Dr Simon Ashworth

You've got to hand it to Elon Musk - getting 71% of British people to agree on anything is impressive

From Escalate to Elevate: A New Paradigm for Comprehensive Cardiogenic Shock Management

CCR Journal Watch

criticalcarereviews.com/latest-evide...

Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at criticalcarereviews.com/newsletters/...

These are the 20 most-studied bacteria — the majority have been ignored Model microbes such as Escherichia coli hog scientists’ attention, leaving most known bacteria with few publications devoted to them.

As someone who researches both some of these overstudied bacteria as well as a host of understudied ones that didn’t make the list and as I know have barely any research papers on this bias was fascinating 🧪
www.nature.com/articles/d41...

A mechanism for the salutary effects of exercise on reducing body-wide inflammation: immune cell specific reduced cf-DNA release
www.pnas.org/doi/abs/10.1...
"having significance for inflammation in diverse contexts such as aging, cancer, autoimmunity, and vaccination." @pnas.org

here is the substack version for those intereste
christinapagel.substack.com/p/what-is-th...

Respiratory infection hospitalisation and rate positivity testing data update from the US.

Influenza, as in the wave of 2023/2024, remains the most dangerous. Fortunately, RSV and SARS-CoV-2, although increased in positivity testing, have not caused such large increases in hospitalisation.

Congestion pricing in Stockholm “reduced ambient air pollution by 5–15 percent and the rate of acute asthma attacks among young children”

jhr.uwpress.org/content/56/4...

All alarms should be going off with these new
@ihmeuw.bsky.social data which show a steadily declining life expectancy in the US

www.thelancet.com/journals/lan...

Even Adults May Soon Be Vulnerable to ‘Childhood’ Diseases (Gift Article) Outbreaks among the unvaccinated are a predictable consequence of falling immunization rates. But even vaccinated adults may be vulnerable to some illnesses.

#MedSky #IDSky #PublicHealth

“Before the first #measles vax was introduced in the 1960s, the disease killed -2.6M people 🌎 each yr. The virus cripples immune defenses, leaving the body vulnerable to other pathogens.”

Say it plainly: we will not go back to that.

www.nytimes.com/2025/01/13/h...

The man in charge of social media platforms used by billions should show some moral courage, writes @jemima.bsky.social www.ft.com/content/682c...

Whooping cough cases in the US are the highest they’ve been in a decade | CNN Whooping cough has been surging in the United States for months and the latest data from the US Centers for Disease Control and Prevention suggests there are no signs of slowing.

I never saw whooping cough during my medical training in India in the 1990s because of childhood vaccination

To see this unfolding today in the US is truly heartbreaking and stunning

Whooping cough cases in the US are the highest they’ve been in a decade

edition.cnn.com/2024/12/25/h...

Good point.

Maybe it’s not about the averages but some courses were drastically shorter?

And 1 day off ICU LOS is £2000…

Streeting ‘shocked’ by his lack of ‘oversight’ of social care Health and social care secretary Wes Streeting has said he is "shocked" by his lack of oversight of adult social care and said he is "determined to improve this" in a call with local leaders this morn...

It may seem oblique, but it’s good to see some positive news about the NHS and its governance

The NHS does deliver a lot of outstanding care…
www.hsj.co.uk/emergency-ca...

Unsurprising but it’s a good start to understand a problem if you want to confront it?

And why should we? Because if we misinform our decisions, are they likely to be any good?

I’m super excited to announce I'm part of an amazing team (<3 @williambrady.bsky.social @killianmcloughlin.bsky.social @mjcrockett.bsky.social) that just published a paper in @science.org on the role of outrage in spread of misinformation

Link here:
science.org/doi/10.1126/...

Summary in🧵🔽
1/

The 18 patients were diagnosed with triple-negative breast cancer that was not metastatic; no spread to other organs. There was no control group to assess efficacy of the treatment. With a small cohort, chance plays a big role. ~50% of patients would be cancer free at 3y.
4/4

The vaccine is well-tolerated and stimulates the immune system. Neoantigen-specific T cell responses were induced in 14/18 patients. At a median follow-up of 36 months, recurrence-free survival was 16/18 in the cohort of vaccinated patients.
3/4

Neoantigen, antigens present in tumour cells only, vaccines can induce or enhance specific antitumor immune responses with minimal risk of autoimmunity. 18 subjects (with remaining tumour after chemo) received 3x a DNA vaccine encoding on average 11 neoantigens per patient.
2/4

Neoantigen DNA vaccines are safe, feasible, and induce neoantigen-specific immune responses in triple-negative breast cancer patients - Genome Medicine Background Neoantigen vaccines can induce or enhance highly specific antitumor immune responses with minimal risk of autoimmunity. We have developed a neoantigen DNA vaccine platform capable of efficiently presenting both HLA class I and II epitopes and performed a phase 1 clinical trial in triple-negative breast cancer patients with persistent disease on surgical pathology following neoadjuvant chemotherapy, a patient population at high risk of disease recurrence. Methods Expressed somatic mutations were identified by tumor/normal exome sequencing and tumor RNA sequencing. The pVACtools software suite of neoantigen prediction algorithms was used to identify and prioritize cancer neoantigens and facilitate vaccine design for manufacture in an academic GMP facility. Neoantigen DNA vaccines were administered via electroporation in the adjuvant setting (i.e., following surgical removal of the primary tumor and completion of standard of care therapy). Vaccines were monitored for safety and immune responses via ELISpot, intracellular cytokine production via flow cytometry, and TCR sequencing. Results Eighteen subjects received three doses of a neoantigen DNA vaccine encoding on average 11 neoantigens per patient (range 4–20). The vaccinations were well tolerated with relatively few adverse events. Neoantigen-specific T cell responses were induced in 14/18 patients as measured by ELISpot and flow cytometry. At a median follow-up of 36 months, recurrence-free survival was 87.5% (95% CI: 72.7–100%) in the cohort of vaccinated patients. Conclusion Our study demonstrates neoantigen DNA vaccines are safe, feasible, and capable of inducing neoantigen-specific immune responses. Clinical trial registration number NCT02348320.

Neoantigen DNA vaccines are safe, feasible, and induce neoantigen-specific immune responses in triple-negative breast cancer patients

A clinical trial to prevent recurrence of tumors promising results for patients with triple-negative breast cancer.

genomemedicine.biome...
1/4

A challenge is how to afford those medicines mindful that the full benefits might take 10-20 years to translate into health savings, and obesity is associated with poverty?

How Every Country Can Halve Premature Death by 2050 There's a clear path for combatting premature death, write Gavin Yamey, Dean Jamison, and Justina Seyi-Olajide.

📣New column in TIME!

I teamed up with economist Dean Jamison (UCSF) & pediatric surgeon Justina Seyi-Olajide (Lagos University Teaching Hospital)

We argue: every country can halve its premature death by 2050

Yes, the world is on fire with challenges, but this is feasible

time.com/7197746/comb...

editorial from @bmj.com and paper: Poor staff retention is associated with higher patient mortality. Have said it before & I’ll say it again. If you don’t care for the carers, they cannot care for their patients.
www.bmj.com/content/387/...

Hard to know who knows more about vaccines eh?

No expertise is perfect but it’s a good deal more reliable than no expertise…

… especially because it is coupled with the willingness, indeed the scientific obligation, to change your mind as the weight of evidence shifts.

Terrific interview

The impact of vaccination on preventing long COVID in the Omicron era: a systematic review and meta-analysis Millions worldwide are living with long COVID. Since therapeutic research is ongoing, long COVID prevention is a pragmatic public health strategy. While prior analyses have shown the benefit of primary vaccination, the effect of booster vaccination on preventing long COVID caused by an Omicron infection has not been fully investigated. This systematic review identified 31 observational studies, among which 11 were deemed suitable for pairwise meta-analyses. Herein, the pooled risk of long COVID was 22–29% ( P <0.0001 and P <0.0001, respectively) lower for vaccinated (any vaccination) populations versus unvaccinated (10 studies); 19% ( P <0.0001) lower for primary course vaccination versus no vaccination (3 studies); 26% ( P <0.0001) lower for booster vaccination versus no vaccination (4 studies) and 23% ( P =0.0044) lower for booster vaccination versus primary course vaccination (3 studies). These findings indicate that booster vaccination can provide additional protection against long COVID; thereby, highlighting the importance of seasonal vaccination against new SARS-CoV-2 variants. ### Competing Interest Statement SA is an employee of BioNTech SE. RG and ZM are employees of Maverex Ltd both of whom received consulting fees from BioNTech SE. GYHL: Consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, Daiichi Sankyo, and Anthos. No fees were received personally. He is a National Institute for Health and Care Research (NIHR) Senior Investigator. MJP has received consulting fees from Gilead Sciences, AstraZeneca, BioVie, Apellis Pharmaceuticals, and BioNTech and research support from Aerium Therapeutics and Shionogi, outside the submitted work. AB: Consultant for Perspectum. Speaker for Shionogi and Pfizer. BD: BioNTech; one-off advisory board on long COVID in 2024. ### Funding Statement This study was funded by BioNTech SE. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: References for data used for the meta-analyses in this study: 1Congdon, S. et al. Nirmatrelvir/ritonavir and risk of long COVID symptoms: a retrospective cohort study. Sci Rep 13, 19688 (2023). <https://doi.org/10.1038/s41598-023-46912-4> 2Di Fusco, M. et al. Impact of COVID-19 and effects of booster vaccination with BNT162b2 on six-month long COVID symptoms, quality of life, work productivity and activity impairment during Omicron. J Patient Rep Outcomes 7, 77 (2023). <https://doi.org/10.1186/s41687-023-00616-5> 3Diexer, S. et al. Association between virus variants, vaccination, previous infections, and post-COVID-19 risk. Int J Infect Dis 136, 14-21 (2023). <https://doi.org/10.1016/j.ijid.2023.08.019> 4Hammel, I. S., Tosi, D. M., Tang, F., Pott, H. & Ruiz, J. G. Frailty as a risk factor for post-acute sequelae of COVID-19 among US veterans during the Delta and Omicron waves. J Am Geriatr Soc 71, 3826-3835 (2023). <https://doi.org/10.1111/jgs.18584> 5Li, J., Nadua, K., Chong, C. Y. & Yung, C. F. Long COVID prevalence, risk factors and impact of vaccination in the paediatric population: a survey study in Singapore. Ann Acad Med Singap 52, 522-532 (2023). <https://doi.org/10.47102/annals-acadmedsg.2023238> 6Lundberg-Morris, L. et al. Covid-19 vaccine effectiveness against post-covid-19 condition among 589 722 individuals in Sweden: population based cohort study. BMJ 383, e076990 (2023). <https://doi.org/10.1136/bmj-2023-076990> 7Mazzitelli, M. et al. Risk of hospitalization and sequelae in patients with COVID-19 treated with 3-day early remdesivir vs. controls in the vaccine and Omicron era: A real-life cohort study. J Med Virol 95, e28660 (2023). <https://doi.org/10.1002/jmv.28660> 8Razzaghi, H. et al. Vaccine effectiveness against long COVID in children. Pediatrics 153 (2024). <https://doi.org/10.1542/peds.2023-064446> 9Wander, P. L. et al. Rates of ICD-10 Code U09.9 documentation and clinical characteristics of VA patients with post-COVID-19 condition. JAMA Netw Open 6, e2346783 (2023). <https://doi.org/10.1001/jamanetworkopen.2023.46783> 10Wu, Q. et al. Real-world effectiveness and causal mediation study of BNT162b2 on long COVID risks in children and adolescents. medRxiv (2024). 11Antonelli, M. et al. SARS-CoV-2 infection following booster vaccination: Illness and symptom profile in a prospective, observational community-based case-control study. J Infect 87, 506-515 (2023). <https://doi.org/10.1016/j.jinf.2023.08.009> I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

The impact of vaccination on preventing long COVID in the Omicron era: a systematic review and meta-analysis

A meta-analysis is as good as the studies they use. 31+2 studies were used.

www.medrxiv.org/cont...
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When oil and gas prices rise, or supply becomes a blackmail weapon, being sustainable for whatever reason will seem like perfect foresight… so maybe not?

And besides it’s all about relationships isn’t it?

How do clinicians diagnose and manage pneumonia in ICU? New from myself and a global group of collaborators
Major findings cover
1) Use of radiology
2) Training and skills in bronchoscopy
3) Availability of molecular diagnostics
4) Antibiotic duration
#emimcc #Ansky #IDsky #AMR
rdcu.be/d1chc

Headline from Nature: “A place of joy”—why scientists are joining the rush to Bluesky

Bluesky is indeed a breath of fresh air

I agree with @smritimallapaty.bsky.social’s headline in this piece in Nature: it is a place of joy!

Likewise.
Reinvention is always refreshing though.

Niche.