- Dual-energy X-ray absorptiometry pitfalls in Thalassemia Major. [Review]
- EEndocrine 2019 Jul 12
- CONCLUSIONS: DXA shows limitations in assessing bone mineral "status" in TM, especially in the paediatric population, due to the peculiar characteristics of bone architecture and deformities associated with the disease. A radiological technique adjustment in this population is mandatory.
- Insight into genetic diversity of Mycobacterium tuberculosis in Kandy, Sri Lanka reveals predominance of the Euro-American lineage. [Journal Article]
- IJInt J Infect Dis 2019 Jul 09
- CONCLUSIONS: The population structure of MTB in Kandy, Sri Lanka was different from the South Asian Region. Clonal expansion of locally evolved lineage 4/SIT3234 and detection of the pre-MDR Beijing isolates from new TB patients is alarming and will require continuous monitoring.
- Stochastic modelling of multistage carcinogenesis and progression of human lung cancer. [Journal Article]
- JTJ Theor Biol 2019 Jul 09
- In this paper, we propose a stochastic multistage model that incorporates clonal expansion of premalignant cells and mutational events. Using the age-specific lung cancer as the test system, the prop…
In this paper, we propose a stochastic multistage model that incorporates clonal expansion of premalignant cells and mutational events. Using the age-specific lung cancer as the test system, the proposed model is used to fit the incidence data in the Surveillance, Epidemiology, and End Results (SEER) registry. We first use the model with different numbers of mutations to fit the data of all lung cancer patients. Our results demonstrate that, although from two to six driver mutations in the genome of lung stem cells are reasonable for normal lung stem cells to become a malignant cell, three driver mutations are most likely to occur in the development of lung cancer. In addition, the models are employed to fit the data of female and male patients separately. The interesting result is that, for female patient data the best fit model contains four mutations while that for male patient data is the three-stage model. Finally, robustness analysis suggests that the decrease of cell net proliferation rates is more effective than the decrease of mutation rates in reducing the lung cancer risk.
- [Smoking control in Spain: current situation and priorities]. [Journal Article]
- RERev Esp Salud Publica 2019 Jul 15; 93
- This paper presents a strategic analysis of the prevention of smoking in Spain. After a review of the situation of the epidemic and of the current prevention policies with the data available in 2019,…
This paper presents a strategic analysis of the prevention of smoking in Spain. After a review of the situation of the epidemic and of the current prevention policies with the data available in 2019, it identifies the main problems to improve the prevention of smoking, while proposing strategies and key actions for the future. Considering as major objectives reducing the initiation of smoking and helping smokers quit, the different strategies of action and the key actions to be developed. In addition to helping smokers to stop smoking from the health services, key preventive actions include several public policies including taxation, banning advertising and other forms of promotion, the regulation of tobacco packaging, the expansion of smoke-free spaces, and information to the public on its effects. Some of them have followed a positive path for prevention in Spain but for others there is wide room for improvement. The MPOWER strategy of the WHO offers a guide for the development of the most effective tobacco control policies. In its light it is recommended to put emphasis on actions related to expanding smoke-free areas, to develop distance support services to stop smoking, to periodically carry out advertising campaigns of wide coverage to encourage quitting, to reinforce support for quitting in health care services, to finance pharmacological treatments, to expand the advertising ban to electronic devices that release nicotine, and to increase the tax burden on tobacco and other products delivering nicotine.
- Controlled human malaria infection with Plasmodium falciparum demonstrates impact of naturally acquired immunity on virulence gene expression. [Journal Article]
- PPPLoS Pathog 2019 Jul 11; 15(7):e1007906
- The pathogenesis of Plasmodium falciparum malaria is linked to the variant surface antigen PfEMP1, which mediates tethering of infected erythrocytes to the host endothelium and is encoded by approxim…
The pathogenesis of Plasmodium falciparum malaria is linked to the variant surface antigen PfEMP1, which mediates tethering of infected erythrocytes to the host endothelium and is encoded by approximately 60 var genes per parasite genome. Repeated episodes of malaria infection result in the gradual acquisition of protective antibodies against PfEMP1 variants. The antibody repertoire is believed to provide a selective pressure driving the clonal expansion of parasites expressing unrecognized PfEMP1 variants, however, due to the lack of experimental in vivo models there is only limited experimental evidence in support of this concept. To get insight into the impact of naturally acquired immunity on the expressed var gene repertoire early during infection we performed controlled human malaria infections of 20 adult African volunteers with life-long malaria exposure using aseptic, purified, cryopreserved P. falciparum sporozoites (Sanaria PfSPZ Challenge) and correlated serological data with var gene expression patterns from ex vivo parasites. Among the 10 African volunteers who developed patent infections, individuals with low antibody levels showed a steep rise in parasitemia accompanied by broad activation of multiple, predominantly subtelomeric var genes, similar to what we previously observed in naïve volunteers. In contrast, individuals with intermediate antibody levels developed asymptomatic infections and the ex vivo parasite populations expressed only few var gene variants, indicative of clonal selection. Importantly, in contrast to parasites from naïve volunteers, expression of var genes coding for endothelial protein C receptor (EPCR)-binding PfEMP1 that are associated with severe childhood malaria was rarely detected in semi-immune adult African volunteers. Moreover, we followed var gene expression for up to six parasite replication cycles and demonstrated for the first time in vivo a shift in the dominant var gene variant. In conclusion, our data suggest that P. falciparum activates multiple subtelomeric var genes at the onset of blood stage infection facilitating rapid expansion of parasite clones which express PfEMP1 variants unrecognized by the host's immune system, thus promoting overall parasite survival in the face of host immunity.
- Changes in Patient Visits After the Implementation of Insurance Billing at a Sexually Transmitted Diseases Clinic in a Medicaid Expansion State. [Journal Article]
- STSex Transm Dis 2019; 46(8):502-506
- CONCLUSIONS: Implementation of insurance billing at a publicly funded STD clinic, with free services provided to uninsured individuals, was associated with a modest increase in patient visits and a decline in patients returning for second visits.
- Cross-sectional evaluation of emergency care capacity at public hospitals in Zambia. [Journal Article]
- EMEmerg Med J 2019 Jul 10
- CONCLUSIONS: Zambian public hospitals have reasonable capacity to care for acutely ill and injured patients; however, there is a need for increased training and improved supply chains.
- Modeling Potential Habitat for Amblyomma Tick Species in California. [Journal Article]
- IInsects 2019 Jul 08; 10(7)
- The Amblyomma genus of ticks comprises species that are aggressive human biters and vectors of pathogens. Numerous species in the genus are undergoing rapid range expansion. Amblyomma ticks have occa…
The Amblyomma genus of ticks comprises species that are aggressive human biters and vectors of pathogens. Numerous species in the genus are undergoing rapid range expansion. Amblyomma ticks have occasionally been introduced into California, but as yet, no established populations have been reported in the state. Because California has high ecological diversity and is a transport hub for potentially parasitized humans and animals, the risk of future Amblyomma establishment may be high. We used ecological niche modeling to predict areas in California suitable for four tick species that pose high risk to humans: Amblyomma americanum, Amblyomma maculatum, Amblyomma cajennense and Amblyomma mixtum. We collected presence data in the Americas for each species from the published literature and online databases. Twenty-three climatic and ecological variables were used in a MaxEnt algorithm to predict the distribution of each species. The minimum temperature of the coldest month was an important predictor for all four species due to high mortality of Amblyomma at low temperatures. Areas in California appear to be ecologically suitable for A. americanum, A. maculatum, and A. cajennense, but not A. mixtum. These findings could inform targeted surveillance prior to an invasion event, to allow mitigation actions to be quickly implemented.
- Is knowledge of HIV status associated with sexual behaviours? A fixed effects analysis of a female sex worker cohort in urban Uganda. [Journal Article]
- JIJ Int AIDS Soc 2019; 22(7):e25336
- CONCLUSIONS: In urban Uganda, FSWs engaged in safer sex with clients when they perceived that they themselves were not living with HIV. Even in communities with very high HIV prevalence, the majority of the population will test HIV-negative. Our results thus imply that expansion of HIV testing programmes may serve as a behavioural HIV prevention measure among FSWs.
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- Quebec's Multi-Party Observatory on Zoonoses and Adaptation to Climate Change. [Journal Article]
- CCCan Commun Dis Rep 2019 May 02; 45(5):143-148
- Climate change has been linked with the establishment and geographical expansion of zoonotic diseases, an example of which is the well-documented increase in human cases of Lyme disease in Quebec, Ca…
Climate change has been linked with the establishment and geographical expansion of zoonotic diseases, an example of which is the well-documented increase in human cases of Lyme disease in Quebec, Canada. As temperatures continue to increase in Quebec, it is anticipated that several zoonotic diseases will be affected. In response to the growing zoonotic issues facing public health authorities, Quebec's Multi-Party Observatory on Zoonoses and Adaptation to Climate Change (Observatoire multipartite québécois sur les zoonoses et l'adaptation aux changements climatiques) (the Observatory) was founded in 2015 as part of the Quebec government's Climate Change Action Plan (Plan d'action 2013-2020 sur les changements climatiques). The Observatory was designed to bring together agencies involved in formulating public policy and experts from the disciplines of human health, animal health and environmental sciences, in a manner similar to the innovative "One World, One Health" approach. The Observatory provides a platform for knowledge sharing and consensus building among representatives of public policy decision makers and scientists. Its main objectives are to anticipate and prioritize potential issues associated with zoonotic diseases in Quebec, in order to support applicable risk management and climate change adaptation. This article describes what the Observatory is, what it does and outlines its plans for the future.