COVID TRAVEL MAP: CROSS STATE TRAVEL COUNTIES AS OF JULY 24, 2020 (MODIFIED JULY 27, 2020)

Posted on July 29, 2020 by Maurice Preter MD

COVID TRAVEL MAP: CROSS STATE TRAVEL COUNTIES AS OF JULY 24, 2020 (MODIFIED JULY 27, 2020)

MONDAY, JULY 27, 2020

Cross State Travel Counties 072420 – Modified 072720.xlsx

Source: https://accd.vermont.gov/content/travel-map-cross-state-travel-counties-2020-07-24-modified-2020-07-27

 

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Evidence-based prevention of Alzheimer’s disease: systematic review

Posted on July 27, 2020 by Maurice Preter MD
https://jnnp.bmj.com/content/early/2020/06/01/jnnp-2019-321913
 
Cognitive neurology
 
Review
 
Evidence-based prevention of Alzheimer’s disease: systematic review and meta-analysis of 243 observational prospective studies and 153 randomised controlled trials
 
  1. Jin-Tai Yu1,
  2. Wei Xu2,
  3. Chen-Chen Tan2,
  4. Sandrine Andrieu3,
  5. John Suckling4,
  6. Evangelos Evangelou5,
  7. An Pan6,
  8. Can Zhang7,
  9. Jianping Jia8,
  10. Lei Feng9,
  11. Ee-Heok Kua9,
  12. Yan-Jiang Wang10,
  13. Hui-Fu Wang2,
  14. Meng-Shan Tan2,
  15. Jie-Qiong Li2,
  16. Xiao-He Hou2,
  17. Yu Wan2,
  18. Lin Tan2,
  19. Vincent Mok11,
  20. Lan Tan2,
  21. Qiang Dong1,
  22. Jacques Touchon12,
  23. Gauthier Serge13,
  24. Paul S Aisen14,
  25. Bruno Vellas15

Author affiliations


  1. Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China

  2. Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China

  3. Department of Epidemiology and Public Health, University of Toulouse III, Toulouse, France

  4. Department of Psychiatry, Medical Research Council and Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK

  5. Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece

  6. Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

  7. Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, USA

  8. Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China

  9. Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

  10. Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China

  11. Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong

  12. Department of Neurology, University Hospital of Montpellier, Montpellier, France

  13. McGill Center for Studies in Aging, McGill University, Montreal, Quebec, Canada

  14. Alzheimer’s Therapeutic Research Institute, University of Southern California, San Diego, California, USA

  15. Department of Geriatrics, Purpan University Hospital, Toulouse, France
  1. Correspondence to Professor Jin-Tai Yu, Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China; jintai_yu@fudan.edu.cn
 

Abstract

Background Evidence on preventing Alzheimer’s disease (AD) is challenging to interpret due to varying study designs with heterogeneous endpoints and credibility. We completed a systematic review and meta-analysis of current evidence with prospective designs to propose evidence-based suggestions on AD prevention.

Methods Electronic databases and relevant websites were searched from inception to 1 March 2019. Both observational prospective studies (OPSs) and randomised controlled trials (RCTs) were included. The multivariable-adjusted effect estimates were pooled by random-effects models, with credibility assessment according to its risk of bias, inconsistency and imprecision. Levels of evidence and classes of suggestions were summarised.

Results A total of 44 676 reports were identified, and 243 OPSs and 153 RCTs were eligible for analysis after exclusion based on pre-decided criteria, from which 104 modifiable factors and 11 interventions were included in the meta-analyses. Twenty-one suggestions are proposed based on the consolidated evidence, with Class I suggestions targeting 19 factors: 10 with Level A strong evidence (education, cognitive activity, high body mass index in latelife, hyperhomocysteinaemia, depression, stress, diabetes, head trauma, hypertension in midlife and orthostatic hypotension) and 9 with Level B weaker evidence (obesity in midlife, weight loss in late life, physical exercise, smoking, sleep, cerebrovascular disease, frailty, atrial fibrillation and vitamin C). In contrast, two interventions are not recommended: oestrogen replacement therapy (Level A2) and acetylcholinesterase inhibitors (Level B).

Interpretation Evidence-based suggestions are proposed, offering clinicians and stakeholders current guidance for the prevention of AD.

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Dietary buckwheat enhances sirtuin1 without calorie restriction

Posted on July 24, 2020 by Maurice Preter MD

This is truly excellent news, at least for каша lovers. 

Abstract

In the present investigation, the role of dietary intervention in male Wistar rats (n = 8, 3 groups) was studied to observe absolute sirtuin 1 (SIRT1) levels (expressed as ng mg−1 total protein) in serum, stomach, liver, and kidney. Dietary buckwheat at 30% (w/w) level of incorporation in the standard diet (Buckwheat Enriched Diet, BED) improved SIRT1 with values 0.933 ± 0.05, 210 ± 7, 63.26 ± 4, and 69.89 ± 3 in serum, stomach, liver, and kidney respectively when compared to the respective control values of 0.536 ± 0.03, 156 ± 23.3, 31.07 ± 2 and 47.11 ± 4. Moreover, BED though isocaloric to CR diet, led to weight gain (g) by 63.11 ± 3.8, ca. 10%, and 40% higher than control (56.27 ± 5.6) and CR (45.05 ± 4.1) diet groups. A marked rise in Feed Efficiency Ratio (FER) by ca. 37% while a 30% decrease in Feed Conversion Ratio (FCR) was observed for the BED group which supports unexpected weight gain in rats post-dietary intervention. The results justify the superior nutritional profile of buckwheat laden with essential nutrients, essential proteins, and bioactives. In contrast, Calorie Restriction (CR) resulted in a decline of the total protein content in circulation by 19%, while reduction of total protein in stomach, liver, and kidney was estimated to be 95%, 35.2%, and 27% respectively though SIRT1 values were comparatively the highest in all the samples studied. A 30-fold enhancement of SIRT1 in stomach post CR is presumed to counter enhanced stress in gastric tissues. Therefore, mild to moderate expression of SIRT1 may confer beneficial effects such as delayed aging and stress resistance but exceedingly high SIRT1 may evoke increased oxidative stress.

https://www.sciencedirect.com/science/article/abs/pii/S0733521020303696

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Leisure time aerobic and muscle strengthening activities are associated with important survival benefits.

Posted on July 21, 2020 by Maurice Preter MD

Adults who engage in leisure time aerobic and muscle strengthening activities at levels recommended by the 2018 physical activity guidelines for Americans show greatly reduced risk of all cause and cause specific mortality. These data suggest that the physical activity levels recommended in the guidelines are associated with important survival benefits.

CCBYNC Open access
Research

Recommended physical activity and all cause and cause specific mortality in US adults: prospective cohort study

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2031 (Published 01 July 2020)Cite this as: BMJ 2020;370:m2031

 
 
  1. Min Zhao, lecturer of nutritional epidemiology12,  
  2. Sreenivas P Veeranki, director of health economics and outcomes research34,  
  3. Costan G Magnussen, senior research fellow of cardiovascular epidemiology567,  
  4. Bo Xi, professor of cardiovascular epidemiology8

Author affiliations

  1. Correspondence to: B Xi xibo2007@126.com
  • Accepted 21 April 2020

Abstract

Objective To determine the association between recommended physical activity according to the 2018 physical activity guidelines for Americans and all cause and cause specific mortality using a nationally representative sample of US adults.

Design Population based cohort study.

Setting National Health Interview Survey (1997-2014) with linkage to the National Death Index records to 31 December 2015.

Participants 479 856 adults aged 18 years or older.

Exposures Participant self-reports of the amount of leisure time spent in aerobic physical activity and muscle strengthening activity each week were combined and categorised into four groups: insufficient activity, aerobic activity only, muscle strengthening only, and both aerobic and muscle strengthening activities according to the physical activity guidelines.

Main outcome measures All cause mortality and cause specific mortality (cardiovascular disease, cancer, chronic lower respiratory tract diseases, accidents and injuries, Alzheimer’s disease, diabetes mellitus, influenza and pneumonia, and nephritis, nephrotic syndrome, or nephrosis) obtained from the National Death Index records.

Results During a median follow-up of 8.75 years, 59 819 adults died from all causes, 13 509 from cardiovascular disease, 14 375 from cancer, 3188 from chronic lower respiratory tract diseases, 2477 from accidents and injuries, 1470 from Alzheimer’s disease, 1803 from diabetes mellitus, 1135 from influenza and pneumonia, and 1129 from nephritis, nephrotic syndrome, or nephrosis. Compared with those who did not meet the physical activity guidelines (n=268 193), those who engaged in recommended muscle strengthening activity (n=21 428; hazard ratio 0.89, 95% confidence interval 0.85 to 0.94) or aerobic activity (n=113 851; 0.71, 0.69 to 0.72) were found to be at reduced risk of all cause mortality; and even larger survival benefits were found in those engaged in both activities (n=76 384; 0.60, 0.57 to 0.62). In addition, similar patterns were reported for cause specific mortality from cardiovascular disease, cancer, and chronic lower respiratory tract diseases.

Conclusions Adults who engage in leisure time aerobic and muscle strengthening activities at levels recommended by the 2018 physical activity guidelines for Americans show greatly reduced risk of all cause and cause specific mortality. These data suggest that the physical activity levels recommended in the guidelines are associated with important survival benefits.

Source:

https://www.bmj.com/content/370/bmj.m2031

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Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial

Posted on July 20, 2020 by Maurice Preter MD

Possible gamechanger. 

Safety and immunogenicity of the ChAdOx1 nCoV-19 vaccine against SARS-CoV-2: a preliminary report of a phase 1/2, single-blind, randomised controlled trial

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31604-4/fulltext

Summary

Background

The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might be curtailed by vaccination. We assessed the safety, reactogenicity, and immunogenicity of a viral vectored coronavirus vaccine that expresses the spike protein of SARS-CoV-2.

Methods

We did a phase 1/2, single-blind, randomised controlled trial in five trial sites in the UK of a chimpanzee adenovirus-vectored vaccine (ChAdOx1 nCoV-19) expressing the SARS-CoV-2 spike protein compared with a meningococcal conjugate vaccine (MenACWY) as control. Healthy adults aged 18–55 years with no history of laboratory confirmed SARS-CoV-2 infection or of COVID-19-like symptoms were randomly assigned (1:1) to receive ChAdOx1 nCoV-19 at a dose of 5 × 1010 viral particles or MenACWY as a single intramuscular injection. A protocol amendment in two of the five sites allowed prophylactic paracetamol to be administered before vaccination. Ten participants assigned to a non-randomised, unblinded ChAdOx1 nCoV-19 prime-boost group received a two-dose schedule, with the booster vaccine administered 28 days after the first dose. Humoral responses at baseline and following vaccination were assessed using a standardised total IgG ELISA against trimeric SARS-CoV-2 spike protein, a muliplexed immunoassay, three live SARS-CoV-2 neutralisation assays (a 50% plaque reduction neutralisation assay [PRNT50]; a microneutralisation assay [MNA50, MNA80, and MNA90]; and Marburg VN), and a pseudovirus neutralisation assay. Cellular responses were assessed using an ex-vivo interferon-γ enzyme-linked immunospot assay. The co-primary outcomes are to assess efficacy, as measured by cases of symptomatic virologically confirmed COVID-19, and safety, as measured by the occurrence of serious adverse events. Analyses were done by group allocation in participants who received the vaccine. Safety was assessed over 28 days after vaccination. Here, we report the preliminary findings on safety, reactogenicity, and cellular and humoral immune responses. The study is ongoing, and was registered at ISRCTN, 15281137, and ClinicalTrials.gov, NCT04324606.

Findings

Between April 23 and May 21, 2020, 1077 participants were enrolled and assigned to receive either ChAdOx1 nCoV-19 (n=543) or MenACWY (n=534), ten of whom were enrolled in the non-randomised ChAdOx1 nCoV-19 prime-boost group. Local and systemic reactions were more common in the ChAdOx1 nCoV-19 group and many were reduced by use of prophylactic paracetamol, including pain, feeling feverish, chills, muscle ache, headache, and malaise (all p<0·05). There were no serious adverse events related to ChAdOx1 nCoV-19. In the ChAdOx1 nCoV-19 group, spike-specific T-cell responses peaked on day 14 (median 856 spot-forming cells per million peripheral blood mononuclear cells, IQR 493–1802; n=43). Anti-spike IgG responses rose by day 28 (median 157 ELISA units [EU], 96–317; n=127), and were boosted following a second dose (639 EU, 360–792; n=10). Neutralising antibody responses against SARS-CoV-2 were detected in 32 (91%) of 35 participants after a single dose when measured in MNA80 and in 35 (100%) participants when measured in PRNT50. After a booster dose, all participants had neutralising activity (nine of nine in MNA80 at day 42 and ten of ten in Marburg VN on day 56). Neutralising antibody responses correlated strongly with antibody levels measured by ELISA (R2=0·67 by Marburg VN; p<0·001).

Interpretation

ChAdOx1 nCoV-19 showed an acceptable safety profile, and homologous boosting increased antibody responses. These results, together with the induction of both humoral and cellular immune responses, support large-scale evaluation of this candidate vaccine in an ongoing phase 3 programme.

Funding

UK Research and Innovation, Coalition for Epidemic Preparedness Innovations, National Institute for Health Research (NIHR), NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland’s NIHR Clinical Research Network, and the German Center for Infection Research (DZIF), Partner site Gießen-Marburg-Langen.

 

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