Infection tracking in travellers using a mobile app (ITIT): the pilot study

BACKGROUND: Current surveillance of travellers' health captures only a small proportion of illness events. We aimed to evaluate the usability and feasibility of using an app to enable travellers to self-report illness. METHOD: This pilot study assesses a novel mobile application called Infection Tracking in Travellers (ITIT) that records travel-related symptoms with associated geolocation and weather data. Participants were recruited in three Swiss travel clinics between December 2021 and March 2022. A feedback survey was used to examine app ease of use, and data from the app was used to examine travel and illness patterns as a proof-of-concept for the larger ITIT study. RESULTS: Participants were recruited from Zurich, Basel, and Geneva, with 37 individuals completing a total of 394 questionnaires in 116 locations in Asia, Africa, the Americas, and Europe. Illness symptoms were reported by 41% of participants, 67% of which were respiratory. The post travel questionnaire showed that all participants found the app easy to use and 63% said they would recommend it to others. Several users provided suggestions for improved usability. CONCLUSION: The app fulfilled its function as a research tool linking infection symptoms with geolocation and climate data

The position of mefloquine as a 21st century malaria chemoprophylaxis

BACKGROUND: Malaria chemoprophylaxis prevents the occurrence of the symptoms of malaria. Travellers to high-risk Plasmodium falciparum endemic areas need an effective chemoprophylaxis. METHODS: A literature search to update the status of mefloquine as a malaria chemoprophylaxis. RESULTS: Except for clearly defined regions with multi-drug resistance, mefloquine is effective against the blood stages of all human malaria species, including the recently recognized fifth species, Plasmodium knowlesi. New data were found in the literature on the tolerarability of mefloquine and the use of this medication by groups at high risk of malaria. DISCUSSION: Use of mefloquine for pregnant women in the second and third trimester is sanctioned by the WHO and some authorities (CDC) allow the use of mefloquine even in the first trimester. Inadvertent pregnancy while using mefloquine is not considered grounds for pregnancy termination. Mefloquine chemoprophylaxis is allowed during breast-feeding. Studies show that mefloquine is a good option for other high-risk groups, such as long-term travellers, VFR travellers and families with small children. Despite a negative media perception, large pharmaco-epidemiological studies have shown that serious adverse events are rare. A recent US evaluation of serious events (hospitalization data) found no association between mefloquine prescriptions and serious adverse events across a wide range of outcomes including mental disorders and diseases of the nervous system. As part of an in-depth analysis of mefloquine tolerability, a potential trend for increased propensity for neuropsychiatric adverse events in women was identified in a number of published clinical studies. This trend is corroborated by several cohort studies that identified female sex and low body weight as risk factors. CONCLUSION: The choice of anti-malarial drug should be an evidence-based decision that considers the profile of the individual traveller and the risk of malaria. Mefloquine is an important, first-line anti-malarial drug but it is crucial for prescribers to screen medical histories and inform mefloquine users of potential adverse events. Careful prescribing and observance of contraindications are essential. For some indications, there is currently no replacement for mefloquine available or in the pipeline

Effect of Periodontal Treatment on HbA1c among Patients with Prediabetes

Evidence is limited regarding whether periodontal treatment improves hemoglobin A1c (HbA1c) among people with prediabetes and periodontal disease, and it is unknown whether improvement of metabolic status persists >3 mo. In an exploratory post hoc analysis of the multicenter randomized controlled trial “Antibiotika und Parodontitis” (Antibiotics and Periodontitis)—a prospective, stratified, double-blind study—we assessed whether nonsurgical periodontal treatment with or without an adjunctive systemic antibiotic treatment affects HbA1c and high-sensitivity C-reactive protein (hsCRP) levels among periodontitis patients with normal HbA1c (≤5.7%, n = 218), prediabetes (5.7% 1 mm in both groups. In the normal HbA1c group, HbA1c values remained unchanged at 5.0% (95% CI, 4.9% to 6.1%) during the observation period. Among periodontitis patients with prediabetes, HbA1c decreased from 5.9% (95% CI, 5.9% to 6.0%) to 5.4% (95% CI, 5.3% to 5.5%) at 15.5 mo and increased to 5.6% (95% CI, 5.4% to 5.7%) after 27.5 mo. At 27.5 mo, 46% of periodontitis patients with prediabetes had normal HbA1c levels, whereas 47.9% remained unchanged and 6.3% progressed to diabetes. Median hsCRP values were reduced in the normal HbA1c and prediabetes groups from 1.2 and 1.4 mg/L to 0.7 and 0.7 mg/L, respectively. Nonsurgical periodontal treatment may improve blood glucose values among periodontitis patients with prediabetes (ClinicalTrials.gov NCT00707369)

Epigenetic variance in dopamine D2 receptor: A marker of IQ malleability?

Genetic and environmental factors both contribute to cognitive test performance. A substantial increase in average intelligence test results in the second half of the previous century within one generation is unlikely to be explained by genetic changes. One possible explanation for the strong malleability of cognitive performance measure is that environmental factors modify gene expression via epigenetic mechanisms. Epigenetic factors may help to understand the recent observations of an association between dopamine-dependent encoding of reward prediction errors and cognitive capacity, which was modulated by adverse life events. The possible manifestation of malleable biomarkers contributing to variance in cognitive test performance, and thus possibly contributing to the “missing heritability” between estimates from twin studies and variance explained by genetic markers, is still unclear. Here we show in 1475 healthy adolescents from the IMaging and GENetics (IMAGEN) sample that general IQ (gIQ) is associated with (1) polygenic scores for intelligence, (2) epigenetic modification of DRD2 gene, (3) gray matter density in striatum, and (4) functional striatal activation elicited by temporarily surprising reward-predicting cues. Comparing the relative importance for the prediction of gIQ in an overlapping subsample, our results demonstrate neurobiological correlates of the malleability of gIQ and point to equal importance of genetic variance, epigenetic modification of DRD2 receptor gene, as well as functional striatal activation, known to influence dopamine neurotransmission. Peripheral epigenetic markers are in need of confirmation in the central nervous system and should be tested in longitudinal settings specifically assessing individual and environmental factors that modify epigenetic structure

Experimental Evolution of Resistance to Artemisinin Combination Therapy Results in Amplification of the mdr1 Gene in a Rodent Malaria Parasite

Background: Lacking suitable alternatives, the control of malaria increasingly depends upon Artemisinin Combination Treatments (ACT): resistance to these drugs would therefore be disastrous. For ACTs, the biology of resistance to the individual components has been investigated, but experimentally induced resistance to component drugs in combination has not been generated. Methodology/Principal Findings: We have used the rodent malaria parasite Plasmodium chabaudi to select in vivo resistance to the artesunate (ATN) + mefloquine (MF) version of ACT, through prolonged exposure of parasites to both drugs over many generations. The selection procedure was carried out over twenty-seven consecutive sub-inoculations under increasing ATN + MF doses, after which a genetically stable resistant parasite, AS-ATNMF1, was cloned. AS-ATNMF1 showed increased resistance to ATN + MF treatment and to artesunate or mefloquine administered separately. Investigation of candidate genes revealed an mdr1 duplication in the resistant parasites and increased levels of mdr1 transcripts and protein. There were no point mutations in the atpase6 or ubp1genes. Conclusion: Resistance to ACTs may evolve even when the two drugs within the combination are taken simultaneously and amplification of the mdr1 gene may contribute to this phenotype. However, we propose that other gene(s), as ye

A computational psychiatry approach identifies how alpha-2A noradrenergic agonist Guanfacine affects feature-based reinforcement learning in the macaque

[EN] Noradrenaline is believed to support cognitive flexibility through the alpha 2A noradrenergic receptor (a2A-NAR) acting in prefrontal cortex. Enhanced flexibility has been inferred from improved working memory with the a2A-NA agonist Guanfacine. But it has been unclear whether Guanfacine improves specific attention and learning mechanisms beyond working memory, and whether the drug effects can be formalized computationally to allow single subject predictions. We tested and confirmed these suggestions in a case study with a healthy nonhuman primate performing a feature-based reversal learning task evaluating performance using Bayesian and Reinforcement learning models. In an initial dose-testing phase we found a Guanfacine dose that increased performance accuracy, decreased distractibility and improved learning. In a second experimental phase using only that dose we examined the faster feature-based reversal learning with Guanfacine with single-subject computational modeling. Parameter estimation suggested that improved learning is not accounted for by varying a single reinforcement learning mechanism, but by changing the set of parameter values to higher learning rates and stronger suppression of non-chosen over chosen feature information. These findings provide an important starting point for developing nonhuman primate models to discern the synaptic mechanisms of attention and learning functions within the context of a computational neuropsychiatry framework.This research was supported by grants from the Canadian Institutes of Health Research (CIHR), the Natural Sciences and Engineering Research Council of Canada (NSERC) and the Ontario Ministry of Economic Development and Innovation (MEDI). We thank Dr. Hongying Wang for invaluable help with drug administration and animal careHassani, SA.; Oemisch, M.; Balcarras, M.; Westendorff, S.; Ardid-Ramírez, JS.; Van Der Meer, MA.; Tiesinga, P.... (2017). 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Efficacy of Quasi Agro Binding Fibre on the Hybrid Composite Used in Advance Application

The choice for natural fibre obtained from agricultural products is on the rise due to its solution to eco-friendly, environmental and improved mechanical properties concerns. Its abundant availability, low cost, emission reduction and adaptability to base material for composite make it a prime material for selection. This review explores diverse perspectives to the future trend of agro fibre in terms of the thermo-mechanical properties as it applies to advanced application in building structures. It is important to investigate the ecofriendliness of the products of composites from fibres in agricultural wastes so as to achieve a green and sustainable environment. This will come to fore by the combined efforts of both researchers and feedback from building stakeholders

Localization of chondroitin sulphate and dermatan sulphate in human dental pulps--an immunohistochemical study.

The distribution of dermatan sulphate and chondroitin sulphate in human dental pulps has been assessed using monoclonal antibodies and immunoperoxidase localization techniques. The pulpal tissues were reacted with specific antibodies following pretreatment of the sections with chondroitinase ACII or chondroitinase ABC. Both the 4‐ and 6‐sulphated isomers of chondroitin sulphate were detected in the tissues studied. Very little derrmatan sulphate could be detected. These glycosaminoglycans appeared throughout the pulpal connective tissues with a particularly strong localization to the region adjacent to the odontoblastic and predentine layers. Such distribution strongly implicates chondroitin sulphate in the mineralization process of human dentine

Beschleunigen parodontale Entzündungen den Alterungsprozess des menschlichen Körpers? – Das Inflammaging-Konzept

Parodontitiden stellen in der zweiten Lebenshälfte die häufigste orale Erkrankung dar. Sie teilen viele Merkmale mit anderen chronischen Erkrankungen, insbesondere einen aus dem Gleichgewicht geratenen Zytokinhaushalt. Die Beziehungen zwischen oralen und inneren Erkrankungen beruhen auf einer mit dem Alter stetig zunehmenden Akkumulation von Proteinoxidierungen, Radikalen, Schäden am Genom und am Epigenom, der klonalen Verbreitung mutierter mtDNA, Immunoseneszenz, psychosozialem Stress, dem vermehrten Auftreten dysbiotischer Mikrobiome, Metaflammation sowie auf Homotoleranz. Die genannten Phänomene sind beteiligt an einem Prozess, welcher einen menschlichen Organismus entzündungsbedingt vorzeitig altern lässt, dem sogenannten Inflammaging. Klinische Folgen des Inflammagings sind die erhöhte Anfälligkeit für Infekte und Malignome sowie ein vermehrtes Auftreten von Autoimmunerkrankungen. Es ist daher plausibel, dass auch über viele Jahre hinweg persistierende parodontale und periimplantäre Entzündungen zum Inflammaging beitragen und somit die Gesundheitserwartung beeinträchtigen. Inflammaging stellt das zentrale Paradigma der Parodontalen Medizin dar. Seine Kontrolle ist das essenzielle Ziel jeder Parodontitis- und Periimplantitistherapie