Pollen exposure and hospitalization due to asthma exacerbations: daily time series in a European city.

Exposure to pollen can contribute to increased hospital admissions for asthma exacerbation. This study applied an ecological time series analysis to examine associations between atmospheric concentrations of different pollen types and the risk of hospitalization for asthma in London from 2005 to 2011. The analysis examined short-term associations between daily pollen counts and hospital admissions in the presence of seasonal and long-term patterns, and allowed for time lags between exposure and admission. Models were adjusted for temperature, precipitation, humidity, day of week, and air pollutants. Analyses revealed an association between daily counts (continuous) of grass pollen and adult hospital admissions for asthma in London, with a 4-5-day lag. When grass pollen concentrations were categorized into Met Office pollen 'alert' levels, 'very high' days (vs. 'low') were associated with increased admissions 2-5 days later, peaking at an incidence rate ratio of 1.46 (95%, CI 1.20-1.78) at 3 days. Increased admissions were also associated with 'high' versus 'low' pollen days at a 3-day lag. Results from tree pollen models were inconclusive and likely to have been affected by the shorter pollen seasons and consequent limited number of observation days with higher tree pollen concentrations. Future reductions in asthma hospitalizations may be achieved by better understanding of environmental risks, informing improved alert systems and supporting patients to take preventive measures

CONOCIMIENTOS DE LOS MÉDICOS Y GINECOBSTETRAS SOBRE ENFERMEDAD PERIODONTAL Y SU RELACIÓN CON COMPLICACIONES EN EL EMBARAZO

Objetivo: evaluar los conocimientos y las prácticas de los médicos generales y ginecobstetras sobre la enfermedad periodontal y su relación con complicaciones del embarazo (parto pretérmino, bajo peso al nacer y preeclampsia). Metodología: se realizó un estudio observacional descriptivo de corte transversal en una muestra de 163 médicos (139 generales y 24 ginecobstetras) de Bucaramanga y su área metropolitana, municipios de Santander y Norte de Santander. Se aplicó un cuestionario de autoreporte y se calcularon frecuencias y proporciones para las variables cualitativas, promedios y desviaciones estándar para las variables cuantitativas. Para establecer las diferencias entre los médicos generales y ginecobstetras se realizaron las prueba de Chi cuadrado, el test exacto de Fisher, la prueba t de Student y la U. de Mann Whitney según la naturaleza y distribución de las variables.  Se considero un valor de p≤0,05 como estadísticamente significativo. Resultados: los médicos y ginecobstetras consideraron que definitivamente la enfermedad periodontal podría ser un factor de riesgo para la salud de la madre y su hijo, en un 66,9% (93) para los médicos generales y en un 75,0% (18) para los ginecobstetras. Así mismo, el 30,7% (42) de los médicos generales y el 45,8% (11) de los ginecobstetras relacionaron a la enfermedad periodontal con el parto pretérmino, bajo peso al nacer y preclampsia. A pesar de estos hallazgos, sólo el 77,4% (106) de los médicos y el 54,2% (13) de los ginecobstetras “siempre” remiten a la gestante a consulta odontológica. Conclusión: aunque los participantes tenían conocimientos sobre los tópicos evaluados, hace falta una mayor aplicación de los mismos para asegurar el bienestar del binomio madre e hijo.  Además, en su mayoría expresaron como “regulares” sus conocimientos sobre enfermedad periodontal y la relación con las complicaciones en el embarazo por lo que sugieren una mayor capacitación acerca de la salud bucal de la gestante

Optimalisasi Pencegahan Stunting Melalui Pembagian Bubur Kacang Hijau serta Perilaku Hidup Bersih dan Sehat pada Masyarakat Kampung Kandis

Stunting atau pendek merupakan kondisi gagal tumbuh pada anak balita akibat kekurangan gizi kronis terutama dalam 1.000 hari pertama kehidupan. Program edukasi stunting merupakan program pencegahan stunting pada bayi dan balita. Tujuan kegiatan ini adalah sebagai upaya pencegahan stunting melalui pemberian makanan tambahan dan sosialisasi pola hidup bersih dan sehat. Metode pelaksanaan dalam program pencegahan stunting kepada masyarakat melalui pemberdayaan kader Posyandu Cinta Balita, sosialisasi pra nikah untuk pemuda dan pemudi di Kampung Kandis, kegiatan pelatihan budidaya tanaman holtikultura, pembagian bubur kacang hijau sebagai bentuk pemenuhan gizi seimbang untuk kesehatan masyarakat, dan sosialisasi perilaku hidup bersih dan sehat kepada ibu guru dan para siswa. Populasi dalam kegiatan pengabdian ini adalah ibu-ibu kader Posyandu Cinta Balita, remaja Kampung Kandis, ibu-ibu Kampung Kandis yang memiliki bayi dan balita, dan ibu-ibu hamil di wilayah Kampung Kandis. Pemahaman mengenai stunting perlu lebih ditekankan di masyarakat serta penguatan dan keaktifan Kader perlu dimasifkan untuk terwujudnya program yang aktif dan baik. Dari program yang kami terapkan di Kampung Kandis dapat diperoleh hasil berupa kesadaran masyarakat akan pentingnya pemberian makanan bergizi bagi anak berupa pemberian bubur kacang hijau, serta kesadaran orang tua akan perilaku hidup bersih dan sehat bagi ana

A neurostructural biomarker of dissociative amnesia: a hippocampal study in dissociative identity disorder

BACKGROUND: Little is known about the neural correlates of dissociative amnesia, a transdiagnostic symptom mostly present in the dissociative disorders and core characteristic of dissociative identity disorder (DID). Given the vital role of the hippocampus in memory, a prime candidate for investigation is whether total and/or subfield hippocampal volume can serve as biological markers of dissociative amnesia. METHODS: A total of 75 women, 32 with DID and 43 matched healthy controls (HC), underwent structural magnetic resonance imaging (MRI). Using Freesurfer (version 6.0), volumes were extracted for bilateral global hippocampus, cornu ammonis (CA) 1-4, the granule cell molecular layer of the dentate gyrus (GC-ML-DG), fimbria, hippocampal-amygdaloid transition area (HATA), parasubiculum, presubiculum and subiculum. Analyses of covariance showed volumetric differences between DID and HC. Partial correlations exhibited relationships between the three factors of the dissociative experience scale scores (dissociative amnesia, absorption, depersonalisation/derealisation) and traumatisation measures with hippocampal global and subfield volumes. RESULTS: Hippocampal volumes were found to be smaller in DID as compared with HC in bilateral global hippocampus and bilateral CA1, right CA4, right GC-ML-DG, and left presubiculum. Dissociative amnesia was the only dissociative symptom that correlated uniquely and significantly with reduced bilateral hippocampal CA1 subfield volumes. Regarding traumatisation, only emotional neglect correlated negatively with bilateral global hippocampus, bilateral CA1, CA4 and GC-ML-DG, and right CA3. CONCLUSION: We propose decreased CA1 volume as a biomarker for dissociative amnesia. We also propose that traumatisation, specifically emotional neglect, is interlinked with dissociative amnesia in having a detrimental effect on hippocampal volume

Randomized Clinical Trial of the Need for Antibiotic Treatment for Low-Risk Catheter-Related Bloodstream Infection Caused by Coagulase-Negative Staphylococci

According to clinical guidelines, the management of catheter-related bloodstream infections (CRBSI) due to coagulase-negative staphylococci (CoNS) includes catheter removal and antibiotic treatment for 5 to 7 days. However, in low-risk episodes, it remains uncertain whether antibiotic therapy is necessary. This randomized clinical trial aims to determine whether the non-administration of antibiotic therapy is as safe and effective as the recommended strategy in low-risk episodes of CRBSI caused by CoNS. With this purpose, a randomized, open-label, multicenter, non-inferiority clinical trial was conducted in 14 Spanish hospitals from 1 July 2019 to 31 January 2022. Patients with low-risk CRBSI caused by CoNS were randomized 1:1 after catheter withdrawal to receive/not receive parenteral antibiotics with activity against the isolated strain. The primary endpoint was the presence of any complication related to bacteremia or to antibiotic therapy within 90 days of follow-up. The secondary endpoints were persistent bacteremia, septic embolism, time until microbiological cure, and time until the disappearance of a fever. EudraCT: 2017-003612-39 INF-BACT-2017. A total of 741 patients were assessed for eligibility. Of these, 27 were included in the study; 15 (55.6%) were randomized to the intervention arm (non-antibiotic administration) and 12 (44.4%) to the control arm (antibiotic therapy as per standard practice). The primary endpoint occurred in one of the 15 patients in the intervention group (septic thrombophlebitis) and in no patients in the control group. The median time until microbiological cure was 3 days (IQR 1-3) in the intervention arm and 1.25 days (IQR 0.5-2.62) in the control arm, while the median time until fever resolution was zero days in both arms. The study was stopped due to the insufficient number of recruited patients. These results seem to indicate that low-risk CRBSI caused by CoNS can be managed without antibiotic therapy after catheter removal; efficacy and safety are not affected

Analysis of labour market needs for engineers with enhanced knowledge in renewable energy in some European and Latin-American Countries

One of the main challenges related to the renewable energy labour market is that of human capital and as a consequence the educational profile of future employees is of paramount importance. Unfortunately, the skill level gained at University does not always fit with the practical needs of industry thus reducing the benefit-cost ratio of new employees and slowing down the transition to a green economy. Within this context, ‘The Crux’ project co-funded by EU under the framework of the Erasmus + programme aims at improving the renewable energy engineering curriculum at different university levels in several Universities of Latin America and Europe. In order to better appreciate the potential impact of the project, a survey on the labour market need for specialists with enhanced knowledge and skills in renewable and sustainable energy technologies has been conducted in the related EU and Latin America countries. More precisely, 60 organizations have been interviewed and almost 70% of them are interested in employing engineers with enhanced knowledge on renewable energy in the next three years. The analysis has shown significant discrepancies between EU and Latin American organizations. In fact, while future employees in EU countries will be mainly related to solar energy and management, the former together with wind and biomass will represent the main renewable energy working sector in Latin American countries. Moreover, MSc level will be the most demanded in EU while bachelor education seems to satisfy the future industry requirements in Latin America. Despite each country having its own needs, the research carried out under this EU project confirms the potential of renewable energy education on the global labour market in the near future

Randomized Clinical Trial of the Need for Antibiotic Treatment for Low-Risk Catheter-Related Bloodstream Infection Caused by Coagulase-Negative Staphylococci

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).According to clinical guidelines, the management of catheter-related bloodstream infections (CRBSI) due to coagulase-negative staphylococci (CoNS) includes catheter removal and antibiotic treatment for 5 to 7 days. However, in low-risk episodes, it remains uncertain whether antibiotic therapy is necessary. This randomized clinical trial aims to determine whether the non-administration of antibiotic therapy is as safe and effective as the recommended strategy in low-risk episodes of CRBSI caused by CoNS. With this purpose, a randomized, open-label, multicenter, non-inferiority clinical trial was conducted in 14 Spanish hospitals from 1 July 2019 to 31 January 2022. Patients with low-risk CRBSI caused by CoNS were randomized 1:1 after catheter withdrawal to receive/not receive parenteral antibiotics with activity against the isolated strain. The primary endpoint was the presence of any complication related to bacteremia or to antibiotic therapy within 90 days of follow-up. The secondary endpoints were persistent bacteremia, septic embolism, time until microbiological cure, and time until the disappearance of a fever. EudraCT: 2017-003612-39 INF-BACT-2017. A total of 741 patients were assessed for eligibility. Of these, 27 were included in the study; 15 (55.6%) were randomized to the intervention arm (non-antibiotic administration) and 12 (44.4%) to the control arm (antibiotic therapy as per standard practice). The primary endpoint occurred in one of the 15 patients in the intervention group (septic thrombophlebitis) and in no patients in the control group. The median time until microbiological cure was 3 days (IQR 1–3) in the intervention arm and 1.25 days (IQR 0.5–2.62) in the control arm, while the median time until fever resolution was zero days in both arms. The study was stopped due to the insufficient number of recruited patients. These results seem to indicate that low-risk CRBSI caused by CoNS can be managed without antibiotic therapy after catheter removal; efficacy and safety are not affected.This project was funded by Parc Taulí Research and Innovation Institute (I3PT) Grants CIR2017/053 and CIR2018/039.CERCA Programme/Generalitat de Catalunya.Peer reviewe

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival