Measles in vulnerable populations: An outbreak in Roma settlements of Loire-Atlantique, France, 2019.

In May 2019, a measles outbreak occurred in the French subregion of Loire-Atlantique, particularly affecting Roma settlements. Various obstacles hindered the implementation of postexposure measures among Roma population, resulting in the spread of the cases to other settlements. Suspected cases of measles were immediately investigated and concerned settlements were visited for measles-mumps-rubella (MMR) vaccination. From July 1 to September 3, 2019, a first and then a second Health Reserve team helped for vaccination on the affected and then also the measles-free settlements. Vaccination uptake was monitored with the use of the department's vaccination center immunization registry. Genotyping of selected samples was performed for comparison with viruses circulating at the same time in France and Romania. As of September 16 2019, 109 cases of measles were confirmed among Roma population, including 99 (91%) children under 15 years. Of the 85 people eligible for vaccination, 60 (71%) had not been vaccinated and 23 (27%) had an unknown vaccination status. Sequence comparison revealed that 28/29 sequenced D8 strains were 100% identical to the strain responsible for a large number of cases throughout France in 2019, and to two sequences reported in Romania among sporadic cases. The vaccination campaign resulted in 1136 people on 35 settlements receiving at least one dose of MMR vaccine and in the increase of one-dose MMR vaccine coverage at 24 months from 43% (23/53) to 91% (48/53). With measles transmission continuing in Europe, efforts must be made to meet immunization coverage targets, particularly in hard-to-reach communities where outbreaks may be difficult to control.

What is the impact of a pre-hospital geriatrician led telephone 'Silver Triage' for older people living with frailty?

PURPOSE: Most older people are conveyed to hospital via ambulance, therefore presenting a focus to reduce hospitalisation. North Central London has introduced 'Silver Triage', a pre-hospital telephone support scheme where geriatricians support the London Ambulance Service with clinical decision-making. METHODS: Data from the first 14 months was analysed descriptively. RESULTS: There have been 452 Silver Triage cases (November 2021 to January 2023). 80% resulted in a decision to not convey. The mode clinical frailty scale (CFS) was 6. CFS did not influence conveyance rates. Prior to triage, paramedics thought hospitalisation was not required in 44% of cases (n = 72/165). All paramedics surveyed (n = 176) would use the service again. Most (66%, n = 108/164) felt they learnt something and 16% (n = 27/164) reported it changed their decision-making process. CONCLUSION: Silver Triage has the potential to improve the care of older people by preventing unnecessary hospitalisation and has been well received by paramedics.

Effect of doses and administration routes of 9R vaccine on protection of Japanese quails against experimental infection with Salmonella Gallinarum / Efeito das doses e vias de administração da vacina 9R na proteção de codornas japonesas contra infeccção experimental com Salmonella Gallinarum

Coturniculture has increased significantly in the last decades. There are several pathogens that can affect these birds. Among the diseases, fowl typhoid stands out as a disease with a potentially great impact to the poultry industry. The objective of this the study was to evaluate the effect of doses and administration routes of live 9R vaccine on protection of Japanese quails against experimental infection with Salmonella Gallinarum (SG). Two hundred and fifty birds were used, divided into five groups: G1, oral vaccination with one dose; G2, oral vaccination with 2 doses; G3, subcutaneous vaccination with one dose; G4, subcutaneous vaccination with two doses and G5 not vaccinated. All birds from all five groups were challenged with SG at an age of 45 days. SG was quantified in the periods of one, four, seven and twelve days after the challenge. The presence of clinical signs and macroscopic lesions of the disease were observed. The groups vaccinated by subcutaneous route had a higher egg production and lower mortality rate. Birds receiving a dose of the vaccine by subcutaneous route also showed lower amount of SG in the liver and spleen seven days after the challenge.(AU)

A coturnicultura tem aumentado significativamente nas últimas décadas. Existem vários patógenos que podem afetar essas aves. Entre as doenças, o tifo aviário se destaca como uma doença de grande impacto para a indústria avícola. O objetivo deste estudo foi avaliar o efeito de doses e vias de administração da vacina viva 9R na proteção de codornas japonesas contra infecção experimental por Salmonella Gallinarum (SG). Foram utilizadas duzentos e cinquenta aves, divididas em cinco grupos: G1, vacinação oral com uma dose; G2, vacinação oral com 2 doses; G3, vacinação subcutânea com uma dose; G4, vacinação subcutânea com duas doses e G5 não vacinado. Todas as aves dos cinco grupos foram desafiadas com SG aos 45 dias de idade. A SG foi quantificada nos períodos de um, quatro, sete e doze dias após o desafio. Foi observada a presença de sinais clínicos e lesões macroscópicas da doença. Os grupos vacinados por via subcutânea apresentaram maior produção de ovos e menor taxa de mortalidade. Aves recebendo uma dose da vacina por via subcutânea também apresentaram menor quantidade de SG no fígado e baço sete dias após o desafio.(AU)

Salmonella Enteritidis infection, corticosterone levels, performance and egg quality in laying hens submitted to different methods of molting.

In commercial layer poultry farming, molt induction is an important tool used by egg producers to prolong the production cycle of laying hens. Conventional molt induction programs involve total feed withdrawal, which raises questions about animal welfare and increased infection susceptibility. The high incidence of paratyphoid salmonellosis infections in commercial poultry farming is still an important health challenge because in addition to affecting the birds, such infections also cause public health problems. In this context, experiments were performed with laying hens at 79 wk of age to compare the conventional forced molting method (fasting) with an alternative method (free wheat bran supply) and determine their effect on the persistence of vaccine antibodies against Newcastle disease, the control and reduction of experimentally inoculated Salmonella Enteritidis, and the performance and egg quality of hens. A reduction (P < 0.05) of Salmonella Enteritidis in the crop and lower production of corticosterone were observed in the birds that received wheat bran compared with those subjected to total fasting. Moreover, a better performance (P < 0.05) with regard to egg production, egg mass, and feed conversion/kg and dozen eggs was observed in the hens that received the alternative treatment compared to the conventional forced molting method. Thus, the use of wheat bran for forced molting was found to be feasible and met the welfare needs of the hens.

The outer membrane Omp85-like protein P39 influences metabolic homeostasis in mature Arabidopsis thaliana.

The Omp85 proteins form a large membrane protein family in bacteria and eukaryotes. Omp85 proteins are composed of a C-terminal ß-barrel-shaped membrane domain and one or more N-terminal polypeptide transport-associated (POTRA) domains. However, Arabidopsis thaliana contains two genes coding for Omp85 proteins without a POTRA domain. One gene is designated P39, according to the molecular weight of the encoded protein. The protein is targeted to plastids and it was established that p39 has electrophysiological properties similar to other Omp85 family members, particularly to that designated as Toc75V/Oep80. We analysed expression of the gene and characterised two T-DNA insertion mutants, focusing on alterations in photosynthetic activity, plastid ultrastructure, global expression profile and metabolome. We observed pronounced expression of P39, especially in veins. Mutants of P39 show growth aberrations, reduced photosynthetic activity and changes in plastid ultrastructure, particularly in the leaf tip. Further, they display global alteration of gene expression and metabolite content in leaves of mature plants. We conclude that the function of the plastid-localised and vein-specific Omp85 family protein p39 is important, but not essential, for maintenance of metabolic homeostasis of full-grown A. thaliana plants. Further, the function of p39 in veins influences the functionality of other plant tissues. The link connecting p39 function with metabolic regulation in mature A. thaliana is discussed.

Effect of guanidinoacetic acid supplementation on live performance, meat quality, pectoral myopathies and blood parameters of male broilers fed corn-based diets with or without poultry by-products.

Creatine is a nitrogenous compound naturally occurring in animal tissues and is obtained from dietary animal protein or de novo synthesis from guanidinoacetic acid (GAA). The dietary supply of this semi-essential nutrient could be adversely compromised when feeding purely vegetable-based diets. The objective of this experiment was to evaluate the effects of GAA supplementation in broilers fed corn-based diets with or without the inclusion of poultry by-products (PBP) on live performance, carcass and cut up yields, meat quality, pectoral muscle myopathies, differential blood count, blood clinical chemistry, serum GAA and its metabolites. The treatments consisted of PBP inclusion in the diets at 0 and 5%, with or without GAA supplementation (0 or 0.06%). A total of 1,280 one-d-old male Ross 708 broiler chicks were randomly placed in 64 floor pens with 16 replicates per treatment combination. At 0, 14, 35, 48, and 55 d, pen BW and feed intake were recorded. BW gain and FCR were calculated at the end of each phase. Individual BW was obtained at 55 d and one broiler per pen was selected for blood collection. Additionally, four broilers per pen were selected (including the chicken for blood collection) for processing. Data were analyzed as a randomized complete block design in a 2 × 2 factorial arrangement with PBP and GAA supplementation as main effects. An improvement (P < 0.05) on FCR of 0.019 (g:g) was detected at 55 d due to GAA supplementation. The probability of having breast meat with low severity of wooden breast (score 2) was increased (P < 0.05) by GAA inclusion in diets without PBP. An interaction effect (P < 0.05) was detected on GAA concentration in blood. The supplementation with GAA and PBP inclusion resulted in higher (P < 0.05) GAA serum concentration. Generally, meat quality parameters were not affected by GAA. In conclusion, GAA supplementation improved FCR regardless of dietary PBP and reduced wooden breast severity by increasing score 2 in diets without PBP.

Diagnostic and prognostic value of miR-1 and miR-29b on adverse ventricular remodeling after acute myocardial infarction - The SITAGRAMI-miR analysis.

BACKGROUND: MicroRNAs (miRs) have shown to exert fibrotic and anti-fibrotic effects in preclinical models of acute myocardial infarction (AMI). The aim of this study was to evaluate miR-1, miR-21, miR-29b and miR-92a as circulating biomarkers for adverse ventricular remodeling (AVR) in post-AMI patients. METHODS: Plasma levels of miR-1, miR-21, miR-29b and miR-92a were measured in 44 patients of the SITAGRAMI trial population at day 4, day 9 and 6month after AMI and in 18 matched controls (CTL). MiR expression patterns were correlated with magnetic resonance imaging (MRI) parameters for AVR (absolute change (Δ) in infarct volume (IV), left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume (LVEDV) between day 4 and 6months after AMI) and a combined cardiovascular endpoint. RESULTS: Expression of miR-1, miR-21 and miR-29b but not miR-92a was increased in AMI vs. CTL cohort showing highest miR levels at d9. However, only miR-1 and miR-29b levels significantly correlated with ΔIV and showed a trend for correlation with ΔLVEF. Only miR-29b levels at day 9 correlated with ΔLVEDV at 6-month follow-up. There was no correlation of miR levels with an adverse outcome. CONCLUSION: Mir-1 and miR-29b plasma levels post-AMI correlate with IV changes. In addition, miR-29b levels are associated with changes of LVEDV over time. These results provide insights into the role of miRs as diagnostic AVR surrogate markers. Further large scale clinical trials will be needed to evaluate the real prognostic relevance of these miRs with respect to a clinical implication in the future.

Established interventions for mitral valve regurgitation. Current evidence.

Severe mitral regurgitation (MR) is a growing medical challenge in today's aging population, leading to increased health expenditure due to the resultant morbidity and mortality. Surgery, either replacement or repair, has been the mainstay of therapy for primary MR. In high-risk or inoperable patients, treatment was limited to medical therapy until 2008. Since then, alternative percutaneous therapies have been introduced and have proven to be safe and effective in patients with secondary MR. Edge-to-edge repair with the MitraClip system is applied worldwide for primary and secondary MR. Randomized data do not support its application in low-risk patients with primary MR. Results from ongoing and future randomized trials will clarify its impact on important clinical endpoints in high-risk and inoperable patients. The Carillon device is a percutaneous indirect annuloplasty technique introduced in 2009 for secondary MR. Clinical data for the novel Cardioband system, using a different intra-atrial annuloplasty technique, have been gathered from more than 40 patients and the system recently received CE mark approval. Other percutaneous repair devices and implantable valves are under development and may be introduced into clinical practice soon. The percutaneous interventional therapy of MR is a highly dynamic field of cardiovascular medicine and has the potential to improve quality of life as well as morbidity and mortality in selected patients.

Toggling the Local Electric Field with an Embedded Adatom Switch.

By means of scanning probe microscopy we demonstrate that Au(+) on NaCl films adsorbs in an embedded, slightly off-centered Cl-Cl bridge position and can be switched between two equivalent mirror-symmetric configurations using the attractive force exerted by a scanning probe tip. Density functional theory calculations demonstrate that the displacement of the Au atom from the centered position of the bridge configuration is accompanied by a large lifting of the closest Cl atom leading to significant changes in the local electrostatic field. Our findings suggest that Au(+) can be used to toggle the local electrostatic field.

DPP-4 inhibition ameliorates atherosclerosis by priming monocytes into M2 macrophages.

OBJECTIVE: Glipitins are widely used for the treatment of type 2 diabetic patients. In addition to their improvement of glycemic control, animal studies have suggested an independent anti-atherosclerotic effect of gliptins. Nevertheless, recent clinical trials regarding long-term effects of gliptin therapy on vascular events have been disappointing. This discrepancy led us to better dissect the functional role of SDF-1/CXCR4 signaling as a potential mechanism underlying gliptin action. The study should give improved understanding of the potential of gliptin therapy in the prevention and treatment of atherosclerosis. METHODS AND RESULTS: In an ApoE-/- mouse model on high cholesterol diet, long-term treatment with the DPP-4 inhibitor Sitagliptin significantly reduced atherosclerosic plaque load in the aorta. Flow cytometry analyses showed an enrichment of M2 macrophages in the aortic wall under gliptin therapy. Importantly, the number of recruited CD206+ macrophages was inversely correlated with total plaque area while no correlation was found for the overall macrophage population or M1 macrophages. Blockade of CXCR4/SDF-1 signaling by AMD3100 inhibited aortic M2 accumulation and the therapeutic effect of Sitagliptin. Correspondingly, Sitagliptin shifted the polarization profile of macrophages towards a M2-like phenotype. CONCLUSION: Sitagliptin-mediated inhibition of early atherosclerosis is based on M2-polarization during monocyte differentiation via the SDF-1/CXCR4 signaling. In contrast to earlier assumptions gliptin treatment might be especially effective in prevention of atherosclerosis.

Manipulation of the charge state of single Au atoms on insulating multilayer films.

We show charge-state manipulation of single Au adatoms on 2-11 monolayer (ML) thick NaCl films on Cu surfaces by attaching or detaching single electrons via the tip of an atomic force microscope (AFM). Tristate charge control (neutral, negatively charged, and positively charged) is achieved. On Cu(100) and Cu(111) supports, charge tristability is achieved independently of the NaCl layer thickness. In contrast, on Cu(311), only Au anions are stable on the thinnest NaCl films, but neutral and positive charge states become sufficiently long lived on films thicker than 4 ML to allow AFM-based charge-state-manipulation experiments.

[Cardiological diseases]. / Kardiologische Krankheitsbilder.

Knowledge of rare but important clinical disease symptoms in cardiology is of vital importance in the daily routine as severe courses of disease as well as death may be prevented by early diagnosis, effective monitoring and timely initiation of an adequate therapy. In this article an important rhythmological disease, arrhythmogenic right ventricular cardiomyopathy, as well as two significant structural diseases, takotsubo (stress-related) cardiomyopathy and aortic aneurysm related to Marfan syndrome, as well as their implications for clinical practice will be presented.

XMetA, an allosteric monoclonal antibody to the insulin receptor, improves glycaemic control in mice with diet-induced obesity.

XMetA, a high-affinity, fully human monoclonal antibody, allosterically binds to and activates the insulin receptor (INSR). Previously, we found that XMetA normalized fasting glucose and glucose tolerance in insulinopenic mice. To determine whether XMetA is also beneficial for reducing hyperglycaemia due to the insulin resistance of obesity, we have now evaluated XMetA in hyperinsulinemic mice with diet-induced obesity. XMetA treatment of these mice normalized fasting glucose for 4 weeks without contributing to weight gain. XMetA also corrected glucose tolerance and improved non-high density lipoprotein cholesterol. These studies indicate, therefore, that monoclonal antibodies that allosterically activate the INSR, such as XMetA, have the potential to be novel agents for the treatment of hyperglycaemia in conditions associated with the insulin resistance of obesity.

[Resource activation in clinical psychology and psychotherapy: review of theoretical issues and current research]. / Ressourcenaktivierung in der klinischen Psychologie und Psychotherapie: Überblick über theoretische Hintergründe und aktuelle Forschungsansätze.

This review summarises theoretical issues and current research on working with clients' resources and strengths in clinical psychology and psychotherapy. Resource activation is considered as an important common factor in psychotherapy. In general, resource activation means an explicit focus on resources, strengths and potentials of the clients. After defining the term resources, considerations with regard to therapeutic attitude, principles of resource activation, approaches to resource diagnostics and different research strategies are presented. Current research focuses especially on the relation between resource activation and process variables in out-patient treatment.

Magnetologic devices fabricated by nanostencil lithography.

We present magnetic quantum cellular automata (MQCA), fabricated by means of nanostencil lithography, i.e., using a resistless shadow masking technique in ultra-high vacuum. The nanostencil tool allows the fabrication and in situ investigation of structures using atomic force microscopy (AFM) and magnetic force microscopy (MFM). We analyze the error distribution within the structures to shed light on the performance and challenges of magnetic cellular logic devices. Simulations are performed to corroborate an improved concept for these devices which makes use of fourfold magnetic anisotropy.

Neurocognitive impairment in unaffected siblings of youth with bipolar disorder.

BACKGROUND: There is growing evidence for the familiality of pediatric bipolar disorder (BPD) and its association with impairments on measures of processing speed, verbal learning and 'executive' functions. The current study investigated whether these neurocognitive impairments index the familial risk underlying the diagnosis. METHOD: Subjects were 170 youth with BPD (mean age 12.3 years), their 118 non-mood-disordered siblings and 79 non-mood-disordered controls. Groups were compared on a battery of neuropsychological tests from the Wechsler Intelligence Scales, the Stroop Color Word Test, the Wisconsin Card Sorting Test (WCST), the Rey-Osterrieth Complex Figure (ROCF), an auditory working memory Continuous Performance Test (CPT) and the California Verbal Learning Test-Children's Version (CVLT-C). Measures were factor analyzed for data reduction purposes. All analyses controlled for age, sex and attention-deficit/hyperactivity disorder (ADHD). RESULTS: Principal components analyses with a promax rotation yielded three factors reflecting: (1) processing speed/verbal learning, (2) working memory/interference control and (3) abstract problem solving. The CPT working memory measure with interference filtering demands (WM INT) was only administered to subjects aged > or =12 years and was therefore analyzed separately. BPD youth showed impairments versus controls and unaffected relatives on all three factors and on the WM INT. Unaffected relatives exhibited impairments versus controls on the abstract problem-solving factor and the WM INT. They also showed a statistical trend (p=0.07) towards worse performance on the working memory/interference control factor. CONCLUSIONS: Neurocognitive impairments in executive functions may reflect the familial neurobiological risk mechanisms underlying pediatric BPD and may have utility as endophenotypes in molecular genetic studies of the condition.

Treatment outcome and follow-up of multidrug-resistant tuberculosis patients, West Coast/Winelands, South Africa, 1992-2002.

SETTING: Brooklyn Chest Hospital, Western Cape, South Africa. OBJECTIVE: To evaluate the treatment outcome and 2- and 5-year follow-up of patients treated for multidrug-resistant tuberculosis (MDR-TB) with individualized regimens. DESIGN: Retrospective cohort study of all MDR-TB patients starting treatment during 1992-2002. Patients were evaluated every 6 months for 2 years after treatment and at 5 years when possible. RESULTS: Over 11 years, 491 (66%) of 747 MDR-TB patients received treatment with two or more second-line drugs; 239 (49%) were cured or completed treatment, 68 (14%) died, 144 (29%) defaulted from treatment, 27 (5%) failed, 10 (2%) transferred out and 3 (<1%) remained on treatment. Only 176 (36%) were tested for human immunodeficiency virus and 15 were positive. The proportion with a successful MDR-TB treatment outcome declined over time, while the proportion who defaulted remained stable. Among 410 patients who had not transferred out or died, 281 (69%) had 2-year data available: 185 (66%) were cured or completed treatment, 32 (11%) were retreated for TB and 64 (23%) died. CONCLUSIONS: Under program conditions in the West Coast/Winelands District, default rates were high and treatment success rates low. Outreach strategies for MDR-TB treatment should only be implemented if adequate resources are committed to the program.

Use of imatinib mesylate in gastrointestinal stromal tumours: Pan-Birmingham Cancer Network experience.

AIMS: Imatinib mesylate, a selective tyrosine kinase receptor inhibitor of KIT and PDGFRalpha, is currently licensed for the treatment of unresectable or metastatic gastrointestinal stromal tumours (GISTs), which are KIT positive. Partial response rates in 65% of patients and stable disease in 20% of patients are typically seen. The aim of this study was to assess the effectiveness and toxicity of an unselected cohort of patients treated with imatinib mesylate and to compare these results with published data. MATERIALS AND METHODS: A retrospective audit of the use of imatinib mesylate in GISTs within the Pan-Birmingham Cancer Network was carried out. In total, 39 patients were identified, the first commenced imatinib mesylate in September 2001. RESULTS: The most common primary tumour sites were small intestine (19 [49%]) and stomach (12 [31%]). Initial curative resection was carried out in 21 (54%), palliative resection in three (8%) and 15 (38%) were unresectable. Of those who had curative resection, the median time to recurrence was 13 months (range 2-276). Common sites of metastases were liver (19 [49%]) and peritoneum (12 [31%]). At 24 months 70% remained on imatinib. A partial response was reported in 23 (59%), stable disease in seven (18%) and disease progression in four (10%). Five patients (13%) have yet to be reassessed at 3 months. Imatinib was well tolerated with minor side-effects; peri-orbital oedema (nine [23%]), skin rash (four [10%]), minor gastrointestinal bleed (one [3%]). No significant toxicity was documented in 18 (46%). CONCLUSIONS: The response rates achieved in this unselected cohort of patients are consistent with published data. The duration of tumour control is good, with most patients responding to imatinib mesylate for more than 2 years. Side-effects are mild and acceptable.

Stability of executive function deficits into young adult years: a prospective longitudinal follow-up study of grown up males with ADHD.

OBJECTIVE: Although individuals with attention deficit-hyperactivity disorder (ADHD) commonly exhibit deficits in executive functions that greatly increase the morbidity of the disorder, all available information on the subject is cross sectional. METHOD: Males (n = 85) 9-22 years with ADHD followed over 7 years into young adulthood were assessed on measures of sustained attention/vigilance, planning and organization, response inhibition, set shifting and categorization, selective attention and visual scanning, verbal and visual learning, and memory. A binary definition of executive function deficits (EFDs) was defined based on a subject manifesting at least two abnormal tests 1.5 standard deviations from controls. RESULTS: The majority of subjects maintained EFDs over time (kappa: 0.41, P < 0.001; sensitivity: 55%, specificity: 85%, positive predictive value: 69%, and negative predictive value: 75%). CONCLUSION: Considering the morbidity of EFDs, these findings stress the importance of their early recognition for prevention and early intervention strategies. EFDs are stable over time.