307 results match your criteria: "Amsterdam Infection and Immunity Institute AI&II[Affiliation]"

Assessing SOFA score trajectories in sepsis using machine learning: A pragmatic approach to improve the accuracy of mortality prediction.

PLoS One

April 2024

Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum Knappschaftskrankenhaus Bochum, Ruhr Universität Bochum, Bochum, Germany.

Article Synopsis
  • Scientists looked at health data from very sick patients with a condition called sepsis to see if machine learning can help predict who might survive better than using regular methods.
  • They tested two machine learning methods using data from a big group of patients and found that these methods were much better at predicting survival than the standard way of checking changes in scores.
  • The results showed that using daily scores from the first week could really help doctors know who might be in trouble, which could lead to better patient care in the future.
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Reinforcement learning for intensive care medicine: actionable clinical insights from novel approaches to reward shaping and off-policy model evaluation.

Intensive Care Med Exp

March 2024

Department of Intensive Care Medicine, Center for Critical Care Computational Intelligence (C4I), Amsterdam Medical Data Science (AMDS), Amsterdam Cardiovascular Science (ACS), Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam Public Health (APH), Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.

Article Synopsis
  • Reinforcement learning (RL) has potential in intensive care medicine due to the wealth of data and real-time decision-making needs, but trust and safety issues hinder its implementation for clinical support, particularly in optimizing ventilator settings for COVID-19 patients.
  • A novel method called cross off-policy evaluation (OPE) was developed to evaluate RL models, using a large dataset from Dutch ICUs and focusing on ventilator settings, with interim and final rewards based on gas exchange indices and patient outcomes.
  • The study found that while many RL policies performed well initially, almost half were deemed suboptimal under more rigorous evaluation, highlighting the importance of detailed clinical policy inspection and restrictions to ensure safety in patient care.
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Autoimmune hemolytic anemia (AIHA) is a rare autoantibody-mediated disease. For steroid and/or rituximab-refractory AIHA, there is no consensus on optimal treatment. Daratumumab, a monoclonal antibody targeting CD38, could be beneficial by suppression of CD38+ plasma cells and thus autoantibody secretion.

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Introduction: The HIV and hepatitis B virus (HBV) epidemics are interconnected with shared routes of transmission and specific antiviral drugs that are effective against both viruses. Nearly, 300 million people around the world live with chronic HBV, many of whom are from priority populations who could benefit from HIV prevention services. Oral pre-exposure prophylaxis (PrEP) for HIV has implications in the prevention and treatment of HBV infection, but many people at increased risk of HIV acquisition may instead prefer long-acting formulations of PrEP, which are currently not active against HBV.

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ESPEN practical short micronutrient guideline.

Clin Nutr

March 2024

Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain. Electronic address:

Background: Trace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. The importance of MNs in common pathologies is recognized by recent research, with deficiencies significantly impacting the outcome.

Objective: This short version of the guideline aims to provide practical recommendations for clinical practice.

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Global guideline for the diagnosis and management of cryptococcosis: an initiative of the ECMM and ISHAM in cooperation with the ASM.

Lancet Infect Dis

August 2024

Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, NC, USA; Department of Molecular Genetics and Microbiology, Duke University Medical Center, Durham, NC, USA. Electronic address:

Cryptococcosis is a major worldwide disseminated invasive fungal infection. Cryptococcosis, particularly in its most lethal manifestation of cryptococcal meningitis, accounts for substantial mortality and morbidity. The breadth of the clinical cryptococcosis syndromes, the different patient types at-risk and affected, and the vastly disparate resource settings where clinicians practice pose a complex array of challenges.

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Micronutrient Status of Critically Ill Patients with COVID-19 Pneumonia.

Nutrients

January 2024

Department of Intensive Care Medicine, Research VUmc Intensive Care (REVIVE), Amsterdam Cardiovascular Science (ACS), Amsterdam Infection and Immunity Institute (AI&II), Amsterdam Medical Data Science (AMDS), Amsterdam UMC, Location VUmc, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.

Micronutrient deficiencies can develop in critically ill patients, arising from factors such as decreased intake, increased losses, drug interactions, and hypermetabolism. These deficiencies may compromise important immune functions, with potential implications for patient outcomes. Alternatively, micronutrient blood levels may become low due to inflammation-driven redistribution rather than consumption.

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Soluble 'SOSIP'-stabilized HIV-1 envelope glycoprotein (Env) trimers elicit dominant antibody responses targeting their glycan-free base regions, potentially diminishing neutralizing responses. Previously, using a nonhuman primate model, we demonstrated that priming with fusion peptide (FP)-carrier conjugate immunogens followed by boosting with Env trimers reduced the anti-base response. Further, we demonstrated that longer immunization intervals further reduced anti-base responses and increased neutralization breadth.

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Background: Pediatric Post-COVID-Condition (PPCC) clinics treat children despite limited scientific substantiation. By exploring real-life management of children diagnosed with PPCC, the International Post-COVID-Condition in Children Collaboration (IP4C) aimed to provide guidance for future PPCC care.

Methods: We performed a cross-sectional international, multicenter study on used PPCC definitions; the organization of PPCC care programs and patients characteristics.

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Article Synopsis
  • Echocardiographic strain imaging is important for assessing heart function, and deep learning (DL) algorithms can automate its interpretation.
  • An automated DL-based algorithm for measuring left ventricular strain was trained and validated using datasets from various studies, showing high accuracy compared to manual measurements.
  • The study concluded that DL algorithms can interpret echocardiographic strain images effectively, potentially improving accessibility to cardiac assessments.
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All-cause mortality before and after DAA availability among people living with HIV and HCV: An international comparison between 2010 and 2019.

Int J Drug Policy

February 2024

Sorbonne Université, INSERM, Pierre Louis Institute of Epidemiology and Public Health, iPLESP, Paris, France; AP-HP, Department of Infectious Diseases, Saint-Antoine Hospital, Paris, France.

Background: Among people living with HIV and hepatitis C virus (HCV), people who inject drugs (PWID) have historically experienced higher mortality rates. Direct-acting antivirals (DAA), which have led to a 90 % HCV cure rate independently of HIV co-infection, have improved mortality rates. However, DAA era mortality trends among PWID with HIV/HCV remain unknown.

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Next-generation bNAbs for HIV-1 cure strategies.

Antiviral Res

February 2024

Amsterdam UMC Location University of Amsterdam, Department of Medical Microbiology, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, the Netherlands. Electronic address:

Despite the ability to suppress viral replication using anti-retroviral therapy (ART), HIV-1 remains a global public health problem. Curative strategies for HIV-1 have to target and eradicate latently infected cells across the body, i.e.

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Objective: Until now, the clinically relevant improvement for the Xerostomia Inventory (XI) has not been defined. Therefore, our aim was to determine the Minimally Important Difference (MID) of the XI for improvement in dry-mouth symptoms in SjD patients.

Method: The study recruited 34 SjD patients who underwent sialendoscopy of major salivary glands and 15 SjD patients in a nonintervention control group.

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Standards for clinical trials for treating TB.

Int J Tuberc Lung Dis

December 2023

Sydney Infectious Diseases Institute (Sydney ID), and, The Children's Hospital at Westmead, Sydney, NSW, WHO Collaborating Centre in Tuberculosis, The University of Sydney, Sydney, NSW, Australia.

The value, speed of completion and robustness of the evidence generated by TB treatment trials could be improved by implementing standards for best practice. A global panel of experts participated in a Delphi process, using a 7-point Likert scale to score and revise draft standards until consensus was reached. Eleven standards were defined: Standard 1, high quality data on TB regimens are essential to inform clinical and programmatic management; Standard 2, the research questions addressed by TB trials should be relevant to affected communities, who should be included in all trial stages; Standard 3, trials should make every effort to be as inclusive as possible; Standard 4, the most efficient trial designs should be considered to improve the evidence base as quickly and cost effectively as possible, without compromising quality; Standard 5, trial governance should be in line with accepted good clinical practice; Standard 6, trials should investigate and report strategies that promote optimal engagement in care; Standard 7, where possible, TB trials should include pharmacokinetic and pharmacodynamic components; Standard 8, outcomes should include frequency of disease recurrence and post-treatment sequelae; Standard 9, TB trials should aim to harmonise key outcomes and data structures across studies; Standard 10, TB trials should include biobanking; Standard 11, treatment trials should invest in capacity strengthening of local trial and TB programme staff.

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A vaccine that can achieve protective immunity prior to sexual debut is critical to prevent the estimated 410,000 new HIV infections that occur yearly in adolescents. As children living with HIV can make broadly neutralizing antibody (bnAb) responses in plasma at a faster rate than adults, early childhood is an opportune window for implementation of a multi-dose HIV immunization strategy to elicit protective immunity prior to adolescence. Therefore, the goal of our study was to assess the ability of a B cell lineage-designed HIV envelope SOSIP to induce bnAbs in early life.

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Even though the coronavirus disease 2019 (COVID-19) pandemic is slowly developing into a conventional infectious disease, the long-term effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus infection are still not well understood. One of the problems is that many COVID-19 cases develop acute kidney injuries. Still, it is heavily debated whether SARS-CoV-2 virus enters and actively replicates in kidney tissue and if SARS-CoV-2 virus particles can be detected in kidney during or post-infection.

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Drug-resistant tuberculosis (TB) infection is a growing and potent concern, and combating it will be necessary to achieve the WHO's goal of a 95% reduction in TB deaths by 2035. While prior studies have explored the evolution and spread of drug resistance, we still lack a clear understanding of the fitness costs (if any) imposed by resistance-conferring mutations and the role that genetic lineage plays in determining the likelihood of resistance evolution. This study offers insight into these questions by assessing the dynamics of resistance evolution in a high-burden Southeast Asian setting with a diverse lineage composition.

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Background: Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave.

Methods: This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020.

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Multiomics Analysis Provides Novel Pathways Related to Progression of Heart Failure.

J Am Coll Cardiol

November 2023

Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Article Synopsis
  • Major advances in heart failure treatment haven't significantly reduced mortality, indicating that current therapies might be missing key biological pathways.
  • A study integrated genetic and molecular data from over 2,500 heart failure patients to identify critical pathways linked to mortality, validating the results with a separate group of nearly 1,800 patients.
  • Four major pathways associated with higher death rates were found: PI3K/Akt, MAPK, Ras signaling, and resistance to epidermal growth factor inhibitor, which are linked to reduced activation of the protective ERBB2 receptor influenced by neuregulin.
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Integrase strand-transfer inhibitor use and cardiovascular events in adults with HIV: an emulation of target trials in the HIV-CAUSAL Collaboration and the Antiretroviral Therapy Cohort Collaboration.

Lancet HIV

November 2023

CAUSALab and Department of Epidemiology, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA; Department of Biostatistics, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA.

Article Synopsis
  • A recent observational study raised concerns about a potentially higher risk of cardiovascular events in ART-naive individuals with HIV on integrase strand-transfer inhibitor (INSTI)-based ART compared to those on other ART regimens.
  • Researchers aimed to mimic target trials to assess the 4-year cardiovascular event risk in ART-naive and ART-experienced individuals using INSTI versus non-INSTI ART.
  • The study analyzed clinical data from 12 HIV cohorts in Europe and North America, focusing on specific criteria for participant eligibility and using logistic regression models to evaluate the impact of treatment strategies on cardiovascular health.
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Impaired gut microbiota-mediated short-chain fatty acid production precedes morbidity and mortality in people with HIV.

Cell Rep

November 2023

Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Karsh Division of Gastroenterology & Hepatology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA; F. Widjaja Inflammatory Bowel Disease Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address:

Article Synopsis
  • Antiretroviral therapy (ART) has improved lifespans for people with HIV (PWH), but they face increased inflammation-related health issues due to changes in the gut microbiome.
  • The study reveals that ART-treated PWH have lower levels of beneficial gut bacteria that produce short-chain fatty acids (SCFAs), which help fight inflammation; even though SCFA levels in feces seem normal, serum levels are actually reduced and correlate with inflammation markers.
  • Findings indicate that microbiome changes linked to HIV occur before the onset of health complications, specifically the reduced ability to convert lactate to propionate, suggesting that gut health may play a crucial role in managing HIV-related health risks.
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Four endemic seasonal human coronaviruses causing common colds circulate worldwide: HKU1, 229E, NL63 and OC43 (ref. ). After binding to cellular receptors, coronavirus spike proteins are primed for fusion by transmembrane serine protease 2 (TMPRSS2) or endosomal cathepsins.

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