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1.
Phys Med ; 124: 103422, 2024 Jul 08.
Article in English | MEDLINE | ID: mdl-38981169

ABSTRACT

PURPOSE: Interdisciplinary scientific communities have shown large interest to achieve a mechanistic description of radiation-induced biological damage, aiming to predict biological results produced by different radiation quality exposures. Monte Carlo track-structure simulations are suitable and reliable for the study of early DNA damage induction used as input for assessing DNA damage. This study presents the most recent improvements of a Geant4-DNA simulation tool named "dsbandrepair". METHODS: "dsbandrepair" is a Monte Carlo simulation tool based on a previous code (FullSim) that estimates the induction of early DNA single-strand breaks (SSBs) and double-strand breaks (DSBs). It uses DNA geometries generated by the DNAFabric computational tool for simulating the induction of early single-strand breaks (SSBs) and double-strand breaks (DSBs). Moreover, the new tool includes some published radiobiological models for survival fraction and un-rejoined DSB. Its application for a human fibroblast cell and human umbilical vein endothelial cell containing both heterochromatin and euchromatin was conducted. In addition, this new version offers the possibility of using the new IRT-syn method for computing the chemical stage. RESULTS: The direct and indirect strand breaks, SSBs, DSBs, and damage complexity obtained in this work are equivalent to those obtained with the previously published simulation tool when using the same configuration in the physical and chemical stages. Simulation results on survival fraction and un-rejoined DSB are in reasonable agreement with experimental data. CONCLUSIONS: "dsbandrepair" is a tool for simulating DNA damage and repair, benchmarked against experimental data. It has been released as an advanced example in Geant4.11.2.

2.
Beilstein J Nanotechnol ; 15: 719-732, 2024.
Article in English | MEDLINE | ID: mdl-38919168

ABSTRACT

A TiO2/graphene quantum dots composite (TiO2/GQDs) obtained by in situ synthesis of GQDs, derived from coffee grounds, and peroxo titanium complexes was used as electrode modifier in the simultaneous electrochemical determination of uric acid and hypoxanthine. The TiO2/GQDs material was characterized by photoluminescence, X-ray diffraction, Raman spectroscopy, high-resolution transmission electron microscopy, and energy-dispersive X-ray mapping. The TiO2/GQDs-GCE exhibits better electrochemical activity for uric acid and hypoxanthine than GQDs/GCE or TiO2/GCE in differential pulse voltammetry (DPV) measurements. Under optimized conditions, the calibration plots were linear in the range from 1.00 to 15.26 µM for both uric acid and hypoxanthine. The limits of detection of this method were 0.58 and 0.68 µM for uric acid and hypoxanthine, respectively. The proposed DPV method was employed to determine uric acid and hypoxanthine in urine samples with acceptable recovery rates.

3.
Nat Commun ; 15(1): 3947, 2024 May 10.
Article in English | MEDLINE | ID: mdl-38729951

ABSTRACT

Gram-negative bacteria (GNB) are a major cause of neonatal sepsis in low- and middle-income countries (LMICs). Although the World Health Organization (WHO) reports that over 80% of these sepsis deaths could be prevented through improved treatment, the efficacy of the currently recommended first- and second-line treatment regimens for this condition is increasingly affected by high rates of drug resistance. Here we assess three well known antibiotics, fosfomycin, flomoxef and amikacin, in combination as potential antibiotic treatment regimens by investigating the drug resistance and genetic profiles of commonly isolated GNB causing neonatal sepsis in LMICs. The five most prevalent bacterial isolates in the NeoOBS study (NCT03721302) are Klebsiella pneumoniae, Acinetobacter baumannii, E. coli, Serratia marcescens and Enterobacter cloacae complex. Among these isolates, high levels of ESBL and carbapenemase encoding genes are detected along with resistance to ampicillin, gentamicin and cefotaxime, the current WHO recommended empiric regimens. The three new combinations show excellent in vitro activity against ESBL-producing K. pneumoniae and E. coli isolates. Our data should further inform and support the clinical evaluation of these three antibiotic combinations for the treatment of neonatal sepsis in areas with high rates of multidrug-resistant Gram-negative bacteria.


Subject(s)
Acinetobacter baumannii , Anti-Bacterial Agents , Gram-Negative Bacteria , Gram-Negative Bacterial Infections , Klebsiella pneumoniae , Microbial Sensitivity Tests , Neonatal Sepsis , Humans , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/pharmacology , Neonatal Sepsis/microbiology , Neonatal Sepsis/drug therapy , Infant, Newborn , Gram-Negative Bacteria/drug effects , Gram-Negative Bacteria/genetics , Gram-Negative Bacteria/isolation & purification , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/microbiology , Acinetobacter baumannii/drug effects , Acinetobacter baumannii/isolation & purification , Acinetobacter baumannii/genetics , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/isolation & purification , Klebsiella pneumoniae/genetics , Amikacin/pharmacology , Amikacin/therapeutic use , Fosfomycin/pharmacology , Fosfomycin/therapeutic use , beta-Lactamases/genetics , beta-Lactamases/metabolism , Escherichia coli/drug effects , Escherichia coli/genetics , Escherichia coli/isolation & purification , Developing Countries , Drug Resistance, Multiple, Bacterial/genetics , Drug Therapy, Combination , Serratia marcescens/drug effects , Serratia marcescens/genetics , Serratia marcescens/isolation & purification , Enterobacter cloacae/drug effects , Enterobacter cloacae/genetics , Enterobacter cloacae/isolation & purification , Bacterial Proteins/genetics , Bacterial Proteins/metabolism
4.
J Interpers Violence ; : 8862605241245375, 2024 Apr 15.
Article in English | MEDLINE | ID: mdl-38622887

ABSTRACT

Although socioeconomic inequality has been identified as a significant factor for violence against women, the connection between these two variables has not been widely recognized and addressed in many countries. This study aims to quantify the degree of socioeconomic inequalities in intimate partner violence (IPV) in Vietnam and investigate the contribution of each determinant factor that contributes to the observed inequality. We utilized the Vietnamese National Survey on Domestic Violence against Women (N = 4,019) for the analysis. Household wealth was used as a proxy for socioeconomic status. We used a concentration index to quantify the degree of socioeconomic inequality in emotional, physical, or sexual violence and a combination of these three types of violence. We further decomposed the concentration index to identify the contribution of each determinant to the observed inequality in IPV. We found that the prevalence of IPV was significantly concentrated among the worse-off across all types of IPV and that disparities in husband's occupation (48%), women's education (39%), husband's education (38%), and class (34%) were the primary factors contributing to increased inequalities in IPV. Our results indicated that higher education and engagement in skilled jobs were highly concentrated among the better-off, creating unequal distribution of these variables across wealth. Policy could mitigate the inequality in IPV by expanding women's access to education and economic opportunities. However, interventions should target both men and women and within couples because husband's characteristics also play an important role in explaining socioeconomic inequalities in IPV.

5.
R Soc Open Sci ; 11(3): 231836, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38545616

ABSTRACT

Research into nanomaterials yields numerous exceptional applications in contemporary science and technology. The subject of this investigation is a one-dimensional nanostructure, six atoms wide, featuring hydrogen-functionalized edges. The theoretical foundation of this study relies on Density Functional Theory (DFT) and is executed through the utilization of the Vienna Ab initio Simulation Package (VASP). The outcomes demonstrate the stability of adsorption configurations, along with the preservation of a hexagonal honeycomb lattice. The pristine configuration, characterized by a wide bandgap, is well-suited for optoelectronic applications, whereas adsorption configurations find their application in gas sensing. Nitrogen (N) adsorption transforms the semiconducting system into a semimetallic one, with the spin-up state showing semiconductor characteristics and the spin-down state exhibiting metallic attributes. The intricate multi-orbital hybridization is explored through the analysis of partial states. While the pristine system remains non-magnetic, N adsorption introduces a magnetic moment of 0.588 µB. The examination of charge density differences indicates a significant charge transfer from N to the CGe substrate surface. Optical properties are systematically investigated, encompassing the dielectric function, absorption coefficient and electron-hole density. Notably, the real part of the dielectric function exhibits negative values, a result that holds promise for future communication applications.

6.
J Phys Condens Matter ; 36(19)2024 Feb 14.
Article in English | MEDLINE | ID: mdl-38316058

ABSTRACT

Emerging materials, particularly nanomaterials, constitute an enduring focal point of scientific inquiry, with quantum dots being of particular interest. This investigation is centered on elucidating the exceptional structural, electromagnetic, and optical characteristics of hexagonal boron nitride (h-BN) quantum dots and h-BN quantum dots doped with carbon (C) and germanium (Ge). The employed methodology in this study hinges on density functional theory coupled with the Vienna Ab initio simulation package. The outcomes of this research unveil the structural stability of hexagonal honeycomb structures upon optimization. Comprehensive examinations encompassing structural properties, electromagnetic characteristics, and charge density variations have been systematically conducted. Furthermore, this work delves into the elucidation of multi-orbital hybridizations that give rise toσbonds andπbonds. Notably, the outcomes of the optical property analysis divulge intriguing observations. Specifically, the absorption coefficient exhibits zero values within select energy ranges within the visible light spectrum, a phenomenon observed in both pristine and C-doped configurations. This discovery underscores the material's optical transparency at these specific radiation energies. Additionally, the 0xand 0ycomponents of the dielectric function display negative values across particular energy ranges, a characteristic that holds significant promise for potential applications in nanotechnology communications, offering minimal energy loss.

7.
Prev Med Rep ; 39: 102635, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38348218

ABSTRACT

Objective: Comprehensive investigations of correlations between subnational socioeconomic factors and trends in mortality and lifestyle are important for addressing public health problems. Methods: Forty-seven prefectures in Japan were divided into quartiles based on the proportion of public assistance recipients (PPAR). Age-standardized mortality from all causes, cancer, heart disease, and stroke in each prefecture were averaged for these quartiles in 2000, 2005, 2010, and 2015. Data from the National Health and Nutrition Survey were obtained for the following periods: 1999-2001, 2003-2005, 2007-2009, 2012, and 2016. Body mass index (BMI), intake of total energy, vegetable and salt, step count, and prevalence of current smoking and drinking for individuals aged 40-69 years age range were standardized for each prefecture and averaged by quartile. A two-way analysis of variance was used to assess differences in mortality and lifestyle across different years or periods, and quartiles. Results: Mortality rates decreased, with the first (lowest) quartile showing the lowest rates, across all causes, cancer and heart diseases in both sexes. BMI exhibited an increase in men, whereas, BMI in women and other lifestyle factors in both sexes, excluding smoking and drinking in women, exhibited a decrease. BMI, vegetable and salt intake, total energy intake in men, and smoking in women varied across quartiles. Lower quartiles exhibited lower BMI and smoking prevalence but higher energy, vegetables, and salt intake. Conclusions: PPAR exhibited favorable trends and significant differences in mortality related to all causes, cancer and heart disease across both sexes, along with BMI among women.

8.
PeerJ Comput Sci ; 9: e1559, 2023.
Article in English | MEDLINE | ID: mdl-38077608

ABSTRACT

The analysis and communication of underwater images are often impeded by various elements such as blur, color cast, and noise. Existing restoration methods only address specific degradation factors and struggle with complex degraded images. Furthermore, traditional convolutional neural network (CNN) based approaches may only restore local color while ignoring global features. The proposed hybrid attention network combining CNN and Transformer focuses on addressing these issues. CNN captures local features and the Transformer uses multi-head self-attention to model global relationships. The network also incorporates degraded channel attention and supervised attention mechanisms to refine relevant features and correlations. The proposed method fared better than existing methods in a variety of qualitative criteria when evaluated against the public EUVP dataset of underwater images.

9.
J Hematol Oncol ; 16(1): 117, 2023 12 12.
Article in English | MEDLINE | ID: mdl-38087365

ABSTRACT

BACKGROUND: T-cell retargeting to eliminate CEACAM5-expressing cancer cells via CEACAM5xCD3 bispecific antibodies (BsAbs) showed limited clinical activity so far, mostly due to insufficient T-cell activation, dose-limiting toxicities, and formation of anti-drug antibodies (ADA). METHODS: We present here the generation and preclinical development of NILK-2301, a BsAb composed of a common heavy chain and two different light chains, one kappa and one lambda, determining specificity (so-called κλ body format). RESULTS: NILK-2301 binds CD3ɛ on T-cells with its lambda light chain arm with an affinity of ≈100 nM, and the CEACAM5 A2 domain on tumor cells by its kappa light chain arm with an affinity of ≈5 nM. FcγR-binding is abrogated by the "LALAPA" mutation (Leu234Ala, Leu235Ala, Pro329Ala). NILK-2301 induced T-cell activation, proliferation, cytokine release, and T-cell dependent cellular cytotoxicity of CEACAM5-positive tumor cell lines (5/5 colorectal, 2/2 gastric, 2/2 lung), e.g., SK-CO-1 (Emax = 89%), MKN-45 (Emax = 84%), and H2122 (Emax = 97%), with EC50 ranging from 0.02 to 0.14 nM. NILK-2301 binds neither to CEACAM5-negative or primary colon epithelial cells nor to other CEACAM family members. NILK-2301 alone or in combination with checkpoint inhibition showed activity in organotypic tumor tissue slices and colorectal cancer organoid models. In vivo, NILK-2301 at 10 mg/kg significantly delayed tumor progression in colon- and a pancreatic adenocarcinoma model. Single-dose pharmacokinetics (PK) and tolerability in cynomolgus monkeys at 0.5 or 10 mg/kg intravenously or 20 mg subcutaneously showed dose-proportional PK, bioavailability ≈100%, and a projected half-life in humans of 13.1 days. NILK-2301 was well-tolerated. Data were confirmed in human FcRn TG32 mice. CONCLUSIONS: In summary, NILK-2301 combines promising preclinical activity and safety with lower probability of ADA-generation due to its format compared to other molecules and is scheduled to enter clinical testing at the end of 2023.


Subject(s)
Adenocarcinoma , Antibodies, Bispecific , Pancreatic Neoplasms , Humans , Animals , Mice , Antibodies, Bispecific/pharmacology , Antibodies, Bispecific/therapeutic use , Adenocarcinoma/drug therapy , Pancreatic Neoplasms/drug therapy , Cell Line, Tumor , Immunotherapy , CD3 Complex , Carcinoembryonic Antigen , GPI-Linked Proteins
10.
J Allergy Clin Immunol Glob ; 2(4): 100148, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37781664

ABSTRACT

We report the case of a patient with eosinophilic granulomatosis with polyangiitis and unexplained thrombocytopenia that culminated in a fatal intracerebral hemorrhage. Because vessel damage associated with thrombocytopenia could be the leading cause of fatal hemorrhage, more urgent treatment of thrombocytopenia should be performed in such cases.

11.
BMC Womens Health ; 23(1): 537, 2023 10 16.
Article in English | MEDLINE | ID: mdl-37845693

ABSTRACT

BACKGROUND: This research investigated the determinants of the number of family planning consumers in Kenya, Nigeria and Uganda, with a focus on outlet's and provider's characteristics which are important factors influencing the choice of using contraceptive methods but largely unexplored in previous literature. METHODS: We utilized a unique panel survey on outlet's in Kenya (n = 1,321), Nigeria (n = 1,255) and Uganda (n = 842), which is part of the Consumer Market for Family Planning conducted in between 2019 and 2020, for the analysis of the pooled data (n = 3,418) and individual country. Random effects Poisson regressions were performed. RESULTS: The pooled data results showed that the expected number of consumers were significantly lower in Nigeria and Uganda than in Kenya, and that working experience (provider's characteristics), types of stores, duration of providing family planning services, participations in community outreach and host community events, and sign of family planning services (outlet's characteristics) were significant determinants of the number of customers. The results for each country revealed interesting similarities and differences in the determinants across the three countries. CONCLUSIONS: This study sheds light on the relationship between the number of family planning customers and outlet's and provider's characteristics, thus providing informative evidence-based to on-going debates on the coverage of family planning services, which is still insufficient in developing countries. As a result, the government's family planning expenditures should instead prioritize small, private enterprises such as pharmacies or drug stores. Furthermore, it is critical to focus on several critical tasks to improve the qualities of outlets and providers to attract customers, such as ensuring that they are eye-catching, advertising FP services, have professional credentials, fulfil providers' obligations to counsel contraceptive users, provide long-term services and community care, and have female providers.


Subject(s)
Contraception , Family Planning Services , Female , Humans , Kenya , Nigeria , Uganda
12.
Article in English | MEDLINE | ID: mdl-37589171

ABSTRACT

Rod-shaped Gram-stain-negative, aerobic bacterial strains, designated PC14 and PC15T, were isolated from a forest soil sample collected in Pyeongchang county, Gangwon-do, Republic of Korea. Strains PC14 and PC15T grew at 15-37 °C (optimum, 28-30 °C in tryptone soya agar and Mueller-Hinton agar), hydrolysed chitin and casein, and tolerated pH 8.5 and 2 % (w/v) NaCl. The strains were most closely related to members of the genus Chitinophaga, namely Chitinophaga arvensicola DSM 3695T (98.4 %), Chitinophaga longshanensis Z29T (98.3 %), Chitinophaga ginsengisegetis Gsoil 040T (97.8 %), Chitinophaga polysaccharea MRP-15T (97.8 %) and Chitinophaga niastensis JS16-4T (97.7 %). The type strain grew well on conventional commercial media in the laboratory, including tryptone soya agar, Mueller-Hinton agar, Reasoner's 2A agar, nutrient agar and Luria-Bertani agar. The major polar lipid profile comprised phosphatidylethanolamine, an unidentified aminolipid and unidentified polar lipids. The major respiratory quinone was menaquinone-7. The main fatty acids were iso-C15:0, C16:1 ω5c, C16:0 3-OH, iso-C15:0 3-OH and iso-C17:0 3-OH. The DNA G+C content of the isolated strain based on the whole genome sequence was 46.6 mol%. The average nucleotide identity and digital DNA-DNA hybridization values between strains PC14 and PC15T and the reference type strains ranged from 71.0 to 76.5 %, and from 20.3 to 20.7 %, respectively. Based on phenotypic, chemotypic and genotypic evidence, strain PC15T could be differentiated phylogenetically and phenotypically from the recognized species of the genus Chitinophaga. Therefore, strain PC15T is considered to represent a novel species, for which the name Chitinophaga nivalis sp. nov. is proposed. The type strain is PC15T (=KACC 22893T=JCM 35788T).


Subject(s)
Fatty Acids , Gammaproteobacteria , Agar , Base Composition , Fatty Acids/chemistry , Phylogeny , Sequence Analysis, DNA , RNA, Ribosomal, 16S/genetics , DNA, Bacterial/genetics , Bacterial Typing Techniques , Republic of Korea , Forests
13.
Prev Med Rep ; 35: 102348, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37576843

ABSTRACT

In Japan, trends in mortality and lifestyle have not been fully investigated according to subnational socioeconomic factors. Forty-seven prefectures (subnational units) were divided into quartiles by annual per capita prefectural income. Age-standardized mortality from all causes, cancer, heart disease, and stroke was averaged by quartile in 1995, 2000, 2005, 2010, and 2015. Data from the National Health and Nutrition Survey were obtained for periods 1 (1995-1997), 2 (1999-2001), 3 (2003-2005), 4 (2007-2009), 5 (2012), and 6 (2016). Body mass index (BMI), the intake of vegetables and salt, the number of steps, and the prevalence of current smoking and drinking for the 40-69-year age range were standardized by 10-year age groups in the 2010 Japanese population and were averaged by quartile. Differences in mortality and lifestyle by year and period, and quartile were tested using a two-way analysis of variance. Mortality decreased in both sexes and mortality in men from all causes, cancer, and stroke differed by quartile, with mortality highest in the first (lowest) quartile. BMI in men and smoking prevalence in women increased, whereas remaining lifestyle factors except for the prevalence of drinking decreased in women. BMI and the number of steps in both sexes and current smoking prevalence in women differed by quartile, with lower quartiles showing a higher BMI and fewer step counts. In conclusion, favorable trends and significant differences in mortality from all causes, cancer, and stroke in men and BMI in women were observed by per capita prefectural income level.

15.
J Phys Condens Matter ; 35(38)2023 Jun 23.
Article in English | MEDLINE | ID: mdl-37321257

ABSTRACT

With the continuous development of nanotechnology, the search for new material structures plays a crucial role. Silicene nanoribbons (SiNRs) are one-dimensional materials that hold promise for numerous potential applications in the future. The electric and optical properties of C, Ge-doped armchair SiNRs are investigated in this study using density functional theory. All the doped configurations are stable and maintain the honeycomb hexagonal structure after optimization. Doping with C yields flatter structures, while doping with Ge yields larger buckling heights. The C 1-1 doping configuration is highlighted because its band gap is extended up to 2.35 eV, making it an ideal candidate for potential optoelectronic applications. The charge distribution, charge density difference, and hybridization of multiple orbitals are also systematically studied. The optical properties reveal the differences between C and Ge doping, with a clear anisotropy observed. Strong absorption occurs at high electromagnetic wave energies, while the absorption coefficient rapidly decreases in the long-wavelength range. The study of electron-hole density shows good agreement with the energy band structure, where electron-hole pairs only exist when the excitation energy is greater than the bandgap width, and not all excitation energy values give rise to electron-hole pairs. This study contributes a small part to creating potential applications in nanotechnology.


Subject(s)
Nanotubes, Carbon , Electricity , Anisotropy , Electrons , Nanotechnology
16.
Phys Med ; 112: 102613, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37356419

ABSTRACT

PURPOSE: This study aimed to develop a computational environment for the accurate simulation of human cancer cell irradiation using Geant4-DNA. New cell geometrical models were developed and irradiated by alpha particle beams to induce DNA damage. The proposed approach may help further investigation of the benefits of external alpha irradiation therapy. METHODS: The Geant4-DNA Monte Carlo (MC) toolkit allows the simulation of cancer cell geometries that can be combined with accurate modelling of physical, physicochemical and chemical stages of liquid water irradiation, including radiolytic processes. Geant4-DNA is used to calculate direct and non-direct DNA damage yields, such as single and double strand breaks, produced by the deposition of energy or by the interaction of DNA with free radicals. RESULTS: In this study, the "molecularDNA" example application of Geant4-DNA was used to quantify early DNA damage in human cancer cells upon irradiation with alpha particle beams, as a function of linear energy transfer (LET). The MC simulation results are compared to experimental data, as well as previously published simulation data. The simulation results agree well with the experimental data on DSB yields in the lower LET range, while the experimental data on DSB yields are lower than the results obtained with the "molecularDNA" example in the higher LET range. CONCLUSION: This study explored and demonstrated the possibilities of the Geant4-DNA toolkit together with the "molecularDNA" example to simulate the helium beam irradiation of cancer cell lines, to quantify the early DNA damage, or even the following DNA damage response.


Subject(s)
Helium , Neoplasms , Humans , Computer Simulation , Linear Energy Transfer , DNA , Monte Carlo Method , DNA Damage , Neoplasms/radiotherapy
17.
Med Mycol ; 61(3)2023 Mar 02.
Article in English | MEDLINE | ID: mdl-36881725

ABSTRACT

Neonatal invasive candidiasis (NIC) has significant morbidity and mortality. Reports have shown a different profile of those neonates affected with NIC and of fluconazole-resistant Candida spp. isolates in low- and middle-income countries (LMICs) compared to high-income countries (HICs). We describe the epidemiology, Candida spp. distribution, treatment, and outcomes of neonates with NIC from LMICs enrolled in a global, prospective, longitudinal, observational cohort study (NeoOBS) of hospitalized infants <60 days postnatal age with sepsis (August 2018-February 2021). A total of 127 neonates from 14 hospitals in 8 countries with Candida spp. isolated from blood culture were included. Median gestational age of affected neonates was 30 weeks (IQR: 28-34), and median birth weight was 1270 gr (interquartile range [IQR]: 990-1692). Only a minority had high-risk criteria, such as being born <28 weeks, 19% (24/127), or birth weight <1000 gr, 27% (34/127). The most common Candida species were C. albicans (n = 45, 35%), C. parapsilosis (n = 38, 30%), and Candida auris (n = 18, 14%). The majority of C. albicans isolates were fluconazole susceptible, whereas 59% of C. parapsilosis isolates were fluconazole-resistant. Amphotericin B was the most common antifungal used [74% (78/105)], followed by fluconazole [22% (23/105)]. Death by day 28 post-enrollment was 22% (28/127). To our knowledge, this is the largest multi-country cohort of NIC in LMICs. Most of the neonates would not have been considered at high risk for NIC in HICs. A substantial proportion of isolates was resistant to first choice fluconazole. Understanding the burden of NIC in LMIC is essential to guide future research and treatment guidelines.


Our study describes neonates from low- and middle-income countries with neonatal invasive candidiasis (NIC). Most of them were outside the groups considered at high risk for NIC described in high-income countries. Candida spp. epidemiology was also different. The mortality was high (22%). Further research in these settings is required.


Subject(s)
Candidiasis, Invasive , Fluconazole , Antifungal Agents/pharmacology , Antifungal Agents/therapeutic use , Birth Weight , Candida , Candida albicans , Candida parapsilosis , Candidiasis, Invasive/drug therapy , Candidiasis, Invasive/epidemiology , Candidiasis, Invasive/microbiology , Candidiasis, Invasive/veterinary , Developing Countries , Drug Resistance, Fungal , Fluconazole/pharmacology , Fluconazole/therapeutic use , Microbial Sensitivity Tests/veterinary , Prospective Studies , Humans , Infant, Newborn , Infant
19.
Singapore Med J ; 64(7): 423-429, 2023 07.
Article in English | MEDLINE | ID: mdl-35706106

ABSTRACT

Introduction: Primary care physicians face the increasing burden of managing multimorbidities in an ageing population. Implementing an integrated care team (ICT) with defined roles and accountability to share consultation tasks is an emerging care model to address this issue. This study compared outcomes with ICT versus usual care for patients with multimorbidities in primary care. Methods: Data was retrospectively extracted from the electronic medical records (EMRs) of consecutive adult Asian patients empanelled to ICT and those in UC at a typical primary care clinic (polyclinic) in eastern Singapore in 2018. The study population had hypertension, and/or hyperlipidaemia and/or type 2 diabetes mellitus (T2DM). Clinical outcomes included the proportion of patients (ICT vs. UC) who attained their treatment goals after 12 months. Process outcomes included the proportion of patients who completed annual diabetic eye and foot screenings, where applicable. Results: Data from 3,302 EMRs (ICT = 1,723, UC = 1,579) from January 2016 to September 2017 was analysed. The ICT cohort was more likely to achieve treatment goals for systolic blood pressure (SBP) (adjusted odds ratio [AOR] = 1.52, 95% confidence interval [CI] = 1.38-1.68), low-density lipoprotein cholesterol (AOR = 1.72, 95% CI = 1.49-1.99), and glycated haemoglobin (AOR = 1.28, 95% CI = 1.09-1.51). The ICT group had higher uptake of diabetic retinal screening (89.1% vs. 83.0%, P < 0.001) and foot screening (85.2% vs. 77.9%, P < 0.001). Conclusion: The ICT model yielded better clinical and process outcomes than UC, with more patients attaining treatment goals.


Subject(s)
Delivery of Health Care, Integrated , Diabetes Mellitus, Type 2 , Noncommunicable Diseases , Adult , Humans , Diabetes Mellitus, Type 2/drug therapy , Retrospective Studies , Noncommunicable Diseases/epidemiology , Noncommunicable Diseases/therapy , Primary Health Care
20.
Singapore medical journal ; : 423-429, 2023.
Article in English | WPRIM (Western Pacific) | ID: wpr-984214

ABSTRACT

INTRODUCTION@#Primary care physicians face the increasing burden of managing multimorbidities in an ageing population. Implementing an integrated care team (ICT) with defined roles and accountability to share consultation tasks is an emerging care model to address this issue. This study compared outcomes with ICT versus usual care for patients with multimorbidities in primary care.@*METHODS@#Data was retrospectively extracted from the electronic medical records (EMRs) of consecutive adult Asian patients empanelled to ICT and those in UC at a typical primary care clinic (polyclinic) in eastern Singapore in 2018. The study population had hypertension, and/or hyperlipidaemia and/or type 2 diabetes mellitus (T2DM). Clinical outcomes included the proportion of patients (ICT vs. UC) who attained their treatment goals after 12 months. Process outcomes included the proportion of patients who completed annual diabetic eye and foot screenings, where applicable.@*RESULTS@#Data from 3,302 EMRs (ICT = 1,723, UC = 1,579) from January 2016 to September 2017 was analysed. The ICT cohort was more likely to achieve treatment goals for systolic blood pressure (SBP) (adjusted odds ratio [AOR] = 1.52, 95% confidence interval [CI] = 1.38-1.68), low-density lipoprotein cholesterol (AOR = 1.72, 95% CI = 1.49-1.99), and glycated haemoglobin (AOR = 1.28, 95% CI = 1.09-1.51). The ICT group had higher uptake of diabetic retinal screening (89.1% vs. 83.0%, P < 0.001) and foot screening (85.2% vs. 77.9%, P < 0.001).@*CONCLUSION@#The ICT model yielded better clinical and process outcomes than UC, with more patients attaining treatment goals.


Subject(s)
Adult , Humans , Diabetes Mellitus, Type 2/drug therapy , Retrospective Studies , Noncommunicable Diseases/therapy , Delivery of Health Care, Integrated , Primary Health Care
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