59 research outputs found
Impact of Chlamydia trachomatis in the reproductive setting: British Fertility Society Guidelines for practice
Chlamydia trachomatis infection of the genital tract is the most common sexually transmitted infection and has a world-wide distribution. The consequences of infection have an adverse effect on the reproductive health of women and are a common cause of infertility. Recent evidence also suggests an adverse effect on male reproduction. There is a need to standardise the approach in managing the impact of C. trachomatis infection on reproductive health. We have surveyed current UK practice towards screening and management of Chlamydia infections in the fertility setting. We found that at least 90% of clinicians surveyed offered screening. The literature on this topic was examined and revealed a paucity of solid evidence for estimating the risks of long-term reproductive sequelae following lower genital tract infection with C. trachomatis. The mechanism for the damage that occurs after Chlamydial infections is uncertain. However, instrumentation of the uterus in women with C. trachomatis infection is associated with a high risk of pelvic inflammatory disease, which can be prevented by appropriate antibiotic treatment and may prevent infected women from being at increased risk of the adverse sequelae, such as ectopic pregnancy and tubal factor infertility. Recommendations for practice have been proposed and the need for further studies is identified
Estudo histológico, imuno-histoquímico e ultra-estrutural das lesões induzidas experimentalmente por Ramaria flavo-brunnescens (Clavariaceae) em bovinos
All-sky search for long-duration gravitational wave transients with initial LIGO
We present the results of a search for long-duration gravitational wave transients in two sets of data collected by the LIGO Hanford and LIGO Livingston detectors between November 5, 2005 and September 30, 2007, and July 7, 2009 and October 20, 2010, with a total observational time of 283.0 days and 132.9 days, respectively. The search targets gravitational wave transients of duration 10-500 s in a frequency band of 40-1000 Hz, with minimal assumptions about the signal waveform, polarization, source direction, or time of occurrence. All candidate triggers were consistent with the expected background; as a result we set 90% confidence upper limits on the rate of long-duration gravitational wave transients for different types of gravitational wave signals. For signals from black hole accretion disk instabilities, we set upper limits on the source rate density between 3.4×10-5 and 9.4×10-4 Mpc-3 yr-1 at 90% confidence. These are the first results from an all-sky search for unmodeled long-duration transient gravitational waves. © 2016 American Physical Society
All-sky search for long-duration gravitational wave transients with initial LIGO
We present the results of a search for long-duration gravitational wave transients in two sets of data collected by the LIGO Hanford and LIGO Livingston detectors between November 5, 2005 and September 30, 2007, and July 7, 2009 and October 20, 2010, with a total observational time of 283.0 days and 132.9 days, respectively. The search targets gravitational wave transients of duration 10-500 s in a frequency band of 40-1000 Hz, with minimal assumptions about the signal waveform, polarization, source direction, or time of occurrence. All candidate triggers were consistent with the expected background; as a result we set 90% confidence upper limits on the rate of long-duration gravitational wave transients for different types of gravitational wave signals. For signals from black hole accretion disk instabilities, we set upper limits on the source rate density between 3.4×10-5 and 9.4×10-4 Mpc-3 yr-1 at 90% confidence. These are the first results from an all-sky search for unmodeled long-duration transient gravitational waves. © 2016 American Physical Society
Large-scale phenotyping of patients with long COVID post-hospitalization reveals mechanistic subtypes of disease
One in ten severe acute respiratory syndrome coronavirus 2 infections result in prolonged symptoms termed long coronavirus disease (COVID), yet disease phenotypes and mechanisms are poorly understood1. Here we profiled 368 plasma proteins in 657 participants ≥3 months following hospitalization. Of these, 426 had at least one long COVID symptom and 233 had fully recovered. Elevated markers of myeloid inflammation and complement activation were associated with long COVID. IL-1R2, MATN2 and COLEC12 were associated with cardiorespiratory symptoms, fatigue and anxiety/depression; MATN2, CSF3 and C1QA were elevated in gastrointestinal symptoms and C1QA was elevated in cognitive impairment. Additional markers of alterations in nerve tissue repair (SPON-1 and NFASC) were elevated in those with cognitive impairment and SCG3, suggestive of brain–gut axis disturbance, was elevated in gastrointestinal symptoms. Severe acute respiratory syndrome coronavirus 2-specific immunoglobulin G (IgG) was persistently elevated in some individuals with long COVID, but virus was not detected in sputum. Analysis of inflammatory markers in nasal fluids showed no association with symptoms. Our study aimed to understand inflammatory processes that underlie long COVID and was not designed for biomarker discovery. Our findings suggest that specific inflammatory pathways related to tissue damage are implicated in subtypes of long COVID, which might be targeted in future therapeutic trials
SARS-CoV-2-specific nasal IgA wanes 9 months after hospitalisation with COVID-19 and is not induced by subsequent vaccination
BACKGROUND: Most studies of immunity to SARS-CoV-2 focus on circulating antibody, giving limited insights into mucosal defences that prevent viral replication and onward transmission. We studied nasal and plasma antibody responses one year after hospitalisation for COVID-19, including a period when SARS-CoV-2 vaccination was introduced. METHODS: In this follow up study, plasma and nasosorption samples were prospectively collected from 446 adults hospitalised for COVID-19 between February 2020 and March 2021 via the ISARIC4C and PHOSP-COVID consortia. IgA and IgG responses to NP and S of ancestral SARS-CoV-2, Delta and Omicron (BA.1) variants were measured by electrochemiluminescence and compared with plasma neutralisation data. FINDINGS: Strong and consistent nasal anti-NP and anti-S IgA responses were demonstrated, which remained elevated for nine months (p < 0.0001). Nasal and plasma anti-S IgG remained elevated for at least 12 months (p < 0.0001) with plasma neutralising titres that were raised against all variants compared to controls (p < 0.0001). Of 323 with complete data, 307 were vaccinated between 6 and 12 months; coinciding with rises in nasal and plasma IgA and IgG anti-S titres for all SARS-CoV-2 variants, although the change in nasal IgA was minimal (1.46-fold change after 10 months, p = 0.011) and the median remained below the positive threshold determined by pre-pandemic controls. Samples 12 months after admission showed no association between nasal IgA and plasma IgG anti-S responses (R = 0.05, p = 0.18), indicating that nasal IgA responses are distinct from those in plasma and minimally boosted by vaccination. INTERPRETATION: The decline in nasal IgA responses 9 months after infection and minimal impact of subsequent vaccination may explain the lack of long-lasting nasal defence against reinfection and the limited effects of vaccination on transmission. These findings highlight the need to develop vaccines that enhance nasal immunity. FUNDING: This study has been supported by ISARIC4C and PHOSP-COVID consortia. ISARIC4C is supported by grants from the National Institute for Health and Care Research and the Medical Research Council. Liverpool Experimental Cancer Medicine Centre provided infrastructure support for this research. The PHOSP-COVD study is jointly funded by UK Research and Innovation and National Institute of Health and Care Research. The funders were not involved in the study design, interpretation of data or the writing of this manuscript
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Inflammatory responses by monocytes and macrophages in pulmonary sarcoidosis and infection
Inflammatory responses by macrophages are essential for host defense, but
also underpin the pathogenesis of numerous diseases. I adopted a systems
biology approach using transcriptional profiling to investigate monocyte and
macrophage inflammatory responses in relation to pulmonary sarcoidosis and
infection, to compare alveolar macrophages (AM) and monocyte derived
macrophages (MDM), and to probe integrated innate and adaptive
immunological responses within the tuberculin skin test (TST). In sarcoidosis I
established the importance of prostaglandin endoperoxide synthase (PTGS)2
promoter haplotypes in determining susceptibility to disease across two
genetically dissimilar ethnic groups, UK Whites and Afro-Caribbeans, but found
no functional effect of promoter haplotype on PTGS2 gene expression, in
mononuclear phagocytic cells. In contrast to the widely held view that AM have
an anti-inflammatory bias, I show that freshly isolated AM have a striking
pro-inflammatory profile that may confound the study of their responses to
innate immune stimulation. In human immunodeficiency virus
(HIV)/Mycobacterium tuberculosis (Mtb) co-infection I show that HIV-1 infection
of macrophages leads to augmented inflammatory responses to Mtb,
accompanied by enhanced viral replication, due to deficient induction of
anti-inflammatory IL10, via attenuation in mitogen activated protein kinase
(MAPK) signalling pathways downstream of TLR2 and dectin-1. These changes
were not evident in HIV-1/Streptococcus pneumoniae co-infected macrophages,
and the specificity of the effect in Mtb co-infection was mirrored by lower IL10
and higher pro-inflammatory IL1β in HIV-infected patients with pulmonary
tuberculosis compared with non-tuberculous infection. Finally, I show that the
TST is characterised by Th1 polarised and cytotoxic T cell responses. Distinct
innate immune and IFNγ-stimulated gene expression signatures under NFκB
and STAT1 transcriptional control and highly enriched for chemokines and MHC
class II molecules, provide a mechanism for paracrine amplification of
inflammatory responses in the TST. Strikingly, identical responses of lower
magnitude were also detectable in clinically negative TST subjects
Pattern of invasion by Adhatoda vasica in savannas of Sariska Tiger Reserve, Rajasthan, Western India
As part of global experiments on Savanna vegetation, we examined the ecological characteristics of an importantsemiarid savanna in the Indian sub-continent i.e Sariska Tiger Reserve, Rajasthan, Western India during April 2009 toMay 2011. 149 plots across five line transects were sampled for phyto-sociological interpretation in the Sariska-Kalighativalley which is the largest savanna valley habitat in the study area. Plots were segregated on the presence/absence ofnative invasive species Adhatoda vasica and community analysis revealed a total of eleven communities (five frominfested plots and six from non-infested plots) and communities having similar composition were compared. Treedensity, seedling density, species richness of shrubs and herbs and diversity and evenness of herbs was higher in noninfestedplots. Sapling density did not follow a trend. Evenness of shrubs was lower in non-infested plots. Furthermore,2 mapping of Adhatoda vasica in the study area revealed that 5.22 km (26.1%) of the Sariska-Kalighati valley was underinfestation and three sites were compared following removal of this species which resulted in increased sapling density,shrub density and grass cover and decreased seedling density and herb density
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