36 research outputs found
Maternal Malaria and Malnutrition (M3) initiative, a pooled birth cohort of 13 pregnancy studies in Africa and the Western Pacific.
PURPOSE: The Maternal Malaria and Malnutrition (M3) initiative has pooled together 13 studies with the hope of improving understanding of malaria-nutrition interactions during pregnancy and to foster collaboration between nutritionists and malariologists. PARTICIPANTS: Data were pooled on 14â
635 singleton, live birth pregnancies from women who had participated in 1 of 13 pregnancy studies. The 13 studies cover 8 countries in Africa and Papua New Guinea in the Western Pacific conducted from 1996 to 2015. FINDINGS TO DATE: Data are available at the time of antenatal enrolment of women into their respective parent study and at delivery. The data set comprises essential data such as malaria infection status, anthropometric assessments of maternal nutritional status, presence of anaemia and birth weight, as well as additional variables such gestational age at delivery for a subset of women. Participating studies are described in detail with regard to setting and primary outcome measures, and summarised data are available from each contributing cohort. FUTURE PLANS: This pooled birth cohort is the largest pregnancy data set to date to permit a more definite evaluation of the impact of plausible interactions between poor nutritional status and malaria infection in pregnant women on fetal growth and gestational length. Given the current comparative lack of large pregnancy cohorts in malaria-endemic settings, compilation of suitable pregnancy cohorts is likely to provide adequate statistical power to assess malaria-nutrition interactions, and could point towards settings where such interactions are most relevant. The M3 cohort may thus help to identify pregnant women at high risk of adverse outcomes who may benefit from tailored intensive antenatal care including nutritional supplements and alternative or intensified malaria prevention regimens, and the settings in which these interventions would be most effective
Malaria, malnutrition, and birthweight: A meta-analysis using individual participant data.
BACKGROUND: Four studies previously indicated that the effect of malaria infection during pregnancy on the risk of low birthweight (LBW; <2,500 g) may depend upon maternal nutritional status. We investigated this dependence further using a large, diverse study population. METHODS AND FINDINGS: We evaluated the interaction between maternal malaria infection and maternal anthropometric status on the risk of LBW using pooled data from 14,633 pregnancies from 13 studies (6 cohort studies and 7 randomized controlled trials) conducted in Africa and the Western Pacific from 1996-2015. Studies were identified by the Maternal Malaria and Malnutrition (M3) initiative using a convenience sampling approach and were eligible for pooling given adequate ethical approval and availability of essential variables. Study-specific adjusted effect estimates were calculated using inverse probability of treatment-weighted linear and log-binomial regression models and pooled using a random-effects model. The adjusted risk of delivering a baby with LBW was 8.8% among women with malaria infection at antenatal enrollment compared to 7.7% among uninfected women (adjusted risk ratio [aRR] 1.14 [95% confidence interval (CI): 0.91, 1.42]; N = 13,613), 10.5% among women with malaria infection at delivery compared to 7.9% among uninfected women (aRR 1.32 [95% CI: 1.08, 1.62]; N = 11,826), and 15.3% among women with low mid-upper arm circumference (MUAC <23 cm) at enrollment compared to 9.5% among women with MUAC â„ 23 cm (aRR 1.60 [95% CI: 1.36, 1.87]; N = 9,008). The risk of delivering a baby with LBW was 17.8% among women with both malaria infection and low MUAC at enrollment compared to 8.4% among uninfected women with MUAC â„ 23 cm (joint aRR 2.13 [95% CI: 1.21, 3.73]; N = 8,152). There was no evidence of synergism (i.e., excess risk due to interaction) between malaria infection and MUAC on the multiplicative (p = 0.5) or additive scale (p = 0.9). Results were similar using body mass index (BMI) as an anthropometric indicator of nutritional status. Meta-regression results indicated that there may be multiplicative interaction between malaria infection at enrollment and low MUAC within studies conducted in Africa; however, this finding was not consistent on the additive scale, when accounting for multiple comparisons, or when using other definitions of malaria and malnutrition. The major limitations of the study included availability of only 2 cross-sectional measurements of malaria and the limited availability of ultrasound-based pregnancy dating to assess impacts on preterm birth and fetal growth in all studies. CONCLUSIONS: Pregnant women with malnutrition and malaria infection are at increased risk of LBW compared to women with only 1 risk factor or none, but malaria and malnutrition do not act synergistically
Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum- endemic regions: a meta-analysis
In areas of moderate to intense Plasmodium falciparum transmission, malaria in pregnancy remains a significant cause of low birth weight, stillbirth, and severe anaemia. Previously, fetal sex has been identified to modify the risks of maternal asthma, pre-eclampsia, and gestational diabetes. One study demonstrated increased risk of placental malaria in women carrying a female fetus. We investigated the association between fetal sex and malaria in pregnancy in 11 pregnancy studies conducted in sub-Saharan African countries and Papua New Guinea through meta-analysis using log binomial regression fitted to a random-effects model. Malaria infection during pregnancy and delivery was assessed using light microscopy, polymerase chain reaction, and histology. Five studies were observational studies and six were randomised controlled trials. Studies varied in terms of gravidity, gestational age at antenatal enrolment and bed net use. Presence of a female fetus was associated with malaria infection at enrolment by light microscopy (risk ratio 1.14 [95% confidence interval 1.04, 1.24]; P = 0.003; n = 11,729). Fetal sex did not associate with malaria infection when other time points or diagnostic methods were used. There is limited evidence that fetal sex influences the risk of malaria infection in pregnancy
Recent smell loss is the best predictor of COVID-19 among individuals with recent respiratory symptoms
In a preregistered, cross-sectional study we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean±SD, C19+: -82.5±27.2 points; C19-: -59.8±37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC=0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings â€2 indicate high odds of symptomatic COVID-19 (4<10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable
Robust estimation of bacterial cell count from optical density
Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data
Sharing and community curation of mass spectrometry data with Global Natural Products Social Molecular Networking
The potential of the diverse chemistries present in natural products (NP) for biotechnology and medicine remains untapped because NP databases are not searchable with raw data and the NP community has no way to share data other than in published papers. Although mass spectrometry techniques are well-suited to high-throughput characterization of natural products, there is a pressing need for an infrastructure to enable sharing and curation of data. We present Global Natural Products Social molecular networking (GNPS, http://gnps.ucsd.edu), an open-access knowledge base for community wide organization and sharing of raw, processed or identified tandem mass (MS/MS) spectrometry data. In GNPS crowdsourced curation of freely available community-wide reference MS libraries will underpin improved annotations. Data-driven social-networking should facilitate identification of spectra and foster collaborations. We also introduce the concept of âliving dataâ through continuous reanalysis of deposited data
Contributions et dĂ©fis de lâutilisation des technopĂ©dagogies Ă des fins de soutien Ă lâappropriation des meilleures pratiques en santĂ© mentale
Contexte MalgrĂ© les ressources considĂ©rables consacrĂ©es et les efforts des nombreux acteurs concernĂ©s, lâĂ©cart entre la production de connaissances scientifiques et leur utilisation dans la pratique demeure un dĂ©fi. Lâutilisation des technologies de lâinformation et des communications (TICs) constitue un outil prĂ©cieux pour rĂ©duire cet Ă©cart. Afin de relever ce dĂ©fi, un projet de dĂ©monstration misant sur lâutilisation des technologies Ă des fins dâapplication des connaissances a Ă©tĂ© dĂ©ployĂ© auprĂšs de 23 équipes de soutien dans la communautĂ© de 5 rĂ©gions du QuĂ©bec (2016-2018). Plus de 324 professionnels de la santĂ© mentale, chefs dâĂ©quipe et gestionnaires ont bĂ©nĂ©ficiĂ© de lâinitiative Ă portĂ©e de main, les meilleures pratiques axĂ©es vers le rĂ©tablissement.Objectif Cet article prĂ©sente les rĂ©sultats de lâĂ©tude de satisfaction effectuĂ©e auprĂšs des chefs dâĂ©quipe responsables du soutien clinique dans les Ă©quipes de soutien dans la communautĂ© Ă lâĂ©tude. Lâobjectif de cette Ă©tude consiste Ă enrichir la comprĂ©hension dâenjeux colligĂ©s en cours dâimplantation et dâĂ©mettre des recommandations en vue dâune mise Ă lâĂ©chelle pĂ©renne du programme dâapplication des connaissances mis en oeuvre.MĂ©thode Un devis qualitatif en recherche Ă©valuative a Ă©tĂ© privilĂ©giĂ©. Au terme du processus dâimplantation du programme, 2 entrevues de groupe ont Ă©tĂ© effectuĂ©es avec les chefs dâĂ©quipe. Une analyse de contenu suivant une approche inductive Ă 3 niveaux de codification a Ă©tĂ© rĂ©alisĂ©e.RĂ©sultats Les rĂ©sultats montrent un dĂ©calage numĂ©rique important au sein du rĂ©seau de la santĂ© et des services sociaux quĂ©bĂ©cois comparativement Ă dâautres secteurs dâactivitĂ©s. Les participants soulignent lâimportance de se doter de mĂ©canismes dâĂ©change et de transfert des connaissances intĂ©grĂ©s aux pratiques organisationnelles (temps dĂ©diĂ©, supervision clinique formelle, etc.) mettant Ă contribution les TICs.Conclusion MalgrĂ© une importante mise Ă niveau technologique requise, les rĂ©sultats confirment la pertinence dâutiliser les technopĂ©dagogies comme principal moyen pour soutenir lâapplication des connaissances et la transformation des pratiques. Les outils conçus et les modalitĂ©s de soutien explorĂ©s semblent faciliter lâaccĂšs aux meilleures pratiques en santĂ© mentale et favoriser leur adoption.Context Despite the considerable resources devoted and the efforts of the many actors involved, the gap between the production of scientific knowledge and its use in practice remains a challenge. The use of information and communication technologies (ICTs) is a valuable tool for reducing this gap. To address this challenge, a demonstration project focusing on the use of technology for knowledge translation was implemented with 23 community support teams in 5 regions of Quebec (2016-2018). More than 324 mental health professionals, team leaders and managers have benefited from the initiative âAt your fingertips, best recovery-oriented practices.âObjective This article presents the results of a satisfaction survey of team leaders responsible for clinical support in the community support teams under study. The purpose of this study is to enhance the understanding of issues identified during implementation and to make recommendations for the sustainable scaling up of the implemented knowledge translation program.Method A qualitative design in this evaluative research was adopted. At the end of the program implementation process, 2 group interviews were conducted with the team leaders. A content analysis following an inductive approach with 3 levels of coding was performed.Results The results show a significant digital gap within the Quebec health and social services network compared to other sectors of activity. Participants underlined the importance of adopting mechanisms for knowledge exchange and transfer that are integrated into organizational practices (dedicated time, formal clinical supervision, etc.) and which make use of ICTs.Conclusion Despite the significant technology upgrade required, the results suggest the relevance of using techno-pedagogy as the primary means of supporting knowledge translation and practice transformation. The tools developed and the support mechanisms explored appear to facilitate access to and adoption of best practices in mental health
Le « prendre soin » de la santĂ© (PSS) : une conception transdisciplinaire et inclusive de la pratique soignante et son intĂ©rĂȘt pour amĂ©liorer les rĂ©sultats de santĂ© des jeunes aux prises avec le diabĂšte
La prĂ©valence accrue des maladies chroniques, dont celles pour lesquelles la prĂ©vention est possible, met en relief certaines limites des perspectives de soins de santĂ© couramment dĂ©ployĂ©es. Nous soutenons quâune meilleure comprĂ©hension du « prendre soin », qui ne se limite pas aux actes mĂ©dicaux et infirmiers, ni Ă la science infirmiĂšre, est nĂ©cessaire pour amĂ©liorer les pratiques et les rĂ©sultats de santĂ©. Prendre soin de la santĂ© (PSS), comprenant le « prendre soin de soi », est un concept plus large que lâobservance du traitement et lâautogestion de la maladie ou de la santĂ©. Cet article vise Ă explorer lâintĂ©rĂȘt du PSS. Une recherche documentaire a Ă©tĂ© rĂ©alisĂ©e pour mieux cerner les particularitĂ©s du PSS, en examinant les fondements philosophiques, thĂ©oriques et pratiques du « prendre soin » par rapport Ă dâautres approches, dont le caring, et aux dĂ©fis rencontrĂ©s. La problĂ©matique de santĂ© des jeunes diabĂ©tiques et de leur famille sert dâancrage Ă la rĂ©flexion proposĂ©e. Pour cette problĂ©matique, entre autres, la recension des Ă©crits suggĂšre que le PSS est porteur de possibilitĂ©s pour amĂ©liorer lâaccompagnement et la qualitĂ© de vie des personnes atteintes et pour dĂ©velopper lâagir prĂ©ventif.The rising prevalence of chronic diseases, including those that are preventable, underlines important limitations of the healthcare perspectives commonly used. We argue that a better understanding of âprendre soinâ (caring), which is not limited to medical or nursing procedures, nor to nursing science, is necessary to improve health practices and outcomes. âPrendre soin de la santĂ©â or PSS (taking care of health or caring), which includes âprendre soin de soiâ (taking care of oneself or self-care), is a concept broader than compliance to treatment and disease or health management. This paper aims at exploring the interest of PSS for healthcare. A literature review was conducted to examine the philosophical, theoretical and practical underpinnings of âprendre soinâ in relation to other approaches, including caring, and current challenges. The proposed analysis is situated within the context of diabetic youth and their familiesâ health care. For this particular situation and others, PSS carries possibilities for improving the assistance and quality of life of the persons affected and to foster prevention
The lipoatrophic caveolin-1 deficient mouse model reveals autophagy in mature adipocytes
International audienc