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91.
Isolde Birdthistle Daniel Kwaro Maryam Shahmanesh Kathy Baisley Sammy Khagayi Natsayi Chimbindi Vivienne Kamire Nondumiso Mthiyane Annabelle Gourlay Jaco Dreyer Penelope Phillips-Howard Judith Glynn Sian Floyd 《PLoS medicine》2021,18(10)
BackgroundThrough a multisectoral approach, the DREAMS Partnership aimed to reduce HIV incidence among adolescent girls and young women (AGYW) by 40% over 2 years in high-burden districts across sub-Saharan Africa. DREAMS promotes a combination package of evidence-based interventions to reduce individual, family, partner, and community-based drivers of young women’s heightened HIV risk. We evaluated the impact of DREAMS on HIV incidence among AGYW and young men in 2 settings.Methods and findingsWe directly estimated HIV incidence rates among open population-based cohorts participating in demographic and HIV serological surveys from 2006 to 2018 annually in uMkhanyakude (KwaZulu-Natal, South Africa) and over 6 rounds from 2010 to 2019 in Gem (Siaya, Kenya). We compared HIV incidence among AGYW aged 15 to 24 years before DREAMS and up to 3 years after DREAMS implementation began in 2016. We investigated the timing of any change in HIV incidence and whether the rate of any change accelerated during DREAMS implementation. Comparable analyses were also conducted for young men (20 to 29/34 years).In uMkhanyakude, between 5,000 and 6,000 AGYW were eligible for the serological survey each year, an average of 85% were contacted, and consent rates varied from 37% to 67%. During 26,395 person-years (py), HIV incidence was lower during DREAMS implementation (2016 to 2018) than in the previous 5-year period among 15- to 19-year-old females (4.5 new infections per 100 py as compared with 2.8; age-adjusted rate ratio (aRR) = 0.62, 95% confidence interval [CI] 0.48 to 0.82), and lower among 20- to 24-year-olds (7.1/100 py as compared with 5.8; aRR = 0.82, 95% CI 0.65 to 1.04). Declines preceded DREAMS introduction, beginning from 2012 to 2013 among the younger and 2014 for the older women, with no evidence of more rapid decline during DREAMS implementation. In Gem, between 8,515 and 11,428 AGYW were eligible each survey round, an average of 34% were contacted and offered an HIV test, and consent rates ranged from 84% to 99%. During 10,382 py, declines in HIV incidence among 15- to 19-year-olds began before DREAMS and did not change after DREAMS introduction. Among 20- to 24-year-olds in Gem, HIV incidence estimates were lower during DREAMS implementation (0.64/100 py) compared with the pre-DREAMS period (0.94/100 py), with no statistical evidence of a decline (aRR = 0.69, 95% CI 0.53 to 2.18). Among young men, declines in HIV incidence were greater than those observed among AGYW and also began prior to DREAMS investments. Study limitations include low study power in Kenya and the introduction of other interventions such as universal treatment for HIV during the study period.ConclusionsSubstantial declines in HIV incidence among AGYW were observed, but most began before DREAMS introduction and did not accelerate in the first 3 years of DREAMS implementation. Like the declines observed among young men, they are likely driven by earlier and ongoing investments in HIV testing and treatment. Longer-term implementation and evaluation are needed to assess the impact of such a complex HIV prevention intervention and to help accelerate reductions in HIV incidence among young women.Isolde Birdthistle and co-workers evaluate a program to address risks of HIV infection in adolescent girls and young women in sub-Saharan Africa. 相似文献
92.
An IL-7 fusion protein that shows increased thymopoietic ability 总被引:2,自引:0,他引:2
Henson SM Snelgrove R Hussell T Wells DJ Aspinall R 《Journal of immunology (Baltimore, Md. : 1950)》2005,175(6):4112-4118
The role of IL-7 during thymopoiesis has led to it being the focus of a number of therapeutic interventions. However, its small size and pleiotropic nature present problems for thymus-directed therapies. We have created a fusion molecule between the extracellular N-terminal domain of CCR9 and IL-7, which has the potential to overcome these difficulties. This novel fusion protein retains the thymopoietic activity of IL-7 and the ligand-binding ability of CCR9. As a thymopoietic agent, compared with IL-7, it shows an enhanced retention in the thymus, increased de novo T cell production, and increased thymic output. Old mice receiving the fusion protein show improved CD8 T cell responses and reduced viral load after infection with influenza virus compared with those receiving IL-7. This chimeric molecule offers a novel therapeutic strategy that may result in the production of an effective immunorestorative agent. 相似文献
93.
CD25-expressing CD8+ T cells are potent memory cells in old age 总被引:3,自引:0,他引:3
Herndler-Brandstetter D Schwaiger S Veel E Fehrer C Cioca DP Almanzar G Keller M Pfister G Parson W Würzner R Schönitzer D Henson SM Aspinall R Lepperdinger G Grubeck-Loebenstein B 《Journal of immunology (Baltimore, Md. : 1950)》2005,175(3):1566-1574
We have recently described an IL-2/IL-4-producing CD8+CD25+ non-regulatory memory T cell population that occurs in a subgroup of healthy elderly persons who characteristically still have a good humoral response after vaccination. The present study addresses this specific T cell subset and investigates its origin, clonal composition, Ag specificity, and replicative history. We demonstrate that CD8+CD25+ memory T cells frequently exhibit a CD4+CD8+ double-positive phenotype. The expression of the CD8 alphabeta molecule and the occurrence of signal-joint TCR rearrangement excision circles suggest a thymic origin of these cells. They also have longer telomeres than their CD8+CD25- memory counterparts, thus indicating a shorter replicative history. CD8+CD25+ memory T cells display a polyclonal TCR repertoire and respond to IL-2 as well as to a panel of different Ags, whereas the CD8+CD25- memory T cell population has a more restricted TCR diversity, responds to fewer Ags, and does not proliferate in response to stimulation with IL-2. Molecular tracking of specific clones with clonotypic primers reveals that the same clones occur in CD8+CD25+ and CD8+CD25- memory T cell populations, demonstrating a lineage relationship between CD25+ and CD25- memory CD8+ T cells. Our results suggest that CD25-expressing memory T cells represent an early stage in the differentiation of CD8+ cells. Accumulation of these cells in elderly persons appears to be a prerequisite of intact immune responsiveness in the absence of naive T cells in old age. 相似文献
94.
Manfred Milinski Sian W. Griffiths Thorsten B. H. Reusch Thomas Boehm 《Proceedings. Biological sciences / The Royal Society》2010,277(1680):391-398
Olfactory information about individual major histocompatibility complex (MHC) immune genotypes is important for mate choice in several species. For example, during the mate choice decisions of three-spined sticklebacks, females assess males on the basis of odour cues that convey information about their MHC diversity. Here, we show that an additional ‘maleness’ signal is needed to validate the MHC signal. Furthermore, using interaction between natural odour of sticklebacks and synthetic MHC-ligand peptides, we show that MHC signals are conditional on the reproductive state in males. By contrast, we find that gravid females do not produce such signals. Since MHC olfactory signals relevant to mate choice decisions are conditional upon gender and reproductive state, we suggest that their manufacture is likely to be costly to senders, and therefore, potentially conditional on the health/parasitization status of the sender. We hypothesize that shedding of peptide–MHC complexes compromises immune function, selecting against unconditional use of these signals. 相似文献
95.
J. W. Astley Cooper 《BMJ (Clinical research ed.)》1928,1(3515):876-877
96.
97.
98.
Anthony A. Laverty Sarah L. Elkin Hilary C. Watt Christopher Millett Louise J. Restrick Sian Williams Derek Bell Nicholas S. Hopkinson 《PloS one》2015,10(2)
ObjectivesWe evaluated the impact of a COPD discharge care bundle on readmission rates following hospitalisation with an acute exacerbation.DesignInterrupted time series analysis, comparing readmission rates for COPD exacerbations at nine trusts that introduced the bundle, to two comparison groups; (1) other NHS trusts in London and (2) all other NHS trusts in England. Care bundles were implemented at different times for different NHS trusts, ranging from October 2009 to April 2011.SettingNine NHS acute trusts in the London, England.ParticipantsPatients aged 45 years and older admitted to an NHS acute hospital in England for acute exacerbation of COPD. Data come from Hospital Episode Statistics, April 2002 to March 2012.ResultsIn hospitals introducing the bundle readmission rates were rising before implementation and falling afterwards (e.g. readmissions within 28 days +2.13% per annum (pa) pre and -5.32% pa post (p for difference in trends = 0.012)). Following implementation, readmission rates within 7 and 28 day were falling faster than among other trusts in London, although this was not statistically significant (e.g. readmissions within 28 days -4.6% pa vs. -3.2% pa, p = 0.44). Comparisons with a national control group were similar.ConclusionsThe COPD discharge care bundle appeared to be associated with a reduction in readmission rate among hospitals using it. The significance of this is unclear because of changes to background trends in London and nationally. 相似文献
99.
Matthew J. Brookes Emma L. Hall Sian E. Robson Darren Price Lena Palaniyappan Elizabeth B. Liddle Peter F. Liddle Stephen E. Robinson Peter G. Morris 《PloS one》2015,10(4)
This paper details a methodology which, when applied to magnetoencephalography (MEG) data, is capable of measuring the spatio-temporal dynamics of ‘disorder’ in the human brain. Our method, which is based upon signal entropy, shows that spatially separate brain regions (or networks) generate temporally independent entropy time-courses. These time-courses are modulated by cognitive tasks, with an increase in local neural processing characterised by localised and transient increases in entropy in the neural signal. We explore the relationship between entropy and the more established time-frequency decomposition methods, which elucidate the temporal evolution of neural oscillations. We observe a direct but complex relationship between entropy and oscillatory amplitude, which suggests that these metrics are complementary. Finally, we provide a demonstration of the clinical utility of our method, using it to shed light on aberrant neurophysiological processing in schizophrenia. We demonstrate significantly increased task induced entropy change in patients (compared to controls) in multiple brain regions, including a cingulo-insula network, bilateral insula cortices and a right fronto-parietal network. These findings demonstrate potential clinical utility for our method and support a recent hypothesis that schizophrenia can be characterised by abnormalities in the salience network (a well characterised distributed network comprising bilateral insula and cingulate cortices). 相似文献
100.
Anne Cori Helen Ayles Nulda Beyers Ab Schaap Sian Floyd Kalpana Sabapathy Jeffrey W. Eaton Katharina Hauck Peter Smith Sam Griffith Ayana Moore Deborah Donnell Sten H. Vermund Sarah Fidler Richard Hayes Christophe Fraser HPTN study team 《PloS one》2014,9(1)