Declining prevalence of HIV-associated neurocognitive disorders in more recent years and associated factors, in a large cohort of ART-treated HIV-infected individuals

alexandrossfakianakis shared this article with you from Inoreader Declining prevalence of HIV-associated neurocognitive disorders in more recent years and associated factors, in a large cohort of ART-treated HIV-infected individuals via Clinical Infectious Diseases Advance Access Abstract Background Human immunodeficiency virus (HIV)-associated neurocognitive disorders (HAND) have been suggested as persistent even with effective antiretroviral therapy (ART). Aims were to evaluate HAND prevalence and associated factors, in a large cohort of people-living-with-HIV (PLWH). Methods ART-treated PLWH, underwent a neuropsychological examination through a battery of 12 tests exploring 5 different domains, between 2009-2020, were included in this cross-sectional analysis. HAND were classified according to Frascati's criteria. Participants were defined as complaining or not-complaining if a cognitive complaint was reported or not. Chi-square for trend and multivariable logistic regression were fitted. Results Overall, 1,424 PLWH were enrolled during four three-years periods. HAND prevalence was 24%. Among complainers (572/1,424), HAND prevalence was 38%, higher than among not-complainers (15%). Over the study period, a decreasing HAND prevalence was found in the entire population (p < 0.001) and in complaining (p < 0.001); in not-complaining it remained stable (p = 0.182). Factors associated with HAND were older age, lower educational level, lower current CD4+ T-cell count and HCV co-infection. Compared to Non-Nucleoside Reverse Transcriptase Inhibitors, individuals receiving dual and Integrase Strand Transfer Inhibitor (INSTI)-based therapies were associated with a decreased risk of HAND, as well as participants tested in more recent years. Conclusions In this large cohort of ART-treated PLWH, mostly virologically suppressed, a remarkable decreasing HAND prevalence was observed . Besides HIV- and patient-related factors, the reduced risk of HAND found with dual and INSTI-based regimens along with a more recent ART initiation, could suggest a potential role of new treatment strategies in this decline, due to their greater virologic efficacy and better tolerability. View on Web

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An Outbreak of Acute Respiratory Disease Caused by HAdV‐55

alexandrossfakianakis shared this article with you from Inoreader An Outbreak of Acute Respiratory Disease Caused by HAdV‐55 in Beijing, China, 2020 via Journal of Medical Virology Abstract Introduction Human adenoviruses (HAdVs) can cause acute respiratory diseases (ARD) worldwide and HAdV-55 is a reemergent pathogen in recent years. In the study, we investigated an outbreak of ARD at a school due to HAdV-55 in Beijing, China during the early outbreak of COVID-19. Methods The epidemic prevention team was dispatched to the school to collect epidemiologic data and nasopharyngeal samples. Then, rRT-PCR and multiplex PCR assays were used to detect SARS-CoV-2 and other respiratory pathogens respectively. One representative HAdV-55 isolate was selected and submitted for whole-genome sequencing using a MiSeq system and the whole-genome phylogenetic tree was conducted based on maximum likelihood method. Results The outbreak lasted from January 27 to February 6, 2020, and 108 students developed fever among which 60 (55.56%) cases were diagnosed with HAdV-55 infection in laboratory using real-time PCR and 56 cases were hospitalized. All the confirmed cases had fever and 11 cases (18.33%) presented fever above 39℃. Other main clinical symptoms included sore throat (43.33%) and headache (43.33%). We obtained and assembled the full genome of one isolate, BJ-446, with 34,761 nucleotides in length. HAdV-55 isolate BJ-446 was 99.85% identical to strain QS-DLL which was the first HAdV-55 strain in China isolated from an ARD outbreak in Shanxi in 2006. One and four amino acid mutations were observed in hexon gene and the coding region of L2 pV 40.1 kDa protein, respectively. Conclusions We identified the first HAdV-55 infection associated with the ARD outbreak in Beijing since the emerging of COVID-19. The study suggests that improved surveillance of HAdV is needed though the COVID-19 is still prevalent in the world. This article is protected by copyright. All rights reserved. View on Web

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Ultra‐Rapid and Ultra‐Sensitive Detection of SARS‐CoV‐2 Antibodies in COVID‐19 Patients via A 3D‐Printed Nanomaterial‐Based Biosensing Platform

alexandrossfakianakis shared this article with you from Inoreader Ultra‐Rapid and Ultra‐Sensitive Detection of SARS‐CoV‐2 Antibodies in COVID‐19 Patients via A 3D‐Printed Nanomaterial‐Based Biosensing Platform via Journal of Medical Virology Abstract Rapid detection of antibodies during infection and after vaccination is critical for the control of infectious outbreaks, understanding immune response, and evaluating vaccine efficacy. In this manuscript, we evaluate a simple ultra-rapid test for SARS-CoV-2 antibodies in COVID-19 patients, which gives quantitative results (i.e., antibody concentration) in 10-15 seconds using a previously reported nanomaterial-based 3D-printed biosensing platform. This platform consists of a micropillar array electrode fabricated via 3D printing of aerosolized gold nanoparticles and coated with nanoflakes of graphene and specific SARS-CoV-2 antigens, including spike S1, S1 receptor-binding domain (RBD) and nucleocapsid (N). The sensor works on the principle of electrochemical transduction where the change of sensor impedance is realized by the interactions between the viral proteins attached to the sensor electrode surface and the antibodies. The three sensors were used t o test samples from 17 COVID-19 patients and 3 patients without COVID-19. Unlike other serological tests, the 3D sensors quantitatively detected antibodies at concentration as low as picomole within 10–12 seconds in human plasma samples. We found that the studied COVID-19 patients had higher concentrations of antibodies to spike proteins (RBD and S1) than to the N protein. These results demonstrate the enormous potential of the rapid antibody test platform for understanding patients' immunity, disease epidemiology and vaccine efficacy, and facilitating control and prevention of infectious epidemics. This article is protected by copyright. All rights reserved. View on Web

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Transmucosal pterygomaxillary disjunction using a piezoelectric device, in the context of the minimally invasive Le Fort I osteotomy protocol

alexandrossfakianakis shared this article with you from Inoreader Transmucosal pterygomaxillary disjunction using a piezoelectric device, in the context of the minimally invasive Le Fort I osteotomy protocol via International Journal of Oral and Maxillofacial Surgery via MedWorm.com The aim of this study was to assess the accuracy and clinical implications of pterygomaxillary junction (PMJ) disjunction with a transmucosal PMJ osteotomy using a piezoelectric hand-piece device, in the context of Le Fort I osteotomy, by evaluating the level of PMJ disarticulation and the need for bone trimming around the pedicle. An ambidirectional 1-month follow-up cohort study was designed involving consecutive patients undergoing minimally invasive maxillary Le Fort I osteotomy through the twist technique. (Source: International Journal of Oral and Maxillofacial Surgery) View on Web

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Risks of monkeypox virus infection in children

alexandrossfakianakis shared this article with you from Inoreader Risks of monkeypox virus infection in children via Journal of Medical Virology Abstact keypox virus (MPXV) has gained global attention in view of the current multi-country outbreak affecting non-endemic regions including several European countries, Canada, the US and Australia, and without known epidemiological links to endemic settings in most cases[1](#ref-0001). The first ever diagnosed human case of MPXV infection was in 1970 in a male infant in the Democratic Republic of Congo (DRC, formerly known as Zaire)[2](#ref-0002), and further cases have since occurred predominantly in West and Central Africa[3](#ref-0003). The limited data available from previous outbreaks suggest that children may be at greater risk of severe forms of disease with potential complications including sepsis, encephalitis and death[4](#ref-0004). Jezek et al. reported on the clinical features and outcomes of 282 patients with monkeypox between 1980 and 1985 in the DRC; 90% of patients were <15 years old (the youngest being one month old)[5](#ref-0005). Amongst unva ccinated patients mortality in their study was 11% but was higher in the youngest children at 15%. In a retrospective study of a 2003 US monkeypox outbreak (due to the West African clade) associated with imported pet prairie dogs, the first outbreak occurring outside of an endemic region, seventy one percent (24/34) of cases were in adults[6](#ref-0006). However, paediatric patients were admitted to the intensive care unit at a significantly higher rate than adults (50% vs 9%, p = 0.02) and the most critically ill patients in the outbreak were two young children whose complications included retropharyngeal abscess and encephalopathy. It however important to note that the age-specific epidemiology of monkeypox has changed over time; the median age at presentation has evolved from young children (4 years old in the 1970s) to young adults (21 years old) in 2010-2019[3](#ref-0003). This article is protected by copyright. All rights reserved. View on Web

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Evaluation of humoral immune responses induced by different SARS‐CoV‐2 spike trimers from wild‐type and emerging variants with individual, sequential, and combinational delivered strategies

alexandrossfakianakis shared this article with you from Inoreader Evaluation of humoral immune responses induced by different SARS‐CoV‐2 spike trimers from wild‐type and emerging variants with individual, sequential, and combinational delivered strategies via Journal of Medical Virology ABSTRACT The spike trimer of SARS-CoV-2 is an effective target for inducing neutralizing antibodies by COVID-19 vaccines. However, the diversity of spike protein from emerging SASR-CoV-2 variants has become the major challenge for development of a universal vaccine. In order to investigate the immunogenicity of spike proteins from various circulating strains including wild-type, Delta and Omicron variants, we produced various natural spike trimers and designed three vaccination strategies, i.e. individual, sequential and bivalent regimens to assess autologous and heterogenous antibody responses in a mouse model. The results indicated that monovalent vaccine strategy with individual spike trimer could only induce binding and neutralizing antibodies against homologous viruses. However, sequential and bivalent immunization with Delta and Omicron spike trimers could induce significantly broader neutralizing antibody responses against heterogenous SARS-CoV-2. Interestingl y, the spike trimer from Omicron variant showed superior immunogenicity in inducing antibody response against recently emerging XE variant. Taken together, our data supported the development of novel vaccination strategies or multivalent vaccine against emerging variants. This article is protected by copyright. All rights reserved. View on Web

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COVID-19 severity and risk of subsequent cardiovascular events

alexandrossfakianakis shared this article with you from Inoreader COVID-19 severity and risk of subsequent cardiovascular events via Clinical Infectious Diseases Advance Access Abstract Background Little is known about the relationship between COVID-19 severity and subsequent risk of experiencing a cardiovascular event (CVE) after COVID-19 recovery. We evaluated this relationship in a large cohort of US adults. Methods Using a claims database, we performed a retrospective cohort study of adults diagnosed with COVID-19 between April 1, 2020 and May 31, 2021. We evaluated the association between COVID-19 severity and risk of CVE >30 d ays after COVID-19 diagnosis using inverse probability of treatment weighted competing risks regression. Severity was based on level of care required for COVID-19 treatment: intensive care unit (ICU) admission, non-ICU hospitalization, or outpatient care only. Results 1,357,518 COVID-19 patients were included (2% ICU, 3% non-ICU hospitalization, and 95% outpatient only). Compared to outpatients, there was an increased risk of any CVE for patients requiring ICU admission (adjusted hazard ratio [HR]: 1.80 [95%CI: 1.71−1.89]) or non-ICU hospitalization (HR: 1.28 [1.24−1.33]). Risk of subsequent hospitalization for CVE was even higher (HR: 3.47 [3.20–3.76] for ICU and HR: 1.96 [1.85–2.09] for non-ICU hospitalized vs. outpatient only). Conclusions COVID-19 patients hospitalized or requiring critical care had a significantly higher risk of experiencing and being hospitalized for post-COVID-19 CVE than patients with milder C OVID-19 who were managed solely in the outpatient setting even after adjusting for differences between these groups. These findings underscore the continued importance of preventing SARS-CoV-2 infection from progressing to severe illness to reduce potential long-term cardiovascular complications. View on Web

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Nephrotoxicity of Vancomycin in Combination with Beta-lactam Agents: Ceftolozane-tazobactam vs. Piperacillin-tazobactam

alexandrossfakianakis shared this article with you from Inoreader Nephrotoxicity of Vancomycin in Combination with Beta-lactam Agents: Ceftolozane-tazobactam vs. Piperacillin-tazobactam via Clinical Infectious Diseases Advance Access Abstract Background Vancomycin (VAN)-associated acute kidney injury (AKI) is increased when VAN is combined with certain beta-lactam (BL) such as piperacillin-tazobactam (TZP) but not had been evaluated with ceftolozane-tazobactam (C/T). We aim to investigate the AKI incidence of VAN in combination with C/T (VAN/C/T) compared to VAN in combination to TZP (VAN-TZP). Method We conducted a multi-center observational comparative study across the United States. The p rimary analysis was a composite outcome of AKI: 1) RIFLE, 2) AKIN, or 3) VAN-induced-nephrotoxicity according to the consensus guidelines. Multivariable logistic regression analysis had been conducted to adjust for confounding variables and stratified Kaplan-Meir analysis to assess the time-to-nephrotoxicity between the two groups. Results We included (n = 90) VAN/C/T and (n = 284) VAN-TZP at an enrollment ratio of 3:1. The primary outcome occurred in 12.2% vs. 25.0% in the VAN-C/T and VAN-TZP groups, respectively (P = 0.011). After adjusting for confounding variables, VAN-TZP was associated with increased odds of AKI compared with patients receiving VAN-C/T; with an aOR of 3.308 [1.560-6.993]. Results of the stratified Kaplan-Meir with log-rank time-to-nephrotoxicity analysis indicate that time to AKI was significantly shorter among patients receiving VAN-TZP (P = 0.004). Cox proportional hazards analysis demonstrated that TZP was consistent with the primary analysis (P = 0.001). Conclusions Collectively, our results suggest that the AKI is not likely to be related to tazobactam but rather to the piperacillin which is a component in the VAN-TZP combination but not the VAN-C/T. View on Web

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Oral Nirmatrelvir and Ritonavir in Non-hospitalized Vaccinated Patients with Covid-19

alexandrossfakianakis shared this article with you from Inoreader Oral Nirmatrelvir and Ritonavir in Non-hospitalized Vaccinated Patients with Covid-19 via Clinical Infectious Diseases Advance Access Abstract Background Treatment of coronavirus disease-2019 (Covid-19) with nirmatrelvir plus ritonavir (NMV-r) in high-risk non-hospitalized unvaccinated patients reduced the risk of progression to severe disease. However, the potential benefits of NMV-r among vaccinated patients are unclear. Methods We conducted a comparative retrospective cohort study using the TriNetX research network. Patients ≥18 years of age who were vaccinated and subsequently developed C ovid-19 between December 1, 2021, and April 18, 2022, were included. Cohorts were developed based on the use of NMV-r within five days of diagnosis. The primary composite outcome was all-cause emergency room (ER) visit, hospitalization, or death at a 30-days follow-up. Secondary outcomes included individual components of primary outcomes, multisystem symptoms, Covid-19 associated complications, and diagnostic test utilization. Results After propensity score matching, 1,130 patients remained in each cohort. A primary composite outcome of all-cause ER visits, hospitalization, or death in 30 days occurred in 89 (7.87%) patients in the NMV-r cohort as compared to 163 (14.4%) patients in the non-NMV-r cohort (OR 0.5, CI 0.39-0.67; p<0.005) consistent with 45% relative risk reduction. A significant reduction in multisystem symptom burden and subsequent complications such as lower respiratory tract infection, cardiac arrhythmia, and diagnostic radiology testing were noted in NM V-r treated patients. There was no apparent increase serious complications between days 10 to 30. Conclusion Treatment with NMV-r in non-hospitalized vaccinated patients with Covid-19 was associated with a reduced likelihood of emergency room visits, hospitalization, or death. Complications and overall resource utilization were also decreased. View on Web

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Novel Machine Learning Model to Predict Interval of Oral Cancer Recurrence for Surveillance Stratification

alexandrossfakianakis shared this article with you from Inoreader Novel Machine Learning Model to Predict Interval of Oral Cancer Recurrence for Surveillance Stratification via The Laryngoscope We developed a machine learning model using a feature selection data input that was able to reliably predict oral cancer recurrence within 1-year intervals. Precise modeling of timing of recurrence can help personalize surveillance protocols to enhance early detection and reduce extraneous healthcare costs. Objective(s) We aimed to develop a machine learning (ML) model to accurately predict the timing of oral squamous cell carcinoma (OSCC) recurrence across four 1-year intervals. Methods Patients with surgically treated OSCC between 2012–2018 were retrospectively identified from the Yale-New Haven Health system tumor registry. Patients with known recurrence or minimum follow-up of 24 months from surgery were included. Patients were classified into one of five levels: four 1-year intervals and one level for no recurrence (within 4 years of surgery). Three sets of data inputs (comprehensive, feature selection, nomogram) were combined with 4 ML architectures (logistic regression, decision tree (DT), support vector machine (SVM), artificial neural network classifiers) yielding 12 models in total. Models were primarily evaluated using mean absolute error (MAE), lower values indicating better prediction of 1-year interval recurrence. Secondary outcomes included accuracy, weighted precision, and weighted recall. Results 389 patients met inclusion criteria: 102 (26.2%) recurred within 48 months of surgery. Median follow-up time was 25 months (IQR: 15–37.5) for patients with recurrence and 44 months (IQR: 32–57) for patients without recurrence. MAE of 0.654% and 80.8% accuracy were achieved on a 15-variable feature selection input by 2 ML models: DT and SVM classifiers. Conclusions To our knowledge, this is the first study to leverage multiclass ML models to predict time to OSCC recurrence. We developed a model using feature selection data input that reliably predicted recurrence within 1-year intervals. Precise modeling of recurrence timing has the potential to personalize surveillance protocols in the future to enhance early detection and reduce extraneous healthcare costs. Level of Evidence III Laryngoscope, 2022 View on Web

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