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1.
Cancer ; 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39352774

RESUMO

BACKGROUND: Health insurance coverage is critical for ensuring access to recommended health care in the United States. This study investigated the associations of health insurance coverage disruptions, also known as coverage churn, and receipt of breast and colorectal cancer screening. METHODS: Adults who were age-eligible and younger than 65 years (range, 50-64 years) for breast (n = 17,128 women) and colorectal (n = 32,562 individuals) cancer screening were identified from 5 years of the National Health Interview Survey. Adults were categorized into five groups based on insurance type at survey (private, public, none) and prior coverage disruptions within the past year. Screening outcomes included: (1) ever-screened, (2) past-year screening, and (3) guideline-concordant screening. Separate multivariate logistic regression models were used to evaluate the associations between insurance coverage disruptions and cancer screening. RESULTS: Among adults who had coverage at the time of the survey, 3.1% with private insurance and 6.5% with public insurance reported prior coverage disruptions. Individuals without health insurance coverage had the lowest level of screening. Among individuals who had private coverage, prior disruptions were associated with lower guideline-concordant screening in adjusted analyses (breast cancer screening: adjusted prevalence ratio [aPR], 0.82; 95% confidence interval [CI], 0.75-0.89; colorectal cancer screening: aPR, 0.78; 95% CI, 0.72-0.86); among those who had public coverage, prior disruptions were also associated with lower guideline-concordant breast cancer screening (aPR, 0.73; 95% CI, 0.60-0.89) and colorectal cancer screening (aPR, 0.84; 95% CI, 0.72-0.99). CONCLUSIONS: Health insurance coverage disruptions were associated with lower past-year and guideline-concordant breast and colorectal cancer screening. The current findings underscore the importance of stable health insurance coverage to improve cancer screening and early detection when treatment is most effective.

2.
Radiol Case Rep ; 19(11): 5094-5099, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39263502

RESUMO

Inferior vena cava IVC is a crucial route for catheter access (both directly to the right heart and indirectly through a transeptal puncture to the left heart, used in most electrophysiological procedures). However, interrupted IVC is a real challenge to traditional arrythmia ablation approaches, compromising in certain cases the success of the procedure. A well-developed azygos continuation offers an alternative pathway, bypassing the interrupted segment of the IVC. We report the case of a 60 years old female, who underwent catheter ablation of a counterclockwise flutter. During the procedure, she was discovered to have an uncommon anatomical venous pathway from femoral access to the right heart chambers. She was diagnosed to have an interruption of the supra-renal segment of the inferior vena cava with azygos continuation. Radiofrequency ablation of the cavotricuspid isthmus was successfully performed through the azygos continuation.

3.
Ergonomics ; : 1-19, 2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-39257187

RESUMO

Interruptions in the working environment cause extra mental workload for the operators, and this phenomenon has garnered significant research attention. This study designed four interruption conditions based on the perceptual and cognitive perspectives of human information processing, using a 2(perceptual primary task and cognitive primary task)*2(perceptual interruption task and cognitive interruption task) factorial design. Multimodal measurement methods were used to evaluate mental workload in different interruption conditions. The results show that when the primary task and the interruption task are different load types, they generate a higher mental workload than the same load type. It can be attributed to the fact that perceptual tasks and cognitive tasks increase mental workload during switching. In addition, based on the multimodal index data, the prediction model of interruption recovery delay time and the classification model of interruption conditions are established, which provides a basis for rational scheduling of work and preventing mental overload.


This study's results enhance our understanding of interruptions from the perspectives of perception and cognition, providing a more accurate theoretical basis for managing mental workload in interruption conditions. The proposed interruption recovery delay time prediction model and the interruption condition classification model have certain reference values for improving interruption management capabilities.

4.
Ann Med Surg (Lond) ; 86(9): 5486-5488, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39238976

RESUMO

Background: Pituitary stalk interruption syndrome is a rare congenital anomaly of the pituitary gland characterized by growth hormones deficiency (with or without other pituitary hormone deficiencies) along with radiological features of a thin or interrupted pituitary stalk, an ectopic or absent posterior pituitary, or a hypoplastic or absent anterior pituitary. Case presentation: A 10-year-old baby boy came with short stature. The laboratory investigations were done and showed low growth hormones and low thyroid-stimulating hormone. MRI showed an ectopic posterior pituitary, a small hypoplastic anterior pituitary, and an absent pituitary stalk. Conclusion: Pituitary stalk interruption syndrome is a very rare entity. MRI is used to diagnose it. Early detection of this syndrome improve the patient symptoms especially before puberty.

5.
Indian J Radiol Imaging ; 34(4): 740-744, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39318575

RESUMO

Posterior pituitary ectopia is a very rare entity in the development of the pituitary gland. Several factors and multiple genes are associated with this entity causing both pituitary and extrapituitary abnormalities. Pituitary abnormalities can be various endocrine problems and extrapituitary abnormalities can be optic nerves and cerebellar hypoplasia, heterotopia, and abnormal vessels. This pictorial review represents the imaging manifestations of extrapituitary intracranial anomalies that can be associated with posterior pituitary ectopia.

6.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 36(4): 422-427, 2024 Jul 26.
Artigo em Chinês | MEDLINE | ID: mdl-39322305

RESUMO

Schistosomiasis was once hyper-endemic in Yunnan Province. Following concerted efforts for over 70 years, remarkable achievements have been made for schistosomiasis control in the province. In 2004, the Mid- and Long-term Plan for Schistosomiasis Prevention and Control in Yunnan Province was initiated in Yunnan Province, and the target for transmission control of schistosomiasis was achieved in the province in 2009. Following the subsequent implementation of the Outline for Key Projects in Integrated Schistosomiasis Control Program (2009-2015) and the 13th Five - year Plan for Schistosomiasis Control in Yunnan Province, no acute schistosomiasis had been identified in Yunnan Province for successive 12 years, and no local Schistosoma japonicum infections had been detected in humans, animals or Oncomelania hupensis snails for successive 6 years in the province by the end of 2020. The transmission of schistosomiasis was interrupted in Yunnan Province in 2020. This review summarizes the history of schistosomiasis, changes in schistosomiasis prevalence and progress of schistosomiasis control in Yunnan Province, and proposes the future priorities for schistosomiasis control in the province.


Assuntos
Esquistossomose , China/epidemiologia , Humanos , Esquistossomose/prevenção & controle , Esquistossomose/transmissão , Esquistossomose/epidemiologia , Animais , Caramujos/parasitologia , Controle de Doenças Transmissíveis/métodos
7.
Nanomaterials (Basel) ; 14(18)2024 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-39330627

RESUMO

The growth interruption technology is introduced to the growth of GaAsP/InAlGaAs quantum well (QW) structure using metal-organic chemical vapor deposition (MOCVD). The effect of growth interruption time (GIT) on the crystalline quality and optical properties are investigated. The two distinctive emission peaks are the transition recombination between the electron level of conduction band and the light and heavy hole level of valence band in the photoluminescence (PL) at room temperature. The PL peaks present a redshift and merge together with the increasing GIT, which is attributed to the QW energy level shift caused by the increase in arsenic concentrations in GaAsP QW, the diversified thickness of QW and the variations of indium components in the InAlGaAs barrier layer. The Gaussian deconvolution parameters in temperature-dependent PL (TDPL) show that the GaAsP/InAlGaAs QW with a GIT of 6 s has a 565.74 meV activation energy, enhancing the carrier confinement in QW and the PL intensity, while the 6 s-GIT GaAsP QW has the increasing interface roughness and the non-radiative centers at the InGaAsP intermediate layer, leading to a spectral broadening. The QW with 10 s-GIT exhibits a small full width at half maximum (FWHM) with the various temperature, indicating reduced interface roughness and excellent crystal quality. An increase in GIT may be suitable for optimizing the optical properties of GaAsP/InAlGaAs QW.

8.
Artigo em Francês | MEDLINE | ID: mdl-39341569

RESUMO

INTRODUCTION: In France, embryo reduction is controversial in twin pregnancy, especially when there is no underlying pathology. The objective of this study was to establish the status of this practice in France and to depict the ethical issues around this problematic. STUDY DESIGN: A questionnaire drafted by Maternal and Fetal Medicine physicians and family planning teams of the University Hospital from Strasbourg was distributed to the 48 French Multidisciplinary Prenatal Diagnosis Centers, among which 28 answered (58,3%). RESULTS: Embryo reduction in twin pregnancy on maternal request has already challenged 71% of the centers; 29% have performed such a reduction. The overall position of the centers to these requests is negative (3.1/10), with very mixed levels of in-team agreement. The main arguments against this practice are that twin pregnancy is not a pathology, that embryo reduction exposes to the risk of loosing the entire pregnancy, the feeling of being held hostage with the alternative of abortion of the whole pregnancy, and the lack of legal framing. On the contrary, the arguments in favor of the reduction are : that the reduction can avoid an abortion, that this type of reduction can be related to a partial abortion, that it responds to women's rights and that mental health is an integral part of women's health. CONCLUSION: There is no consensus about how to respond to patients requesting for embryo reduction in twin pregnancy. However, the majority of Centers have been confronted with it and it would be necessary to open the debate on this problem and the ethical questions it raises.

9.
Dev Neurorehabil ; 27(7): 268-272, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39217464

RESUMO

Pica is a life-threatening behavior that is relatively common among individuals with intellectual and developmental disabilities. Pica can be conceptualized as a response chain in which the pica item acts as a discriminative stimulus for the next response (i.e. picking up the pica item), which itself acts as a discriminative stimulus for the final response (i.e. consumption). Interventions that disrupt this response chain and alter the discriminative properties of the pica stimulus may be clinically indicated. Preliminary research supports response-interruption and redirection (RIRD) with differential reinforcement of alternative behavior (DRA) as an effective intervention for pica. We evaluated this procedure in an inpatient unit with a young boy with who engaged in pica. Our outcomes provide additional support for DRA with RIRD as an effective pica treatment.


Assuntos
Terapia Comportamental , Pica , Humanos , Masculino , Terapia Comportamental/métodos , Criança , Reforço Psicológico , Deficiência Intelectual , Deficiências do Desenvolvimento/reabilitação
10.
Res Social Adm Pharm ; 2024 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-39218734

RESUMO

BACKGROUND: Tuberculosis (TB) treatment interruption poses risks of antimicrobial resistance, potentially leading to treatment failure and mortality. Addressing the risk of early treatment interruption is crucial in tuberculosis care and management to improve treatment outcomes and curb disease transmission. OBJECTIVES: This study aimed to identify risk factors of TB treatment interruption and construct a predictive scoring model that enables objective risk stratification for better prediction of treatment interruption. METHODS: A multicentre retrospective cohort study was conducted at public health clinics in Sarawak, Malaysia over 11 months from March 2022 to January 2023, involving adult patients aged ≥18 years with drug-susceptible TB diagnosed between 2018 and 2021. Cumulative missed doses or discontinuation of TB medications for ≥2 weeks, either consecutive or non-consecutive, was considered as treatment interruption. The model was developed and internally validated using the split-sample method. Multiple logistic regression analysed 18 pre-defined variables to identify the predictors of TB treatment interruption. The Hosmer-Lemeshow test and area under the receiver operating characteristic curve (AUC) were employed to evaluate model performance. RESULTS: Of 2953 cases, two-thirds (1969) were assigned to the derivation cohort, and one-third (984) formed the validation cohort. Positive predictors included smoking, previously treated cases, and adverse drug reactions, while concurrent diabetes was protective. Based on the validation dataset, the model demonstrated good calibration (P = 0.143) with acceptable discriminative ability (AUC = 0.775). A cutoff score of 2.5 out of 11 achieved a sensitivity of 81 % and a specificity of 64.4 %. Risk stratification into low (0-2), medium (3-5), and high-risk (≥6) categories showed ascending interruption rates of 5.3 %, 18.1 %, and 41.3 %, respectively (P < 0.001). CONCLUSION: The predictive scoring model aids in risk assessment for TB treatment interruption, enabling focused monitoring and personalized intervention plans for higher-risk groups in the early treatment phase.

11.
Differentiation ; : 100813, 2024 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-39327214

RESUMO

The Fibroblast growth factor (FGFs) family consists of at least 22 members that exert their function by binding and activating fibroblast growth factor receptors (FGFRs). The Fgf8/FgfD subfamily member, Fgf17, is located on human chromosome 8p21.3 and mouse chromosome 14 D2. In humans, FGF17 can be alternatively spliced to produce two isoforms (FGF17a and b) whereas three isoforms are present in mice (Fgf17a, b, and c), however, only Fgf17a and Fgf17b produce functional proteins. Fgf17 is a secreted protein with a cleavable N-terminal signal peptide and contains two binding domains, namely a conserved core region and a heparin binding site. Fgf17 mRNA is expressed in a wide range of different tissues during development, including the rostral patterning centre, midbrain-hindbrain boundary, tailbud mesoderm, olfactory placode, mammary glands, and smooth muscle precursors of major arteries. Given its broad expression pattern during development, it is surprising that adult Fgf17-/- mice displayed a rather mild phenotype; such that mutants only exhibited morphological changes in the frontal cortex and mid/hind brain boundary and changes in certain social behaviours. In humans, FGF17 mutations are implicated in several diseases, including Congenital Hypogonadotropic Hypogonadism and Kallmann Syndrome. FGF17 mutations contribute to CHH/KS in 1.1% of affected individuals, often presenting in conjunction with mutations in other FGF pathway genes like FGFR1 and FLRT3. FGF17 mutations were also identified in patients diagnosed with Dandy-Walker malformation and Pituitary Stalk Interruption Syndrome, however, it remains unclear how FGF17 is implicated in these diseases. Altered FGF17 expression has been observed in several cancers, including prostate cancer, hematopoietic cancers (acute myeloid leukemia and acute lymphoblastic leukemia), glioblastomas, perineural invasion in cervical cancer, and renal cell carcinomas. Furthermore, FGF17 has demonstrated neuroprotective effects, particularly during ischemic stroke, and has been shown to improve cognitive function in ageing mice.

12.
Drug Discov Ther ; 18(4): 240-244, 2024 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-39155084

RESUMO

Drug-resistant bacterial infections have become a substantial problem in various communities. Appropriate antimicrobial use is required because reducing antimicrobial use could reduce the number of resistant bacteria. The inappropriate use of antimicrobials can be prevented by improving the knowledge of patients, physicians, and other healthcare professionals; however, no antimicrobial awareness survey specifically aimed at patients has been conducted yet. Therefore, to promote proper antimicrobial use, mainly by patients, we conducted a survey on the attitudes of patients who brought their antimicrobial prescriptions from insurance pharmacies. The results were based on 858 responses. Awareness of the terms "bacteria, viruses, and antimicrobials" was > 80%, whereas that of "drug-resistant bacteria" was only 37.2%. Only 26.5% of respondents understood what the efficacy of antimicrobial drugs meant. Additionally, 31.5% of the respondents had experienced discontinuation antimicrobials, and approximately 70% of the reasons for discontinuation were self-judged symptom improvement. Furthermore, those who had experienced discontinuation were less aware of the various aspects of antimicrobial use than those who had not. In antimicrobial treatment, avoiding the emergence of drug-resistant bacteria is difficult, is detrimental to patients consuming treatment, and presents a major problem in society. Therefore, healthcare professionals should strive to optimize infectious disease treatment by providing appropriate guidance on the proper use of antimicrobials, significance of taking them, and harmful effects of their discontinuation to patients.


Assuntos
Farmacorresistência Bacteriana , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Inquéritos e Questionários , Idoso , Antibacterianos/uso terapêutico , Anti-Infecciosos/uso terapêutico , Adulto Jovem , Infecções Bacterianas/tratamento farmacológico , Adolescente
13.
Genet Med ; 26(11): 101239, 2024 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-39140258

RESUMO

PURPOSE: To determine the frequency and clinical impact of loss-of-interruption (LOI) and duplication-of-interruption modifier variants of the HTT CAG and CCG repeat in a cohort of individuals with Huntington disease (HD). METHODS: We screened symptomatic HD participants from the UBC HD Biobank and 5 research sites for sequence variants. After variant identification, we examined the clinical impact and frequency in the reduced penetrance range. RESULTS: Participants with CAG-CCG LOI and CCG LOI variants have a similar magnitude of earlier onset of HD, by 12.5 years. The sequence variants exhibit ancestry-specific differences. Participants with the CAG-CCG LOI variant also have a faster progression of Total Motor Score by 1.9 units per year. Symptomatic participants with the CAG-CCG LOI variant show enrichment in the reduced penetrance range. The CAG-CCG LOI variant explains the onset of 2 symptomatic HD participants with diagnostic repeats below the pathogenetic range. CONCLUSION: Our findings have significant clinical implications for participants with the CAG-CCG LOI variant who receive inaccurate diagnoses near diagnostic cutoff ranges. Improved diagnostic testing approaches and clinical management are needed for these individuals. We present the largest and most diverse HTT CAG and CCG sequence variant cohort and emphasize their importance in clinical presentation in HD.

14.
J Theor Biol ; 594: 111914, 2024 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-39111541

RESUMO

We investigate an efficient computational tool to suggest useful treatment regimens for people infected with the human immunodeficiency virus (HIV). Structured treatment interruption (STI) is a regimen in which therapeutic drugs are periodically administered and withdrawn to give patients relief from an arduous drug therapy. Numerous studies have been conducted to find better STI treatment strategies using various computational tools with mathematical models of HIV infection. In this paper, we leverage a modified version of the double deep Q network with prioritized experience replay to improve the performance of classic deep learning algorithms. Numerical simulation results show that our methodology produces significantly more optimal cost values for shorter treatment periods compared to other recent studies. Furthermore, our proposed algorithm performs well in one-day segment scenarios, whereas previous studies only reported results for five-day segment scenarios.


Assuntos
Aprendizado Profundo , Infecções por HIV , Humanos , Infecções por HIV/tratamento farmacológico , Algoritmos , Fármacos Anti-HIV/uso terapêutico , Simulação por Computador , Esquema de Medicação
15.
Front Oncol ; 14: 1337194, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39109283

RESUMO

Background: Many cancer patients have not received timely treatment or even had treatment interruptions due to the COVID-19 pandemic. The objective of this investigation was to evaluate whether the prognosis of patients with breast cancer after surgery was affected by any interruptions in radiotherapy. Methods: The healthcare documents for breast cancer patients experiencing radiotherapy interruption after surgery, including treatment-related characteristics, and time of interruption, type of disease progression, and survival status, were collected between January and April 2020 during the Wuhan blockade. Results: The final number of patients included was 148, and neither the Kaplan-Meier (KM) survival curve nor the cross-tabulation analysis found statistical significance. Cox regression analysis also did not identify risk factors associated with PFS. Conclusions: The prognosis of patients with postoperative breast cancer may not be significantly impacted by the interruption of radiotherapy, given its integration with additional treatments like targeted and endocrine therapies.

16.
Clin Case Rep ; 12(8): e9274, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39109310

RESUMO

Pituitary stalk interruption syndrome is a rare, congenital abnormality. Early identification and treatment can improve patient prognosis and quality of life and prevent adverse effect on growth and development. The patient described is an 8-year-old child with a history of short stature.

17.
J Int AIDS Soc ; 27(8): e26349, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39155436

RESUMO

INTRODUCTION: To assess the effectiveness of novel HIV curative strategies, "cure" trials require periods of closely monitored antiretroviral therapy (ART) analytical treatment interruptions (ATIs). We performed a systematic review and meta-analysis to identify the impact of ATI with or without novel therapeutics in cure-related studies on the time to viral re-suppression following ART restart. METHODS: Medline, Embase and Web of Science databases were searched for human studies involving ATIs from 1 January 2015 till 22 April 2024. The primary outcome was time to first viral re-suppression (plasma HIV viral load [VL] <50 copies/ml) stratified by receipt of interventional drug with ATI (IA) or ATI-only groups. Random-effects proportional meta-analysis and multivariable Cox proportional hazards analysis were performed using R. RESULTS: Of 1073 studies screened, 13 were included that met the inclusion criteria with VL data available after restarting ART (n = 213 participants). There was no difference between time to viral suppression in IA or ATI-only cohorts (p = 0.22). For 87% of participants, viral suppression within 12 weeks of ART restart was achieved, and all eventually had at least one VL <50 copies/ml during follow-up. After adjusting for covariables, while participants in the IA cohort were associated with less rapid suppression (adjusted hazard ratio [aHR] 0.61, 95% CI 0.40-0.94, p = 0.026), other factors include greater log VL at ART restart (aHR 0.56, 95% CI 0.46-0.68, p<0.001), duration since HIV diagnosis (aHR 0.93, 95% CI 0.89-0.96) and longer intervals between HIV VL monitoring (aHR 0.66, 95% CI 0.59-0.74, p<0.001). However, the use of integrase inhibitors was associated with more rapid viral suppression (aHR 1.74, 95% CI 1.16-2.59). DISCUSSION: When designing studies involving ATIs, information on time to viral re-suppression after restarting ART is important to share with participants, and should be regularly monitored and reported, to assess the impact and safety of specific trial interventions in ATI studies. CONCLUSIONS: The majority of participants achieved viral suppression after restarting ART in ATI studies. ART regimens containing integrase inhibitors and frequent VL monitoring should be offered for people restarting ART after ATI studies to ensure rapid re-suppression.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Carga Viral , Humanos , Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/virologia , Fatores de Tempo , Resultado do Tratamento , Carga Viral/efeitos dos fármacos , Suspensão de Tratamento
18.
Front Pediatr ; 12: 1334610, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39156017

RESUMO

Introduction: Ectopic posterior pituitary (EPP) is a rare congenital abnormality, sometimes associated with other midline defects, such as pituitary stalk interruption syndrome (PSIS), in which thin or absent pituitary stalk and anterior pituitary hypoplasia are combined to EPP. Most cases are sporadic, with few reports of familial cases, and many congenital hypopituitarism (CH) cases remain unsolved. Objective: To search for candidate genes associated with this condition, we performed trio-based whole-exome sequencing (WES) on patients with EPP, including two familial cases. Methods: This study included subjects with EPP and PSIS diagnosed by a simple MRI protocol (FAST1.2). We performed two distinct analyses in the trio-based WES. We looked for previously described genes associated with pituitary development. Next, we investigated the whole exome for variants inherited in a pattern consistent with a monogenic etiology. Results: Ten families were evaluated; eight were composed of a child with EPP and healthy parents, one has two affected siblings, and one family has a son and mother with EPP. When analyzing the previously described candidate variants associated with pituitary development, we found variants in GLI2 and FGFR1 in three families. We also found six other variants of interest in three patients: KMT2A, GALR3, RTN4R, SEMA3A, NIPBL, and DSCAML1. Conclusion: The analysis allowed us to find previously reported and not reported GLI2 variants, all inherited from healthy parents, which reinforces the incomplete penetrance pattern of GLI2 variants in the development of EPP and draws attention to possible future functional studies of those variants that have a recurrent expression in CH. We also found novel FGFR1 and SEMA3A variants that suggest an oligogenic mechanism in PSIS and EPP, as seen in patients with hypogonadotropic hypogonadism. We report the first case of a patient with Wiedemann-Steiner syndrome and PSIS, suggesting that the KMT2A gene may be related to pituitary development. Furthermore, the trios' analysis allowed us to find five other variants of interest. Future investigations may clarify the roles of these variants in the etiology of EPP and PSIS.

19.
Pathogens ; 13(8)2024 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-39204271

RESUMO

Onchocerciasis causes severe morbidity in sub-Saharan Africa. Abia, Anambra, Enugu, and Imo states of Nigeria were historically classified meso- or hyperendemic and eligible for ivermectin mass drug administration (MDA). After ≥25 years of annual and biannual MDA, serological and entomological assessments were conducted to determine if Onchocerca volvulus transmission was interrupted. Dried blood spots collected in October 2020 from ≥3167 children 5-9 years old in each state were screened for O. volvulus-specific Ov16 antibody by enzyme-linked immunosorbent assay. Additionally, 52,187 Simulium damnosum heads (≥8845 per state) collected over 12 months between 2021 and 2022 were tested by pooled polymerase chain reaction (PCR) for O-150 DNA. Among seven seropositive children, four were found for follow-up skin snip PCR to confirm active infection. Three were negative and the fourth was excluded as he was visiting from an endemic state. The final seroprevalence estimates of each state had 95% upper confidence limits (UCL) < 0.1%. All fly pools were negative by O-150 PCR, giving a 95% UCL infective fly prevalence < 0.05% in each state. Each state therefore met the World Health Organization epidemiological and entomological criteria for stopping MDA effective January 2023. With 18.9 million residents eligible for MDA, this marked the largest global onchocerciasis stop-treatment decision to date.

20.
Rep Pract Oncol Radiother ; 29(3): 271-279, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39144261

RESUMO

Background: The objective was to enhance the biological compensation factor related to irradiation interruption in a short time (short irradiation interruption) in hypoxic tumors using a refined microdosimetric kinetic model (MKM) for photon radiation therapy. Materials and methods: The biological dose differences were calculated for CHO-K1 cells exposed to a photon beam, considering interruptions of (τ) of 0-120 min and pO2 at oxygen levels of 0.075-160 mm Hg. The interrupted dose fraction (IDF) was defined as the percentage ratio of the dose delivered before short irradiation interruption to the total dose, which ranged from 10-90%. The compensated dose was calculated based on an IDF of 10-90% for a dose of 2-8 Gy and oxygen levels of 0.075-160 mm Hg. Results: The Δ with and without short irradiation interruption was more pronounced with a higher dose and increased pO2. It exceeded 3% between IDF of 50% and either 10% or 90% and occurred more than τ = 50 min at 0.075 mm Hg, τ = 20 min at 3 mm Hg, τ = 20 min at 8 mm Hg, τ = 20 min at 15 mm Hg, τ = 20 min at 38 mm Hg, and τ = 20 min at 160 mm Hg. The dose compensation factor was greater at higher IDF rates. Conclusion: The biological dose decreased with longer interruption times and higher oxygen concentrations. The improved model can compensate for the biological doses at various oxygen concentrations. Advances in knowledge: The current study improved the dose compensation method for the decrease in the biological effect owing to short irradiation interruption by considering the oxygen concentration.

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