Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Τετάρτη 27 Απριλίου 2022

Impact of SARS‐CoV‐2 Mu variant on vaccine effectiveness: a comparative genomics study at the peak of the third wave

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Abstract

We assessed the circulation of SARS-CoV-2 variants amongst vaccinated military personnel in Bogotá, Colombia to evaluate the mutations of certain variants and their potential for breakthrough infection in vaccinated subjects. We observed that in vaccinated individuals the most frequent infecting lineage was Mu (B.1.621 and B.1.621.1). The above possibly associated with specific mutations that confers it with vaccine-induced immune escape ability. Our findings highlight the importance of how genomic tracking coupled with epidemiological surveillance can assist in the study of novel emerging variants (e.g. Omicron) and their impact on vaccination efforts worldwide.

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Seroprevalence of neutralizing antibodies against respiratory syncytial virus in healthy adults

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Abstract

Respiratory syncytial virus (RSV) is the major cause of pneumonia and bronchiolitis in infants and young children, and mediates substantial morbidity and mortality in the elderly and immunocompromised globally. Development a safe and effective RSV vaccine and an optimized neutralizing antibody (NAb) with strong virus-neutralizing activity is appealing. To gain some detailed knowledge on the humoral immune response to RSV subgroup A (RSV-A) and RSV-B, we investigated the seroprevalence of pre-existing NAbs by using the microneutralization assay in healthy adult from Guangzhou, southern China. We found that the overall seropositive rate was 84.86% for anti-RSV NAbs. Furthermore, the seropositive rates were 68.47% and 73.61% for anti-RSV-A NAbs and anti-RSV-B NAbs, respectively. In addition, although the seropositive rates and NAb levels were not associated with the blood type, type AB individuals displaying higher seropositive rates for anti-RSV-A NAbs with hi gh titer (≥ 288) and anti-RSV-B NAbs, especially those with moderate titer (≥ 72-< 288). The seropositive rates and titers were comparable between anti-RSV-A NAbs and anti-RSV-B NAbs in the AB blood type group. Interestingly, only when the NAb titer of the serum to RSV-A was not less than 288, was it not less than 18 to RSV-B, and vice versa. These results would be helpful for a better understanding of the human serum NAb responses to RSV-A and RSV-B.

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Cell pyroptosis in picornavirus and its potential for treating viral infection

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Abstract

Cell pyroptosis has received increased attention due to the associations between innate immunity and disease, and it has become a major focal point recently due to in-depth studies of cancer. With increased research on pyroptosis, scientists have discovered that it has an essential role in viral infections, especially in the occurrence and development of some picornavirus infections. Many picornaviruses, including Coxsackievirus, a71 enterovirus, human rhinovirus, encephalomyocarditis virus, and foot-and-mouth disease virus induce pyroptosis to varying degrees. This review summarized the mechanisms by which these viruses induce cell pyroptosis, which can be an effective defense against pathogen infection. However, excessive inflammasome activation or pyroptosis also can damage the host's health or aggravate disease progression. Careful approaches that acknowledge this dual effect will aid in the exploration of picornavirus infections and the mechanisms that produce the inflammatory response. This information will promote the development of drugs that can inhibit cell pyroptosis and provide new avenues for future clinical treatment.

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Evaluation of A NEW “All in One” SARS‐CoV‐2 antigen‐detecting rapid diagnostic test AND self‐test: diagnostic performance and usability in child and adult populationS

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Abstract

The control of the COVID-19 epidemics has been one global health priorities for the last two years. To that end, more reliable and easy-to-use, regardless of age, diagnostic tests are necessary. Considering that, we evaluated an innovative two-step self-test, the AAZ COVID-VIRO ALL IN®, switching from the classic nasal swab to a nasal sponge. We performed a multicentre study, on 124 adults and children, in a point-of-care setting. Sensitivity, specificity and overall acceptance of the COVID-VIRO ALL IN® self-test compared to RT-PCR on nasopharyngeal samples were of 93.0%, 100% and 97.5%, respectively. We then performed a multicentre, usability study to evaluate the ease of use of COVID-VIRO ALL IN® on 68 laypersons adults. A vast majority of participants correctly executed and interpreted the test. The usability was then specifically investigated on 40 children and teenagers, comparing COVID-VIRO® first generation to the new COVID-VIRO ALL IN®. They all found COVID-VIRO ALL IN® more comfortable and easier to use. For young children, the new self-test seems safer (less risk of trauma, no liquid exposure), and faster than saliva-based RT-PCR. Moreover, the COVID-VIRO ALL IN® can easily be adapted as a multiplex self-test for other respiratory viruses, opening new perspectives of simultaneous, rapid and massive detection of respiratory infections, especially among vulnerable populations like children and elderly people.

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Characterizing HIV-preventive, plasma tenofovir concentrations. A pooled participant-level data analysis from HIV pre-exposure prophylaxis (PrEP) clinical trials.

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Abstract
Background
Daily dosing of tenofovir disoproxil fumarate (TDF), with or without emtricitabine (FTC), has high efficacy in preventing HIV infection when individuals are adherent. The target protective plasma concentration of tenofovir (TFV), however, is not fully understood. The aim of this study is to estimate the protective TFV plasma concentration.
Methods
Participant data from TFV-based daily oral and topical active arms of phase III trials (iPrEx, VOICE and Partners PrEP) were pooled (n = 2,950). Individual specific risk scores (low and high risk) of acquiring HIV, based on an earlier placebo analysis, were created. Longitudinal TFV pharmacokinetics (PK), HIV outcome, individual risk scores and the effect of sex at birth data were integrated and analyzed using non-linear mixed effects models (NONMEM).
Results
Around 50% of the individuals were estimated to be adherent, which differed from self-reported adherenc e (∼90%) and large variation between longitudinal adherence patterns were identified. Following oral administration, the estimated protective TFV trough concentration was substantially higher in high risk females (45.8 ng/mL) compared to high risk males (16.1 ng/mL) and to low risk individuals (∼7.5 ng/mL). Dosing simulations indicated that high risk women require full adherence to maintain protective levels.
Conclusions
Using the largest PK-HIV outcome database to date, we developed a population adherence-PK-risk-outcome model. Our results indicate that high risk females need higher levels of plasma TFV to achieve HIV protection compared to males. HIV protection exceeds 90% in all populations if daily adherence is achieved.
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Low Body Mass Index at Treatment Initiation and Rifampicin-Resistant Tuberculosis Treatment Outcomes: An Individual Participant Data Meta-Analysis

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Abstract
Background
The impact of low body-mass-index at treatment initiation on rifampicin-resistant tuberculosis treatment outcomes is uncertain. We evaluated the association between body-mass-index at rifampicin-resistant tuberculosis treatment initiation and end-of-treatment outcomes, and its modifying factors.
Methods
We did an individual participant data meta-analysis of adults ≥18 years with rifampicin-resistant tuberculosis whose body-mass-index was documented at treatment initiation. We compared odds of any unfavorable treatment outcome, mortality, or failure/recurrence between patients who were underweight (body-mass-index <18.5 kg/m2) and not underweight. Adjusted odds ratios and 95%CI were estimated using logistic regression, with matching on demographic, clinical, and treatment-related factors. We evaluated effect modification by HIV-infection and other variables using likelihood ratio tests. In secondary an alysis, we estimated cumulative incidence of mortality during treatment, stratified by HIV-infection.
Results
Overall, 5148 patients were included; 1702 (33%) were underweight at treatment initiation. The median (IQR) age was 37 years (29 to 47) and 455 (9%) were living with HIV. Compared to non-underweight patients, the adjusted odds ratio among underweight patients was 1.7 (95%CI 1.4-1.9) for any unfavorable outcome, 3.1 (2.4-3.9) for death, and 1.6 (1.2-2.0) for failure/recurrence. Significant effect modification was observed for WHO region where the participant was treated. Among patients without HIV, cumulative incidence of 24-month mortality 14.8% (95%CI 12.7%-17.3%) for underweight and 5.6% (4.5%-7.0%) for not underweight patients. Among patients living with HIV, corresponding values were 33.0% (25.6%-42.6%) and 20.9% (14.1%-27.6%).
Conclusions
Low body-mass-index at treatment initiation for rifampicin-resistant tuberculosis is associated with increased odds of unfavorable treatment outcome, particularly mortality.
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Research Review: Do antibullying interventions reduce internalizing symptoms? A systematic review, meta‐analysis, and meta‐regression exploring intervention components, moderators, and mechanisms

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Background

Effective antibullying interventions may reduce the impact of bullying on young people's mental health. Nevertheless, little is known about their effectiveness in reducing internalizing symptoms such as anxiety or depression, and what factors may influence intervention effects. The aim of this systematic review, meta-analysis, and metaregression is to assess the effects of school-based antibullying interventions on children's and adolescent's internalizing symptoms. The secondary aims are to explore potential moderators, intervention components, and reductions in bullying as mediators of intervention effects on internalizing symptoms.

Methods

We searched nine databases: PsycINFO, Web of Science, ERIC, SCOPUS, CINAHL, Medline, Embase, ProQuest, and Cochrane Library, and performed an author search of included studies in English from January 1983 to April 2021. We included studies that evaluated school-based antibullying interventions using controlled designs and reporting on both bullying and internalizing outcomes. Random-effects and metaregression models were used to derive Hedges g values with pooled 95% CIs as estimates of effect size and to test associations between moderator variables and effect size estimates. Path analysis was used to test potential mediation using effect size measures of victimization, perpetration, and internalizing outcomes. Quality and risk of bias were assessed using Cochrane collaboration tools.

Results

This review included 22 studies with 58,091 participants in the meta-analysis. Antibullying interventions had a very small effect in reducing overall internalizing symptoms (ES, 0.06; 95% CI, 0.0284 to 0.1005), anxiety (ES, 0.08; 95% CI, 0.011 to 0.158), and depression (ES, 0.06; 95% CI, 0.014 to 0.107) at postintervention. The reduction in internalizing symptoms did not vary significantly across geographic location, grade level, program duration, and intensity. The intervention component 'working with peers' was associated with a significant reduction, and 'using CBT techniques' was associated with a significant increase in internalizing outcomes. Bullying victimization and perpetration did not mediate the relationship between intervention condition and internalizing outcomes.

Conclusions

Antibullying interventions have a small impact on reducing internalizing symptoms. Ongoing development of antibullying interventions should address how best to maximize their impact on internalizing symptoms to safeguard young people from the damaging mental health outcomes of bullying.

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Effectiveness of mRNA-based vaccines during the emergence of SARS-CoV-2 Omicron variant

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Abstract
Background
We evaluated effectiveness of mRNA-based vaccines following emergence of SARS-CoV-2 Omicron variant.
Methods
Recipients of a third dose of BNT162b2 or mRNA-1273 ≥ 180 days after the primary series were matched to primary series recipients and unvaccinated persons. Participants were followed from December 1, 2021 to March 12, 2022. Outcomes were documented SARS-CoV-2 infection, COVID-19 hospitalization, and COVID-19 death. Effectiveness was calculated from 100-day risks estimated with the Kaplan-Meier estimator.
Results
BNT162b2 and mRNA-1273 groups respectively included 221,267 and 187,507 third dose recipients matched to equal numbers of primary series recipients and unvaccinated persons. Compared to no vaccination, effectiveness of a third dose of BNT162b2 was 47.8% (95% confidence interval [CI]: 45.2-50.3), 81.8% (95% CI 79.2-84.2), and 89.6% (95% CI 85.0-93.6) against documented infection, hospitalizat ion, and death, respectively. Effectiveness of a third dose of BNT162b2 compared to the primary series was 30.1% (95% CI 26.2-33.7), 61.4% (95% CI 55.0-67.1), and 78.8% (95% CI 67.9-87.5) against documented infection, hospitalization, and death, respectively.Effectiveness of a third dose of mRNA-1273 compared to no vaccination was 61.9% (95% CI 59.4-64.4), 87.9% (95% CI 85.3-90.2), and 91.4% (95% CI 86.4-95.6) against documented infection, hospitalization, and death, respectively. Effectiveness of a third dose of mRNA-1273 compared to the primary series was 37.1% (95% CI 32.2-41.7), 63.5% (95% CI 53.7-71.6), and 75.0% (95% CI 55.4-88.0) against documented infection, hospitalization, and death, respectively.
Conclusions
BNT162b2 and mRNA-1273 were effective against COVID-19 following emergence of Omicron variant. A third dose provided additional protection over the primary series.
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Rab22a promotes the proliferation, migration, and invasion of lung adenocarcinoma via up-regulating PI3K/Akt/mTOR signaling pathway

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1-s2.0-S0014482722X00098-cov150h.gif

Publication date: Available online 27 April 2022

Source: Experimental Cell Research

Author(s): Jinping Wang, Xue Luo, Jinxi Lu, Xi Wang, Yuan Miao, Qingchang Li, Liang Wang

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Cytokine profile and cholesterol levels in patients with Niemann-Pick type C disease presenting neurological symptoms: The in vivo effect of miglustat and the in vitro effect of N-acetylcysteine and Coenzyme Q10

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1-s2.0-S0014482722X00098-cov150h.gif

Publication date: Available online 27 April 2022

Source: Experimental Cell Research

Author(s): Tatiane G. Hammerschmidt, Bruna Donida, Jéssica L. Faverzani, Alana P. Moura, Bianca G. dos Reis, Andryele Z. Machado, Rejane G. Kessler, Fernanda M. Sebastião, Luiza S. Reinhardt, Dinara J. Moura, Carmen R. Vargas

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Factors Correlating with Survival Following Adjuvant or Definitive Radiosurgery for Large Brain Metastases

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Abstract
Background
We sought to identify variates correlating with overall survival (OS) in patients treated with surgery (S) plus adjuvant stereotactic radiosurgery (SRS) versus definitive SRS for large (>4cc) brain metastases (BrM).
Methods
We used univariate (UVA) and multivariate analyses (MVA) to identify survival correlates among eligible patients identified from a prospective registry and compared definitive SRS to S+ adjuvant SRS cohorts using propensity score-matched analysis (PSMA). Secondary outcomes were measured using the cumulative incidence (CI) method.
Results
We identified 364 patients; 127 and 237 were treated with S+SRS and definitive SRS, respectively. On UVA, SRS alone [HR1.73 (1.35,2.22) P<0.001), BrM quantity [HR 1.13 (1.06-1.22) (P<0.001)]; performance status (PS) [HR 2.78 (1.73-4.46) (P<0.001)]; extracranial disease (ECD) [HR 1.82 (1.37,2.40) (P<0.001)]; and receipt of systemic treatment after BrM therapy, [HR 0.58 (0.46-073) (P<0.001)] correlated with OS. On MVA, SRS alone [HR 1.81 (1.19,2.74) (P<0.0054)], SRS target volume [HR 1.03 (1.01,1.06) (P<0.0042)], and receipt of systemic treatment [HR 0.68 (0.50,0.93) (P<0.015)] correlated with OS. When PSMA was used to balance ECD, BrM quantity, PS, and SRS target volume, SRS alone remained correlated with worsened OS [HR 1.62 (1.20-2.19) (P=0.0015)]. CI of local failure requiring resection at 12 months was 3% versus 7% for S+SRS and SRS cohorts, respectively [(HR 2.04 (0.89-4.69) (P =0.091)]. CI of pachymeningeal failure at 12 months was 16% versus 0% for S+SRS and SRS.
Conclusion
SRS target volume, receipt of systemic therapies, and treatment with S+SRS instead of definitive SRS correlated with improved survival in patients with large BrM.
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The intrinsic and microenvironmental features of diffuse midline glioma; implications for the development of effective immunotherapeutic treatment strategies

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Abstract
Diffuse midline glioma (DMG), including those of the brainstem (diffuse intrinsic pontine glioma), are pediatric tumors of the central nervous system (CNS). Recognized as the most lethal of all childhood cancers, palliative radiotherapy remains the only proven treatment option, however, even for those that respond, survival is only temporarily extended. DMG harbor an immunologically 'cold' tumor microenvironment (TME) with few infiltrating immune cells. The mechanisms underpinning the cold TME are not well understood. Low expression levels of immune checkpoint proteins, including PD-1, PD-L1 and CTLA-4, are recurring features of DMG and likely contribute to the lack of response to immune checkpoint inhibitors (ICIs). The unique epigenetic signatures (including stem cell-like methylation patterns), a low tumor mutational burden, and recurring somatic mutations (H3K27M, TP53, ACVR1, MYC and PIK3CA), possibly play a role in the reduced efficacy of traditional immunotherapies. Therefore, to circumvent the lack of efficacy thus far seen for the use of ICIs, adoptive cell transfer (including chimeric antigen receptor T cells) and the use of oncolytic viruses, are currently being evaluated for the treatment of DMG. It remains an absolute imperative that we improve our understanding of DMG's intrinsic and TME features if patients are to realize the potential benefits offered by these sophisticated treatments. Herein, we summarize the limitations of immunotherapeutic approaches, highlight the emerging safety and clinical efficacy shown for sophisticated cell-based therapies, as well as the evolving knowledge underpinning the DMG-immune axis, to guide in the development of immunotherapies that we hope will improve outcomes.
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