Prevalence of ragweed allergy in rural Geneva - a pilot study.

OBJECTIVE: The prevalence of ragweed allergy is increasing worldwide. Ragweed distribution and abundance is spreading in Europe in a wide area ranging from the Rhone valley in France to Hungary and Ukraine, where the rate of the prevalence can peak at as high as 12%. Low-grade ragweed colonisation was seen in Geneva and Ticino, less than two decades ago. There were fears that allergies to ragweed would increase Switzerland. The intent of this study was to assess the rate of prevalence of sensitisation and allergy to ragweed in the population living in the first rural Swiss setting where ragweed had been identified in 1996, and to evaluate indirectly the efficacy of elimination and containment strategies. MATERIAL AND METHODS: In 2009, 35 adults in a rural village in the Canton of Geneva were recruited. Data were collected by means of questionnaires and skin-prick tests were done on each participant. The study was approved by the local Ethics Committee. RESULTS: Based on questionnaires, 48.6% had rhinitis (95% confidence interval [CI] 32.9-64.4; n = 17/35) and 17.1% asthma (95% CI 8.1-32.6; n = 6/35). Atopy was diagnosed in 26.4% (95% CI 12.9-44.4) of the sample (n = 9/34). Ragweed sensitisation was found in 2.9% (95% CI 0.7-19.7; n = 1/34), mugwort sensitisation in 2.9% (95% CI 0.1-14.9; n = 1/35), alder sensitisation in 17.1% (95% CI 6.6-33.6; n = 6/35), ash sensitisation in 12.5% (95% CI 3.5-29.0; n = 4/32) and grass sensitisation in 22.9% (95% CI 10.4-40.1; n = 8/35). Ragweed (95% CI 0.1-14.9; n = 1/34) and mugwort allergies (95% CI 0.1-14.9; n = 1/35) were both found in 2.9% of the population. CONCLUSION: This study showed a surprisingly low incidence of ragweed sensitisation and allergy, of 2.9% and 2.9%, respectively, 20 years after the first ragweed detection in Geneva. The feared rise in ragweed allergy seems not to have happened in Switzerland, compared with other ragweed colonised countries. These results strongly support early field strategies against ragweed

Exhaled nitric oxide decreases after positive food-allergen challenge

Background: Exhaled nitric oxide (FeNO) is a well described marker of airway inflammation in asthma and is also known to increase after chronic exposure to inhaled allergens. It is not known whether monitoring FeNO could be useful during food challenges to detect early or subclinical reactions. Methods: Forty children aged 3 to 16 years undergoing an allergen-food challenge at two centres were prospectively recruited for this study. FeNO was assessed before and repeatedly after the food-challenge. Results: Data were obtained from a total of 53 challenges (16 positive, 37 negative) and were compared between the two groups. Half of the patients with a positive food challenge exhibited clinical upper respiratory symptoms. The FeNO significantly decreased in 7 of 16 patients with a positive challenge test within 60 to 90 minutes after the first symptoms of an allergic reaction. Conclusion: Our results show a significant decrease in FeNO after a positive food challenge suggesting involvement of the lower airways despite absence of clinical and functional changes of lower airways. Prospective blinded studies are needed to confirm these results

Factors associated with rifampin resistance in staphylococcal periprosthetic joint infections (PJI): a matched case-control study

Purpose: Rifampin combination therapy plays an important role in the management of staphylococcal periprosthetic joint infection (PJI). However, the emergence of rifampin resistance is a feared complication. We retrospectively analysed predetermined potential risk factors in patients with rifampin-resistant staphylococcal PJI in a multicentre case-control study. Methods: Cases (n=48) were defined as PJI caused by rifampin-resistant staphylococci. Rifampin-susceptible controls (n=48) were matched for microorganism and type of prosthetic joint. Uni- and multivariable conditional logistic regression analyses were performed to estimate odds ratios (OR) with 95% confidence intervals (95% CI). Results: Forty-eight cases (31 men; median age 67years; age range 39-88years) with hip- (n=29), knee- (n=13), elbow- (n=4), shoulder- (n=1) or ankle-PJI (n=1) were enrolled in the study. Staphylococcus aureus and coagulase-negative staphylococci were isolated in ten and 38 episodes, respectively. Most of the cases (n=44, 92%) had a previous PJI, and 93 % (n=41) of these had been treated with rifampin. There was an independent association of emergence of rifampin resistance with male sex (OR 3.6, 95% CI 1.2-11),≥3 previous surgical revisions (OR 4.7, 95% CI 1.6-14.2), PJI treatment with high initial bacterial load (inadequate surgical debridement, <2weeks of intravenous treatment of the combination medication; OR 4.9, 95% CI 1.6-15) and inadequate rifampin therapy (OR 5.4, 95% CI 1.2-25). Conclusions: Based on our results, extensive surgical debridement and adequate antibiotic therapy are needed to prevent the emergence of rifampin resistanc

Veränderungen der Ertragsmodelle durch digitale Produkt-Service- Systeme am Beispiel dormakaba

Dormakaba ist ein globaler Anbieter von smarten und sicheren Zutrittslösungen und ein Beispiel für Digitalisierung von produzierenden Unternehmen. Die Digitalisierung betrifft nicht nur dormakaba selber, sondern verändert Abläufe und Geschäftsmodelle in der gesamten Gebäude- & Sicherheitsbranche. Zum einen werden Räume flexibler genutzt. Zum anderen kommen digitale Lösungen bereits bei der Planung und Realisierung sowie bei der Verwaltung von Gebäuden zum Einsatz. Mit der digitalen Plattform „dormakaba exivo“ ermöglicht dormakaba die elektronische Verwaltung von Zutrittsberechtigungen. Dies ist die Grundlage für vielfältige neue Geschäftsmodelle rund um den Zugang zu und die Nutzung von Räumen. Im Business Model Profit Schema wird für einige dieser neuen Geschäftsmodelle dargestellt, welche physischen Komponenten oder Dienstleistungen kostenfrei oder zu sehr niedrigen Kosten zur Verfügung gestellt werden und mit welchen Dienstleistungen Deckungsbeiträge erwirtschaftet werden

A review of the Cis-Andean species of Hemibrycon Günther (Teleostei: Characiformes: Characidae: Stevardiinae), with description of two new species

As espécies de Hemibrycon que ocorrem a leste das Cordilheiras dos Andes são revisadas com base na análise do material tipo e exemplares adicionais. Nove espécies são redescritas: H. beni da bacia do río Beni, Bolívia; H. helleri do alto río Ucayali, Peru; H. huambonicus para as bacias dos ríos Huallaga e Marañon, Peru; H. jeslkii para as porções superiores das bacias dos rios Marañon, Ucayali e Madeira, Bolívia, Brasil e Peru; H. metae para a bacia do río Orinoco, Colômbia e Venezuela, e bacias costeiras do Caribe na Venezuela; H. polyodon (espécie-tipo) para a bacia do río Pastaza, Equador; H. surinamensis para as bacia costeiras da Guiana Francesa e Suriname, e porção inferior das bacias dos rios Tapajós, Tocantins e Xingu, Brasil; H. taeniurus para os rios da ilha de Trinidad, Trinidad and Tobago; H. tridens para a bacia do alto río Ucayali, Peru. Duas espécies novas são descritas: H. inambari para a bacia do alto río Madre de Dios, Peru e H. mikrostiktos para a bacia do río Ucayali, Peru. Estas espécies distinguem-se principalmente pelo padrão de colorido e caracteres merísticos. A área de distribuição do gênero é ampliada para as porções inferiores das bacias do Tapajós, Tocantins e Xingu, Brasil, com o primeiro registro de H. surinamensis para este país. Uma nova diagnose e descrição são fornecidas para a espécie-tipo do gênero, apesar de ter sido recentemente redescrita. A série-tipo de H. helleri previamente considerada questionável é encontrada e descrita. Hemibrycon coxeyi e H. pautensis são considerados sinônimos juniores de H. polyodon. Tetragonopterus (Hemibrycon) trinitatis, anteriormente considerada como species inquirenda em Characidae, e Hemibrycon guppyi são sinônimos juniores de H. taeniurus. Hemibrycon orcesi é transferida para Boehlkea. É apresentada uma chave taxonômica para as espécies do gênero a leste das Cordilheiras dos Andes.The species of Hemibrycon occurring in the east of the Andean Cordilleras are reviewed based on their type series and additional specimens. Nine species are redescribed: H. beni from río Beni basin, Bolivia; H. helleri from the upper rio Ucayali, Peru; H. huambonicus from the ríos Huallaga and Marañon basins, Peru; H. jeslkii from the upper portions of ríos Marañon, Ucayali and Madeira basins, Bolivia, Brazil, and Peru; H. metae from río Orinoco basin, Colombia and Venezuela, and Caribbean coastal basins of Venezuela; H. polyodon (type species) from río Pastaza basin, Ecuador; H. surinamensis from coastal basins of French Guiana and Suriname, and from lower rios Tapajós, Tocantins and Xingu basins, Brazil; H. taeniurus from river basins from Trinidad Island, Trinidad and Tobago, and H. tridens from upper río Ucayali basin, Peru. Two new species are described: H. inambari from the upper río Madre de Dios basin, Peru and H. mikrostiktos from río Ucayali basin, Peru. These species are distinguished among themselves mainly by the color pattern, and meristic characters. The distribution area of the genus is enlarged reaching the lower Tapajós, Tocantins and Xingu river basins, Brazil, with the first record of the occurrence of H. surinamensis in this country. A new description and diagnosis is provided for the type species of the genus, regardless its recent redescription. The type series of H. helleri that was previously considered dubious is found and described. Hemibrycon coxeyi and H. pautensis are considered junior synonyms of H. polyodon. Tetragonopterus (Hemibrycon) trinitatis, previously considered species inquirenda in Characidae, and Hemibrycon guppyi are junior synonyms of H. taeniurus. Hemibrycon orcesi is transferred to Boehlkea. A taxonomic key for the species of the genus to the east of the Andean Cordilleras is presented

The combined diabetes and renal control trial (C-DIRECT) - a feasibility randomised controlled trial to evaluate outcomes in multi-morbid patients with diabetes and on dialysis using a mixed methods approach

Background: This cluster randomised controlled trial set out to investigate the feasibility and acceptability of the “Combined Diabetes and Renal Control Trial” (C-DIRECT) intervention, a nurse-led intervention based on motivational interviewing and self-management in patients with coexisting end stage renal diseases and diabetes mellitus (DM ESRD). Its efficacy to improve glycaemic control, as well as psychosocial and self-care outcomes were also evaluated as secondary outcomes. Methods: An assessor-blinded, clustered randomised-controlled trial was conducted with 44 haemodialysis patients with DM ESRD and ≥ 8% glycated haemoglobin (HbA1c), in dialysis centres across Singapore. Patients were randomised according to dialysis shifts. 20 patients were assigned to intervention and 24 were in usual care. The C-DIRECT intervention consisted of three weekly chair-side sessions delivered by diabetes specialist nurses. Data on recruitment, randomisation, and retention, and secondary outcomes such as clinical endpoints, emotional distress, adherence, and self-management skills measures were obtained at baseline and at 12 weeks follow-up. A qualitative evaluation using interviews was conducted at the end of the trial. Results: Of the 44 recruited at baseline, 42 patients were evaluated at follow-up. One patient died, and one discontinued the study due to deteriorating health. Recruitment, retention, and acceptability rates of C-DIRECT were generally satisfactory HbA1c levels decreased in both groups, but C-DIRECT had more participants with HbA1c < 8% at follow up compared to usual care. Significant improvements in role limitations due to physical health were noted for C-DIRECT whereas levels remained stable in usual care. No statistically significant differences between groups were observed for other clinical markers and other patient-reported outcomes. There were no adverse effects. Conclusions: The trial demonstrated satisfactory feasibility. A brief intervention delivered on bedside as part of routine dialysis care showed some benefits in glycaemic control and on QOL domain compared with usual care, although no effect was observed in other secondary outcomes. Further research is needed to design and assess interventions to promote diabetes self-management in socially vulnerable patients

Using ancient DNA to unravel taxonomic puzzles: the identity of Deuterodon pedri (Ostariophysi: Characidae)

ABSTRACT Accurate identification is essential for any study exploring biodiversity. Unfortunately, museum type specimens preserved for more than a hundred years are often not informative enough for precise identification of the species represented by the name-bearing type. The use of ancient DNA can help solve taxonomic problems when name-bearing types no longer have diagnostic morphological features that allow for an accurate identification of the species involved. That is the case for Deuterodon pedri, an endemic species from a small drainage in the rio Doce basin in Minas Gerais, Brazil, for which the type material is in poor condition. Specimens of D. pedri were collected in 1865 by the Thayer Expedition to Brazil and fixed in spirits, enabling them to yield viable DNA. As the morphology alone of the type material does not allow for an accurate identification, we used both morphological and ancient DNA (aDNA) methods to decisively establish the identity of D. pedri. This identification allowed us to recognize the species among recently collected specimens and then, based on them, redescribe the species. A genetype for the lectotype of D. pedri is presented