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BMC Infectious Diseases, 28.09.2023
Tilføjet 28.09.2023
Abstract Background Sepsis is a life-threatening condition caused by an abnormal response of the body to infection and imposes a significant health and economic burden worldwide due to its high mortality rate. Early recognition of sepsis is crucial for effective treatment. This study aimed to systematically evaluate the performance of various machine learning models in predicting the onset of sepsis. Methods We conducted a comprehensive search of the Cochrane Library, PubMed, Embase, and Web of Science databases, covering studies from database inception to November 14, 2022. We used the PROBAST tool to assess the risk of bias. We calculated the predictive performance for sepsis onset using the C-index and accuracy. We followed the PRISMA guidelines for this study. Results We included 23 eligible studies with a total of 4,314,145 patients and 26 different machine learning models. The most frequently used models in the studies were random forest (n = 9), extreme gradient boost (n = 7), and logistic regression (n = 6) models. The random forest (test set n = 9, acc = 0.911) and extreme gradient boost (test set n = 7, acc = 0.957) models were the most accurate based on our analysis of the predictive performance. In terms of the C-index outcome, the random forest (n = 6, acc = 0.79) and extreme gradient boost (n = 7, acc = 0.83) models showed the highest performance. Conclusion Machine learning has proven to be an effective tool for predicting sepsis at an early stage. However, to obtain more accurate results, additional machine learning methods are needed. In our research, we discovered that the XGBoost and random forest models exhibited the best predictive performance and were most frequently utilized for predicting the onset of sepsis. Trial registration CRD42022384015
Læs mere Tjek på PubMedBMC Infectious Diseases, 28.09.2023
Tilføjet 28.09.2023
Abstract Background Hemorrhagic fever with renal syndrome (HFRS) caused by Orthohantavirus (OHV) and scrub typhus (ST) caused by Orientia tsutsugamushi (OT) are two infectious diseases prevalent in southwest China. Rodents are the natural host and the main source of the two diseases. OT infection to humans is usually resulted from bite of an infective chigger mite on rodents, and OHV is transmitted through contact or inhalation of aerosols and secretions from infected rodent. The use of antibiotics and hormones is crucial for infectious diseases, although the clinical manifestations are not obvious and a definitive diagnosis becomes more difficult in the presence of these drugs. Clinically, fever is the first symptom of these two diseases, and most of them are accompanied by common symptoms such as chills and headaches. The clinical symptoms of these two diseases are very similar and therefore it is not easy to make a differential diagnosis. Case presentation In this case, a 44-year-old male famer with pulmonary tuberculosis and a history of working in coal transportation was admitted to the hospital because of respiratory symptoms accompanied by fever, headache, and skin rashes on his body. Biochemical and urinalysis revealed the hepatic and renal injury. The subsequent molecular testing confirmed he suffered from HFRS and scrub typhus simultaneously that the serological and clinical diagnosis could not identify the cause of infection before. Such case has not been reported in Yunnan Province before. Conclusion The clinical diagnosis should be combined with serological and nucleic acid testing approaches for differential diagnosis in areas where HFRS and ST are endemic.
Læs mere Tjek på PubMedBMC Infectious Diseases, 28.09.2023
Tilføjet 28.09.2023
Abstract Background Brain abscesses caused by Prevotella oris are rarely reported. Here, we described a case of a brain infection caused by Prevotella oris that was detected by metagenomic next-generation sequencing (mNGS). Case presentation A 63-year-old man with no medical history reported headache in the right frontotemporal region, fever, and intermittent diplopia. Magnetic resonance imaging (MRI) revealed abnormal signals and enhancement changes in the superior sellar region. mNGS testing showed that cerebrospinal fluid collected from the spine was positive for Prevotella oris. After receiving a combined treatment of antibiotic therapy, the patient recovered well. Conclusion We reviewed the relevant literature and summarized the characteristics and prognosis of this type of bacterial infection to provide ideas for clinicians to diagnose and treat this disease.
Læs mere Tjek på PubMedBMC Infectious Diseases, 28.09.2023
Tilføjet 28.09.2023
Abstract Background With the absence of new antimicrobial drugs being developed to replace those facing resistance, bacterial resistance continues to grow. Despite previous studies conducted in various countries, there is a lack of comprehensive local reporting on the occurrence of carbapenem resistance among gram-negative bacteria. Objective This study aims to identify the prevalence of carbapenem-resistant gram-negative bacterial isolates. Method A retrospective cross-sectional study was conducted at an academic hospital in Jordan over an eight-month period, spanning from November 2021 to June 2022. The study involved screening electronic medical records to identify patients with clinical cultures showing the growth of Gram-negative bacteria. Antimicrobial susceptibility results of the Gram-negative isolates were recorded. Results A total of 1,043 isolated Gram-negative bacteria were analyzed for carbapenem susceptibility. Among the species tested, the most common carbapenem-resistant bacteria were Acinetobacter baumannii (153/164, 93.3%), followed by Klebsiella pneumonia (184/311, 59.2%), and Pseudomonas aeruginosa (67/160, 41.9%). The least commonly isolated species resistant to carbapenem were Escherichia coli (25/361, 6.9%) and Proteus mirabilis (1/30, 3.3%). None of Serratia marcescens or Proteus vulgaris isolates were resistant to carbapenem (0%). Overall, the prevalence of carbapenem-resistance gram-negative isolates was 41.2% (430 out of 1,043). Conclusion This study provides population-specific data that are crucial for guiding empirical antimicrobial treatment decisions not only within the participating hospital but also in other nearby healthcare facilities. The results underscore the urgent need for coordinated efforts to address antibiotic resistance in Jordan. Comprehensive measures such as strict infection control methods, annual nationwide surveillance programs, and effective antimicrobial stewardship programs at the national level are imperative to reduce the overuse of broad-spectrum antibiotics.
Læs mere Tjek på PubMedGurnani, Payal K.; Barlow, Brooke; Boling, Bryan; Busse, Laurence W.; Diaz-Gomez, Jose L.; Ford, Jenna; Gibson, Gabrielle A.; Khanna, Ashish K.; Lee, Jennifer S.; Rivosecchi, Ryan M.; Spezzano, Katherine M.; Thornton, Nathan; Vallabhajosyula, Saraschandra; Witenko, Corey J.; Wieruszewski, Patrick M.
Critical Care Explorations, 28.09.2023
Tilføjet 28.09.2023
OBJECTIVES: A number of trials related to critical care pharmacotherapy were published in 2022. We aimed to summarize the most influential publications related to the pharmacotherapeutic care of critically ill patients in 2022. DATA SOURCES: PubMed/Medical Literature Analysis and Retrieval System Online and the Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update. STUDY SELECTION: Randomized controlled trials, prospective studies, or systematic review/meta-analyses of adult critically ill patients assessing a pharmacotherapeutic intervention and reporting clinical endpoints published between January 1, 2022, and December 31, 2022, were included in this article. DATA EXTRACTION: Articles from a systematic search and the Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update were included and stratified into clinical domains based upon consistent themes. Consensus was obtained on the most influential publication within each clinical domain utilizing an a priori defined three-round modified Delphi process with the following considerations: 1) overall contribution to scientific knowledge and 2) novelty to the literature. DATA SYNTHESIS: The systematic search and Clinical Pharmacy and Pharmacology Pharmacotherapy Literature Update yielded a total of 704 articles, of which 660 were excluded. The remaining 44 articles were stratified into the following clinical domains: emergency/neurology, cardiovascular, gastroenterology/fluids/nutrition, hematology, infectious diseases/immunomodulation, and endocrine/metabolic. The final article selected from each clinical domain was summarized following a three-round modified Delphi process and included three randomized controlled trials and three systematic review/meta-analyses. Article topics summarized included dexmedetomidine versus other sedatives during mechanical ventilation, beta-blocker treatment in the critically ill, restriction of IV fluids in septic shock, venous thromboembolism prophylaxis in critically ill adults, duration of antibiotic therapy for Pseudomonas aeruginosa ventilator-associated pneumonia, and low-dose methylprednisolone treatment in severe community-acquired pneumonia. CONCLUSIONS: This concise review provides a perspective on articles published in 2022 that are relevant to the pharmacotherapeutic care of critically ill patients and their potential impact on clinical practice.
Læs mere Tjek på PubMedMary-Claire R Walsh, Mohammed Shafiul Alam, Kristen K Pierce, Marya Carmolli, Masud Alam, Dorothy M Dickson, Dan M Bak, Sajia Afreen, Forida Nazib, Kibria Golam, Firdausi Qadri, Sean A Diehl, Anna P Durbin, Stephen S Whitehead, Rashidul Haque, Beth D Kirkpatrick
Lancet Infectious Diseases, 28.09.2023
Tilføjet 28.09.2023
With 3 years of follow-up, the single-dose tetravalent dengue vaccine, TV005, was well tolerated and immunogenic for all four serotypes in young children to adults, including individuals with no previous dengue exposure.
Læs mere Tjek på PubMedJacklin F Mosha, Nancy S Matowo, Manisha A Kulkarni, Louisa A Messenger, Eliud Lukole, Elizabeth Mallya, Tatu Aziz, Robert Kaaya, Boniface A Shirima, Gladness Isaya, Monica Taljaard, Ramadhan Hashim, Jacklin Martin, Alphaxard Manjurano, Immo Kleinschmidt, Franklin W Mosha, Mark Rowland, Natacha Protopopoff
Lancet Infectious Diseases, 28.09.2023
Tilføjet 28.09.2023
Despite low coverage, the protective efficacy against malaria offered by chlorfenapyr–PY LLINs was superior to that provided by standard PY LLINs over a 3-year LLIN lifespan. Appropriate LLIN replacement strategies to maintain adequate usage of nets will be necessary to maximise the full potential of these nets.
Læs mere Tjek på PubMedShivraj M. Yabaji, Oleksii S. Rukhlenko, Sujoy Chatterjee, Bidisha Bhattacharya, Emily Wood, Marina Kasaikina, Boris N. Kholodenko, Alexander A. Gimelbrant, Igor Kramnik
Science Advances, 27.09.2023
Tilføjet 27.09.2023
Kaiyi Jiang, Justin Lim, Samantha Sgrizzi, Michael Trinh, Alisan Kayabolen, Natalya Yutin, Weidong Bao, Kazuki Kato, Eugene V. Koonin, Jonathan S. Gootenberg, Omar O. Abudayyeh
Science Advances, 27.09.2023
Tilføjet 27.09.2023
Bernard Cazelles, Kévin Cazelles, Huaiyu Tian, Mario Chavez, Mercedes Pascual
Science Advances, 27.09.2023
Tilføjet 27.09.2023
Wei Jiang, Fan Zhu, Huiming Xu, Li Xu, Haoyang Li, Xin Yang, Shabbir Khan Afridi, Shuiqing Lai, Xiusheng Qiu, Chunxin Liu, Huilu Li, Youming Long, Yuge Wang, Kevin Connolly, Jack A. Elias, Chun Geun Lee, Yaxiong Cui, Yu-Wen Alvin Huang, Wei Qiu, Changyong Tang
Science Advances, 27.09.2023
Tilføjet 27.09.2023
Clinical Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
AbstractWe estimated the risk of death from coronavirus disease 2019 in vaccinated compared with unvaccinated patients. The risk of death was reduced 44% after 1 dose of the Pfizer-BioNTech BNT162b2 vaccine, 55% after 1 dose of the Oxford-Astrazeneca ChAdOx1 vaccine, and 69% after 2 doses of the BNT162b2 vaccine. This is above the protection provided against infection.
Læs mere Tjek på PubMedClinical Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
AbstractBackgroundThere is a lack of evidence on oral amoxicillin pharmacokinetics and exposure in neonates with possible serious bacterial infection (pSBI). We aimed to describe amoxicillin disposition following oral and intravenous administration and to provide dosing recommendations for preterm and term neonates treated for pSBI.MethodsIn this pooled-population pharmacokinetic study, 3 datasets were combined for nonlinear mixed-effects modeling. In order to evaluate amoxicillin exposure following oral and intravenous administration, pharmacokinetic profiles for different dosing regimens were simulated with the developed population pharmacokinetic model. A target of 50% time of the free fraction above the minimal inhibitory concentration (MIC) with an MICECOFF of 8 mg/L (to cover gram-negative bacteria such as Escherichia coli) was used.ResultsThe cohort consisted of 261 (79 oral, 182 intravenous) neonates with a median (range) gestational age of 35.8 weeks (range, 24.9–42.4) and bodyweight of 2.6 kg (range, 0.5–5). A 1-compartment model with first-order absorption best described amoxicillin pharmacokinetics. Clearance (L/h/kg) in neonates born after 30 weeks’ gestation increased with increasing postnatal age (PNA day 10, 1.25-fold; PNA day 20, 1.43-fold vs PNA day 3). Oral bioavailability was 87%. We found that a twice-daily regimen of 50 mg/kg/day is superior to a 3- or 4-times daily schedule in the first week of life for both oral and intravenous administration.ConclusionsThis pooledpopulation pharmacokinetic description of intravenous and oral amoxicillin in neonates provides age-specific dosing recommendations. We conclude that neonates treated with oral amoxicillin in the first weeks of life reach adequate amoxicillin levels following a twice-daily dosing regimen. Oral amoxicillin therapy could therefore be an adequate, cost-effective, and more patient-friendly alternative for neonates worldwide.
Læs mere Tjek på PubMedClinical Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
AbstractBackgroundHematogenous vertebral osteomyelitis (HVOM) is an incompletely understood complication of Staphylococcus aureus bacteremia (SAB).MethodsEligible SAB patients with and without HVOM were prospectively enrolled from 1995 through 2019 at Duke University Health System. HVOM was diagnosed either radiographically or microbiologically. Multivariable logistic regression analysis was performed to identify clinical and microbial factors associated with HVOM risk. All bloodstream S. aureus isolates were genotyped using spa typing.ResultsOf 3165 cases of SAB, 127 (4.0%) developed HVOM. Patients who experienced HVOM were more likely to have community-acquired SAB (30.7% vs 16.7%, P < .001), have a longer time to diagnosis of SAB (median, 5 days; interquartile range [IQR], 2–10.5 vs median, 2 days; IQR, 0–4; P < .001), and to exhibit persistent bacteremia (48.8% vs 20.6%, P < .001). A significant number of HVOM patients developed infective endocarditis (26% vs 15.2%, P = .002). Overall, 26.2% (n = 33) of SAB patients with HVOM underwent surgical intervention. Methicillin resistance (46.6% vs 41.7%, P = .318) and bacterial genotype were not associated with the development of HVOM. At the 12-month follow-up, 22% of patients with HVOM had died. Of the surviving patients, 20.4% remained on antibiotic therapy, and 29.6% had recurrence of either HVOM or SAB.ConclusionsAmong patients with SAB, HVOM risk was associated with clinical factors and not bacterial genotype. Despite being a rare complication of SAB, patients with HVOM had high all-cause mortality rates and healthcare resource requirements up to 1 year after their HVOM diagnosis. Close clinical monitoring is indicated in this vulnerable population.
Læs mere Tjek på PubMedClinical Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
AbstractBackgroundGrowing evidence suggests that some coronavirus disease 2019 (COVID-19) survivors experience a wide range of long-term postacute sequelae. We examined the postacute risk and burden of new-incident cardiovascular, cerebrovascular, and other thrombotic complications after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a highly vaccinated multiethnic Southeast Asian population, during Delta predominance.MethodsThis cohort study used national testing and healthcare claims databases in Singapore to build a cohort of individuals who had a positive SARS-CoV-2 test between 1 September and 30 November 2021 when Delta predominated community transmission. Concurrently, we constructed a test-negative control group by enrolling individuals between 13 April 2020 and 31 December 2022 with no evidence of SARS-CoV-2 infection. Participants in both groups were followed up for a median of 300 days. We estimated risks of new-incident cardiovascular, cerebrovascular, and other thrombotic complications using doubly robust competing-risks survival analysis. Risks were reported using 2 measures: hazard ratio (HR) and excess burden (EB) with 95% confidence intervals.ResultsWe included 106 012 infected cases and 1 684 085 test-negative controls. Compared with the control group, individuals with COVID-19 exhibited increased risk (HR, 1.157 [1.069–1.252]) and excess burden (EB, 0.70 [.53–.88]) of new-incident cardiovascular and cerebrovascular complications. Risks decreased in a graded fashion for fully vaccinated (HR, 1.11 [1.02–1.22]) and boosted (HR, 1.10 [.92–1.32]) individuals. Conversely, risks and burdens of subsequent cardiovascular/cerebrovascular complications increased for hospitalized and severe COVID-19 cases (compared to nonhospitalized cases).ConclusionsIncreased risks and excess burdens of new-incident cardiovascular/cerebrovascular complications were reported among infected individuals; risks can be attenuated with vaccination and boosting.
Læs mere Tjek på PubMedKarl Stattin, Michael Hultström, Robert Frithiof, Miklos Lipcsey, Rafael Kawati
PLoS One Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
by Karl Stattin, Michael Hultström, Robert Frithiof, Miklos Lipcsey, Rafael Kawati COVID-19 is associated with prolonged intensive care unit (ICU) stay and considerable mortality. The onset of persistent critical illness, defined as when prior illness predicts death better than acute physiological derangement, has not been studied in COVID-19. This national cohort study based on the Swedish Intensive Care Registry (SIR) included all patients admitted to a Swedish ICU due to COVID-19 from 6 March 2020 to 9 November 2021. Simplified Acute Physiology Score-3 (SAPS3) Box 1 was used as a measure of prior illness and Box 3 as a measure of acute derangement to evaluate the onset and importance of persistent critical illness in COVID-19. To compare predictive capacity, the area under receiver operating characteristic (AUC) of SAPS3 and its constituent Box 1 and 3 was calculated for 30-day mortality. In 7 969 patients, of which 1 878 (23.6%) died within 30 days of ICU admission, the complete SAPS3 score had acceptable discrimination: AUC 0.75 (95% CI 0.74 to 0.76) but showed under prediction in low-risk patients and over prediction in high-risk patients. SAPS3 Box 1 showed markedly better discrimination than Box 3 (AUC 0.74 vs 0.65, P
Læs mere Tjek på PubMedLorena Carvelli, Louis Hermo, Cristian O’Flaherty, Richard Oko, Alexey V. Pshezhetsky, Carlos R. Morales
PLoS One Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
by Lorena Carvelli, Louis Hermo, Cristian O’Flaherty, Richard Oko, Alexey V. Pshezhetsky, Carlos R. Morales Heparan sulfate (HS), an abundant component of the apical cell surface and basement membrane, belongs to the glycosaminoglycan family of carbohydrates covalently linked to proteins called heparan sulfate proteoglycans. After endocytosis, HS is degraded in the lysosome by several enzymes, including heparan-alpha-glucosaminide N-acetyltransferase (HGSNAT), and in its absence causes Mucopolysaccharidosis III type C (Sanfilippo type C). Since endocytosis occurs in epithelial cells of the testis and epididymis, we examined the morphological effects of Hgsnat inactivation in these organs. In the testis, Hgsnat knockout (Hgsnat-Geo) mice revealed statistically significant decrease in tubule and epithelial profile area of seminiferous tubules. Electron microscopy (EM) analysis revealed cross-sectional tubule profiles with normal and moderately to severely altered appearances. Abnormalities in Sertoli cells and blood-testis barrier and the absence of germ cells in some tubules were noted along with altered morphology of sperm, sperm motility parameters and a reduction in fertilization rates in vitro. Along with quantitatively increased epithelial and tubular profile areas in the epididymis, EM demonstrated significant accumulations of electrolucent lysosomes in the caput-cauda regions that were reactive for cathepsin D and prosaposin antibodies. Lysosomes with similar storage materials were also found in basal, clear and myoid cells. In the mid/basal region of the epithelium of caput-cauda regions of KO mice, large vacuolated cells, unreactive for cytokeratin 5, a basal cell marker, were identified morphologically as epididymal mononuclear phagocytes (eMPs). The cytoplasm of the eMPs was occupied by a gigantic lysosome suggesting an active role of these cells in removing debris from the epithelium. Some eMPs were found in proximity to T-lymphocytes, a feature of dendritic cells. Taken together, our results reveal that upon Hgsnat inactivation, morphological alterations occur to the testis affecting sperm morphology and motility parameters and abnormal lysosomes in epididymal epithelial cells, indicative of a lysosomal storage disease.
Læs mere Tjek på PubMedMåns Stefansson, Oscar Bladh, Ola Flink, Otto Skolling, Hans-Peter Ekre, Lars Rombo, Lars Engstrand, Johan Ursing
PLoS One Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
by Måns Stefansson, Oscar Bladh, Ola Flink, Otto Skolling, Hans-Peter Ekre, Lars Rombo, Lars Engstrand, Johan Ursing Background Faecal microbiota transplantation (FMT) is recommended treatment for recurrent Clostridioides difficile infection and is studied as a potential modifier of other gastrointestinal and systemic disorders. Autologous FMT limits the potential risks of donor transplant material and enables prophylactic treatment. Capsulized FMT is convenient and accessible, but safety data are lacking. Aims To describe safety and tolerability of capsules containing autologous FMT, compared to placebo, in healthy volunteers treated with antibiotics. Method Healthy volunteers without antibiotic exposure during the past three months, that had a negative Clostridioides difficile stool sample, were recruited. Study persons donated faeces for production of capsules containing autologous microbiota. They were then given Clindamycin for seven days to disrupt the intestinal microbiota, which was followed by a two-day washout. Study persons were then randomized (1:1) to unsupervised treatment with autologous faecal matter or placebo, with two capsules twice daily for five days. A standardized questionnaire about side effects and tolerability, daily until day 28, and on days 60 and 180, was completed. Results Twenty-four study persons were included, all completed the treatment. One person from the placebo and FMT groups each, were lost to follow up from days 21 and 60, respectively. No study person experienced serious side effects, but severe fatigue was reported during the antibiotic period (n = 2). Reported side effects were mild to moderate and there were no significant differences between the groups. Reported general and intestinal health improved significantly and similarly in both groups after the antibiotic treatment. Time to normalized intestinal habits were 17 and 19 days from study start in the placebo group and the FMT group, respectively (p = 0.8). Conclusion Capsulized frozen autologous faecal microbiota transplantation was safe and well tolerated but did not affect time to normalized intestinal habits compared to placebo. Trial registration EudraCT 2017-002418-30.
Læs mere Tjek på PubMedChristoph-Alexander Joachim von Klot, Cornelius Köpp, Markus Antonius Kuczyk, Mathias Wolters
PLoS One Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
by Christoph-Alexander Joachim von Klot, Cornelius Köpp, Markus Antonius Kuczyk, Mathias Wolters Objectives Clinical, time-dependent, therapeutic and diagnostic data of patients with LUTS are highly complex. To better manage these data for therapists’ and researchers’ we developed the application ShinyLUTS. Material and methods The statistical programming language R and the framework Shiny were used to develop a platform for data entry, monitoring of therapy and scientific data analysis. As part of a use case, ShinyLUTS was evaluated for patients with non-neurogenic LUTS who were receiving Rezum™ therapy. Results The final database on patients with LUTS comprised a total of 8.118 time-dependent parameters in 11 data tables. Data entry, monitoring of therapy as well as data retrieval for scientific use, was deemed feasible, intuitive and well accepted. Conclusion The ShinyLUTs application presented here is suitable for collecting, archiving, and managing complex data on patients with LUTS. Aside from the implementation in a scientific workflow, it is suited for monitoring treatment of patients and functional results over time.
Læs mere Tjek på PubMedRichard Adjei Akuffo, Carmen Sanchez, Ivy Amanor, Jennifer Seyram Amedior, Nana Konama Kotey, Francis Anto, Thomas Azurago, Anthony Ablordey, Felicia Owusu-Antwi, Abate Beshah, Yaw Ampem Amoako, Richard Odame Phillips, Michael Wilson, Kingsley Asiedu, Jose-Antonio Ruiz-Postigo, Javier Moreno, Mourad Mokni
PLoS One Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
by Richard Adjei Akuffo, Carmen Sanchez, Ivy Amanor, Jennifer Seyram Amedior, Nana Konama Kotey, Francis Anto, Thomas Azurago, Anthony Ablordey, Felicia Owusu-Antwi, Abate Beshah, Yaw Ampem Amoako, Richard Odame Phillips, Michael Wilson, Kingsley Asiedu, Jose-Antonio Ruiz-Postigo, Javier Moreno, Mourad Mokni Background A recent study detected cutaneous leishmaniasis (CL) in 31.9% of persons with skin ulcers in the Oti Region of Ghana, resulting in a need to investigate other potential causes of the unexplained skin ulcers. Methodology/Principal findings A community based cross-sectional study was conducted in the Oti region to investigate skin ulcers of undetermined aetiologies. To confirm a diagnosis of cutaneous leishmaniasis, Buruli ulcer, Haemophilus ducreyi ulcers, or yaws, DNA obtained from each patient skin ulcer sample was systematically subjected to polymerase chain reaction (PCR) for Leishmania spp., Mycobacterium ulcerans, Haemophilus ducreyi, and Treponema pallidum sub species pertenue. A total of 101 skin ulcer samples were obtained from 101 persons. Co-infection of more than one organism was observed in 68.3% of the samples. Forty (39.6%) participants had a positive result for Leishmania spp., 68 (67.3%) for Treponema pallidum sub. Sp. pertenue, and 74 (73.3%) for H. ducreyi. Twenty (19.8%) of the patient ulcers were simultaneously infected with Leishmania spp., Treponema pallidum sub. Sp. pertenue, and H. ducreyi. None of the patients’ lesions yielded a positive result for Mycobacterium ulcerans. Conclusions/Significance This study detected single and mixed occurrence of the causative organisms of CL, yaws, and H. ducreyi cutaneous ulcers in CL endemic communities of the Oti Region in Ghana. These findings emphasize the importance of integrating multiple skin diseases on a common research platform and calls for the development of a comprehensive guideline for diagnosing and treating tropical ulcers in the study areas.
Læs mere Tjek på PubMedJannis Dickow, Melanie A. Gunawardene, Stephan Willems, Johannes Feldhege, Peter Wohlmuth, Martin Bachmann, Martin W. Bergmann, Wolfgang Gesierich, Lorenz Nowak, Ulrich-Frank Pape, Ruediger Schreiber, Sebastian Wirtz, Raphael Twerenbold, Sara Sheikhzadeh, Nele Gessler
PLoS One Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
by Jannis Dickow, Melanie A. Gunawardene, Stephan Willems, Johannes Feldhege, Peter Wohlmuth, Martin Bachmann, Martin W. Bergmann, Wolfgang Gesierich, Lorenz Nowak, Ulrich-Frank Pape, Ruediger Schreiber, Sebastian Wirtz, Raphael Twerenbold, Sara Sheikhzadeh, Nele Gessler Background With the emergence of new subvariants, the disease severity of Severe Acute Respiratory Syndrome Coronavirus-2 has attenuated. This study aimed to compare the disease severity in patients hospitalized with omicron variant infection to those with influenza infection. Methods We compared data from the multicenter observational, prospective, epidemiological “CORONA Germany” (Clinical Outcome and Risk in hospitalized COVID-19 patients) study on patients infected with Severe Acute Respiratory Syndrome Coronavirus-2 to retrospective data on influenza infection cases from November 2016 to August 2022. Severe Acute Respiratory Syndrome Coronavirus-2 cases were classified as wild-type/delta variant before January 2022, or omicron variant from January 2022 onward. The primary outcome was in-hospital mortality, adjusted for age, gender, and comorbidities. Results The study included 35,806 patients from 53 hospitals in Germany, including 4,916 patients (13.7%) with influenza infection, 16,654 patients (46.5%) with wild-type/delta variant infection, and 14,236 patients (39.8%) with omicron variant infection. In-hospital mortality was highest in patients with wild-type/delta variant infection (16.8%), followed by patients with omicron variant infection (8.4%) and patients with influenza infection (4.7%). In the adjusted analysis, higher age was the strongest predictor for in-hospital mortality (age 80 years vs. age 50 years: OR 4.25, 95% CI 3.10–5.83). Both, patients with wild-type/delta variant infection (OR 3.54, 95% CI 3.02–4.15) and patients with omicron variant infection (OR 1.56, 95% CI 1.32–1.84) had a higher risk for in-hospital mortality than patients with influenza infection. Conclusion After adjusting for age, gender and comorbidities, patients with wild-type/delta variant infection had the highest risk for in-hospital mortality compared to patients with influenza infection. Even for patients with omicron variant infection, the adjusted risk for in-hospital mortality was higher than for patients with influenza infection. The adjusted risk for in-hospital mortality showed a strong age dependency across all virus types and variants. Trial registration number NCT04659187.
Læs mere Tjek på PubMedDawa Chyophel Lepcha, Ayush Dogra, Bhawna Goyal, Vishal Goyal, Vinay Kukreja, Durga Prasad Bavirisetti
PLoS One Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
by Dawa Chyophel Lepcha, Ayush Dogra, Bhawna Goyal, Vishal Goyal, Vinay Kukreja, Durga Prasad Bavirisetti Low-dose computed tomography (LDCT) has attracted significant attention in the domain of medical imaging due to the inherent risks of normal-dose computed tomography (NDCT) based X-ray radiations to patients. However, reducing radiation dose in CT imaging produces noise and artifacts that degrade image quality and subsequently hinders medical disease diagnostic performance. In order to address these problems, this research article presents a competent low-dose computed tomography image denoising algorithm based on a constructive non-local means algorithm with morphological residual processing to achieve the task of removing noise from the LDCT images. We propose an innovative constructive non-local image filtering algorithm by means of applications in low-dose computed tomography technology. The nonlocal mean filter that was recently proposed was modified to construct our denoising algorithm. It constructs the discrete property of neighboring filtering to enable rapid vectorized and parallel implantation in contemporary shared memory computer platforms while simultaneously decreases computing complexity. Subsequently, the proposed method performs faster computation compared to a non-vectorized and serial implementation in terms of speed and scales linearly with image dimension. In addition, the morphological residual processing is employed for the purpose of edge-preserving image processing. It combines linear lowpass filtering with a nonlinear technique that enables the extraction of meaningful regions where edges could be preserved while removing residual artifacts from the images. Experimental results demonstrate that the proposed algorithm preserves more textural and structural features while reducing noise, enhances edges and significantly improves image quality more effectively. The proposed research article obtains better results both qualitatively and quantitively when compared to other comparative algorithms on publicly accessible datasets.
Læs mere Tjek på PubMedPrashant Mahajan, Vaishali Patil
PLoS One Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
by Prashant Mahajan, Vaishali Patil Engineering profession for students and diverse students for Engineering Campuses (ECs) is the prestige to have for both. Worldwide higher education has been impacted by COVID-19 pandemic, but particularly pulling padlocked doors of Indian engineering campuses (ECs) down. Students’ attitudes regarding choice, liking, and preferences were also affected. Knowing how tough ’college choice’ was before the pandemic, one can guess how difficult it will be today. The objective of this study was to explore students’ perceptions of choice characteristics related to ECs and diverse students enabling choice decisions under the COVID-19 situation, and to discover any possible relationships among them. Research questions were qualitatively examined with the statistical confirmation of related hypothesizes by utilizing ANOVA and Regression analysis. A self-reported quantitative survey composed of a closed-ended structured questionnaire was administered on the students of first-year engineering who had recently enrolled in ECs of North Maharashtra Region of India, after pandemic hitting India. According to the study, ECs have several characteristics impacting students’ selection of ECs under pandemic. The influence of proximity, image and reputation, educational quality, and curriculum delivery was significant in contributing sustainability of ECs. This influence was significant across students’ psychological and behavioural biases on likes, choices, and preferences. Furthermore, multiple relationships were noted within the sub-groups of demographic, geographic, socioeconomic, academic performance, and psychological and behavioural traits due to the impact of ECs’ characteristics on sustainability. The study has provided a framework for policymakers and administrators to strengthen repositioning towards sustainability while capturing potentially diverse enrolments. Even if we have to coexist with pandemic forever or with more similar pandemics, the findings of this study may undergo a fundamental transformation for ECs (existing and forthcoming). On the other hand, by understanding the importance and relations of choice characteristics may smoothen the complex nature of \'college choice\' for prospective students.
Læs mere Tjek på PubMedChu hyun Kim, Myung Jin Chung, Yoon Ki Cha, Seok Oh, Kwang gi Kim, Hongseok Yoo
PLoS One Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
by Chu hyun Kim, Myung Jin Chung, Yoon Ki Cha, Seok Oh, Kwang gi Kim, Hongseok Yoo To evaluate the effect of the deep learning model reconstruction (DLM) method in terms of image quality and diagnostic agreement in low-dose computed tomography (LDCT) for interstitial lung disease (ILD), 193 patients who underwent LDCT for suspected ILD were retrospectively reviewed. Datasets were reconstructed using filtered back projection (FBP), adaptive statistical iterative reconstruction Veo (ASiR-V), and DLM. For image quality analysis, the signal, noise, signal-to-noise ratio (SNR), blind/referenceless image spatial quality evaluator (BRISQUE), and visual scoring were evaluated. Also, CT patterns of usual interstitial pneumonia (UIP) were classified according to the 2022 idiopathic pulmonary fibrosis (IPF) diagnostic criteria. The differences between CT images subjected to FBP, ASiR-V 30%, and DLM were evaluated. The image noise and BRISQUE scores of DLM images was lower and SNR was higher than that of the ASiR-V and FBP images (ASiR-V vs. DLM, p < 0.001 and FBP vs. DLR-M, p < 0.001, respectively). The agreement of the diagnostic categorization of IPF between the three reconstruction methods was almost perfect (κ = 0.992, CI 0.990–0.994). Image quality was improved with DLM compared to ASiR-V and FBP.
Læs mere Tjek på PubMedMalaria Journal, 27.09.2023
Tilføjet 27.09.2023
Abstract Background Larval Source Management (LSM) is an important tool for malaria vector control and is recommended by WHO as a supplementary vector control measure. LSM has contributed in many successful attempts to eliminate the disease across the Globe. However, this approach is typically labour-intensive, largely due to the difficulties in locating and mapping potential malarial mosquito breeding sites. Previous studies have demonstrated the potential for drone imaging technology to map malaria vector breeding sites. However, key questions remain unanswered related to the use and cost of this technology within operational vector control. Methods Using Zanzibar (United Republic of Tanzania) as a demonstration site, a protocol was collaboratively designed that employs drones and smartphones for supporting operational LSM, termed the Spatial Intelligence System (SIS). SIS was evaluated over a four-month LSM programme by comparing key mapping accuracy indicators and relative costs (both mapping costs and intervention costs) against conventional ground-based methods. Additionally, malaria case incidence was compared between the SIS and conventional study areas, including an estimation of the incremental cost-effectiveness of switching from conventional to SIS larviciding. Results The results demonstrate that the SIS approach is significantly more accurate than a conventional approach for mapping potential breeding sites: mean % correct per site: SIS = 60% (95% CI 32–88%, p = 0.02), conventional = 18% (95% CI − 3–39%). Whilst SIS cost more in the start-up phase, overall annualized costs were similar to the conventional approach, with a simulated cost per person protected per year of $3.69 ($0.32 to $15.12) for conventional and $3.94 ($0.342 to $16.27) for SIS larviciding. The main economic benefits were reduced labour costs associated with SIS in the pre-intervention baseline mapping of habitats. There was no difference in malaria case incidence between the three arms. Cost effectiveness analysis showed that SIS is likely to provide similar health benefits at similar costs compared to the conventional arm. Conclusions The use of drones and smartphones provides an improved means of mapping breeding sites for use in operational LSM. Furthermore, deploying this technology does not appear to be more costly than a conventional ground-based approach and, as such, may represent an important tool for Malaria Control Programmes that plan to implement LSM.
Læs mere Tjek på PubMedMalaria Journal, 27.09.2023
Tilføjet 27.09.2023
Abstract Background Larval Source Management (LSM) is an important tool for malaria vector control and is recommended by WHO as a supplementary vector control measure. LSM has contributed in many successful attempts to eliminate the disease across the Globe. However, this approach is typically labour-intensive, largely due to the difficulties in locating and mapping potential malarial mosquito breeding sites. Previous studies have demonstrated the potential for drone imaging technology to map malaria vector breeding sites. However, key questions remain unanswered related to the use and cost of this technology within operational vector control. Methods Using Zanzibar (United Republic of Tanzania) as a demonstration site, a protocol was collaboratively designed that employs drones and smartphones for supporting operational LSM, termed the Spatial Intelligence System (SIS). SIS was evaluated over a four-month LSM programme by comparing key mapping accuracy indicators and relative costs (both mapping costs and intervention costs) against conventional ground-based methods. Additionally, malaria case incidence was compared between the SIS and conventional study areas, including an estimation of the incremental cost-effectiveness of switching from conventional to SIS larviciding. Results The results demonstrate that the SIS approach is significantly more accurate than a conventional approach for mapping potential breeding sites: mean % correct per site: SIS = 60% (95% CI 32–88%, p = 0.02), conventional = 18% (95% CI − 3–39%). Whilst SIS cost more in the start-up phase, overall annualized costs were similar to the conventional approach, with a simulated cost per person protected per year of $3.69 ($0.32 to $15.12) for conventional and $3.94 ($0.342 to $16.27) for SIS larviciding. The main economic benefits were reduced labour costs associated with SIS in the pre-intervention baseline mapping of habitats. There was no difference in malaria case incidence between the three arms. Cost effectiveness analysis showed that SIS is likely to provide similar health benefits at similar costs compared to the conventional arm. Conclusions The use of drones and smartphones provides an improved means of mapping breeding sites for use in operational LSM. Furthermore, deploying this technology does not appear to be more costly than a conventional ground-based approach and, as such, may represent an important tool for Malaria Control Programmes that plan to implement LSM.
Læs mere Tjek på PubMedMalaria Journal, 27.09.2023
Tilføjet 27.09.2023
Abstract Background Larval Source Management (LSM) is an important tool for malaria vector control and is recommended by WHO as a supplementary vector control measure. LSM has contributed in many successful attempts to eliminate the disease across the Globe. However, this approach is typically labour-intensive, largely due to the difficulties in locating and mapping potential malarial mosquito breeding sites. Previous studies have demonstrated the potential for drone imaging technology to map malaria vector breeding sites. However, key questions remain unanswered related to the use and cost of this technology within operational vector control. Methods Using Zanzibar (United Republic of Tanzania) as a demonstration site, a protocol was collaboratively designed that employs drones and smartphones for supporting operational LSM, termed the Spatial Intelligence System (SIS). SIS was evaluated over a four-month LSM programme by comparing key mapping accuracy indicators and relative costs (both mapping costs and intervention costs) against conventional ground-based methods. Additionally, malaria case incidence was compared between the SIS and conventional study areas, including an estimation of the incremental cost-effectiveness of switching from conventional to SIS larviciding. Results The results demonstrate that the SIS approach is significantly more accurate than a conventional approach for mapping potential breeding sites: mean % correct per site: SIS = 60% (95% CI 32–88%, p = 0.02), conventional = 18% (95% CI − 3–39%). Whilst SIS cost more in the start-up phase, overall annualized costs were similar to the conventional approach, with a simulated cost per person protected per year of $3.69 ($0.32 to $15.12) for conventional and $3.94 ($0.342 to $16.27) for SIS larviciding. The main economic benefits were reduced labour costs associated with SIS in the pre-intervention baseline mapping of habitats. There was no difference in malaria case incidence between the three arms. Cost effectiveness analysis showed that SIS is likely to provide similar health benefits at similar costs compared to the conventional arm. Conclusions The use of drones and smartphones provides an improved means of mapping breeding sites for use in operational LSM. Furthermore, deploying this technology does not appear to be more costly than a conventional ground-based approach and, as such, may represent an important tool for Malaria Control Programmes that plan to implement LSM.
Læs mere Tjek på PubMedMalaria Journal, 27.09.2023
Tilføjet 27.09.2023
Abstract Background The World Health Organization approved the RTS,S/AS01 malaria vaccine for wider rollout, and Kenya participated in a phased pilot implementation from 2019 to understand its impact under routine conditions. Vaccine delivery requires coverage measures at national and sub-national levels to evaluate progress over time. This study aimed to estimate the coverage of the RTS,S/AS01 vaccine during the first 36 months of the Kenyan pilot implementation. Methods Monthly dose-specific immunization data for 23 sub-counties were obtained from routine health information systems at the facility level for 2019–2022. Coverage of each RTS,S/AS01 dose was determined using reported doses as a numerator and service-based (Penta 1 and Measles) or population (projected infant populations from WorldPop) as denominators. Descriptive statistics of vaccine delivery, dropout rates and coverage estimates were computed across the 36-month implementation period. Results Over 36 months, 818,648 RTSS/AS01 doses were administered. Facilities managed by the Ministry of Health and faith-based organizations accounted for over 88% of all vaccines delivered. Overall, service-based malaria vaccine coverage was 96%, 87%, 78%, and 39% for doses 1–4 respectively. Using a population-derived denominator for age-eligible children, vaccine coverage was 78%, 68%, 57%, and 24% for doses 1–4, respectively. Of the children that received measles dose 1 vaccines delivered at 9 months (coverage: 95%), 82% received RTSS/AS01 dose 3, only 66% of children who received measles dose 2 at 18 months (coverage: 59%) also received dose 4. Conclusion The implementation programme successfully maintained high levels of coverage for the first three doses of RTSS/AS01 among children defined as EPI service users up to 9 months of age but had much lower coverage within the community with up to 1 in 5 children not receiving the vaccine. Consistent with vaccines delivered over the age of 1 year, coverage of the fourth malaria dose was low. Vaccine uptake, service access and dropout rates for malaria vaccines require constant monitoring and intervention to ensure maximum protection is conferred.
Læs mere Tjek på PubMedMalaria Journal, 27.09.2023
Tilføjet 27.09.2023
Abstract Background The World Health Organization approved the RTS,S/AS01 malaria vaccine for wider rollout, and Kenya participated in a phased pilot implementation from 2019 to understand its impact under routine conditions. Vaccine delivery requires coverage measures at national and sub-national levels to evaluate progress over time. This study aimed to estimate the coverage of the RTS,S/AS01 vaccine during the first 36 months of the Kenyan pilot implementation. Methods Monthly dose-specific immunization data for 23 sub-counties were obtained from routine health information systems at the facility level for 2019–2022. Coverage of each RTS,S/AS01 dose was determined using reported doses as a numerator and service-based (Penta 1 and Measles) or population (projected infant populations from WorldPop) as denominators. Descriptive statistics of vaccine delivery, dropout rates and coverage estimates were computed across the 36-month implementation period. Results Over 36 months, 818,648 RTSS/AS01 doses were administered. Facilities managed by the Ministry of Health and faith-based organizations accounted for over 88% of all vaccines delivered. Overall, service-based malaria vaccine coverage was 96%, 87%, 78%, and 39% for doses 1–4 respectively. Using a population-derived denominator for age-eligible children, vaccine coverage was 78%, 68%, 57%, and 24% for doses 1–4, respectively. Of the children that received measles dose 1 vaccines delivered at 9 months (coverage: 95%), 82% received RTSS/AS01 dose 3, only 66% of children who received measles dose 2 at 18 months (coverage: 59%) also received dose 4. Conclusion The implementation programme successfully maintained high levels of coverage for the first three doses of RTSS/AS01 among children defined as EPI service users up to 9 months of age but had much lower coverage within the community with up to 1 in 5 children not receiving the vaccine. Consistent with vaccines delivered over the age of 1 year, coverage of the fourth malaria dose was low. Vaccine uptake, service access and dropout rates for malaria vaccines require constant monitoring and intervention to ensure maximum protection is conferred.
Læs mere Tjek på PubMedMalaria Journal, 27.09.2023
Tilføjet 27.09.2023
Abstract Background The World Health Organization approved the RTS,S/AS01 malaria vaccine for wider rollout, and Kenya participated in a phased pilot implementation from 2019 to understand its impact under routine conditions. Vaccine delivery requires coverage measures at national and sub-national levels to evaluate progress over time. This study aimed to estimate the coverage of the RTS,S/AS01 vaccine during the first 36 months of the Kenyan pilot implementation. Methods Monthly dose-specific immunization data for 23 sub-counties were obtained from routine health information systems at the facility level for 2019–2022. Coverage of each RTS,S/AS01 dose was determined using reported doses as a numerator and service-based (Penta 1 and Measles) or population (projected infant populations from WorldPop) as denominators. Descriptive statistics of vaccine delivery, dropout rates and coverage estimates were computed across the 36-month implementation period. Results Over 36 months, 818,648 RTSS/AS01 doses were administered. Facilities managed by the Ministry of Health and faith-based organizations accounted for over 88% of all vaccines delivered. Overall, service-based malaria vaccine coverage was 96%, 87%, 78%, and 39% for doses 1–4 respectively. Using a population-derived denominator for age-eligible children, vaccine coverage was 78%, 68%, 57%, and 24% for doses 1–4, respectively. Of the children that received measles dose 1 vaccines delivered at 9 months (coverage: 95%), 82% received RTSS/AS01 dose 3, only 66% of children who received measles dose 2 at 18 months (coverage: 59%) also received dose 4. Conclusion The implementation programme successfully maintained high levels of coverage for the first three doses of RTSS/AS01 among children defined as EPI service users up to 9 months of age but had much lower coverage within the community with up to 1 in 5 children not receiving the vaccine. Consistent with vaccines delivered over the age of 1 year, coverage of the fourth malaria dose was low. Vaccine uptake, service access and dropout rates for malaria vaccines require constant monitoring and intervention to ensure maximum protection is conferred.
Læs mere Tjek på PubMedMalaria Journal, 27.09.2023
Tilføjet 27.09.2023
Abstract Background Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) has revolutionized identification of bacteria and is becoming available in an increasing number of laboratories in malaria-endemic countries. The purpose of this proof-of-concept study was to explore the potential of MALDI-TOF as a diagnostic tool for direct detection and quantification of Plasmodium falciparum in human blood. Methods Three different P. falciparum strains (3D7, HB3 and IT4) were cultured and synchronized following standard protocols. Ring-stages were diluted in fresh blood group 0 blood drawn in EDTA from healthy subjects to mimic clinical samples. Samples were treated with saponin and washed in PBS to concentrate protein material. Samples were analysed using a Microflex LT MALDI-TOF and resulting mass spectra were compared using FlexAnalysis software. Results More than 10 peaks specific for P. falciparum were identified. The identified peaks were consistent among the three genetically unrelated strains. Identification was possible in clinically relevant concentrations of 0.1% infected red blood cells, and a close relationship between peak intensity and the percentage of infected red blood cells was seen. Conclusion The findings indicate that the method has the potential to detect and quantify P. falciparum at clinically relevant infection intensities and provides proof-of-concept for MALDI-TOF-based diagnosis of human malaria. Further research is needed to include other Plasmodium spp., wildtype parasite isolates and to increase sensitivity. MALDI-TOF may be a useful tool for mass-screening purposes and for diagnosis of malaria in settings where it is readily available.
Læs mere Tjek på PubMedMalaria Journal, 27.09.2023
Tilføjet 27.09.2023
Abstract Background Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) has revolutionized identification of bacteria and is becoming available in an increasing number of laboratories in malaria-endemic countries. The purpose of this proof-of-concept study was to explore the potential of MALDI-TOF as a diagnostic tool for direct detection and quantification of Plasmodium falciparum in human blood. Methods Three different P. falciparum strains (3D7, HB3 and IT4) were cultured and synchronized following standard protocols. Ring-stages were diluted in fresh blood group 0 blood drawn in EDTA from healthy subjects to mimic clinical samples. Samples were treated with saponin and washed in PBS to concentrate protein material. Samples were analysed using a Microflex LT MALDI-TOF and resulting mass spectra were compared using FlexAnalysis software. Results More than 10 peaks specific for P. falciparum were identified. The identified peaks were consistent among the three genetically unrelated strains. Identification was possible in clinically relevant concentrations of 0.1% infected red blood cells, and a close relationship between peak intensity and the percentage of infected red blood cells was seen. Conclusion The findings indicate that the method has the potential to detect and quantify P. falciparum at clinically relevant infection intensities and provides proof-of-concept for MALDI-TOF-based diagnosis of human malaria. Further research is needed to include other Plasmodium spp., wildtype parasite isolates and to increase sensitivity. MALDI-TOF may be a useful tool for mass-screening purposes and for diagnosis of malaria in settings where it is readily available.
Læs mere Tjek på PubMedMalaria Journal, 27.09.2023
Tilføjet 27.09.2023
Abstract Background Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) has revolutionized identification of bacteria and is becoming available in an increasing number of laboratories in malaria-endemic countries. The purpose of this proof-of-concept study was to explore the potential of MALDI-TOF as a diagnostic tool for direct detection and quantification of Plasmodium falciparum in human blood. Methods Three different P. falciparum strains (3D7, HB3 and IT4) were cultured and synchronized following standard protocols. Ring-stages were diluted in fresh blood group 0 blood drawn in EDTA from healthy subjects to mimic clinical samples. Samples were treated with saponin and washed in PBS to concentrate protein material. Samples were analysed using a Microflex LT MALDI-TOF and resulting mass spectra were compared using FlexAnalysis software. Results More than 10 peaks specific for P. falciparum were identified. The identified peaks were consistent among the three genetically unrelated strains. Identification was possible in clinically relevant concentrations of 0.1% infected red blood cells, and a close relationship between peak intensity and the percentage of infected red blood cells was seen. Conclusion The findings indicate that the method has the potential to detect and quantify P. falciparum at clinically relevant infection intensities and provides proof-of-concept for MALDI-TOF-based diagnosis of human malaria. Further research is needed to include other Plasmodium spp., wildtype parasite isolates and to increase sensitivity. MALDI-TOF may be a useful tool for mass-screening purposes and for diagnosis of malaria in settings where it is readily available.
Læs mere Tjek på PubMedSuhas BobbaNicole C. HowardShibali DasMushtaq AhmedNargis KhanIgnacio MarchanteLuis B. BarreiroJoaquin SanzMaziar DivangahiShabaana A. Khader 1 Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, USA 2 Department of Microbiology, University of Chicago, Chicago, Illinois, USA 3 Meakins-Christie Laboratories, Department of Medicine, McGill University, Montreal, Quebec, Canada 4 Meakins-Christie Laboratories, Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada 5 Meakins-Christie Laboratories, Department of Pathology, McGill University, Montreal, Quebec, Canada 6 Department of Theoretical Physics, University of Zaragoza, Institute for Biocomputation and Physics of Complex Systems (BIFI), Zaragoza, Spain 7 Department of Medicine, Genetic Section, University of Chicago, Chicago, Illinois, USA , Sabine Ehrt
Infection and Immunity, 27.09.2023
Tilføjet 27.09.2023
Hamtandi Magloire NatamaGemma MoncunillMarta VidalToussaint RouambaRuth AguilarRebeca SantanoEduard Rovira-VallbonaAlfons JiménezM. Athanase SoméHermann SorghoInnocent ValéaMaminata Coulibaly-TraoréRoss L. CoppelDavid CavanaghChetan E. ChitnisJames G. BeesonEvelina AngovSheetij DuttaBenoit GamainLuis IzquierdoPetra F. MensHenk D. F. H. SchalligHalidou TintoAnna Rosanas-UrgellCarlota Dobaño 1 Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre-Ouest, Nanoro, Burkina Faso 2 Barcelona Institute for Global Health (ISGlobal), Hospital Clínic – Universitat de Barcelona, Barcelona, Spain 3 CIBER de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain 4 CIBER de Epidemiologia y Salud Pública (CIBERESP), Barcelona, Spain 5 Infection and Immunity Program, Department of Microbiology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, Victoria, Australia 6 Centre for Immunity, Infection & Evolution, Institute of Immunology & Infection Research, Ashworth Laboratories, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom 7 Malaria Parasite Biology and Vaccines Unit, Department of Parasites and Insect Vectors, Institut Pasteur, Université de Paris, Paris, France 8 Burnet Institute, Melbourne, Victoria, Australia 9 U.S. Military Malaria Vaccine Program, Walter Reed Army Institute of Research (WRAIR), Silver Spring, Maryland, USA 10 Université Paris Cité, INSERM, Paris, France 11 Academic Medical Centre at the University of Amsterdam, Amsterdam, the Netherlands 12 Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium , Jeroen P. J. Saeij
Infection and Immunity, 27.09.2023
Tilføjet 27.09.2023
Arshad RizviGermán Vargas-CuebasAdrianne N. EdwardsMichael A. DiCandiaZavier A. CarterCheyenne D. LeeMarcos P. MonteiroShonna M. McBride 1 Department of Microbiology and Immunology, Emory University School of Medicine, Emory Antibiotic Resistance Center, Atlanta, Georgia, USA , Nancy E. Freitag
Infection and Immunity, 27.09.2023
Tilføjet 27.09.2023
Listeria monocytogenes requires DHNA-dependent intracellular redox homeostasis facilitated by Ndh2 for survival and virulence
Hans B. SmithKijeong LeeMatthew J. FreemanDavid M. StevensonDaniel Amador-NoguezJohn-Demian Sauer 1 Department of Medical Microbiology and Immunology, University of Wisconsin-Madison, Madison, Wisconsin, USA 2 Department of Bacteriology, University of Wisconsin-Madison, Madison, Wisconsin, USA , Nancy E. Freitag
Infection and Immunity, 27.09.2023
Tilføjet 27.09.2023
Abdu A Adamu, Téné-Alima Essoh, Rabiu I Jalo, Charles S Wiysonge
International Journal of Infectious Diseases, 27.09.2023
Tilføjet 27.09.2023
Routine childhood immunization is considered one of the most effective public health interventions in the world because of its impact on child morbidity and mortality [1]. According to the United Nations Children\'s Fund (UNICEF), routine immunization averts about 4.4 million child deaths globally per year [2]. Studies have shown that routine childhood immunization also has high economic benefit and yields significant social returns [3]. Using the value-of-a-statistical life method, the return on investment (ROI) of routine childhood immunization in low- and middle-income countries in the “decade of vaccines” was estimated to be about 51.8 [3].
Læs mere Tjek på PubMedElena Bruzzesi, Arianna Gabrieli, Davide Bernasconi, Giulia Marchetti, Andrea Calcagno, Diego Ripamonti, Andrea Antinori, Nicola Squillace, Antonella Cingolani, Antonio Muscatello, Alessandra Bandera, Andrea Gori, Stefano Rusconi, Silvia Nozza, INACTION Study Group
Journal of Medical Virology, 27.09.2023
Tilføjet 27.09.2023
Hanne M. L. Zimmermann, Thomas Gültzow, Tamika A. Marcos, Haoyi Wang, Kai. J. Jonas, Sarah E. Stutterheim
Journal of Medical Virology, 27.09.2023
Tilføjet 27.09.2023
Gabriela M. Coelho, Allan H. D. Cataneo, Sonia M. Raboni, Meri B. Nogueira, Caroline B. Vaz Paula, Ana C. S. F. Almeida, Vanessa Z. Rogerio, Nilson T. Zanchin, Lucia Noronha, Camila Zanluca, Claudia N. Duarte dos Santos
Journal of Medical Virology, 27.09.2023
Tilføjet 27.09.2023
Tian Tian, Leiwen Fu, Zhen Lu, Junye Bian, Xinyi Zhou, Bingyi Wang, Yi‐Fan Lin, Zewen Zhang, Lirong Liu, Miaomiao Xi, Chen Zhen, Jianghong Dai, Huachun Zou
Journal of Medical Virology, 27.09.2023
Tilføjet 27.09.2023
Bing Li, Jing Zhang, Yang Huang, Xinrui Li, Jing Feng, Yan Li, Rongxin Zhang
Journal of Medical Virology, 27.09.2023
Tilføjet 27.09.2023
Yan Zhan, Ling Ye, Qianying Ouyang, Jiye Yin, Jiajia Cui, Ke Liu, Chengxian Guo, Haibo Zhang, Jingbo Zhai, Chunfu Zheng, Aoxiang Guo, Bao Sun
Journal of Medical Virology, 27.09.2023
Tilføjet 27.09.2023
Tannor, E. K., Quentin, W., Busse, R., Opoku, D., Amuasi, J.
BMJ Open, 27.09.2023
Tilføjet 27.09.2023
IntroductionThe COVID-19 pandemic has exposed weaknesses in health systems of many countries, including those in sub-Saharan Africa. Despite comparatively low rates of COVID-19 admissions and deaths in sub-Saharan Africa, the pandemic still had a significant impact by disrupting health service utilisation (HSU). The aim of this scoping review is to synthesise the available evidence on HSU in sub-Saharan Africa during the COVID-19 pandemic, especially focusing on (1) changes in HSU compared with the prepandemic period, (2) changes in HSU among particular patient groups studied and (3) identifying factors determining changes in HSU as a result of the COVID-19 pandemic. Method and analysisThe scoping review will be guided by the methodological framework for conducting scoping reviews developed by Arskey and O’Malley. We will identify relevant studies on HSU in sub-Saharan Africa during the COVID-19 pandemic using PubMed (MEDLINE), Embase, Scopus and Web of Science databases from 1 December, 2019 to 31 March 2023. We will search grey literature, government and organisational websites for reports and conference proceedings. Included studies will be restricted to those reported in English or French. Two reviewers will independently screen articles at the title and abstract stage for inclusion into full text screening. We will provide a general descriptive overview, tabular summaries and content analysis for the extracted data. Ethics and disseminationEthical approval is not required for the conduct of the scoping review. We will disseminate our findings via open access peer-reviewed journals and scientific presentations. Our scoping review findings will help to determine the feasibility of a subsequent systematic review (and meta-analysis) on HSU during the COVID-19 pandemic.
Læs mere Tjek på PubMedAlkner, S., de Boniface, J., Lundstedt, D., Mjaaland, I., Ryden, L., Vikstrom, J., Bendahl, P.-O., Holmberg, E., Sackey, H., Wieslander, E., Karlsson, P.
BMJ Open, 27.09.2023
Tilføjet 27.09.2023
IntroductionModern systemic treatment has reduced incidence of regional recurrences and improved survival in breast cancer (BC). It is thus questionable whether regional radiotherapy (RT) is still beneficial in patients with sentinel lymph node (SLN) macrometastasis. Postoperative regional RT is associated with an increased risk of arm morbidity, pneumonitis, cardiac disease and secondary cancer. Therefore, there is a need to individualise regional RT in relation to the risk of recurrence. Methods and analysisIn this multicentre, prospective randomised trial, clinically node-negative patients with oestrogen receptor-positive, HER2-negative BC and 1-2 SLN macrometastases are eligible. Participants are randomly assigned to receive regional RT (standard arm) or not (intervention arm). Regional RT includes the axilla level I–III, the supraclavicular fossa and in selected patients the internal mammary nodes. Both groups receive RT to the remaining breast. Chest-wall RT after mastectomy is given in the standard arm, but in the intervention arm only in cases of widespread multifocality according to national guidelines. RT quality assurance is an integral part of the trial. The trial aims to include 1350 patients between March 2023 and December 2028 in Sweden and Norway. Primary outcome is recurrence-free survival (RFS) at 5 years. Non-inferiority will be declared if outcome in the de-escalation arm is not >4.5 percentage units below that with regional RT, corresponding to an HR of 1.41 assuming 88% 5-year RFS with standard treatment. Secondary outcomes include locoregional recurrence, overall survival, patient-reported arm morbidity and health-related quality of life. Gene expression analysis and tumour tissue-based studies to identify prognostic and predictive markers for benefit of regional RT are included. Ethics and disseminationThe trial protocol is approved by the Swedish Ethics Authority (Dnr-2022-02178-01, 2022-05093-02, 2023-00826-02, 2023-03035-02). Results will be presented at scientific conferences and in peer-reviewed journals. Trial registration numberNCT05634889.
Læs mere Tjek på PubMedShannon, B., Bowles, K.-A., Williams, C., Ravipati, T., Deighton, E., Andrew, N.
BMJ Open, 27.09.2023
Tilføjet 27.09.2023
ObjectiveThe Community Care programme is an initiative aimed at reducing hospitalisations and emergency department (ED) presentations among patients with complex needs. We aimed to describe the characteristics of the programme participants and identify factors associated with enrolment into the programme. DesignThis observational cohort study was conducted using routinely collected data from the National Centre for Healthy Ageing data platform. SettingThe study was carried out at Peninsula Health, a health service provider serving a population in Melbourne, Victoria, Australia. ParticipantsWe included all adults with unplanned ED presentation or hospital admission to Peninsula Health between 1 November 2016 and 31 October 2017, the programme’s first operational year. Outcome measuresCommunity Care programme enrolment was the primary outcome. Participants’ demographics, health factors and enrolment influences were analysed using a staged multivariable logistic regression. ResultsWe included 47 148 adults, of these, 914 were enrolled in the Community Care programme. Participants were older (median 66 vs 51 years), less likely to have a partner (34% vs 57%) and had more frequent hospitalisations and ED visits. In the multivariable analysis, factors most strongly associated with enrolment included not having a partner (adjusted OR (aOR) 1.83, 95% CI 1.57 to 2.12), increasing age (aOR 1.01, 95% CI 1.01 to 1.02), frequent hospitalisations (aOR 7.32, 95% CI 5.78 to 9.24), frequent ED visits (aOR 2.0, 95% CI 1.37 to 2.85) and having chronic diseases, such as chronic pulmonary disease (aOR 2.48, 95% CI 2.06 to 2.98), obesity (aOR 2.06, 95% CI 1.39 to 2.99) and diabetes mellitus (complicated) (aOR 1.75, 95% CI 1.44 to 2.13). Residing in aged care home and having high socioeconomic status) independently associated with reduced odds of enrolment. ConclusionsThe Community Care programme targets patients with high-readmission risks under-representation of individuals residing in residential aged care homes warrants further investigation. This study aids service planning and offers valuable feedback to clinicians about programme beneficiaries
Læs mere Tjek på PubMed