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Atrial fibrillation is the most common cardiac arrhythmia and a leading cause of mortality and morbidity. Optimal management of atrial fibrillation is paramount to improve quality of life and reduce the impact on health and social care services. Owing to its strong associations with other cardiovascular and non-cardiovascular comorbidities, a holistic management approach to atrial fibrillation care is advocated, but this is yet to be clearly defined by international clinical guidelines. This ambiguity has prompted us to review the available clinical evidence on different management strategies to optimise atrial fibrillation care in the context of performance and quality measures, which can be used to objectively assess standards of care.

In low-malaria-transmission areas of Madagascar, annual parasite incidence (API) from routine data has been used to target indoor residual spraying at sub-district commune levels. To assess validity of this approach, we conducted school-based serological surveys and health facility (HF) data quality assessments in seven districts to compare API to "gold-standard" commune-level serological measures.

At two primary schools in each of 93 communes, 60 students were randomly selected along with parents and teachers. Capillary blood was drawn for rapid diagnostic tests (RDTs) and serology. Multiplex bead-based immunoassays to detect antibodies to five Plasmodium falciparum antigens were conducted, and finite mixture models used to characterize seronegative and seropositive populations. Reversible catalytic models generated commune-level annual seroconversion rates (SCRs). HF register data were abstracted to assess completeness and accuracy.

RDT positivity from 12,770 samples was 0.5%. Seroprevalence to tested antigens ranged from 17.9% (MSP-1) to 59.7% (PF13). Median commune-level SCR was 0.0108 (range 0.001, 0.075). Compared to SCRs, API identified 71% (95% CI 51%, 87%) of the 30% highest-transmission communes; sensitivity declined at lower levels. Routine data accuracy did not substantially affect API performance.

API performs reasonably well at identifying higher-transmission communes, but sensitivity declined at lower transmission levels.

API performs reasonably well at identifying higher-transmission communes, but sensitivity declined at lower transmission levels.

Inflammasome-induced neuroinflammation is a major pathogenic mechanism underlying the degeneration of nigral dopaminergic neurons in Parkinson's disease (PD). Baicalein is a flavonoid isolated from the traditional Chinese medicinal herbal Scutellaria baicalensis Georgi with known anti-inflammatory and neuroprotective efficacy in models of neurodegenerative diseases, including PD. However, its effects on inflammasome-induced neuroinflammation during PD remain unclear.

We used N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to induce PD-like pathology in mice. Behavioral assessments including the pole test, rotarod test and open filed test were conducted to evaluate the effects of baicalein on MPTP-induced motor dysfunction. The efficacies of baicalein against MPTP-induced dopaminergic neuron loss and glial cell activation in the substantia nigra compact (SNc) were examined by immunohistochemistry, effects on proinflammatory cytokines by qPCR and enzyme-linked immunosorbent assay (ELISA), effects on inflammasome pathway activation by immunoblotting and flow cytometry.

Administration of baicalein reversed MPTP-induced motor dysfunction, loss of dopaminergic neurons, and pro-inflammatory cytokine elevation. Baicalein also inhibited NLRP3 and caspase-1 activation and suppressed gasdermin D (GSDMD)-dependent pyroptosis. Additionally, baicalein inhibited the activation and proliferation of disease-associated proinflammatory microglia.

These findings suggest that baicalein can reverse MPTP-induced neuroinflammation in mice by suppressing NLRP3/caspase-1/GSDMD pathway. Our study provides potential insight of baicalein in PD therapy.

These findings suggest that baicalein can reverse MPTP-induced neuroinflammation in mice by suppressing NLRP3/caspase-1/GSDMD pathway. Our study provides potential insight of baicalein in PD therapy.

The Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) mobile health (mHealth) program was a cluster-randomized controlled trial of diarrhea patient households conducted in Dhaka, Bangladesh.

Patients were block-randomized to three arms standard recommendation on oral rehydration solution use; health facility delivery of CHoBI7 plus mHealth (no home visits); and health facility delivery of CHoBI7 plus two home visits and mHealth. The primary outcome was reported diarrhea in the past two weeks collected monthly for 12 months. The secondary outcomes were stunting, underweight, and wasting at a 12 month follow-up. Analysis was intention-to-treat. The trial is registered at ClinicalTrials.gov (NCT04008134).

Between December 4, 2016 and April 26, 2018, 2626 participants in 769 households were randomly allocated to three arms 849 participants to standard message, 886 to mHealth with no home visits, and 891 to mHealth with two home visits. Children under five years had significantly lower 12-month diarrhea prevalence in both the mHealth with two home visits arm (Prevalence Ratio(PR) 0.73 (95% Confidence Interval(CI) 0.61, 0.87)) and the mHealth with no home visits arm (PR 0.82 (95% CI 0.69, 0.97)). Children under 2 years were significantly less likely to be stunted in both the mHealth with two home visits arm (33% vs. 45%, Odds Ratio(OR) 0.55, 95% CI 0.31, 0.97) and the mHealth with no home visits arm (32% vs. learn more 45%, OR 0.54, 95% CI 0.31, 0.96) compared to children in the standard message arm.

The CHoBI7 mHealth program lowered pediatric diarrhea and stunting among diarrhea patient households.

The CHoBI7 mHealth program lowered pediatric diarrhea and stunting among diarrhea patient households.

In mid-2016, a cholera outbreak occurred in Kathmandu Valley, Nepal. This retrospective study aims to determine if a reactive, ring vaccination strategy would have been useful in preventing cholera transmission during that outbreak.

Data on cholera cases were collected as part of hospital-based surveillance in the Kathmandu Valley in 2016. Global Positioning System (GPS) coordinates were obtained during household visits. Geographic clusters of cases were visually determined and tested statistically for clustering. Cluster size was determined based on the distribution of cases around the index case.

GPS coordinates for 69 cases were analysed. Six geographic clusters were identified, all of which showed significant clustering of cases. Approximately 85% of cases within a cluster occurred more than 7d after the index case. The median ring size was 1km, with a population of 14000 people.

Cholera cases were clustered in space and the majority of cases occurred over 1week after the initial cases in the cluster, allowing for an opportunity to prevent transmission through the use of the vaccine soon after the initial case was identified.