Understanding Biofilm-Phage Interactions in Cystic Fibrosis Patients Using Mathematical Frameworks

When planktonic bacteria adhere together to a surface, they begin to form biofilms, or communities of bacteria. Biofilm formation in a host can be extremely problematic if left untreated, especially since antibiotics can be ineffective in treating the bacteria. Certain lung diseases such as cystic fibrosis can cause the formation of biofilms in the lungs and can be fatal. With antibiotic-resistant bacteria, the use of phage therapy has been introduced as an alternative or an additive to the use of antibiotics in order to combat biofilm growth. Phage therapy utilizes phages, or viruses that attack bacteria, in order to penetrate and eradicate biofilms. In order to evaluate the effectiveness of phage therapy against biofilm bacteria, we adapt an ordinary differential equation model to describe the dynamics of phage-biofilm combat in the lungs. We then create our own phage-biofilm model with ordinary differential equations and stochastic modeling. Then, simulations of parameter alterations in both models are investigated to assess how they will affect the efficiency of phage therapy against bacteria. By increasing the phage mortality rate, the biofilm growth can be balanced and allow the biofilm to be more vulnerable to antibiotics. Thus, phage therapy is an effective aid in biofilm treatment

Safety and Tolerability of Intravenous Immunoglobulin in Chronic Inflammatory Demyelinating Polyneuropathy:Results of the ProCID Study

Background and Aims: The ProCID study evaluated the efficacy and safety of three doses of a 10% liquid intravenous immunoglobulin (IVIg) preparation (panzyga®) in patients with chronic inflammatory demyelinating polyneuropathy (CIDP). This report describes the safety findings. Methods: Patients were randomised to receive a 2.0 g/kg induction dose followed by maintenance doses of either 0.5, 1.0 or 2.0 g/kg IVIg every 3 weeks over 24 weeks. Results:All 142 enrolled patients were included in the safety analyses. In total, 286 treatment-emergent adverse events (TEAEs) were reported in 89 patients, of which 173 (60.5%) were considered treatment-related. Most TEAEs were of mild severity. Eleven serious TEAEs were reported in 6 patients. Two serious TEAEs in one patient (headache and vomiting) were considered related to treatment, which resolved without study discontinuation. No treatment-related thrombotic events, haemolytic transfusion reactions or deaths occurred. One patient discontinued the study due to a TEAE (allergic dermatitis) probably related to IVIg. Headache was the only dose-dependent TEAE, with incidences ranging from 2.9 to 23.7%, the incidence of all other TEAEs was similar across treatment groups. Most TEAEs were associated with the induction dose infusion, and the rate of TEAEs decreased thereafter. The median (IQR) daily IVIg dose was 78 (64–90) g, and 94.4% of patients tolerated the maximal infusion rate of 0.12 ml/kg/min without pre-medication. Interpretation:Infusions of 10% IVIg at doses up to 2.0 g/kg with high infusion rates were safe and well tolerated in patients with CIDP. Clinical trial numbers: EudraCT 2015-005443-14, NCT02638207.</p

Hochschuladäquat und berufsfeldbedeutsam? Professionalisierung und Reflexion in der ersten Phase der Lehrer*innenbildung am Beispiel der Formate rekonstruktive Kasuistik und Lerntagebuch

Der vorliegende Beitrag thematisiert das Verhältnis von Professionalisierung und Reflexion entlang der zwei Reflexionsformate rekonstruktive Kasuistik und Lerntagebuch, die mit dem strukturtheoretischen und dem kompetenztheoretischen Zugang einem jeweils anderen professionstheoretischen Paradigma angehören. Dabei wird theoretisch wie empirisch fundiert der Frage nachgegangen, wie sich diese Reflexionsformate zwischen Hochschuladäquanz und Berufsfeldbedeutsamkeit verorten, welche Bedeutung Reflexion in diesen Formaten also auch für weitere Phasen der Lehrer*innenbildung zugesprochen werden kann. Darüber hinaus werden Unterschiede, aber auch sich zeigende Gemeinsamkeiten der Reflexionsformate sichtbar gemacht, die weiterführend vor dem Hintergrund von Multiparadigmatik und einer phasenübergreifenden Professionalisierung diskutiert werden. (DIPF/Orig.

Exposure to animals and risk of oligoarticular juvenile idiopathic arthritis: a multicenter case-control study

<p>Abstract</p> <p>Background</p> <p>An inverse association between early contact with microbial compounds and respiratory allergies is well established. The protective effect of infant contact with animals was also shown for inflammatory bowel disease (IBD) and systemic lupus erythematosus (SLE). We aimed to test the association between animal contact in infancy and oligoarticular juvenile idiopathic arthritis (OA JIA).</p> <p>Methods</p> <p>Parents of children with OA JIA registered at the Hospital for Pediatric Rheumatology in Garmisch-Partenkirchen were asked to complete a questionnaire. Children who underwent strabismus surgery at six referral centers for ophthalmology served as controls. Children age 6 to 18 years born in Germany without malformations were included (238 cases; response 89% and 832 controls; response 86%). Data were analyzed using logistic regression models after adjusting for potential confounders.</p> <p>Results</p> <p>Neither place of living (urban vs. rural area), living on a farm, nor regular farm animal (adjusted odds ratio 0.79; 95% confidence interval 0.42-1.47) or pet contact (0.79; 0.55-1.14) during infancy were clearly related to case status. Allergic rhinitis was inversely related to OA JIA (0.57; 0.34-0.95).</p> <p>Neither place of living (urban vs. rural area), living on a farm, nor regular farm animal (adjusted odds ratio 0.79; 95% confidence interval 0.42-1.47) or pet contact (0.79; 0.55-1.14) during infancy were related to case status. Allergic rhinitis was inversely related to OA JIA (0.57; 0.34-0.95).</p> <p>Conclusions</p> <p>Contact with farm environments in infancy might not be associated with OA JIA. This finding is consistent with previous findings for diabetes mellitus type 1 but contradicts results for IBD and SLE.</p

Autonomie und Patientenberatung

Dierks M-L, Schaeffer D. Autonomie und Patientenberatung. In: Rosenbrock R, Hartung S, eds. Handbuch Partizipation und Gesundheit. Bern: Huber; 2012: 285-295

Plasmid-Mediated Quinolone Resistance in Isolates Obtained in German Intensive Care Units

Screening of 703 isolates of Enterobacteriaceae, obtained from 34 German intensive care units (ICUs), revealed qnr-positive, integron-containing isolates of Enterobacter sp. and Citrobacter freundii from four patients in 2 German ICUs. This is one of the first reports of qnr-positive strains obtained from patients in Europe

Distinguishing Properties and Relations in the Denotation of Adjectives. An Empirical Investigation

Hartung M, Frank A. Distinguishing Properties and Relations in the Denotation of Adjectives. An Empirical Investigation. In: Gamerschlag T, Gerland D, Osswald R, Petersen W, eds. Frames and Concept Types. Applications in Linguistics and Philosophy. Studies in Linguistics and Philosophy. Springer; 2014: 179-197

Hochschuladäquat und berufsfeldbedeutsam? Professionalisierung durch Reflexion in der ersten Phase der Lehrer*innenbildung am Beispiel der Formate rekonstruktive Kasuistik und Lerntagebuch

te Poel K, Schlag S, Lischka-Schmidt R, Hartung-Beck V, Wittek D, Bauer T. Hochschuladäquat und berufsfeldbedeutsam? Professionalisierung durch Reflexion in der ersten Phase der Lehrer*innenbildung am Beispiel der Formate rekonstruktive Kasuistik und Lerntagebuch. In: Kunze I, Reintjes C, eds. Reflexion und Reflexivität in Unterricht, Schule und Lehrer*innenbildung. Accepted

Randomized trial of three IVIg doses for treating chronic inflammatory demyelinating polyneuropathy

Intravenous immunoglobulin treatment for chronic inflammatory demyelinating polyneuropathy usually starts with a 2.0 g/kg induction dose followed by 1.0 g/kg maintenance doses every 3 weeks. No dose-ranging studies with intravenous immunoglobulin maintenance therapy have been published. The Progress in Chronic Inflammatory Demyelinating polyneuropathy (ProCID) study was a prospective, double-blind, randomized, parallel-group, multicentre, phase III study investigating the efficacy and safety of 10% liquid intravenous immunoglobulin (Panzyga(®)) in patients with active chronic inflammatory demyelinating polyneuropathy. Patients were randomized 1:2:1 to receive the standard intravenous immunoglobulin induction dose and then either 0.5, 1.0 or 2.0 g/kg maintenance doses every 3 weeks. The primary end point was the response rate in the 1.0 g/kg group, defined as an improvement ≥1 point in adjusted Inflammatory Neuropathy Cause and Treatment score at Week 6 versus baseline and maintained at Week 24. Secondary end points included dose response and safety. This trial was registered with EudraCT (Number 2015–005443-14) and clinicaltrials.gov (NCT02638207). Between August 2017 and September 2019, the study enrolled 142 patients. All 142 were included in the safety analyses. As no post-infusion data were available for three patients, 139 were included in the efficacy analyses, of whom 121 were previously on corticosteroids. The response rate was 80% (55/69 patients) [95% confidence interval (CI): 69–88%] in the 1.0 g/kg group, 65% (22/34; CI: 48–79%) in the 0.5 g/kg group, and 92% (33/36; CI: 78–97%) in the 2.0 g/kg group. While the proportion of responders was higher with higher maintenance doses, logistic regression analysis showed that the effect on response rate was driven by a significant difference between the 0.5 and 2.0 g/kg groups, whereas the response rates in the 0.5 and 2.0 g/kg groups did not differ significantly from the 1.0 g/kg group. Fifty-six per cent of all patients had an adjusted Inflammatory Neuropathy Cause and Treatment score improvement 3 weeks after the induction dose alone. Treatment-related adverse events were reported in 16 (45.7%), 32 (46.4%) and 20 (52.6%) patients in the 0.5, 1.0 and 2.0 g/kg dose groups, respectively. The most common adverse reaction was headache. There were no treatment-related deaths. Intravenous immunoglobulin (1.0 g/kg) was efficacious and well tolerated as maintenance treatment for patients with chronic inflammatory demyelinating polyneuropathy. Further studies of different maintenance doses of intravenous immunoglobulin in chronic inflammatory demyelinating polyneuropathy are warranted