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Analysis of spatial and temporal aggregation of influenza cases in Quzhou before and after COVID-19 pandemic. 新冠肺炎大流行前后衢州市流感病例时空聚集分析
Pub Date : 2025-12-01 Epub Date: 2024-12-23 DOI: 10.1080/07853890.2024.2443565
Qing Gao, Hui Yang, Zhao Yu, Qi Wang, Shuangqing Wang, Bingdong Zhan

Background: The global seasonal influenza activity has decreased during the coronavirus disease 2019 (COVID-19) pandemic. Non-pharmaceutical interventions (NPIs), such as reducing gatherings and wearing masks, can have varying impacts on the spread of influenza. We aim to analyse the basic characteristics, epidemiology and space-time clustering of influenza in Quzhou city before and after the COVID-19 pandemic based on five years of surveillance data.

Methods: Influenza case incidence data from 2018-2023 were collected and organized in Quzhou City to analyse the space-time aggregation of influenza incidence before and after COVID-19 pandemic through global spatial autocorrelation analysis and space-time scan analysis methods.

Results: The annual average fluctuation of influenza in Quzhou City from 2018-2023 was large, with gradual decreases in 2019-2020, 2020-2021 and 2021-2022, all of which showed obvious winter and spring peaks; The highest incidence rate in 2022-2023, with a bimodal distribution. The majority of the population is under 15 years of age, accounting for more than 70% of the population. The population classification is dominated by students, nursery children and children in the diaspora. In 2020-2021, the cases in the student group of the 5-14 years old population declined. Global spatial autocorrelation analysis of influenza incidence rate in Quzhou City in each year of 2019-2023Moran's I > 0 and p < 0.05. Space-time scan analysis of the aggregation area is located in Longyou County and the township streets on the border of urban counties, and the number of aggregation areas decreased significantly in 2020-2021 and 2021-2022.

Conclusion: The COVID-19 pandemic has an important impact on changes in influenza incidence levels and spatial and temporal epidemiologic aggregation patterns. Influenza incidence in Quzhou City fluctuates widely, with large changes in the age and occupational composition ratios of the incidence population, and influenza incidence presents a more pronounced spatial correlation and aggregation.

背景:在2019冠状病毒病(COVID-19)大流行期间,全球季节性流感活动有所下降。非药物干预措施(npi),如减少聚会和戴口罩,可以对流感的传播产生不同的影响。利用5年的监测资料,分析衢州市新冠肺炎疫情前后流感的基本特征、流行病学和时空聚类。方法:收集整理衢州市2018-2023年流感病例发病数据,采用全球空间自相关分析和时空扫描分析方法,分析2019冠状病毒病大流行前后流感发病的时空聚集性。结果:2018-2023年衢州市流感年平均波动较大,2019-2020年、2020-2021年和2021-2022年呈逐渐下降趋势,均呈现明显的冬春季高峰;2022-2023年发病率最高,呈双峰分布。大多数人口是15岁以下,占人口的70%以上。人口分类以学生、托儿所儿童和散居海外的儿童为主。2020-2021年,5-14岁学生群体病例数下降。2019-2023年衢州市各年流感发病率全球空间自相关分析结论:2019冠状病毒病大流行对流感发病率水平变化和时空流行病学聚集格局有重要影响。衢州市流感发病波动较大,发病人群年龄和职业构成比变化较大,流感发病呈现较为明显的空间相关性和聚集性。
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引用次数: 0
Research trends and key contributors in studies on influenza vaccines for children: A 20-year bibliometric analysis. 儿童流感疫苗研究的研究趋势和主要贡献者:20年文献计量分析。
IF 4.1 4区 医学 Q2 BIOTECHNOLOGY & APPLIED MICROBIOLOGY Pub Date : 2025-12-01 Epub Date: 2024-12-20 DOI: 10.1080/21645515.2024.2443281
Ning Sun, Rui Wei, Bochao Jia, Taiwei Lou, Zirong Li, Xiaowei Nie, Wenxiao Yu, Miaoran Wang, Qiuyan Li

Globally, there are over 3 million severe cases of influenza each year, leading to up to half a million deaths. This study provides a comprehensive analysis of the current status of children's influenza vaccine research over the past 20 years and explores potential future research trends, including improvements in vaccine coverage and strategies to address vaccine hesitancy. We extracted all research data on children's influenza vaccines from 2004 to 2024 using the Web of Science Core Collection (WOSCC). The contributions of various countries/regions, institutions, authors, and journals in this field were assessed, and research hotspots as well as promising future trends were predicted through keyword analysis using CiteSpace and VOSviewer. A total of 2,598 related publications from 2004 to 2024 were identified and collected for analysis. The United States (USA) and England emerged as the leading contributors with the highest number of published papers. AstraZeneca was identified as a key leader among research institutions, and Ambrose Christopher S was recognized as the most productive author in this field. The journals Vaccine and Human Vaccines & Immunotherapeutics stood out as the most prominent publications in this area. The keyword analysis highlighted that international research collaboration maybe a promising strategy for bridging global gaps; Addressing vaccine hesitancy could potentially increase vaccination coverage; Live attenuated vaccines, intranasal administration and universal vaccines are promising directions for future development. These insights highlight potential avenues for improving influenza vaccine coverage and inform strategies to mitigate vaccine hesitancy, crucial for protecting children and enhancing public health.

全球每年有300多万例严重流感病例,导致多达50万人死亡。本研究全面分析了过去20年来儿童流感疫苗研究的现状,并探讨了潜在的未来研究趋势,包括提高疫苗覆盖率和解决疫苗犹豫问题的策略。我们使用Web of Science Core Collection (WOSCC)提取了2004 - 2024年关于儿童流感疫苗的所有研究数据。通过CiteSpace和VOSviewer的关键词分析,评估了各国/地区、机构、作者和期刊在该领域的贡献,预测了该领域的研究热点和未来发展趋势。从2004年到2024年,共收集了2598份相关出版物进行分析。美国(USA)和英国成为发表论文数量最多的主要贡献者。阿斯利康被认为是研究机构中的关键领导者,Ambrose Christopher S被认为是该领域最具生产力的作者。《疫苗》和《人类疫苗与免疫疗法》杂志是这一领域最突出的出版物。关键词分析强调,国际研究合作可能是弥合全球差距的一个有希望的战略;解决疫苗犹豫问题可能会增加疫苗接种覆盖率;减毒活疫苗、鼻内给药和通用疫苗是未来的发展方向。这些见解突出了改善流感疫苗覆盖率的潜在途径,并为减轻疫苗犹豫的战略提供信息,这对保护儿童和加强公共卫生至关重要。
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引用次数: 0
Targeting oxidative stress in preeclampsia. 靶向氧化应激在子痫前期。
IF 1.5 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2025-12-01 Epub Date: 2024-12-27 DOI: 10.1080/10641955.2024.2445556
Dinara Afrose, Sofía Alfonso-Sánchez, Lana McClements

Preeclampsia is a complex condition characterized by elevated blood pressure and organ damage involving kidneys or liver, resulting in significant morbidity and mortality for both the mother and the fetus. Increasing evidence suggests that oxidative stress, often caused by mitochondrial dysfunction within fetal trophoblast cells may play a major role in the development and progression of preeclampsia. Oxidative stress occurs as a result of an imbalance between the production of reactive oxygen species (ROS) and the capacity of antioxidant defenses, which can lead to placental cellular damage and endothelial cell dysfunction. Targeting oxidative stress appears to be a promising therapeutic approach that has the potential to improve both short- and long-term maternal and fetal outcomes, thus reducing the global burden of preeclampsia. The purpose of this review is to provide a comprehensive account of the mechanisms of oxidative stress in preeclampsia. Furthermore, it also examines potential interventions for reducing oxidative stress in preeclampsia, including natural antioxidant supplements, lifestyle modifications, mitochondrial targeting antioxidants, and pharmacological agents.A better understanding of the mechanism of action of proposed therapeutic strategies targeting oxidative stress is essential for the identification of companion biomarkers and personalized medicine approaches for the development of effective treatments of preeclampsia.

子痫前期是一种复杂的疾病,其特征是血压升高和涉及肾脏或肝脏的器官损害,可导致母亲和胎儿的显著发病率和死亡率。越来越多的证据表明,氧化应激(通常由胎儿滋养细胞线粒体功能障碍引起)可能在子痫前期的发生和发展中发挥重要作用。氧化应激是活性氧(ROS)产生与抗氧化防御能力失衡的结果,可导致胎盘细胞损伤和内皮细胞功能障碍。靶向氧化应激似乎是一种很有前途的治疗方法,有可能改善短期和长期的母婴结局,从而减少先兆子痫的全球负担。本综述的目的是提供一个全面的机制氧化应激在子痫前期。此外,研究还探讨了减少子痫前期氧化应激的潜在干预措施,包括天然抗氧化剂补充剂、生活方式改变、线粒体靶向抗氧化剂和药物。更好地了解针对氧化应激的治疗策略的作用机制对于确定伴随生物标志物和个性化药物方法以开发有效的子痫前期治疗方法至关重要。
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引用次数: 0
The regulatory roles of RNA-binding proteins in the tumour immune microenvironment of gastrointestinal malignancies. rna结合蛋白在胃肠道恶性肿瘤肿瘤免疫微环境中的调控作用。
IF 3.6 3区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2025-12-01 Epub Date: 2024-12-24 DOI: 10.1080/15476286.2024.2440683
Dongqi Li, Xiangyu Chu, Weikang Liu, Yongsu Ma, Xiaodong Tian, Yinmo Yang

The crosstalk between the tumour immune microenvironment (TIME) and tumour cells promote immune evasion and resistance to immunotherapy in gastrointestinal (GI) tumours. Post-transcriptional regulation of genes is pivotal to GI tumours progression, and RNA-binding proteins (RBPs) serve as key regulators via their RNA-binding domains. RBPs may exhibit either anti-tumour or pro-tumour functions by influencing the TIME through the modulation of mRNAs and non-coding RNAs expression, as well as post-transcriptional modifications, primarily N6-methyladenosine (m6A). Aberrant regulation of RBPs, such as HuR and YBX1, typically enhances tumour immune escape and impacts prognosis of GI tumour patients. Further, while targeting RBPs offers a promising strategy for improving immunotherapy in GI cancers, the mechanisms by which RBPs regulate the TIME in these tumours remain poorly understood, and the therapeutic application is still in its early stages. This review summarizes current advances in exploring the roles of RBPs in regulating genes expression and their effect on the TIME of GI tumours, then providing theoretical insights for RBP-targeted cancer therapies.

肿瘤免疫微环境(TIME)和肿瘤细胞之间的串扰促进了胃肠道(GI)肿瘤的免疫逃避和免疫治疗抵抗。基因的转录后调控是胃肠道肿瘤进展的关键,rna结合蛋白(rbp)通过其rna结合结构域发挥关键调控作用。rbp可能通过调节mrna和非编码rna的表达以及转录后修饰(主要是n6 -甲基腺苷(m6A))来影响TIME,从而表现出抗肿瘤或促肿瘤的功能。rbp如HuR和YBX1的异常调节通常会促进肿瘤免疫逃逸,影响胃肠道肿瘤患者的预后。此外,虽然靶向rbp为改善胃肠道癌症的免疫治疗提供了一种有希望的策略,但rbp在这些肿瘤中调节时间的机制仍然知之甚少,治疗应用仍处于早期阶段。本文综述了rbp在胃肠道肿瘤基因表达调控中的作用及其对肿瘤时间的影响,为rbp靶向肿瘤治疗提供理论依据。
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引用次数: 0
Induction of cell death in malignant cells and regulatory T cells in the tumor microenvironment by targeting CD137. 靶向CD137诱导恶性细胞死亡和肿瘤微环境中的调节性T细胞
IF 6.5 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-12-01 Epub Date: 2024-12-24 DOI: 10.1080/2162402X.2024.2443265
Rui Sun, Kang Yi Lee, Yu Mei, Emily Nickles, Jia Le Lin, Runze Xia, Haiyan Liu, Herbert Schwarz

Regulatory T cells (Tregs) contribute significantly to the immunosuppressive nature of the tumor microenvironment which is a main barrier for immunotherapies of solid cancers. Reducing Treg numbers enhances anti-tumor immune responses but current depletion strategies also impair effector T cells (Teffs), potentially leading to reduced anti-tumor immunity and/or autoimmune diseases. CD137 has been identified as the most differentially expressed gene between peripheral Tregs and intratumoral Tregs in virtually all solid cancers. Further, CD137 is expressed by malignant cells of certain cancers, making it a potential target for tumor immunotherapy. Here, we report the development of a fully human anti-human CD137 antibody of the IgG1 isotype, clone P1A1, that induces antibody-dependent cell-mediated cytotoxicity (ADCC) in CD137+ Tregs and cancer cells. P1A1 cross-reacts with murine CD137 which allowed testing murine chimeric P1A1 in syngeneic murine tumor models where P1A1 significantly reduced the number of CD137+ Tregs and inhibited tumor growth in a murine hepatocellular carcinoma (HCC) and a melanoma lung metastasis model. P1A1 can also be internalized thus enabling it as a carrier for drugs to target CD137+ Tregs and cancer cells. These anti-cancer properties suggest a translation of P1A1 to human immunotherapy.

调节性T细胞(Tregs)在肿瘤微环境的免疫抑制特性中发挥着重要作用,这是实体癌免疫治疗的主要屏障。减少Treg数量可以增强抗肿瘤免疫反应,但目前的消耗策略也会损害效应T细胞(Teffs),可能导致抗肿瘤免疫功能降低和/或自身免疫性疾病。CD137已被确定为几乎所有实体癌中外周treg和瘤内treg之间表达差异最大的基因。此外,CD137在某些癌症的恶性细胞中表达,使其成为肿瘤免疫治疗的潜在靶点。在这里,我们报道了一种IgG1同型的全人源抗CD137抗体的开发,克隆P1A1,在CD137+ Tregs和癌细胞中诱导抗体依赖细胞介导的细胞毒性(ADCC)。P1A1与小鼠CD137发生交叉反应,从而可以在同基因小鼠肿瘤模型中测试小鼠嵌合P1A1,在小鼠肝细胞癌(HCC)和黑色素瘤肺转移模型中,P1A1显著减少CD137+ Tregs的数量并抑制肿瘤生长。P1A1也可以内化,从而使其成为靶向CD137+ Tregs和癌细胞的药物载体。这些抗癌特性表明P1A1可用于人类免疫治疗。
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引用次数: 0
Multicomponent body composition of university club sport athletes. 高校社团体育运动员的多组分身体组成。
IF 4.5 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-12-01 Epub Date: 2024-12-26 DOI: 10.1080/15502783.2024.2446575
Dale R Wagner, Edward M Heath, Sara A Harper, Elizabeth A Cafferty, Masaru Teramoto, Alyssa Evans, Tate Burch, Jacob McBride, Steven Spencer, Michael N Vakula

Background: The body composition of National Collegiate Athletic Association (NCAA) athletes is well documented but no such data exist for university club sports athletes. Additionally, the majority of norms for NCAA athletes were created from individual methods requiring assumptions.

Objective: This study used a four-component (4C) model to measure the body composition of university club sports athletes.

Methods: Data were collected on club athletes participating in baseball, climbing, cycling, figure skating, gymnastics, ice hockey, lacrosse, pickleball, powerlifting, racquetball, rodeo, rugby, soccer, swimming, ultimate, and volleyball. The 4C model consisted of body volume, total body water, and bone mineral content measured by air displacement plethysmography, bioimpedance spectroscopy, and dual-energy x-ray absorptiometry, respectively. Percentile ranks were created for body fat percentage (%BF) and fat-free mass index (FFMI). Mean differences across teams were quantified with Cohen's d.

Results: In total, 225 athletes (137 men, 88 women) completed data collection. Athletes varied in competitive experience (1 to 22 y) and body mass index (16.9 to 36.4 kg·m-2). The density of the FFM was significantly greater than the assumed value of 1.100 g·cm-3 for both men (p = .043) and women (p = .011). The %BF ranged from 4.9% to 35.7% (14.3 ± 5.8% BF) for men and from 15.5% to 42.8% (25.2 ± 6.0% BF) for women. FFMI ranged from 15.6 kg·m-2 to 26.8 kg·m-2 (30.0 kg·m-2 outlier removed) for men and from 14.1 kg·m-2 to 22.6 kg·m-2 for women. Differences across sports in %BF and FFMI were considered large-sized effects (d ≥ 0.80) for both men and women. Weight-sensitive sports (e.g. cycling and climbing) had the lightest athletes and were among the leanest, whereas power athletes (e.g. powerlifting and rugby) were among the heaviest athletes and had the highest FFMI.

Conclusions: Differences in %BF and FFMI are evident across sports. Due to the small sample size, use caution when interpreting the data as reference values for club sports athletes.

背景:全国大学体育协会(NCAA)运动员的身体组成有很好的记录,但没有大学俱乐部体育运动员的数据。此外,NCAA运动员的大多数标准都是根据需要假设的个人方法创建的。目的:采用四组分(4C)模型对高校社团体育运动员的身体成分进行测量。方法:收集参加棒球、攀岩、自行车、花样滑冰、体操、冰球、长曲棍球、匹克球、力量举重、壁球、牛仔竞技、橄榄球、足球、游泳、极限和排球的俱乐部运动员的数据。4C模型由体体积、全身水和骨矿物质含量组成,分别通过空气位移体积描记仪、生物阻抗谱和双能x射线吸收仪测量。对体脂率(%BF)和无脂质量指数(FFMI)进行百分位排序。结果:总共有225名运动员(137名男性,88名女性)完成了数据收集。运动员在竞技经验(1 ~ 22岁)和体重指数(16.9 ~ 36.4 kg·m-2)方面存在差异。男性(p = 0.043)和女性(p = 0.011)的FFM密度均显著大于假设值1.100 g·cm-3。男性的BF百分比为4.9%至35.7%(14.3±5.8% BF),女性为15.5%至42.8%(25.2±6.0% BF)。男性FFMI范围为15.6 kg·m-2至26.8 kg·m-2(除去30.0 kg·m-2异常值),女性FFMI范围为14.1 kg·m-2至22.6 kg·m-2。不同运动中BF %和FFMI的差异被认为对男性和女性都有较大的影响(d≥0.80)。体重敏感运动(如自行车和攀岩)的运动员最轻,也是最瘦的,而力量运动员(如举重和橄榄球)是最重的运动员,FFMI最高。结论:在不同的运动中,BF和FFMI的差异是明显的。由于样本量小,在将数据解释为俱乐部体育运动员的参考值时要谨慎。
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引用次数: 0
The indirect costs of five cancers in Egypt: years of life lost and productivity costs. 埃及五种癌症的间接成本:生命损失和生产力成本。
IF 2.9 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-12-01 Epub Date: 2024-12-20 DOI: 10.1080/13696998.2024.2435750
Karim Abdel Wahab, Ahmed Hassan, Ahmed Morsi, Sneha Amritlal, Anne Meiwald, Robert Hughes, Aimée Fox, Goran Bencina, Bernadette Pöllinger

Background: In Egypt, there were 150,578 new cancer cases and 95,275 cancer deaths in 2022, indicating a substantial burden on patients and the healthcare system. The analysis aims to support decision-making related to investments in cancer prevention and new treatments, by highlighting the economic burden associated with five types of cancer.

Methods: The human capital approach was used to estimate productivity losses from premature mortality due to liver, lung, breast, bladder, and cervical cancer in Egypt in 2019 by calculating years of life lost (YLL), years of productive life lost (YPLL), and present value of future lost productivity (PVFLP). Mortality data were sourced from the World Health Organization (WHO), while life expectancy, retirement age, gross domestic product (GDP) per capita, and labor force participation rates were obtained from the World Bank. Income data, such as annual earnings and minimum wage were sourced from the Wage Indicator database. Deterministic sensitivity analysis (DSA) assessed the sensitivity of results to input variations.

Results: In 2019, Egypt had a total of 45,114 deaths, from liver, lung, breast, cervical, and bladder cancers, resulting in a productivity loss of $430,086,636. Liver cancer led to the most male deaths (17,745) and breast cancer to the most female deaths (6,754), with PVFLP of $232,663,468 and $130,745,592, respectively. The five cancers resulted in 551,336 YLL and 235,415 YPLL in Egypt. The total PVFLP was estimated at $217,224,178 for females and $212,862,458 for males, with a total PVFLP/death of $9,533. The DSA showed that the PVFLP was most sensitive to changes in the retirement age.

Conclusion: In conclusion, there is a substantial economic burden relating to premature cancer mortality in Egypt, highlighting that policies and treatment advances to decrease cancer are working, however, there is need for continuous prioritization of awareness programs, cancer screening and treatment advancements.

背景:在埃及,2022年有150,578例新发癌症病例和95275例癌症死亡,这表明对患者和医疗保健系统造成了巨大负担。该分析旨在通过强调与五种癌症相关的经济负担,支持与癌症预防和新疗法投资相关的决策。方法:采用人力资本方法,通过计算生命损失年数(YLL)、生产寿命损失年数(YPLL)和未来生产力损失现值(PVFLP),估算2019年埃及肝癌、肺癌、乳腺癌、膀胱癌和宫颈癌导致的过早死亡造成的生产力损失。死亡率数据来自世界卫生组织(世卫组织),而预期寿命、退休年龄、人均国内生产总值(GDP)和劳动力参与率则来自世界银行。收入数据,如年收入和最低工资来源于工资指标数据库。确定性敏感性分析(DSA)评估了结果对输入变量的敏感性。结果:2019年,埃及共有45114人死于肝癌、肺癌、乳腺癌、宫颈癌和膀胱癌,导致生产力损失430,086,636美元。肝癌导致的男性死亡人数最多(17 745人),乳腺癌导致的女性死亡人数最多(6 754人),PVFLP分别为232,663,468美元和130 745,592美元。这五种癌症在埃及导致551,336例YLL和235,415例YPLL。估计女性的PVFLP总额为217,224,178美元,男性为212,862,458美元,PVFLP/死亡总额为9,533美元。DSA显示PVFLP对退休年龄的变化最为敏感。结论:总而言之,埃及存在与癌症过早死亡相关的巨大经济负担,这突出表明减少癌症的政策和治疗进展正在发挥作用,然而,需要持续优先考虑意识项目,癌症筛查和治疗进展。
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引用次数: 0
Early combination of sotrovimab with nirmatrelvir/ritonavir or remdesivir is associated with low rate of persisting SARS CoV-2 infection in immunocompromised outpatients with mild-to-moderate COVID-19: a prospective single-centre study. 一项前瞻性单中心研究表明,在患有轻中度COVID-19的免疫功能低下门诊患者中,sotrovimab与尼马特利韦/利托那韦或瑞德西韦的早期联合用药与持续低SARS CoV-2感染率相关。
Pub Date : 2025-12-01 Epub Date: 2024-12-11 DOI: 10.1080/07853890.2024.2439541
I Gentile, G Viceconte, F Cuccurullo, D Pietroluongo, A D'Agostino, M Silvitelli, S Mercinelli, R Scotto, F Grimaldi, S Palmieri, A Gravetti, F Trastulli, M Moccia, A R Buonomo

Background: Immunocompromised patients are at high risk of developing persisting/prolonged COVID-19. Data on the early combined use of antivirals and monoclonal antibodies in this population are scarce.

Research design and methods: We performed an observational, prospective study, enrolling immunocompromised outpatients with mild-to-moderate COVID-19, treated with a combination of sotrovimab plus one antiviral (remdesivir or nirmatrelvir/ritonavir) within 7 days from symptom onset. Primary outcome was hospitalization within 30 days. Secondary outcomes were: needing for oxygen therapy; development of persistent infection; death within 60 days and reinfection or relapse within 90 days.

Results: We enrolled 52 patients. No patient was hospitalized within 30 days of disease onset, required oxygen administration, died within 60 days, or experienced a reinfection or clinical relapse within 90 days.The clearance rates were 67% and 97% on the 14th day after the end of therapy and at the end of the follow-up period, respectively.Factors associated with longer infection were initiation of therapy 3 days after symptom onset and enrollment for more than 180 days from the beginning of the study. However, only the latter factor was independently associated with a longer SARS-CoV-2 infection, suggesting a loss of efficacy of this strategy with the evolution of SARS-CoV-2 variants.

Conclusions: Early administration of combination therapy with a direct antiviral and sotrovimab seems to be effective in preventing hospitalization, progression to severe COVID-19, and development of prolonged/persisting SARS-CoV-2 infection in immunocompromised patients.

背景:免疫功能低下患者发展为持续/长期COVID-19的风险很高。在这一人群中早期联合使用抗病毒药物和单克隆抗体的数据很少。研究设计和方法:我们进行了一项观察性、前瞻性研究,纳入了轻至中度COVID-19免疫功能低下的门诊患者,这些患者在症状出现后7天内联合使用sotrovimab加一种抗病毒药物(remdesivir或nirmatrelvir/ritonavir)治疗。主要结局为30天内住院。次要结局是:需要吸氧治疗;持续感染的发展;60天内死亡,90天内再感染或复发。结果:我们入组了52例患者。没有患者在发病30天内住院,没有患者需要给氧,没有患者在60天内死亡,没有患者在90天内再次感染或临床复发。治疗结束后第14天和随访结束时,清除率分别为67%和97%。与感染时间延长相关的因素是在症状出现后3天开始治疗,以及从研究开始入组超过180天。然而,只有后一个因素与更长时间的SARS-CoV-2感染独立相关,这表明该策略随着SARS-CoV-2变体的进化而失去效力。结论:免疫功能低下患者早期给予直接抗病毒药物和索罗维单抗联合治疗似乎可有效预防住院、进展为严重COVID-19以及长期/持续的SARS-CoV-2感染。
{"title":"Early combination of sotrovimab with nirmatrelvir/ritonavir or remdesivir is associated with low rate of persisting SARS CoV-2 infection in immunocompromised outpatients with mild-to-moderate COVID-19: a prospective single-centre study.","authors":"I Gentile, G Viceconte, F Cuccurullo, D Pietroluongo, A D'Agostino, M Silvitelli, S Mercinelli, R Scotto, F Grimaldi, S Palmieri, A Gravetti, F Trastulli, M Moccia, A R Buonomo","doi":"10.1080/07853890.2024.2439541","DOIUrl":"10.1080/07853890.2024.2439541","url":null,"abstract":"<p><strong>Background: </strong>Immunocompromised patients are at high risk of developing persisting/prolonged COVID-19. Data on the early combined use of antivirals and monoclonal antibodies in this population are scarce.</p><p><strong>Research design and methods: </strong>We performed an observational, prospective study, enrolling immunocompromised outpatients with mild-to-moderate COVID-19, treated with a combination of sotrovimab plus one antiviral (remdesivir or nirmatrelvir/ritonavir) within 7 days from symptom onset. Primary outcome was hospitalization within 30 days. Secondary outcomes were: needing for oxygen therapy; development of persistent infection; death within 60 days and reinfection or relapse within 90 days.</p><p><strong>Results: </strong>We enrolled 52 patients. No patient was hospitalized within 30 days of disease onset, required oxygen administration, died within 60 days, or experienced a reinfection or clinical relapse within 90 days.The clearance rates were 67% and 97% on the 14th day after the end of therapy and at the end of the follow-up period, respectively.Factors associated with longer infection were initiation of therapy 3 days after symptom onset and enrollment for more than 180 days from the beginning of the study. However, only the latter factor was independently associated with a longer SARS-CoV-2 infection, suggesting a loss of efficacy of this strategy with the evolution of SARS-CoV-2 variants.</p><p><strong>Conclusions: </strong>Early administration of combination therapy with a direct antiviral and sotrovimab seems to be effective in preventing hospitalization, progression to severe COVID-19, and development of prolonged/persisting SARS-CoV-2 infection in immunocompromised patients.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"57 1","pages":"2439541"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11636137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genomic characterizations of Klebsiella variicola: emerging pathogens identified from sepsis patients in Ethiopian referral hospitals. 变异克雷伯氏菌的基因组特征:从埃塞俄比亚转诊医院败血症患者中发现的新病原体。
IF 8.4 2区 医学 Q1 IMMUNOLOGY Pub Date : 2025-12-01 Epub Date: 2024-12-18 DOI: 10.1080/22221751.2024.2440494
Melese Hailu Legese, Daniel Asrat, Adane Mihret, Badrul Hasan, Abraham Aseffa, Göte Swedberg

Healthcare in low- and middle-income countries is becoming problematic due to the emergence of multidrug-resistant bacteria causing serious morbidity and mortality. Klebsiella variicola carrying multiple antimicrobial resistance (AMR) genes were found significantly among sepsis patients in a study done between October 2019 and September 2020 at four Ethiopian hospitals located in the central (Tikur Anbessa and Yekatit 12), southern (Hawassa), and northern (Dessie) parts. Among 1416 sepsis patients, 74 K. variicola isolates were identified using MALDI-TOF, most of them at Dessie (n = 44) and Hawassa (n = 28) hospitals. Whole genome sequencing showed that K. variicola strains identified at Dessie Hospital displayed phylogenetic clonality, carried an IncM1 plasmid and the majority were ST3924. Many K. variicola identified at Hawassa Hospital were clonally clustered and the majority belonged to novel STs and carried IncFIB(K) and IncFII(K) plasmids concurrently. Fifty K. variicola carried ESBL genes while 2 isolates harboured AmpC. Other frequently found genes were aac(3)-lla, blaCTX-M-15, blaTEM-1B, blaLEN2, blaOXA-1, blaSCO-1, catB3, dfrA14, QnrB1, aac(6')-lb-cr and sul2. Virulence genes detected at both sites were mrk operons for biofilm formation and siderophore ABC transporter operons for iron uptake. Capsular alleles varied, with wzi 269 at Dessie and wzi 582 at Hawassa. The isolation of multidrug-resistant K. variicola as an emerging sepsis pathogen calls for strong infection prevention strategies and antimicrobial stewardship supported by advanced bacterial identification techniques.

由于耐多药细菌的出现,造成严重的发病率和死亡率,低收入和中等收入国家的医疗保健问题日益严重。2019年10月至2020年9月期间,在位于中部(Tikur Anbessa和Yekatit 12)、南部(Hawassa)和北部(Dessie)地区的四家埃塞俄比亚医院进行的一项研究中,在败血症患者中发现了携带多种抗微生物药物耐药性(AMR)基因的克雷伯氏菌。在1416例脓毒症患者中,使用MALDI-TOF鉴定出74株天花分枝杆菌,其中大部分来自Dessie医院(n=44)和Hawassa医院(n=28)。全基因组测序结果显示,在Dessie医院鉴定的天花菌株具有系统发育克隆性,携带IncM1质粒,多数为ST3924。在Hawassa医院发现的许多天花病毒是克隆聚集的,大多数属于新型STs,同时携带IncFIB(K)和IncFII(K)质粒。50株携带ESBL基因,2株携带AmpC基因。其他常发现的基因有aac(3)-lla、blaCTX-M-15、blaTEM-1B、blaLEN2、blaOXA-1、blaSCO-1、catB3、dfrA14、QnrB1、aac(6’)-lb-cr和sul2。在这两个位点检测到的毒力基因分别是负责生物膜形成的mrk操纵子和负责铁载体ABC转运体操纵子。荚膜等位基因各不相同,Dessie为wzi 269, Hawassa为wzi 582。作为一种新兴的败血症病原体,多重耐药的variicola的分离需要强有力的感染预防策略和先进的细菌鉴定技术支持的抗菌管理。
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引用次数: 0
Predictive value of three nutritional indexes for disease activity in patients with inflammatory bowel disease. 三种营养指标对炎症性肠病患者疾病活动的预测价值。
Pub Date : 2025-12-01 Epub Date: 2024-12-20 DOI: 10.1080/07853890.2024.2443256
Zhuoyan Chen, Liuwei Zeng, Weimin Cai, Xian Song, Qian Xu, Jun Xu, Luying Zhao, Yuan Zeng, Xiangting Zhang, Xiao Wu, Ruoru Zhou, Huiya Ying, Kanglei Ying, Yuhao Chen, Fujun Yu

Background: Malnutrition is prevalent in patients with inflammatory bowel disease (IBD); however, its ability to predict the disease activity in IBD remains unexplored. Therefore, this study aimed to explore the association between malnutrition and disease activity in IBD.

Methods: In this retrospective study, we enrolled 1006 patients diagnosed with IBD from the First Affiliated Hospital of Wenzhou Medical University from 2011 to 2022. Malnutrition was assessed based on the prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and controlling nutritional status (CONUT) scores. Logistic regression analyses were performed to identify predictors for disease activity. Restricted cubic spline analysis was performed to evaluate the possible nonlinear relations, and subgroup analysis was performed to explore potential interactions. Additionally, prediction performances were compared through receiver operating characteristic curves, net reclassification improvement, and integrated discrimination improvement.

Results: The prevalence of malnutrition calculated by the PNI, GNRI, and CONUT scores in IBD was 16.9%, 72.1%, and 75.6%, respectively and significant correlations were observed among them. Multivariate logistic regression analysis showed that PNI, GNRI, and CONUT were independent risk factors for disease activity, and no significant nonlinear relationship was observed between disease activity and all three indexes. No statistically significant interactive effect was found in nearly all the subgroups. GNRI showed the highest predictive value compared with PNI and CONUT. Additionally, combining any of the three indexes improved the ability of C-reactive protein to predict IBD activity.

Conclusions: All three nutritional indexes evaluated malnutrition to be an independent risk factor for IBD activity.

背景:营养不良在炎症性肠病(IBD)患者中很普遍,然而,营养不良预测IBD疾病活动的能力仍有待探索。因此,本研究旨在探讨营养不良与 IBD 疾病活动性之间的关系:在这项回顾性研究中,我们纳入了 2011 年至 2022 年温州医科大学附属第一医院确诊的 1006 例 IBD 患者。营养不良根据预后营养指数(PNI)、老年营养风险指数(GNRI)和控制营养状况(CONUT)评分进行评估。为确定疾病活动性的预测因素,进行了逻辑回归分析。为评估可能存在的非线性关系,进行了限制性三次样条分析,为探索潜在的相互作用,进行了亚组分析。此外,还通过接收者操作特征曲线、净再分类改进和综合辨别改进对预测性能进行了比较:结果:根据 PNI、GNRI 和 CONUT 评分计算出的 IBD 患者营养不良发生率分别为 16.9%、72.1% 和 75.6%,且三者之间存在显著相关性。多变量逻辑回归分析表明,PNI、GNRI 和 CONUT 是疾病活动性的独立风险因素,疾病活动性与这三个指标之间没有明显的非线性关系。几乎在所有亚组中都没有发现具有统计学意义的交互效应。与 PNI 和 CONUT 相比,GNRI 的预测价值最高。此外,将这三个指标中的任何一个结合起来,都能提高 C 反应蛋白预测 IBD 活动性的能力:结论:所有三种营养指数都认为营养不良是导致 IBD 活动的独立风险因素。
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引用次数: 0
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