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ABSTRACT Aims/Introduction PIONEER REAL Japan was a non‐interventional prospective study of oral semaglutide in adults with type 2 diabetes in Japanese clinical practice. Materials and Methods Adults naïve to injectable glucose‐lowering therapies initiated oral semaglutide in routine clinical practice and were followed for 34–44 weeks. The primary endpoint was change in glycated hemoglobin (HbA1c) from baseline to end of study; the co‐primary endpoint was number of adverse events (AEs). Secondary endpoints included change in bodyweight from baseline to end of study. Analyses were also carried out for subgroups aged

Abstract Background Rates of keratinocyte carcinoma (KC) across Europe are impacted by population demographics and geography. Regional differences in KC occurrence exist, but few European studies investigate incidences of specific subtypes in the secondary healthcare sector on a national level. Objectives To determine geographical differences in incidence rate and lifetime risk of KC subtypes across Denmark, including nodular and superficial basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and the KC precursor, Bowen's disease (BD), identified in office‐based dermatological practice. Methods Based on a nationwide registry (The Danish Skin Cancer Registry), all patients in Denmark's five regions with a histologically‐ or clinically verified KC or BD registered in a state‐funded office‐based dermatology practice between 2013 and 2022 were included. Trends in national‐ and region‐specific age and sex standardised tumour incidence rates (STIR) were calculated. Further, national lifetime risk of each tumour subtype was estimated. Results Between 2013 and 2022, the combined STIR for KC/BD rose 172% nationally from 180 to 489 per 100,000 person‐years (PY). This increase reflected rising rates of nodular BCC, SCC, and BD, while superficial BCC incidence was relatively stable. Regional differences in STIR for combined KC/BD were observed, with the Capital Region and North Jutland generally demonstrating higher rates than Zealand, Southern‐ and Central Denmark (e.g., North Jutland vs. Southern Denmark: 714 vs. 405/100,000PY). While the estimated lifetime risk of developing at least one KC or BD tumour was 21.8%, risk varied with tumour subtype, resulting in subtype‐specific risks of 16.4%, 5.1%, 1.9% and 1.3% for nodular BCC, superficial BCC, SCC, and BD, respectively. Conclusions In Denmark's secondary dermatological care sector, incidence of nodular BCC, SCC and BD continues to rise with an overall lifetime risk nearing 22%. While KC incidence is increasing in Denmark, the study detected differences in geographical trends and rate increases of specific tumour subtypes.

Purpose: This study aimed to determine if any cases of pulmonary arterial hypertension (PAH) were missed using routine screening of systemic sclerosis (SSc). We assessed the potential benefits of adding the DETECT algorithm and invasive hemodynamic exercise testing into the local screening process in a Danish single-center cohort without known PAH. Methods: Seventy-three patients with SSc (aged 60 ± 10 years; 56 (77%) females) underwent echocardiography. Among them, 24/73 had an elevated step 2 score of whom 3 had a high risk of pulmonary hypertension on echocardiographic assessment. Four patients declined right heart catheterization. Twenty patients (aged 62 ± 10 years, 13 (65%) females) underwent invasive hemodynamic assessment at rest. Nineteen patients participated in invasive hemodynamic exercise testing. Results: At rest, 3/20 patients met the 2022 ESC guidelines for PAH (mean pulmonary arterial pressure (mPAP) >20 mm Hg, pulmonary arterial wedge pressure (PAWP) ≤15 mm Hg, and pulmonary vascular resistance >2 Wood units). According to the 2015 ESC guidelines, only 1/19 patients had PAH. During exercise, 18/19 experienced an mPAP of >30 mm Hg, with the majority (13/19) showing an abnormal pulmonary pressure-flow relationship >3 mm Hg/liter/min. Interestingly, 7 out of 9 patients with no pulmonary hypertension (PH) at rest had exercise-induced pulmonary hypertension. One-quarter of the patients had pulmonary hypertension associated with left ventricular dysfunction (group 2 PH, WHO classification). Conclusions: In a Danish cohort of 73 patients with SSc already undergoing bi-annual PAH screening, applying the DETECT algorithm identified 3 patients meeting the 2022 ESC/ERS guideline criteria for PAH at rest, 1 of whom demonstrated increased PAWP with exercise. However, many patients exhibited an abnormal pulmonary vascular response to exercise and/or signs of group 2 PH.

Cloud Computing (CC) refers to the physical structure of a communications network, where data is stored in large data centers and can be accessed anywhere, at any time, and from different devices. This systematic literature review identifies and categorizes the potential and barriers of cloud-based teaching in schools from an international perspective. This study applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology for determining the articles and reporting analysis. A total of 510 articles were identified from ERIC, IEEE Xplore, Science Direct, and Primo. After screening and eligibility checking, 13 articles focusing on "cloud computing and school" were included for qualitative and meta-analysis. The papers are coded, devising 31 themes grouped into five categories. The adoption of CC in schools is associated with five factors: 1) globalization (easier access to education, data access everywhere/accessibility/infrastructure, 21st Century Skills); 2) educational benefits (motivation, teacher-parent communication, collaboration, flexibility, productivity, creativity, self-organized learning, communication, sharing of knowledge, problem-solving, responsible students/peer review/no bad excuses); 3) administrative benefits (economy--operations, computer lifetime, licenses, timesaving, BYOD, software diversity); 4) barriers (technical barriers, cultural barriers, security, privacy, laws and regulations for schools, age restrictions/parent acceptance, and opacity); and 5) implementation (management support, paradigm shift in education, incongruence between implementation strategies).

Parasite aggregation within hosts is a fundamental feature of parasite distributions, whereby the majority of parasites are harboured by a minority of hosts. Parasite aggregation can influence their transmission and hence control. In this narrative review, possible sources of aggregation of Taenia solium cysticerci in pigs are discussed, along with implications for control of the parasite. While heavy T. solium infections in pigs could most likely be associated with ingestion of high doses of infective parasite eggs, consistent with coprophagic behaviour of pigs, lighter infections indicate a role of indirect routes of transmission to pigs, mostly from lower infection doses. Light infections are likely to be missed by commonly used diagnostic methods - tongue examination or meat inspection - and end up in the food chain. Hence, they entail a ‘hidden’ risk and are of a particular public health concern, especially in areas where meat is consumed raw or undercooked. To be effective and sustainable, control strategies against T. solium likely require a broader understanding of, and consideration for parasite transmission dynamics. More importantly, a holistic One Health approach incorporating interventions on humans, pigs and the environment will likely have a larger, more successful and sustainable impact.

Aims/Introduction: PIONEER REAL Japan was a non‐interventional prospective study of oral semaglutide in adults with type 2 diabetes in Japanese clinical practice. Materials and Methods: Adults naïve to injectable glucose‐lowering therapies initiated oral semaglutide in routine clinical practice and were followed for 34–44 weeks. The primary endpoint was change in glycated hemoglobin (HbA1c) from baseline to end of study; the co‐primary endpoint was number of adverse events (AEs). Secondary endpoints included change in bodyweight from baseline to end of study. Analyses were also carried out for subgroups aged <75 and ≥75 years. Results: A total of 624 participants initiated oral semaglutide; 578 completed the study. Mean baseline HbA1c and bodyweight were 7.7% and 72.4 kg, respectively. At end of study, estimated change (95% confidence interval [CI]) in HbA1c from baseline was −0.7 percentage points (−0.77, −0.61) overall, −0.8 percentage points (−0.86, −0.67) in the <75 years subgroup and −0.5 percentage points (−0.68, −0.41) in the ≥75 years subgroup (all P < 0.0001). Estimated change (95% CI) in bodyweight was −2.8 (−3.19, −2.50) kg overall, −2.9 (−3.38, −2.49) kg in the <75 years subgroup and − 2.7 (−3.18, −2.14) kg in the ≥75 years subgroup (all P < 0.0001). AEs occurred in 161 (25.8%) participants: 99 of 423 (23.4%) and 62 of 201 (30.8%) participants in the <75 and ≥75 years subgroups, respectively. Gastrointestinal AEs were the AEs most frequently leading to oral semaglutide discontinuation. Conclusions: In routine clinical practice, HbA1c and bodyweight were significantly reduced from baseline in adults initiating oral semaglutide, including those aged ≥75 years, with no new safety concerns. [ABSTRACT FROM AUTHOR]

COVID-19 has been associated with acral ischemia and digital necrosis. Standard treatment of acral ischemia and digital or acral necrosis includes ongoing therapy with vasodilators and anticoagulants. However, these treatments are not always efficient to avoid the progression of necroses, which in the worst case can lead to amputation. Here, we report a case in which interdigital Botox® (botulinum toxin type A) nerve cord injection stopped the progression of acral necroses arising from an underlying vasculopathy due to COVID-19. Moreover, Botox® injection eliminated inflammation in the affected acral area within 2 weeks. This is the first case report to suggest Botox® injection as a new and improving treatment for acral necroses due to COVID-19.

This article explores Marc Shaiman's use of stylistic pastiche in Catch Me If You Can. Building on previous studies of style imitation in musical theatre, I develop a model for analysing different forms of pastiche. This model categorizes instances of pastiche according to the specificity of the stylistic reference, the function of the pastiche and how the pastiche is integrated into the song. Each component of the model is illuminated through a selection of examples. In Catch Me If You Can, I argue that Shaiman tends to use intra-opus (song) references in order to enhance the lyrical and narrative content, while his broader style references tend to be used for setting and reinforcing aspects of time and place. I conclude with the suggestion that this model could be deployed on other musicals. This will lead to a better understanding of how Shaiman's practices align or deviate from other composers who engage with this widespread technique. [ABSTRACT FROM AUTHOR]

Abstract Background Taenia solium is a zoonotic parasite responsible for neurocysticercosis—a major cause of late-onset acquired epilepsy in humans. Lack of affordable, specific and sensitive diagnostic tools hampers control of the parasite. This study assessed the performance of an antigen detection enzyme-linked immunosorbent assay (Ag-ELISA) in the diagnosis of viable T. solium cysticercosis in naturally infected slaughter-age pigs in an endemic area in Tanzania. Methods A total of 350 pigs were bled before they were slaughtered and their carcases examined. Serum was analyzed for circulating antigens by using a monoclonal antibody-based B158/B60 Ag-ELISA. Each carcase was examined for the presence of Taenia hydatigena cysticerci and half carcase musculature together with the whole brain, head muscles, tongue, heart and diaphragm were sliced with fine cuts (

Background: There are limited estimates of the incidence rates (IRs) of mastocytosis, and only a few studies have addressed the long-term consequences of living with these diagnoses. Previous reports have shown that systemic mastocytosis is associated with leukemic transformations and an increased risk of death as opposed to cutaneous mastocytosis (CM) and indolent systemic mastocytosis (ISM), which have benign diagnoses with life expectancy rates similar to those of the background population. Objective: This study aimed to analyze the incidence and mortality of mastocytosis. Methods: A population-based matched cohort study of patients with mastocytosis between 1 January 1, 1977 and 31 December 31, 2014 was identified from the Danish National Health Registries. IRs of CM, ISM, and pediatric mastocytosis were highlighted. Survival estimates were compared with those of a healthy background population, using a Cox proportional hazard model. Results: A total of 1461 patients with mastocytosis were identified. The annual IR of overall mastocytosis was 1.1 per 100,000 person years (95% confidence interval [CI], 1.0–1.2). Among children, the IR was 1.8 per 100,000 person years (95% CI, 1.6–2.1). The prevalence of any comorbidity was twice as high among patients with mastocytosis compared with the population without mastocytosis (odds ratio: 2.1; 95% CI, 1.8–2.5). The Charlson Comorbidity Index–adjusted mortality among adult patients with mastocytosis was HRCutaneous Mastocytosis 1.2 (95% CI, 0.8–1.9), HRIndolent Systemic Mastocytosis 1.9 (95% CI 1.4–2.5), and HRSystemic Mastocytosis 4.2 (95%, CI 1.9–9.4), respectively. Conclusion: Based on an entire nation, with free health care at the point of access, we estimated an annual IR of mastocytosis and its subgroups. We discovered that patients with ISM had an increased risk of death compared with the general population. Our data supported the overall benign nature of CM diagnosed after age 2 years.

Abstract Background Taenia solium taeniasis/cysticercosis is a disease of substantial economic and public health importance particularly in low–income countries. The disease was reported to be endemic in Mbeya Rural and Mbozi districts, in the southern highlands of Tanzania, the major pig production area in the country. In 2008, using B158/B60 antigen detection enzyme–linked immunosorbent assay (Ag–ELISA), porcine cysticercosis prevalence of up to 32% was reported in the districts. A number of interventions have been implemented in selected villages including an integrated approach consisting of improving pig confinement and selective treatment of pigs with oxfendazole. Mass drug administration with praziquantel targeting schistosomiasis, with an expected effect on T. solium, was also provided to school–age children in the area. This study aimed at providing an update on prevalence and intensities of porcine cysticercosis; and assessing farmers’ knowledge, attitudes and practices which could be associated to disease transmission in the area. The study involved a questionnaire survey conducted using face–to–face household interviews with 890 consenting farmers; and carcass dissections performed on 282 pigs randomly selected from the surveyed households. Results Twenty–six pigs (9.2%) were infected with T. solium; of which two–thirds (65.4%) had light to moderate infection intensities (1–1000 cysticerci), and one–third (34.6%) had heavy intensities (> 1000 cysticerci). Questionnaire results showed that only 5.7% of the respondents perceived T. solium cysticercosis to be an important disease in pigs. About 18.5% of the respondents were aware of T. solium taeniasis, but 32% of them were unaware of how the infection is acquired. Half of the respondents had seen cysticerci in pork, of whom 61% were not aware that consumption of infected pork could cause taeniasis. Latrines were observed to often (90%) lack doors with 45% considered accessible to pigs. Conclusions This study provided an evidence that the disease was still endemic in the area. Poor knowledge of farmers, attitudes, and risky practices responsible for disease perpetuation were also revealed. A One Health approach targeting the whole area incorporating improvement of farmer knowledge regarding disease transmission needs to be trialed as a feasible approach to control.

Abstract Background Taenia saginata is an important zoonotic parasite, causing taeniosis in humans and cysticercosis in bovines, the latter being a significant concern for the global beef industry. Many countries in East, Southeast and South Asia are experiencing rapid economic growth, and an increasing number of people in these countries are dependent on the livestock industry. Currently, however, an overview of the prevalence of T. saginata in this region is lacking. In this review, we analysed the available literature on T. saginata taeniosis and bovine cysticercosis for East, Southeast and South Asia. Methods A systematic review was conducted, based on both published and grey literature. Articles published between 1990 and 2017 were mined for information on the occurrence, prevalence, and geographical distribution of T. saginata taeniosis and bovine cysticercosis in East, Southeast and South Asia. Results The presence of T. saginata was described in 15 of 27 countries of the region, including Afghanistan, Cambodia, China, India, Indonesia, Japan, Lao PDR, Malaysia, Mongolia, Nepal, Pakistan, Philippines, South Korea, Thailand and Vietnam. The only country that reported an absence of T. saginata is Japan, although sporadic reports of imported cases and unconfirmed reports of autochthonous infections were identified. Nationwide surveys of taeniosis with systematic sample collection and high sample numbers were available for Cambodia, China, Lao PDR, and South Korea, although speciation of Taenia was not always performed. Regional prevalence of taeniosis and bovine cysticercosis in endemic regions ranged between 0.02–42.6%, and 0.76–46.7%, respectively. However, data for bovine cysticercosis were only available for five countries (Japan, Lao PDR, Mongolia, Pakistan and Vietnam). Conclusions The data indicate a widespread occurrence of T. saginata throughout East, Southeast and South Asia. Identification of Taenia spp. in human infections was frequently not performed, leading to gaps in knowledge about the distribution of human tapeworm infections, mainly in regions where different human Taenia species co-occur. A high prevalence of T. saginata taeniosis and bovine cysticercosis may reflect insufficiencies in sanitation, limited health education standards, and insufficient food safety measures. Therefore, there is a need to improve local surveillance, notification, and overall control systems.

Consumer purchase data (CPD) can be a powerful tool in the investigation of foodborne outbreaks through analyses of electronic records of food that individuals buy. The objective of this study was to develop a common framework for use of CPD in foodborne outbreak investigations using the expertise of European public health professionals from 11 European countries. We also aimed to describe barriers and limitations preventing CPD utilization. CPD are mainly gathered from supermarket loyalty programmes, smaller consortia, and independent supermarkets. Privacy legislation governing CPD was perceived as the most crucial barrier for CPD usage, but still resolvable. The main practical challenges were obtaining consumer consent for CPD usage, the associated workload, data access, format, and analysis. Harmonising methods and reporting across countries, standardised consent forms and electronic consent methods were identified as solutions. This guideline was developed to support outbreak investigators in overcoming barriers in using CPD, thereby increasing public health professionals’ application and value of this powerful investigation tool. In addition, we hope this framework will lead to more public health institutions, in collaboration with food safety authorities, making use of CPD in outbreak investigations in the future.

The cestode Taenia solium is responsible for a considerable cross-sectoral health and economic burden due to human neurocysticercosis and porcine cysticercosis. The 2012 World Health Organization (WHO) roadmap for neglected tropical diseases called for the development of a validated strategy for control of T. solium; however, such a strategy is not yet available. In 2019, WHO launched a global consultation aimed at refining the post-2020 targets for control of T. solium for a new roadmap for neglected tropical diseases. In response, two groups working on taeniasis and cysticercosis mathematical models (cystiSim and EPICYST models), together with a range of other stakeholders organized a workshop to provide technical input to the WHO consultation and develop a research plan to support efforts to achieve the post-2020 targets. The workshop led to the formation of a collaboration, CystiTeam, which aims to tackle the population biology, transmission dynamics, epidemiology and control of T. solium through mathematical modelling approaches. In this paper, we outline developments in T. solium control and in particular the use of modelling to help achieve post-2020 targets for control of T. solium. We discuss the steps involved in improving confidence in the predictive capacities of existing mathematical and computational models on T. solium transmission, including model comparison, refinement, calibration and validation. Expanding the CystiTeam partnership to other research groups and stakeholders, particularly those operating in different geographical and endemic areas, will enhance the prospects of improving the applicability of T. solium transmission models to inform taeniasis and cysticercosis control strategies. Taenia solium est un cestode qui entraine une charge intersectorielle economique et sanitaire considerable en provoquant une neurocysticercose humaine et une cysticercose porcine. La feuille de route sur les maladies tropicales negligees, publiee en 2012 par Organisation mondiale de la Sante (OMS), appelait a developper une strategie de controle validee pour T. solium; cependant, cette strategie n'est pas encore disponible a l'heure actuelle. En 2019, l'OMS a lance une procedure de consultation mondiale visant a preciser les objectifs de controle de T. solium apres 2020, afin de rediger une nouvelle feuille de route sur les maladies tropicales negligees. Deux groupes qui travaillent sur des modeles mathematiques de taeniasis et cysticercose (modeles cystiSim et EPICYST) ainsi qu'une serie d'autres intervenants ont donc organise un atelier pour fournir une contribution technique a cette consultation et developper un programme de recherche destine a soutenir les efforts de realisation des objectifs ulterieurs a 2020. L'atelier a donne naissance a une collaboration, CystiTeam, qui s'interesse a la biologie des populations, a la dynamique de transmission, a l'epidemiologie et au controle de T. solium en employant des methodes de modelisation mathematique. Le present document retrace revolution du controle de T. solium, en particulier l'usage de la modelisation pour contribuer a atteindre les objectifs d'apres 2020 en la matiere. Nous abordons les diverses etapes de renforcement de la confiance accordee aux capacites predictives des modeles mathematiques et informatiques existants sur la transmission de T. solium, notamment la comparaison, l'optimisation, le calibrage et la validation des modeles. Elargir le partenariat CystiTeam en integrant d'autres groupes de recherche et intervenants, surtout ceux operant dans dfferentes zones geographiques et endemiques, accroitra les chances d'amelioration de l'applicabilite pour les modeles de transmission de T. solium, et permettra ainsi d'etablir des strategies de lutte contre la taeniasis et la cysticercose. El cestodo Taenia solium es responsable de una importante carga sanitaria y economica transversal debido a la neurocisticercosis humana y la cisticercosis porcina. En la hoja de ruta de la Organizacion Mundial de la Salud (OMS) de 2012 sobre las enfermedades tropicales desatendidas se solicitaba la elaboracion de una estrategia validada para el control de T. solium; sin embargo, dicha estrategia aun no esta disponible. En 2019, la OMS inicio una consulta mundial destinada a perfeccionar los objetivos de control de T. solium aplicables a partir de 2020 con miras a elaborar una hoja de ruta nueva sobre las enfermedades tropicales desatendidas. Consecuentemente, dos grupos que trabajan en modelos matematicos de teniasis y cisticercosis (modelos cystiSim y EPICYST), junto con un grupo de otros interesados, organizaron un seminario para contribuir tecnicamente a la consulta de la OMS y elaborar un plan de investigacion a fin de apoyar los esfuerzos para lograr los objetivos a partir de 2020. El seminario impulso la formacion de un equipo de colaboracion, CystiTeam, para abordar la biologia de la poblacion, la dinamica de la transmision, la epidemiologia y el control de T. solium mediante enfoques de modelos matematicos. En el presente documento se describen las novedades en el control de T. solium y, en particular, la aplicacion de modelos para ayudar a lograr los objetivos a partir de 2020 sobre el control de T. solium. Se analizan las etapas necesarias para mejorar la confianza en las capacidades de prediccion de los modelos matematicos y computacionales existentes sobre la transmision de T. solium, incluyendo la comparacion, el perfeccionamiento, el ajuste y la validacion de los modelos. La ampliacion de la asociacion CystiTeam a otros grupos de investigacion e interesados, en particular los que operan en diferentes zonas geograficas y endemicas, reforzara las perspectivas de mejorar la aplicabilidad de los modelos sobre las transmision de T. solium para fundamentar las estrategias de control de la teniasis y la cisticercosis., Introduction Infection by the cestode Taenia solium, a zoonotic tapeworm, exerts a considerable health and economic burden as the cause of cysticercosis in humans and pigs in endemic countries. The [...]