Temporal dynamics of Middle East respiratory syndrome coronavirus in the Arabian Peninsula, 2012-2017

Altres ajuts: CERCA Programme/Generalitat de CatalunyaMiddle East respiratory syndrome coronavirus (MERS-CoV) remains a notable disease and poses a significant threat to global public health. The Arabian Peninsula is considered a major global epicentre for the disease and the virus has crossed regional and continental boundaries since 2012. In this study, we focused on exploring the temporal dynamics of MERS-CoV in human populations in the Arabian Peninsula between 2012 and 2017, using publicly available data on case counts and combining two analytical methods. Disease progression was assessed by quantifying the time-dependent reproductive number (TD-Rs), while case series temporal pattern was modelled using the AutoRegressive Integrated Moving Average (ARIMA). We accounted for geographical variability between three major affected regions in Saudi Arabia including Eastern Province, Riyadh and Makkah. In Saudi Arabia, the epidemic size was large with TD-Rs >1, indicating significant spread until 2017. In both Makkah and Riyadh regions, the epidemic progression reached its peak in April 2014 (TD-Rs > 7), during the highest incidence period of MERS-CoV cases. In Eastern Province, one unique super-spreading event (TD-R > 10) was identified in May 2013, which comprised of the most notable cases of human-to-human transmission. Best-fitting ARIMA model inferred statistically significant biannual seasonality in Riyadh region, a region characterised by heavy seasonal camel-related activities. However, no statistical evidence of seasonality was identified in Eastern Province and Makkah. Instead, both areas were marked by an endemic pattern of cases with sporadic outbreaks. Our study suggested new insights into the epidemiology of the virus, including inferences about epidemic progression and evidence for seasonality. Despite the inherent limitations of the available data, our conclusions provide further guidance to currently implement risk-based surveillance in high-risk populations and, subsequently, improve related interventions strategies against the epidemic at country and regional levels

Temporal dynamics of Middle East respiratory syndrome coronavirus in the Arabian Peninsula, 2012-2017

Middle East respiratory syndrome coronavirus (MERS-CoV) remains a notable disease and poses a significant threat to global public health. The Arabian Peninsula is considered a major global epicentre for the disease and the virus has crossed regional and continental boundaries since 2012. In this study, we focused on exploring the temporal dynamics of MERS-CoV in human populations in the Arabian Peninsula between 2012 and 2017, using publicly available data on case counts and combining two analytical methods. Disease progression was assessed by quantifying the time-dependent reproductive number (TD-Rs), while case series temporal pattern was modelled using the AutoRegressive Integrated Moving Average (ARIMA). We accounted for geographical variability between three major affected regions in Saudi Arabia including Eastern Province, Riyadh and Makkah. In Saudi Arabia, the epidemic size was large with TD-Rs >1, indicating significant spread until 2017. In both Makkah and Riyadh regions, the epidemic progression reached its peak in April 2014 (TD-Rs > 7), during the highest incidence period of MERS-CoV cases. In Eastern Province, one unique super-spreading event (TD-R > 10) was identified in May 2013, which comprised of the most notable cases of human-to-human transmission. Best-fitting ARIMA model inferred statistically significant biannual seasonality in Riyadh region, a region characterised by heavy seasonal camel-related activities. However, no statistical evidence of seasonality was identified in Eastern Province and Makkah. Instead, both areas were marked by an endemic pattern of cases with sporadic outbreaks. Our study suggested new insights into the epidemiology of the virus, including inferences about epidemic progression and evidence for seasonality. Despite the inherent limitations of the available data, our conclusions provide further guidance to currently implement risk-based surveillance in high-risk populations and, subsequently, improve related interventions strategies against the epidemic at country and regional levels.info:eu-repo/semantics/publishedVersio

Apoptosis, toll-like, RIG-I-like and NOD-like receptors are pathways jointly induced by diverse respiratory bacterial and viral pathogens

Lower respiratory tract infections are among the top five leading causes of human death. Fighting these infections is therefore a world health priority. Searching for induced alterations in host gene expression shared by several relevant respiratory pathogens represents an alternative to identify new targets for wide-range host-oriented therapeutics. With this aim, alveolar macrophages were independently infected with three unrelated bacterial (Streptococcus pneumoniae, Klebsiella pneumoniae, and Staphylococcus aureus) and two dissimilar viral (respiratory syncytial virus and influenza A virus) respiratory pathogens, all of them highly relevant for human health. Cells were also activated with bacterial lipopolysaccharide (LPS) as a prototypical pathogen-associated molecular pattern. Patterns of differentially expressed cellular genes shared by the indicated pathogens were searched by microarray analysis. Most of the commonly up-regulated host genes were related to the innate immune response and/or apoptosis, with Toll-like, RIG-I-like and NOD-like receptors among the top 10 signaling pathways with over-expressed genes. These results identify new potential broad-spectrum targets to fight the important human infections caused by the bacteria and viruses studied here.The authors gratefully acknowledge financial support from the “CIBER de Enfermedades Respiratorias” (CIBERES), an initiative of the “Instituto de Salud Carlos III” (ISCIII), Spain. Research activities in the participating laboratories received further funding from the following sources: Centro Nacional de Microbiología, ISCIII, PI15CIII/00024 and MINECO (SAF2015- 67033-R); Centro Nacional de Biotecnología, MINECO (BFU2014-57797-R); Hospital Universitari Germans Trias I Pujol, Spanish Society of Pneumology and Thoracic Surgery (SEPAR 054/2011); Departamento de Bioquímica y Biología Molecular I, MINECO (SAF2015-65307-R); Centro de Investigaciones Biológicas, MINECO (SAF2012-39444-C01/02); Fundación de Investigación Sanitaria de las Islas Baleares, MINECO (SAF2012-39841); Instituto de Agrobiotecnología, MINECO (SAF2015-66520-R); Instituto de Química Física Rocasolano, MINECO (BFU2015-70052-R) and the Marie Curie Initial Training Network GLYCOPHARM (PITN-GA- 2012-317297). Subprograma Estatal de Formación (BES-2013- 065355)

Anti-tumour necrosis factor discontinuation in inflammatory bowel disease patients in remission: study protocol of a prospective, multicentre, randomized clinical trial

Background: Patients with inflammatory bowel disease who achieve remission with anti-tumour necrosis factor (anti-TNF) drugs may have treatment withdrawn due to safety concerns and cost considerations, but there is a lack of prospective, controlled data investigating this strategy. The primary study aim is to compare the rates of clinical remission at 1?year in patients who discontinue anti-TNF treatment versus those who continue treatment. Methods: This is an ongoing, prospective, double-blind, multicentre, randomized, placebo-controlled study in patients with Crohn?s disease or ulcerative colitis who have achieved clinical remission for ?6?months with an anti-TNF treatment and an immunosuppressant. Patients are being randomized 1:1 to discontinue anti-TNF therapy or continue therapy. Randomization stratifies patients by the type of inflammatory bowel disease and drug (infliximab versus adalimumab) at study inclusion. The primary endpoint of the study is sustained clinical remission at 1?year. Other endpoints include endoscopic and radiological activity, patient-reported outcomes (quality of life, work productivity), safety and predictive factors for relapse. The required sample size is 194 patients. In addition to the main analysis (discontinuation versus continuation), subanalyses will include stratification by type of inflammatory bowel disease, phenotype and previous treatment. Biological samples will be obtained to identify factors predictive of relapse after treatment withdrawal. Results: Enrolment began in 2016, and the study is expected to end in 2020. Conclusions: This study will contribute prospective, controlled data on outcomes and predictors of relapse in patients with inflammatory bowel disease after withdrawal of anti-TNF agents following achievement of clinical remission. Clinical trial reference number: EudraCT 2015-001410-1

Students on placement

Like other professions, many undergraduate LIS courses require students to undertake some form of practicum as part of their course work in order to gain a better understanding of the link between theory and professional practice. As part of that placement, they are often required to maintain a learning diarz where they reflect on that linkage and other aspects of their workplace learning which then forms the basis of an assessable piece of work. In addition, the learning diary is also used to record their day-to-day activities and the application of their class based learning in the work environment. This information is then used to build and develop their e-portfolios, adding a practical dimension to round out the skills and knowledge already embedded in the portfolio. This paper will report outcomes of a survey of LIS students undertaken in Slovenia and Australia on their experience of work placements and the benefits this can bring to enhancing their personal portfolios. In both countries, undergraduate students undertake a three week placement during the latter stages of their course when their portfolios have been established for some time. The placements are in a wide range of information agencies and have been selected in consultation between the student and staff member for their suitability in meeting the student\u27s longer term career ambitions. The research has also an important comparative dimension, comparing two geographically distant countries with similar approaches to LIS education, and their experience in using e-portfolio in placements as the part of preparation of students for their future professional careers. Students were asked to complete a survey prior to undertaking their placement which sought to determine their expectations as to the usefulness and relevance of the placement in enhancing their portfolios and subsequent career prospects. After completing their placement, students completed a second survey as to how well the experience fitted with their expectations and its benefits to their portfolios and professional ambitions. The outcomes from this research will help inform the nature of the work placement experience - where it fits with expectations and where it doesn\u27t - and how useful the activity is in giving breadth and depth to a student\u27s portfolio in order to increase its value as a tool when seeking employment

Temporal dynamics of Middle East respiratory syndrome coronavirus in the Arabian Peninsula, 2012-2017

Altres ajuts: CERCA Programme/Generalitat de CatalunyaMiddle East respiratory syndrome coronavirus (MERS-CoV) remains a notable disease and poses a significant threat to global public health. The Arabian Peninsula is considered a major global epicentre for the disease and the virus has crossed regional and continental boundaries since 2012. In this study, we focused on exploring the temporal dynamics of MERS-CoV in human populations in the Arabian Peninsula between 2012 and 2017, using publicly available data on case counts and combining two analytical methods. Disease progression was assessed by quantifying the time-dependent reproductive number (TD-Rs), while case series temporal pattern was modelled using the AutoRegressive Integrated Moving Average (ARIMA). We accounted for geographical variability between three major affected regions in Saudi Arabia including Eastern Province, Riyadh and Makkah. In Saudi Arabia, the epidemic size was large with TD-Rs >1, indicating significant spread until 2017. In both Makkah and Riyadh regions, the epidemic progression reached its peak in April 2014 (TD-Rs > 7), during the highest incidence period of MERS-CoV cases. In Eastern Province, one unique super-spreading event (TD-R > 10) was identified in May 2013, which comprised of the most notable cases of human-to-human transmission. Best-fitting ARIMA model inferred statistically significant biannual seasonality in Riyadh region, a region characterised by heavy seasonal camel-related activities. However, no statistical evidence of seasonality was identified in Eastern Province and Makkah. Instead, both areas were marked by an endemic pattern of cases with sporadic outbreaks. Our study suggested new insights into the epidemiology of the virus, including inferences about epidemic progression and evidence for seasonality. Despite the inherent limitations of the available data, our conclusions provide further guidance to currently implement risk-based surveillance in high-risk populations and, subsequently, improve related interventions strategies against the epidemic at country and regional levels

Model for Enhancing Integrated Identification, Assessment, and Operational Control of On-Site Environmental Impacts and Health and Safety Risks in Construction Firms

Certifiable management-system standards apply similar management techniques and principles, but each system still tends to have a separate structure in construction companies. Research and practice have demonstrated that management tasks may be duplicated when standards are implemented in parallel. Consequently, integrated management systems are strongly advocated. However, existing literature demonstrates that the integration of planning and control instruments involves a high level of uncertainty. This paper presents an innovative model to enhance the integration of environmental- and health and safety–management systems in construction companies, focusing on the subsystems for identifying, assessing, and operationally controlling environmental aspects and health and safety hazards and using risk as an integrating factor. The findings of this study have direct implications for both designers and contractors because the model helps to explicitly consider on-site environmental impacts and construction-worker safety during the design process and offers on-site guidance to eliminate the remaining impacts and risks or reduce them to acceptable levels. A case study is reported to illustrate the practical use of the proposed model and its benefits

Model for enhancing integrated identification, assessment, and operational control of on-site environmental impacts and health and safety risks in construction firms

Certifiable management-system standards apply similar management techniques and principles, but each system still tends to have a separate structure in construction companies. Research and practice have demonstrated that management tasks may be duplicated when standards are implemented in parallel. Consequently, integrated management systems are strongly advocated. However, existing literature demonstrates that the integration of planning and control instruments involves a high level of uncertainty. This paper presents an innovative model to enhance the integration of environmental- and health and safety – management systems in construction companies, focusing on the subsystems for identifying, assessing, and operationally controlling environmental aspects and health and safety hazards and using risk as an integrating factor. The findings of this study have direct implications for both designers and contractors because the model helps to explicitly consider on-site environmental impacts and construction-worker safety during the design process and offers on-site guidance to eliminate the remaining impacts and risks or reduce them to acceptable levels. A case study is reported to illustrate the practical use of the proposed model and its benefits.Peer Reviewe