Showing papers by "University of Crete published in 2021"
Daniel J. Klionsky1, Amal Kamal Abdel-Aziz2, Sara Abdelfatah3, Mahmoud Abdellatif4 +2980 more•Institutions (777)
TL;DR: In this article, the authors present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes.
Abstract: In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field.
1,129 citations
University of Michigan1, Cornell University2, University of Pennsylvania3, University of Massachusetts Medical School4, Baylor College of Medicine5, University of Naples Federico II6, Spanish National Research Council7, Complutense University of Madrid8, New York University9, Boston Children's Hospital10, University of Rome Tor Vergata11, NewYork–Presbyterian Hospital12, University of Pittsburgh13, French Institute of Health and Medical Research14, University of Paris15, National University of Cuyo16, Albert Einstein College of Medicine17, University of New Mexico18, Goethe University Frankfurt19, Weizmann Institute of Science20, University of Turku21, Sapienza University of Rome22, Virginia Commonwealth University23, St. Jude Children's Research Hospital24, Discovery Institute25, University of Copenhagen26, University of Tromsø27, Eötvös Loránd University28, Merck & Co.29, University of Freiburg30, Babraham Institute31, University of South Australia32, University of Adelaide33, University of Oviedo34, University of Chicago35, University of Graz36, National Institutes of Health37, City University of New York38, Queens College39, University of Tokyo40, University of Zurich41, University of British Columbia42, Austrian Academy of Sciences43, University of California, San Francisco44, Russian Academy of Sciences45, University Medical Center Groningen46, University of Cambridge47, University of Glasgow48, Rutgers University49, University of Padua50, University of Bern51, Kazan Federal University52, University of Oxford53, University of Oslo54, Oslo University Hospital55, University of Crete56, Foundation for Research & Technology – Hellas57, Francis Crick Institute58, Osaka University59, Harvard University60, Chinese Academy of Sciences61, Icahn School of Medicine at Mount Sinai62, Shanghai Jiao Tong University63, Karolinska Institutet64
TL;DR: In this paper, preclinical data linking autophagy dysfunction to the pathogenesis of major human disorders including cancer as well as cardiovascular, neurodegenerative, metabolic, pulmonary, renal, infectious, musculoskeletal, and ocular disorders.
Abstract: Autophagy is a core molecular pathway for the preservation of cellular and organismal homeostasis. Pharmacological and genetic interventions impairing autophagy responses promote or aggravate disease in a plethora of experimental models. Consistently, mutations in autophagy-related processes cause severe human pathologies. Here, we review and discuss preclinical data linking autophagy dysfunction to the pathogenesis of major human disorders including cancer as well as cardiovascular, neurodegenerative, metabolic, pulmonary, renal, infectious, musculoskeletal, and ocular disorders.
365 citations
Akershus University Hospital1, University College London2, Discovery Institute3, Northwestern University4, University of Oxford5, National and Kapodistrian University of Athens6, University of Oslo7, Oslo University Hospital8, University of Tromsø9, University of Crete10, Foundation for Research & Technology – Hellas11, University of Cambridge12, Max Planck Society13
TL;DR: A recent review as discussed by the authors examines several emerging features of autophagy and postulates how they may be linked to aging as well as to the development and progression of disease, and discusses current preclinical evidence arguing for the use of auto-ophagy modulators as suppressors of age-related pathologies such as neurodegenerative diseases.
Abstract: Autophagy is a fundamental cellular process that eliminates molecules and subcellular elements, including nucleic acids, proteins, lipids and organelles, via lysosome-mediated degradation to promote homeostasis, differentiation, development and survival. While autophagy is intimately linked to health, the intricate relationship among autophagy, aging and disease remains unclear. This Review examines several emerging features of autophagy and postulates how they may be linked to aging as well as to the development and progression of disease. In addition, we discuss current preclinical evidence arguing for the use of autophagy modulators as suppressors of age-related pathologies such as neurodegenerative diseases. Finally, we highlight key questions and propose novel research avenues that will likely reveal new links between autophagy and the hallmarks of aging. Understanding the precise interplay between autophagy and the risk of age-related pathologies across organisms will eventually facilitate the development of clinical applications that promote long-term health. This Review synthesizes recent research on the mechanisms and roles of autophagy in health, aging and disease and discusses how drugs that modulate the process of autophagy could be used to suppress age-associated diseases.
255 citations
University of Cincinnati1, Sorbonne2, University of Göttingen3, University of Manchester4, Katholieke Universiteit Leuven5, University of Siena6, Albany Medical College7, University of Paris8, Utrecht University9, Maastricht University10, Cleveland Clinic11, University of Duisburg-Essen12, University of Crete13, University of Freiburg14, University of Bern15, Cochrane Collaboration16
TL;DR: The European Respiratory Society Task Force (TF) as discussed by the authors developed recommendations based on the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology.
Abstract: Background The major reasons to treat sarcoidosis are to lower the morbidity and mortality risk or to improve quality of life (QoL). The indication for treatment varies depending on which manifestation is the cause of symptoms: lungs, heart, brain, skin, or other manifestations. While glucocorticoids (GC) remain the first choice for initial treatment of symptomatic disease, prolonged use is associated with significant toxicity. GC-sparing alternatives are available. The presented treatment guideline aims to provide guidance to physicians treating the very heterogenous sarcoidosis manifestations. Materials and Methods A European Respiratory Society Task Force (TF) committee composed of clinicians, methodologists, and patients with experience in sarcoidosis developed recommendations based on the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology. The committee developed eight PICO (Patients, Intervention, Comparison, Outcomes) questions and these were used to make specific evidence-based recommendations. Results The TF committee delivered twelve recommendations for seven PICOs. These included treatment of pulmonary, cutaneous, cardiac, and neurologic disease as well as fatigue. One PICO question regarding small fiber neuropathy had insufficient evidence to support a recommendation. In addition to the recommendations, the committee provided information on how they use alternative treatments, when there was insufficient evidence to support a recommendation. Conclusions There are many treatments available to treat sarcoidosis. Given the diverse nature of the disease, treatment decisions require an assessment of organ involvement, risk for significant morbidity, and impact on QoL of the disease and treatment. Message An evidence based guideline for treatment of sarcoidosis is presented. The panel used the GRADE approach and specific recommendations are made. A major factor in treating patients is the risk of loss of organ function or impairment of quality of life.
199 citations
Ghent University1, Sun Yat-sen University2, Stockholm University3, Eastern Virginia Medical School4, University of Greifswald5, University of Pittsburgh6, University of Copenhagen7, University of Barcelona8, University of Crete9, Sapienza University of Rome10, Guy's and St Thomas' NHS Foundation Trust11, Katholieke Universiteit Leuven12
TL;DR: EUFOREA, the European Forum for Research and Education in Allergy and Airway Diseases, here proposes structured definitions to enable communication between clinicians and provides a practical algorithm to define type 2 inflammation in CRSwNP in daily clinic.
Abstract: Uncontrolled severe chronic rhinosinusitis with nasal polyps (CRSwNP) is the most bothersome phenotype of chronic rhinosinusitis; it is typically characterized by a type 2 inflammatory reaction and by comorbidities, including asthma, nonsteroidal anti-inflammatory drug–exacerbated respiratory disease, and allergies. Here, the European Forum for Research and Education in Allergy and Airway Diseases proposes structured definitions to enable communication between clinicians and provides a practical algorithm to define type 2 inflammation in CRSwNP in daily clinical practice. A rational approach for the treatment of uncontrolled severe CRSwNP is discussed; it consists of evaluating the perspective and risks of surgery and efficacy and adverse events of biologics on the basis of currently available data. Further, possible combinations of surgery and biologics are discussed, and a rationale is provided. Here, it is of importance to adequately counsel the patient about both approaches to enable a decision-making process with an informed patient. Criteria for the selection of a biologic drug are provided, as several biologics for uncontrolled severe CRSwNP will be available in many countries within a short time. Further, suggestions for monitoring of the drug effects that support recognition of responders to the therapy and, subsequently, the decision regarding continuation or discontinuation of the biologic are proposed.
152 citations
University of Dundee1, China-Japan Friendship Hospital2, Université Paris-Saclay3, Technion – Israel Institute of Technology4, University of Crete5, Copenhagen University Hospital6, Katholieke Universiteit Leuven7, Ruijin Hospital8, Shanghai Jiao Tong University9, University Hospital of Basel10, University of Leicester11, Hochschule Hannover12, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico13, University of Bern14, University of Paris15
TL;DR: In this paper, a task force from the European Respiratory Society and endorsed by the Chinese Thoracic Society identified priority interventions for the initial version of this "living guideline" using PICO (population, intervention, comparator, outcome) format.
Abstract: INTRODUCTION: Hospitalised patients with coronavirus disease 2019 (COVID-19) as a result of SARS-CoV-2 infection have a high mortality rate and frequently require noninvasive respiratory support or invasive ventilation. Optimising and standardising management through evidence-based guidelines may improve quality of care and therefore patient outcomes. METHODS: A task force from the European Respiratory Society and endorsed by the Chinese Thoracic Society identified priority interventions (pharmacological and non-pharmacological) for the initial version of this "living guideline" using the PICO (population, intervention, comparator, outcome) format. The GRADE approach was used for assessing the quality of evidence and strength of recommendations. Systematic literature reviews were performed, and data pooled by meta-analysis where possible. Evidence tables were presented and evidence to decision frameworks were used to formulate recommendations. RESULTS: Based on the available evidence at the time of guideline development (20 February, 2021), the panel makes a strong recommendation in favour of the use of systemic corticosteroids in patients requiring supplementary oxygen or ventilatory support, and for the use of anticoagulation in hospitalised patients. The panel makes a conditional recommendation for interleukin (IL)-6 receptor antagonist monoclonal antibody treatment and high-flow nasal oxygen or continuous positive airway pressure in patients with hypoxaemic respiratory failure. The panel make strong recommendations against the use of hydroxychloroquine and lopinavir-ritonavir. Conditional recommendations are made against the use of azithromycin, hydroxychloroquine combined with azithromycin, colchicine, and remdesivir, in the latter case specifically in patients requiring invasive mechanical ventilation. No recommendation was made for remdesivir in patients requiring supplemental oxygen. Further recommendations for research are made. CONCLUSION: The evidence base for management of COVID-19 now supports strong recommendations in favour and against specific interventions. These guidelines will be regularly updated as further evidence becomes available.
147 citations
TL;DR: In this article, the loss in a topological defect potential in a non-Hermitian photonic lattice can be tuned solely by nonlinearity, enabling the transition between parity-time symmetry and non-PT symmetry regimes and the maneuvering of topological zero modes.
Abstract: Topology, parity-time (PT) symmetry, and nonlinearity are at the origin of many fundamental phenomena in complex systems across the natural sciences, but their mutual interplay remains unexplored. We established a nonlinear non-Hermitian topological platform for active tuning of PT symmetry and topological states. We found that the loss in a topological defect potential in a non-Hermitian photonic lattice can be tuned solely by nonlinearity, enabling the transition between PT-symmetric and non-PT-symmetric regimes and the maneuvering of topological zero modes. The interaction between two apparently antagonistic effects is revealed: the sensitivity close to exceptional points and the robustness of non-Hermitian topological states. Our scheme using single-channel control of global PT symmetry and topology via local nonlinearity may provide opportunities for unconventional light manipulation and device applications.
113 citations
IMDEA1, International University of Sarajevo2, University of Novi Sad3, Nicolaus Copernicus University in Toruń4, Saints Cyril and Methodius University of Skopje5, University of Tartu6, Université Paris-Saclay7, Silesian University of Technology8, Sarajevo School of Science and Technology9, University of Innsbruck10, South-West University "Neofit Rilski"11, University of Turku12, University of Porto13, University of Crete14, University of Bergen15, University of Ljubljana16, University College Cork17, Carlos III Health Institute18, University of Málaga19
TL;DR: In this paper, a review of the state-of-the-art ML methods and respective software applied in human microbiome studies, performed as part of the COST Action ML4Microbiome activities, is presented.
Abstract: The number of microbiome-related studies has notably increased the availability of data on human microbiome composition and function. These studies provide the essential material to deeply explore host-microbiome associations and their relation to the development and progression of various complex diseases. Improved data-analytical tools are needed to exploit all information from these biological datasets, taking into account the peculiarities of microbiome data, i.e., compositional, heterogeneous and sparse nature of these datasets. The possibility of predicting host-phenotypes based on taxonomy-informed feature selection to establish an association between microbiome and predict disease states is beneficial for personalized medicine. In this regard, machine learning (ML) provides new insights into the development of models that can be used to predict outputs, such as classification and prediction in microbiology, infer host phenotypes to predict diseases and use microbial communities to stratify patients by their characterization of state-specific microbial signatures. Here we review the state-of-the-art ML methods and respective software applied in human microbiome studies, performed as part of the COST Action ML4Microbiome activities. This scoping review focuses on the application of ML in microbiome studies related to association and clinical use for diagnostics, prognostics, and therapeutics. Although the data presented here is more related to the bacterial community, many algorithms could be applied in general, regardless of the feature type. This literature and software review covering this broad topic is aligned with the scoping review methodology. The manual identification of data sources has been complemented with: (1) automated publication search through digital libraries of the three major publishers using natural language processing (NLP) Toolkit, and (2) an automated identification of relevant software repositories on GitHub and ranking of the related research papers relying on learning to rank approach.
105 citations
Max Planck Society1, University of Luxembourg2, Braunschweig University of Technology3, Goethe University Frankfurt4, London School of Economics and Political Science5, University of Trento6, University of London7, University of Alabama at Birmingham8, Minerva Foundation Institute for Medical Research9, Medical University of Vienna10, Ludwig Maximilian University of Munich11, University of Maribor12, University of Crete13, University of Vienna14, University of Warsaw15
98 citations
TL;DR: In this article, a review of the diagnostic strategies available for the diagnosis of COVID-19 infection in both clinical and research settings is presented, in which the technical and instrumental characteristics of diagnostic methods used are described.
Abstract: The Coronavirus Disease 2019 (COVID19) pandemic has forced the scientific community to rapidly develop highly reliable diagnostic methods in order to effectively and accurately diagnose this pathology, thus limiting the spread of infection. Although the structural and molecular characteristics of the severe acute respiratory syndrome coronavirus 2 (SARSCoV2) were initially unknown, various diagnostic strategies useful for making a correct diagnosis of COVID19 have been rapidly developed by private research laboratories and biomedical companies. At present, rapid antigen or antibody tests, immunoenzymatic serological tests and molecular tests based on RTPCR are the most widely used and validated techniques worldwide. Apart from these conventional methods, other techniques, including isothermal nucleic acid amplification techniques, clusters of regularly interspaced short palindromic repeats/Cas (CRISPR/Cas)based approaches or digital PCR methods are currently used in research contexts or are awaiting approval for diagnostic use by competent authorities. In order to provide guidance for the correct use of COVID19 diagnostic tests, the present review describes the diagnostic strategies available which may be used for the diagnosis of COVID19 infection in both clinical and research settings. In particular, the technical and instrumental characteristics of the diagnostic methods used are described herein. In addition, updated and detailed information about the type of sample, the modality and the timing of use of specific tests are also discussed.
96 citations
TL;DR: In this paper, the authors examined the role of beliefs in predicting intentions to be vaccinated against COVID-19, when a vaccine becomes available, and highlighted interaction effects among the HBM components and how critical events may moderate belief effects.
Abstract: With the COVID-19 pandemic recognized as a major threat to human health is of paramount importance to improve the vaccination uptake of the future COVID-19 vaccine. The study extended the health belief model (HBM) using insights from trait theory and events systems theory, to examine the role of beliefs in predicting intentions to be vaccinated against COVID-19, when a vaccine becomes available. Employees from Greece (N = 1006) participated from October 1 to November 5, 2020, in an anonymous online factorial survey experiment. Measures of dispositional optimism, faith in intuition, risk-taking propensity, and acquiring resources mindset were included as individual difference variables. Multilevel modeling techniques were used for data analyses. Components of HBM had significant effects on intentions to vaccinate. Two-way interactions between severity and susceptibility beliefs and three-way interaction among perceived severity, susceptibility, and perceived benefits were detected. In line with the events systems theory, a critical event moderated beliefs' effects on intention to vaccinate. Acquiring resources mindset emerged as important individual difference that positively related to intentions. The model explained 59 per cent of the variance in vaccination intentions. The study highlighted interaction effects among the HBM components and how critical events may moderate belief effects.
TL;DR: In this article, the authors investigated the impact of mass-transfer physics on the observable properties of binary black hole populations that formed through isolated binary evolution and found that low common envelope efficiency translates to tighter orbits following the common envelope and therefore more tidally spun up second-born black holes.
Abstract: We study the impact of mass-transfer physics on the observable properties of binary black hole populations that formed through isolated binary evolution We used the POSYDON framework to combine detailed MESA binary simulations with the COSMIC population synthesis tool to obtain an accurate estimate of merging binary black hole observables with a specific focus on the spins of the black holes We investigate the impact of mass-accretion efficiency onto compact objects and common-envelope efficiency on the observed distributions of the effective inspiral spin parameter χ eff , chirp mass M chirp , and binary mass ratio q We find that low common envelope efficiency translates to tighter orbits following the common envelope and therefore more tidally spun up second-born black holes However, these systems have short merger timescales and are only marginally detectable by current gravitational-wave detectors as they form and merge at high redshifts (z ∼ 2), outside current detector horizons Assuming Eddington-limited accretion efficiency and that the first-born black hole is formed with a negligible spin, we find that all non-zero χ eff systems in the detectable population can come only from the common envelope channel as the stable mass-transfer channel cannot shrink the orbits enough for efficient tidal spin-up to take place We find that the local rate density (z ≃ 001) for the common envelope channel is in the range of ∼17–113 Gpc−3 yr−1 , considering a range of α CE ∈ [02, 50], while for the stable mass transfer channel the rate density is ∼25 Gpc−3 yr−1 The latter drops by two orders of magnitude if the mass accretion onto the black hole is not Eddington limited because conservative mass transfer does not shrink the orbit as efficiently as non-conservative mass transfer does Finally, using GWTC-2 events, we constrained the lower bound of branching fraction from other formation channels in the detected population to be ∼02 Assuming all remaining events to be formed through either stable mass transfer or common envelope channels, we find moderate to strong evidence in favour of models with inefficient common envelopes
TL;DR: In this paper, a review of the assessment reports of the European Medicine Agency (EMA) concerning the safety of the 3 vaccines currently used in the EU (Pfizer, Moderna and Astra-Zeneca) is presented.
Abstract: The COVID-19 pandemic has had an unprecedented and devastating impact on public health, society and economics around the world. As a result, the development of vaccines to protect individuals from symptomatic COVID-19 infections has represented the only feasible health tool to combat the spread of the disease. However, at the same time the development and regulatory assessment of different vaccines has challenged pharmaceutical industries and regulatory agencies as this process has occurred in the shorter time ever though. So far, two mRNA and two adenovirus-vectored vaccines have received a conditional marketing authorisation in the EU and other countries. This review summarized and discusses the assessment reports of the European Medicine Agency (EMA) concerning the safety of the 3 vaccines currently used in the EU (Pfizer, Moderna and Astra-Zeneca). A particular focus has been paid to safety information from pre-clinical (animal) and clinical (phase 3 trials) studies. Overall, the most frequent adverse effects reported after the administration of these vaccines consisted of local reactions at the injection site (sore arm and erythema) followed by non-specific systemic effects (myalgia, chills, fatigue, headache, and fever), which occurred soon after vaccination and resolved shortly. Rare cases of vaccine-induced immune thrombotic thrombocytopenia have been reported for Vaxzevria. Data on long-term studies, interaction with other vaccines, use in pregnancy/breast-feeding, use in immunocompromised subjects, and in subjects with comorbidities, autoimmune or inflammatory disorders are still missing for these vaccines. Therefore, careful follow-up and surveillance studies for continued vaccine safety monitoring will be needed to ascertain the potential risks of such adverse events or diseases. In conclusion, the benefits and risks of current COVID-19 vaccines must be weighed against the real possibility of contract the disease and develop complications and long-term sequels; all this on the basis of the available scientific evidence and in the absence of unmotivated biases.
Maria Lc Iurilli1, Bin Zhou1, James E. Bennett1, Rodrigo M. Carrillo-Larco1 +1399 more•Institutions (374)
TL;DR: In this article, the authors investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants.
Abstract: From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.
TL;DR: In this article, the effects of increased alcohol consumption and the most important consequences on the health of the population during the social isolation and lockdown during current COVID-19 pandemic were discussed.
Abstract: Alcohol consumption is associated with multiple diseases and might contribute to vulnerability to SARS-CoV-2 infection. It can also catalyze exacerbations of mental and organic illnesses and predispose to behaviors with an increased risk of infection, severity of disease but also independently of sociopathic behavior and violence. Globally, millions of premature deaths from excessive alcohol consumption occur each year. This paper discusses the effects of increased alcohol consumption and the most important consequences on the health of the population during the social isolation and lockdown during current COVID-19 pandemic.
Maastricht University1, Radboud University Nijmegen2, VU University Amsterdam3, Erasmus University Medical Center4, University of New South Wales5, University of Amsterdam6, University of the West Indies7, University of Copenhagen8, University of Gothenburg9, Universidade Federal de Santa Catarina10, University of Western Australia11, University of Crete12, The Chinese University of Hong Kong13, University of the Faroe Islands14, University of Porto15
TL;DR: A systematic review and meta-analysis found an age-standardized prevalence of YOD of 119.0 per 100,000 population in the age range of 30 to 64 years, corresponding to 3.9 million people aged 30-64 years living with YOD in the world.
Abstract: Importance: Reliable prevalence estimates are lacking for young-onset dementia (YOD), in which symptoms of dementia start before the age of 65 years. Such estimates are needed for policy makers to organize appropriate health care. Objective: To determine the global prevalence of YOD. Data Sources: The PubMed, Embase, CINAHL, and PsycInfo databases were systematically searched for population-based studies on the prevalence of YOD published between January 1, 1990, and March 31, 2020. Study Selection: Studies containing data on the prevalence of dementia in individuals younger than 65 years were screened by 2 researchers for inclusion in a systematic review and meta-analysis. Data Extraction and Synthesis: Prevalence estimates on 5-year age bands, from 30 to 34 years to 60 to 64 years, were extracted. Random-effects meta-analyses were conducted to pool prevalence estimates. Results were age standardized for the World Standard Population. Heterogeneity was assessed by subgroup analyses for sex, dementia subtype, study design, and economic status based on the World Bank classification and by meta-regression. Main Outcomes and Measures: Prevalence estimates of YOD for 5-year age bands. Results: A total of 95 unique studies were included in this systematic review, of which 74 with 2 760 379 unique patients were also included in 5-year age band meta-analyses. Studies were mostly conducted in Europe and in older groups in Asia, North America, and Oceania. Age-standardized prevalence estimates increased from 1.1 per 100â¯000 population in the group aged 30 to 34 years to 77.4 per 100â¯000 population in the group aged 60 to 64 years. This gives an overall global age-standardized prevalence of 119.0 per 100â¯000 population in the age range of 30 to 64 years, corresponding to 3.9 million people aged 30 to 64 years living with YOD in the world. Subgroup analyses showed prevalence between men and women to be similar (crude estimates for men, 216.5 per 100 000 population; for women, 293.1 per 100 000 population), whereas prevalence was lower in high-income countries (crude estimate, 663.9 per 100 000 population) compared with upper-middle-income (crude estimate, 1873.6 per 100 000 population) and lower-middle-income (crude estimate, 764.2 per 100 000 population) countries. Meta-regression showed that age range (P < .001), sample size (P < .001), and study methodology (P = .02) significantly influenced heterogeneity between studies. Conclusions and Relevance: This systematic review and meta-analysis found an age-standardized prevalence of YOD of 119.0 per 100â¯000 population, although estimates of the prevalence in low-income countries and younger age ranges remain scarce. These results should help policy makers organize sufficient health care for this subgroup of individuals with dementia. Study Registration: PROSPERO CRD42019119288.
TL;DR: In this article, the authors present the direct and indirect psychological impact of COVID-19 on the general public, as well as on vulnerable groups, including the elderly, the young, healthcare professionals, people with pre-existing mental health issues, those infected by the virus, homeless people and refugees.
Abstract: As one year is approaching since the beginning of the Coronavirus disease 2019 (COVID-19) pandemic, it is important to acknowledge the detrimental effect that it is having on mental health at the individual, societal and public health levels. The current review presents the direct and indirect psychological impact of COVID-19 on the general public, as well as on vulnerable groups, including the elderly, the young, healthcare professionals, people with pre-existing mental health issues, those infected by COVID-19, homeless people and refugees. Important findings are discussed in the present review, including the social stigma in older people associated with portraying COVID-19 as the disease of the elderly, and the limited psychological impact of COVID-19 in the severely mentally ill, alongside the response of the mental healthcare systems globally to this unparalleled public health crisis. The important lessons to be learnt so far can help formulate individual mental health recommendations, as well as improved intervention and prevention public health strategies.
TL;DR: In the United Kingdom, between 1998 and 2018, 101,891 people were admitted to hospital for anaphylaxis and 30,700 (30.1%) were coded as due to a food trigger.
Abstract: Objective To describe time trends for hospital admissions due to food anaphylaxis in the United Kingdom over the past 20 years. Design Analysis of national data, 1998-2018. Setting Data relating to hospital admissions for anaphylaxis and deaths, and prescription data for adrenaline autoinjector devices. Participants UK population as a whole and devolved nations (England, Scotland, Wales, and Northern Ireland). Main outcome measures Time trends, age, and sex distributions for hospital admissions for anaphylaxis due to food and non-food triggers, and how these admission rates compare with the case fatality rate (number of fatalities as a proportion of hospital admissions). Results Between 1998 and 2018, 101 891 people were admitted to hospital for anaphylaxis. Of these admissions, 30 700 (30.1%) were coded as due to a food trigger. Food anaphylaxis admissions increased from 1.23 to 4.04 per 100 000 population per year (from 1998 to 2018), an annual increase of 5.7% (95% confidence interval 5.5% to 5.9%, P Conclusions Hospital admissions for food induced anaphylaxis have increased from 1998 to 2018, however the case fatality rate has decreased. In school aged children, cow’s milk is now the most common single cause of fatal anaphylaxis.
TL;DR: Although the absence of a beneficial treatment effect suggests that sildenafil is not an appropriate treatment in the overall population, further research is required to establish if specific subgroups of patients with IPF might benefit from sildanafil.
Laboratory of Molecular Biology1, University of the West2, University of Patras3, University of Thessaly4, Aristotle University of Thessaloniki5, Georgia Institute of Technology6, University of Paris7, King's College London8, University of Catania9, University of Utah10, I.M. Sechenov First Moscow State Medical University11, University of Konstanz12, Johns Hopkins University13, University of Aberdeen14, University of Porto15, Rovira i Virgili University16, University of Crete17
TL;DR: Recommendations for measures that will reinstate primary and community care at the forefront in managing the current public health crisis by protecting hospitals from unnecessary admissions, providing primary and secondary prevention services in relation to CO VID-19 and maintaining population health through treatment of non-COVID-19 conditions are provided.
Abstract: COVID-19 pandemic mitigation strategies are mainly based on social distancing measures and healthcare system reinforcement. However, many countries in Europe and elsewhere implemented strict, horizontal lockdowns because of extensive viral spread in the community which challenges the capacity of the healthcare systems. However, strict lockdowns have various untintended adverse social, economic and health effects, which have yet to be fully elucidated, and have not been considered in models examining the effects of various mitigation measures. Unlike commonly suggested, the dilemma is not about health vs wealth because the economic devastation of long-lasting lockdowns will definitely have adverse health effects in the population. Furthermore, they cannot provide a lasting solution in pandemic containment, potentially resulting in a vicious cycle of consecutive lockdowns with in-between breaks. Hospital preparedness has been the main strategy used by governments. However, a major characteristic of the COVID-19 pandemic is the rapid viral transmission in populations with no immunity. Thus, even the best hospital system could not cope with the demand. Primary, community and home care are the only viable strategies that could achieve the goal of pandemic mitigation. We present the case example of Greece, a country which followed a strategy focused on hospital preparedness but failed to reinforce primary and community care. This, along with strategic mistakes in epidemiological surveillance, resulted in Greece implementing a second strict, horizontal lockdown and having one of the highest COVID-19 death rates in Europe during the second wave. We provide recommendations for measures that will reinstate primary and community care at the forefront in managing the current public health crisis by protecting hospitals from unnecessary admissions, providing primary and secondary prevention services in relation to COVID-19 and maintaining population health through treatment of non-COVID-19 conditions. This, together with more selective social distancing measures (instead of horizontal lockdowns), represents the only viable and realistic long-term strategy for COVID-19 pandemic mitigation.
TL;DR: Higher non-carcinogenic and carcinogenic risks were associated with the inhalation pathway in adults and children with the exception of carcinogenic risk for children, where the ingestion route remains the most important, while As was linked with the highest risks for nearly all exposure pathways.
TL;DR: The findings indicate that quarantine measures have a significant impact on the levels of depression among both university students and their family members during the quarantine period of COVID‐19 pandemic.
Abstract: WHAT IS KNOWN ON THE SUBJECT?: Mental health is deteriorated during the quarantine period. Mental health status is affected by the quarantine even after the end of it and for an extended period. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Depression levels among nursing/midwifery students during the quarantine period are high. Depression levels among students' family members during the quarantine period are high. Those who are not satisfied with COVID-19 prevention measures and those who believe that COVID-19 and quarantine can cause problems on health, have elevated levels of depression. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Provision of mental health services during the quarantine period should be a priority for the healthcare system. Offering mental health first aid training and support can improve the mental health status of students and their family members. ABSTRACT: Introduction The use of quarantine method has a significant impact on mental health status. Aim This study aimed to assess the levels of depression among bachelor and master university students (nurses/midwives) and their family members' during the quarantine period of COVID-19 pandemic. Method A cross-sectional study was conducted in Vlora University, Albania. Patient Health Questionnaire (PHQ-9) was used. Institutional e-mails of all active students were used for their recruitment. Results In total, 863 students and 249 family members participated in the study. The mean PHQ-9 score was 6.220 (SD = 5.803) and 6.280 (SD = 5.857) for students and family members, respectively. Being unsatisfied with COVID-19 prevention measures, beliefs that COVID-19 infection and quarantine process can cause problems on their health status were the key factors for students to be screened positive for mental problems in multiple regression analysis. For parents, the last two factors were found to contribute significantly. Discussion Our findings indicate that quarantine measures have a significant impact on the levels of depression among both university students and their family members. Broader population studies are necessary to safeguard these results. Implications for Practice Provision of mental health services during the quarantine period is of paramount significance. Mental health first aid training and support could benefit both students and their parents significantly. Additionally, follow-up services after the end of quarantine are recommended.
Imperial College Healthcare1, National University of Ireland, Galway2, Ghent University3, Karolinska Institutet4, Utrecht University5, European Society of Cardiology6, University of Lausanne7, Vilnius University8, Charles University in Prague9, Al-Farabi University10, University of Sarajevo11, Shupyk National Medical Academy of Postgraduate Education12, Assiut University13, Jagiellonian University Medical College14, University of Crete15, University of Zagreb16, Kyrgyz State Medical Academy17, University Hospital Centre Zagreb18, University of Banja Luka19
TL;DR: The primary care arm of the EUROASPIRE V survey revealed that large proportions of people at high cardiovascular disease risk have unhealthy lifestyles and inadequate control of blood pressure, lipids and diabetes.
Abstract: BackgroundEuropean Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE) V in primary care was carried out by the European Society of Cardiology EURObservational ...
Max Planck Society1, University of Luxembourg2, University of Antwerp3, RWTH Aachen University4, University of Malta5, London School of Economics and Political Science6, University of Latvia7, Ludwig Maximilian University of Munich8, University of London9, Minerva Foundation Institute for Medical Research10, Medical University of Vienna11, Utrecht University12, Wrocław University of Technology13, University of Bergen14, University of Bern15, University of Minho16, University of Porto17, University of Maribor18, University of Crete19, University of Edinburgh20, University of Vienna21, Umeå University22, Dublin City University23, University of Warsaw24, National and Kapodistrian University of Athens25, Innsbruck Medical University26
TL;DR: In this article, the authors examined key aspects that are likely to influence the COVID-19 pandemic in Europe, including progress of national and global vaccination programs, emergence and spread of variants of concern (VOCs), and public responses to non-pharmaceutical interventions (NPIs).
Abstract: How will the coronavirus disease 2019 (COVID-19) pandemic develop in the coming months and years? Based on an expert survey, we examine key aspects that are likely to influence the COVID-19 pandemic in Europe. The challenges and developments will strongly depend on the progress of national and global vaccination programs, the emergence and spread of variants of concern (VOCs), and public responses to non-pharmaceutical interventions (NPIs). In the short term, many people remain unvaccinated, VOCs continue to emerge and spread, and mobility and population mixing are expected to increase. Therefore, lifting restrictions too much and too early risk another damaging wave. This challenge remains despite the reduced opportunities for transmission given vaccination progress and reduced indoor mixing in summer 2021. In autumn 2021, increased indoor activity might accelerate the spread again, whilst a necessary reintroduction of NPIs might be too slow. The incidence may strongly rise again, possibly filling intensive care units, if vaccination levels are not high enough. A moderate, adaptive level of NPIs will thus remain necessary. These epidemiological aspects combined with economic, social, and health-related consequences provide a more holistic perspective on the future of the COVID-19 pandemic.
University of Crete1, University of Padua2, University College London3, Monash University4, Johns Hopkins University5, Scientific University of the South6, University of Manchester7, Cliniques Universitaires Saint-Luc8, University of Pisa9, University of Düsseldorf10, The Feinstein Institute for Medical Research11
TL;DR: The DORIS Task Force recommended a single definition of remission in SLE, based on clinical SLEDAI = 0, evaluator’s global assessment <0.5, which is recommended for use as an aspirational treatment target in clinical care, a clear concept in education, and a key outcome in research including clinical trials and observational studies.
Abstract: Background: Remission is the stated goal for both patient and care-giver (1), but consensus on a definition of remission has been lacking. Previously, an international task force consisting of patient representatives and medical specialists published a frame-work for such a definition (2), but without making a final recommendation. Objectives: To achieve consensus around a definition of remission in SLE (DORIS). Methods: The DORIS task force met annually from 2015 to 2020 and consisted of patient representatives and specialists in rheumatology, nephrology, dermatology, and clinical immunology. Systemic literature reviews of several key topics were done and specific research questions were examined in suitably chosen datasets. The findings were discussed, reformulated as recommendations, and voted upon. Level of evidence (LoE), strength of recommendation (SoR), and agreement were determined in standard fashion. The final recommendation for the DORIS definition of remission was established by electronic vote after finalization of the minutes of the most recent task force meeting. Results: Based on data from the literature and from several SLE-specific data sets, five key recommendations were endorsed (Table 1) that should be seen as additions to those published previously (2). Literature reviews identified strong support for the face-, content-, construct- and criterion validity of the definition based on the clinical SLEDAI (not including anti-DNA and complement) equal to zero plus low physician global assessment and allowing stable medical treatment. Thus, the DORIS Task Force recommended a single definition of remission in SLE, based on clinical SLEDAI = 0, evaluator’s global assessment Conclusion: The 2021 DORIS definition of remission in SLE was established. It is recommended for use as an aspirational treatment target in clinical care, a clear concept in education, and a key outcome in research including clinical trials and observational studies. References: [1]van Vollenhoven RF, Mosca M, Bertsias G, et al. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Ann Rheum Dis 2014;73:958-67. [2]van Vollenhoven R, Voskuyl A, Bertsias G, et al. A framework for remission in SLE: consensus findings from a large international task force on definitions of remission in SLE (DORIS). Ann Rheum Dis 2016. Disclosure of Interests: Ronald van Vollenhoven Speakers bureau: AbbVie, Galapagos, GSK, Janssen, Pfizer, UCB, Consultant of: AbbVie, AstraZeneca, Biogen, Biotest, Celgene, Galapagos, Gilead, Janssen, Pfizer, Sanofi, Servier, UCB, Vielabo, Grant/research support from: BMS, GSK, Lilly, UCB, George Bertsias: None declared, Andrea Doria: None declared, David Isenberg: None declared, Eric F. Morand: None declared, Michelle A Petri: None declared, Bernardo Pons-Estel Consultant of: GSK, Janssen, Anisur Rahman: None declared, Manuel Ugarte-Gil Grant/research support from: Janssen, Pfizer, Alexandre Voskuyl: None declared, Laurent Arnaud Consultant of: Alexion, Amgen, Astra-Zeneca, BMS, GSK, Janssen-Cilag, LFB, Lilly, Menarini France, Medac, Novartis, Pfizer, Roche-Chugai, UCB., Ian N. Bruce: None declared, Ricard Cervera Consultant of: GSK, Alexion, Eli Lilly, Astra Zeneca, Termo-Fisher, Rubio, Nathalie Costedoat-Chalumeau: None declared, Caroline Gordon Speakers bureau: UCB, Consultant of: Center for Disease Control, Astra-Zeneca, MGP, Sanofi, UCB, Frederic Houssiau: None declared, Marta Mosca: None declared, Matthias Schneider: None declared, Michael Ward: None declared, Cynthia Aranow: None declared.
Wrocław Medical University1, Swiss Institute of Allergy and Asthma Research2, University of Marburg3, Stanford University4, University of Toronto5, University of Cape Town6, Carol Davila University of Medicine and Pharmacy7, Charité8, University of Montpellier9, National Institutes of Health10, Catholic University of the Sacred Heart11, Woolcock Institute of Medical Research12, Laval University13, University of Turin14, University of Mainz15, Universidade Federal de Minas Gerais16, Humanitas University17, University of South Florida18, Sofia Medical University19, Federal University of Bahia20, University of Cagliari21, Huazhong University of Science and Technology22, Ain Shams University23, Wuhan University24, Istanbul University25, University of Helsinki26, University of Exeter27, Bethel University28, Medical University of Vienna29, University of Paris-Sud30, Ghent University Hospital31, Makerere University32, Utrecht University33, The Chinese University of Hong Kong34, National Institute for Health and Welfare35, Medical University of Łódź36, Semmelweis University37, Vilnius University38, Hospital Kuala Lumpur39, Boston Children's Hospital40, Karolinska Institutet41, University of Belgrade42, Tishreen University43, University of Barcelona44, Russian National Research Medical University45, St. Joseph's Healthcare Hamilton46, McMaster University47, Monash University48, University College Cork49, Chiba University50, Charles University in Prague51, University of Manchester52, University of Genoa53, Nippon Medical School54, École Polytechnique55, University of Coimbra56, Technion – Israel Institute of Technology57, Emek Medical Center58, Medical University of Warsaw59, Complutense University of Madrid60, University of Edinburgh61, University of Palermo62, University of São Paulo63, University of Copenhagen64, University of Beira Interior65, Medical University of Graz66, University of Crete67, European Union of Medical Specialists68, University of Bari69, National University of Singapore70, Celal Bayar University71, National University of Villa María72, Transylvania University73
TL;DR: In this article, an exploratory qualitative study using semi-structured interviews in primary care in the UK, Belgium, the Netherlands, Ireland, Germany, Poland, Greece and Sweden was conducted between April and July 2020 to understand the experiences of European primary care working during the peak of the COVID-19 pandemic.
Abstract: BACKGROUND: Primary care has a crucial role in responding to the COVID-19 pandemic as the first point of patient care and gatekeeper to secondary care. Qualitative studies exploring the experiences of healthcare professionals during the COVID-19 pandemic have mainly focused on secondary care. AIM: To understand the experiences of European PCPs working during the first peak of the COVID-19 pandemic. DESIGN AND SETTING: An exploratory qualitative study, using semi-structured interviews in primary care in England, Belgium, the Netherlands, Ireland, Germany, Poland, Greece and Sweden, between April and July 2020. METHOD: Interviews were audio recorded, transcribed and analysed using a combination of inductive and deductive thematic analysis techniques. RESULTS: Eighty interviews were conducted with PCPs. PCPs had to make their own decisions on how to rapidly transform services in relation to COVID-19 and non-COVID-19 care. Despite being overwhelmed with guidance, they often lacked access to practical training. Consequently, PCPs turned to their colleagues for moral support and information to try to quickly adjust to new ways of working, including remote care, and deal with uncertainty. CONCLUSION: PCPs rapidly transformed primary care delivery despite a number of challenges. Representation of primary care at policy level and engagement with local primary care champions will facilitate easy and coordinated access to practical information on how to adapt services, ongoing training and access to appropriate mental health support services for PCPs. Preservation of autonomy and responsiveness of primary care are critical to preserve the ability for rapid transformation in any future crisis of care delivery.
TL;DR: In this article, the authors demonstrate that intense laser-atom interactions may lead to the generation of highly non-classical light states, which are a superposition of two distinct coherent states: the initial state of the laser and the coherent state reduced in amplitude that results from the interaction with atoms.
Abstract: The physics of intense laser–matter interactions1,2 is described by treating the light pulses classically, anticipating no need to access optical measurements beyond the classical limit. However, the quantum nature of the electromagnetic fields is always present3. Here we demonstrate that intense laser–atom interactions may lead to the generation of highly non-classical light states. This was achieved by using the process of high-harmonic generation in atoms4,5, in which the photons of a driving laser pulse of infrared frequency are upconverted into photons of higher frequencies in the extreme ultraviolet spectral range. The quantum state of the fundamental mode after the interaction, when conditioned on the high-harmonic generation, is a so-called Schrodinger cat state, which corresponds to a superposition of two distinct coherent states: the initial state of the laser and the coherent state reduced in amplitude that results from the interaction with atoms. The results open the path for investigations towards the control of the non-classical states, exploiting conditioning approaches on physical processes relevant to high-harmonic generation. Schrodinger cat states are observed in intense laser–atom interactions. These are a superposition of the initial state of the laser and the coherent state that results from the interaction between the light and atoms.
TL;DR: In this article, the authors developed two Twitter polls to explore the public's views on available COVID-19 vaccines and observed an elevated willingness to undergo vaccination among their study sample.
Abstract: Background: On January 30, 2020, the World Health Organization’s Emergency Committee declared the rapid, worldwide spread of COVID-19 a global health emergency. Since then, tireless efforts have been made to mitigate the spread of the disease and its impact, and these efforts have mostly relied on nonpharmaceutical interventions. By December 2020, the safety and efficacy of the first COVID-19 vaccines were demonstrated. The large social media platform Twitter has been used by medical researchers for the analysis of important public health topics, such as the public’s perception on antibiotic use and misuse and human papillomavirus vaccination. The analysis of Twitter-generated data can be further facilitated by using Twitter’s built-in, anonymous polling tool to gain insight into public health issues and obtain rapid feedback on an international scale. During the fast-paced course of the COVID-19 pandemic, the Twitter polling system has provided a viable method for gaining rapid, large-scale, international public health insights on highly relevant and timely SARS-CoV-2–related topics.
Objective: The purpose of this study was to understand the public’s perception on the safety and acceptance of COVID-19 vaccines in real time by using Twitter polls.
Methods: We developed 2 Twitter polls to explore the public’s views on available COVID-19 vaccines. The surveys were pinned to the Digital Health and Patient Safety Platform Twitter timeline for 1 week in mid-February 2021, and Twitter users and influencers were asked to participate in and retweet the polls to reach the largest possible audience.
Results: The adequacy of COVID-19 vaccine safety (ie, the safety of currently available vaccines; poll 1) was agreed upon by 1579 out of 3439 (45.9%) Twitter users. In contrast, almost as many Twitter users (1434/3439, 41.7%) were unsure about the safety of COVID-19 vaccines. Only 5.2% (179/3439) of Twitter users rated the available COVID-19 vaccines as generally unsafe. Poll 2, which addressed the question of whether users would undergo vaccination, was answered affirmatively by 82.8% (2862/3457) of Twitter users, and only 8% (277/3457) categorically rejected vaccination at the time of polling.
Conclusions: In contrast to the perceived high level of uncertainty about the safety of the available COVID-19 vaccines, we observed an elevated willingness to undergo vaccination among our study sample. Since people's perceptions and views are strongly influenced by social media, the snapshots provided by these media platforms represent a static image of a moving target. Thus, the results of this study need to be followed up by long-term surveys to maintain their validity. This is especially relevant due to the circumstances of the fast-paced pandemic and the need to not miss sudden rises in the incidence of vaccine hesitancy, which may have detrimental effects on the pandemic’s course.
TL;DR: In this paper, the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation, was tested to reduce negative emotions and increase positive emotions.
Abstract: The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world.