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1.
Lancet Microbe ; 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38964359

RESUMEN

Tuberculosis is a leading cause of death from an infectious agent globally. Infectious subclinical tuberculosis accounts for almost half of all tuberculosis cases in national tuberculosis prevalence surveys, and possibly contributes to transmission and might be associated with morbidity. Modelling studies suggest that new tuberculosis vaccines could have substantial health and economic effects, partly based on the assumptions made regarding subclinical tuberculosis. Evaluating the efficacy of prevention of disease tuberculosis vaccines intended for preventing both clinical and subclinical tuberculosis is a priority. Incorporation of subclinical tuberculosis as a composite endpoint in tuberculosis vaccine trials can help to reduce the sample size and duration of follow-up and to evaluate the efficacy of tuberculosis vaccines in preventing clinical and subclinical tuberculosis. Several design options with various benefits, limitations, and ethical considerations are possible in this regard, which would allow for the generation of the evidence needed to estimate the positive global effects of tuberculosis vaccine trials, in addition to informing policy and vaccination strategies.

2.
Int J Public Health ; 69: 1606993, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38978833

RESUMEN

Objectives: To investigate the association of musical activity with mental health during the COVID-19 pandemic. Methods: A total of 3,666 participants reported their musical activity before and mental health indicators before and during the pandemic. Depression was assessed with the Patient Health Questionnaire, anxiety with the Generalized Anxiety Disorder scale. The association between mental health scores and musical activities was investigated using linear regression. Results: Within the last 12 months, 22.1% of the participants reported musical activity (15.1% singing, 14.5% playing an instrument). Individuals with frequent singing as their main musical activity had higher scores before the pandemic than non-musicians and the worsening during the pandemic was more pronounced compared to non-musicians. Instrumentalists tended to have slightly lower scores than non-musicians indicating a possible beneficial effect of playing an instrument on mental health. Conclusion: The pandemic led to a worsening of mental health, with singers being particularly affected. Singers showed poorer mental health before the pandemic. The tendency for instrumentalists to report lower depression scores compared to non-musicians may support the hypothesis that music-making has a beneficial effect on health.


Asunto(s)
Ansiedad , COVID-19 , Depresión , Música , Humanos , COVID-19/psicología , COVID-19/epidemiología , Femenino , Alemania/epidemiología , Masculino , Depresión/epidemiología , Depresión/psicología , Persona de Mediana Edad , Música/psicología , Adulto , Ansiedad/epidemiología , SARS-CoV-2 , Salud Mental , Canto , Estudios de Cohortes , Anciano , Pandemias
3.
Mol Cell Proteomics ; : 100800, 2024 Jun 14.
Artículo en Inglés | MEDLINE | ID: mdl-38880244

RESUMEN

Data-independent acquisition (DIA) has revolutionized the field of mass spectrometry (MS)-based proteomics over the past few years. DIA stands out for its ability to systematically sample all peptides in a given mass-to-charge range, allowing an unbiased acquisition of proteomics data. This greatly mitigates the issue of missing values and significantly enhances quantitative accuracy, precision, and reproducibility compared to many traditional methods. This review focuses on the critical role of DIA analysis software tools, primarily focusing on their capabilities and the challenges they address in proteomic research. Advances in MS technology, such as trapped ion mobility spectrometry, or high field asymmetric waveform ion mobility spectrometry require sophisticated analysis software capable of handling the increased data complexity and exploiting the full potential of DIA. We identify and critically evaluate leading software tools in the DIA landscape, discussing their unique features, and the reliability of their quantitative and qualitative outputs. We present the biological and clinical relevance of DIA-MS and discuss crucial publications that paved the way for in-depth proteomic characterization in patient-derived specimens. Furthermore, we provide a perspective on emerging trends in clinical applications and present upcoming challenges including standardization and certification of MS-based acquisition strategies in molecular diagnostics. While we emphasize the need for continuous development of software tools to keep pace with evolving technologies, we advise researchers against uncritically accepting the results from DIA software tools. Each tool may have its own biases, and some may not be as sensitive or reliable as others. Our overarching recommendation for both researchers and clinicians is to employ multiple DIA analysis tools, utilizing orthogonal analysis approaches to enhance the robustness and reliability of their findings.

4.
Sci Rep ; 14(1): 13705, 2024 06 14.
Artículo en Inglés | MEDLINE | ID: mdl-38871833

RESUMEN

Of the early Eocene amber deposits known across the world, Belgian amber has been mostly absent from the relevant literature. We reinvestigated amber held in the palaeobotanical collection of the Royal Belgian Institute of Natural Sciences, Brussels, which derived from three localities in Belgium that originated from two geographical areas (Leval-Trahegnies and Orp-le-Grand). Using Fourier transform infrared (FTIR) spectroscopy we show the close chemical relationship of Belgian amber to the early Eocene Oise amber from the Paris Basin, and highlight the potential effect of weathering on the amber chemistry. The amber derives from a very similar botanical source as the Oise amber (Combretaceae or Leguminosae-Caesalpinioideae), but from different coeval basins. The two Leval-Trahegnies localities provided amber that exhibit different stages of weathering (heavily fissured and crazed, darkened) and lacking any inclusions. The Orp-le-Grand locality provided the least weathered amber, with one amber piece containing two inclusions: a mite and a new genus and species of hemipteran (Cativolcus uebruum gen. et sp. nov.), and a second one that preserved the impression of insect wings pressed into the surface.


Asunto(s)
Ámbar , Fósiles , Bélgica , Ámbar/química , Animales , Francia , Espectroscopía Infrarroja por Transformada de Fourier , Ácaros , Hemípteros/anatomía & histología , Paleontología/métodos
5.
Sci Rep ; 14(1): 14069, 2024 06 18.
Artículo en Inglés | MEDLINE | ID: mdl-38890477

RESUMEN

Musical activities (MA) such as singing, playing instruments, and listening to music may be associated with health benefits. However, evidence from epidemiological studies is still limited. This study aims at describing the relation between MA and both sociodemographic and health-related factors in a cross-sectional approach. A total of 6717 adults (50.3% women, 49.7% men, median age: 51 years (IQR 43-60) were recruited from the study center Berlin-Mitte of the German National Cohort (NAKO), a population-based prospective study. This study is based on a sample randomly selected from the population registry of Berlin, Germany, aged 20 to 69 years. 53% of the participants had been musically active at least once in their life (56.1% women, 43.9% men). Playing keyboard instruments (30%) and singing (21%) were the most frequent MA. Participants listened to music in median 90 min per day (IQR 30.0-150.0). Musically active individuals were more likely to have a higher education, higher alcohol consumption, were less likely to be physically active, and had a lower BMI compared to musically inactive individuals. This large population-based study offers a comprehensive description of demographic, health, and lifestyle characteristics associated with MA. Our findings may aid in assessing long-term health consequences of MA.


Asunto(s)
Música , Humanos , Persona de Mediana Edad , Femenino , Masculino , Adulto , Alemania , Anciano , Estudios Prospectivos , Estudios Transversales , Canto/fisiología , Adulto Joven , Estudios de Cohortes , Estilo de Vida
6.
Methods Mol Biol ; 2809: 157-169, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38907897

RESUMEN

The Immuno Polymorphism Database (IPD) plays a pivotal role for immunogenetics. Due to technical limitations, genotyping often focuses on specific key regions like the antigen recognition domain (ARD) for HLA genotyping, and the databases are populated accordingly. More recently, though, modern next generation sequencing (NGS) assays allow using larger gene segments or even complete genes for genotyping. It is therefore essential that the databases are updated with complete genetic reference sequences to fully serve current and future applications. However, the process of manually annotating and submitting full-length allele sequences to IPD is time-consuming and error-prone, which may discourage HLA-genotyping laboratories or researchers from submitting full-length sequences of novel alleles.Here, we detail the process of preparing and submitting novel HLA, MIC, and KIR alleles to ENA and IPD using TypeLoader2, a convenient software tool developed to streamline this process by automating the sequence annotation, the creation of all necessary files, as well as parts of the submission process itself. The software is freely available from GitHub ( https://github.com/DKMS-LSL/typeloader ).


Asunto(s)
Alelos , Antígenos HLA , Secuenciación de Nucleótidos de Alto Rendimiento , Receptores KIR , Programas Informáticos , Humanos , Receptores KIR/genética , Antígenos HLA/genética , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Bases de Datos Genéticas , Biología Computacional/métodos , Genotipo , Polimorfismo Genético
7.
Methods Mol Biol ; 2809: 145-156, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38907896

RESUMEN

The prerequisite for successful HLA genotyping is the integrity of the large allele reference database IPD-IMGT/HLA. Consequently, it is in the laboratories' best interest that the data quality of submitted novel sequences is high. However, due to its long and variable length, the gene HLA-DRB1 presents the biggest challenge and as of today only 16% of the HLA-DRB1 alleles in the database are characterized in full length. To improve this situation, we developed a protocol for long-range PCR amplification of targeted HLA-DRB1 alleles. By subsequently combining both long-read and short-read sequencing technologies, our protocol ensures phased and error-corrected sequences of reference grade quality. This dual redundant reference sequencing (DR2S) approach is of particular importance for correctly resolving the challenging repeat regions of DRB1 intron 1. Until today, we used this protocol to characterize and submit 384 full-length HLA-DRB1 sequences to IPD-IMGT/HLA.


Asunto(s)
Alelos , Bases de Datos Genéticas , Cadenas HLA-DRB1 , Cadenas HLA-DRB1/genética , Humanos , Reacción en Cadena de la Polimerasa/métodos , Análisis de Secuencia de ADN/métodos , Genotipo , Prueba de Histocompatibilidad/métodos
8.
J Clin Psychol ; 2024 Jun 26.
Artículo en Inglés | MEDLINE | ID: mdl-38932513

RESUMEN

OBJECTIVE: Cognitive theories emphasize the central role of anger and anger suppression in obsessive-compulsive disorder (OCD). According to these theories, anger suppression is seen as a consequence of OCD, whereas cognitive beliefs, such as an inflated sense of responsibility, are seen as antecedent factors. To extend the findings from cross-sectional studies, the current study investigated the temporal associations between OCD symptoms, an inflated sense of responsibility, and anger suppression. Consistent with cognitive considerations, we hypothesized that OCD symptoms mediate the association between feelings of responsibility and anger suppression. These associations were also explored in patients presenting particularly high checking-related symptoms. Further, the stability of effects beyond controlling for depressive symptoms and medication intake was explored. METHODS: A total of N = 48 patients with OCD (50% female, M = 32.46 [SD = 10.63] years of age) completed measures on obsessive beliefs, OCD symptoms, and anger suppression at three assessment points: before and after a metacognitive intervention as well as at a follow-up 6 months later. Mediation models investigating symptom associations at these three timepoints were conducted. Exploratory analyses investigating these associations in individuals presenting high checking-related symptoms (n = 20) and testing the stability of effects beyond controlling for depressive symptoms and medication intake were conducted. RESULTS: The sense of responsibility did not significantly predict the level of anger suppression. A temporal association between OCD symptoms (as assessed with the self-report measure) and anger suppression could be evidenced, which was stable beyond controlling for depressive symptoms and medication intake. Against the expectations based on cognitive theories, the sense of responsibility did not predict OCD symptoms. No mediating effect of OCD symptoms was found. CONCLUSION: In line with cognitive viewpoints, the present study shows that higher OCD symptoms predict higher levels of anger suppression in a longitudinal design, thereby contributing to the suppression of anger. This effect seems to be independent from depressive symptoms and medication intake. The effect of sense of responsibility on OCD symptoms was less clear and could only be found in the subgroup of patients with OCD and checking-related symptoms, who generally presented higher levels of responsibility. Overall, this is the first study demonstrating temporal associations between OCD symptoms and anger suppression. Acknowledging that anger and anger suppression may be a consequence of OCD symptoms and may also affect aspects of psychotherapy, which can ultimately inform future adjustments to psychotherapeutic treatment.

9.
Haemophilia ; 30(4): 1032-1042, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38837595

RESUMEN

INTRODUCTION: Patients with haemophilia (PwH) are at increased risk of falls due to haemophilic arthropathy. Yet, studies on clinical tests associated with the risk of falling are scarce in PwH. AIMS: (1) To evaluate the feasibility of different clinical motor performance tests associated with the risk of falling in PwH; (2) to evaluate PwH's performance of these tests compared to a control group; (3) to identify possible influencing factors that affect performance. METHODS: Twenty-nine severe and moderate PwH (57.0 years, IQR: 48.0-61.5) and 29 healthy age- and BMI-matched control participants (CG) performed 13 different clinical tests (SPPB, timed up and go, push and release, functional reach, single-leg stance, knee and grip strength). Haemophilia joint health score (HJHS), kinesiophobia (TSK-11), subjective physical performance (HEP-Test-Q), falls efficiency (FES-I) and falls were assessed. RESULTS: No adverse events occurred. PwH showed impaired performance in all clinical tests, a lower falls efficiency and a higher HJHS than CG. PwH with higher HJHS, lower HEP-Test-Q and higher TSK-11 scores showed higher deficits. Largest discrepancies were observed in the single-leg stance with eyes open and knee extensor strength, where orthopaedically majorly affected PwH showed worse performance compared to minorly affected PwH and the CG, respectively. The prevalence of ≥1 fall in the last year was 27.6% (PwH) and 10.3% (CG). CONCLUSION: These clinical tests are feasible in PwH. Impaired joint status, a high kinesiophobia and low physical performance impair performance. These tests can be used by clinicians for gaining specific information on functional motor abilities of patients.


Asunto(s)
Accidentes por Caídas , Hemofilia A , Humanos , Hemofilia A/complicaciones , Estudios de Casos y Controles , Persona de Mediana Edad , Masculino , Accidentes por Caídas/estadística & datos numéricos , Femenino , Adulto
11.
J Sports Sci ; 42(7): 574-588, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38726662

RESUMEN

Exercise-Induced Hypoalgesia (EIH) refers to an acute reduced pain perception after exercise. This systematic review and meta-analysis investigated the effect of a single aerobic exercise session on local and remote EIH in healthy individuals, examining the role of exercise duration, intensity, and modality. Pressure pain thresholds (PPT) are used as the main measure, applying the Cochrane risk of bias tool and GRADE approach for certainty of evidence assessment. Mean differences (MD; Newton/cm²) for EIH effects were analysed. Thirteen studies with 23 exercises and 14 control interventions are included (498 participants). Most studies used bicycling, with only two including running/walking and one including rowing. EIH occurred both locally (MD = 3.1) and remotely (MD = 1.8), with high-intensity exercise having the largest effect (local: MD = 7.5; remote: MD = 3.0) followed by moderate intensity (local: MD = 3.1; remote: MD = 3.0). Low-intensity exercise had minimal impact. Neither long nor short exercise duration induced EIH. Bicycling was found to be effective in eliciting EIH, in contrast to the limited research observed in other modalities. The overall evidence quality was moderate with many studies showing unclear risk biases.


Asunto(s)
Ejercicio Físico , Percepción del Dolor , Umbral del Dolor , Humanos , Ejercicio Físico/fisiología , Umbral del Dolor/fisiología , Percepción del Dolor/fisiología , Ciclismo/fisiología , Carrera/fisiología , Factores de Tiempo
12.
Child Abuse Negl ; 153: 106815, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38735124

RESUMEN

BACKGROUND: The darknet hosts an increasing number of hidden services dedicated to the distribution of child sexual abuse material (CSAM). Given that by contributing CSAM to the forum members subject themselves to criminal prosecution, questions regarding the motivation for members contributing to darknet CSAM forums arise. OBJECTIVE: Building on insights gained from research into clearnet communities, here we examine the extent to which social incentives generated by the online CSAM community may explain members' posting behavior on darknet CSAM forums. PARTICIPANTS AND SETTING: We analyze digital forensic artifacts on the online behavior of members of a darknet CSAM forum that was shut down by law enforcement agencies in July 2015. METHODS: We apply group-based trajectory modelling (GBTM), social network analysis, and mixed-effect survival models. RESULTS: Applying GBTM three posting trajectories can be distinguished. Social network analyses finds the reply network to be more centralized than predicted by chance. Mixed-effect survival models show positive associations between the length of members' first post and the time since members' first registration on the forum and subsequent posting. Contrarily, the number of replies received appears to mitigate subsequent posting. CONCLUSIONS: Findings show posting activity on the forum to be concentrated in a minority of forum members who show posting trajectories that are both frequent and persistent. Results further suggest persistence in posting is motivated by social identity and, to a lesser extent, differential association processes.


Asunto(s)
Abuso Sexual Infantil , Capital Social , Aprendizaje Social , Humanos , Abuso Sexual Infantil/psicología , Abuso Sexual Infantil/estadística & datos numéricos , Niño , Análisis de Redes Sociales , Red Social , Medios de Comunicación Sociales/estadística & datos numéricos , Femenino , Masculino , Aplicación de la Ley/métodos
13.
Scand J Pain ; 24(1)2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38592740

RESUMEN

INTRODUCTION: Pain is a common comorbidity in patients with hemophilia (PwH) due to hemophilic arthropathy. This study aims to explore pain sensitivity in PwH methodologically investigating in cuff pressure testing compared to algometer testing. METHODS: 37 PwH and 35 healthy control subjects (Con) enrolled in this study. Joint health status was assessed. Subjective pain was evaluated using numeric rating scales. Pain sensitivity was measured with pressure algometry and cuff pressure algometry. Pressure pain thresholds of the algometer (PPTa) were measured at knee, ankle joints, and forehead. Subsequently, thresholds of cuff pressure were measured at the left and right lower legs (PPTcuff). In both, lower values represent higher pain sensitivity. RESULTS: PwH exerted a worse joint health status than Con. Pain sensitivity was higher in PwH compared to Con as PPTa of the knee and ankle joints were lower in PwH. No difference was observed in PPTa at the forehead. Contrastingly, lower pain sensitivity was detected in PwH by higher PPTcuff values compared to Con in both legs. CONCLUSION: While PPTa of the knee and ankle joints are lower in PwH, PPTcuff are higher in PwH compared to Con. This reveals a paradox situation, highlighting that PwH experience local, joint- and hemophilic arthropathy-related pain, whereas pain sensitivity of non-affected soft tissue structures is lower. The reasons explaining the PPTcuff results remain elusive but might be explained by coping strategies counteracting chronic joint pain, resulting in lower sensitivity at non-affected structures.


Asunto(s)
Artritis , Hemofilia A , Enfermedades Vasculares , Humanos , Hemofilia A/complicaciones , Umbral del Dolor , Dolor , Articulación de la Rodilla
14.
Haemophilia ; 30(3): 827-835, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38600680

RESUMEN

BACKGROUND: Patients with haemophilia (PwH) suffer from chronic pain due to joint alterations induced by recurring haemorrhage. OBJECTIVES: This study aimed to investigate the relationship between structural alterations and pain perception at the ankle joint in PwH. PATIENTS/METHODS: Ankle joints of 79 PwH and 57 healthy controls (Con) underwent ultrasound examination (US) and assessment of pain sensitivity via pressure pain thresholds (PPT). US discriminated between joint activity (synovitis) and joint damage (cartilage and/or bone degeneration) applying the HEAD-US protocol. Based on US-findings, five subgroups were built: PwH with activity/damage, PwH with activity/no damage, PwH with no activity/no damage, controls with activity/no damage and controls with no activity/no damage. RESULTS: Joint activity and joint damage were significantly increased in ankles of PwH compared to Con (p ≤.001). Subgroup analysis revealed that structural alterations negatively impact pain perception. This is particularly evident when comparing PwH with both activity/damage to PwH with no activity/no damage at the tibiotalar joint (p = .001). At the fibulotalar joint, no significant differences were observed between PwH subgroups. Further analysis showed that both joint activity and joint damage result in an increase in pain sensitivity (p ≤.001). CONCLUSION: The data suggest a relation between joint activity, joint damage and pain perception in PwH. Even minor changes due to synovitis appear to affect pain perception, with the effect not intensifying at higher levels of inflammation. In terms of joint damage, severe degeneration leads to a sensitised pain state most robustly, whereas initial changes do not seem to significantly affect pain perception.


Asunto(s)
Articulación del Tobillo , Hemofilia A , Percepción del Dolor , Humanos , Hemofilia A/complicaciones , Hemofilia A/fisiopatología , Articulación del Tobillo/fisiopatología , Articulación del Tobillo/patología , Masculino , Adulto , Percepción del Dolor/fisiología , Femenino , Persona de Mediana Edad , Adulto Joven , Ultrasonografía , Umbral del Dolor
15.
Neuroimage Clin ; 42: 103601, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38579595

RESUMEN

BACKGROUND: Strokes frequently result in long-term motor deficits, imposing significant personal and economic burdens. However, our understanding of the underlying neural mechanisms governing motor learning in stroke survivors remains limited - a fact that poses significant challenges to the development and optimisation of therapeutic strategies. OBJECTIVE: This study investigates the diversity in motor learning aptitude and its associated neurological mechanisms. We hypothesised that stroke patients exhibit compromised overall motor learning capacity, which is associated with altered activity and connectivity patterns in the motor- and default-mode-network in the brain. METHODS: We assessed a cohort of 40 chronic-stage, mildly impaired stroke survivors and 39 age-matched healthy controls using functional Magnetic Resonance Imaging (fMRI) and connectivity analyses. We focused on neural activity and connectivity patterns during an unilateral motor sequence learning task performed with the unimpaired or non-dominant hand. Primary outcome measures included task-induced changes in neural activity and network connectivity. RESULTS: Compared to controls, stroke patients showed significantly reduced motor learning capacity, associated with diminished cerebral lateralization. Task induced activity modulation was reduced in the motor network but increased in the default mode network. The modulated activation strength was associated with an opposing trend in task-induced functional connectivity, with increased connectivity in the motor network and decreased connectivity in the DMN. CONCLUSIONS: Stroke patients demonstrate altered neural activity and connectivity patterns during motor learning with their unaffected hand, potentially contributing to globally impaired motor learning skills. The reduced ability to lateralize cerebral activation, along with the enhanced connectivity between the right and left motor cortices in these patients, may signify maladaptive neural processes that impede motor adaptation, possibly affecting long-term rehabilitation post-stroke. The contrasting pattern of activity modulation and connectivity alteration in the default mode network suggests a nuanced role of this network in post-stroke motor learning. These insights could have significant implications for the development of customised rehabilitation strategies for stroke patients.


Asunto(s)
Imagen por Resonancia Magnética , Red Nerviosa , Accidente Cerebrovascular , Humanos , Masculino , Femenino , Persona de Mediana Edad , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/complicaciones , Accidente Cerebrovascular/diagnóstico por imagen , Anciano , Red Nerviosa/fisiopatología , Red Nerviosa/diagnóstico por imagen , Adulto , Aprendizaje/fisiología , Encéfalo/fisiopatología , Encéfalo/diagnóstico por imagen , Destreza Motora/fisiología , Discapacidades para el Aprendizaje/fisiopatología , Discapacidades para el Aprendizaje/etiología , Conectoma/métodos
16.
Lancet Haematol ; 11(5): e324-e335, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38583455

RESUMEN

BACKGROUND: Whether high-dose cytarabine-based salvage chemotherapy, administered to induce complete remission in patients with poor responsive or relapsed acute myeloid leukaemia scheduled for allogeneic haematopoietic stem-cell transplantation (HSCT) after intensive conditioning confers a survival advantage, is unclear. METHODS: To test salvage chemotherapy before allogeneic HSCT, patients aged between 18 and 75 years with non-favourable-risk acute myeloid leukaemia not in complete remission after first induction or untreated first relapse were randomly assigned 1:1 to remission induction with high-dose cytarabine (3 g/m2 intravenously, 1 g/m2 intravenously for patients >60 years or with a substantial comorbidity) twice daily on days 1-3 plus mitoxantrone (10 mg/m2 intravenously) on days 3-5 or immediate allogeneic HSCT for the disease control group. Block randomisation with variable block lengths was used and patients were stratified by age, acute myeloid leukaemia risk, and disease status. The study was open label. The primary endpoint was treatment success, defined as complete remission on day 56 after allogeneic HSCT, with the aim to show non-inferiority for disease control compared with remission induction with a non-inferiority-margin of 5% and one-sided type 1 error of 2·5%. The primary endpoint was analysed in both the intention-to-treat (ITT) population and in the per-protocol population. The trial is completed and was registered at ClinicalTrials.gov, NCT02461537. FINDINGS: 281 patients were enrolled between Sept 17, 2015, and Jan 12, 2022. Of 140 patients randomly assigned to disease control, 135 (96%) proceeded to allogeneic HSCT, 97 (69%) after watchful waiting only. Of 141 patients randomly assigned to remission induction, 134 (95%) received salvage chemotherapy and 128 (91%) patients subsequently proceeded to allogeneic HSCT. In the ITT population, treatment success was observed in 116 (83%) of 140 patients in the disease control group versus 112 (79%) of 141 patients with remission induction (test for non-inferiority, p=0·036). Among per-protocol treated patients, treatment success was observed in 116 (84%) of 138 patients with disease control versus 109 (81%) of 134 patients in the remission induction group (test for non-inferiority, p=0·047). The difference in treatment success between disease control and remission induction was estimated as 3·4% (95% CI -5·8 to 12·6) for the ITT population and 2·7% (-6·3 to 11·8) for the per-protocol population. Fewer patients with disease control compared with remission induction had non-haematological adverse events grade 3 or worse (30 [21%] of 140 patients vs 86 [61%] of 141 patients, χ2 test p<0·0001). Between randomisation and the start of conditioning, with disease control two patients died from progressive acute myeloid leukaemia and zero from treatment-related complications, and with remission induction two patients died from progressive acute myeloid leukaemia and two from treatment-related complications. Between randomisation and allogeneic HSCT, patients with disease control spent a median of 27 days less in hospital than those with remission induction, ie, the median time in hospital was 15 days (range 7-64) versus 42 days (27-121, U test p<0·0001), respectively. INTERPRETATION: Non-inferiority of disease control could not be shown at the 2·5% significance level. The rate of treatment success was also not statistically better for patients with remission induction. Watchful waiting and immediate transplantation could be an alternative for fit patients with poor response or relapsed acute myeloid leukaemia who have a stem cell donor available. More randomised controlled intention-to-transplant trials are needed to define the optimal treatment before transplantation for patients with active acute myeloid leukaemia. FUNDING: DKMS and the Gert and Susanna Mayer Stiftung Foundation.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Leucemia Mieloide Aguda , Inducción de Remisión , Trasplante Homólogo , Humanos , Trasplante de Células Madre Hematopoyéticas/métodos , Leucemia Mieloide Aguda/terapia , Leucemia Mieloide Aguda/tratamiento farmacológico , Persona de Mediana Edad , Masculino , Femenino , Adulto , Anciano , Citarabina/uso terapéutico , Citarabina/administración & dosificación , Adulto Joven , Adolescente , Mitoxantrona/uso terapéutico , Mitoxantrona/administración & dosificación , Terapia Recuperativa/métodos , Resultado del Tratamiento , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Recurrencia
17.
Front Immunol ; 15: 1350470, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38629074

RESUMEN

Optimizing natural killer (NK) cell alloreactivity could further improve outcome after allogeneic hematopoietic cell transplantation (alloHCT). The donor's Killer-cell Immunoglobulin-like Receptor (KIR) genotype may provide important information in this regard. In the past decade, different models have been proposed aiming at maximizing NK cell activation by activating KIR-ligand interactions or minimizing inhibitory KIR-ligand interactions. Alternative classifications intended predicting outcome after alloHCT by donor KIR-haplotypes. In the present study, we aimed at validating proposed models and exploring more classification approaches. To this end, we analyzed samples stored at the Collaborative Biobank from HLA-compatible unrelated stem cell donors who had donated for patients with acute myeloid leukemia (AML) or myelodysplastic neoplasm (MDS) and whose outcome data had been reported to EBMT or CIBMTR. The donor KIR genotype was determined by high resolution amplicon-based next generation sequencing. We analyzed data from 5,017 transplants. The median patient age at alloHCT was 56 years. Patients were transplanted for AML between 2013 and 2018. Donor-recipient pairs were matched for HLA-A, -B, -C, -DRB1, and -DQB1 (79%) or had single HLA mismatches. Myeloablative conditioning was given to 56% of patients. Fifty-two percent of patients received anti-thymocyte-globulin-based graft-versus-host disease prophylaxis, 32% calcineurin-inhibitor-based prophylaxis, and 7% post-transplant cyclophosphamide-based prophylaxis. We tested several previously reported classifications in multivariable regression analyses but could not confirm outcome associations. Exploratory analyses in 1,939 patients (39%) who were transplanted from donors with homozygous centromeric (cen) or telomeric (tel) A or B motifs, showed that the donor cen B/B-tel A/A diplotype was associated with a trend to better event-free survival (HR 0.84, p=.08) and reduced risk of non-relapse mortality (NRM) (HR 0.65, p=.01). When we further dissected the contribution of B subtypes, we found that only the cen B01/B01-telA/A diplotype was associated with a reduced risk of relapse (HR 0.40, p=.04) while all subtype combinations contributed to a reduced risk of NRM. This exploratory finding has to be validated in an independent data set. In summary, the existing body of evidence is not (yet) consistent enough to recommend use of donor KIR genotype information for donor selection in routine clinical practice.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Histocompatibilidad , Leucemia Mieloide Aguda , Síndromes Mielodisplásicos , Receptores KIR , Humanos , Persona de Mediana Edad , Genotipo , Trasplante de Células Madre Hematopoyéticas/normas , Leucemia Mieloide Aguda/terapia , Ligandos , Pronóstico , Receptores KIR/genética , Síndromes Mielodisplásicos/terapia
18.
Int J Prosthodont ; 0(0): 1-19, 2024 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-38536148

RESUMEN

PURPOSE: To update data on the transfer accuracy of digital implant impressions by using a coordinate-based analysis, latest intraoral scanners (IOSs) were investigated in an established clinical close model set-up. MATERIALS AND METHODS: An implant master model (IMM) of the maxilla with four implants in the posterior area (#14/#24 and #16/#26) and a reference cube was scanned with four different IOS (i700 (Medit), Primescan (Dentsply Sirona), Trios 4 and Trios 5 (3Shape) ten times each. Datasets were compared with a reference dataset of IMM that was generated with x-ray computed tomography in advance. 3D deviations for the implant-abutment-interface points (IAIPs) were calculated. Statistical analysis was performed by multifactorial ANOVA (p < .05). RESULTS: Overall deviations for trueness (mean) ± precision (SD) of the IAIPs ranged from 88±47 µm for the Primescan, followed by 112±57 µm for the i700, 121±42 µm for the Trios 4 and 124±43 µm for the Trios 5 with decreasing accuracy along the scan path. For trueness, one significant difference between the Primescan and the T4 was detected for one implant position. For precision, no significant differences were noticed. CONCLUSIONS: Although the latest IOS showed a significant improvement in transfer accuracy, the accumulating deviation along the scan path is not yet resolved. Considering the Trios system, the innovation seems to be limited as no improvement could be detected between Trios 4 and 5.

19.
Best Pract Res Clin Haematol ; 37(1): 101541, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38490766

RESUMEN

Allogeneic hematopoietic stem cell (HSC) transplantation is a curative therapy for many severe blood diseases. As many patients have no suitable family donor, large unrelated donor registries and donor centers have been established in many countries, along with an international system for the provision of unrelated donor HSC products. As an essential part of this system, DKMS operates donor centers in 7 countries with a total of 12.2 million donors and over 114,000 donations so far, and a multinational donor registry. In 2022, DKMS donors contributed 57.5% of all cross-border donations worldwide. In this review, we describe the international system for the provision of unrelated donor HSC products as well as tasks and responsibilities of donor registries and donor centers. We also discuss relevant aspects of DKMS donor centers, namely donor file composition, matching and donation probabilities and actual donations, and the unique multinational approach of the DKMS Registry.


Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Donante no Emparentado , Humanos , Donantes de Tejidos , Sistema de Registros , Células Madre Hematopoyéticas
20.
Physiol Behav ; 278: 114505, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38432443

RESUMEN

Children's body odours are effective chemical cues in the parent-child relationship. Mothers can recognize the odour of their child and prefer this odour over that of unfamiliar children. This effect is mediated by genetic similarity and developmental stage and is therefore suited to promote parental care at pre-pubertal stage, while facilitating incest avoidance at (post-)pubertal stage. The present study tested whether similar mechanisms apply to fathers. Therefore n = 56 fathers evaluated body odour samples of their own and of unfamiliar children in varying genetic and developmental stages. Genetic status was determined by human leucocyte antigen (HLA) profiling, developmental status by standardized assessment of pubertal status and steroid hormone concentration (estradiol, testosterone). Similar to mothers, fathers identified their own child's body odour above chance and preferred that odour. The paternal preference did not relate to HLA similarity but decreased with increasing age of the child. The decline was associated with higher pubertal stages in daughters only, which supports the hypothesis of odour-mediated incest prevention in opposite-sex parent-child dyads.


Asunto(s)
Olor Corporal , Relaciones Padre-Hijo , Masculino , Femenino , Humanos , Adolescente , Olfato , Padre , Odorantes , Madres , Antígenos de Histocompatibilidad Clase II
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