120 research outputs found

    Group B Streptococcus vaccine development: present status and future considerations, with emphasis on perspectives for low and middle income countries.

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    Globally, group B Streptococcus (GBS) remains the leading cause of sepsis and meningitis in young infants, with its greatest burden in the first 90 days of life. Intrapartum antibiotic prophylaxis (IAP) for women at risk of transmitting GBS to their newborns has been effective in reducing, but not eliminating, the young infant GBS disease burden in many high income countries. However, identification of women at risk and administration of IAP is very difficult in many low and middle income country (LMIC) settings, and is not possible for home deliveries. Immunization of pregnant women with a GBS vaccine represents an alternate pathway to protecting newborns from GBS disease, through the transplacental antibody transfer to the fetus in utero. This approach to prevent GBS disease in young infants is currently under development, and is approaching late stage clinical evaluation. This manuscript includes a review of the natural history of the disease, global disease burden estimates, diagnosis and existing control options in different settings, the biological rationale for a vaccine including previous supportive studies, analysis of current candidates in development, possible correlates of protection and current status of immunogenicity assays. Future potential vaccine development pathways to licensure and use in LMICs, trial design and implementation options are discussed, with the objective to provide a basis for reflection, rather than recommendations

    A new MRI rating scale for progressive supranuclear palsy and multiple system atrophy: validity and reliability

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    AIM To evaluate a standardised MRI acquisition protocol and a new image rating scale for disease severity in patients with progressive supranuclear palsy (PSP) and multiple systems atrophy (MSA) in a large multicentre study. METHODS The MRI protocol consisted of two-dimensional sagittal and axial T1, axial PD, and axial and coronal T2 weighted acquisitions. The 32 item ordinal scale evaluated abnormalities within the basal ganglia and posterior fossa, blind to diagnosis. Among 760 patients in the study population (PSP = 362, MSA = 398), 627 had per protocol images (PSP = 297, MSA = 330). Intra-rater (n = 60) and inter-rater (n = 555) reliability were assessed through Cohen's statistic, and scale structure through principal component analysis (PCA) (n = 441). Internal consistency and reliability were checked. Discriminant and predictive validity of extracted factors and total scores were tested for disease severity as per clinical diagnosis. RESULTS Intra-rater and inter-rater reliability were acceptable for 25 (78%) of the items scored (≥ 0.41). PCA revealed four meaningful clusters of covarying parameters (factor (F) F1: brainstem and cerebellum; F2: midbrain; F3: putamen; F4: other basal ganglia) with good to excellent internal consistency (Cronbach α 0.75-0.93) and moderate to excellent reliability (intraclass coefficient: F1: 0.92; F2: 0.79; F3: 0.71; F4: 0.49). The total score significantly discriminated for disease severity or diagnosis; factorial scores differentially discriminated for disease severity according to diagnosis (PSP: F1-F2; MSA: F2-F3). The total score was significantly related to survival in PSP (p<0.0007) or MSA (p<0.0005), indicating good predictive validity. CONCLUSIONS The scale is suitable for use in the context of multicentre studies and can reliably and consistently measure MRI abnormalities in PSP and MSA. Clinical Trial Registration Number The study protocol was filed in the open clinical trial registry (http://www.clinicaltrials.gov) with ID No NCT00211224

    Identification of regulatory variants associated with genetic susceptibility to meningococcal disease

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    Non-coding genetic variants play an important role in driving susceptibility to complex diseases but their characterization remains challenging. Here, we employed a novel approach to interrogate the genetic risk of such polymorphisms in a more systematic way by targeting specific regulatory regions relevant for the phenotype studied. We applied this method to meningococcal disease susceptibility, using the DNA binding pattern of RELA - a NF-kB subunit, master regulator of the response to infection - under bacterial stimuli in nasopharyngeal epithelial cells. We designed a custom panel to cover these RELA binding sites and used it for targeted sequencing in cases and controls. Variant calling and association analysis were performed followed by validation of candidate polymorphisms by genotyping in three independent cohorts. We identified two new polymorphisms, rs4823231 and rs11913168, showing signs of association with meningococcal disease susceptibility. In addition, using our genomic data as well as publicly available resources, we found evidences for these SNPs to have potential regulatory effects on ATXN10 and LIF genes respectively. The variants and related candidate genes are relevant for infectious diseases and may have important contribution for meningococcal disease pathology. Finally, we described a novel genetic association approach that could be applied to other phenotypes

    Zur Bestimmung der Cyans�ure in den Handelscyaniden

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    Zur Bestimmung des Phosphors in Eisen und Stahl

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    Corrosion-induced release of Cu and Zn into rainwater from brass, bronze and their pure metals. A 2-year field study

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    A 2-year field study has been conducted in an urban environment to provide annual release rates of copper and zinc from brass (20 wt% Zn) and copper and tin from bronze (6 wt% Sn) compared to sheets of their pure alloy constituents, copper and zinc. Despite relatively low nominal bulk alloy content, substantially more zinc was released from brass compared to copper. Both metals were released at a significantly slower rate from the brass alloy, compared to the pure metals. The proportion of release rates of copper and zinc from the alloy differed significantly from their proportions in the bulk alloy. Bronze showed relatively constant release rates of copper, being similar to that of pure copper sheet. The release of tin from bronze was negligible. The results clearly show that alloys and the pure metals behave very differently when exposed to rainwater. Accordingly, release rates from pure metals cannot be used to predict release rates of individual constituents from their alloys. Generated data are of importance within REACH, the new chemical policy of the European commission, where metal alloys erroneously are being treated as mixtures of chemical substances

    Descrição das genitálias de dois holótipos de Craspedochoeta Macquart (Diptera, Anthomyiidae)

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    <abstract language="eng">The genital pieces of the holotypes of Craspedochoeta pallidithorax (Albuquerque, 1959) and C. xanthopyga (Albuquerque, 1959), both females, are herein described, including illustrations
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