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Annals of Hepatology 2024
Topics: Humans; Severity of Illness Index; Constriction, Pathologic; Male; Predictive Value of Tests; Female
PubMed: 38944460
DOI: 10.1016/j.aohep.2024.101513 -
Nigerian Journal of Clinical Practice Jun 2024Antimicrobial stewardship is an important action plan for curbing the rising trend of antimicrobial resistance (AMR). Surveillance of antimicrobial use and consumption...
BACKGROUND
Antimicrobial stewardship is an important action plan for curbing the rising trend of antimicrobial resistance (AMR). Surveillance of antimicrobial use and consumption is needed as baseline data and for monitoring the impact of antimicrobial stewardship interventions. The survey was done to understand the burden of AMR, in view of establishing an antimicrobial stewardship program in our hospital.
METHODS
A point prevalence survey (PPS) of antimicrobial use and consumption was conducted on all inpatients admitted before 8.00 am on the days of the survey using a standardized questionnaire. The collected data were entered online into the Global PPS web-based application (www.global-pps.com), for analysis.
RESULT
Of the 178 patients admitted during the survey period, 50.6% were on one or more antimicrobial agents. All the patients in adult intensive care units were on antibiotics (100%), followed by neonatal intensive care units (83.3%), with the least being adult medical wards (39.4%). Beta-lactam antibiotics were the most frequently prescribed antimicrobial for various infections, especially skin and soft tissue infections, 41.3%, which were the most common diagnoses treated with antibiotics. The infection was mostly community-acquired (81.6%), of which 94.9% were treated empirically. There was no written guideline in existence.
CONCLUSION
The present study revealed a poor prescribing habit because of a high rate of empirical treatment. The need for antimicrobial stewardship cannot be overemphasized as it will help streamline and improve the prescribing pattern.
Topics: Humans; Antimicrobial Stewardship; Nigeria; Female; Male; Tertiary Care Centers; Adult; Prevalence; Middle Aged; Surveys and Questionnaires; Anti-Bacterial Agents; Practice Patterns, Physicians'; Anti-Infective Agents; Drug Prescriptions; Aged; Adolescent; Young Adult; Drug Utilization
PubMed: 38943293
DOI: 10.4103/njcp.njcp_449_23 -
Trials Jun 2024Acute leukaemias (AL) are life-threatening blood cancers that can be potentially cured with treatment involving myelosuppressive, multiagent, intensive chemotherapy...
Biomarker Driven Antifungal Stewardship (BioDriveAFS) in acute leukaemia-a multi-centre randomised controlled trial to assess clinical and cost effectiveness: a study protocol for a randomised controlled trial.
BACKGROUND
Acute leukaemias (AL) are life-threatening blood cancers that can be potentially cured with treatment involving myelosuppressive, multiagent, intensive chemotherapy (IC). However, such treatment is associated with a risk of serious infection, in particular invasive fungal infection (IFI) associated with prolonged neutropenia. Current practice guidelines recommend primary antifungal (AF) prophylaxis to be administered to high-risk patients to reduce IFI incidence. AFs are also used empirically to manage prolonged neutropenic fever. Current strategies lead to substantial overuse of AFs. Galactomannan (GM) and β-D-glucan (BG) biomarkers are also used to diagnose IFI. Combining both biomarkers may enhance the predictability of IFI compared to administering each test alone. Currently, no large-scale randomised controlled trial (RCT) has directly compared a biomarker-based diagnostic screening strategy without AF prophylaxis to AF prophylaxis (without systematic biomarker testing).
METHODS
BioDriveAFS is a multicentre, parallel, two-arm RCT of 404 participants from UK NHS Haematology departments. Participants will be allocated on a 1:1 basis to receive either a biomarker-based antifungal stewardship (AFS) strategy, or a prophylactic AF strategy, which includes existing standard of care (SoC). The co-primary outcomes will be AF exposure in the 12-month post randomisation and the patient-reported EQ-5D-5L measured at 12-month post randomisation. Secondary outcomes will include total AF exposure, probable/proven IFI, survival (all-cause mortality and IFI mortality), IFI treatment outcome, AF-associated adverse effects/events/complications, resource use, episodes of neutropenic fever requiring hospital admission or outpatient management, AF resistance in fungi (non-invasive and invasive) and a Desirability of Outcome Ranking. The trial will have an internal pilot phase during the first 9 months. A mixed methods process evaluation will be integrated in parallel to the internal pilot phase and full trial, aiming to robustly assess how the intervention is delivered. Cost-effectiveness analysis will also be performed.
DISCUSSION
The BioDriveAFS trial aims to further the knowledge of strategies that will safely optimise AF use through comparison of the clinical and cost-effectiveness of a biomarker-led diagnostic strategy versus prophylactic AF to prevent and manage IFI within acute leukaemia. The evidence generated from the study will help inform global clinical practice and approaches within antifungal stewardship.
TRIAL REGISTRATION
ISRCTN11633399. Registered 24/06/2022.
Topics: Humans; Antifungal Agents; Cost-Benefit Analysis; Randomized Controlled Trials as Topic; Invasive Fungal Infections; Multicenter Studies as Topic; Biomarkers; Galactose; Mannans; Treatment Outcome; beta-Glucans; Antimicrobial Stewardship; Leukemia; Time Factors; Cost-Effectiveness Analysis
PubMed: 38943201
DOI: 10.1186/s13063-024-08272-w -
Archives of Gerontology and Geriatrics Jun 2024A meta-analysis was conducted to evaluate the impact of resistance training on pro-inflammatory cytokines c-reactive protein (CRP), interleukin 6 (IL 6), and tumor...
BACKGROUND AND OBJECTIVE
A meta-analysis was conducted to evaluate the impact of resistance training on pro-inflammatory cytokines c-reactive protein (CRP), interleukin 6 (IL 6), and tumor necrosis factor- α (TNF- α) in middle-aged and elderly individuals.
METHODS
The retrieval period for the Web of Science and other large electronic databases is set by default to March 2022. Both included and excluded researchers are independent examination literature on the impact of resistance exercise on markers of inflammation in the elderly. The physical medical care Evidence Database scale (Physical Therapy Evidence Database, PEDro) was used to evaluate the research quality, and Revmen 5.3 was used to end the index analysis.
RESULTS
After a total of four rounds of elimination, 12 items were eventually included. The total sample size for the research was 388 persons. Resistance training substantially reduced CRP levels in middle-aged and older individuals, with SMD = -0.56 and 95 % confidence interval ([-0.78, -0.34], P < 0.00001, correspondingly. Resistance training can successfully lower IL6 concentrations in middle-aged and older adults, although the combined impact is not substantial. SMD = -0.25, 95 % CI [-0.54, 0.04]; P = 0.09. TNF- concentrations did not alter significantly following resistance exercise in middle-aged and older adults. The overall effect was SMD = -0.07, with a 95 % confidence interval [-0.37, 0.23], while P = 0.64.
CONCLUSION
Resistance training reduces CRP, IL6, and TNF-α levels among middle-aged and elderly people. However, it has no significant anti-inflammatory effects on TNF-α. Resistance exercise at a moderate level for 3 times / week with a duration of 6-12 weeks or 16-32 weeks, significantly reduced CRP levels. This work contributing to exploring the resistance training program for the elderly to reduce inflammatory markers, and further, providing suggestions for the elderly to participate in resistance training and reduce the concentration of inflammatory markers.
PubMed: 38941946
DOI: 10.1016/j.archger.2024.105536 -
Journal of Medical Internet Research Jun 2024Previous mobile health (mHealth) studies have revealed significant links between depression and circadian rhythm features measured via wearables. However, the...
BACKGROUND
Previous mobile health (mHealth) studies have revealed significant links between depression and circadian rhythm features measured via wearables. However, the comprehensive impact of seasonal variations was not fully considered in these studies, potentially biasing interpretations in real-world settings.
OBJECTIVE
This study aims to explore the associations between depression severity and wearable-measured circadian rhythms while accounting for seasonal impacts.
METHODS
Data were sourced from a large longitudinal mHealth study, wherein participants' depression severity was assessed biweekly using the 8-item Patient Health Questionnaire (PHQ-8), and participants' behaviors, including sleep, step count, and heart rate (HR), were tracked via Fitbit devices for up to 2 years. We extracted 12 circadian rhythm features from the 14-day Fitbit data preceding each PHQ-8 assessment, including cosinor variables, such as HR peak timing (HR acrophase), and nonparametric features, such as the onset of the most active continuous 10-hour period (M10 onset). To investigate the association between depression severity and circadian rhythms while also assessing the seasonal impacts, we used three nested linear mixed-effects models for each circadian rhythm feature: (1) incorporating the PHQ-8 score as an independent variable, (2) adding seasonality, and (3) adding an interaction term between season and the PHQ-8 score.
RESULTS
Analyzing 10,018 PHQ-8 records alongside Fitbit data from 543 participants (n=414, 76.2% female; median age 48, IQR 32-58 years), we found that after adjusting for seasonal effects, higher PHQ-8 scores were associated with reduced daily steps (β=-93.61, P<.001), increased sleep variability (β=0.96, P<.001), and delayed circadian rhythms (ie, sleep onset: β=0.55, P=.001; sleep offset: β=1.12, P<.001; M10 onset: β=0.73, P=.003; HR acrophase: β=0.71, P=.001). Notably, the negative association with daily steps was more pronounced in spring (β of PHQ-8 × spring = -31.51, P=.002) and summer (β of PHQ-8 × summer = -42.61, P<.001) compared with winter. Additionally, the significant correlation with delayed M10 onset was observed solely in summer (β of PHQ-8 × summer = 1.06, P=.008). Moreover, compared with winter, participants experienced a shorter sleep duration by 16.6 minutes, an increase in daily steps by 394.5, a delay in M10 onset by 20.5 minutes, and a delay in HR peak time by 67.9 minutes during summer.
CONCLUSIONS
Our findings highlight significant seasonal influences on human circadian rhythms and their associations with depression, underscoring the importance of considering seasonal variations in mHealth research for real-world applications. This study also indicates the potential of wearable-measured circadian rhythms as digital biomarkers for depression.
Topics: Humans; Seasons; Female; Circadian Rhythm; Male; Wearable Electronic Devices; Adult; Longitudinal Studies; Depression; Middle Aged; Retrospective Studies; Telemedicine
PubMed: 38941600
DOI: 10.2196/55302 -
Bioinformatics (Oxford, England) Jun 2024Exponential growth in sequencing databases has motivated scalable De Bruijn graph-based (DBG) indexing for searching these data, using annotations to label nodes with...
MOTIVATION
Exponential growth in sequencing databases has motivated scalable De Bruijn graph-based (DBG) indexing for searching these data, using annotations to label nodes with sample IDs. Low-depth sequencing samples correspond to fragmented subgraphs, complicating finding the long contiguous walks required for alignment queries. Aligners that target single-labelled subgraphs reduce alignment lengths due to fragmentation, leading to low recall for long reads. While some (e.g. label-free) aligners partially overcome fragmentation by combining information from multiple samples, biologically irrelevant combinations in such approaches can inflate the search space or reduce accuracy.
RESULTS
We introduce a new scoring model, 'multi-label alignment' (MLA), for annotated DBGs. MLA leverages two new operations: To promote biologically relevant sample combinations, 'Label Change' incorporates more informative global sample similarity into local scores. To improve connectivity, 'Node Length Change' dynamically adjusts the DBG node length during traversal. Our fast, approximate, yet accurate MLA implementation has two key steps: a single-label seed-chain-extend aligner (SCA) and a multi-label chainer (MLC). SCA uses a traditional scoring model adapting recent chaining improvements to assembly graphs and provides a curated pool of alignments. MLC extracts seed anchors from SCAs alignments, produces multi-label chains using MLA scoring, then finally forms multi-label alignments. We show via substantial improvements in taxonomic classification accuracy that MLA produces biologically relevant alignments, decreasing average weighted UniFrac errors by 63.1%-66.8% and covering 45.5%-47.4% (median) more long-read query characters than state-of-the-art aligners. MLAs runtimes are competitive with label-combining alignment and substantially faster than single-label alignment.
AVAILABILITY AND IMPLEMENTATION
The data, scripts, and instructions for generating our results are available at https://github.com/ratschlab/mla.
Topics: Algorithms; Sequence Alignment; Software; Computational Biology; Sequence Analysis, DNA; Databases, Genetic
PubMed: 38940164
DOI: 10.1093/bioinformatics/btae226 -
Bioinformatics (Oxford, England) Jun 2024We learn more effectively through experience and reflection than through passive reception of information. Bioinformatics offers an excellent opportunity for...
MOTIVATION
We learn more effectively through experience and reflection than through passive reception of information. Bioinformatics offers an excellent opportunity for project-based learning. Molecular data are abundant and accessible in open repositories, and important concepts in biology can be rediscovered by reanalyzing the data.
RESULTS
In the manuscript, we report on five hands-on assignments we designed for master's computer science students to train them in bioinformatics for genomics. These assignments are the cornerstones of our introductory bioinformatics course and are centered around the study of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). They assume no prior knowledge of molecular biology but do require programming skills. Through these assignments, students learn about genomes and genes, discover their composition and function, relate SARS-CoV-2 to other viruses, and learn about the body's response to infection. Student evaluation of the assignments confirms their usefulness and value, their appropriate mastery-level difficulty, and their interesting and motivating storyline.
AVAILABILITY AND IMPLEMENTATION
The course materials are freely available on GitHub at https://github.com/IB-ULFRI.
Topics: Computational Biology; SARS-CoV-2; Humans; COVID-19; Genomics; Students
PubMed: 38940150
DOI: 10.1093/bioinformatics/btae208 -
LASSA FEVER IN INTERNALLY-DISPLACED PERSONS' CAMP: A CASE REPORT AT ZABARMARI, BORNO STATE, NIGERIA.Annals of Ibadan Postgraduate Medicine Apr 2024Lassa fever is a viral hemorrhagic disease caused by the Lassa virus, a single stranded RNA virus of the Arenavirus family. It is a zoonotic illness spread by rats of...
INTRODUTION
Lassa fever is a viral hemorrhagic disease caused by the Lassa virus, a single stranded RNA virus of the Arenavirus family. It is a zoonotic illness spread by rats of the speciesMastomys natalensis . Between weeks 1 and 17, (2017), 242 suspected Lassa fever cases were reported in Nigeria, with 58 laboratory confirmed cases and 46 fatalities (CFR, 19.01%) from 50 Local Government Areas (LGAs) in 20 States.
METHODS
We conducted an outbreak investigation and gathered a thorough clinical history of the index case as well as contacts, who were then followed up using the standard viral hemorrhagic fever contact monitoring form. Following that, blood samples were collected from this patient. A total of 54 contacts were tracked for 21 days and their temperatures were recorded using a clinical thermometer. Furthermore, an environmental evaluation of the Zabarmari community and the Madinatu Internally-displaced persons' (IDP) camp was carried out.
RESULTS
The index case was a 32-year-old woman who was internallydisplaced in Zabarmari community. Her symptoms began with fever and vaginal bleeding and progressed to bleeding from the nose, mouth, and urethra. There was a history of rat exposure as well as inadequate environmental sanitation and hygiene. Real Time PCR detected Lassa fever in the blood sample. The Borno State Ministry of Environment, in partnership with the Ministry of Health, undertook public health education on Lassa fever prevention and implemented excellent sanitary measures.
CONCLUSION
Increased awareness creation on good infection prevention and control practices is crucial among internally-displaced person and health care providers to prevent occurrence and spread of the disease.
PubMed: 38939877
DOI: No ID Found -
Journal of Chemical Education Feb 2024Artificial intelligence (AI) is rapidly transforming our world, making it imperative to educate the next generation about both the potential benefits and challenges...
Artificial intelligence (AI) is rapidly transforming our world, making it imperative to educate the next generation about both the potential benefits and challenges associated with AI. This study presents a cross-disciplinary curriculum that connects AI and chemistry disciplines in the high school classroom. Particularly, we leverage machine learning (ML), an important and simple application of AI to instruct students to build an ML-based virtual pH meter for high-precision pH read-outs. We used a "codeless" and free ML neural network building software - Orange, along with a simple chemical topic of pH to show the connection between AI and chemistry for high-schoolers who might have rudimentary backgrounds in both disciplines. The goal of this curriculum is to promote student interest and drive in the analytical chemistry domain and offer insights into how the interconnection between chemistry and ML can benefit high-school students in science learning. The activity involves students using pH strips to measure the pH of various solutions with local relevancy and then building an ML neural network model to predict the pH value based on color changes of pH strips. The integrated curriculum increased student interest in chemistry and ML and demonstrated the relevance of science to their daily lives and global issues. This approach is transformative in developing a broad spectrum of integration topics between chemistry and ML and understanding their global impacts.
PubMed: 38939529
DOI: 10.1021/acs.jchemed.3c00589 -
Human Resources For Health Jun 2024Peer mentorship can be a potential tool to reduce the disparities in health research capacity between high- and low- and middle-income countries. This case study...
BACKGROUND
Peer mentorship can be a potential tool to reduce the disparities in health research capacity between high- and low- and middle-income countries. This case study describes the potential of peer mentorship to tackle two critical issues: bridging health research capacity of doctors from low- and middle-income countries (LMICs) and the transformation of human resource for health brain drain into "brain gain".
CASE PRESENTATION
In 2021, a virtual peer mentorship group was established by 16 alumni of the University of Benin College of Medical Sciences' 2008 graduating class, residing across three continents. This program aimed to facilitate research collaboration and skill development among colleagues with diverse research experience levels, fostering a supportive environment for career development in research. The group relied heavily on digital technology to carry out its activities due to the different geographical locations of the group members. Led by experienced peer leaders, the group fostered a collaborative learning environment where members leveraged each other's expertise. Within 18 months, we published two research papers in high-impact peer-reviewed global health journals, launched a mixed-methods research study, and conducted training sessions on research design and implementation. Findings from our work were presented at conferences and workshops. However, logistical hurdles, competing priorities, structural constraints, and uneven participation presented challenges.
CONCLUSION
The peer mentorship collaboration has achieved some successes so far, and this model can be emulated by other cohorts of medical professionals across LMICs. Despite the group's success at a micro- or individual level, there remain significant structural barriers to research capacity building in LMICs that can only be addressed at the meso- and macro-levels by institutions and government, respectively. A systems-level approach is required to develop and support research capacity building and foster global research collaboration and effectively turn brain drain into brain gain.
Topics: Humans; Mentors; Peer Group; Nigeria; Developing Countries; Capacity Building; Biomedical Research; Mentoring; Cooperative Behavior; Brain Drain
PubMed: 38937753
DOI: 10.1186/s12960-024-00932-x