Inflammatory bowel disease (IBD) is considered to result from interplay between host and intestinal microbiota. While IBD in adults has shown to be associated with marked changes in the intestinal ...microbiota, there are only a few studies in children, and particularly studies focusing on therapeutic responses are lacking. Hence, this prospective study addressed the intestinal microbiota in pediatric IBD especially related to the level of inflammation.
In total, 68 pediatric patients with IBD and 26 controls provided stool and blood samples in a tertiary care hospital and 32 received anti-tumor necrosis factor-α (anti-TNF-α). Blood inflammatory markers and fecal calprotectin levels were determined. The intestinal microbiota was characterized by phylogenetic microarray and qPCR analysis.
The microbiota varied along a gradient of increasing intestinal inflammation (indicated by calprotectin levels), which was associated with reduced microbial richness, abundance of butyrate producers, and relative abundance of Gram-positive bacteria (especially Clostridium clusters IV and XIVa). A significant association between microbiota composition and inflammation was indicated by a set of bacterial groups predicting the calprotectin levels (area under curve (AUC) of 0.85). During the induction of anti-TNF-α, the microbial diversity and similarity to the microbiota of controls increased in the responder group by week 6, but not in the non-responders (P<0.01; response related to calprotectin levels). The abundance of six groups of bacteria including those related to Eubacterium rectale and Bifidobacterium spp. predicted the response to anti-TNF-α medication.
Intestinal microbiota represents a potential biomarker for correlating the level of inflammation and therapeutic responses to be further validated.
This work establishes structure-property relationships in Ru-based catalytic systems for selective hydrodeoxygenation of ketones to alkenes by combining extensive catalytic testing,
in situ
X-ray ...absorption spectroscopy (XAS) under high pressures and temperatures and
ex situ
XAS structural characterization supported by density functional theory (DFT) calculations. Catalytic tests revealed the difference in hydrogenation selectivity for ketones (exemplified by acetone) or alkenes (exemplified by propene) upon changing the reaction conditions, more specifically in the presence of CO during a pretreatment step. XAS data demonstrated the evolution of the local ruthenium structure with different amounts of Cl/Br and CO ligands. In addition, in the absence of CO, the catalyst was reduced to Ru
0
, and this was associated with a significant decrease of the selectivity for ketone hydrogenation. For the Ru-bromide carbonyl complex, selectivity towards acetone hydrogenation over propene hydrogenation was explained on the basis of different relative energies of the first intermediate states of each reaction. These results give a complete understanding of the evolution of the Ru species, used for the catalytic valorization of biobased polyols to olefins in ionic liquids, identifying the undesired deactivation routes as well as possibilities for reactivation.
This work establishes structure-property relationships in Ru-based catalytic systems for the selective hydrodeoxygenation of ketones to alkenes.
Objective
To investigate whether exposure to hyperemesis gravidarum (HG) is associated with increased maternal long‐term mortality.
Design
Population‐based cohort study.
Setting
Medical Birth ...Registry of Norway (1967–2002) linked to the Cause of Death Registry.
Population
Women in Norway with singleton births in the period 1967–2002, with and without HG. Women were followed until 2009 or death.
Methods
Cox proportional hazard regression model was applied to estimate hazard ratios (HRs) with 95% confidence interval (CI).
Main outcome measures
The primary outcome was all‐cause mortality during follow up. Secondary outcomes were cause‐specific mortality (cardiovascular mortality, deaths due to cancer, external causes or mental and behavioural disorders).
Results
Of 999 161 women with singleton births, 13 397 (1.3%) experienced HG. During a median follow up of 26 years (25 902 036 person‐years), 43 470 women died (4.4%). Women exposed to HG had a lower risk of long‐term all‐cause mortality compared with women without HG (crude HR 0.82; 95% CI 0.75–0.90). When adjusting for confounders, this reduction was no longer significant (adjusted HR 0.92; 95% CI 0.84–1.01). Women exposed to HG had a similar risk of cardiovascular death as women not exposed (adjusted HR 1.04; 95% CI 0.83–1.29), but a lower long‐term risk of death from cancer (adjusted HR 0.86; 95% CI 0.75–0.98).
Conclusion
In this large population‐based cohort study, HG was not associated with an increased risk of long‐term all‐cause mortality. Women exposed to HG had no increase in mortality due to cardiovascular disease, but had a reduced risk of death from cancer.
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Population‐based cohort study: Hyperemesis was not associated with an increased risk of long‐term mortality.
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Population‐based cohort study: Hyperemesis was not associated with an increased risk of long‐term mortality.
A novel approach for the analysis of extended X-ray absorption fine structure (EXAFS) spectra is developed exploiting an inverse machine learning-based algorithm. Through this approach, it is ...possible to explore and account for, in a precise way, the nonlinear geometry dependence of the photoelectron backscattering phases and amplitudes of single and multiple scattering paths. In addition, the determined parameters are directly related to the 3D atomic structure, without the need to use complex parametrization as in the classical fitting approach. The applicability of the approach, its potential and the advantages over the classical fit were demonstrated by fitting the EXAFS data of two molecular systems, namely, the KAu (CN)2 and the RuCl2(CO)32 complexes.
A new method has been developed for generating highly dispersed base sites on metal–organic framework (MOF) lattices. The base catalytic activity of two alkaline earth MOFs, M
2
(BTC)(NO
3
)(DMF) (M ...= Ba or Sr, H
3
BTC = 1,3,5-benzenetricarboxylic acid, DMF =
N
,
N
-dimethylformamide) was studied as a function of their activation procedures. The catalytic activity in Knoevenagel condensation and Michael addition reactions was found to increase strongly with activation temperature. Physicochemical characterization using FTIR,
13
C CP MAS NMR, PXRD, XPS, TGA-MS, SEM, EPR, N
2
physisorption and nitrate content analysis shows that during activation, up to 85% of the nitrate anions are selectively removed from the structure and replaced with other charge compensating anions such as O
2−
. The defect sites generated
via
this activation act as new strong basic sites within the catalyst structure. A fluorescence microscopic visualization of the activity convincingly proves that it is exclusively associated with the hexagonal crystals, and that reaction proceeds inside the crystal's interior. Theoretical analysis of the Ba-material shows that the basicity of the proposed Ba
2+
–O
2−
–Ba
2+
motifs is close to that of the edge sites in BaO.
Abstract Breast cancer is the most common malignancy amongst women in the developed world. For patients with hormone-sensitive breast cancer eligible for adjuvant hormonal therapy, it is important to ...know if the ovaries are (still) functional or not. Indeed, the choice for a specific adjuvant hormonal treatment depends on the menopausal status of an individual woman. The currently available measures to determine the menopausal status are conflicting. Until better measures become available, we propose a practical guideline enabling an optimal choice of adjuvant hormonal therapy for women with a hormone receptor positive breast cancer taking into account uncertainties about their menopausal status.
•Incidence and mortality of HPV-related cancers is high in Caribbean countries.•In Caribbean Netherlands, HPV-seropositivity for multiple high-risk types was high.•Women had a nearly 3-fold higher ...seroprevalence than men, with antibody responses against HPV16 and 52 mostly detected.•Sex-neutral vaccination and routine cervical cancer screening should be considered.
Incidence and mortality of human papillomavirus (HPV)-related cancers differs geographically, with high rates in Caribbean countries. Seroepidemiological data provide information on lifetime cumulative HPV exposure and contributing risk factors, but has not been available yet for Caribbean Netherlands (CN), comprising the islands Bonaire, St. Eustatius and Saba. Therefore, a cross-sectional population-based serosurveillance study was performed in this (recently girls-only HPV-vaccinated) population in 2017.
Blood samples from participants (n = 1,823, 0–90 years) were tested for seven high-risk (hr)-HPV-specific IgG-antibodies using a VLP-based multiplex-immunoassay. Risk factors for HPV-seropositivity were analysed among persons unvaccinated aged ≥ 15 years who ever had sex (n = 1,080).
Among unvaccinated individuals aged ≥ 15 years, overall seropositivity was high (34%), with over half of them being seropositive for ≥ 2 hr-HPV types, and HPV16 and 52 being most prevalent (13%). Seroprevalence was substantial higher in unvaccinated women (51%) than men (18%), predominantly peaking in women aged 20–59 years, and was highest on St. Eustatius (38%). Besides age and sex, sexual risk factors were associated with HPV-seropositivity.
In accordance with the Caribbean region, seroprevalence of multiple hr-HPV types was high in CN. These data corroborate the decision regarding introduction of a sex-neutral HPV-vaccination program and the relevance for considering a population-based cervical cancer screening program.
•B. pertussis circulation in the Caribbean Netherlands is vastly underestimated•8.2% of residents aged ≥ 9 years were infected with B. pertussis in the past year•The highest frequency of recent B. ...pertussis infections was on Bonaire (8.6%)•Risk factors for infection included age 12–29 years and Dutch Caribbean origin•Seroepidemiological studies are essential for monitoring B. pertussis circulation
Pertussis is a respiratory infectious disease caused by Bordetella pertussis. In the Caribbean Netherlands (CN), comprising the islands Bonaire, St Eustatius, and Saba, registration of cases is mandatory for disease surveillance. However, insufficient laboratory facilities hamper case confirmation, and circulation persists. The aim of this seroepidemiological study was to gain insight into B. pertussis circulation in CN, and to investigate what factors contribute to the risk of infection.
Blood samples and questionnaires were collected for 1829 participants aged 0–90 years. Concentrations of B. pertussis toxin-specific IgG antibodies (anti-Pt) were determined using a bead-based immunoassay to indicate infections within the previous 12 months (based on anti-Pt ≥ 50 IU/mL) in participants without detectable vaccine-induced humoral immunity. Risk factors for recent infection were analyzed using logistic regression models.
An estimated 8.2% (95% CI 6.6–10.1) of CN residents aged ≥ 9 years were found to have been recently infected by B. pertussis. Risk factors for a recent infection were age 12–29 years (13.8–14.6%) and Dutch Caribbean or Surinamese origin (10.7%).
B. pertussis infections occur frequently among CN residents aged ≥ 9 years, although few clinical pertussis cases are reported. Transmission to vulnerable individuals seems likely and should be taken into account in optimizing vaccination programs.
Purpose
The purpose of this study was to assess in which proportion of patients with degenerative knee disease aged 50+ in whom a knee arthroscopy is performed, no valid surgical indication is ...reported in medical records, and to explore possible explanatory factors.
Methods
A retrospective study was conducted using administrative data from January to December 2016 in 13 orthopedic centers in the Netherlands. Medical records were selected from a random sample of 538 patients aged 50+ with degenerative knee disease in whom arthroscopy was performed, and reviewed on reported indications for the performed knee arthroscopy. Valid surgical indications were predefined based on clinical national guidelines and expert opinion (e.g., truly locked knee). A knee arthroscopy without a reported valid indication was considered potentially low value care. Multivariate logistic regression analysis was performed to assess whether age, diagnosis (“Arthrosis” versus “Meniscal lesion”), and type of care trajectory (initial or follow-up) were associated with performing a potentially low value knee arthroscopy.
Results
Of 26,991 patients with degenerative knee disease, 2556 (9.5%) underwent an arthroscopy in one of the participating orthopedic centers. Of 538 patients in whom an arthroscopy was performed, 65.1% had a valid indication reported in the medical record and 34.9% without a reported valid indication. From the patients without a valid indication, a joint patient–provider decision or patient request was reported as the main reason. Neither age OR 1.013 (95% CI 0.984–1.043), diagnosis OR 0.998 (95% CI 0.886–1.124) or type of care trajectory OR 0.989 (95% CI 0.948–1.032) were significantly associated with performing a potentially low value knee arthroscopy.
Conclusions
In a random sample of knee arthroscopies performed in 13 orthopedic centers in 2016, 65% had valid indications reported in the medical records but 35% were performed without a reported valid indication and, therefore, potentially low value care. Patient and/or surgeons preference may play a large role in the decision to perform an arthroscopy without a valid indication. Therefore, interventions should be developed to increase adherence to clinical guidelines by surgeons that target invalid indications for a knee arthroscopy to improve care.
Level of evidence
IV.
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