Publications by authors named "Herbst K"

Randomized controlled trials (RCTs) are at the top of the pyramid of evidence as they offer the best answer on the efficacy of a new treatment. RCTs are true experiments in which participants are randomly allocated to receive a certain intervention (experimental group) or a different intervention (comparison group), or no treatment at all (control or placebo group). Randomization, along with other methodological features such as blinding and allocation concealment, safeguard against biases.

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Background: The measurement of cause-specific mortality is critical for health system planning but remains a challenge in many low-resource settings due to societal, legal, and logistical barriers. We present a co-development process with community members for the design and implementation of an autopsy program to improve cause of death data in a historically underserved population.

Methods: We sought to develop an autopsy program at the Africa Health Research Institute (AHRI) Health and Demographic Surveillance Site (HDSS).

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Cognitive decline in Parkinson's disease (PD) varies widely. While models to predict cognitive progression exist, comparing traditional probabilistic models to deep learning methods remains understudied. This study compares sequential modeling techniques to identify cognitive progression in individuals with and without PD.

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Purpose: Dexmedetomidine increases sleep and reduces delirium in postoperative patients, but it is expensive and requires a monitored environment. Clonidine, another 2-agonist, is cheaper and is used safely for other purposes in wards. We assessed whether clonidine would improve sleep in postoperative high-dependency unit (HDU) patients.

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Building longitudinal population cohorts in Africa for coordinated research and surveillance can influence the setting of national health priorities, lead to the introduction of appropriate interventions, and provide evidence for targeted treatment, leading to better health across the continent. However, compared to cohorts from the global north, longitudinal continental African population cohorts remain scarce, are relatively small in size, and lack data complexity. As infections and noncommunicable diseases disproportionately affect Africa's approximately 1.

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Objective: To develop and externally validate models to predict probabilities of alpha-synuclein (a-syn) positive or negative status in vivo in a mixture of people with and without Parkinson's disease (PD) using easily accessible clinical predictors.

Methods: Uni- and multi-variable logistic regression models were developed in a cohort of participants from the Parkinson Progression Marker Initiative (PPMI) study to predict cerebrospinal fluid (CSF) a-syn status as measured by seeding amplification assay (SAA). Models were externally validated in a cohort of participants from the Systemic Synuclein Sampling Study (S4) that had also measured CSF a-syn status using SAA.

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Background: The absence of high-quality comprehensive civil registration and vital statistics systems across many settings in Africa has led to little empirical data on causes of death in the region. We aimed to use verbal autopsy data to provide comparative, population-based estimates of cause-specific mortality among adolescents and adults in eastern and southern Africa.

Methods: In this surveillance study, we harmonised verbal autopsy and residency data from nine health and demographic surveillance system (HDSS) sites in Kenya, Malawi, Tanzania, South Africa, Uganda, and Zimbabwe, each with variable coverage from Jan 1, 1995, to Dec 31, 2019.

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There is minimal knowledge regarding the durability of neutralization capacity and level of binding antibody generated against the highly transmissible circulating Omicron subvariants following SARS-CoV-2 infection in children with acute COVID-19 and those diagnosed with multisystem inflammatory syndrome in children (MIS-C) in the absence of vaccination. In this study, SARS-CoV-2 neutralization titers against the ancestral strain (WA1) and Omicron sublineages were evaluated in unvaccinated children admitted for COVID-19 ( = 32) and MIS-C ( = 32) at the time of hospitalization (baseline) and at six to eight weeks post-discharge (follow-up) between 1 April 2020, and 1 September 2022. In addition, antibody binding to the spike receptor binding domain (RBD) from WA1, BA.

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Multisystem Inflammatory Syndrome in Children (MIS-C) is a potentially life-threatening complication of COVID-19. The pathophysiological mechanisms leading to severe disease are poorly understood. This study leveraged clinical samples from a well-characterized cohort of children hospitalized with COVID-19 or MIS-C to compare immune-mediated biomarkers.

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Lipedema is a chronic, idiopathic, and painful disease characterized by an excess of adipose tissue in the extremities. The goal of this study is to characterize the gene expression of estrogen receptors (ERα and ERβ), G protein-coupled estrogen receptor (GPER), and ER-metabolizing enzymes: hydroxysteroid 17-beta dehydrogenase (HSD17B1, 7, B12), cytochrome P450 (CYP19A1), hormone-sensitive lipase (LIPE), enzyme steroid sulfatase (STS), and estrogen sulfotransferase (SULT1E1), which are markers in Body Mass Index (BMI) and age-matched non-lipedema (healthy) and lipedema ASCs and spheroids. Flow cytometry and cellular proliferation assays, RT-PCR, and Western Blot techniques were used to determine the expression of ERs and estrogen-metabolizing enzymes.

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Objective This study aimed to quantify the effect of social media posts on study enrollment among children with mild coronavirus disease 2019 (COVID-19). Methods The primary outcome was weekly study enrollments analyzed using a run chart. A secondary analysis used linear regression to assess study enrollments two days before and after a social media post, adjusted for the statewide pediatric seven-day-average severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) case rate, social media posting day, and the interaction of these two variables.

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Introduction: Understanding mortality variability by age and cause is critical to identifying intervention and prevention actions to support disadvantaged populations. We assessed mortality changes in two rural South African populations over 25 years covering pre-AIDS and peak AIDS epidemic and subsequent antiretroviral therapy (ART) availability.

Methods: Using population surveillance data from the Agincourt Health and Socio-Demographic Surveillance System (AHDSS; 1994-2018) and Africa Health Research Institute (AHRI; 2000-2018) for 5-year periods, we calculated life expectancy from birth to age 85, mortality age distributions and variation, and life-years lost (LYL) decomposed into four cause-of-death groups.

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The interpretation of complex biological datasets requires the identification of representative variables that describe the data without critical information loss. This is particularly important in the analysis of large phenotypic datasets (phenomics). Here we introduce Multi-Attribute Subset Selection (MASS), an algorithm which separates a matrix of phenotypes (e.

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Background: Antibodies against factor (F)VIII are a major complication in the treatment of patients with severe hemophilia A. The Nijmegen-Bethesda assay (NBA) is the gold standard for detection of neutralizing antibodies (inhibitors), whereas both inhibitors and nonneutralizing antibodies can be detected by immunoassays such as enzyme-linked immunosorbent assay (ELISA) and multiplex bead-based assays.

Objectives: Evaluation of an in-house Luminex bead-based assay (LumiTope) compared with a commercially available ELISA and NBA.

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Health-related quality of life (HRQoL) assesses the perceived impact of health status across life domains. Although research has explored the relationship between specific conditions, including HIV, and HRQoL in low-resource settings, less attention has been paid to the association between multimorbidity and HRQoL. In a secondary analysis of cross-sectional data from the Vukuzazi ("Wake up and know ourselves" in isiZulu) study, which identified the prevalence and overlap of non-communicable and infectious diseases in the uMkhanyakunde district of KwaZulu-Natal, we (1) evaluated the impact of multimorbidity on HRQoL; (2) determined the relative associations among infectious diseases, non-communicable diseases (NCDs), and HRQoL; and (3) examined the effects of controlled versus non-controlled disease on HRQoL.

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Article Synopsis
  • Animal experimentation in Pediatric Urology requires understanding physiological differences between species and selecting appropriate disease models instead of just healthy animals.
  • Diseased models can better simulate human pathologies, especially for conditions like congenital malformations and effects of prenatal factors.
  • Properly formulating research questions is essential before choosing the right animal models and species for these studies.
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  • The relevance of animal experimentation hinges on the specific research question being explored.
  • It is crucial to carefully formulate the research question before selecting an appropriate animal species for experimentation.
  • Understanding the anatomical and physiological differences and similarities among species can enhance the likelihood of obtaining useful data for human applications.
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Objective: Lipedema is an autosomal dominant genetic disease that mainly affects women. It is characterized by excess deposition of subcutaneous adipose tissue, pain, and anxiety. The genetic and environmental etiology of lipedema is still largely unknown.

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Article Synopsis
  • Lipedema is a chronic condition affecting many women, leading to painful fat buildup in the limbs, which can impair mobility and overall quality of life, with treatment options ranging from conservative measures to lipedema reduction surgery (LRS).
  • A study involving 189 women found common comorbidities, such as joint hypermobility and arthritis, with some patients experiencing complications like lightheadedness after surgery.
  • After receiving LRS, significant improvements were observed in various physical and emotional health metrics, indicating that the surgery can have a positive impact on the lives of those affected by lipedema.
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Background: Mast cells are immune cells that mediate hypersensi-tivity and allergic reactions in the body, secreting histamine and other inflammatory molecules. They have been associated with different inflammatory conditions such as obesity and other adipose tissue di-sorders. Lipedema is a chronic disease characterized by an abnormal accumulation of adipose tissue on the legs and arms, pain, and other symptoms.

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Background: Lipedema, a complex and enigmatic adipose tissue disorder, remains poorly understood despite its significant impact on the patients' quality of life. Genetic investigations have uncovered potential contributors to its pathogenesis, including somatic mutations, which are nonheritable genetic alterations that can play a pivotal role in the development of this disease.

Aim: This review aims to elucidate the role of somatic mutations in the etiology of lipedema by examining their implications in adipose tissue biology, inflammation, and metabolic dysfunction.

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Article Synopsis
  • - The global infertility crisis and rising infant mortality from preterm births have sparked interest in artificial placenta (AP) and artificial womb (AW) technologies, which replicate the conditions of a natural womb by providing nutrients and managing waste for developing fetuses.
  • - This review highlights the history and potential applications of AP and AW technologies while examining the challenges and ethical issues surrounding their development and use.
  • - Ongoing research is necessary to explore possible negative effects of these technologies and to address ethical concerns before they can be widely implemented.
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  • The article provides an overview of human cloning, discussing its history, biological mechanisms, and societal impacts, with a focus on techniques like somatic cell nuclear transfer (SCNT).
  • It highlights advancements in cloning technology, including successful animal cloning and potential future improvements like gene editing and embryo reprogramming.
  • The ethical implications of human cloning are examined, particularly regarding human dignity, identity, and kinship, emphasizing the need for careful governance and consideration of safety and exploitation concerns.
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Article Synopsis
  • * He significantly advanced the understanding of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) through his leadership in initiatives like the ME Biobank and EUROMENE, emphasizing patient education and treatment development.
  • * In addition to his scientific contributions, Professor Pheby was also involved in humanitarian efforts, child protection advocacy, and served on the Independent Ethics Committee of MAGI, leaving behind a legacy of compassion and innovation in medical research.
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