Andreassenmelchiorsen4603
The COVID-19 pandemic has uncovered and intensified existing societal inequalities. People on the move and residents of urban slums and informal settlements are among some of the most affected groups in the Global South. Given the current living conditions of migrants, the WHO guidelines on how to prevent COVID-19 (such as handwashing, physical distancing and working from home) are challenging to nearly impossible in informal settlements. We use the case of India to highlight the challenges of migrants and urban slum dwellers during the COVID-19 response, and to provide human rights-based recommendations for immediate action to safeguard these vulnerable populations.A questionnaire survey was distributed via the Internet to 600 respondents. Preliminary results revealed that most Japanese people regularly washed their hands and had low resistance to wearing masks even before the COVID-19 pandemic. Internet news was the most common source of information. Half of the respondents said they would "stay at home evacuation" if a disaster occurred during the COVID-19 pandemic, reflecting the strategy promoted to reduce crowding in evacuation shelters. If a state of emergency must be reinstated, one-third of respondents said they could bear it for a few months and another one-third for a few weeks.The Sendai Framework for Disaster Risk Reduction (SFDRR) has helped to reduce global disaster risk, but there has been a lack of progress in disaster risk reduction (DRR) for people living in fragile and conflict affected contexts (FCAC). Given the mounting evidence that DRR cannot be implemented through conventional approaches in FCAC, serious efforts must be made to understand how to meet SFDRR's goals. This paper offers a case study of international non-governmental organization GOAL's programming that responds to the protracted crisis in Syria, with critical discussion on SFDRR and how to adapt humanitarian relief and disaster resilience.The global spread of SARS-CoV-2 is currently continuing, and the World Health Organization has announced the risk assessment of the viruses as high. In this study, we analyzed virology features of SARS-CoV-2 causing a family cluster outbreak. Among the six family members, five have been laboratory-confirmed infection of SARS-CoV-2 viruses. A total of five SARS-CoV-2 viruses have been isolated from the nasopharyngeal swabs. The complete genome of the viruses exhibited 100% nucleotide identity with each other. Only two nucleotide differences have been observed between genomes of the isolated viruses and the HCoV/Wuhan/ IVDC-HB-01/2019 strain. Therefore, SARS-CoV-2 has been confirmed as the causation of the family cluster infections.The ketogenic diet (KD) may have a role in treating super-refractory status epilepticus (SRSE). Predominantly used in paediatric epilepsy, there are few reports of its use in adults. We describe a 19-year-old man with UBE2A deficiency syndrome, drug resistant generalized epilepsy, and severe intellectual disability, who developed SRSE. Initiation of the KD on day 81 of his intensive care unit stay and achieving a state of ketosis seven days later resulted in SRSE resolution and discharge from hospital and recovery to his normal cognitive state. Initiating the KD required a multidisciplinary team for diet initiation and carer education. The KD requires a prospective study of efficacy for SRSE and this should include adult patients.Epilepsy in POLG related disease usually involves biallelic recessive mutations causing chronic neuronal loss and neuronal death. However, monoallelic POLG mutations have been reported in patients with neurological features such as seizures [1]. In these patients a second allele/gene was anticipated but not identified. The genetic etiology in epilepsy can contribute to better treatment strategies. For example, valproic acid (VPA) should be avoided in patients with POLG related epilepsy due to possible hepatotoxicity. We report a 12-year old boy with initially drug-resistant focal onset epilepsy, a mild developmental delay and behavioral issues. He carries potential pathogenic variants in the DNA polymerase gamma (POLG) gene (from asymptomatic mother) and in the liprin-alpha-4 (PPFIA4) gene (from asymptomatic father). This latter gene has never been related to (neurological) disorders, although its gene product interacts with several genes that play a role in excitatory neurotransmission and epileptogenesis. Hence, we hypothesize that the phenotype of our patient could be due to combination of detrimental effects to the neurons by the two aforementioned pathogenic variants. Nonetheless, we cannot exclude another undetected POLG mutation. In essence, genetic research should be aware that unexplained neurological disease can be caused by an oligogenic, rather than a monogenic, etiology.Today, there is a real political urge to see the sharing of ballistic data intensify across Europe mostly due to recent events such as terrorist attacks. However, technical constraints remain and two main options are being discussed. The first one relies on a centralized common database, implying a vendor monopoly for all Europe and a unified protocol among member states. The second one advocates for a distributed framework relying on existing national infrastructures and leaving each country responsible for its own protocols. This article describes a prototype network linking Switzerland and France using the Evofinder® system by ScannBI. We will first focus on how this network was set up, and then report some results from tests conducted to assess the viability of the concept. These results demonstrate that the second option cannot be discarded and pave the way for a distributed network. This solution appears to be cheaper, more adaptable and answers the practical needs of member states.A survey evaluation was conducted in the division of cardiology at a tertiary care academic centre to assess barriers, facilitators, acceptability, and feasibility of virtual care during the COVID-19 pandemic. Survey responses from 26 health care providers, 45 patients and 2 caregivers demonstrated that virtual visits (primarily by telephone) were feasible and generally acceptable to most respondents. Key opportunities for improvement included availability of easy-to-use video platforms; space and equipment in clinics; provision of information to patients before visits; and appropriate selection of patients for virtual visits. Results will inform optimization of virtual care during this pandemic and beyond.
Hepatitis C virus (HCV) eradication with direct-acting antivirals (DAAs) reduces but does not eliminate the risk for hepatocellular carcinoma (HCC). The development of surveillance strategies for HCC after the sustained virologic response (SVR) is therefore warranted. We aimed to evaluate the role of spleen stiffness measurement (SSM) in the prediction of HCC risk in a cohort of patients with advanced chronic liver disease (ACLD) treated with DAAs.
This is a retrospective cohort study of 140 patients with HCV-related ACLD successfully treated with DAAs in our centre between 2015 and 2017. Patients with available liver stiffness (LSM) and SSM before treatment and 6 months after (SVR24) were included. A Cox regression model investigated the association between SSM and HCC development.
During a median follow-up of 41.5 (IQR 32-49) months, 20 patients presented with HCC. SSM at SVR24 predicted HCC development in univariate and adjusted multivariate analysis (hazard ratio 1.025; 95% CI 1.001-1.050); the besttment with direct-acting antivirals.
It is not known how hepatic bile acids transport kinetics changes postprandially in the intact liver. Weused positron emission tomography (PET)/computed tomography (CT) with the tracer [
-methyl-
C]cholylsarcosine (
C-CSar), a synthetic sarcosine conjugate of cholic acid, to quantify fasting and postprandial hepatic bile acid transport kinetics in healthy human participants.
Six healthy human participants underwent dynamic liver
C-CSar PET/CT (60 min) during fasting and from 15 min after ingestion of a standard liquid meal. Hepatobiliary secretion kinetics of
C-CSar was calculated from PET data, blood samples (arterial and hepatic venous) and hepatic blood flow measured using indocyanine green infusion.
In the postprandial state, hepatic blood perfusion increased on average by 30% (
<0.01), and the flow-independent hepatic intrinsic clearance of
C-CSar from blood into bile increased by 17% from 1.82 (range, 1.59-2.05) to 2.13 (range, 1.75-2.50) ml blood/min/ml liver tissue (
= 0.042). The secretion of bile acids by the liver into the intestines changes after a standard liquid meal. The transport of bile acids from liver cells into bile and bile flow was increased after the meal.
In patients with severe alcoholic hepatitis (SAH), little is known about the profile of peripheral blood mononuclear cells (PBMCs) at baseline and during corticosteroid therapy, among those who can be treated successfully with steroids (steroid-responders [R] and those who cannot (steroid-non-responders [NR]); 2 groups with different outcomes.
We performed RNA-seq analysis in PBMCs from 32 patients with definite SAH, at baseline and after 7 days of corticosteroids. click here The data were sorted into R and NR (n= 16, each group) using the Lille model and 346 blood transcription modules (BTMs) were identified. BTMs are predefined modules of highly co-expressed PBMC genes, which can determine specific immune cell types and cellular functions. The activity of each BTM was taken as the mean value of its member genes.
At baseline, 345 BTMs had higher activity (
were upregulated) in NR relative to R. The 100 most upregulated BTMs in NR, included several modules related to lymphoid lineage (T, B, and natural killer [N where it can be estimated if a patient is going to respond or not to steroid therapy using the gene expression information of blood cells. This method will allow clinicians to assess the response of patients to steroids earlier, and will help them in adopting alternate strategies if the treatment is found to be ineffective in a particular patient.
Patients with severe alcoholic hepatitis receive steroid therapy as the main line of treatment; however, this treatment is ineffective in some patients. This only becomes apparent after 7 days of steroid therapy. We have developed an approach where it can be estimated if a patient is going to respond or not to steroid therapy using the gene expression information of blood cells. This method will allow clinicians to assess the response of patients to steroids earlier, and will help them in adopting alternate strategies if the treatment is found to be ineffective in a particular patient.
This first report of the Linköping Covid-19 Study (LinCoS) aimed at determination of Covid-19-associated mortality, impairments, activity and participation limitations denoting rehabilitation needs four months after discharge from hospital.
An ambidirectional population-based cohort study including all confirmed Covid-19 cases admitted to hospital during 1/03-31/05 and those living in home healthcare settings identified through a regional registry and evaluated through medical records, including WHO Clinical Progression Scale (CPS). All patients discharged from hospital were followed-up by structured telephone interview at 4 months post-discharge. Respondents indicated any new or aggravated persisting problems in any of 25 body functions and 12 activity/participation items and rated them for impact on daily life.
Out of 734 hospitalised patients, 149 were excluded, 125 died, and 460 were alive at 4-month follow-up of whom 433 (94.1%) were interviewed. In total, 40% reported impairments and activity/participation limitations affecting daily life and warranted further multi-professional rehabilitation assessment, predominantly those with severe disease and a considerable proportion of those with moderate disease.
