Summary A systematic review and meta-analysis was done on the use of PCR tests for the diagnosis of invasive aspergillosis. Data from more than 10 000 blood, serum, or plasma samples obtained from ...1618 patients at risk for invasive aspergillosis were retrieved from 16 studies. Overall, the mean diagnostic odds ratios (DORs) of PCR for proven and probable cases were similar whether two consecutive positive samples were required to define positivity (DOR 15·97 95% CI 6·83–37·34) or a single positive PCR test was required (DOR 16·41 95% CI 6·43–41·88). Sensitivity and specificity of PCR for two consecutive positive samples were 0·75 (95% CI 0·54–0·88) and 0·87 (95% CI 0·78–0·93), respectively, and if only a single positive sample was required, these values were 0·88 (95% CI 0·75–0·94) and 0·75 (95% CI 0·63–0·84), respectively. Whereas specificity based on a single positive test was significantly lower (p=0·027) than two positive tests, the sensitivity and DOR did not differ significantly. A single PCR-negative result is thus sufficient to exclude a diagnosis of proven or probable invasive aspergillosis. However, two positive tests are required to confirm the diagnosis because the specificity is higher than that attained from a single positive test. Populations at risk varied and there was a lack of homogeneity of the PCR methods used. Efforts are underway to devise a standard for Aspergillus sp PCR for screening, which will help enable formal validation of PCR and estimate its use in patients most likely to benefit.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Human and livestock diseases can be difficult to control where infection persists in wildlife populations. For three decades, European badgers (Meles meles) have been culled by the British government ...in a series of attempts to limit the spread of Mycobacterium bovis, the causative agent of bovine tuberculosis (TB), to cattle. Despite these efforts, the incidence of TB in cattle has risen consistently, re-emerging as a primary concern for Britain's cattle industry. Recently, badger culling has attracted controversy because experimental studies have reached contrasting conclusions (albeit using different protocols), with culled areas showing either markedly reduced or increased incidence of TB in cattle. This has confused attempts to develop a science-based management policy. Here we use data from a large-scale, randomized field experiment to help resolve these apparent differences. We show that, as carried out in this experiment, culling reduces cattle TB incidence in the areas that are culled, but increases incidence in adjoining areas. These findings are biologically consistent with previous studies but will present challenges for policy development.
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DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
3.
A haplotype map of the human genome Gibbs, Richard A; Belmont, John W; Boudreau, Andrew ...
Nature,
10/2005, Volume:
437, Issue:
7063
Journal Article
Peer reviewed
Open access
Inherited genetic variation has a critical but as yet largely uncharacterized role in human disease. Here we report a public database of common variation in the human genome: more than one million ...single nucleotide polymorphisms (SNPs) for which accurate and complete genotypes have been obtained in 269 DNA samples from four populations, including ten 500-kilobase regions in which essentially all information about common DNA variation has been extracted. These data document the generality of recombination hotspots, a block-like structure of linkage disequilibrium and low haplotype diversity, leading to substantial correlations of SNPs with many of their neighbours. We show how the HapMap resource can guide the design and analysis of genetic association studies, shed light on structural variation and recombination, and identify loci that may have been subject to natural selection during human evolution.
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Abstract Background The prevalence of sexual assault and harassment at universities is unclear because of under-reporting. Furthermore, student perceptions of vulnerability to sexual assault and how ...these relate to alcohol consumption are unknown. The present study assesses the prevalence of sexual assault and harassment in a student sample, and how this relates to issues of vulnerability and alcohol use. Methods Participants were recruited via a weekly email of notices that is sent to all students attending a town-based Scottish university of about 7200 students. The study was approved by the university ethics committee, and all participants gave informed consent before participating. The online survey was available in November, 2013, and included validated scales examining personal experience of sexual harassment and assault, perception of own and peers' vulnerability to sexual assault, and the Alcohol Use Disorder Identification Test (AUDIT). Data were analysed with χ2 and t tests. Findings The survey was completed by 135 female and 40 male students, aged 17–56 years (mean 21·9, SD 5·4), 84 (48%) of whom were in their first year of study. There was no significant difference in the proportion of male students (22·5%) and female students (37·0%) who reported having experienced some form of sexual harassment or assault at the university. Participants perceived themselves as significantly less vulnerable than same-sex peers ( t (df 160)=6·10, 95% CI −1·09 to −0·55; p<0·0001) and judged peers to significantly underestimate their own vulnerability ( t (df 159)=4·86, 0·40 to 0·95; p<0·0001). Controlling for sex, AUDIT did not predict judgments of own vulnerability (β=0·02, 95% CI −0·03 to 0·06, p=0·49), but hazardous drinkers were more likely to report experiences of sexual harassment than non-hazardous drinkers (χ2 (df 2)=20·98, p<0·0001). Interpretation Prevalence rates for experiencing sexual harassment or assault were high, and participants underestimated their own vulnerability compared with peers. Although hazardous drinkers were more likely to report experiencing sexual harassment or assault than non-hazardous drinkers, this finding was not shown in their judged vulnerability, again suggesting a misperception. The role of alcohol and vulnerability misperceptions should be considered in future interventions. The study was limited by oversampling female first-year students, thereby producing a non-representative sample. Funding None.
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Abstract Background Interpersonal violence among young men is a major public health problem in Scotland, UK. Treatment for violent injury might represent a teachable moment to provide a brief ...intervention for reducing violence. To inform development of such an intervention, a review was undertaken to examine existing models of brief intervention, and to assess evidence of their effect. Methods We searched three databases (Web of Knowledge, PubMed, and PsycINFO) for articles published in English before March 11, 2013, using the following criteria: violence (Violen* OR Agress* OR Assault* OR Homicide OR Murder OR GBH OR Grievous Bodily Harm OR ABH OR Actual Bodily Harm), intervention (Interven* OR Program* OR Initiative), intervention length (Brief OR Rapid OR Short), and sex of participants (Male* OR man OR boy* OR men). After removal of duplicates, 553 articles were retrieved. Titles and abstracts were independently appraised with prespecified inclusion and exclusion criteria by three authors resulting in 50 full texts. Articles were most commonly excluded for describing interventions that were group-based or part of a long-term programme. Full texts were reviewed by the first author, identifying eight distinct brief interventions for reducing violence. Findings The key findings of the review included: the use of brief motivational interviewing for engaging with at-risk participants; the value of social norms approaches for correcting peer norm misperceptions; the benefit of working with victims of violence in medical settings (particularly oral and maxillofacial surgeries); the importance of addressing alcohol in violent encounters; the advantages of computer-therapist hybrid models of delivery; and the need for adequate follow-up evaluation as part of a randomised controlled trial. Interpretation The review was a valuable exercise in assessing the existence of brief interventions for reducing violence and summarising their key characteristics. It was, however, constrained by the potentially overly restrictive search criteria, which limited the number of included interventions and follow-up data for some interventions, thereby preventing assessment of effectiveness. Nonetheless, brief interventions are potentially useful in the prevention of interpersonal violence among young men. The findings of the review will inform the development of a brief intervention for reducing violence with young men in Scotland who have sustained injuries through interpersonal violence. Funding Violence Reduction Unit (Police Scotland).
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