bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a FIT-Based Colorectal Cancer Screening Program on Mortality Estimated by the Regression Discontinuity Design
Authors: Thomsen Mette K , Nicolaisen Sia K , Pedersen Lars , Lash Timothy L , Erichsen Rune , Sørensen Henrik Toft , Mikkelsen Ellen M
Published: April 2023

The fecal immunochemical test (FIT) has been implemented in colorectal cancer (CRC) screening programs, but effect evaluations are lacking. We evaluated the effect of a positive FIT on all-cause and CRC mortality using the regression discontinuity design. The Danish CRC screening program invites all residents 50–74 years old, using a 20-μg hemoglobin/g feces cutoff for colonoscopy referral. In this cohort study, we followed all first-time screening participants from 2014–2019 until 2020. We estimated the local effect of screening results, of just above the cutoff vs. just below, as hazard ratios (HRs) between models fitted at each side of the cutoff. We conducted the analysis within a narrow hemoglobin range (≥17 and <23, n = 16,428) and a wider range (≥14 and <26, n = 35,353). Those screened just above the cutoff had lower all-cause mortality compared with below (HR = 0.87, 95% confidence interval: 0.69; 1.10), estimated from the narrow range. The CRC mortality analysis had few outcomes. In the wider range, those with a FIT just above the cutoff had a lower hazard of CRC mortality compared with just below the cutoff (HR = 0.49, 95% confidence interval: 0.17; 1.41). A FIT result just above the cutoff, leading to referral to colonoscopy, pointed towards reduced all-cause and CRC mortality compared with just below the cutoff.
Improved Patient Satisfaction With Skin After Treatment of Cheek Skin Roughness and Fine Lines With VYC-12L: Participant-Reported Outcomes From a Prospective, Randomized Study
Authors: Chiu Annie , Montes Jose Raul , Munavalli Girish , Shamban Ava , Chawla Smita , Abrams Steve
Published: April 2023

Background

VYC-12L is a hyaluronic acid filler to improve skin quality. A prospective study showed safety and effectiveness of VYC-12L for improving cheek skin smoothness and fine lines.

Objectives

To report participant-reported outcomes, subgroup analyses, and physician experience from the prospective study.

Methods

Adults with moderate to severe Allergan Cheek Skin Smoothness (ACSS) scale scores were randomized 2:1 to VYC-12L or control (no treatment with optional treatment). Participant assessments included FACE-Q Satisfaction With Skin, FACE-Q Appraisal of Lines, natural look and feel, the Global Aesthetic Improvement Scale (GAIS), and safety. Subgroup analyses examined ACSS responder rate (≥1-grade improvement from baseline to 1 month).

Results

FACE-Q Satisfaction With Skin overall mean scores improved from baseline to 1 month posttreatment by 32.0 and 1.4 in the VYC-12L and control groups, respectively. FACE-Q Appraisal of Lines overall mean scores improved from baseline to 1 month posttreatment by 23.3 and 0.4 in VYC-12L and control, respectively. Treated participants had high median scores (≥9.0) of natural look and feel of their cheek skin. GAIS responder rate was high at Month 1 (85.5%; 95% CI, 79.3%-91.7%) and through Month 6 (83.1%; 95% CI, 76.5%-89.7%). Mean participant-rated pain scores were low (<3). The most common injection site reactions were redness, swelling, and lumps/bumps; most resolved within 3 days. Subgroup analyses showed significant differences in ACSS responder rate between VYC-12L and control groups 1 month posttreatment. Physician injectors reported that VYC-12L was easily injected at the superficial skin and integrated quickly.

Conclusions

VYC-12L treatment produced significant improvements in satisfaction with skin and cheek skin smoothness, as measured by participant-reported outcome measures.

Level of Evidence: 2
Heterologous expression of the lectin CmRlec from Cordyceps militaris (Cordycipitaceae, Ascomycota) in Escherichia coli
Authors: Ono Akiko , Zhang Jili , Tanaka Yuki , Sato Chihiro , Yoda Akiyoshi , Ogata Makoto , Nomura Takahito , Suzuki Tomohiro
Published: April 2023

Ascomycete lectins may play an important role in their life cycle. In this report, we mined a ricin B-type lectin, named CmRlec, from the Cordyceps militaris genome by homology search. Furthermore, we succeeded in the soluble expression of CmRlec using β-glucuronidase as a solubilization tag and demonstrated that this lectin is a novel chitin-recognizing lectin.
Evolink: a phylogenetic approach for rapid identification of genotype–phenotype associations in large-scale microbial multispecies data
Authors: Yang Yiyan , Jiang Xiaofang
Published: April 2023

Motivation

The discovery of the genetic features that underly a phenotype is a fundamental task in microbial genomics. With the growing number of microbial genomes that are paired with phenotypic data, new challenges, and opportunities are arising for genotype-phenotype inference. Phylogenetic approaches are frequently used to adjust for the population structure of microbes but scaling them to trees with thousands of leaves representing heterogeneous populations is highly challenging. This greatly hinders the identification of prevalent genetic features that contribute to phenotypes that are observed in a wide diversity of species.

Results

In this study, Evolink was developed as an approach to rapidly identify genotypes associated with phenotypes in large-scale multispecies microbial datasets. Compared with other similar tools, Evolink was consistently among the top-performing methods in terms of precision and sensitivity when applied to simulated and real-world flagella datasets. In addition, Evolink significantly outperformed all other approaches in terms of computation time. Application of Evolink on flagella and gram-staining datasets revealed findings that are consistent with known markers and supported by the literature. In conclusion, Evolink can rapidly detect phenotype-associated genotypes across multiple species, demonstrating its potential to be broadly utilized to identify gene families associated with traits of interest.

Availability and implementation

The source code, docker container, and web server for Evolink are freely available at https://github.com/nlm-irp-jianglab/Evolink.
Embryonic factors mediate the maternal age-induced programming of offspring postnatal behavior in mice
Authors: Ziętek Marta Marlena , Sampino Silvestre
Published: April 2023

Advanced maternal age is associated with adverse pregnancy and offspring outcomes, including neurodevelopmental disorders. While age-related oocyte and embryonic abnormalities may underlie this association, the aged maternal uterine environment also plays an important role in offspring development and survival. The aim of this study was to evaluate the contribution of maternal age-related embryonic and uterine factors on pregnancy and offspring behavior, by using a model of reciprocal embryo transfer between old and young female mice. Pregnancies were obtained by transferring embryos collected from either old (9–14 months) or young (3–4 months) C57BL/6J female mice to either young or old recipients. The results showed that embryos from old and young donors have comparable developmental potential when transferred to young recipients, whereas no pregnancies were obtained by transferring embryos of young females to old recipients. Moreover, the offspring conceived by aged females displayed altered ultrasonic vocalization and learning skills compared to the progeny of young females, even though they were both prenatally and postnatally fostered by young recipients. These results indicate that maternal factors mostly determine the occurrence of age-related pregnancy complications, whereas the long-term effects of maternal aging on the offspring’s behavior could be already established at pre-implantation stages and depend on embryonic factors.
Experimental evidence that behavioral nudges in citizen science projects can improve biodiversity data
Authors: Callaghan Corey T , Thompson Maureen , Woods Adam , Poore Alistair G B , Bowler Diana E , Samonte Fabrice , Rowley Jodi J L , Roslan Nadiah , Kingsford Richard T , Cornwell William K , Major Richard E
Published: April 2023

One way to improve the value of citizen science data for a specific aim is through promoting adaptive sampling, where the marginal value of a citizen science observation is dependent on existing data collected to address a specific question. Adaptive sampling could increase sampling at places or times—using a dynamic and updateable framework—where data are expected to be most informative for a given ecological question or conservation goal. We used an experimental approach to test whether the participants in a popular Australian citizen science project—FrogID—would follow an adaptive sampling protocol aiming to maximize understanding of frog diversity. After a year, our results demonstrated that these citizen science participants were willing to adopt an adaptive sampling protocol, improving the sampling of biodiversity consistent with a specific aim. Such adaptive sampling can increase the value of citizen science data for biodiversity research and open up new avenues for citizen science project design.
Technological innovations enhance invasive species management in the anthropocene
Authors: Fricke Rachel M , Olden Julian D
Published: April 2023

Curbing the introduction, spread, and impact of invasive species remains a longstanding management and policy prerogative. In recent decades, globalization and environmental change have further complicated efforts to execute science-based actions that address these challenges. New technologies offer exciting opportunities to advance invasion science knowledge, enhance management actions, and guide policy strategies but are increasingly complex and inaccessible to most practitioners. In the present article, we offer a synthetic perspective of innovative technologies with applications for invasive species management related to pathway intervention, spread prevention, impact mitigation, and public engagement. We also describe tools that augment big data processing required by some methods (e.g., remote sensing, mobile application data), such as automated image and text recognition built on machine learning. Finally, we explore challenges and opportunities for successful integration of emerging technologies into invasive species management, focusing on pipelines that enable practitioners to integrate tools into practice while recognizing logistic and financial constraints.
The Generalized Pustular Psoriasis Physician Global Assessment (GPPGA) score: online assessment and validation study of a specific measure of GPP disease activity
Authors: Burden A David , Bachelez Hervé , Choon Siew Eng , Marrakchi Slaheddine , Tsai Tsen-Fang , Turki Hamida , Morita Akimichi , Lebwohl Mark G , Bissonnette Robert , Zheng Min , Anadkat Milan J , Navarini Alexander A , Tang Ming , Thoma Christian , Duffin Kristina Callis
Published: April 2023

Generalized pustular psoriasis (GPP), a rare and potentially life-threatening neutrophilic skin disease, is characterized by recurrent flares of pustulation on nonacral skin with associated erythema, crusting and scaling. There are no agreed or validated measurements for assessing GPP severity or symptom improvement; clinically validated endpoints that incorporate key manifestations of GPP, and are meaningful and reliable for the evaluation of treatment response, are needed.
Functional connectivity in older adults—the effect of cerebral small vessel disease
Authors: Drenth Nadieh , Foster-Dingley Jessica C , Bertens Anne Suzanne , Rius Ottenheim Nathaly , van der Mast Roos C , Rombouts Serge A R B , van Rooden Sanneke , van der Grond Jeroen
Published: April 2023

Ageing is associated with functional reorganization that is mainly characterized by declining functional connectivity due to general neurodegeneration and increasing incidence of disease. Functional connectivity has been studied across the lifespan; however, there is a paucity of research within the older groups (≥75 years) where neurodegeneration and disease prevalence are at its highest. In this cross-sectional study, we investigated associations between age and functional connectivity and the influence of cerebral small vessel disease (CSVD)—a common age-related morbidity—in 167 community-dwelling older adults aged 75–91 years (mean = 80.3 ± 3.8). Resting-state functional MRI was used to determine functional connectivity within ten standard networks and calculate the whole-brain graph theoretical measures global efficiency and clustering coefficient. CSVD features included white matter hyperintensities, lacunar infarcts, cerebral microbleeds, and atrophy that were assessed in each individual and a composite score was calculated. Both main and interaction effects (age*CSVD features) on functional connectivity were studied. We found stable levels of functional connectivity across the age range. CSVD was not associated with functional connectivity measures. To conclude, our data show that the functional architecture of the brain is relatively unchanged after 75 years of age and not differentially affected by individual levels of vascular pathology.
Spatial characterization of tangle-bearing neurons and ghost tangles in the human inferior temporal gyrus with three-dimensional imaging
Authors: Zwang Theodore J , Woost Benjamin , Bailey Joshua , Hoglund Zachary , Richardson Douglas S , Bennett Rachel E , Hyman Bradley T
Published: April 2023

Studies of post-mortem human tissue provide insight into pathological processes, but are inherently limited by practical considerations that limit the scale at which tissue can be examined, and the obvious issue that the tissue reflects only one time point in a continuous disease process. We approached this problem by adapting new tissue clearance techniques to an entire cortical area of human brain, which allows surveillance of hundreds of thousands of neurons throughout the depth of the entire cortical thickness. This approach allows detection of ‘rare’ events that may be difficult to detect in standard 5 micrometre-thick paraffin sections. For example, it is well established that neurofibrillary tangles begin within a neuron, and ultimately, in at least some instances, persist in the brain even after the neuron has died. These are referred to as ‘ghost tangles’, a term that appropriately implies their ‘difficult to see’ ephemeral qualities. We set out to find ghost tangles as one example of the power of the tissue clearance/image analysis techniques to detect rare events, and to learn what happens at the end-point of a tangle’s life history. We were able to identify 8103 tau tangles, 132 465 neurons and 299 640 nuclei in tissue samples from three subjects with severe Alzheimer’s disease (Braak V–VI) and 4 tau tangles, 200 447 neurons and 462 715 nuclei in tissue samples from three subjects with no significant tau pathology (Braak 0–I). Among these data, we located 57 ghost tangles, which makes them only 0.7% of the total tau tangles observed. We found that ghost tangles are more likely to be found in cortical layers 3 and 5 (49/57), with a select few scattered across other layers 1, 2, 4 and 6. This ability to find rare events, such as ghost tangles, in large enough quantities to statistically test their distribution exemplifies how tissue clearing can be used as a powerful tool for studying selective vulnerability or resilience to pathology across brain regions.
Research progress and prospects on hydrogen separation membranes
Authors: Liu Congmin , Zhang Xin , Zhai Junxiang , Li Xuan , Guo Xiuying , He Guangli
Published: April 2023

Membrane separation technologies, with a broad application prospect in the field of hydrogen separation, are characterized by the simplicity of the devices, high energy efficiency and environmental friendliness. The performance of separation membranes is the primary factor that determines the efficiency of hydrogen separation. Therefore, the development of hydrogen separation membranes is always a research focus. This paper presents and reviews the research developments and features of organic membranes, inorganic membranes and hybrid matrix membranes for hydrogen separations. First, the characterization methods of key index parameters of membrane materials are presented. Second, the performance parameters of different types of membrane are compared. Finally, the trend of technological development of different types of membrane materials is forecast.
Using pentamidine to treat cutaneous leishmaniasis in children: a 10-year study in French Guiana
Authors: Heleine Melissa , Elenga Narcisse , Njuieyon Falucar , Martin Elise , Piat Camille , Pansart Chloé , Couppie Pierre , Hernandez Miguel , Demar Magalie , Blaizot Romain
Published: April 2023

There are little data on pentamidine as a treatment for paediatric cutaneous leishmaniasis (CL). The objective of this study was to describe the effectiveness and safety of pentamidine over a 10-year period. Every child seen in French Guiana between 2010 and 2020 with proven CL and treated with pentamidine was included. In total, 55 children met the inclusion criteria – 23 girls and 32 boys. There were 38 patients (38/55, 69%) with a > 50% improvement at 1 month after pentamidine treatment and a complete cure at 3 months; 16 children had a < 50% improvement at 1 month and were given a second dose. Of these 16, 8 showed a complete cure at 3 months, 5 were lost to follow-up and 3 showed therapeutic failure at 3 months. The overall cure rate was 84% (46/55) after one or two doses. In terms of the safety of pentamidine, no severe adverse events (grade ≥ 3) were reported.
Histo-Blood Group Antigen Null Phenotypes Associated With a Decreased Risk of Clinical Rotavirus Vaccine Failure Among Children <2 Years of Age Participating in the Vaccine Impact on Diarrhea in Africa (VIDA) Study in Kenya, Mali, and the Gambia
Authors: Schwartz Lauren M , Oshinsky Jennifer , Reymann Mardi , Esona Mathew D , Bowen Michael D , Jahangir Hossain M , Zaman Syed M A , Jones Joquina Chiquita M , Antonio Martin , Badji Henry , Sarwar Golam , Sow Samba O , Sanogo Doh , Keita Adama Mamby , Tamboura Boubou , Traoré Awa , Onwuchekwa Uma , Omore Richard , Verani Jennifer R , Awuor Alex O , Ochieng John B , Juma Jane , Ogwel Billy , Parashar Umesh D , Tate Jacqueline E , Kasumba Irene N , Tennant Sharon M , Neuzil Kathleen M , Rowhani-Rahbar Ali , Elizabeth Halloran M , Atmar Robert L , Pasetti Marcela F , Kotloff Karen L
Published: April 2023

Background

Previously studied risk factors for rotavirus vaccine failure have not fully explained reduced rotavirus vaccine effectiveness in low-income settings. We assessed the relationship between histo-blood group antigen (HBGA) phenotypes and clinical rotavirus vaccine failure among children <2 years of age participating in the Vaccine Impact on Diarrhea in Africa Study in 3 sub-Saharan African countries.

Methods

Saliva was collected and tested for HBGA phenotype in children who received rotavirus vaccine. The association between secretor and Lewis phenotypes and rotavirus vaccine failure was examined overall and by infecting rotavirus genotype using conditional logistic regression in 218 rotavirus-positive cases with moderate-to-severe diarrhea and 297 matched healthy controls.

Results

Both nonsecretor and Lewis-negative phenotypes (null phenotypes) were associated with decreased rotavirus vaccine failure across all sites (matched odds ratio, 0.30 [95% confidence interval: 0.16–0.56] or 0.39 [0.25–0.62], respectively]. A similar decrease in risk against rotavirus vaccine failure among null HBGA phenotypes was observed for cases with P[8] and P[4] infection and their matched controls. While we found no statistically significant association between null HBGA phenotypes and vaccine failure among P[6] infections, the matched odds ratio point estimate for Lewis-negative individuals was >4.

Conclusions

Our study demonstrated a significant relationship between null HBGA phenotypes and decreased rotavirus vaccine failure in a population with P[8] as the most common infecting genotype. Further studies are needed in populations with a large burden of P[6] rotavirus diarrhea to understand the role of host genetics in reduced rotavirus vaccine effectiveness.
Management of Diarrhea in Young Children in Sub-Saharan Africa: Adherence to World Health Organization Recommendations During the Global Enteric Multisite Study (2007–2011) and the Vaccine Impact of Diarrhea in Africa (VIDA) Study (2015–2018)
Authors: Deichsel Emily L , Keita Adama Mamby , Verani Jennifer R , Powell Helen , Jamka Leslie P , Hossain M Jahangir , Jones Joquina Chiquita M , Omore Richard , Awuor Alex O , Sow Samba O , Sanogo Doh , Tapia Milagritos D , Neuzil Kathleen M , Kotloff Karen L
Published: April 2023

Background

Reducing diarrhea-related morbidity and mortality is a global priority, particularly in low-resource settings. We assessed adherence to diarrhea case management indicators in the Global Enteric Multisite Study (GEMS) and Vaccine Impact of Diarrhea in Africa (VIDA) study.

Methods

GEMS (2007–2010) and VIDA (2015–2018) were age-stratified case-control studies of moderate-to-severe diarrhea (MSD) in children aged <5 years. In this case-only analysis, we included children enrolled in The Gambia, Kenya, and Mali. A case with no dehydration received adherent care at home if they were offered more than usual fluids and at least the same as usual to eat. Children with diarrhea and some dehydration are to receive oral rehydration salts (ORS) in the facility. The recommendation for severe dehydration is to receive ORS and intravenous fluids in the facility. Adherent care in the facility included a zinc prescription independent of dehydration severity.

Results

For home-based management of children with MSD and no signs of dehydration, 16.6% in GEMS and 15.6% in VIDA were adherent to guidelines. Adherence to guidelines in the facility was likewise low during GEMS (some dehydration, 18.5%; severe dehydration, 5.5%). The adherence to facility-based rehydration and zinc guidelines improved during VIDA to 37.9% of those with some dehydration and 8.0% of children with severe dehydration.

Conclusions

At research sites in The Gambia, Kenya, and Mali, suboptimal adherence to diarrhea case management guidelines for children aged <5 years was observed. Opportunities exist for improvement in case management for children with diarrhea in low-resource settings.
A Description of the Statistical Methods for the Vaccine Impact on Diarrhea in Africa (VIDA) Study
Authors: Powell Helen , Liang Yuanyuan , Neuzil Kathleen M , Jamka Leslie P , Nasrin Dilruba , Sow Samba O , Hossain M Jahangir , Omore Richard , Kotloff Karen L
Published: April 2023

Background

Diarrheal diseases remain a health threat to children in low- and middle-income countries. The Vaccine Impact on Diarrhea in Africa (VIDA) study was a 36-month, prospective, matched case-control study designed to estimate the etiology, incidence, and adverse clinical consequences of moderate-to-severe diarrhea (MSD) in children aged 0–59 months. VIDA was conducted following rotavirus vaccine introduction at 3 censused sites in sub-Saharan Africa that participated in the Global Enteric Multicenter Study (GEMS) ∼10 years earlier. We describe the study design and statistical methods of VIDA and where they differ from GEMS.

Methods

We aimed to enroll 8–9 MSD cases every 2 weeks from sentinel health centers in 3 age strata (0–11, 12–23, 24–59 months) and 1 to 3 controls matched by age, sex, date of case enrollment, and village. Clinical, epidemiological, and anthropometric data were collected at enrollment and ∼60 days later. A stool specimen collected at enrollment was analyzed by both conventional methods and quantitative PCR for enteric pathogens. For the matched case-control study, we estimated the population-based, pathogen-specific attributable fraction (AF) and attributable incidence adjusted for age, site, and other pathogens, and identified episodes attributable to a specific pathogen for additional analyses. A prospective cohort study nested within the original matched case-control study allowed assessment of (1) the association between potential risk factors and outcomes other than MSD status and (2) the impact of MSD on linear growth.

Conclusions

GEMS and VIDA together comprise the largest and most comprehensive assessment of MSD conducted to date in sub-Saharan Africa populations at highest risk for morbidity and mortality from diarrhea. The statistical methods used in VIDA have endeavored to maximize the use of available data to produce more robust estimates of the pathogen-specific disease burden that might be prevented by effective interventions.
Shigellain Africa: New Insights From the Vaccine Impact on Diarrhea in Africa (VIDA) Study
Authors: Kasumba Irene N , Badji Henry , Powell Helen , Hossain M Jahangir , Omore Richard , Sow Samba O , Verani Jennifer R , Platts-Mills James A , Widdowson Marc-Alain , Zaman Syed M A , Jones Jennifer , Sen Sunil , Permala-Booth Jasnehta , Nasrin Shamima , Roose Anna , Nasrin Dilruba , Ochieng John Benjamin , Juma Jane , Doh Sanogo , Jones Joquina Chiquita M , Antonio Martin , Awuor Alex O , Sugerman Ciara E , Watson Nora , Focht Christopher , Liu Jie , Houpt Eric , Kotloff Karen L , Tennant Sharon M
Published: April 2023

Background

We evaluated the burden of Shigella spp from children aged 0–59 months with medically attended moderate-to-severe diarrhea and matched controls at sites in Mali, The Gambia, and Kenya participating in the Vaccine Impact on Diarrhea in Africa (VIDA) study from 2015 to 2018.

Methods

Shigella spp were identified using coprocultures and serotyping in addition to quantitative polymerase chain reaction (qPCR). Episode-specific attributable fractions (AFe) for Shigella were calculated using Shigella DNA quantity; cases with AFe ≥0.5 were considered to have shigellosis.

Results

The prevalence of Shigella was determined to be 359 of 4840 (7.4%) cases and 83 of 6213 (1.3%) controls by culture, and 1641 of 4836 (33.9%) cases and 1084 of 4846 (22.4%) controls by qPCR (cycle threshold <35); shigellosis was higher in The Gambia (30.8%) than in Mali (9.3%) and Kenya (18.7%). Bloody diarrhea attributed to Shigella was more common in 24- to 59-month-old children (50.1%) than 0- to 11-month-old infants (39.5%). The Shigella flexneri serogroup predominated among cases (67.6% of isolates), followed by Shigella sonnei (18.2%), Shigella boydii (11.8%), and Shigella dysenteriae (2.3%). The most frequent S. flexneri serotypes were 2a (40.6%), 1b (18.8%), 6 (17.5%), 3a (9.0%), and 4a (5.1%). Drug-specific resistance among 353 (98.3%) Shigella cases with AMR data was as follows: trimethoprim-sulfamethoxazole (94.9%), ampicillin (48.4%), nalidixic acid (1.7%), ceftriaxone (0.3%), azithromycin (0.3%), and ciprofloxacin (0.0%).

Conclusions

A high prevalence of shigellosis continues in sub-Saharan Africa. Strains are highly resistant to commonly used antibiotics while remaining susceptible to ciprofloxacin, ceftriaxone, and azithromycin.
Prevalence ofSalmonellain Stool During the Vaccine Impact on Diarrhea in Africa (VIDA) Study, 2015–2018
Authors: Kasumba Irene N , Powell Helen , Omore Richard , Hossain M Jahangir , Sow Samba O , Ochieng John Benjamin , Badji Henry , Verani Jennifer R , Widdowson Marc-Alain , Sen Sunil , Nasrin Shamima , Permala-Booth Jasnehta , Jones Jennifer A , Roose Anna , Nasrin Dilruba , Sugerman Ciara E , Juma Jane , Awuor Alex , Jones Joquina Chiquita M , Doh Sanogo , Okoi Catherine , Zaman Syed M A , Antonio Martin , Hunsperger Elizabeth , Onyango Clayton , Platts-Mills James , Liu Jie , Houpt Eric , Neuzil Kathleen M , Kotloff Karen L , Tennant Sharon M
Published: April 2023

Background

Non-typhoidal Salmonella (NTS) is a common cause of gastroenteritis in young children, with limited data on NTS serovars and antimicrobial resistance in Africa.

Methods

We determined the prevalence of Salmonella spp. and frequency of antimicrobial resistance among serovars identified in stools of 0–59 month-old children with moderate-to-severe diarrhea (MSD) and controls enrolled in the Vaccine Impact on Diarrhea in Africa (VIDA) Study in The Gambia, Mali, and Kenya in 2015–2018, and compared with data from the Global Enteric Multicenter Study (GEMS; 2007–2010) and the GEMS-1A study (2011). Salmonella spp. was detected by quantitative real-time PCR (qPCR) and culture-based methods. Identification of serovars was determined by microbiological methods.

Results

By qPCR, the prevalence of Salmonella spp. among MSD cases was 4.0%, 1.6%, and 1.9% and among controls was 4.6%, 2.4%, and 1.6% in The Gambia, Mali, and Kenya, respectively, during VIDA. We observed year-to-year variation in serovar distribution and variation between sites. In Kenya, Salmonella enterica serovar Typhimurium decreased (78.1% to 23.1%; P < .001) among cases and controls from 2007 to 2018, whereas serogroup O:8 increased (8.7% to 38.5%; P = .04). In The Gambia, serogroup O:7 decreased from 2007 to 2018 (36.3% to 0%; P = .001) but S. enterica serovar Enteritidis increased during VIDA (2015 to 2018; 5.9% to 50%; P = .002). Only 4 Salmonella spp. were isolated in Mali during all 3 studies. Multidrug resistance was 33.9% in Kenya and 0.8% in The Gambia across all 3 studies. Ceftriaxone resistance was only observed in Kenya (2.3%); NTS isolates were susceptible to ciprofloxacin at all sites.

Conclusions

Understanding variability in serovar distribution will be important for the future deployment of vaccines against salmonellosis in Africa.
The Full Impact of Rotavirus Vaccines in Africa Has Yet to Be Realized
Authors: Steele A Duncan , Armah George E , Mwenda Jason M , Kirkwood Carl D
Published: April 2023

Africa bears the brunt of diarrheal mortality globally. Rotavirus vaccination rates are high across the continent and demonstrate impact on diarrheal disease reduction. Nevertheless, there is room for significant improvement in managing rotavirus vaccine coverage, in access to recognized public services such as appropriate medical care, including oral rehydration therapy and improved water and sanitation.
Etiology, Presentation, and Risk Factors for Diarrheal Syndromes in 3 Sub-Saharan African Countries After the Introduction of Rotavirus Vaccines From the Vaccine Impact on Diarrhea in Africa (VIDA) Study
Authors: Buchwald Andrea G , Verani Jennifer R , Keita Adama Mamby , Jahangir Hossain M , Roose Anna , Sow Samba O , Omore Richard , Doh Sanogo , Jones Joquina Chiquita M , Nasrin Dilruba , Zaman Syed M A , Okoi Catherine , Antonio Martin , Ochieng John B , Juma Jane , Onwuchekwa Uma , Powell Helen , Platts-Mills James A , Tennant Sharon M , Kotloff Karen L
Published: April 2023

Background

Diarrheal disease is heterogeneous, including watery diarrhea (WD) and dysentery, some cases of which become persistent diarrhea (PD). Changes in risk over time necessitate updated knowledge of these syndromes in sub-Saharan Africa.

Methods

The Vaccine Impact on Diarrhea in Africa (VIDA) study was an age-stratified, case-control study of moderate-to-severe diarrhea among children <5 years old in The Gambia, Mali, and Kenya (2015–2018). We analyzed cases with follow-up of about 60 days after enrollment to detect PD (lasting ≥14 days), examined the features of WD and dysentery, and examined determinants for progression to and sequelae from PD. Data were compared with those from the Global Enteric Multicenter Study (GEMS) to detect temporal changes. Etiology was assessed from stool samples using pathogen attributable fractions (AFs), and predictors were assessed using χ2 tests or multivariate regression, where appropriate.

Results

Among 4606 children with moderate-to-severe diarrhea, 3895 (84.6%) had WD and 711 (15.4%) had dysentery. PD was more frequent among infants (11.3%) than in children 12–23 months (9.9%) or 24–59 months (7.3%), P = .001 and higher in Kenya (15.5%) than in The Gambia (9.3%) or Mali (4.3%), P < .001; the frequencies were similar among children with WD (9.7%) and those with dysentery (9.4%). Compared to children not treated with antibiotics, those who received antibiotics had a lower frequency of PD overall (7.4% vs 10.1%, P = .01), and particularly among those with WD (6.3% vs 10.0%; P = .01) but not among children with dysentery (8.5% vs 11.0%; P = .27). For those with watery PD, Cryptosporidium and norovirus had the highest AFs among infants (0.16 and 0.12, respectively), while Shigella had the highest AF (0.25) in older children. The odds of PD decreased significantly over time in Mali and Kenya while increasing significantly in The Gambia.

Conclusions

The burden of PD endures in sub-Saharan Africa, with nearly 10% of episodes of WD and dysentery becoming persistent.
Prevalence, Clinical Severity, and Seasonality of Adenovirus 40/41, Astrovirus, Sapovirus, and Rotavirus Among Young Children With Moderate-to-Severe Diarrhea: Results From the Vaccine Impact on Diarrhea in Africa (VIDA) Study
Authors: Keita Adama Mamby , Doh Sanogo , Sow Samba O , Powell Helen , Omore Richard , Jahangir Hossain M , Ogwel Billy , Ochieng John B , Jones Joquina Chiquita M , Zaman Syed M A , Awuor Alex O , Juma Jane , Nasrin Dilruba , Liu Jie , Traoré Awa , Onwuchekwa Uma , Badji Henry , Sarwar Golam , Antonio Martin , Houpt Eric R , Tennant Sharon M , Kasumba Irene N , Jamka Leslie P , Roose Anna , Platts-Mills James A , Verani Jennifer R , Tate Jacqueline E , Parashar Umesh D , Neuzil Kathleen M , Kotloff Karen L
Published: April 2023

Background

While rotavirus causes severe diarrheal disease in children aged <5 years, data on other viral causes in sub-Saharan Africa are limited.

Methods

In the Vaccine Impact on Diarrhea in Africa study (2015–2018), we analyzed stool from children aged 0–59 months with moderate-to-severe diarrhea (MSD) and without diarrhea (controls) in Kenya, Mali, and The Gambia using quantitative polymerase chain reaction. We derived the attributable fraction (AFe) based on the association between MSD and the pathogen, accounting for other pathogens, site, and age. A pathogen was attributable if the AFe was ≥0.5.

The severity of attributable MSD was defined by a modified Vesikari score (mVS). Monthly cases were plotted against temperature and rainfall to assess seasonality.

Results

Among 4840 MSD cases, proportions attributed to rotavirus, adenovirus 40/41, astrovirus, and sapovirus were 12.6%, 2.7%, 2.9%, and 1.9%, respectively. Attributable rotavirus, adenovirus 40/41, and astrovirus MSD cases occurred at all sites, with mVS of 11, 10, and 7, respectively. MSD cases attributable to sapovirus occurred in Kenya, with mVS of 9. Astrovirus and adenovirus 40/41 peaked during the rainy season in The Gambia, while rotavirus peaked during the dry season in Mali and The Gambia.

Conclusions

In sub-Saharan Africa, rotavirus was the most common cause of MSD; adenovirus 40/41, astrovirus, and sapovirus contributed to a lesser extent among children aged <5 years. Rotavirus- and adenovirus 40/41-attributable MSD were most severe. Seasonality varied by pathogen and location. Efforts to increase the coverage of rotavirus vaccines and to improve prevention and treatment for childhood diarrhea should continue.
Condition-Dependent and Dynamic Impacts of Indoor Masking Policies for Coronavirus Disease 2019 Mitigation: A Nationwide, Interrupted Time-Series Analysis
Authors: Ertem Zeynep , Nelson Richard E , Schechter-Perkins Elissa M , Al-Amery Amera , Zhang Xilin , Branch-Elliman Westyn
Published: April 2023

Background

The effectiveness and sustainability of masking policies as a pandemic control measure remain uncertain. Our aim was to evaluate different masking policy types on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) incidence and to identify factors and conditions impacting effectiveness.

Methods

Nationwide, retrospective cohort study of US counties from 4/4/2020–28/6/2021. Policy impacts were estimated using interrupted time-series models with the masking policy change date (eg, recommended-to-required, no-recommendation-to-recommended, no-recommendation-to-required) modeled as the interruption. The primary outcome was change in SARS-CoV-2 incidence rate during the 12 weeks after the policy change; results were stratified by coronavirus disease 2019 (COVID-19) risk level. A secondary analysis was completed using adult vaccine availability as the policy change.

Results

In total, N = 2954 counties were included (2304 recommended-to-required, 535 no-recommendation-to-recommended, 115 no-recommendation-to-required). Overall, indoor mask mandates were associated with 1.96 fewer cases/100 000/week (cumulative reduction of 23.52/100 000 residents during the 12 weeks after policy change). Reductions were driven by communities with critical and extreme COVID-19 risk, where masking mandated policies were associated with an absolute reduction of 5 to 13.2 cases/100 000 residents/week (cumulative reduction of 60 to 158 cases/100 000 residents over 12 weeks). Impacts in low- and moderate-risk counties were minimal (<1 case/100 000 residents/week). After vaccine availability, mask mandates were not associated with significant reductions at any risk level.

Conclusions

Masking policy had the greatest impact when COVID-19 risk was high and vaccine availability was low. When transmission risk decreases or vaccine availability increases, the impact was not significant regardless of mask policy type. Although often modeled as having a static impact, masking policy effectiveness may be dynamic and condition dependent.
Changes in Population Immunity Against Infection and Severe Disease From Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Variants in the United States Between December 2021 and November 2022
Authors: Klaassen Fayette , Chitwood Melanie H , Cohen Ted , Pitzer Virginia E , Russi Marcus , Swartwood Nicole A , Salomon Joshua A , Menzies Nicolas A
Published: April 2023

Background

Although a substantial fraction of the US population was infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during December 2021–February 2022, the subsequent evolution of population immunity reflects the competing influences of waning protection over time and acquisition or restoration of immunity through additional infections and vaccinations.

Methods

Using a Bayesian evidence synthesis model of reported coronavirus disease 2019 (COVID-19) data (diagnoses, hospitalizations), vaccinations, and waning patterns for vaccine- and infection-acquired immunity, we estimate population immunity against infection and severe disease from SARS-CoV-2 Omicron variants in the United States, by location (national, state, county) and week.

Results

By 9 November 2022, 97% (95%–99%) of the US population were estimated to have prior immunological exposure to SARS-CoV-2. Between 1 December 2021 and 9 November 2022, protection against a new Omicron infection rose from 22% (21%–23%) to 63% (51%–75%) nationally, and protection against an Omicron infection leading to severe disease increased from 61% (59%–64%) to 89% (83%–92%). Increasing first booster uptake to 55% in all states (current US coverage: 34%) and second booster uptake to 22% (current US coverage: 11%) would increase protection against infection by 4.5 percentage points (2.4–7.2) and protection against severe disease by 1.1 percentage points (1.0–1.5).

Conclusions

Effective protection against SARS-CoV-2 infection and severe disease in November 2022 was substantially higher than in December 2021. Despite this high level of protection, a more transmissible or immune evading (sub)variant, changes in behavior, or ongoing waning of immunity could lead to a new SARS-CoV-2 wave.
Clinical utility and prognostic value of right atrial function in severe tricuspid regurgitation: one more piece of the puzzle
Authors: Hinojar Rocio , Fernández-Golfín Covadonga , González Gómez Ariana , García-Martin Ana , Monteagudo Juan Manuel , García Lunar Inés , García Sebastian Cristina , Rivas Sonia , Sanchez Recalde Angel , Zamorano Jose Luis
Published: April 2023

Aims

The optimal management of severe tricuspid regurgitation (TR) remains controversial. While right ventricular systolic function is an established prognostic marker of outcomes, the potential role of right atrial (RA) function is unknown. This study aimed to describe RA function by 2D speckle-tracking echocardiography (STE) in at least severe TR and to evaluate its potential association with cardiovascular outcomes.

Methods and results

Consecutive patients with at least (≥) severe TR (severe, massive, or torrential TR) evaluated in the Heart Valve Clinic following a comprehensive clinical protocol were included. Consecutive control subjects and patients with permanent isolated atrial fibrillation (AF) were included for comparison (control and AF group, respectively). RA function was measured with 2D-STE and two components of RA function were calculated: reservoir (RASr) and contractile (RASct) strain (AutoStrain, Philips Medical Systems the EPIQ system). A combined endpoint of hospital admission due to heart failure (HF) or all-cause mortality was defined. Patients with ≥ severe TR (n = 140) showed lower RASr compared with controls (n = 20) and with the AF group (n = 20) (P < 0.001). Atrial TR showed lower RASr compared with other aetiologies of TR (P < 0.001). After a median follow-up of 2.2 years (IQR: 12–41 months), RASr remained an independent predictor of mortality and HF. A cut-off value of RASr of <9.4% held the best accuracy to predict outcomes.

Conclusion

RA function by 2D-STE independently predicts mortality and HF hospitalizations in patients with ≥ severe TR.
The first reported case of embolic protection device implantation in a patient with prosthetic valve thrombosis treated with thrombolytic therapy: a case report
Authors: Osmonov Damirbek , Saitkulova Aynagul , Yuldashev Gayrat , Nazarov Asan , Tashmamatov Abdiashim
Published: April 2023

Background

Prosthetic valve thrombosis (PVT) is a rare but one of the most dreaded complications of implanted mechanical valves. Although surgery is the first-line treatment modality particularly in symptomatic obstructive mechanical valve thrombosis, it is associated with high rates of morbidity and mortality. Thrombolytic therapy has also been used as an alternative to surgical treatment. The risk for cerebral thromboembolism associated with thrombolytic therapy seems to be the main limitation for its use in left-sided mechanical valve thrombosis. To the best of our knowledge, this is the first case of implantation of embolic protection devices during thrombolytic therapy of PVT.

Case summary

Our report describes management of patient with obstructive PVT of the aortic valve. Fluoroscopy showed an immobile anterior disc of the aortic prosthesis. Transoesophageal echocardiography (TOE) detected the severely restricted prosthetic valve motions and a huge mass at the supravalvular site. A patient had very high surgical risks. Although, thrombolytic treatment was not without risk due to the large thrombus (>10 mm) increasing the risk of thromboembolism. We implanted embolic protection devices into both internal carotid arteries followed by the administration of a thrombolytic therapy with 50 mg Alteplase. After the procedure an embolized thrombus was detected at the apex at the left-sided placed device. There were no signs of transient ischaemic attack nor stroke, and the procedure was ended uneventful. The TOE performed on the next day confirmed successful resolution of the thrombus.

Discussion

Mechanical left-sided prosthetic valve obstruction is a serious complication with high mortality and morbidity and requires urgent therapy. The choice between surgery, thrombolysis, and escalation of anticoagulation is considered on an individual basis. In patients with high surgical risk and high risk of embolization, an embolic protection device may be used in conjunction with thrombolytic therapy to decrease the risk of embolic cerebral events.
Psychological therapies for depression and cardiovascular risk: evidence from national healthcare records in England
Authors: El Baou Céline , Desai Roopal , Cooper Claudia , Marchant Natalie L , Pilling Steve , Richards Marcus , Saunders Rob , Buckman Joshua E J , Aguirre Elisa , John Amber , Stott Joshua
Published: April 2023

Aims

People with depression are up to 72% more at risk to develop cardiovascular disease (CVD) in their lifetime. Evidence-based psychotherapies are first-line interventions for the treatment of depression and are delivered nationally in England through the National Health Service via the Improving Access to Psychological Therapy (IAPT) primary care programme. It is currently unknown whether positive therapy outcomes may be associated with cardiovascular risk reduction. This study aimed to examine the association between psychotherapy outcomes for depression and incident CVD.

Methods and results

A cohort of 636 955 individuals who have completed a course of psychotherapy was built from linked electronic healthcare record databases of national coverage in England: the national IAPT database, the Hospital Episode Statistics (HES) database, and the HES–ONS (Office of National Statistics) mortality database. Multivariable Cox models adjusting for clinical and demographic covariates were run to estimate the association between reliable improvement from depression and the risk of subsequent incidence of cardiovascular events. After a median follow-up of 3.1 years, reliable improvement from depression symptoms was associated with a lower risk of new onset of any CVD [hazard ratio (HR): 0.88, 95% confidence interval (CI): 0.86, 0.89], coronary heart disease (HR: 0.89, 95% CI: 0.86, 0.92), stroke (HR: 0.88, 95% CI: 0.83, 0.94), and all-cause mortality (HR: 0.81, 95% CI: 0.78, 0.84). This association was stronger in the under 60 compared with the over 60 for all outcomes. Results were confirmed in sensitivity analyses.

Conclusion

Management of depression through psychological interventions may be associated with reduced risk of CVD. More research is needed to understand the causality of these associations.
Treatment of pathophysiologic propagation outside of the pulmonary veins in retreatment of atrial fibrillation patients: RECOVER AF study
Authors: Betts Timothy R , Good Wilson W , Melki Lea , Metzner Andreas , Grace Andrew , Verma Atul , Murray Stephen , James Simon , Wong Tom , Boersma Lucas V A , Steven Daniel , Sultan Arian , Busch Sonia , Neužil Petr , de Asmundis Carlo , Lee Justin , Szili-Török Tamás
Published: April 2023

Aims

RECOVER AF evaluated the performance of whole-chamber non-contact charge-density mapping to guide the ablation of non-pulmonary vein (PV) targets in persistent atrial fibrillation (AF) patients following either a first or second failed procedure.

Methods and results

RECOVER AF was a prospective, non-randomized trial that enrolled patients scheduled for a first or second ablation retreatment for recurrent AF. The PVs were assessed and re-isolated if necessary. The AF maps were used to guide the ablation of non-PV targets through elimination of pathologic conduction patterns (PCPs). Primary endpoint was freedom from AF on or off antiarrhythmic drugs (AADs) at 12 months. Patients undergoing retreatment with the AcQMap System (n = 103) were 76% AF-free at 12 months [67% after single procedure (SP)] on or off AADs (80% free from AF on AADs). Patients who had only received a pulmonary vein isolation (PVI) prior to study treatment of non-PV targets with the AcQMap System were 91% AF-free at 12 months (83% SP). No major adverse events were reported.

Conclusion

Non-contact mapping can be used to target and guide the ablation of PCPs beyond the PVs in persistent AF patients returning for a first or second retreatment with 76% freedom from AF at 12 months. The AF freedom was particularly high, 91% (43/47), for patients enrolled having only a prior de novo PVI, and freedom from all atrial arrhythmias for this cohort was 74% (35/47). These early results are encouraging and suggest that guiding individualized targeted ablation of PCPs may therefore be advantageous to target at the earliest opportunity in patients with persistent AF.