Bucknerburnham5098
To determine the relative effectiveness and safety of doses of secukinumab and guselkumab in patients with active psoriatic arthritis (PsA).
A Bayesian network meta-analysis was performed incorporating data from randomized controlled trials (RCTs) to evaluate the effectiveness and safety of secukinumab 150 mg, secukinumab 300mg, and guselkumab 100 mg every 4 weeks (Q4W) and guselkumab every 8 weeks (Q8W).
Six RCTs, including 2,385 patients, fulfilled the inclusion criteria. The surface under the cumulative ranking curve (SUCRA) revealed that secukinumab 300mg had the highest probability of reaching a 20% American College of Rheumatology (ACR20) response rate, followed by secukinumab 150mg, guselkumab 100 mg Q4W, guselkumab 100 mg Q8W, and placebo. The ACR50 response rate revealed the same distribution pattern as the ACR20 response rate. The SUCRA rating, dependent on the psoriasis area and severity index of at least 75% (PASI75) response rate, showed that guselkumab 100 mg Q4W had the highest possibility of achieving the PASi75 response, followed by guselkumab 100 mg Q8W, secukinumab 300 mg, secukinumab 150 mg, and placebo. Safety analyses focused on serious adverse events (SAEs), adverse events (AEs), and withdrawals attributable to AEs that did not have statistically relevant variation in the respective intervention categories.
Based on the ACR20 and ACR50 response rates, secukinumab 300 mg had the strongest response effectiveness, whereas guselkumab 100 mg Q4W was the most effective treatment strategy for PsA based on PASI75. However, there was little disparity between the treatment options with regard to SAEs.
Based on the ACR20 and ACR50 response rates, secukinumab 300 mg had the strongest response effectiveness, whereas guselkumab 100 mg Q4W was the most effective treatment strategy for PsA based on PASI75. However, there was little disparity between the treatment options with regard to SAEs.IntroductionIn contrast to countries where carbapenemase-producing Enterobacterales (CPE) are endemic, only sporadic cases were reported in Switzerland until 2013. selleck An aggravation of the epidemiological situation in neighbouring European countries indicated the need for a surveillance study in Switzerland.AimWe aimed to describe CPE distributions in Switzerland and identify epidemiological factors associated with changes in incidence.MethodsData on all human CPE isolates from 2013 to 2018 were collected by the Swiss Centre for Antibiotic Resistance (ANRESIS) and analysed for temporal and regional trends by Generalised Poisson regression. Isolates associated with infection or colonisation were included in a primary analysis; a secondary analysis included invasive isolates only. Statistical detection of regional clusters was performed with WHONET/SaTScan.ResultsWe analysed 731 CPE isolates, of which 325 (44.5%) were associated with screenings and 173 (23.7%) with infections. Yearly detection of CPE isolates increased considerably during the study period from 65 to 212. The most frequently isolated species were Klebsiella pneumoniae (54%) and Escherichia coli (28%). The most frequent genotypes were OXA-48 (43%), KPC (21%) and NDM (14%). In contrast to the French-speaking parts of Switzerland (West, Geneva) where OXA-48 were the predominant genotypes (around 60%), KPC was the most frequently detected genotype in the Italian-speaking region (63%). WHONET/SaTScan outbreak detection analysis identified seven clusters in five regions of Switzerland.ConclusionsIn a first continuous surveillance of CPE in Switzerland, we found that the epidemiological situation aggravated nationwide and that regional patterns of CPE genotypes mirrored the situation in neighbouring European countries.Following the spread of the SARS-CoV-2 B.1.1.7 variant, social distancing was strengthened in France in January 2021. Using a two-strain mathematical model calibrated on genomic surveillance, we estimated that curfew measures allowed hospitalisations to plateau by decreasing transmission of the historical strains while B.1.1.7 continued to grow. School holidays appear to have further slowed down progression in February. Without progressively strengthened social distancing, a rapid surge of hospitalisations is expected, despite the foreseen increase in vaccination rhythm.BackgroundChildren's role in SARS-CoV-2 epidemiology remains unclear. We investigated an initially unnoticed SARS-CoV-2 outbreak linked to schools in northern France, beginning as early as mid-January 2020.AimsThis retrospective observational study documents the extent of SARS-CoV-2 transmission, linked to an affected high school (n = 664 participants) and primary schools (n = 1,340 study participants), in the context of unsuspected SARS-CoV-2 circulation and limited control measures.MethodsBetween 30 March and 30 April 2020, all school staff, as well as pupils and their parents and relatives were invited for SARS-CoV-2 antibody testing and to complete a questionnaire covering symptom history since 13 January 2020.ResultsIn the high school, infection attack rates were 38.1% (91/239), 43.4% (23/53), and 59.3% (16/27), in pupils, teachers, and non-teaching staff respectively vs 10.1% (23/228) and 12.0% (14/117) in the pupils' parents and relatives (p less then 0.001). Among the six primary schools, three children attending separate schools at the outbreak start, while symptomatic, might have introduced SARS-CoV-2 there, but symptomatic secondary cases related to them could not be definitely identified. In the primary schools overall, antibody prevalence in pupils sharing classes with symptomatic cases was higher than in pupils from other classes 15/65 (23.1%) vs 30/445 (6.7%) (p less then 0.001). Among 46 SARS-CoV-2 seropositive pupils less then 12 years old, 20 were asymptomatic. Whether past HKU1 and OC43 seasonal coronavirus infection protected against SARS-CoV-2 infection in 6-11 year olds could not be inferred.ConclusionsViral circulation can occur in high and primary schools so keeping them open requires consideration of appropriate control measures and enhanced surveillance.
To assess the frequency with which soft drinks and premiums are available with children's meals marketed on the top restaurant chains' websites worldwide.
Cross-sectional structured observational assessment of secondary information about top international restaurant chain children's meals.
Websites of top restaurant chains for 193 countries and five regions of the United Nations.
Top restaurant chains (including McDonald's, Subway, Burger King and KFC) across 193 countries. Children's meal images and descriptions were reviewed to determine if the meal was marketed with a soft drink as a beverage option and whether the meal offered a premium.
Children's meals were marketed online on restaurant websites by at least one of the four chains in a total of seventy eight of the 193 countries (40·4 %). Overall, 56·3 % of countries with any online children's meal marketing by the four chains included at least one chain that marketed soft drinks and 92·3 % marketed premiums with the meal.
Every region in the world includes marketing of children's meals on the websites of the top restaurant chains. The high prevalence of premiums marketed online with children's meals is of concern. Similarly, with over 50 % of countries with online children's meal marketing having at least one chain that offers soft drinks as part of the meals, additional regulation and education may be warranted.
Every region in the world includes marketing of children's meals on the websites of the top restaurant chains. The high prevalence of premiums marketed online with children's meals is of concern. Similarly, with over 50 % of countries with online children's meal marketing having at least one chain that offers soft drinks as part of the meals, additional regulation and education may be warranted.
Gestational anaemia (GA) is common in developing countries. This study assessed the relationship of late GA and negative perinatal outcomes in participants recruited in a reference maternity unit of the Caribbean region of Colombia.
Prospective analytical birth cohort study. Maternal Hb and serum ferritin (SF) levels were measured. GA was defined as Hb levels <6·82 mmol/l (<11 g/dl), SF depletion as SF levels <12 µg/l. Birth outcomes such as low birth weight (LBW), preterm birth (PB) and small for gestational age (SGA) were examined.
Mothers in the first stage of labour, living in urban or rural areas of Bolívar, were enrolled in an obstetrical centre located in Cartagena, Colombia. Blood and stool samples were taken prior delivery. Maternal blood count, SF levels and infant anthropometric data were recorded for analysis.
1218 pregnant women aged 18-42 years and their newborns.
Prevalence of GA and SF depletion was 41·6 % and 41·1 %, respectively. GA was positively associated with poverty-related sociodemographic conditions. Prenatal care attendance lowered the risk of PB, LBW and SGA. Birth weight was inversely associated with Hb levels, observing a -36·8 g decrease in newborn weight per 0·62 mmol/l (or 1 g/dl) of maternal Hb. SF depletion, but not anaemia, was associated with PB. SGA outcome showed a significant association with anaemia, but not a significant relationship with SF depletion.
Birth weight and other-related perinatal outcomes are negatively associated with Hb and SF depletion. Prenatal care attendance reduced the risk of negative birth outcomes.
Birth weight and other-related perinatal outcomes are negatively associated with Hb and SF depletion. Prenatal care attendance reduced the risk of negative birth outcomes.
Evidence supports the use of group therapy for symptom reduction and improving functioning in people with psychosis. However, research guidelines highlight the importance of establishing the feasibility of interventions. Adherence is an important indicator of feasibility and an essential step in supporting the development of the evidence base for group interventions. This review aims to estimate adherence, and possible barriers and facilitators, to psychotherapeutic groups in people with psychosis.
Embase, Ovid MEDLINE and PsycINFO databases were searched for cross-referencing terms related to group therapy and psychosis. Studies were assessed against inclusion criteria and methodological quality was evaluated. Data wasextracted from each paper including the average session attendance, demographic, clinical, study and therapy-related characteristics and the impact of these on adherence levels evaluated.
Fifty-nine original research papers were included, reporting on 52 independent studies which consistege. Study sample size was inversely associated with adherence levels. Study quality was variable with approximately 61.5% found to be at risk of bias. The results support the feasibility of group therapy and suggest that adherence in people with psychosis is not dissimilar to those for people experiencing common mental health difficulties. These findings, alongside efficacy evidence, support the use of group interventions in people with psychosis but also highlight the need for further high-quality research on the efficacy for these approaches.
