Journals
2025 EN
Ballif Marie · Correia da Silva Saúde Manuela · Haerry David
+6 more
Abstract Introduction As life expectancy among persons with HIV on antiretroviral therapy (ART) is increasing, comorbidities and polypharmacy increase. Drug–drug interactions (DDIs) are common among persons with HIV with a history of virological failure, since many are receiving boosted ART. We assessed the willingness of individuals with a history of virological failure on a boosted ART to participate in simplification trials and evaluated their expectations towards ART. Methods We conducted a cross‐sectional survey among persons with HIV at five hospitals in Switzerland between October 2021 and July 2022. We collected data using quantitative paper‐based questionnaires and analysed the data using descriptive statistics. Community representatives were involved in the study planning and conduct, and in the interpretation of findings. Results Overall, 143 (64%) of 223 eligible persons with HIV participated. Median age was 59 years (interquartile range [IQR] 52.5–63.5), 32 (22%) were female, median time on ART was 26 years (IQR: 20–27). Among participants, 104 (72%) would agree to participate in clinical trials aiming at evaluating simplified ART regimens with reduced DDI risks, or were still undecided. Of them, 92 (88%) were satisfied with their current treatment. Their main expectations about simplified ART were treatment efficacy (91%), fewer DDIs (83%), low pill number (78%) and forgiveness in case of missed doses (75%). Conclusions Persons with HIV and a history of virological failure were motivated to participate in clinical research. This underlines the importance of including them in future trials. Furthermore, conducting feasibility surveys and including persons with HIV in the study design prior to trials ensures their relevance and alignment with people's needs and expectations.
Journals
2025 EN
Meyer Sophia C. · Klein Zoe · Schoepf Isabella C.
+17 more
Abstract Objectives The risk of diabetes mellitus (DM) is increased in people with HIV. Chronic inflammation contributes to DM risk. High leukocytes are associated with DM in the general population, but in people with HIV, evidence of a leukocyte–DM association is limited. Methods We included participants of the Swiss HIV Cohort Study with new‐onset DM (2000–2023) and matched controls. We obtained uni‐ and multivariable odds ratios (ORs) for DM, based on traditional and HIV‐related DM risk factors, leukocyte count and potential confounders for leukocyte count. Results Among 732 DM cases (median age 54 years, 79% male at birth, 86% with suppressed HIV RNA) and 2032 DM‐free controls, the latest leukocyte count prior to DM diagnosis was higher in cases than in controls (median [interquartile range], 6200 [5115–7800] vs. 5900/μL [4800–7180]; p < 0.001), but leucocytosis (>11 000/μL) was uncommon (3.8% vs. 2.3%; p = 0.032). DM‐OR in the highest vs. lowest leukocyte quintile was 1.91 (95% confidence interval, 1.45–2.52) in univariable analysis and 2.47 (1.71–3.57) in multivariable analysis. For comparison, multivariable DM‐OR for dyslipidaemia, overweight, ≥12‐month stavudine exposure and ≥12‐month integrase inhibitor exposure were 2.23 (1.80–2.75), 2.83 (2.21–3.62), 1.54 (1.16–2.04) and 2.29 (1.13–4.62), respectively. We found no relevant confounders for the leukocyte–DM association. Leukocytes were significantly associated with DM up to 10 years before diagnosis (all p < 0.02). Conclusions High leukocyte count is an independent DM risk factor in people with HIV in Switzerland and increases the risk of DM to a degree similar to traditional and HIV‐related risk factors, up to 10 years before DM diagnosis.
Journals
2025 EN
Lasne Dominique · Testa Sophie · Kitchen Steve
+3 more
ABSTRACT Introduction According to the new In Vitro Diagnostic Medical Device Regulation (EU) (IVDR) an In Vitro Medical Device (IVD) is considered as a laboratory developed test (LDT) if used outside of intended use. It is therefore essential that the information given by the manufacturer about the intended use is clear, precise, and well documented. For now, the only source of information for laboratories is the instructions for use (IFU). Our primary aim was to analyze the IFU provided by several manufacturers for a large panel of coagulation assays. The secondary objective was to provide a list of minimum information that must be accessible to clinical laboratories. Methods We analyzed 195 IFU for the main assays used in European hemostasis clinical laboratories commercialized by 12 manufacturers. Results The “intended use” section appears in almost all IFU, but the information given in this section is very heterogeneous. We observed disagreement for each of the assays assessed with some intended uses not supported by guidance or guidelines. Some indications in use by clinical laboratories are not provided by the manufacturers. We only found information on clinical performance for a limited number of assays. For some assays, data are available in the literature but are not reported in the IFU. The matrix and the importance of a pre‐test probability are not systematically mentioned. Conclusions We urgently request access to the necessary information to know the intended use of a reagent according to the IVDR. We define the minimum information that should be available to laboratories. We call for joint discussions to maintain innovation and ensure the quality, safety, and accessibility of innovative diagnostics.
Journals
2025 EN
Kong Darren Chyi Hsiang · Lassere Marissa Nichole Dominique · Raj Annamma Kochummen Dorai
+1 more
Abstract Background Giant cell arteritis (GCA) has possible links to environmental factors such as air pollution. Aims We examined whether bushfire‐related air pollution during the 2019–2020 Australian bushfires was associated with GCA incidence. Methods We retrospectively analysed 29 biopsy‐confirmed cases (2018–2021) and matched onset dates with air pollutant levels. A bidirectional time‐stratified case‐crossover design was performed using conditional logistic regression. Results Non‐significant associations were demonstrated between pollutant exposure and GCA, with inconsistent results across air quality stations. Conclusions No clear link was found. Further studies with larger samples and longer follow‐up are needed.
John Wiley & Sons Australia
Journals
2025 EN
Braeckman Jolien · Wyckaert Mariotte · De Vriendt Patricia
+5 more
ABSTRACT Due to the rising number of long‐term mental health conditions, there has been a shift in therapeutic focus from curing these conditions, to living a meaningful life with them. Self‐management is described as the ability to live with the emotional, life role and medical consequences of long‐term conditions such as schizophrenia. However, the perspective of people with schizophrenia on self‐management in current literature is missing. A lack of understanding of strategies used by people with schizophrenia to self‐manage, could adversely affect the use of self‐management interventions. Therefore, this study aims to identify how people with schizophrenia manage their daily life. Semi‐structured interviews ( n = 9) were conducted in a qualitative descriptive design. The study is reported by using the COREQ checklist. All participants, recruited through purposive sampling, have been stabilised after a schizophrenic episode and have been reintegrated into their community. The data were analysed through thematic analysis. Self‐management for people with schizophrenia is an individualised process that revolves around performing day‐to‐day activities according to the participant's wishes. In addition, participants tried to prevent relapse by self‐managing daily life. Personal‐, social‐ and schizophrenia‐related factors were seen as barriers and/or facilitators in their self‐management. These barriers and/or facilitators were self‐managed using daily activities. Current self‐management interventions for this population often aim at improving medication adherence. Self‐management interventions facilitated by health care professionals should (i) focus more on supporting patients in finding their daily structure through meaningful activities and (ii) be mindful of the duality contained within self‐management of people with stabilised schizophrenia.
Journals
2025 EN
Wille Christophe · Hove Geert · Loon Jos
+2 more
ABSTRACT Background People with intellectual disabilities in Flanders (Belgium) often rely on their direct support professionals (DSPs) to engage in meaningful activities. While structured approaches exist to guide engagement, limited insight is available into the specific support DSPs need in practice. Methods A descriptive qualitative study was conducted using in‐depth interviews with 13 DSPs. Thematic analysis was performed using NVivo 12. Results Five themes emerged: (1) Basic assumptions regarding meaningful activities, (2) Relationship between people with intellectual disabilities and DSPs as a prerequisite for enabling meaningful activities, (3) Facilitating factors in enabling meaningful activities, (4) Areas of tension in enabling meaningful activities, and (5) Barriers to enabling meaningful activities. Conclusions DSPs recognise the importance of meaningful activities but face significant challenges in practice. Addressing these challenges requires training and support tailored to their specific needs and the realities of their daily work, ensuring they are better equipped to foster engagement in meaningful activities.
Journals
2025 EN
Martins Raphaël P. · Groussin Pierre · Bessière Francis
+16 more
ABSTRACT Introduction Radiofrequency ablation is a cornerstone therapy for patients with ischemic cardiomyopathy (ICM) presenting with ventricular tachycardia (VT). In this context, ablation is typically performed endocardially as a first‐line approach. However, despite acute procedural success, the risk of recurrence remains high, potentially due to the presence of epicardial substrate. Several observational studies have suggested the potential benefits of a first‐line endo‐epicardial approach in decreasing recurrence. In this context, the EPIC‐VT trial was designed to compare endocardial‐only ablation versus combined endo‐epicardial ablation as a first‐line approach in ICM patients with VT. Methods The EPIC‐VT trial is a prospective, multicenter, controlled, randomized, open‐label superiority trial with two parallel groups (endocardial‐only approach vs . combined endo‐epicardial approach) in a 1:1 ratio. The primary objective of this study is to demonstrate that a combined endo‐epicardial approach reduces the risk of VT recurrence compared to an endocardial approach alone in patients with ICM. Patients will be followed for 2 years after the procedure. Results and Conclusion To date, only retrospective studies have compared VA recurrences in patients with ICM, depending on whether ablation was performed using an endocardial or an endo‐epicardial approach, with conflicting results. A meta‐analysis suggested an advantage of the endo‐epicardial approach over the endocardial approach (odds ratio = 0.39 [95% CI: 0.18–0.83]). However, the level of evidence remains low, and no controlled randomized study has confirmed this hypothesis. If the EPIC‐VT study confirms the superiority of a first‐line endo‐epicardial approach, such strategy could become the preferred option for VT ablation in ICM, thereby reducing the risk of VA recurrence.
Journals
2025 EN
Etienne Olivier · Wang Caroline Jiamiao · Bourgi Rim
+2 more
ABSTRACT Objective This retrospective clinical study aimed to evaluate the survival rates of ceramic laminate veneers in relation to dentin exposure, endodontic treatment, preparation design, and the type of dual‐cure resin cement used. Materials and Methods A total of 672 veneers were placed in 189 patients and followed for 1 to 15 years. Veneer supporting teeth were categorized after etching based on the degree of dentin exposure into three groups: GA1 (enamel only), GA2 (< 30% dentin), and GA3 (> 30% dentin). Additional variables included endodontic treatment, preparation design, and the resin cement system used. Kaplan–Meier survival analysis, Log‐Rank tests ( α = 0.05), and Odds Ratios (ORs) were computed. All procedures were performed by a single clinician, veneers were fabricated by a single ceramist, and the study was performed by a different, single examiner. Results The cumulative 15‐year estimated survival rate was 96%, mean survival 5.98 years. Veneers in the GA1 group showed an estimated survival rate of 96.7%, compared to 95.3% in GA2 and 93.9% in GA3. A statistically significant difference was found between GA1 and GA3 ( p = 0.033). Endodontically treated teeth and those with dentin exposure exhibited higher risks of failure (OR = 1.68 and 3.47, respectively). Endodontic treatment, preparation design, and resin cement type did not significantly affect survival ( p > 0.05). Conclusions The extent of dentin exposure significantly impacts the survival of bonded ceramic veneers after 1 to 15 years of follow‐up. Preservation of enamel is critical for optimizing outcomes. Clinical Significance These findings suggest that meticulous patient selection, preparation techniques, optimal bonding protocols, and bonding exclusively to enamel, whenever possible, are essential for ensuring the clinical success of CLV bonded with dual‐cured resin.
Journals
2025 EN
Malleret Cassandra · BlancLegendre Mélanie · Guillot Laëtitia
+10 more
ABSTRACT Brain aromatase, an enzyme responsible for the local synthesis of estrogens, plays a key role in regulating behavior and neuroplasticity in mammals. In teleost fish, brain aromatase is encoded by the cyp19a1b gene, which is strongly expressed in radial glial cells; however, the specific functions of this enzyme are currently unknown. To investigate its role, a cyp19a1b ‐mutant zebrafish line was generated using gene‐editing techniques. Behavioral, neurogenic, and neurotransmission‐related parameters were assessed in adult male and female zebrafish. Behavioral analysis highlighted significant alterations in mutant zebrafish, including changes in swimming activity, boldness, sociability, and aggression, with a stronger effect in males compared to females. Beyond these behavioral modifications, mutant zebrafish exhibited disrupted cell proliferation patterns, as assessed by PCNA immunofluorescence in key forebrain regions. Specifically, proliferation decreased in the telencephalon and in the caudal hypothalamus of mutant zebrafish while increasing in the olfactory bulbs. The number of dopaminergic and serotonergic neurons, visualized by immunofluorescence, remained unchanged. Similarly, HPLC‐ED quantification of monoamines and their metabolites showed no significant differences between mutant and wild‐type zebrafish. To further explore the impact of the cyp19a1b mutation on gene expression, transcriptomic analysis was performed using BRB‐Seq technology. Gene expression analyses identified several processes affected by the mutation, including cell proliferation, apoptosis, estrogen signaling, neuroplasticity, and behavioral regulation, in a sex‐ and region‐dependent manner. In conclusion, our results demonstrate that several behaviors, including locomotor activity, sociability, aggressiveness, and anxiety, exhibit marked sexual dimorphism. They show that the cyp19a1b mutation affects locomotor activity in a context‐dependent manner, increases boldness, and reduces aggressiveness. In addition, transcriptomic analyses revealed widespread dysregulation of gene expression, which likely contributes to the observed behavioral alterations. Taken together, these findings underscore the crucial role of brain aromatase in the neurobiological regulation of diverse behaviors.
Journals
2025 EN
ScheninKing Andrianisaina Palmyre · Castillo MarieCarmen · Barlagne Gabrielle
+11 more
Accessible Summary What is known about the subject Caring for a family member with a mental illness induces a burden on the caregiver, an impact on their quality of life and premature ageing of more than ten years.What the paper adds to existing knowledge We conducted systematised and individualised nursing interviews with family members, on the first days of a relative’s hospitalisation, during hospitalisation and three months after discharge. We observed persistent depressive symptoms during and after hospitalisation. Burden and depression were higher, and quality of life was lower, for women caregivers and when the caregivers admitted the patients involuntarily in the hospital ward. When the caregivers were experiencing a patient’s first hospitalisation, we also found higher depressive symptoms and lower quality of life.What are the implications for practice This study emphasises the need for new interventions such as psychoeducation to alleviate the suffering of families. Considering the burden of families could become a prevention objective from the patient’s first hospitalisation and prevent them from mental or physical health problems.Abstract Introduction The burden consequent to providing care to patients with psychiatric chronic conditions is often overlooked by health professionals. Aim We assessed the impact of patients' psychiatric hospitalisation on their caregivers, through evaluating their suffering, burden and quality of life, in three stages: upon the patients' admission, their discharge and 3 months after their discharge. Method In total, 127 caregivers of adult patients whose first hospitalisation was less than 5 years ago were assessed using the 36‐item Short‐Form Health Survey, the Zarit Burden Interview and the Center for Epidemiologic Studies Depression scale. Results Females and caregivers who admitted patients against their will experienced higher burden and depression and lower mental quality of life. We also found higher depressive symptoms and lower quality of life among caregivers during a patient's first hospitalisation. The caregiver's familial relationship to the patient was not associated with these outcomes. Finally, burden decreased and quality of life increased over time. Discussion Results suggest that several variables associated with patient hospitalisations were correlated with burden, depression or quality of life. Implications for Practice Burden could be targeted with interventions such as group psychoeducation for caregivers during or after the patient's hospitalisation, in order to reduce their distress and improve their quality of life. Psychiatric and mental health nurses can provide support to caregivers with systematic assessments of their burden and quality of life, so as to better meet their needs and promote their ability to cope with mental illness.