Correspondence Between Cytomegalovirus Immunoglobulin-G Levels Measured in Saliva and Serum

Human cytomegalovirus (HCMV) infects more than 80% of the global population. While mostly asymptomatic, HCMV infection can be serious among the immunocompromised, and it is implicated in chronic disease pathophysiology in adulthood. Large-scale minimally invasive HCMV screening could advance research and public health efforts to monitor infection prevalence and prevent or mitigate downstream risks associated with infection. We examine the utility of measuring HCMV immunoglobulin-G (IgG) levels in saliva as an index of serum levels. Matched serum and saliva samples from healthy adults (N = 98; 44% female; 51% white) were assayed for HCMV IgG, total salivary protein, and salivary markers related to oral inflammation, blood, and tissue integrity. We examine the serum-saliva association for HCMV IgG and assess the influence of participant characteristics and factors specific to the oral compartment (e.g., oral inflammation) on HCMV IgG levels and cross-specimen relations. We found a robust serum-saliva association for HCMV IgG with serum antibody levels accounting for \u3e60% of the variance in salivary levels. This relation remained after adjusting for key demographic and oral immune-related variables. Compared to the serum test, the salivary HCMV IgG test had 51% sensitivity and 97% specificity. With improvements in assay performance and sample optimization, HCMV antibody levels in oral fluids may be a useful proxy for serum levels

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Correspondence Between Cytomegalovirus Immunoglobulin-G Levels Measured in Saliva and Serum

Human cytomegalovirus (HCMV) infects more than 80% of the global population. While mostly asymptomatic, HCMV infection can be serious among the immunocompromised, and it is implicated in chronic disease pathophysiology in adulthood. Large-scale minimally invasive HCMV screening could advance research and public health efforts to monitor infection prevalence and prevent or mitigate downstream risks associated with infection. We examine the utility of measuring HCMV immunoglobulin-G (IgG) levels in saliva as an index of serum levels. Matched serum and saliva samples from healthy adults (N = 98; 44% female; 51% white) were assayed for HCMV IgG, total salivary protein, and salivary markers related to oral inflammation, blood, and tissue integrity. We examine the serum-saliva association for HCMV IgG and assess the influence of participant characteristics and factors specific to the oral compartment (e.g., oral inflammation) on HCMV IgG levels and cross-specimen relations. We found a robust serum-saliva association for HCMV IgG with serum antibody levels accounting for \u3e60% of the variance in salivary levels. This relation remained after adjusting for key demographic and oral immune-related variables. Compared to the serum test, the salivary HCMV IgG test had 51% sensitivity and 97% specificity. With improvements in assay performance and sample optimization, HCMV antibody levels in oral fluids may be a useful proxy for serum levels

Correspondence Between Cytomegalovirus Immunoglobulin-G Levels Measured in Saliva and Serum.

Human cytomegalovirus (HCMV) infects more than 80% of the global population. While mostly asymptomatic, HCMV infection can be serious among the immunocompromised, and it is implicated in chronic disease pathophysiology in adulthood. Large-scale minimally invasive HCMV screening could advance research and public health efforts to monitor infection prevalence and prevent or mitigate downstream risks associated with infection. We examine the utility of measuring HCMV immunoglobulin-G (IgG) levels in saliva as an index of serum levels. Matched serum and saliva samples from healthy adults (N = 98; 44% female; 51% white) were assayed for HCMV IgG, total salivary protein, and salivary markers related to oral inflammation, blood, and tissue integrity. We examine the serum-saliva association for HCMV IgG and assess the influence of participant characteristics and factors specific to the oral compartment (e.g., oral inflammation) on HCMV IgG levels and cross-specimen relations. We found a robust serum-saliva association for HCMV IgG with serum antibody levels accounting for >60% of the variance in salivary levels. This relation remained after adjusting for key demographic and oral immune-related variables. Compared to the serum test, the salivary HCMV IgG test had 51% sensitivity and 97% specificity. With improvements in assay performance and sample optimization, HCMV antibody levels in oral fluids may be a useful proxy for serum levels

Investigating students’ opinions on how university career services should operate in a post COVID-19 Ireland

This article was written by current students and recent graduates of Trinity Business School, Trinity College Dublin in conjunction with a guidance counsellor from the college. The goal of the paper is to provide suggestions on what university careers services in Ireland could consider when providing services to students in a post COVID-19 world. The recommendations are as follows 1) embedding careers as a module in the course curricula so that students feel encouraged to engage with career exploration rather than perceive it as optional, 2) focus on developing closer relationships with students with a view to fostering more in depth career exploration, 3) using technology in a manner that supports the development of closer working relationships between student and guidance counsellors, and 4) guidance counsellors to consider introducing green guidance so as to encourage students to consider the wider ecological implications of their career decisions

Développement d’un outil d’aide à la décision pour la gestion intégrée des adventices

EAGESTADAGROSUPINRACT1 EJ2Integrated weed management consists in using several weed management techniques in a long-term approach. The vast number of techniques precludes cropping systems from being easily conceived and climatic interactions render the systems difficult to pursue. Farmers and farm advisors need decision support systems (DSS) to develop weed management strategies adapted to multicriteria/multiobjectives of weed management, to the economic, social and environmental stakes and to the constraints of farmers. Such a DSS is developed from the mechanistic weed dynamic model FLORSYS. This model is a “virtual field” allowing the evaluation of the performance of agricultural systems over a large range of agricultural and pedoclimatic situations. Different stakeholders are associated with the tool development in order to adapt the prototypes to the farmers' objectives and constraints, via surveys, meetings and workshops with the future users.La gestion intégrée des adventices consiste à combiner de nombreuses pratiques agricoles en anticipant leurs effets à long terme. La multitude de combinaisons possibles rend les systèmes de culture difficiles à concevoir et l’interaction avec le climat rend les sytèmes difficiles à mettre en oeuvre. Les agriculteurs et conseillers agricoles ont donc besoin d’outils d’aide à la décision leur permettant de développer des stratégies adaptées à l'aspect multicritères/multiobjectifs de la gestion de la flore adventice, aux enjeux économiques, sociaux et environnementaux et aux moyens disponibles et objectifs particuliers de chaque agriculteur. Un tel outil d’aide à la décision est développé à partir du modèle mécaniste de dynamique de la flore adventice FLORSYS. Ce modèle simule une "parcelle virtuelle" et permet l’évaluation des performances de systèmes de culture sur une large gamme de situations agricoles et pédoclimatiques. Différents acteurs sont associés au développement de l’outil afin d’adapter les prototypes aux objectifs et contraintes des agriculteurs, via des enquêtes, des rencontres et des ateliers avec les futurs utilisateurs

Développement d’un outil d’aide à la décision pour la gestion intégrée des adventices : implication des futurs utilisateurs

EAGESTADAGROSUPINRA DOCTAfin de concevoir un outil d’aide à la décision pour aider à la gestion intégrée des adventices à partir du modèle FlorSys, nous avons développé une méthode afin d’utiliser le contenu logique et objectif de FlorSys et de co-construire la structure et le format de l’outil. Différents acteurs ont été associés dans le co-développement de l’outil afin d’adapter les prototypes aux objectifs et contraintes des agriculteurs, via des enquêtes, des rencontres et des ateliers avec les futurs utilisateurs. Ces interactions ont permis de déterminer 2 cas d’usages : (1) la reconception de système de cultures via des méta-règles de décisions ; (2) l’ajustement des pratiques avec des listes détaillées d’opération. L’outil devra comporter 3 composantes : (1) un guide de conception de système ; (2) des tests et évaluations synthétiques et (3) des tests et évaluations détaillées