Examining capillary ketone testing in hospitalised patients: indications and outcomes.

Elevated blood ketone levels (ketosis) in inpatients with diabetes can herald diabetic ketoacidosis (DKA). However, ketosis can also occur in individuals without diabetes in certain settings. It is unclear what proportion of inpatients with ketosis are in DKA and which patients are at the highest risk of DKA.

Assessing ventilation through ambient carbon dioxide concentrations across multiple healthcare levels in Ghana.

Infection prevention and control (IPC) measures safeguard primary healthcare systems, especially as the infectious disease landscape evolves due to climate and environmental change, increased global mobility, and vaccine hesitancy and inequity, which can introduce unexpected pathogens. This study explores the importance of an "always-on," low-cost IPC approach, focusing on the role of natural ventilation in health facilities, particularly in low-resource settings. Ambient carbon dioxide (CO2) levels are increasingly used as a measure of ventilation effectiveness allowing for spot checks and targeted ventilation improvements.

Overcoming resistance to belief revision and correction of misinformation beliefs: psychophysiological and behavioral effects of a counterfactual mindset.

In a series of experiments involving beliefs and misinformation beliefs, we find that individuals who are prompted with a counterfactual mindset are significantly more likely to change their existing beliefs when presented with evidence that contradicts their beliefs. While research finds that beliefs that are considered part of one's identity are highly resistant to change in the face of evidence that challenges these beliefs, four experiments provide evidence that counterfactual generation causes individuals to adjust beliefs and correct misinformation beliefs in response to contradicting evidence. Indeed, we find that a counterfactual mindset was effective in promoting incorporation of accurate facts and causing individuals to revise misinformation beliefs about COVID vaccination safety for a large sample of individuals who have rejected COVID vaccinations.

Glycaemic outcomes in hospital with IDegAsp versus BIAsp30 premixed insulins.

Background And Aims: IDegAsp (Ryzodeg 70/30), a unique premixed formulation of long-acting insulin degludec and rapid-acting insulin aspart, is increasing in use. Management of IDegAsp during hospitalisation is challenging because of degludec's ultra-long duration of action. We investigated inpatient glycaemia in patients treated with IDegAsp compared to biphasic insulin aspart (BIAsp30; Novomix30).

Novel advanced imaging techniques for cerebral oedema.

Cerebral oedema following acute ischemic infarction has been correlated with poor functional outcomes and is the driving mechanism of malignant infarction. Measurements of midline shift and qualitative assessment for herniation are currently the main CT indicators for cerebral oedema but have limited sensitivity for small cortical infarcts and are typically a delayed sign. In contrast, diffusion-weighted (DWI) or T2-weighted magnetic resonance imaging (MRI) are highly sensitive but are significantly less accessible.

Early intervention model of inpatient diabetes care improves glycemia following hospitalization.

Admission to hospital provides an opportunity to optimize long-term diabetes management, but clinical inertia is common. We previously reported the randomized study of a proactive inpatient diabetes service (RAPIDS), investigating an early intervention model of care and demonstrated improved in-hospital glycemia and clinical outcomes. This follow-up study assessed whether proactive care in hospital improved postdischarge HbA1c.

Temporal trends in the prevalence and incidence of depression and the interplay of comorbidities in patients with young- and usual-onset type 2 diabetes from the USA and the UK.

Aims/hypothesis: We aimed to investigate the prevalence and incidence of depression, and the interplay of cardiometabolic comorbidities, in the differentiation of depression risk between young-onset diabetes (diagnosis at age <40 years) and usual-onset diabetes (diagnosis at age ≥40 years).

Methods: Using electronic medical records from the UK and USA, retrospective cohorts of adults with incident type 2 diabetes diagnosed between 2006 and 2017 were examined. Trends in the prevalence and incidence of depression, and risk of developing depression, in participants with young-onset type 2 diabetes compared with usual-onset type 2 diabetes were assessed separately by sex and comorbidity status.

Real world outcomes and implementation pathways of exome sequencing in an adult genetic department.

Purpose: This study aimed to correlate the indications and diagnostic yield of exome sequencing (ES) in adult patients across various clinical settings. The secondary aim was to examine the clinical utility of ES in adult patients.

Methods: Data on demographics, clinical indications, results, management changes, and cascade testing were collected for 250 consecutive patients who underwent ES through an adult genetics department between 2016 and 2021.

Malaria in Pregnancy: From Placental Infection to Its Abnormal Development and Damage.

Malaria remains a global health burden with accounting for the highest mortality and morbidity. Malaria in pregnancy can lead to the development of placental malaria, where -infected erythrocytes adhere to placental receptors, triggering placental inflammation and subsequent damage, causing harm to both mother and her infant. Histopathological studies of -infected placentas revealed various placental abnormalities such as excessive perivillous fibrinoid deposits, breakdown of syncytiotrophoblast integrity, trophoblast basal lamina thickening, increased syncytial knotting, and accumulation of mononuclear immune cells within intervillous spaces.

Poor Birth Outcomes in Malaria in Pregnancy: Recent Insights Into Mechanisms and Prevention Approaches.

Pregnant women in malaria-endemic regions are susceptible to malaria in pregnancy, which has adverse consequences on birth outcomes, including having small for gestational age and preterm babies. These babies are likely to have low birthweights, which predisposes to infant mortality and lifelong morbidities. During malaria in pregnancy, infected erythrocytes express a unique variant surface antigen, VAR2CSA, that mediates sequestration in the placenta.

Risk factors for COVID-19 infection, disease severity and related deaths in Africa: a systematic review.

Objective: The aim of this study was to provide a comprehensive evidence on risk factors for transmission, disease severity and COVID-19 related deaths in Africa.

Design: A systematic review has been conducted to synthesise existing evidence on risk factors affecting COVID-19 outcomes across Africa.

Data Sources: Data were systematically searched from MEDLINE, Scopus, MedRxiv and BioRxiv.

COVID-19 in Ethiopia: a geospatial analysis of vulnerability to infection, case severity and death.

Background: COVID-19 has caused a global public health crisis affecting most countries, including Ethiopia, in various ways. This study maps the vulnerability to infection, case severity and likelihood of death from COVID-19 in Ethiopia.

Methods: Thirty-eight potential indicators of vulnerability to COVID-19 infection, case severity and likelihood of death, identified based on a literature review and the availability of nationally representative data at a low geographic scale, were assembled from multiple sources for geospatial analysis.

Granulocyte-Macrophage Colony Stimulating Factor As an Indirect Mediator of Nociceptor Activation and Pain.

The interaction between the immune system and the nervous system has been at the center of multiple research studies in recent years. Whereas the role played by cytokines as neuronal mediators is no longer contested, the mechanisms by which cytokines modulate pain processing remain to be elucidated. In this study, we have analyzed the involvement of granulocyte-macrophage colony stimulating factor (GM-CSF) in nociceptor activation in male and female mice.

Mortality and morbidity of patients with treated and untreated epilepsy in New Zealand.

Objective: To investigate whether delayed or no treatment was associated with increased mortality and morbidity risks in people with newly diagnosed epilepsy.

Methods: We examined New Zealand hospitalization and antiseizure medication prescription data from 2007-2015. Mortality and hospital-diagnosed morbidities were compared between patients immediately treated after epilepsy diagnosis, treated after a delay, or untreated for the duration of follow-up, adjusted for age, sex, and ethnicity.

The role of super-spreading events in Mycobacterium tuberculosis transmission: evidence from contact tracing.

Background: In current epidemiology of tuberculosis (TB), heterogeneity in infectiousness among TB patients is a challenge, which is not well studied. We aimed to quantify this heterogeneity and the presence of "super-spreading" events that can assist in designing optimal public health interventions.

Methods: TB epidemiologic investigation data notified between 1 January 2005 and 31 December 2015 from Victoria, Australia were used to quantify TB patients' heterogeneity in infectiousness and super-spreading events.

Neutrophils and Malaria.

Neutrophils are abundant in the circulation and are one of the immune system's first lines of defense against infection. There has been substantial work carried out investigating the role of neutrophils in malaria and it is clear that during infection neutrophils are activated and are capable of clearing malaria parasites by a number of mechanisms. This review focuses on neutrophil responses to human malarias, summarizing evidence which helps us understand where neutrophils are, what they are doing, how they interact with parasites as well as their potential role in vaccine mediated immunity.

The Rough Guide to Monocytes in Malaria Infection.

While half of the world's population is at risk of malaria, the most vulnerable are still children under five, pregnant women and returning travelers. Anopheles mosquitoes transmit malaria parasites to the human host; but how interact with the innate immune system remains largely unexplored. The most recent advances prove that monocytes are a key component to control parasite burden and to protect host from disease.

Immune Cytokines and Their Receptors in Inflammatory Pain.

There is burgeoning interest in the interaction between the immune and nervous systems. Pain is mediated by primary sensory neurons (nociceptors) that can respond to a variety of thermal, mechanical and chemical signals. Cytokines are now recognized as important mediators of inflammatory pain.

Glyburide treatment in gestational diabetes is associated with increased placental glucose transporter 1 expression and higher birth weight.

Use of glyburide in gestational diabetes (GDM) has raised concerns about fetal and neonatal side effects, including increased birth weight. Placental nutrient transport is a key determinant of fetal growth, however the effect of glyburide on placental nutrient transporters is largely unknown. We hypothesized that glyburide treatment in GDM pregnancies is associated with increased expression of nutrient transporters in the syncytiotrophoblast plasma membranes.

The effects of inter-trial interval on implicit learning of sequential visual isometric pinch task.

Sequential visual isometric pinch task (SVIPT) has been recently used as a visuomotor sequence task in clinical research. The influence of varying intervals between sequenced trials on the acquisition of implicit sequence learning is not yet determined for SVIPT. The aim of this study was to investigate the effects of inter-trial interval (ITI) on implicit motor sequence learning using SVIPT.

Reliability of Motor Evoked Potentials Induced by Transcranial Magnetic Stimulation: The Effects of Initial Motor Evoked Potentials Removal.

Introduction: Transcranial magnetic stimulation (TMS) is a useful tool for assessment of corticospinal excitability (CSE) changes in both healthy individuals and patients with brain disorders. The usefulness of TMS-elicited motor evoked potentials (MEPs) for the assessment of CSE in a clinical context depends on their intra-and inter-session reliability. This study aimed to evaluate if removal of initial MEPs elicited by using two types of TMS techniques influences the reliability scores and whether this effect is different in blocks with variable number of MEPs.

Prognostic indicators in pediatric clinically isolated syndrome.

Objective: To assess prognostic factors for a second clinical attack and a first disability-worsening event in pediatric clinically isolated syndrome (pCIS) suggestive of multiple sclerosis (MS) patients.

Methods: A cohort of 770 pCIS patients was followed up for at least 10 years. Cox proportional hazard models and Recursive Partitioning and Amalgamation (RECPAM) tree-regression were used to analyze data.

Single-Session Anodal tDCS with Small-Size Stimulating Electrodes Over Frontoparietal Superficial Sites Does Not Affect Motor Sequence Learning.

Due to the potential of anodal transcranial direct current stimulation (a-tDCS) for enhancement of fine sequenced movements and increasing interest in achieving high level of fine movements in the trained and untrained hands especially at initial stage of learning, we designed this study to investigate whether the application of single-session a-tDCS with small-size stimulating electrodes over FPN sites, such as dorsolateral prefrontal cortex (DLPFC), primary motor cortex (M1) or posterior parietal cortex (PPC) could enhance sequence learning with the trained hand and these effects are transferred into the untrained hand or not. A total of 51 right-handed healthy participants were randomly assigned to one of the four stimulation groups: a-tDCS of left M1, DLPFC, PPC, or sham. Stimulation was applied for 20 min during a sequential visual isometric pinch task (SVIPT).