| 1. |
- Demczuk, Walter H.B., et al.
(författare)
-
Neisseria gonorrhoeae Sequence Typing for Antimicrobial Resistance : a Novel Antimicrobial Resistance Multilocus Typing Scheme for Tracking Global Dissemination of N. gonorrhoeae Strains
- 2017
-
Ingår i: Journal of Clinical Microbiology. - : American Society for Microbiology. - 0095-1137 .- 1098-660X. ; 55:5, s. 1454-1468
-
Tidskriftsartikel (refereegranskat)abstract
- A curated Web-based user-friendly sequence typing tool based on antimicrobial resistance determinants in Neisseria gonorrhoeae was developed and is publicly accessible (https://ngstar.canada.ca). The N. gonorrhoeae Sequence Typing for Antimicrobial Resistance (NG-STAR) molecular typing scheme uses the DNA sequences of 7 genes (penA, mtrR, porB, ponA, gyrA, parC, and 23S rRNA) associated with resistance to β-lactam antimicrobials, macrolides, or fluoroquinolones. NG-STAR uses the entire penA sequence, combining the historical nomenclature for penA types I to XXXVIII with novel nucleotide sequence designations; the full mtrR sequence and a portion of its promoter region; portions of ponA, porB, gyrA, and parC; and 23S rRNA sequences. NG-STAR grouped 768 isolates into 139 sequence types (STs) (n = 660) consisting of 29 clonal complexes (CCs) having a maximum of a single-locus variation, and 76 NG-STAR STs (n = 109) were identified as unrelated singletons. NG-STAR had a high Simpson's diversity index value of 96.5% (95% confidence interval [CI] = 0.959 to 0.969). The most common STs were NG-STAR ST-90 (n = 100; 13.0%), ST-42 and ST-91 (n = 45; 5.9%), ST-64 (n = 44; 5.72%), and ST-139 (n = 42; 5.5%). Decreased susceptibility to azithromycin was associated with NG-STAR ST-58, ST-61, ST-64, ST-79, ST-91, and ST-139 (n = 156; 92.3%); decreased susceptibility to cephalosporins was associated with NG-STAR ST-90, ST-91, and ST-97 (n = 162; 94.2%); and ciprofloxacin resistance was associated with NG-STAR ST-26, ST-90, ST-91, ST-97, ST-150, and ST-158 (n = 196; 98.0%). All isolates of NG-STAR ST-42, ST-43, ST-63, ST-81, and ST-160 (n = 106) were susceptible to all four antimicrobials. The standardization of nomenclature associated with antimicrobial resistance determinants through an internationally available database will facilitate the monitoring of the global dissemination of antimicrobial-resistant N. gonorrhoeae strains.
|
|
| 2. |
- Govsyeyev, Nicholas, et al.
(författare)
-
Rivaroxaban in Patients with Symptomatic Peripheral Artery Disease after Lower Extremity Bypass Surgery with Venous and Prosthetic Conduits
- 2023
-
Ingår i: Journal of Vascular Surgery. - : Elsevier. - 0741-5214 .- 1097-6809. ; 77:4, s. 1107-1118.e2
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with peripheral artery disease (PAD) requiring lower extremity revascularization (LER) are at high risk of adverse limb and cardiovascular events. VOYAGER PAD demonstrated that rivaroxaban significantly reduced this risk with an overall favorable net benefit in patients undergoing surgical revascularization; however, the efficacy and safety in those treated by surgical bypass including stratified by bypass conduit (venous or prosthetic) has not been described.METHODS: In the VOYAGER PAD trial, patients with PAD after surgical and endovascular infrainguinal LER were randomized to rivaroxaban 2.5 mg twice daily or placebo and followed for a median of 28 months. The primary endpoint was a composite of acute limb ischemia (ALI), major amputation of vascular etiology, myocardial infarction, ischemic stroke, or cardiovascular death. The principal safety outcome was Thrombolysis in Myocardial Infarction (TIMI) major bleeding. Index procedure details including conduit type (venous or prosthetic) were collected at baseline.RESULTS: Among 6564 randomized, 2185 (33%) underwent surgical LER. Of these, surgical bypass was performed in 1448 (66%), using prosthetic conduit in 773 (53%) and venous in 646 (45%). Adjusting for baseline differences and anatomic factors, the risk for unplanned limb revascularization in the placebo arm was 2.5-fold higher for those receiving prosthetic versus venous conduits (adjHR 2.53, 95% CI 1.65-3.90; p<0.001) while the risk for ALI was 3 times greater (adjHR 3.07, 95% CI 1.84-5.11; p<0.001). Rivaroxaban reduced the primary outcome in patients treated with bypass surgery (HR 0.78, 95% CI 0.62-0.98) with consistent benefits in those receiving venous (HR 0.66, 95% CI 0.49-0.96) and prosthetic (HR 0.87, 95% CI 0.66-1.15) conduits (pinteraction 0.254). In the overall trial, TIMI major bleeding was increased with rivaroxaban; however, numbers in those treated with bypass surgery were low (5 with rivaroxaban, 9 with placebo, HR 0.55, 95% CI 0.18-1.65) and not powered to show statistical significance.CONCLUSIONS: Surgical bypass with prosthetic conduit is associated with significantly higher rates of major adverse limb events relative to venous conduits even after adjusting for patient and anatomic characteristics. Adding rivaroxaban 2.5 mg twice daily to aspirin or dual antiplatelet therapy significantly reduces this risk, increases bleeding, but has a favorable benefit risk in patients treated with bypass surgery and regardless of conduit type. Rivaroxaban should be considered after lower extremity bypass for symptomatic PAD to reduce ischemic complications of the heart, limb, and brain.
|
|
| 3. |
- Justesen, L., et al.
(författare)
-
The Breakfast Club - co-creational meal practices as rehabilitation strategies in nursing homes
- 2019
-
Ingår i: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 29:Suppl. 4, s. 178-179
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: A growing aging population demands new welfare public health activities in nursing homes. Involving residents in meal activity through a co-creational approach as part of a rehabilitation strategy has been suggested as a solution, but knowledge is limited. This project explore how co-creational meal practices in a breakfast club might improve residents’ food related functionality and quality of life.Methods: The project is designed as a three-year complex intervention study in a Danish nursing home. A breakfast club is held with 4-5 residents (16 all together) and 2-6 staff members on a weekly basis during a period of 10 month. Residents are on shift hosting the club and all members are preparing the meal together. The degree of food related functionality is assessed after each club and is analyzed through paired t-test on mean values. Semi-structured interviews in combination with Research Driven Photo-Elicitation is conducted with 16 residents and 8-10 staff members before, during and after holding the clubs in order to evaluate quality of life and potentials for implementing meal practices to everyday practices. A hermeneutic analysis strategy is applied.Results: Preliminary results from 12 breakfast clubs finds an increase in residents food related functionality. Data will be presented in November 2019. All residents express impact on quality of life independent of physical or mental state. Improved functionality is not the main value for participation in the breakfast club. Staff became aware of utilizing residents food related functionality.Conclusions: The study will contribute with new knowledge about whether co-creational meal activities could have a positive effect on functional abilities and improve health-related quality of life in residents in nursing homes. A meal practice based on co-creation has potential to become implemented as a public health activity in nursing homes and increase residents’ quality of life and food related functionality.
|
|
| 4. |
|
|
| 5. |
- van Zalk, Maarten Herman Walter, et al.
(författare)
-
It takes three : selection, influence, and de-selection processes of depression in adolescent friendship networks
- 2010
-
Ingår i: Developmental Psychology. - : American Psychological Association (APA). - 0012-1649 .- 1939-0599. ; 46:4, s. 927-938
-
Tidskriftsartikel (refereegranskat)abstract
- The authors of this study tested a selection influence de-selection model of depression. This model explains friendship influence processes (i.e., friends' depressive symptoms increase adolescents' depressive symptoms) while controlling for two processes: friendship selection (i.e., selection of friends with similar levels of depressive symptoms) and friendship de-selection (i.e., de-selection of friends with dissimilar levels of depressive symptoms). Further, this study is unique in that these processes were studied both inside and outside the school context. The authors used a social network approach to examine 5 annual measurements of data in a large (N = 847) community-based network of adolescents and their friends (M = 14.3 years old at first measurement). Results supported the proposed model: adolescents tend to select friends with similar levels of depression, and friends may increase each other's depressive symptoms as relationships endure. These two processes were most salient outside the school context. At the same time, friendships seemed to be ended more frequently if adolescents' level of depressive symptoms was dissimilar to that of their friends.
|
|
| 6. |
- van Zalk, Maarten Herman Walter, et al.
(författare)
-
Peer contagion and adolescent depression : the role of failure anticipation
- 2010
-
Ingår i: Journal of clinical child and adolescent psychology (Print). - : Informa UK Limited. - 1537-4416 .- 1537-4424. ; 39:6, s. 837-848
-
Tidskriftsartikel (refereegranskat)abstract
- The current study investigated the mechanisms underlying peer contagion of depressive symptoms in adolescence. Five annual measurements of data were gathered from a large (N=842) community-based network of adolescents (M=14.3 years at first measurement). Results showed that, after controlling for selection and deselection of friends on the basis of depressive symptoms, peers' depressive symptoms predicted increases in adolescents' depressive symptoms over time. Failure anticipation mediated effects of peers' depressive symptoms on adolescents' depressive symptoms, particularly for girls. Thus, results suggest that peers' depressive symptoms place adolescents at risk of developing depressive symptoms through increasing in failure anticipation.
|
|
