver fibrosis in HBV-infected patients. The influence of NAFLD on the degree of liver inflammation and fibrosis is different in distinct clinical phases of chronic HBV infection.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.09.2023
Tilføjet 30.09.2023
Abstract Background Multidrug-resistant tuberculosis (MDR–TB) remains a major public health problem in many high tuberculosis (TB) burden countries. Phenotypic drug susceptibility testing (DST) take several weeks or months to result, but line probe assays and Xpert/Rif Ultra assay detect a limited number of resistance conferring gene mutations. Whole genome sequencing (WGS) is an advanced molecular testing method which theoretically can predict the resistance of M. tuberculosis (Mtb) isolates to all anti-TB agents through a single analysis. Methods Here, we aimed to identify the level of concordance between the phenotypic and WGS-based genotypic drug susceptibility (DS) patterns of MDR–TB isolates. Overall, data for 12 anti-TB medications were analyzed. Results In total, 63 MDR–TB Mtb isolates were included in the analysis, representing 27.4% of the total number of MDR–TB cases in Latvia in 2012–2014. Among them, five different sublineages were detected, and 2.2.1 (Beijing group) and 4.3.3 (Latin American-Mediterranean group) were the most abundant. There were 100% agreement between phenotypic and genotypic DS pattern for isoniazid, rifampicin, and linezolid. High concordance rate (> 90%) between phenotypic and genotypic DST results was detected for ofloxacin (93.7%), pyrazinamide (93.7%) and streptomycin (95.4%). Phenotypic and genotypic DS patterns were poorly correlated for ethionamide (agreement 56.4%), ethambutol (85.7%), amikacin (82.5%), capreomycin (81.0%), kanamycin (85.4%), and moxifloxacin (77.8%). For capreomycin, resistance conferring mutations were not identified in several phenotypically resistant isolates, and, in contrary, for ethionamide, ethambutol, amikacin, kanamycin, and moxifloxacin the resistance-related mutations were identified in several phenotypically sensitive isolates. Conclusions WGS is a valuable tool for rapid genotypic DST for all anti-TB agents. For isoniazid and rifampicin phenotypic DST potentially can be replaced by genotypic DST based on 100% agreement between the tests. However, discrepant results for other anti-TB agents limit their prescription based solely on WGS data. For clinical decision, at the current level of knowledge, there is a need for combination of genotypic DST with modern, validated phenotypic DST methodologies for those medications which did not showed 100% agreement between the methods.
Læs mere Tjek på PubMedBMC Infectious Diseases, 30.09.2023
Tilføjet 30.09.2023
Abstract Background Herein, we analyzed the efficacy of main antibiotic therapy regimens in the treatment of healthcare-associated meningitis (HCAM). Materials/methods This retrospective cohort study was conducted in 18 tertiary-care academic hospitals Turkey, India, Egypt and Romania. We extracted data and outcomes of all patients with post-neurosurgical meningitis cases fulfilling the study inclusion criteria and treated with empirical therapy between December 2006-September 2018. Results Twenty patients in the cefepime + vancomycin-(CV) group, 31 patients in the ceftazidime + vancomycin-(CFV) group, and 119 patients in the meropenem + vancomycin-(MV) group met the inclusion criteria. The MV subgroup had a significantly higher mean Glasgow Coma Score, a higher rate of admission to the intensive care unit within the previous month, and a higher rate of antibiot herapy within the previous month before the meningitis episode (p 0.05) among the three cohorts. No regimen was effective against carbapenem-resistant bacteria, and vancomycin resulted in an EOT clinical success rate of 60.6% in the methicillin-resistant staphylococci or ampicillin-resistant enterococci subgroup (n = 34). Conclusions Our study showed no significant difference in terms of clinical success and mortality among the three treatment options. All regimens were ineffective against carbapenem-resistant bacteria. Vancomycin was unsuccessful in approximately 40% of cases involving methicillin-resistant staphylococci or ampicillin-resistant enterococci.
Læs mere Tjek på PubMedIrshad Ali Sodhar, Anum S. Hussaini, Mary Jean Brown
Tropical Medicine & International Health, 30.09.2023
Tilføjet 30.09.2023
Mingda Hu, Xin Wang, Beiping Li, Boqian Wang, Yunxiang Zhao, Zili Chai, Yuan Jin, Junjie Yue, Hongguang Ren
Journal of Medical Virology, 30.09.2023
Tilføjet 30.09.2023
Annabel Rector, Mandy Bloemen, Marc Van Ranst, Elke Wollants
Journal of Medical Virology, 30.09.2023
Tilføjet 30.09.2023
José Valter J. Silva Júnior, Carlos Dornels Freire Souza, Eduardo Furtado Flores, Rudi Weiblen, Rodrigo Feliciano Carmo
Journal of Medical Virology, 30.09.2023
Tilføjet 30.09.2023
Ping‐Ing Lee, Ching‐Chuan Liu, Ya‐Li Hu, Jong‐Min Chen
Journal of Medical Virology, 30.09.2023
Tilføjet 30.09.2023
Xinjie Li, Yuqi Zhang, Jie Wang, Jun Han, Tao Shen
Journal of Medical Virology, 30.09.2023
Tilføjet 30.09.2023
Danli Yang, Jun Zou, Guiwen Guan, Xiaoyu Feng, Ting Zhang, Guixin Li, Hui Liu, Huiling Zheng, Jingyuan Xi, Guangxin Yu, Lizhong Dai, Fengmin Lu, Xiangmei Chen
Journal of Medical Virology, 30.09.2023
Tilføjet 30.09.2023
Tianyi Liang, Kaixin Guo, Peng Ni, Guangcai Duan, Rongguang Zhang
Journal of Medical Virology, 30.09.2023
Tilføjet 30.09.2023
Malaria Journal, 30.09.2023
Tilføjet 30.09.2023
Abstract Background Ivermectin (IVM) mass drug administration is a candidate complementary malaria vector control tool. Ingestion of blood from IVM treated hosts results in reduced survival in mosquitoes. Estimating bio-efficacy of IVM on wild-caught mosquitoes requires they ingest the drug in a blood meal either through a membrane or direct feeding on a treated host. The latter, has ethical implications, and the former results in low feeding rates. Therefore, there is a need to develop a safe and effective method for IVM bio-efficacy monitoring in wild mosquitoes. Methods Insectary-reared Anopheles gambiae s.s. were exposed to four IVM doses: 85, 64, 43, 21 ng/ml, and control group (0 ng/ml) in three different solutions: (i) blood, (ii) 10% glucose, (iii) four ratios (1:1, 1:2, 1:4, 1:8) of blood in 10% glucose, and fed through filter paper. Wild-caught An. gambiae s.l. were exposed to 85, 43 and 21 ng/ml IVM in blood and 1:4 ratio of blood-10% glucose mixture. Survival was monitored for 28 days and a pool of mosquitoes from each cohort sacrificed immediately after feeding and weighed to determine mean weight of each meal type. Results When administered in glucose solution, mosquitocidal effect of IVM was not comparable to the observed effects when similar concentrations were administered in blood. Equal concentrations of IVM administered in blood resulted in pronounced reductions in mosquito survival compared to glucose solution only. However, by adding small amounts of blood to glucose solution, mosquito mortality rates increased resulting in similar effects to what was observed during blood feeding. Conclusion Bio-efficacy of ivermectin is strongly dependent on mode of drug delivery to the mosquito and likely influenced by digestive processes. The assay developed in this study is a good candidate for field-based bio-efficacy monitoring: wild mosquitoes readily feed on the solution, the assay can be standardized using pre-selected concentrations and by not involving treated blood hosts (human or animal) variation in individual pharmacokinetic profiles as well as ethical issues are bypassed. Meal volumes did not explain the difference in the lethality of IVM across the different meal types necessitating further research on the underlying mechanisms.
Læs mere Tjek på PubMedMalaria Journal, 30.09.2023
Tilføjet 30.09.2023
Abstract Background Up until the present, pyrethroid-treated bed nets have been a key tool for vector control in the fight against malaria. A global system that sets standards and facilitates procurement has successfully driven down the price of these bed nets to enable more of them to be distributed. As a result of their mass rollout, malaria cases have been significantly reduced, but pyrethroid resistance is now widespread. Going forward, new insecticides have been and continue to be developed for use on bed nets, but it is unclear how to best deploy them for maximum impact. Methods Here, an app for the optimization of bed nets based on their insecticide loading concentration and deployment lifespan is presented. Underlying the app are simple models that incorporate the chemical and physical properties of bed nets, and the genetic and ecological properties of resistance evolution in mosquitoes. Where possible, default parameter values are fitted from experimental data. The app numerically searches across a massive number of these simple models with variable loading and lifespan to find their optima under different criteria that constrain the options for vector control. Results The app is not intended to provide a definite answer about the best bed net design, but allows for the quantative exploration of trade-offs and constraints under different conditions. Here, results for the deployment of a new insecticide are explored under default parameter values across public health budgets for the purchase of bed nets. Optimization can lead to substantial gains in the average control of the mosquito population, and these gains are comparatively greater with lower budgets. Whilst optimizing a bed net within the constraints of the incentives of the existing system of standards and procurement leads to substantially greater control than not optimizing the bed net, optimizing the bed net without constraints leads to yet substantially greater control. The most important factor in this optimization is coverage, which depends on the price per bed net. With this in mind, it is unsurprising that the optimization for plausible budgets suggests that a pyrethroid would be the preferred partner for a new insecticide under current constraints because it is cost-effective in the balance of being less expensive than the new insecticide but also less effective due to pre-existing resistance. Surprisingly, a pyrethroid is shown to be an effective partner for a new insecticide in this model because of its contribution to resistance management in delaying the onset of resistance to the new insecticide. Conclusions This study highlights the importance of trade-offs in the design of bed nets for vector control. Further, it suggests that there are challenges in the roll-out of bed nets with new insecticides because of the constraints imposed by the global system of standards and procurement, which currently fails to adequately incentivize important considerations in bed net design like resistance management.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 30.09.2023
Tilføjet 30.09.2023
AbstractBackgroundJC polyomavirus(JCPyV) causes progressive multifocal leukoencephalopathy(PML), a potentially fatal complication of severe immune suppression with no effective treatment. Natural killer (NK) cells play critical roles in defense against viral infections, yet NK cell response to JCPyV infection remains unexplored.MethodsNK and T cell responses against the JCPyV VP1 were compared using intracellular cytokine staining (ICS) upon stimulation with peptide pools. A novel flow cytometry-based assay was developed to determine NK cell killing efficiency of JCPyV-infected astrocyte-derived SVG-A cells. Blocking antibodies were used to identify the specific NK cell receptors in immune recognition of JCPyV-infected cells.ResultsIn about 40% of healthy donors, we detected robust CD107a upregulation and IFN-γ production by NK cells, extending beyond T cell responses. Next, using the NK cell-mediated killing assay, we showed that co-culture of NK cells and JCPyV-infected SVG-A cells leads to a 60% reduction in infection, on average. JCPyV-infected cells had enhanced expression of ULBP2 – a ligand for the activating NK cell receptor NKG2D and addition of NKG2D blocking antibodies decreased NK cell degranulation.ConclusionNKG2D-mediated activation of NK cells plays a key role in controlling JCPyV replication and may be a promising immunotherapeutic target to boost NK cell anti-JCPyV activity.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 30.09.2023
Tilføjet 30.09.2023
AbstractBackgroundThe BCG (Bacillus Calmette-Guérin) vaccine can induce non-specific protection against unrelated infections. We aimed to test the effect of BCG on absenteeism and health of Danish health care workers (HCWs) during the COVID-19 pandemic.MethodsA single-blinded randomized controlled trial including 1,221 HCWs from nine Danish hospitals. Participants were randomized 1:1 to standard dose BCG or placebo. Primary outcome was days of unplanned absenteeism. Main secondary outcomes were incidence of COVID-19, all-cause hospitalization, and infectious disease episodes.ResultsThere was no significant effect of BCG on unplanned absenteeism. Mean number of days absent per 1000 workdays was 20 in the BCG group and 17 in the placebo group (RR 1.23, 95% credibility interval: 0.98 to 1.53). BCG had no effect on incidence of COVID-19 or all-cause hospitalization overall. In secondary analyses BCG re-vaccination was associated with higher COVID-19 incidence (HR 2.47, 95% confidence interval (CI): 1.07 to 5.71), but also reduced risk of hospitalization (HR 0.28, CI: 0.09 to 0.86). The incidence of infectious disease episodes was similar between randomization groups (HR 1.09, CI: 0.96 to 1.24).ConclusionsIn this relatively healthy cohort of HCWs, there was no overall effect of BCG on any of the study outcomes.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 30.09.2023
Tilføjet 30.09.2023
AbstractThe antiviral susceptibility of currently circulating (2022–2023) highly pathogenic avian influenza (HPAI) A(H5N1) viruses was assessed by genotypic and phenotypic approaches. The frequency of neuraminidase (NA) and polymerase acidic (PA) substitutions associated with reduced inhibition by NA inhibitors (NAIs) (21/2698, 0.78%) or by the PA inhibitor baloxavir (14/2600, 0.54%) was low. Phenotypic testing of 22 clade 2.3.2.1a and 2.3.4.4b viruses revealed broad susceptibility to NAIs and baloxavir concluding that most contemporary HPAI A(H5N1) viruses retain susceptibility to antiviral drugs. Novel NA-K432E and NA-T438I substitutions (N2 numbering) were identified at elevated frequencies (104/2698, 3.85%) and caused reduced zanamivir and peramivir inhibition.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 30.09.2023
Tilføjet 30.09.2023
AbstractBackgroundPregnancy and HIV may influence TB infection (TBI) detection using interferon gamma-release assays (QFT-Plus) and tuberculin skin tests (TST).MethodsParticipants from antenatal clinics in Western Kenya underwent QFT-Plus and TST in pregnancy, 6-weeks (6wkPP) and 12-months postpartum (12moPP).Results400 participants (200 WHIV/200 HIV-negative) enrolled in pregnancy at median 28 weeks gestation (IQR 24-30).QFT-Plus + prevalence was higher than TST + in pregnancy (32.5% vs. 11.6%) and through 12moPP (6wkPP: QFT-Plus 30.9% vs. TST 18.0%, 12moPP: QFT-Plus 29.5% vs. TST 17.1%, all p
Læs mere Tjek på PubMedJournal of Infectious Diseases, 30.09.2023
Tilføjet 30.09.2023
AbstractIntroductionInfluenza remains an important cause of hospitalizations in the United States. Estimating the number of influenza hospitalizations is vital for public health decision making. Combining existing surveillance systems through capture-recapture methods allows for more comprehensive burden estimations.MethodsData from independent surveillance systems were combined using capture-recapture methods to estimate influenza hospitalization rates for children and adults in Middle Tennessee during consecutive influenza seasons from 2016-17 through 2019-20. EIP identified cases through surveillance of laboratory results for hospitalized children and adults. HAIVEN and NVSN recruited hospitalized patients with respiratory symptoms or fever. Population-based influenza rates and the proportion of cases detected by each surveillance system were calculated.ResultsEstimated overall influenza hospitalization rates ranged from 23 influenza-related hospitalizations per 10,000 persons in 2016-17 to 40 per 10,000 persons in 2017-18. Adults age ≥65 years had the highest hospitalization rates across seasons and experienced a rate of 170 hospitalizations per 10,000 persons during the 2017-18 season. EIP consistently identified a higher proportion of influenza cases for adults and children compared with HAIVEN and NVSN, respectively.ConclusionCurrent surveillance systems underestimate the influenza burden. Capture-recapture provides an alternative approach to use data from independent surveillance systems and complement population-based burden estimates.
Læs mere Tjek på PubMedJournal of Infectious Diseases, 30.09.2023
Tilføjet 30.09.2023
AbstractBackgroundThe incidence of syphilis continues to increase in the United States, yet little is known about Treponema pallidum genomic epidemiology within American metropolitan areas.MethodsWe performed whole-genome sequencing and tprK deep sequencing of 28 T. pallidum–containing specimens, collected mostly from remnant Aptima swab specimens from 24 individuals from Seattle Sexual Health Clinic during 2021–2022.ResultsAll 12 individuals infected with Nichols-lineage strains were men who have sex with men, while a specific SS14 cluster (mean, 0.33 single-nucleotide variant) included 1 man who has sex with women and 5 women. All T. pallidum strains sequenced were azithromycin resistant via 23S ribosomal RNA A2058G mutation. Identical T. pallidum genomic sequences were found in pharyngeal and rectal swab specimens taken concurrently from the same individuals. The tprK sequences were less variable between patient-matched specimens and between epidemiologically linked clusters. We detected a 528–base pair deletion in the tprK donor site locus, eliminating 9 donor sites, in T. pallidum genomes of 3 individuals with secondary syphilis, associated with diminution of TprK diversity.ConclusionsWe developed an end-to-end workflow for public health genomic surveillance of T. pallidum from remnant Aptima swab specimens. tprK sequencing may assist in linking cases beyond routine T. pallidum genome sequencing. T. pallidum strains with deletions in tprK donor sites currently circulate and are associated with diminished TprK antigenic diversity.
Læs mere Tjek på PubMedImmunity, 30.09.2023
Tilføjet 30.09.2023
Publication date: Available online 29 September 2023 Source: Immunity Author(s): Lihong Liu, Ryan G. Casner, Yicheng Guo, Qian Wang, Sho Iketani, Jasper Fuk-Woo. Chan, Jian Yu, Bernadeta Dadonaite, Manoj S. Nair, Hiroshi Mohri, Eswar R. Reddem, Shuofeng Yuan, Vincent Kwok-Man Poon, Chris Chung-Sing Chan, Kwok-Yung Yuen, Zizhang Sheng, Yaoxing Huang, Jesse D. Bloom, Lawrence Shapiro, David D. Ho
Læs mere Tjek på PubMedInfection, 30.09.2023
Tilføjet 30.09.2023
Abstract Purpose Emerging SARS-CoV-2 variants have impacted the in vitro activity of sotrovimab, with variable fold changes in neutralization potency for the Omicron BA.2 sublineage and onward. The correlation between reduced in vitro activity and clinical efficacy outcomes is unknown. A systematic literature review (SLR) evaluated the effectiveness of sotrovimab on severe clinical outcomes during Omicron BA.2 predominance. Methods Electronic databases were searched for peer-reviewed journals, preprint articles, and conference abstracts published from January 1–November 3, 2022. Results Five studies were included, which displayed heterogeneity in study design and population. Two UK studies had large samples of patients during BA.2 predominance: one demonstrated clinical effectiveness vs molnupiravir during BA.1 (adjusted hazard ratio [aHR] 0.54, 95% CI 0.33–0.88; p = 0.014) and BA.2 (aHR 0.44, 95% CI 0.27–0.71; p = 0.001); the other reported no difference in the clinical outcomes of sotrovimab-treated patients when directly comparing sequencing-confirmed BA.1 and BA.2 cases (HR 1.17, 95% CI 0.74–1.86). One US study showed a lower risk of 30-day all-cause hospitalization/mortality for sotrovimab compared with no treatment during the BA.2 surge in March (adjusted relative risk [aRR] 0.41, 95% CI 0.27–0.62) and April 2022 (aRR 0.54, 95% CI 0.08–3.54). Two studies from Italy and Qatar reported low progression rates but were either single-arm descriptive or not sufficiently powered to draw conclusions on the effectiveness of sotrovimab. Conclusion This SLR showed that the effectiveness of sotrovimab was maintained against Omicron BA.2 in both ecological and sequencing-confirmed studies, by demonstrating low/comparable clinical outcomes between BA.1 and BA.2 periods or comparing against an active/untreated comparator.
Læs mere Tjek på PubMedMegan O’DriscollDarunee BuddhariAngkana T. HuangAdam WaickmanSurachai KaewhirunSopon IamsirithawornDirek KhampaenAaron FarmerStefan FernandezIsabel Rodriguez-BarraquerAnon SrikiatkhachornStephen ThomasTimothy EndyAlan L. RothmanKathryn AndersonDerek A. T. CummingsHenrik SaljeaDepartment of Genetics, University of Cambridge, Cambridge CB23EH, United KingdombDepartment of Virology, Armed Forces Research Institute of Medical Sciences, Bangkok 10400, ThailandcDepartment of Microbiology and Immunology, State University of New York Upstate Medical University, Syracuse, NY 13210dDepartment of Disease Control, Ministry of Public Health, Nonthaburi 11000, ThailandeUniversity of California, San Francisco, CA 94143fDepartment of Cell and Molecular Biology, Institute for Immunology and Informatics, University of Rhode Island, Providence, RI 02903gFaculty of Medicine, King Mongkut’s Institute of Technology Ladkrabang, Bangkok 10520, ThailandhDepartment of Medicine, State University of New York Upstate Medical University, Syracuse, NY 13210iCoalition for Epidemic Preparedness Innovations, Washington, DC 20006jDepartment of Biology, University of Florida, Gainesville, FL 32611
Proceedings of the National Academy of Sciences: Immunology and Inflammation, 30.09.2023
Tilføjet 30.09.2023
Proceedings of the National Academy of Sciences, Volume 120, Issue 41, October 2023.
Læs mere Tjek på PubMedPrzemysław Kołodziej, Beata Szostakowska, Anna Lass, Małgorzata Sulima, Katarzyna Sikorska, Janusz Kocki, Witold Krupski, Dorota Starownik, Paweł Bojar, Justyna Szumiło, Beata Kasztelan-Szczerbińska, Halina Cichoż-Lach, Jacek Bogucki, Magdalena Szymańska, Hanna Fota-Markowska, Anna Bogucka-Kocka
Lancet Infectious Diseases, 30.09.2023
Tilføjet 30.09.2023
The Grand Round concerns a 24-year-old man from Zimbabwe who was studying and living in Poland. The patient had been complaining of abdominal pain, fatigue, alternating diarrhoea and constipation, and presence of blood in his stool for 3 years. The patient had the following diagnostic tests: colonoscopy, CT scan, histopathology, and parasitological and molecular tests. Results of the examinations showed that the cause of the patient\'s complaints was chronic intestinal schistosomiasis due to the co-infection with Schistosoma intercalatum and Schistosoma mansoni.
Læs mere Tjek på PubMedGan Sha, Guotian Li
Trends in Microbiology, 30.09.2023
Tilføjet 30.09.2023
The effector repertoire of a pathogen is dynamically evolving. However, the effector translocation mechanism, partly elucidated recently, may be conserved. By targeting the effector translocation machinery, rather than the individual evolving effector, rational design of durable and broad-spectrum disease resistance can be achieved, facilitated by genome-editing and artificial intelligence-enabling technologies.
Læs mere Tjek på PubMedSong Hong, Junmei Shang, Yaneli Sun, Guirong Tang, Chengshu Wang
Trends in Microbiology, 30.09.2023
Tilføjet 30.09.2023
Entomopathogenic fungi (EPF) distribute in different fungal phyla with variable host ranges and play essential role in regulating insect populations by infecting hosts via cuticle penetration. The representative ascomycete EPF of Metarhizium and Beauveria species have been widely used in mechanistic investigations of fungus–insect interactions and as ecofriendly mycoinsecticides. Here, we review the function of diverse genes, pathways, and secondary metabolites associated with EPF stepwise infections. In particular, emerging evidence has shown that EPF have to outcompete insect ectomicrobiotas prior to penetrating cuticles, and subvert or evade host antifungal immunity by using effector-like proteins and chemicals like plant pathogens. Future prospects are discussed for a better understanding of fungal pathobiology, which will provide novel insights into microbe–animal interactions.
Læs mere Tjek på PubMedBrent M. Robicheau, Jennifer Tolman, Dhwani Desai, Julie LaRoche
Science Advances, 30.09.2023
Tilføjet 30.09.2023
Bocheng Xu, Weike Shaoyong, Lin Wang, Chen Yang, Tingjun Chen, Xiao Jiang, Rong Yan, Zipeng Jiang, Pan Zhang, Mingliang Jin, Yizhen Wang
Science Advances, 30.09.2023
Tilføjet 30.09.2023
Cesar Cristancho-Rojas, Cara D. Varley, Sofia Chapela Lara, Yousra Kherabi, Emily Henkle, Kevin L. Winthrop
Clinical Microbiology and Infection, 29.09.2023
Tilføjet 29.09.2023
Nontuberculous mycobacteria (NTM) are highly abundant in soil, dust, and water sources, making human–pathogen contact frequent and recurrent. NTM represents over 200 species/subspecies; some are considered strict or opportunistic pathogens. Mycobacterium abscessus, often regarded as one of the most antibiotic-resistant mycobacteria, is the second most frequent NTM pulmonary disease (NTM-PD) pathogen.
Læs mere Tjek på PubMedZhang, J. J., Sun, R., Guo, S., Yang, S.
BMJ Open, 29.09.2023
Tilføjet 29.09.2023
IntroductionThe lifestyle and habit changes that have emerged as a result of quarantine measures may have had a negative impact on defecation habits. However, there is a lack of data on combined estimates of its occurrence and prevalence. Methods and analysisWe will conduct a systematic search for observational studies on PubMed/MEDLINE, Web of Science, Cochrane Library, EMBASE, CNKI, SinoMed, VIP China Science and Technology Journal database, Chinese Biomedical Databases and Wanfang Data. The search will include literature published from the inception of the databases to September 2022. Two authors will independently screen articles and extract data based on predefined inclusion and exclusion criteria. The risk of bias in the included studies will be evaluated using the Newcastle-Ottawa Scale for observational studies. Statistical analysis will be performed using Review Manager software V.5.4 and STATA V.16.0 software. Heterogeneity among studies will be assessed using the Q statistical test and I2 statistical tests. In case of significant heterogeneity, subgroup analysis and sensitivity analysis will be conducted to explore the source of heterogeneity. Sensitivity analyses will also be performed to assess the reliability of the study findings. If feasible, a meta-analysis will be conducted. Otherwise, a descriptive synthesis will be performed using a best-evidence synthesis approach. The primary outcome of interest will be the prevalence of constipation. The secondary outcomes will involve examining the association of risk factors. To evaluate potential publication bias, we will use both the Begg funnel plot and Egger’s weighted regression statistics. Furthermore, to accurately assess the quality of evidence for our primary outcome, we will employ the Grading of Recommendations Assessment, Development and Evaluation system. Ethics and disseminationThis systematic review protocol will only consider published studies available in databases and will not include individual patient data. Therefore, ethical approval is not required, and the findings will be published in a peer-reviewed journal. PROSPER registration numberCRD42022366176.
Læs mere Tjek på PubMedXia, R., Fei, Y., Zhang, L., Jie, Z., Fan, X., Dai, M., Moore, M., Willcox, M., Hu, X., Francis, N., Liang, C., Fei, G., Liu, J.
BMJ Open, 29.09.2023
Tilføjet 29.09.2023
IntroductionChronic obstructive pulmonary disease (COPD) represents one of the leading causes of death worldwide. Published clinical trials suggest that the Chinese patent herbal medicine Shufeng Jiedu capsule (SFJD) is safe and may be effective for treating acute exacerbations of COPD (AECOPD). However, these effects have been reported with low or very low certainty evidence. This trial aims to evaluate the effectiveness and safety of SFJD for AECOPD. Methods and analysisThis study is designed as a multicentre, randomised, double-blind, placebo-controlled trial. Three hundred patients with moderate or severe hospitalised AECOPD will be recruited in Beijing, Shanghai and Hefei. Participants will be randomly assigned to SFJD and usual care or placebo and usual care at a ratio of 1:1. SFJD and placebo will be administered orally four capsules three times daily for 7 consecutive days followed by an 8-week follow-up period. The primary outcome will be COPD symptom severity as measured by the EXAcerbation of Chronic Pulmonary Disease Tool score. Secondary outcomes include clinical symptoms, quality of life, length of hospital stay, a total dose of antibiotics, the frequency of recurrence of AECOPD, haematological biomarkers, death and adverse events. This study will answer the question of whether SFJD was safe to use and will improve symptoms in people with AECOPD, and will therefore reduce the necessity for antibiotics, the risk and duration of admission to hospital, and the risk of recurrence. Ethics and disseminationThe ethics committee of the first affiliated hospital of Anhui Medical University, Beijing University of Chinese Medicine affiliated Dongzhimen hospital and fifth people’s hospital of Shanghai Fudan University approved the study protocol. Informed written consent will be obtained from all the participants. The results of this trial will be disseminated at academic conferences and in peer-reviewed publications. Trial registration numberISRCTN99049821.
Læs mere Tjek på PubMedAiano, F., Ireland, G., Powell, A., Campbell, C. N. J., Judd, A., Davies, B., Saib, A., Mangtani, P., Nguipdop-Djomo, P., SIS Study Group, Ladhani, S. N., Ahmad, Baawuah, Beckmann, Brent, Brent, Brown, Garstang, Okike, Ramsay, McCrae, Kelly, Stocker, Diamond, Rourke, Dawe, Jones, Cook, McClenahan, McKay, Phelan, Lin, Warren-Gash, Lewin
BMJ Open, 29.09.2023
Tilføjet 29.09.2023
ObjectivesTo assess socioeconomic and geographical factors associated with COVID-19 vaccine uptake in pupils attending state-funded secondary schools in England. DesignCross-sectional observational study. SettingState-funded schools in England. ParticipantsPupils aged 12–17 years attending state-funded schools in England for the academic year 2021/2022. Outcome measuresDemographic, socioeconomic and geographical factors associated with vaccination uptake. We linked individual-level data from the English Schools Census to the National Immunisation Management System to obtain COVID-19 vaccination status of 3.2 million adolescents. We used multivariable logistic regression to assess demographic, socioeconomic and geographical factors associated with vaccination. ResultsBy 9 January 2022, 56.8% of adolescents aged 12–17 years old had received at least one dose, with uptake increasing from 48.7% in those aged 12 years old to 77.2% in those aged 17 years old. Among adolescents aged 12–15 years old, there were large variations in vaccine uptake by region and ethnic group. Pupils who spoke English as an additional language (38.2% vs 55.5%), with special educational needs (48.1% vs 53.5%), eligible for free school meals (35.9% vs 58.9%) and lived in more deprived areas (36.1% in most deprived vs 70.3% in least deprived) had lower vaccine uptake. Socioeconomic variables had greater impact on the odds of being vaccinated than geographical variables. School-level analysis found wide variation in vaccine uptake between schools even within the same region. Schools with higher proportions of pupils eligible for free school meals had lower vaccine uptake. ConclusionsWe found large differences in vaccine uptake by geographical region and ethnicity. Socioeconomic variables had a greater impact on the odds of being vaccinated than geographical variables. Further research is required to identify evidence-based interventions to improve vaccine uptake in adolescents.
Læs mere Tjek på PubMedJiang, D., Wang, Q., Xiao, X., Zhang, J., Xie, Y., Zhu, Y., Li, S., Bao, L., Song, H., Yang, Q.
BMJ Open, 29.09.2023
Tilføjet 29.09.2023
ObjectivesWorkplace violence (WPV) against healthcare workers (HCWs) is a global issue. Our research aimed to elucidate the status and associated factors of WPV among front-line/non-front-line HCWs during the COVID-19 pandemic. DesignThis cross-sectional study was conducted among HCWs in Hangzhou City through multistage sampling from December 2020 to January 2021. ParticipantsThis study included 14 909 valid samples (N=3748 front-line HCWs and N=11 161 non-front-line HCWs). Primary and secondary outcome measuresWe assessed the WPV status by Chinese version of WPV questionnaire. Binary logistic regression model was established to examine the associated factors of front-line/non-front-line HCWs experiencing WPV. ResultsThe total WPV prevalence equalled 37.25% for front-line HCWs and 27.73% for non-front-line HCWs. Among front-line HCWs, females were less likely to experience WPV (OR 0.837, 95% CI 0.710 to 0.988), while individuals who were undergraduate (OR 1.251, 95% CI 1.061 to 1.541) and had higher professional title (intermediate: OR 1.475, 95% CI 1.227 to 1.772; advanced: OR 1.693, 95% CI 1.294 to 2.216) were more likely to suffer from WPV; for non-front-line HCWs, individuals who aged over 50 years old (OR 0.721, 95% CI 0.563 to 0.969), had worked between 10 and 19 years (OR 0.847, 95% CI 0.749 to 0.958) and worked in the non-graded hospital (OR 0.714, 95% CI 0.614 to 0.832) had less chance to experience WPV, while individuals who had higher educational level (undergraduate: OR 1.323, 95% CI 1.179 to 1.484; ≥graduate: OR 1.519, 95% CI 1.217 to 1.895), were nurse (OR 1.142, 95% CI 1.031 to 1.265), and had higher professional title (intermediate: OR 1.458, 95% CI 1.297 to 638; advanced: OR 1.928, 95% CI 1.607 to 2.313) were more inclined to suffer from WPV (p all
Læs mere Tjek på PubMedVaidya, A., Simkhada, P., Lee, A., Jones, S., Mukumbang, F. C.
BMJ Open, 29.09.2023
Tilføjet 29.09.2023
IntroductionThe burden of non-communicable diseases (NCDs) is increasing rapidly, particularly in low- and middle-income countries (LMIC), accounting for 85% of premature deaths in the region. LMICs have been facing an increasing trend of a double burden of disease (infectious diseases and NCDs) that has led to multiple challenges in prioritising strategies for NCDs control amidst limited resources. Evidence indicates that measures such as the WHO’s package of essential non-communicable (PEN) diseases interventions can prevent and control NCDs. However, because of the complexity of such health interventions, there is limited evidence that explains how the intervention works, for whom and in what context. We aim to unpack the causal mechanisms explaining how, why, for whom and in what context PEN prevents and controls NCDs. Methods and analysisWe propose a realist review to understand how, why, for whom and under what circumstances PEN works or does not work. The review process includes five steps applied iteratively throughout the study: clarification of review scope, searching for evidence, appraising and extracting data, synthesising evidence and drawing conclusions, and disseminating the findings. Programme theories will be developed using the realist logic for theory formulation—Retroductive Theorising. The context-mechanism-outcome (CMO) heuristic tool will be used to develop the programme theories. Portions of the reviewed documents describing constructs of context, mechanism and outcomes will be coded inductively and extracted. These extracted constructs will then be linked abductively to formulate CMO configurations. Ethics and disseminationFormal ethical approval is not required for this review. Study findings will be disseminated through publications in peer-reviewed journals, conference presentations and formal and informal reports.
Læs mere Tjek på PubMedHuyst, V., Dewinter, J., Noens, I., Platteau, T., Tsoumanis, A.
BMJ Open, 29.09.2023
Tilføjet 29.09.2023
IntroductionAutistic individuals identify with a wider range of sexual orientations than non-autistic individuals, including higher rates of bisexual orientation in autistic men. Gay, bisexual and other men who have sex with men are at greater risk for HIV. Prevalence data of autistic traits in people living with HIV or using Pre-Exposure Prophylaxis (PrEP) for HIV are lacking so far. Such data, combined with insights in barriers and facilitators for safer sex in autistic people living with HIV or using PrEP, are a first step to improve health support for autistic people in HIV clinics. This support is crucial since autistic individuals have worse physical and mental health outcomes. The objective of this research is to determine the prevalence of autistic traits within the group of people living with HIV or using PrEP in Belgium and to describe specific facilitators and barriers for sexual safer behaviour in people living with HIV and PrEP users with autistic traits. Methods and analysisThe research is a cross-sectional, observational and multicentre study with recruitment of individual participants. The research consists of two phases. In phase 1, adults coming for HIV/AIDS care or HIV PrEP in participating Belgian HIV Reference Centres will be invited to fill in the validated Autism Spectrum Quotient questionnaire. In phase 2, participants with a score above the predefined cut-off for autistic traits (>26), who agreed to be informed about this score, will be invited to complete an additional survey, inquiring facilitators and barriers for sexual safer behaviour. Ethics and dissemination of resultsInstitutional Review Board Institute of Tropical Medicine Antwerp, 25 July 2022, REF 1601/22 and University Hospital of Antwerp, 12 September 2022, Project ID 3679: BUN B3002022000111. Study results will be published in peer-reviewed journals and presented to Belgian HIV Reference Centres and at conferences.
Læs mere Tjek på PubMedYusuke Saeki, Yoshihiro Moriyama, Yuichi Araki, Atsushi Oda, Kojiro Nakaoka, Masaharu Inagaki
American Journal of Respiratory and Critical Care Medicine , 29.09.2023
Tilføjet 29.09.2023
American Journal of Respiratory and Critical Care Medicine, Volume 208, Issue 7, Page 814-815, October 1, 2023.
Læs mere Tjek på PubMedJonas C. Schupp, Edward P. Manning, Maurizio Chioccioli, Jan C. Kamp, Leonard Christian, Changwan Ryu, Erica Herzog, Mark P. Kühnel, Antje Prasse, Naftali Kaminski, Danny D. Jonigk, Robert J. Homer
American Journal of Respiratory and Critical Care Medicine , 29.09.2023
Tilføjet 29.09.2023
American Journal of Respiratory and Critical Care Medicine, Volume 208, Issue 7, Page 819-822, October 1, 2023.
Læs mere Tjek på PubMedBMC Infectious Diseases, 29.09.2023
Tilføjet 29.09.2023
Abstract Background Coronavirus disease 2019 (COVID-19) is a rapidly developing and sometimes lethal pulmonary disease. Accurately predicting COVID-19 mortality will facilitate optimal patient treatment and medical resource deployment, but the clinical practice still needs to address it. Both complete blood counts and cytokine levels were observed to be modified by COVID-19 infection. This study aimed to use inexpensive and easily accessible complete blood counts to build an accurate COVID-19 mortality prediction model. The cytokine fluctuations reflect the inflammatory storm induced by COVID-19, but their levels are not as commonly accessible as complete blood counts. Therefore, this study explored the possibility of predicting cytokine levels based on complete blood counts. Methods We used complete blood counts to predict cytokine levels. The predictive model includes an autoencoder, principal component analysis, and linear regression models. We used classifiers such as support vector machine and feature selection models such as adaptive boost to predict the mortality of COVID-19 patients. Results Complete blood counts and original cytokine levels reached the COVID-19 mortality classification area under the curve (AUC) values of 0.9678 and 0.9111, respectively, and the cytokine levels predicted by the feature set alone reached the classification AUC value of 0.9844. The predicted cytokine levels were more significantly associated with COVID-19 mortality than the original values. Conclusions Integrating the predicted cytokine levels and complete blood counts improved a COVID-19 mortality prediction model using complete blood counts only. Both the cytokine level prediction models and the COVID-19 mortality prediction models are publicly available at http://www.healthinformaticslab.org/supp/resources.php.
Læs mere Tjek på PubMed