| 581. |
- de Glanville, William A., et al.
(författare)
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Poor performance of the rapid test for human brucellosis in health facilities in Kenya
- 2017
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Ingår i: PLoS Neglected Tropical Diseases. - : Public Library of Science (PLoS). - 1935-2727 .- 1935-2735. ; 11:4
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Tidskriftsartikel (refereegranskat)abstract
- Human brucellosis is considered to be an important but typically under-diagnosed cause of febrile illness in many low and middle-income countries. In Kenya, and throughout East Africa, laboratory diagnosis for the disease is based primarily on the febrile antigen Brucella agglutination test (FBAT), yet few studies of the diagnostic accuracy of this test exist. Assessment of the performance of the FBAT is essential for its appropriate clinical use, as well as for evaluating surveillance data reported by public health systems. To assess FBAT performance, we collected sera from people with symptoms compatible with brucellosis attending two health facilities in Busia County, Kenya. Sera were tested using the FBAT and results compared with those from the Rose Bengal Test (RBT), an assay with well-known performance characteristics. Positives on either test were confirmed using the classical serum agglutination test (SAT)-Coombs test combination and a rapid IgM/IgG lateral flow immunochromatography assay (LFA). A questionnaire focussing on known risk factors for exposure to Brucella spp. was also conducted, and relationships with FBAT positivity examined using logistic regression. Out of 825 recruited individuals, 162 (19.6%) were classified as positive using the FBAT. In contrast, only eight (1.0%) were positive using the RBT. Of the 162 FBAT positives, one (0.62%) had an atypical agglutination in SAT and three (1.9%) showed low Coombs titres. Out of 148 FBAT positive individuals tested using the LFA, five (3.4%) were IgM positive and none were IgG positive. Poor or no correlation was observed between FBAT results and most established risk factors for Brucella infection. We observed substantial disagreement between the FBAT and a number of well-known serological tests, with the majority of reactive FBAT results appearing to be false positives. Poor FBAT specificity, combined with a lack of confirmatory testing, strongly suggests overdiagnosis of brucellosis is common in this low prevalence setting. This is expected to have important economic impacts on affected patients subjected to the long and likely unnecessary courses of multiple antibiotics required for treatment of the disease.
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| 582. |
- de Goffau, Marcus C., et al.
(författare)
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Human placenta has no microbiome but can contain potential pathogens
- 2019
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Ingår i: Nature. - : NATURE PUBLISHING GROUP. - 0028-0836 .- 1476-4687. ; 572:7769, s. 329-334
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Tidskriftsartikel (refereegranskat)abstract
- We sought to determine whether pre-eclampsia, spontaneous preterm birth or the delivery of infants who are small for gestational age were associated with the presence of bacterial DNA in the human placenta. Here we show that there was no evidence for the presence of bacteria in the large majority of placental samples, from both complicated and uncomplicated pregnancies. Almost all signals were related either to the acquisition of bacteria during labour and delivery, or to contamination of laboratory reagents with bacterial DNA. The exception was Streptococcus agalactiae (group B Streptococcus), for which non-contaminant signals were detected in approximately 5% of samples collected before the onset of labour. We conclude that bacterial infection of the placenta is not a common cause of adverse pregnancy outcome and that the human placenta does not have a microbiome, but it does represent a potential site of perinatal acquisition of S. agalactiae, a major cause of neonatal sepsis.
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| 583. |
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| 584. |
- Dukpa, Dorji, et al.
(författare)
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Applied dendroecology informs the sustainable management of Blue Pine forests in Bhutan
- 2018
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Ingår i: Dendrochronologia. - : Elsevier BV. - 1125-7865 .- 1612-0051. ; 49, s. 89-93
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Forskningsöversikt (refereegranskat)abstract
- Tree ring science is a new discipline in Bhutan but has contributed substantially to our understanding of climate history and informed sustainable forest management practices in the country. This paper describes dendroecological contributions to the second aspect for Blue Pine using three case studies. i) The effects of livestock grazing impact on Blue Pine radial growth were quantified. Radial growth increment was tendentially higher after three years of livestock exclosure, as compared to continued grazing. However, differences remained statistically not significant, likely due to the brevity of the treatment period. ii) Radial growth rates of Blue Pine were characterized across a 400m elevation gradient. Cumulative radial growth over 40 years differed by a factor of more than three between the low and the high end of the gradient. However, below 2300 m, radial growth showed a continuous decline from 1990, likely as a results of drought due to climate change. iii) Effects of three levels of prescribed thinning of pole stage (DBH 30-50 cm) Blue Pine in central Bhutan showed distinct response to thinning. Heavy thinning lead to a thinning shock in the year after harvest and did not lead to significantly higher radial growth as compared to moderate thinning, which is thus recommended for the species. A positive thinning effect remained for seven years post operation. The case studies were incorporated into national guidelines on sustainable forest management in Bhutan and prove the demand for tree ring based research to inform policy and practice.
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| 585. |
- Esper, Jan, et al.
(författare)
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Ranking of tree-ring based temperature reconstructions of the past millennium
- 2016
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Ingår i: Quaternary Science Reviews. - : Elsevier BV. - 0277-3791 .- 1873-457X. ; 145, s. 134-151
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Tidskriftsartikel (refereegranskat)abstract
- Tree-ring chronologies are widely used to reconstruct high-to low-frequency variations in growing season temperatures over centuries to millennia. The relevance of these timeseries in large-scale climate reconstructions is often determined by the strength of their correlation against instrumental temperature data. However, this single criterion ignores several important quantitative and qualitative characteristics of tree-ring chronologies. Those characteristics are (i) data homogeneity, (ii) sample replication, (iii) growth coherence, (iv) chronology development, and (v) climate signal including the correlation with instrumental data. Based on these 5 characteristics, a reconstruction-scoring scheme is proposed and applied to 39 published, millennial-length temperature reconstructions from Asia, Europe, North America, and the Southern Hemisphere. Results reveal no reconstruction scores highest in every category and each has their own strengths and weaknesses. Reconstructions that perform better overall include N-Scan and Finland from Europe, E-Canada from North America, Yamal and Dzhelo from Asia. Reconstructions performing less well include W-Himalaya and Karakorum from Asia, Tatra and S-Finland from Europe, and Great Basin from North America. By providing a comprehensive set of criteria to evaluate tree-ring chronologies we hope to improve the development of large-scale temperature reconstructions spanning the past millennium. All reconstructions and their corresponding scores are provided at www.blogs.uni-mainz.de/fb09climatology.
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| 586. |
- Esper, Jan, et al.
(författare)
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The IPCC’s reductive Common Era temperature history
- 2024
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Ingår i: Communications Earth & Environment. - 2662-4435. ; 5
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Forskningsöversikt (refereegranskat)abstract
- Common Era temperature variability has been a prominent component in Intergovernmental Panel on Climate Change reports over the last several decades and was twice featured in their Summary for Policymakers. A single reconstruction of mean Northern Hemisphere temperature variability was first highlighted in the 2001 Summary for Policymakers, despite other estimates that existed at the time. Subsequent reports assessed many large-scale temperature reconstructions, but the entirety of Common Era temperature history in the most recent Sixth Assessment Report of the Intergovernmental Panel on Climate Change was restricted to a single estimate of mean annual global temperatures. We argue that this focus on a single reconstruction is an insufficient summary of our understanding of temperature variability over the Common Era. We provide a complementary perspective by offering an alternative assessment of the state of our understanding in high-resolution paleoclimatology for the Common Era and call for future reports to present a more accurate and comprehensive assessment of our knowledge about this important period of human and climate history.
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| 587. |
- Facon, T, et al.
(författare)
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Daratumumab plus lenalidomide and dexamethasone in transplant-ineligible newly diagnosed multiple myeloma: frailty subgroup analysis of MAIA
- 2022
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Ingår i: Leukemia. - : Springer Science and Business Media LLC. - 1476-5551 .- 0887-6924. ; 36:4, s. 1066-1077
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Tidskriftsartikel (refereegranskat)abstract
- In the phase 3 MAIA study of patients with transplant-ineligible newly diagnosed multiple myeloma (NDMM), daratumumab plus lenalidomide/dexamethasone (D-Rd) improved progression-free survival (PFS) versus lenalidomide/dexamethasone (Rd). We present a subgroup analysis of MAIA by frailty status. Frailty assessment was performed retrospectively using age, Charlson comorbidity index, and baseline Eastern Cooperative Oncology Group performance status score. Patients were classified as fit, intermediate, non-frail (fit + intermediate), or frail. Of the randomized patients (D-Rd, n = 368; Rd, n = 369), 396 patients were non-frail (D-Rd, 196 [53.3%]; Rd, 200 [54.2%]) and 341 patients were frail (172 [46.7%]; 169 [45.8%]). After a 36.4-month median follow-up, non-frail patients had longer PFS than frail patients, but the PFS benefit of D-Rd versus Rd was maintained across subgroups: non-frail (median, not reached [NR] vs 41.7 months; hazard ratio [HR], 0.48; P < 0.0001) and frail (NR vs 30.4 months; HR, 0.62; P = 0.003). Improved rates of complete response or better and minimal residual disease (10–5) negativity were observed for D-Rd across subgroups. The most common grade 3/4 treatment-emergent adverse event in non-frail and frail patients was neutropenia (non-frail, 45.4% [D-Rd] and 37.2% [Rd]; frail, 57.7% and 33.1%). These findings support the clinical benefit of D-Rd in transplant-ineligible NDMM patients enrolled in MAIA, regardless of frailty status.
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| 588. |
- Fairbanks, R. J., et al.
(författare)
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Resilience and resilience engineering in health care
- 2014
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Ingår i: Joint Commission Journal on Quality and Patient Safety. - : Joint Commission Resources, Inc.. - 1553-7250 .- 1938-131X. ; 40:8, s. 376-383
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Tidskriftsartikel (refereegranskat)
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| 589. |
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| 590. |
- Flores-Langarica, A., et al.
(författare)
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CD103 + CD11b + mucosal classical dendritic cells initiate long-term switched antibody responses to flagellin
- 2018
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Ingår i: Mucosal Immunology. - : Elsevier BV. - 1933-0219. ; 11:3, s. 681-692
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Tidskriftsartikel (refereegranskat)abstract
- Antibody responses induced at mucosal and nonmucosal sites demonstrate a significant level of autonomy. Here, we demonstrate a key role for mucosal interferon regulatory factor-4 (IRF4)-dependent CD103 + CD11b + (DP), classical dendritic cells (cDCs) in the induction of T-dependent immunoglobulin G (IgG) and immunoglobulin A (IgA) responses in the mesenteric lymph node (MLN) following systemic immunization with soluble flagellin (sFliC). In contrast, IRF8-dependent CD103 + CD11b ' (SP) are not required for these responses. The lack of this response correlated with a complete absence of sFliC-specific plasma cells in the MLN, small intestinal lamina propria, and surprisingly also the bone marrow (BM). Many sFliC-specific plasma cells accumulating in the BM of immunized wild-type mice expressed α 4 β 7 +, suggesting a mucosal origin. Collectively, these results suggest that mucosal DP cDC contribute to the generation of the sFliC-specific plasma cell pool in the BM and thus serve as a bridge linking the mucosal and systemic immune system.
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