Publications by authors named "S W Janson"

195 Publications

The Darwin Prospective Melioidosis Study: a 30-year prospective, observational investigation.

Lancet Infect Dis 2021 Jul 22. Epub 2021 Jul 22.

Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia; Infectious Diseases Department, Royal Darwin Hospital and Northern Territory Medical Programme, Darwin, NT, Australia.

Background: The global distribution of melioidosis is under considerable scrutiny, with both unmasking of endemic disease in African and Pacific nations and evidence of more recent dispersal in the Americas. Because of the high incidence of disease in tropical northern Australia, The Darwin Prospective Melioidosis Study commenced in October, 1989. We present epidemiology, clinical features, outcomes, and bacterial genomics from this 30-year study, highlighting changes in the past decade.

Methods: The present study was a prospective analysis of epidemiological, clinical, and laboratory data for all culture-confirmed melioidosis cases from the tropical Northern Territory of Australia from Oct 1, 1989, until Sept 30, 2019. Cases were identified on the basis of culture-confirmed melioidosis, a laboratory-notifiable disease in the Northern Territory of Australia. Patients who were culture-positive were included in the study. Multivariable analysis determined predictors of clinical presentations and outcome. Incidence, survival, and cluster analyses were facilitated by population and rainfall data and genotyping of Burkholderia pseudomallei, including multilocus sequence typing and whole-genome sequencing.

Findings: There were 1148 individuals with culture-confirmed melioidosis, of whom 133 (12%) died. Median age was 50 years (IQR 38-60), 48 (4%) study participants were children younger than 15 years of age, 721 (63%) were male individuals, and 600 (52%) Indigenous Australians. All but 186 (16%) had clinical risk factors, 513 (45%) had diabetes, and 455 (40%) hazardous alcohol use. Only three (2%) of 133 fatalities had no identified risk. Pneumonia was the most common presentation occurring in 595 (52%) patients. Bacteraemia occurred in 633 (56%) of 1135 patients, septic shock in 240 (21%) patients, and 180 (16%) patients required mechanical ventilation. Cases correlated with rainfall, with 80% of infections occurring during the wet season (November to April). Median annual incidence was 20·5 cases per 100 000 people; the highest annual incidence in Indigenous Australians was 103·6 per 100 000 in 2011-12. Over the 30 years, annual incidences increased, as did the proportion of patients with diabetes, although mortality decreased to 17 (6%) of 278 patients over the past 5 years. Genotyping of B pseudomallei confirmed case clusters linked to environmental sources and defined evolving and new sequence types.

Interpretation: Melioidosis is an opportunistic infection with a diverse spectrum of clinical presentations and severity. With early diagnosis, specific antimicrobial therapy, and state-of-the-art intensive care, mortality can be reduced to less than 10%. However, mortality remains much higher in the many endemic regions where health resources remain scarce. Genotyping of B pseudomallei informs evolving local and global epidemiology.

Funding: The Australian National Health and Medical Research Council.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S1473-3099(21)00022-0DOI Listing
July 2021

Childhood exposure to physical and emotional violence over a 57-year period in Sweden.

Scand J Public Health 2021 Jun 24:14034948211023634. Epub 2021 Jun 24.

Department of Women's and Children's Health, Uppsala University, Sweden.

Aims: The aim of the present study was to examine the prevalence of childhood experiences of physical violence (CPV) and emotional violence (CEV) at the hands of parents over a 57-year period among adults born between 1937 and 1993.

Methods: In 2012, a survey among women and men aged 18-74 years in Sweden was undertaken to examine the lifetime prevalence of physical, psychological and sexual violence and associations with current health in adulthood. Questionnaires were based on the Adverse Childhood Experiences study and a previous national survey of violence exposure. Descriptive statistics were used to analyse the frequency of exposure to CPV and CEV, and changes over time were analysed using analysis of variance and logistic regression.

Results: A total of 10,337 individuals participated (response rates: 56% for women and 48% for men). CPV decreased significantly over the time period studied, particularly for those born after 1983. This decrease was more evident for male respondents. Throughout the time period studied, the proportion of women reporting CEV was higher than for men. Among both genders there was a steady rise in CEV rates from those born in the late 1930s to those born in the mid-1980s, after which there was a decline that was more marked for men.

Conclusions: A significant group of children in Sweden experience violence at the hands of parents. However, our data corroborate previous national studies that children's exposure to violence has decreased. Clear gender differences indicate that these changes have affected girls and boys differently.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/14034948211023634DOI Listing
June 2021

AGC kinases and MAB4/MEL proteins maintain PIN polarity by limiting lateral diffusion in plant cells.

Curr Biol 2021 May 10;31(9):1918-1930.e5. Epub 2021 Mar 10.

Institute of Science and Technology Austria (IST Austria), 3400 Klosterneuburg, Austria. Electronic address:

Polar subcellular localization of the PIN exporters of the phytohormone auxin is a key determinant of directional, intercellular auxin transport and thus a central topic of both plant cell and developmental biology. Arabidopsis mutants lacking PID, a kinase that phosphorylates PINs, or the MAB4/MEL proteins of unknown molecular function display PIN polarity defects and phenocopy pin mutants, but mechanistic insights into how these factors convey PIN polarity are missing. Here, by combining protein biochemistry with quantitative live-cell imaging, we demonstrate that PINs, MAB4/MELs, and AGC kinases interact in the same complex at the plasma membrane. MAB4/MELs are recruited to the plasma membrane by the PINs and in concert with the AGC kinases maintain PIN polarity through limiting lateral diffusion-based escape of PINs from the polar domain. The PIN-MAB4/MEL-PID protein complex has self-reinforcing properties thanks to positive feedback between AGC kinase-mediated PIN phosphorylation and MAB4/MEL recruitment. We thus uncover the molecular mechanism by which AGC kinases and MAB4/MEL proteins regulate PIN localization and plant development.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cub.2021.02.028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8112251PMC
May 2021

Can we trust our gut feeling when we suspect child abuse?

Authors:
Staffan Janson

Acta Paediatr 2021 06 11;110(6):1713-1714. Epub 2021 Feb 11.

Department of Public Health, Karlstad University, Karlstad, Sweden.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/apa.15783DOI Listing
June 2021

Drowning is a complex but preventable cause of child mortality.

Authors:
Staffan Janson

Acta Paediatr 2021 07 10;110(7):1981-1982. Epub 2020 Dec 10.

Department of Public Health, Karlstad University, Karlstad, Sweden.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/apa.15674DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8359451PMC
July 2021
-->