Estimation of the national disease burden of influenza-associated severe acute respiratory illness in Kenya and Guatemala : a novel methodology

Background: Knowing the national disease burden of severe influenza in low-income countries can inform policy decisions around influenza treatment and prevention. We present a novel methodology using locally generated data for estimating this burden. Methods and Findings: This method begins with calculating the hospitalized severe acute respiratory illness (SARI) incidence for children <5 years old and persons ≥5 years old from population-based surveillance in one province. This base rate of SARI is then adjusted for each province based on the prevalence of risk factors and healthcare-seeking behavior. The percentage of SARI with influenza virus detected is determined from provincial-level sentinel surveillance and applied to the adjusted provincial rates of hospitalized SARI. Healthcare-seeking data from healthcare utilization surveys is used to estimate non-hospitalized influenza-associated SARI. Rates of hospitalized and non-hospitalized influenza-associated SARI are applied to census data to calculate the national number of cases. The method was field-tested in Kenya, and validated in Guatemala, using data from August 2009–July 2011. In Kenya (2009 population 38.6 million persons), the annual number of hospitalized influenza-associated SARI cases ranged from 17,129–27,659 for children <5 years old (2.9–4.7 per 1,000 persons) and 6,882–7,836 for persons ≥5 years old (0.21–0.24 per 1,000 persons), depending on year and base rate used. In Guatemala (2011 population 14.7 million persons), the annual number of hospitalized cases of influenza-associated pneumonia ranged from 1,065–2,259 (0.5–1.0 per 1,000 persons) among children <5 years old and 779–2,252 cases (0.1–0.2 per 1,000 persons) for persons ≥5 years old, depending on year and base rate used. In both countries, the number of non-hospitalized influenza-associated cases was several-fold higher than the hospitalized cases. Conclusions: Influenza virus was associated with a substantial amount of severe disease in Kenya and Guatemala. This method can be performed in most low and lower-middle income countries

Comparative efficacy of serotonin (5-HT3) receptor antagonists in patients undergoing surgery: a systematic review and network meta-analysis

BACKGROUND: Serotonin (5-HT(3)) receptor antagonists are commonly used to decrease nausea and vomiting for surgery patients. We conducted a systematic review on the comparative efficacy of 5-HT(3) receptor antagonists. METHODS: Searches were done in MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify studies comparing 5-HT(3) receptor antagonists with each other, placebo, and/or combined with other antiemetic agents for patients undergoing surgical procedures. Screening search results, data abstraction, and risk of bias assessment were conducted by two reviewers independently. Random-effects pairwise meta-analysis and network meta-analysis (NMA) were conducted. PROSPERO registry number: CRD42013003564. RESULTS: Overall, 450 studies and 80,410 patients were included after the screening of 7,608 citations and 1,014 full-text articles. Significantly fewer patients experienced nausea with any drug relative to placebo, except for ondansetron plus metoclopramide in a NMA including 195 RCTs and 24,230 patients. Significantly fewer patients experienced vomiting with any drug relative to placebo except for palonosetron plus dexamethasone in NMA including 238 RCTs and 12,781 patients. All agents resulted in significantly fewer patients with postoperative nausea and vomiting versus placebo in a NMA including 125 RCTs and 16,667 patients. CONCLUSIONS: Granisetron plus dexamethasone was often the most effective antiemetic, with the number needed to treat ranging from two to nine. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12916-015-0371-y) contains supplementary material, which is available to authorized users

Particle release from implantoplasty of dental implants and impact on cells

Abstract: Background: With increasing numbers of dental implants placed annually, complications such as peri-implantitis and the subsequent periprosthetic osteolysis are becoming a major concern. Implantoplasty, a commonly used treatment of peri-implantitis, aims to remove plaque from exposed implants and reduce future microbial adhesion and colonisation by mechanically modifying the implant surface topography, delaying re-infection/colonisation of the site. This in vitro study aims to investigate the release of particles from dental implants and their effects on human gingival fibroblasts (HGFs), following an in vitro mock implantoplasty procedure with a diamond burr. Materials and methods: Commercially available implants made from grade 4 (commercially pure, CP) titanium (G4) and grade 5 Ti-6Al-4 V titanium (G5) alloy implants were investigated. Implant particle compositions were quantified by inductively coupled plasma optical emission spectrometer (ICP-OES) following acid digestion. HGFs were cultured in presence of implant particles, and viability was determined using a metabolic activity assay. Results: Microparticles and nanoparticles were released from both G4 and G5 implants following the mock implantoplasty procedure. A small amount of vanadium ions were released from G5 particles following immersion in both simulated body fluid and cell culture medium, resulting in significantly reduced viability of HGFs after 10 days of culture. Conclusion: There is a need for careful evaluation of the materials used in dental implants and the potential risks of the individual constituents of any alloy. The potential cytotoxicity of G5 titanium alloy particles should be considered when choosing a device for dental implants. Additionally, regardless of implant material, the implantoplasty procedure can release nanometre-sized particles, the full systemic effect of which is not fully understood. As such, authors do not recommend implantoplasty for the treatment of peri-implantitis

Sleeping sickness and its relationship with development and biodiversity conservation in the Luangwa valley, Zambia

The Luangwa Valley has a long historical association with Human African trypanosomiasis (HAT) and is a recognised geographical focus of this disease. It is also internationally acclaimed for its high biodiversity and contains many valuable habitats. Local inhabitants of the valley have developed sustainable land use systems in co-existence with wildlife over centuries, based on non-livestock keeping practices largely due to the threat from African Animal Trypanosomiasis. Historical epidemics of human sleeping sickness have influenced how and where communities have settled and have had a profound impact on development in the Valley. Historical attempts to control trypanosomiasis have also had a negative impact on conservation of biodiversity. Centralised control over wildlife utilisation has marginalised local communities from managing the wildlife resource. To some extent this has been reversed by the implementation of community based natural resource management programmes in the latter half of the 20th century and the Luangwa Valley provides some of the earliest examples of such programmes. More recently, there has been significant uncontrolled migration of people into the mid-Luangwa Valley driven by pressure on resources in the eastern plateau region, encouragement from local chiefs and economic development in the tourist centre of Mfuwe. This has brought changing land-use patterns, most notably agricultural development through livestock keeping and cotton production. These changes threaten to alter the endemically stable patterns of HAT transmission and could have significant impacts on ecosystem health and ecosystem services. In this paper we review the history of HAT in the context of conservation and development and consider the impacts current changes may have on this complex social-ecological system. We conclude that improved understanding is required to identify specific circumstances where win-win trade-offs can be achieved between the conservation of biodiversity and the reduction of disease in the human population.Ecosystem Services for Poverty Alleviation (ESPA

Chandra centres for COSMOS X-ray galaxy groups: differences in stellar properties between central dominant and offset brightest group galaxies

We present the results of a search for galaxy clusters and groups in the similar to 2 deg(2) of the COSMOS field using all available X-ray observations from the XMM-Newton and Chandra observatories. We reach an X-ray flux limit of 3 x 10(-16) erg cm(-2) s(-1) in the 0.5-2 keV range, and identify 247 X-ray groups with M-200c = 8 x 10(12)-3 x 10(14)M(circle dot) at a redshift range of 0.08 <= z < 1.53, using the multiband photometric redshift and the master spectroscopic redshift catalogues of the COSMOS. The X-ray centres of groups are determined using high-resolution Chandra imaging. We investigate the relations between the offset of the brightest group galaxies (BGGs) from halo X-ray centre and group properties and compare with predictions from semi-analytic models and hydrodynamical simulations. We find that BGG offset decreases with both increasing halo mass and decreasing redshift with no strong dependence on the X-ray flux and SNR. We show that the BGG offset decreases as a function of increasing magnitude gap with no considerable redshift-dependent trend. The stellar mass of BGGs in observations extends over a wider dynamic range compared to model predictions. At z < 0.5, the central dominant BGGs become more massive than those with large offsets by up to 0.3 dex, in agreement with model prediction. The observed and predicted log-normal scatter in the stellar mass of both low- and large-offset BGGs at fixed halo mass is similar to 0.3 dex

Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems

Acute gastrointestinal (GI) dysfunction and failure have been increasingly recognized in critically ill patients. The variety of definitions proposed in the past has led to confusion and difficulty in comparing one study to another. An international working group convened to standardize the definitions for acute GI failure and GI symptoms and to review the therapeutic options

Azithromycin-chloroquine and the intermittent preventive treatment of malaria in pregnancy

In the high malaria-transmission settings of sub-Saharan Africa, malaria in pregnancy is an important cause of maternal, perinatal and neonatal morbidity. Intermittent preventive treatment of malaria in pregnancy (IPTp) with sulphadoxine-pyrimethamine (SP) reduces the incidence of low birth-weight, pre-term delivery, intrauterine growth-retardation and maternal anaemia. However, the public health benefits of IPTp are declining due to SP resistance. The combination of azithromycin and chloroquine is a potential alternative to SP for IPTp. This review summarizes key in vitro and in vivo evidence of azithromycin and chloroquine activity against Plasmodium falciparum and Plasmodium vivax, as well as the anticipated secondary benefits that may result from their combined use in IPTp, including the cure and prevention of many sexually transmitted diseases. Drug costs and the necessity for external financing are discussed along with a range of issues related to drug resistance and surveillance. Several scientific and programmatic questions of interest to policymakers and programme managers are also presented that would need to be addressed before azithromycin-chloroquine could be adopted for use in IPTp

<em>Euclid</em> preparation: LIII. LensMC, weak lensing cosmic shear measurement with forward modelling and Markov Chain Monte Carlo sampling

\ua9 The Authors 2024. LENSMC is a weak lensing shear measurement method developed for Euclid and Stage-IV surveys. It is based on forward modelling in order to deal with convolution by a point spread function (PSF) with comparable size to many galaxies, sampling the posterior distribution of galaxy parameters via Markov chain Monte Carlo, and marginalisation over nuisance parameters for each of the 1.5 billion galaxies observed by Euclid. We quantified the scientific performance through high-fidelity images based on the Euclid Flagship simulations and emulation of the Euclid VIS images, realistic clustering with a mean surface number density of 250 arcmin2 (IE &lt; 29.5) for galaxies, and 6 arcmin2 (IE &lt; 26) for stars, and a diffraction-limited chromatic PSF with a full width at half maximum of 02.22 and spatial variation across the field of view. LENSMC measured objects with a density of 90 arcmin2 (IE &lt; 26.5) in 4500 deg2. The total shear bias was broken down into measurement (our main focus here) and selection effects (which will be addressed in future work). We found measurement multiplicative and additive biases of m1 = (3.6 \ub1 0.2) A- 103, m2 = (4.3 \ub1 0.2) A- 103, c1 = (1.78 \ub1 0.03) A- 104, and c2 = (0.09 \ub1 0.03) A- 104; a large detection bias with a multiplicative component of 1.2 A- 102 and an additive component of 3 A- 104; and a measurement PSF leakage of α1 = (9 \ub1 3) A- 104 and α2 = (2 \ub1 3) A- 104. When model bias is suppressed, the obtained measurement biases are close to Euclid requirement and largely dominated by undetected faint galaxies (5 A- 103). Although significant, model bias will be straightforward to calibrate given its weak sensitivity on galaxy morphology parameters. LENSMC is publicly available at gitlab.com/gcongedo/LensMC