We conducted a review of the peer-reviewed literature focused on conducting community health needs assessments and highlighted the necessary steps to conduct a community health needs assessment in a rural community. F...We conducted a review of the peer-reviewed literature focused on conducting community health needs assessments and highlighted the necessary steps to conduct a community health needs assessment in a rural community. From the literature review, we identified three steps necessary— establishing partnerships, using a mixed methods approach, and disseminating results—to successfully conduct a needs assessment that fitted the definition of the Affordable Care Act. These three steps have been used as a guide for developing a protocol for conducting a community health needs assessment in Meadville, PA. We detail our preliminary project protocol here.展开更多
Background:Lymphatic filariasis(LF),also known as elephantiasis,is a neglected tropical disease(NTD)targeted for elimination through a Global Programme to Eliminate LF(GPELF).Between 2000 and 2014,the GPELF has delive...Background:Lymphatic filariasis(LF),also known as elephantiasis,is a neglected tropical disease(NTD)targeted for elimination through a Global Programme to Eliminate LF(GPELF).Between 2000 and 2014,the GPELF has delivered 5.6 billion treatments to over 763 million people.Updating the estimated health and economic benefits of this significant achievement is important in justifying the resources and investment needed for eliminating LF.Method:We combined previously established models to estimate the number of clinical manifestations and disability-adjusted life years(DALYs)averted from three benefit cohorts(those protected from acquiring infection,those with subclinical morbidity prevented from progressing and those with clinical disease alleviated).The economic savings associated with this disease prevention was then analysed in the context of prevented medical expenses incurred by LF clinical patients,potential income loss through lost-labour,and prevented costs to the health system to care for affected individuals.The indirect cost estimates were calculated using the human capital approach.A combination of four wage sources was used to estimate the fair market value of time for an agricultural worker with LF infection(to ensure a conservative estimate,the lowest wage value was used).Results:We projected that due to the first 15 years of the GPELF 36 million clinical cases and 175(116–250)million DALYs will potentially be averted.It was estimated that due to this notable health impact,US$100.5 billion will potentially be saved over the lifetimes of the benefit cohorts.This total amount results from summing the medical expenses incurred by LF patients(US$3 billion),potential income loss(US$94 billion),and costs to the health system(US$3.5 billion)that were projected to be prevented.The results were subjected to sensitivity analysis and were most sensitive to the assumed percentage of work hours lost for those suffering from chronic disease(changing the total economic benefit between US$69.30–150.7 billion).Conclusions:Despite the limitations of any such analysis,this study identifies substantial health and economic benefits that have resulted from the first 15 years of the GPELF,and it highlights the value and importance of continued investment in the GPELF.展开更多
The Coastal Coral Tree (Erythrina caffra Thunb.) produces floral nectar (FN) that serves to attract pollinating insects, but also secretes nectar from extra-floral (EFN) glands that serves to attract predatory insects...The Coastal Coral Tree (Erythrina caffra Thunb.) produces floral nectar (FN) that serves to attract pollinating insects, but also secretes nectar from extra-floral (EFN) glands that serves to attract predatory insects, such as ants. While studies on myrmecophytes (i.e. specialized plants that attract and interact with ants) have primarily focused on interspecific evaluations of EFN chemistry, the Coastal Coral tree offers an opportunity to contrast intraspecific nectar chemistry with differing evolutionary and ecological functions. We hypothesized that the richness of (molecular) sugar species, relative concentrations, and diversity of sugars in FN and foliar EFN would diverge due to differences in the ecological role of the two types of nectar. High performance liquid chromatography with refractive index detection was used to identify the richness of sugar species (based on retention time), measure the relative concentrations, and evaluate the diversity of sugars in FN and foliar EFN secretions. We detected sugar species unique to each gland type and reported significant differences in the relative concentration of one sugar species common to both gland types. While the mean diversity index of sugars was similar for both gland types, the diversity of foliar EFN sugars was significantly more variable than that of FN sugars. The composition of FN showed little variation, and was reflective of its fundamental role in plant reproduction. Foliar EFN, however, demonstrated the variability expected of a context-dependent myrmecophyte that interacts with a facultative ant species assemblage across a mosaic of abiotic and biotic conditions.展开更多
The combination of ASC22, an anti-PD-L1 antibody potentially enhancing HIV-specific immunity and chidamide, a HIV latency reversal agent, may serve as a strategy for antiretroviral therapy-free virological control for...The combination of ASC22, an anti-PD-L1 antibody potentially enhancing HIV-specific immunity and chidamide, a HIV latency reversal agent, may serve as a strategy for antiretroviral therapy-free virological control for HIV. People living with HIV, having achieved virological suppression, were enrolled to receive ASC22 and chidamide treatment in addition to their antiretroviral therapy. Participants were monitored over 24 weeks to measure changes in viral dynamics and the function of HIV-specific CD8^(+) T cells (NCT05129189). 15 participants completed the study. At week 8, CA HIV RNA levels showed a significant increase from baseline, and the values returned to baseline after discontinuing ASC22 and chidamide. The total HIV DNA was only transiently increased at week 4 (P = 0.014). In contrast, integrated HIV DNA did not significantly differ from baseline. Increases in the proportions of effector memory CD4^(+) and CD8^(+) T cells (TEM) were observed from baseline to week 24 (P = 0.034 and P = 0.002, respectively). The combination treatment did not succeed in enhancing the function of HIV Gag/Pol- specific CD8^(+) T cells. Nevertheless, at week 8, a negative correlation was identified between the proportions of HIV Gag-specific TEM cells and alterations in integrated DNA in the T cell function improved group (P = 0.042 and P = 0.034, respectively). Nine adverse events were solicited, all of which were graded 1 and resolved spontaneously. The combined treatment of ASC22 and chidamide was demonstrated to be well-tolerated and effective in activating latent HIV reservoirs. Further investigations are warranted in the context of analytic treatment interruption.展开更多
Dear Editor,The central nervous system(CNS)is a target of the human immunodeficiency virus(HIV)[1].Late presenters with advanced HIV infection may develop opportunistic cerebral infections or lymphoma,most often Epste...Dear Editor,The central nervous system(CNS)is a target of the human immunodeficiency virus(HIV)[1].Late presenters with advanced HIV infection may develop opportunistic cerebral infections or lymphoma,most often Epstein-Barr virus(EBV)-related.Abnormal neurological examination or changed mental status are first evaluated by imaging for diagnosis[2],however,specificity remains poor.In the absence of suspected intracranial hypertension,cerebrospinal fluid(CSF)analysis is a diagnostic tool for CNS disorders.However,in the absence of meningitis results are frequently not contributive for a diagnosis.展开更多
In December 2019,initial cases of the novel coronavirus(2019-nCoV)infection,termed coronavirus disease 2019(COVID-19),were first reported in Wuhan,China.[1]In humans,infections with the human coronavirus 229E,OC43,NL6...In December 2019,initial cases of the novel coronavirus(2019-nCoV)infection,termed coronavirus disease 2019(COVID-19),were first reported in Wuhan,China.[1]In humans,infections with the human coronavirus 229E,OC43,NL63,and HKU1 usually result in mild,selflimiting upper respiratory tract infections.However,other variants have rapid transmission rates and can cause severe respiratory syndrome and death.These variants include severe acute respiratory syndrome coronavirus(SARSCoV),Middle East respiratory syndrome coronavirus(MERS-CoV),and the current 2019-nCoV.展开更多
Increased microbial translocation and chronic immune activation are two critical problems for people living with HIV(PLWH)in the antiretroviral therapy(ART)era.Compared with numerous studies on bacterial microbiomic c...Increased microbial translocation and chronic immune activation are two critical problems for people living with HIV(PLWH)in the antiretroviral therapy(ART)era.Compared with numerous studies on bacterial microbiomic communities,there are only a limited number of studies focusing on fungal microbiomic composition and products in PLWH.This study protocol is used to evaluate the changes in bacterial and fungal microbiome populations induced by terbinafine treatment,which is an antifungal agent widely used amongst PLWH.Twenty-two PLWH on a stable ART regimen for more than six months,who require treatment for onychomycosis,will be recruited.The participants will be followed-up for a 12-week treatment period(oral terbinafine 250mg daily)and another 12-weeks of terbinafine discontinuation.Plasma and fecal samples will be collected before and after terbinafine treatment,and for 12weeks after the discontinuation of terbinafine.Plasma gut injury and microbial translocation biomarker assays,in addition to testing for gut microbiome composition,will be undertaken.With this pilot study,we will perform formal sample size calculations and test study feasibility for a possible full-scale study.展开更多
Human immunodeficiency virus(HIV)has been shown to evolve independently in different anatomical compartments.Characterizing HIV genetic evolution in different tissues and cells provides insights into the mechanisms th...Human immunodeficiency virus(HIV)has been shown to evolve independently in different anatomical compartments.Characterizing HIV genetic evolution in different tissues and cells provides insights into the mechanisms that maintain the viral reservoir.HIV compartmentalization has been well documented in the semen but rarely in male genital tract(MGT)organs.The precise mechanisms that result in the development of HIV compartmentalization in multiple genitourinary sites have been poorly explored due to the difficulty in accessing these tissues.Based on evidence from lymph nodes and gut tissues,mechanisms that may influence compartmentalization include immune pressures,local concentrations of antiviral drugs,clonal expansion of different cell types and inflammation that alters the cellular microenvironment.We reviewed phylogenetic evidences supporting viral compartmentalization between the blood and multiple genitourinary sites in HIV-infected people.Characterizing distinct viral subpopulations enhances our overall understanding of the HIV reservoir inMGTand could ultimately lead to the development of novel therapies to eradicate the virus in tissues.展开更多
Due to its ubiquitous presence in the environment and the lack of a scientific consensus regarding the environmental safety of the widely used anionic surfactant Sodium Lauryl Sulfate(CAS No:151-21-3),a systematic lit...Due to its ubiquitous presence in the environment and the lack of a scientific consensus regarding the environmental safety of the widely used anionic surfactant Sodium Lauryl Sulfate(CAS No:151-21-3),a systematic literature review and thematic analysis was conducted.All studies about sodium lauryl sulfate(SLS)in the environment in key databases were reviewed,with coding methods used to identify impact categories from SLS exposure without potential narration bias.Based on the limited number of studies on SLS,there is empirical evidence of this surfactant contributing to environmental toxicity at various concentrations(0.004-3509 mg L^(-1)),with aquatic organisms at a higher risk from exposure.Furthermore,exposure to SLS can elicit changes to various organismic processes and environmental equilibrium.Hence,further study on SLS in various environmental compartments is recommended to monitor the level of SLS pollution,understand its behavior upon contact with various environmental media,and understand its impacts on flora and fauna.Lastly,SLS quantification should be done on commonly used consumer products to potentially regulate its use and to consequently curb SLS pollution from its source.展开更多
文摘We conducted a review of the peer-reviewed literature focused on conducting community health needs assessments and highlighted the necessary steps to conduct a community health needs assessment in a rural community. From the literature review, we identified three steps necessary— establishing partnerships, using a mixed methods approach, and disseminating results—to successfully conduct a needs assessment that fitted the definition of the Affordable Care Act. These three steps have been used as a guide for developing a protocol for conducting a community health needs assessment in Meadville, PA. We detail our preliminary project protocol here.
基金HCT and AAB,are supported by London Centre for Neglected Tropical Disease Research(funded by GSK).MHB(employed by GSK)had a role in study design,and preparation of the manuscript.
文摘Background:Lymphatic filariasis(LF),also known as elephantiasis,is a neglected tropical disease(NTD)targeted for elimination through a Global Programme to Eliminate LF(GPELF).Between 2000 and 2014,the GPELF has delivered 5.6 billion treatments to over 763 million people.Updating the estimated health and economic benefits of this significant achievement is important in justifying the resources and investment needed for eliminating LF.Method:We combined previously established models to estimate the number of clinical manifestations and disability-adjusted life years(DALYs)averted from three benefit cohorts(those protected from acquiring infection,those with subclinical morbidity prevented from progressing and those with clinical disease alleviated).The economic savings associated with this disease prevention was then analysed in the context of prevented medical expenses incurred by LF clinical patients,potential income loss through lost-labour,and prevented costs to the health system to care for affected individuals.The indirect cost estimates were calculated using the human capital approach.A combination of four wage sources was used to estimate the fair market value of time for an agricultural worker with LF infection(to ensure a conservative estimate,the lowest wage value was used).Results:We projected that due to the first 15 years of the GPELF 36 million clinical cases and 175(116–250)million DALYs will potentially be averted.It was estimated that due to this notable health impact,US$100.5 billion will potentially be saved over the lifetimes of the benefit cohorts.This total amount results from summing the medical expenses incurred by LF patients(US$3 billion),potential income loss(US$94 billion),and costs to the health system(US$3.5 billion)that were projected to be prevented.The results were subjected to sensitivity analysis and were most sensitive to the assumed percentage of work hours lost for those suffering from chronic disease(changing the total economic benefit between US$69.30–150.7 billion).Conclusions:Despite the limitations of any such analysis,this study identifies substantial health and economic benefits that have resulted from the first 15 years of the GPELF,and it highlights the value and importance of continued investment in the GPELF.
基金supported by a Kadner-Pitts Research Grant from the Loyola Marymount University(LMU)Biology Departmenta Continuing Faculty Grant from the LMU Frank R.Seaver College of Science&Engineering+2 种基金Student support was funded by a grant from the Beta Beta Beta National Biological Honor Societythrough stipends from both the LMU Undergraduate Research Opportunities Programthe LMU Summer Undergraduate Research Program.
文摘The Coastal Coral Tree (Erythrina caffra Thunb.) produces floral nectar (FN) that serves to attract pollinating insects, but also secretes nectar from extra-floral (EFN) glands that serves to attract predatory insects, such as ants. While studies on myrmecophytes (i.e. specialized plants that attract and interact with ants) have primarily focused on interspecific evaluations of EFN chemistry, the Coastal Coral tree offers an opportunity to contrast intraspecific nectar chemistry with differing evolutionary and ecological functions. We hypothesized that the richness of (molecular) sugar species, relative concentrations, and diversity of sugars in FN and foliar EFN would diverge due to differences in the ecological role of the two types of nectar. High performance liquid chromatography with refractive index detection was used to identify the richness of sugar species (based on retention time), measure the relative concentrations, and evaluate the diversity of sugars in FN and foliar EFN secretions. We detected sugar species unique to each gland type and reported significant differences in the relative concentration of one sugar species common to both gland types. While the mean diversity index of sugars was similar for both gland types, the diversity of foliar EFN sugars was significantly more variable than that of FN sugars. The composition of FN showed little variation, and was reflective of its fundamental role in plant reproduction. Foliar EFN, however, demonstrated the variability expected of a context-dependent myrmecophyte that interacts with a facultative ant species assemblage across a mosaic of abiotic and biotic conditions.
基金Ascletis Pharma Inc.and the Shanghai Commission of Science and Technology(grant no.20MC1920100,grant no.20Y31900400 and grant no.21Y11901200)。
文摘The combination of ASC22, an anti-PD-L1 antibody potentially enhancing HIV-specific immunity and chidamide, a HIV latency reversal agent, may serve as a strategy for antiretroviral therapy-free virological control for HIV. People living with HIV, having achieved virological suppression, were enrolled to receive ASC22 and chidamide treatment in addition to their antiretroviral therapy. Participants were monitored over 24 weeks to measure changes in viral dynamics and the function of HIV-specific CD8^(+) T cells (NCT05129189). 15 participants completed the study. At week 8, CA HIV RNA levels showed a significant increase from baseline, and the values returned to baseline after discontinuing ASC22 and chidamide. The total HIV DNA was only transiently increased at week 4 (P = 0.014). In contrast, integrated HIV DNA did not significantly differ from baseline. Increases in the proportions of effector memory CD4^(+) and CD8^(+) T cells (TEM) were observed from baseline to week 24 (P = 0.034 and P = 0.002, respectively). The combination treatment did not succeed in enhancing the function of HIV Gag/Pol- specific CD8^(+) T cells. Nevertheless, at week 8, a negative correlation was identified between the proportions of HIV Gag-specific TEM cells and alterations in integrated DNA in the T cell function improved group (P = 0.042 and P = 0.034, respectively). Nine adverse events were solicited, all of which were graded 1 and resolved spontaneously. The combined treatment of ASC22 and chidamide was demonstrated to be well-tolerated and effective in activating latent HIV reservoirs. Further investigations are warranted in the context of analytic treatment interruption.
基金supported by grants from the National Key R&D Program of China(Grants No.2022YFC2305202,2021YFC2301900-2021YFC2301901)。
文摘Dear Editor,The central nervous system(CNS)is a target of the human immunodeficiency virus(HIV)[1].Late presenters with advanced HIV infection may develop opportunistic cerebral infections or lymphoma,most often Epstein-Barr virus(EBV)-related.Abnormal neurological examination or changed mental status are first evaluated by imaging for diagnosis[2],however,specificity remains poor.In the absence of suspected intracranial hypertension,cerebrospinal fluid(CSF)analysis is a diagnostic tool for CNS disorders.However,in the absence of meningitis results are frequently not contributive for a diagnosis.
基金This work was funded by grants from the Chongqing Special Research Project for Prevention and Control of Novel Coronavirus Pneumonia(No.cstc2020jscxfyzx0074)the Canadian Institutes of Health Research(No.HB2164064).
文摘In December 2019,initial cases of the novel coronavirus(2019-nCoV)infection,termed coronavirus disease 2019(COVID-19),were first reported in Wuhan,China.[1]In humans,infections with the human coronavirus 229E,OC43,NL63,and HKU1 usually result in mild,selflimiting upper respiratory tract infections.However,other variants have rapid transmission rates and can cause severe respiratory syndrome and death.These variants include severe acute respiratory syndrome coronavirus(SARSCoV),Middle East respiratory syndrome coronavirus(MERS-CoV),and the current 2019-nCoV.
基金This work was supported by the Joint Medical Research Project(2020GDRC010)of Chongqing Science&Technology Bureau and Chongqing Health Commission,the Research Project of Chinese Federation of Public Health foundation(GWLM202024)the Youth Scientific Research and Innovation Fund Project of Chongqing Public Health Medical Center(2019QNKYXM02).
文摘Increased microbial translocation and chronic immune activation are two critical problems for people living with HIV(PLWH)in the antiretroviral therapy(ART)era.Compared with numerous studies on bacterial microbiomic communities,there are only a limited number of studies focusing on fungal microbiomic composition and products in PLWH.This study protocol is used to evaluate the changes in bacterial and fungal microbiome populations induced by terbinafine treatment,which is an antifungal agent widely used amongst PLWH.Twenty-two PLWH on a stable ART regimen for more than six months,who require treatment for onychomycosis,will be recruited.The participants will be followed-up for a 12-week treatment period(oral terbinafine 250mg daily)and another 12-weeks of terbinafine discontinuation.Plasma and fecal samples will be collected before and after terbinafine treatment,and for 12weeks after the discontinuation of terbinafine.Plasma gut injury and microbial translocation biomarker assays,in addition to testing for gut microbiome composition,will be undertaken.With this pilot study,we will perform formal sample size calculations and test study feasibility for a possible full-scale study.
基金This work was funded by the China Scholarship Council(No.201906325018)the Canadian Institutes of Health Research(CIHR+3 种基金grants MOP 103230 and PTJ 166049)the Vaccines&Immunotherapy Core of the CIHR Canadian HIV Trials Network(CTN,grant CTN 257)the CIHR-funded Canadian HIV Cure Enterprise(CanCURE)Team Grant HB2-164064This work was also supported by the Fonds de la Recherche Quebec-Sante(FRQ-S):Reseau SIDA/Maladies infectieuses and Therapie cellulaire.Stephane Isnard is supported by a Fond de Recherche Quebec Santefellowship and a CIHR/CTN Postdoctoral Fellowship Award.Jean-Pierre Routy is the holder of the Louis Lowenstein Chair in Hematology and Oncology,McGill University and William Turner award holder from the McGill University Health Centre.
文摘Human immunodeficiency virus(HIV)has been shown to evolve independently in different anatomical compartments.Characterizing HIV genetic evolution in different tissues and cells provides insights into the mechanisms that maintain the viral reservoir.HIV compartmentalization has been well documented in the semen but rarely in male genital tract(MGT)organs.The precise mechanisms that result in the development of HIV compartmentalization in multiple genitourinary sites have been poorly explored due to the difficulty in accessing these tissues.Based on evidence from lymph nodes and gut tissues,mechanisms that may influence compartmentalization include immune pressures,local concentrations of antiviral drugs,clonal expansion of different cell types and inflammation that alters the cellular microenvironment.We reviewed phylogenetic evidences supporting viral compartmentalization between the blood and multiple genitourinary sites in HIV-infected people.Characterizing distinct viral subpopulations enhances our overall understanding of the HIV reservoir inMGTand could ultimately lead to the development of novel therapies to eradicate the virus in tissues.
文摘Due to its ubiquitous presence in the environment and the lack of a scientific consensus regarding the environmental safety of the widely used anionic surfactant Sodium Lauryl Sulfate(CAS No:151-21-3),a systematic literature review and thematic analysis was conducted.All studies about sodium lauryl sulfate(SLS)in the environment in key databases were reviewed,with coding methods used to identify impact categories from SLS exposure without potential narration bias.Based on the limited number of studies on SLS,there is empirical evidence of this surfactant contributing to environmental toxicity at various concentrations(0.004-3509 mg L^(-1)),with aquatic organisms at a higher risk from exposure.Furthermore,exposure to SLS can elicit changes to various organismic processes and environmental equilibrium.Hence,further study on SLS in various environmental compartments is recommended to monitor the level of SLS pollution,understand its behavior upon contact with various environmental media,and understand its impacts on flora and fauna.Lastly,SLS quantification should be done on commonly used consumer products to potentially regulate its use and to consequently curb SLS pollution from its source.
