Association between asymptomatic Plasmodium falciparum malaria infection, anaemia and mean corpuscular volume of school children in the Volta Region of Ghana

Background

Although, several studies have reported abnormal Mean Corpuscular Volume (MCV) values and anaemia associated with malaria infections with a focus on Plasmodium falciparum among patients with complicated and uncomplicated malaria, none has looked at the association with asymptomatic malaria. This study aimed to assess this association.

Methods

We conducted a cross-sectional study using 3 mL of blood samples from 549 children aged 5-17 years attending 5 schools selected in the Volta Region. Semi-structured questionnaires were administered to the children to obtain demographic data. Blood samples were collected to estimate the children's full blood count (FBC) and malaria status. Data obtained were analysed using STATA 15 software. P-values of less than 0.05 were considered statistically significant.

Results

Most of the children in this study (49.9%) had normal MCV (81.3-91.3 fL) with an overall malaria prevalence of 55.6 % (95% CI: 51.3-59.8) and anaemia prevalence of 48.6% (95% CI 44.4-52.9). Most anaemic children had normal MCV (81.3-91.3 fL) (49.8, 95% CI 43.7-56.0). The predicted probability of malaria was highly likely among children with normal MCV (81.3-91.3 fL) but with high variability and uncertainty among those with low MCV (<81.3 fL) and high MCV (>91.3 fL).

Conclusion

This study shows a reduced predicted probability of malaria among children with low and high MCV, playing a protective function against malaria. Further studies are required to elucidate the interaction.

Influencing intertidal food web: Implications of ocean acidification on the physiological energetics of key species the 'wedge' clam Donax faba

Ocean acidification has become increasingly severe in coastal areas. It poses emerging threats to coastal organisms and influences ecological functioning. Donax faba, a dominant clam in the intertidal zone of the Bay of Bengal, plays an important role in the coastal food web. This clam has been widely consumed by the local communities and also acts as a staple diet for shorebirds and crustaceans. In this paper, we investigated how acidified conditions will influence the physiology, biochemical constituents, and energetics of Donax faba. Upon incubation for 2 months in lowered pH 7.7 ± 0.05 and control 8.1 ± 0.05 conditions, we found a delayed growth in the acidified conditions followed by decrease in calcium ions in the clam shell. Although not significant, we found the digestive enzymes showed a downward trend. Total antioxidant was significantly increased in the acidified condition compared to the control. Though not significant, the expression level of MDA and antioxidant enzymes (SOD, CAT, GST, GPX, and APX) showed increasing trend in acidified samples. Among nutrients such as amino acids and fatty acids, there was no significant difference between treatments, however, showed a downward trend in the acidified conditions compared to control. Among the minerals, iron and zinc showed significant increase in the acidified conditions. The above results suggest that the clam growth, and physiological energetics may have deleterious effects if exposed for longer durations at lowered pH condition thereby affecting the organisms involved in the coastal food web.

Polyethylene terephthalate waste derived nanomaterials (WDNMs) and its utilization in electrochemical devices

Plastics are a vital component of our daily lives in the contemporary globalization period; they are present in all facets of modern life. Because the bulk of synthetic plastics utilized in the market are non-biodegradable by nature, the issues associated with their contamination are unavoidable in an era dominated by polymers. Polyethylene terephthalate (PET), which is extensively used in industries such as automotive, packaging, textile, food, and beverages production represents a major share of these non-biodegradable polymer productions. Given its extensive application across various sectors, PET usage results in a considerable amount of post-consumer waste, majority of which require disposal after a certain period. However, the recycling of polymeric waste materials has emerged as a prominent topic in research, driven by growing environmental consciousness. Numerous studies indicate that products derived from polymeric waste can be converted into a new polymeric resource in diverse sectors, including organic coatings and regenerative medicine. This review aims to consolidate significant scientific literatures on the recycling PET waste for electrochemical device applications. It also highlights the current challenges in scaling up these processes for industrial application.

Knowledge and perception of asymptomatic malaria in the Volta region of Ghana

BACKGROUND

The control of asymptomatic malaria is considered a key aspect of malaria control. This study aimed to assess the knowledge and perception of asymptomatic malaria among people in Ho municipality of the Volta region.

METHODS

A descriptive cross-sectional study involving questionnaire administration was conducted among randomly sampled residents of the Ho municipality of the Volta region of Ghana. Using SPSS version 25 statistical software, frequency distributions and proportions were computed for sociodemographic variables while knowledge and perception about asymptomatic malaria were computed into percentages and categorized into three levels based on Bloom's cut-off for further analysis. Findings with p-values <0.05 were considered statistically significant.

RESULTS

Among the 200 participants, 197 (98.5%) were aware of malaria. The majority (116 [58.0%]) of the study participants agreed to the possibility of asymptomatic infection, but most (133 [66.5%]) of the community members did not know that asymptomatic individuals can still transmit infections. The majority of the participants (184 [92.0%]) showed interest in getting further education on asymptomatic malaria and a significant majority (180 [90.0%]) expressed a willingness to take treatment after testing positive without showing any symptoms.

CONCLUSIONS

Asymptomatic malaria control can be achieved through a mass testing and treatment strategy, therefore improving the knowledge and perception about asymptomatic malaria might improve malaria control.

Knowledge, Attitude, and Practice towards Prevention of Intestinal Helminth Infection among Residents of the Ho Municipality in the Volta Region of Ghana

Background

This study investigated the knowledge, attitude, and practices of residents in the Ho municipality towards intestinal helminth infections and their prevention.

Method

A descriptive cross-sectional study involving questionnaire administration was conducted among randomly sampled residents of the Ho municipality of the Volta Region of Ghana. A minimum sample size of 400 was calculated for subjects using Yamane's formula for population. Pearson's chi-square analysis was done to determine any relationship between sociodemographic characteristics and the categories of knowledge, attitude, and practices. Results from data analysis were computed as frequencies and percentages. P < 0.05 is considered statistically significant.

Results

Of the 400 participants, 343 (85.7%) were aware of intestinal helminths, but the majority had poor knowledge of its cause despite 50.5% (202) having good knowledge scores. Most participants (331, 82.8%) had a bad attitude toward preventing the disease. Most (335, 83.8%) of the community members still adhered to the poor practice of open defecation with the excuse of unavailable latrines, and some (143, 35.8%) believe that intestinal helminths are nothing to worry about.

Conclusion

Health education should address the perceptions towards preventing intestinal helminthiasis and be complemented by making available public lavatories in the municipality to curb the unacceptable practice of open defecation.

Diabetes mellitus: An overview of the types, prevalence, comorbidity, complication, genetics, economic implication, and treatment

Diabetes is one of the deadliest diseases. Due to its effects on the lives of people, it has attracted a lot of attention recently. The causes of the various forms of diabetes, including type 1 and type 2, were discussed along with how they affect those who have the disease. Younger people are more prone to type 1 diabetes than older people, who are more likely to develop type 2. The treatment options and strategies for the two forms of diabetes were also discussed in addition to how the disease affects the quality of life of people. Among several factors that were explained, it has been shown that people from low and middle-income countries are more prone to having diabetes. Additionally, the condition is more likely to affect some races more than others. It is associated with obesity. According to statistics, those who are poor are more severely affected by the disease. The progression of the disease over time has been associated with an increase in disability and mortality.

Effect of SARS-CoV-2 infection on the liver

There have been numerous concerns about the disease and how it affects the human body since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic began in December 2019. The impact of SARS-CoV-2 on the liver is being carefully investigated due to an increase in individuals with hepatitis and other liver illnesses, such as alcoholic liver disease. Additionally, the liver is involved in the metabolism of numerous drugs used to treat comorbidities and coronavirus disease 2019 (COVID-19). Determining how SARS-CoV-2 affects the liver and what factors place individuals with COVID-19 at a higher risk of developing liver problems are the two main objectives of this study. This evaluation of the literature included research from three major scientific databases. To provide an update on the current impact of COVID-19 on the liver, data was collected and relevant information was incorporated into the review. With more knowledge about the effect of the disease on the liver, better management and therapeutics can be developed, and education can ultimately save lives and reduce the long-term impact of the pandemic on our population.

Review of the prevalence, diagnostics, and containment measures of the current mpox outbreak

Monkeypox (mpox), is a disease from the Poxviridae family that can cause several serious medical issues. This mini-review sought to analyze the existing literature regarding the current mpox outbreak with a focus on the prevalence, diagnostics, and containment measures. Mpox cases have been reported to World Health Organization (WHO) from 85 Member States in all six WHO regions during the period of January 1, 2022, through August 3, 2022. Standardized or optimized guidelines for the clinical care of patients with mpox are limited, particularly in low-resource settings. In an effort to achieve guidance and meet standards, special attention should be paid to this outbreak in order to eradicate such a rare infectious disease by analyzing prevention and control measures. Patient outcomes may also be poor, and their illnesses may last for a long time. The spectrum of clinical symptoms, including complications and sequelae, as well as aspects of the illness may be indicators of sickness severity and complications; therefore, its clinical presentation must be better understood to improve containment measures. In addition, it is important to create and evaluate a standard of care that takes a variety of parameters into account, including antiviral, immune therapies, and clinical metrics that are particular to mpox. The global emergence of mpox has presented new challenges for public health and has called for further investigation into its epidemiological profile across international contexts.

An inexpensive and rapid diagnostic method for detection of SARS-CoV-2 RNA by loop-mediated isothermal amplification (LAMP)

SARS-CoV-2 is a public pandemic health concern globally. Nasopharyngeal and oropharyngeal swab samples are used for Covid-19 viral detection. Sample collection procedure was tedious and uncomfortable and unsuitable for biochemical and CBC analysis in swab samples. Biochemistry and CBC tests are key determinant in management of Covid-19 patients. We developed a LAMP test to detect viral RNA in blood samples. LAMP is required four specific primers targeting the internal transcribed S-region and loop primers for viral RNA amplification. RNA was extracted from blood samples by TRIzol method. LAMP reaction was performed at 60 °C for 1 hour and amplicons were visualized in HNB dye. No cross-reactivity was seen with HBV, HCV, and HIV infected sample. Out of 40 blood samples, 33 samples were positive for LAMP and Q-PCR analysis, one sample was positive for LAMP and negative for Q-PCR, two samples were negative for LAMP but positive for Q-PCR, and four blood samples were negative for LAMP and Q-PCR. LAMP method has an accuracy of 92.50%, with sensitivity and specificity of 94.28% and 80%, respectively. Thus, LAMP diagnostic test has proved reliable, fast, inexpensive and can be useful for detection where the limited resources available.•LAMP method is a potential tool for detection of SARS-CoV-2.•Blood samples are the key determinant for routine diagnostics as well as molecular diagnostics.•LAMP assay is an appropriate diagnostics method which offers greater simplicity, low cost, sensitivity, and specificity than other methods in molecular diagnostics.

Assessing nursing mothers' knowledge, perceptions and uptake of Sulphadoxine Pyrimethamine (IPTp-SP) during pregnancy in the Ho Teaching Hospital of the Volta Region of Ghana

Intermittent preventive therapy during pregnancy with Sulphadoxine Pyrimethamine (IPTp-SP) is one of the potent strategies for preventing malaria in pregnancy (MiP). Factors such as the pregnant woman's knowledge and very importantly perception or belief about IPTp-SP remains key determinant of IPTp-SP uptake. This study assessed the knowledge and perception of nursing mothers and their uptake of IPTp-SP during pregnancy in the Ho Teaching Hospital. We administered a close-ended questionnaire to 303 nursing mothers and obtained their sociodemographic details as well as information on their knowledge and perception of IPTp-SP utilization. We also reviewed the nursing mothers' antenatal care (ANC) booklets to ascertain the number of times IPTp-SP was taken during pregnancy. Pearson chi-square was used to determine the association between the sociodemographic variable and the categories of knowledge, perception, and uptake of IPTp-SP. Analysis, was done using SPSS, and the p-value of less than 5% was considered statistically significant. Of the 303 nursing mothers sampled in this study, 265(87.5%) had heard about IPTp-SP of which 138(52.1%) had average knowledge of IPTp-SP. A total of 168(63.4%) had poor perception, and 168(64.6%) had adequate uptake (3-4 doses) of IPTp. Education was significantly associated with perception and uptake, with the majority of women who demonstrated excellent perception were those who had tertiary education (7, 6.35%, p = 0.05), and the majority who demonstrated excellent uptake (5 completed doses) were women who had tertiary education (47, 37.9%, p = 0.01). While knowledge was average, perception of IPTp-SP was poor for the majority of the nursing mothers which might have hampered their uptake of IPTp-SP during pregnancy. It is important that continuous assessment of the individual factors affecting the uptake of IPTp-SP be done regularly to curb the negative influences on the uptake of IPTp-SP.

Evaluation of growth, primary productivity, nutritional composition, redox state, and antimicrobial activity of red seaweeds Gracilaria debilis and Gracilaria foliifera under pCO2-induced seawater acidification

The genus Gracilaria is an economically important group of seaweeds as several species are utilized for various products such as agar, used in medicines, human diets, and poultry feed. Hence, it is imperative to understand their response to predicted ocean acidification conditions. In the present work, we have evaluated the response of Gracilaria foliifera and Gracilaria debilis to carbon dioxide (pCO₂) induced seawater acidification (pH 7.7) for two weeks in a controlled laboratory conditions. As a response variable, we have measured growth, productivity, redox state, primary and secondary metabolites, and mineral compositions. We found a general increase in the daily growth rate, primary productivity, and tissue chemical composition (such as pigments, soluble and insoluble sugars, amino acids, and fatty acids), but a decrease in the mineral contents under the acidified condition. Under acidification, there was a decrease in malondialdehyde. However, there were no significant changes in the total antioxidant capacity and a majority of enzymatic and non-enzymatic antioxidants, except for an increase in tocopherols, ascorbate and glutathione-s-transferase in G. foliifera. These results indicate that elevated pCO₂ will benefit the growth of the studied species. No sign of oxidative stress markers indicating the acclimatory response of these seaweeds towards lowered pH conditions. Besides, we also found increased antimicrobial activities of acidified samples against several of the tested food pathogens. Based on these observations, we suggest that Gracilaria spp. will be benefitted from the predicted future acidified ocean.

Experimental Evidence of t_{2g} Electron-Gas Rashba Interaction Induced by Asymmetric Orbital Hybridization

We report the control of Rashba spin-orbit interaction by tuning asymmetric hybridization between Ti orbitals at the LaAlO_{3}/SrTiO_{3} interface. This asymmetric orbital hybridization is modulated by introducing a LaFeO_{3} layer between LaAlO_{3} and SrTiO_{3}, which alters the Ti-O lattice polarization and traps interfacial charge carriers, resulting in a large Rashba spin-orbit effect at the interface in the absence of an external bias. This observation is verified through high-resolution electron microscopy, magnetotransport and first-principles calculations. Our results open hitherto unexplored avenues of controlling Rashba interaction to design next-generation spin orbitronics.

Clinical and genetic correlates of mitral valve pathology in patients with heritable thoracic aortic disease: results from the montalcino aortic consortium

Background

Mitral valve (MV) pathology, including prolapse and regurgitation, is a well-known cardiovascular manifestation associated with the genes that predispose to Heritable Thoracic Aortic Disease (HTAD). The extent to which there are differences in prevalence, presentation and severity of MV pathology as a function of the underlying genetic cause has not been investigated in detail.

Purpose

Assess the prevalence, presenting features and outcome of mitral valve pathology according to the underlying genetic defect in patients with HTAD.

Study design

We leveraged clinical and genetic data of a large international multicenter retrospective cohort study. Probands and relatives with a validated (likely) pathogenic (LP/P) variant in 8 HTAD genes were included. Genes were categorized in 2 groups: Group 1 encoding for components of the TGFβ pathway (TGFBR1, TGFBR2, SMAD3 and TGFB2) and Group 2 encoding for proteins involved in vascular smooth muscle cell contraction (VSMC) (ACTA2, MYLK, PRKG1, MYH11). Comparison between these groups was performed. MV pathology was defined as at least moderate MV regurgitation, MV prolapse and past MV surgeries.

Results

A total of 459 patients. 68.8% of the patients carried a variant in one of the Group 1 genes and 31.2% had a Group 2 gene variant. 52 patients (11.3%) presented MV pathology. Significant differences in MV status according to the gene group were present: 15.5% of the patients in group 1 presented MV disease, versus 2.1% in group 2, (p&lt;0.001). Within Group 1, LP/P variants in SMAD3 were most common (32.7%), followed by TGFBR2 (25.0%) and TGFB2 (23.1%) (p=0.006). The remaining 5.8% of MV pathology cases were patients carrying ACTA2 variants. No MV pathology was found in MYLK, PRKG1 and MYH11 variant carriers.

Compared to patients without MV pathology, patients with MV pathology more often underwent aortic aneurysm repair (34.6% vs 15.5%, p&lt;0.001). To the contrary, aortic dissection/rupture occurred less frequently in patients with MV pathology (7.7% vs 26.8%, p&lt;0.001). No differences were observed for prevalence of congenital heart defects, left ventricular dilatation, arrhythmic events or heart failure.

Conclusion

Patients with HTAD carrying LP/P variants in genes encoding TGFβ components present more frequently with MV pathology than patients carrying variants in genes encoding proteins involved in VSMC contraction. In the latter group, only patients carrying ACTA2 variants presented MV pathology. Patients with MV pathology are more likely to undergo aortic aneurysm repair and present less frequently with aortic dissection/rupture. Whether the presence of MV pathology accelerates the diagnosis and hence leads to a more aggressive management/stricter surveillance in these patients and/or whether biological differences between these genetic entities explain these differences requires further study. These data provide tools for developing improved, gene-tailored management of patients with HTAD.

Funding Acknowledgement

Type of funding sources: Foundation. Main funding source(s): Baillet Latour FoundationFunds for Scientific Research Flanders

COVID-19 and the Human Gut Microbiome: An Under-Recognized Association

Coronavirus disease 2019 (COVID-19) is an infectious disease with a wide range of respiratory and extrapulmonary symptoms, as well as gastrointestinal symptoms. Despite recent research linking gut microbiota to infectious diseases like influenza, minimal information is known about the gut microbiota's function in COVID-19 pathogenesis. Studies suggest that dysbiosis of the gut microbiota and gut barrier dysfunction may play a role in COVID-19 pathogenesis by disrupting host immune homeostasis. Regardless of whether patients had taken medication or disease severity, the gut microbiota composition was significantly altered in COVID-19 patients compared to non-COVID-19 individuals. Several gut commensals with recognized immunomodulatory potential, such as Faecalibacterium prausnitzii, Eubacterium rectale, and bifidobacteria, were underrepresented in patients and remained low in samples taken several weeks after disease resolution. Furthermore, even with disease resolution, dysbiosis in the gut microbiota may contribute to chronic symptoms, underscoring the need to learn more about how gut microbes play a role in inflammation and COVID-19.

The magnitude of anemia and preventive practices in mothers with children under five years of age in Dodi Papase, Volta region of Ghana

Background

Socio-demographic factors influence the magnitude of anemia in endemic areas. The purpose of this study is to establish the magnitude of anemia and to determine anemia preventive practices carried out by mothers with children under five years of age in the Kadjebi District of the Volta region of Ghana.

Methods

This purposive sampling study involved women of reproductive age with children less than five years of age from Saint Mary Theresa Hospital and nurses practicing in the pediatric ward of the hospital. A questionnaire and interview guide were administered respectively, and the data collected were analyzed using the Statistical Package for Social Sciences version 21.

Results

A total of 150 participants were studied; among which analysis of anemia was carried out on 129 women whose children had their hemoglobin levels checked and recorded in the laboratory. Hemoglobin levels recorded for these children showed that 85.3% were anemic, even though 93.8% of the mothers had been given iron supplements during their pregnancy. Furthermore, anemia prevention practices comprised whether the child had been given any anti-malaria prophylaxis (98.4% denied), if the child had been dewormed in the last three months (89.9% denied), whether the child was given iron supplements in the last three months (59.7% denied), if the child had been given vitamin supplements in the last three months (24.0% denied).

Conclusion

Most of the children in the study were anemic. Mothers practiced exclusive breastfeeding, iron, and vitamin supplementation, and ensured that children slept under insecticide-treated mosquito nets as a means of preventing malaria.

Scintillation light detection in the 6-m drift-length ProtoDUNE Dual Phase liquid argon TPC

DUNE is a dual-site experiment for long-baseline neutrino oscillation studies, neutrino astrophysics and nucleon decay searches. ProtoDUNE Dual Phase (DP) is a 6  ×  6  ×  6 m 3 liquid argon time-projection-chamber (LArTPC) that recorded cosmic-muon data at the CERN Neutrino Platform in 2019-2020 as a prototype of the DUNE Far Detector. Charged particles propagating through the LArTPC produce ionization and scintillation light. The scintillation light signal in these detectors can provide the trigger for non-beam events. In addition, it adds precise timing capabilities and improves the calorimetry measurements. In ProtoDUNE-DP, scintillation and electroluminescence light produced by cosmic muons in the LArTPC is collected by photomultiplier tubes placed up to 7 m away from the ionizing track. In this paper, the ProtoDUNE-DP photon detection system performance is evaluated with a particular focus on the different wavelength shifters, such as PEN and TPB, and the use of Xe-doped LAr, considering its future use in giant LArTPCs. The scintillation light production and propagation processes are analyzed and a comparison of simulation to data is performed, improving understanding of the liquid argon properties.

Perspective Chapter: SARS-CoV-2 Variants - Two Years Post-Onset of the Pandemic

Since the pandemic began in China in December 2019, thousands of variants of SARS-CoV-2 have emerged globally since late 2020. The World Health Organization (WHO) defined the SARS-CoV-2 variant of concern (VOC) as a variant with increased transmissibility, virulence, and decreased response to available diagnostics, vaccines, and therapeutics. Areas of the emerging variant of concern arise from countries like the United Kingdom, South Africa, Brazil, and India. These mutations carry a lineage from N501Y, D614G, N439K, Y453F, and others, which are globally dominated by clades 20A, 20B, and 20C. SARS-CoV-2 VOC emerged after 11 months of evolution since the onset through massive human-to-human transmission with five major VOCs recognized by the WHO, namely Alpha, Beta, Gamma, Delta, and Omicron. Their emergence could be attributed to changing immunological dynamics in the human population, which has resulted in resistance or escape from neutralizing antibodies, or to mutations and/or recombinations that increase transmission or pathogenicity. This literature review intends to identify and report on SARS-CoV-2 variants that have evolved two years post-onset of the pandemic and their disease implications.

Investigation on characterization, antifouling and cytotoxic properties of zinc oxide nanoparticles biosynthesized by a mangrove-associated actinobacterium Streptomyces olivaceus (MSU3)

The present study was undertaken to biosynthesize zinc oxide nanoparticles (ZnONPs) using a mangrove-associated actinobacterium Streptomyces olivaceus (MSU3) under in vitro conditions. The synthesized ZnONPs were structurally characterized through UV, FT-IR, TG-DTA, XRD, SEM and EDX analysis. Analysis of biosynthesized ZnONPs in UV-Vis spectroscopy showed presence of functional groups between the wavelengths 325 and 380 nm. FT-IR analysis showed the functional groups, such as halo bromide (C-Br), alkyne (C≡C), carboxylic acid (O-H), nitro (N-O), fluoro (C-F), alkene (C=C) and aromatic (R-C-H) groups, respectively, within the wave numbers between 614.30 and 3074.41 cm^-1. The crystalline poly-dispersed quasi spherical nature of ZnONPs expressed the average particle size of 37.9 nm with the 2θ values of 11.802-37.885°. Antibacterial activity of ZnONPs showed pronounced inhibitory zone (25 mm) and least MIC and MBC values (125 and 250 µg ml^-1) against Escherchia sp. In the antifouling study, ZnONPs strongly inhibited byssal thread formation in mussel Perna indica and recorded LC₅₀ value of 424.47 µg ml^-1. Mollusc foot adherence assay inferred that the ZnONPs effectively inhibited settlement of limpet Patella vulgata and showed minimal fouling (26.43%) at 350 µg ml^-1 and recorded LC₅₀ value of 218.77 µg ml^-1. Results of anticrustacean assay depicted that, ZnONPs had registered LC₅₀ value of 676.08 µg ml^-1 against Artemia salina nauplii. From this study, it could be concluded that an eco-friendly approach could be used to open a new avenue for biosynthesis of ZnONPs from a mangrove associated actinobacterium S. olivaceus (MSU3) in antifouling studies.

Candida auris: An Overview of the Emerging Drug-Resistant Fungal Infection

Candida auris is an invasive fungal pathogen that has been recognized globally as a serious health threat due to its extensive innate and acquired resistance to antifungal drugs. A growing number of emerging cases of C. auris have been reported with resistance to the standard antifungal treatments including azoles, echinocandins, and polyenes, making it difficult to treat. Unlike other Candida species, C. auris is challenging to diagnose using the standard laboratory methods and are typically prone to misidentification, resulting in inappropriate management. Consequently, C. auris infections have spread globally. The Centers for Disease Control and Prevention data showed that clinical cases of C. auris increased from 329 in 2018 to 1,012 in 2021. The incidence and prevalence of this invasive fungal infection are high in immunocompromised and hospitalized patients. Patients who had an organ transplant, are on immunosuppressive agents, are diabetic, recent antibiotic use, catheter use, and prolonged hospital or nursing homestays are vulnerable to C. auris infections. C. auris is rapidly spreading across healthcare settings globally and monitoring of its virulence as well as devising appropriate treatment approaches are thus highly required.

Current advancements and future prospects of COVID-19 vaccines and therapeutics: a narrative review

Coronavirus disease 2019 (COVID-19) has made a global impact on the daily lives of humanity, devastating health systems, and cataclysmically affecting the world’s economy. Currently, the Standard Public Health Protective practices consist of but are not limited to wearing masks, social distancing, isolating sick and exposed people, and contact tracing. Scientists around the globe undertook swift scientific efforts to develop safe and effective therapeutics and vaccines to combat COVID-19. Presently, as of mid-March 2022, 57.05% of the world population have been fully vaccinated, and 65.3% of the United States of America’s (USA) total population have been fully vaccinated while 76.7% have received at least one dose of the vaccine. This article explores the various vaccines created through modern science and technology, including their safety, efficacy, and mechanism of action. Although the vaccines produced are up to 95.0% efficacious, their efficacy wanes over time, underscoring the need for booster doses. Also, vaccination has not been able to prevent “breakthrough” infections. The limitations of the SARS-CoV-2 vaccines indicate that further measures are required to ensure a firm control of the COVID-19 pandemic. Therefore, the Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) for the use of certain therapeutic agents because they have shown remarkable clinical outcomes. Several therapeutic agents for the treatment of mild-to-moderate COVID-19 include Gilead’s remdesivir, Regeneron’s casirivimab and imdevimab combination, Eli Lilly’s baricitinib and remdesivir combination, Pfizer’s co-packaged nirmatrelvir tablets and ritonavir tablets, and Merck’s molnupiravir capsules. Hence concerted efforts in early and accurate diagnosis, education on the COVID-19 virulence, transmission and preventive measures, global vaccination, and therapeutic agents could bring this COVID-19 pandemic under control across the globe.

SARS-CoV-2 Omicron variant (B.1.1.529): A concern with immune escape

Omicron, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant that is now spreading across the world, is the most altered version to emerge so far, with mutations comparable to changes reported in earlier variants of concern linked with increased transmissibility and partial resistance to vaccine-induced immunity. This article provides an overview of the SARS-CoV-2 variant Omicron (B.1.1.529) by reviewing the literature from major scientific databases. Although clear immunological and clinical data are not yet available, we extrapolated from what is known about mutations present in the Omicron variant of SARS-CoV-2 and offer preliminary indications on transmissibility, severity, and immune escape through existing research and databases.

A Look at COVID-19 Global Health Situation, 1-Year Post Declaration of the Pandemic

The new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic on 11 March 2020 by the World Health Organization (WHO). The impacts of COVID-19 have changed over the past year globally. There were 116 million confirmed cases of COVID-19 in more than 220 countries, including 2.5 million deaths, as reported at the end of the first week of March 2021. Throughout this time, different variants of SARS-CoV-2 have emerged. In early March, the United States of America (USA) led in both confirmed cases and casualties, while India followed in the number of confirmed cases and Brazil in the number of deaths. Vaccines are available in the USA and worldwide to help combat COVID-19. The level of preparedness among multisectoral communities played a role in transmission rates; therefore, lessons learned from past outbreaks, alongside this pandemic, are crucial in establishing policies and regulations to reduce and/or prevent the spread. This narrative literature review provides an update on the global spread of the COVID-19 outbreak, and the current impact of the pandemic 1-year after the declaration, preparedness, and mitigation efforts since the outbreak.

Influence of seawater acidification on biochemical composition and oxidative status of green algae Ulva compressa

The sequestration of elevated atmospheric CO₂ levels in seawater results in increasing acidification of oceans and it is unclear what the consequences of this will be on seaweed ecophysiology and ecological services they provide in the coastal ecosystem. In the present study, we examined the physiological and biochemical response of intertidal green seaweed Ulva compressa to elevated pCO₂ induced acidification. The green seaweed was exposed to control (pH 8.1) and acidified (pH 7.7) conditions for 2 weeks following which net primary productivity, pigment content, oxidative status and antioxidant enzymes, primary and secondary metabolites, and mineral content were assessed. We observed an increase in primary productivity of the acidified samples, which was associated with increased levels of photosynthetic pigments. Consequently, primary metabolites levels were increased in the thalli grown under lowered pH conditions. There was also richness in various minerals and polyunsaturated fatty acids, indicating that the low pH elevated the nutritional quality of U. compressa. We found that low pH reduced malondialdehyde (MDA) content, suggesting reduced oxidative stress. Consistently we found reduced total antioxidant capacity and a general reduction in the majority of enzymatic and non-enzymatic antioxidants in the thalli grown under acidified conditions. Our results indicate that U. compressa will benefit from seawater acidification by improving productivity. Biochemical changes will affect its nutritional qualities, which may impact the food chain/food web under future acidified ocean conditions.

Plasma cell rich acute rejection: Risk factors, treatment and outcomes

Plasma cell-rich rejection is a rare and poorly defined entity. Its treatment is not clearly defined and has universally poor prognosis. More data should be published from various transplant centers around the world to identify the treatment that has the best outcomes and to formulate treatment guidelines for these cases. It is a retrospective analysis of kidney biopsies form 2008 to 2018. Four hundred biopsied were screened and 55 were found to have features of rejection and among them, 13 had plasma cell-rich rejection. Data of treatment given and the graft survival outcomes in these cases were retrieved by medical records. One patient had complete recovery, three had graft loss and the remaining nine had permanent decline in glomerular filtration rate. Decrease in immunosuppression and presence of infection are risk factors for plasma cell-rich acute rejection (PCAR). It can be acute cell-mediated rejection (ACR)/antibody-mediated rejection (AMR)/ACR+AMR. Resistant rejection, ACR+AMR, C4d positivity, and severe interstitial inflammation are poor prognostic factors. Overzealous decrease in immunosuppression should not be done. Management of immunosuppression during infection is most critical for the development of PCAR. Bortezomib is emerging as a therapeutic modality for the treatment of PCAR.

Blood group discrepancy in Ah para-Bombay phenotype: a rare blood group variant and its clinical significance

Individuals with the rare para-Bombay phenotype have inherited defects in producing H associated with FUT1 and/or FUT2 genes. We report a case of blood group discrepancy in a para-Bombay patient from a tertiary care hospital of eastern India. A 31-year-old woman with rheumatic heart disease presented with fatigue and breathlessness and was then scheduled for valvuloplasty, for which a blood transfusion request was sent to the blood center. During pre-transfusion testing, red blood cell (RBC) testing showed group O, and serum testing showed strong reactivity with group B RBCs, weak reactivity with group O RBCs, and very weak reactivity with group A RBCs. Saliva inhibition testing and enzyme treatment of RBCs concluded the patient to be of "A_h para-Bombay" phenotype. The patient's Lewis phenotype was Le(a-b+). This patient's serum also had cold-reacting anti-IH along with anti-B. This case report highlights the importance of performing an advanced immunohematologic workup, including adsorption, elution, enzyme treatment, and saliva inhibition testing for identification of weak A or B subgroups as well as the rare para-Bombay blood group, when routine ABO typing, using forward and reverse grouping, is inconclusive. Accurate identification of blood group helps in preventing transfusion-related adverse events and encouraging safe transfusion practice.

Individuals with the rare para-Bombay phenotype have inherited defects in producing H associated with FUT1 and/or FUT2 genes. We report a case of blood group discrepancy in a para-Bombay patient from a tertiary care hospital of eastern India. A 31-year-old woman with rheumatic heart disease presented with fatigue and breathlessness and was then scheduled for valvuloplasty, for which a blood transfusion request was sent to the blood center. During pre-transfusion testing, red blood cell (RBC) testing showed group O, and serum testing showed strong reactivity with group B RBCs, weak reactivity with group O RBCs, and very weak reactivity with group A RBCs. Saliva inhibition testing and enzyme treatment of RBCs concluded the patient to be of “A_h para-Bombay” phenotype. The patient’s Lewis phenotype was Le(a–b+). This patient’s serum also had cold-reacting anti-IH along with anti-B. This case report highlights the importance of performing an advanced immunohematologic workup, including adsorption, elution, enzyme treatment, and saliva inhibition testing for identification of weak A or B subgroups as well as the rare para-Bombay blood group, when routine ABO typing, using forward and reverse grouping, is inconclusive. Accurate identification of blood group helps in preventing transfusion-related adverse events and encouraging safe transfusion practice.

An Early Breast Cancer Detection System Using Stacked Auto Encoder Deep Neural Network with Particle Swarm Optimization Based Classification Method

The demand in breast cancer’s early detection and diagnosis over the last few decade has given a new research avenues. For an individual who is suffered from breast cancer, a successful treatment plan can be specified if early stage diagnosis of non-communicable disease is done as stated by world health organization (WHO). Around the world, mortality can be reduced by cure disease’s early diagnosis. For breast cancer’s early detection and to detect other abnormalities of human breast tissue, digital mammogram is used as a most popular screening method. Early detection is assisted by periodic clinical check-ups and self-tests and survival chance is significantly enhanced by it. For mammograms (MGs), deep learning (DL) methods are investigated by researchers due to traditional computer-aided detection (CAD) systems limitations and breast cancer’s early detection’s extreme importance and patients false diagnosis high impact. So, there is need to have a noninvasive cancer detection system which is efficient, accurate, fast and robust. There are two process in proposed work, Histogram Rehabilitated Local Contrast Enhancement (HRLCE) technique is used in initial process for contrast enhancement with two processing stages. Contrast enhancements potentiality is enhanced while preserving image’s local details by this technique. So, for cancer classification, Particle Swarm Optimization (PSO) and stacked auto encoders (SAE) combined with framework based on DNN called SAE-PSO-DNN Model is used. The SAE-DNN parameters with two hidden layers are tuned using PSO and Limited-memory BFGS (LBFGS) is used as a technique for reducing features. Specificity, sensitivity, normalized root mean square erro (NRMSE), accuracy parameters are used for evaluating SAE-PSO-DNN models results. Around 92% of accurate results are produced by SAE-PSO-DNN model as shown in experimentation results, which is far better than Convolutional Neural Network (CNN) as well as Support Vector Machine (SVM) techniques.

An Early Breast Cancer Detection System Using Recurrent Neural Network (RNN) with Animal Migration Optimization (AMO) Based Classification Method

Breast cancer can be detected using early signs of it mammograms and digital mammography. For Computer Aided Detection (CAD), algorithms can be developed using this opportunities. Early detection is assisted by self-test and periodical check-ups and it can enhance the survival chance significantly. Due the need of breast cancer’s early detection and false diagnosis impact on patients, made researchers to investigate Deep Learning (DL) techniques for mammograms. So, it requires a non-invasive cancer detection system, which is highly effective, accurate, fast as well as robust. Proposed work has three steps, (i) Pre-processing, (ii) Segmentation, and (iii) Classification. Firstly, preprocessing stage removing noise from images by using mean and median filtering algorithms are used, while keeping its features intact for better understanding and recognition, then edge detection by using canny edge detector. It uses Gaussian filter for smoothening image. Gaussian smoothening is used for enhancing image analysis process quality, result in blurring of fine-scaled image edges. In the next stage, image representation is changed into something, which makes analyses process as a simple one. Foreground and background subtraction is used for accurate breast image detection in segmentation. After completion of segmentation stage, the remove unwanted image in input image dataset. Finally, a novel RNN forclassifying and detecting breast cancer using Auto Encoder (AE) based RNN for feature extraction by integrating Animal Migration Optimization (AMO) for tuning the parameters of RNN model, then softmax classifier use RNN algorithm. Experimental results are conducted using Mini-Mammographic (MIAS) dataset of breast cancer. The classifiers are measured through measures like precision, recall, f-measure and accuracy.

Anemia prevalence in mothers with children under five years of age in Dodi Papase, Volta region of Ghana and preventive practices

Introduction/Objective

Sociodemographic factors influence the prevalence of anemia in endemic areas. The purpose of this study is to establish the prevalence and causes of anemia and to determine anemia preventive practices carried out by mothers with children under five years of age in the Kadjebi District of the Volta region of Ghana.

Methods/Case Report

This homogenous sampling study involved women of reproductive age with children less than five years of age from Saint Mary Theresa Hospital. Interview guides were administered, and the data collected were analyzed using the Statistical Package for Social Sciences (SPSS) version 21.

Results (if a Case Study enter NA)

A total of 150 participants were studied. 52.7% of the mothers indicated that their children had never been diagnosed with anemia; however, Hb levels recorded for these children showed that 73.3% were anemic, even though 93.8% of the mothers had been given iron supplements during their pregnancy. Furthermore, anemia prevention practices comprised of whether the child had been given any anti-malaria prophylaxis (98.4% denied / 1.6% confirmed) if the child had been dewormed in the last three months (89.9% denied / 10.1% confirmed), whether the child was given iron supplements in the last three months (59.7% denied / 40.3% confirmed), if the child had been given vitamin supplements in the last three months (24.0% denied / 76.0% confirmed).

Conclusion

Nutritional deficiencies, worm infestation, and malaria were identified as the major causes of anemia among the children. Mothers were educated about the possible causes and prevention methods of anemia.

Evaluation of COVID-19 Antigen Fluorescence Immunoassay Test for Rapid Detection of SARS-CoV-2

Introduction

Tests detecting SARS-CoV-2-specific antigen have recently been developed, and many of them are now commercially available. However, the real-world performance of these assays is uncertain; therefore, their validation is important. In this study, we have evaluated the performance of STANDARD F COVID-19 antigen fluorescence immunoassay (FIA) kit.

Methods

Nasopharyngeal samples collected from patients were subjected to the test as per manufacturer's instructions. The performance of the kit was compared with the gold standard real-time polymerase chain reaction.

Results

A total of 354 patients were tested with STANDARD F COVID-19 antigen FIA test kit. The overall sensitivity, specificity, positive predictive value, and negative predictive value of this test were found to be 38%, 99%, 96.2%, and 72%, respectively, with a diagnostic accuracy of 75.7%.

Conclusion

STANDARD F COVID-19 antigen FIA showed high specificity and positive predictive value but low sensitivity and negative predictive value.

Prospects for beyond the Standard Model physics searches at the Deep Underground Neutrino Experiment: DUNE Collaboration

The Deep Underground Neutrino Experiment (DUNE) will be a powerful tool for a variety of physics topics. The high-intensity proton beams provide a large neutrino flux, sampled by a near detector system consisting of a combination of capable precision detectors, and by the massive far detector system located deep underground. This configuration sets up DUNE as a machine for discovery, as it enables opportunities not only to perform precision neutrino measurements that may uncover deviations from the present three-flavor mixing paradigm, but also to discover new particles and unveil new interactions and symmetries beyond those predicted in the Standard Model (SM). Of the many potential beyond the Standard Model (BSM) topics DUNE will probe, this paper presents a selection of studies quantifying DUNE's sensitivities to sterile neutrino mixing, heavy neutral leptons, non-standard interactions, CPT symmetry violation, Lorentz invariance violation, neutrino trident production, dark matter from both beam induced and cosmogenic sources, baryon number violation, and other new physics topics that complement those at high-energy colliders and significantly extend the present reach.

Global Pandemicity of COVID-19: Situation Report as of June 9, 2020

A novel coronavirus was identified as the cause of a cluster of pneumonia cases in Wuhan, China in December 2019. This cluster quickly spread across the globe and led the World Health Organization (WHO) to declare severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) a pandemic on March 11, 2020. It's sudden emergence, ceaseless human-to-human transmission, and rapid spread has led to continuous pandemicity. As of June 9, 2020, there were 7 039 918 confirmed cases and 404 396 deaths globally. The rate of spread of COVID-19 is affected through respiratory droplets, most commonly when infected individuals cough or talk. The virus is released through respiratory secretions that infect individuals once contact with mucous membranes is made directly or indirectly. Our research was conducted via an electronic literature review on PubMed, Google Scholar, and MedLine Plus. Data were then collected from peer-reviewed articles that included applicable keywords and published between January 1, 2020, and June 9, 2020. This article highlights the rapid spread of SARS-CoV-2 worldwide and indicates a higher number of mortalities in the elderly and those with comorbidities. As the number of cases increases, an immediate need to "flatten the curve" is essential to avoid catastrophic overwhelming of hospital systems across the affected countries. To do so, there is an emphasis on detection, testing, isolating the infected, and organizing the healthcare response to the virus. The rapid spread of infection has impacted over 200 countries and territories to date. This report takes a closer look at the cases, fatalities, and recoveries in different regions of the world with details regarding the geographic scale of SARS-CoV-2 spread, risks, and the subsequent impact on the countries affected. Also, this report discusses some effective measures that were carried out by some countries that helped them to mitigate the pandemic and flatten the curve of COVID-19 spread as early as possible.

ICU shift related effects on sleep, fatigue and alertness levels

BACKGROUND

Shift work may lead to suboptimal sleep resulting in impaired alertness, and lowered performance levels, all of which can lead to medical errors.

AIMS

To examine fatigue, sleepiness and behavioural alertness prospectively in a tertiary level Australian intensive care unit (ICU).

METHODS

All full-time doctors providing 24-h resident cover on a 12-h day and 12-h night shift roster were invited to participate in this study. Data collected included Epworth Sleepiness Scale (ESS), sleep and awake history, Samn-Perelli Fatigue (SPF) Scale, Karolinska Sleepiness Scale (KSS) and iOS-based Psychomotor Vigilance Test (behavioural alertness). Data about medical emergency team (MET) shifts were collected separately as they were perceived to be busier shifts.

RESULTS

Twenty-nine ICU doctors participated in this study for a consecutive 6-week period. At baseline the median (interquartile range (IQR)) ESS was 5 (3-9). Day shift leads to an increase in fatigue and sleepiness (both P < 0.01). Night shift leads to worsening in fatigue, sleepiness and psychomotor vigilance (all P < 0.01). MET shifts had a lower psychomotor vigilance than non-MET shifts. The difference in the psychomotor vigilance was mostly due to the difference in recorded lapses and response time.

CONCLUSIONS

Shift work ICU doctors experience high levels of fatigue and sleepiness. Night shifts also lead to decreased vigilance. This is even more evident in doctors working MET shifts. These factors may lead to errors. Optimal rostering may reduce these effects and improve patient safety.

The emerging SARS-CoV-2 variants of concern

Since emerging from Wuhan, China, in December of 2019, the coronavirus (SARS-CoV-2) has been causing devastating severe respiratory infections in humans worldwide. With the disease spreading faster than the medical community could contain it, death tolls increased at an alarming rate worldwide, causing the World Health Organization to officially sanction the SARS-CoV-2 outbreak as a pandemic, leading to a state of worldwide lockdown for the majority of the year 2020. There have been reports of new strains of the virus emerging in various parts of the world, with some strains displaying even greater infectivity and transmissibility. Areas of the emerging variant of concern arise from countries like the United Kingdom, South Africa, Brazil, and India. These mutations carry a lineage from N501Y, D614G, N439K, Y453F, and others, which are globally dominated by clades 20A, 20B, and 20C. This literature review intends to identify and report SARS-CoV-2 variants that are currently evolving and their disease implications.

446. COVID 19 Pandemicity: a global situation report as of June 9, 2020

Background

The World Health Organization (WHO) declared severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) a pandemic on March 11, 2020. This report takes a closer look at the cases, fatalities, and recoveries in different regions of the world with details regarding the geographic scale of SARS-CoV-2 spread, risks, and the subsequent impact on the countries affected. Also, this report discusses some effective measures that were carried out by some countries that helped them to mitigate the pandemic and flatten the curve of COVID-19 spread as early as possible.

Methods

Our research was conducted via an electronic literature review on PubMed, Google Scholar, and MedLine Plus. Data were then collected from peer-reviewed articles that included applicable keywords and published between January 1, 2020, and June 9, 2020

Results

The rapid spread of infection has impacted over 200 countries and territories to date. As of June 9, 2020, there were 7,039,918 confirmed cases and 404,396 deaths globally. The USA is the North American country with the highest number of confirmed COVID 19 cases with 1,993,560. In South America, total confirmed cases in Brazil are 691,758. The most affected country in the African region is South Africa with 50,879. In Europe, the Russian Federation top with 485,253 confirmed cases. China with 84,638 is still the Western Pacific country with the most confirmed COVID 19 cases. India had 266,598 total confirmed cases and Australia reported 7,265 confirmed cases. Fatalities recorded similar patterns regionally except in Europe where the UK recorded the highest number of fatalities with 40,597 deaths and Iran had the highest number of fatalities with 5,957 cases in Asia. The goal of the practice “slowing the spread” is to prevent hospital systems from being strained beyond their capacity, thus resulting in less mortality. Countries yet to see the peak would benefit substantially by implementing aggressive social distancing, self-isolation, closure of schools and other institutions, encouraging working from home, and/or placing hard limits on the size of crowds at events.

Confirmed cases of COVID-19 globally, as of June 9, 2020.

Confirmed fatalities due to COVID-19 globally, as of June 9, 2020.

Conclusion

As the number of cases increases, an immediate need to “flatten the curve” is essential to avoid catastrophic overwhelming of hospital systems across the affected countries.

Disclosures

All Authors: No reported disclosures

Navigating the Diagnostics of COVID-19

Introduction/Objective

The recent outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Hubei province, China in December 2019 and has spread worldwide at an alarming rate. With millions of individuals infected and over two hundred thousand deaths, the necessity to develop fast and efficient diagnostic methods is of high importance. Diagnostic modalities rely on a combination of epidemiology, clinical presentation, laboratory examination, and appropriate imaging to diagnose and distinguish SARS-CoV-2 from other pulmonary infections. The purpose of this paper is to report on currently available diagnostic screening methods for patients infected with SARS-CoV-2 to guide frontline healthcare workers involved with COVID-19 patient care.

Methods

An electronic literature search was performed for peer-reviewed articles published from January 1, 2020, until April 26, 2020. Articles were then reviewed and included based on the applicability to the topic.

Results

The preferred diagnostic approach is reverse transcription of the virus’ RNA followed by PCR amplification (RT-PCR). This method recognizes the gene-specific primers to target various viral protein genes, such as the envelope protein gene or the nucleocapsid protein gene, which enables this test to be both sensitive and specific toward SARS-CoV-2. However, this method has been proven to be time-consuming taking hours-to-days for the results. In order to improve the speed and efficiency of diagnostics, newer rapid diagnostic serological tests are being developed for testing SARS-CoV-2, each with its own unique advantages and disadvantages. They could potentially be used as triage tests to rapidly identify patients who are very likely to have COVID-19 in combination with other accurate diagnostic methods.

Conclusion

Therefore, a combination of diagnostic testing used in a timely manner may be beneficial for the rapid and accurate detection of SARS-CoV-2. This was evident in cases where despite initial negative RT-PCR tests for various patients, who later demonstrate chest CT scans with various degrees of consolidation and ground-glass opacity. Thus establishing the need for radiology diagnosis to be complementary to RT-PCR for COVID-19 patients. Hopefully, the continuous development and use of rapid diagnostic tests and the implementation of public health measures will help control the spread of the disease.

Incidence and risk predictors analysis of adverse donor reactions in whole blood donation

OBJECTIVE

Adverse donor reactions in normal healthy blood donors is not unusual. However, these unpleasant effects have a negative impact on donor retention. Adverse event due to blood donation is multifactorial in origin. Therefore, the objective of this study was to determine the frequency and type of adverse donor reactions during or after blood donation. More importantly, this study also aimed at analyzing important risk predictors of adverse donor reaction.

MATERIAL AND METHODS

This was a retrospective study conducted from May 2017 to April 2019 in the department of Transfusion Medicine at a tertiary care center in eastern India. Data were stored in Microsoft excel 2016 by using a standardized format as per ISBT criteria and analyzed with software "R, version 3.5.3" to find out the various independent precipitating factor.

RESULTS

Overall, 107 donors (0.98%) experienced adverse events with 10,814 whole blood donations. The first time, females, younger age donors (18-30 years), and donors with a mean arterial blood pressure of less than 90mm of Hg were the most important independent risk factors predicting the possibility of adverse donor reaction. Donors' weight, hemoglobin, and the type of donation had not affected the frequency of adverse events.

CONCLUSION

Analysis of adverse donor reactions helps in selecting the blood donors who are at risk of donor reactions. Our study highlights the importance of proper predonation screening especially in terms of assessment of mean blood pressure, along with identification of first time and female blood donors in order to reduce untoward donor reaction.

Navigating the Diagnostics of COVID-19

The recent outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Hubei province, China, in December 2019 and has spread worldwide at an alarming rate. With over eight million individuals infected and exceeding 400,000 deaths globally, the necessity to develop fast and efficient diagnostic methods is of high importance. This paper reports on currently available diagnostic screening methods for patients infected with SARS-CoV-2 to guide frontline healthcare workers involved with the diagnosis of 2019 novel coronavirus disease (COVID-19) patient. An electronic literature search was performed for peer-reviewed articles published from January 1, 2020, until June 19, 2020. Published articles were then reviewed and included based on the applicability to the topic. The preferred diagnostic approach is the reverse transcription (RT) of the virus’ ribonucleic acid (RNA) followed by polymerase chain reaction (PCR) amplification (RT-PCR). However, this method has been proven to be time-consuming. In improving the speed and efficiency of diagnostics, newer rapid diagnostic serological tests are in development for testing SARS-CoV-2, each with its unique advantages and disadvantages. They could potentially be used as triage tests to rapidly identify patients who are very likely to have COVID-19 in combination with other accurate diagnostic methods, such as diagnostic imaging. A combination of the disease history, clinical manifestations, laboratory diagnostic testing, and diagnostic imaging is crucial for making an accurate and useful diagnosis for COVID-19. Hopefully, the continuous development and use of rapid diagnostic tests and the implementation of public health measures will help control the spread of the disease.

Measles Outbreak in Unvaccinated and Partially Vaccinated Children and Adults in the United States and Canada (2018-2019): A Narrative Review of Cases

Since 2018 and currently in 2019, the United States and Canada experienced a rapidly spreading measles virus outbreak. The developing outbreak may be due to a lack of vaccination, an inadequate dosage of measles (MMR) vaccine, clusters of intentionally under-vaccinated children, imported measles from global travel, and from those who are immunocompromised or have other life-threatening diseases. The infection originated mainly from travelers who acquired measles abroad and has thus led to a major outbreak and health concern not only in the United States and Canada but also in other parts of the world. According to World Health Organization, from January 2019 through September 2019, 1234 cases of measles have been reported in the United States and 91 reported cases in Canada, while in 2018, 372 and 28 cases were reported in the United States and Canada, respectively. A potential driving factor to the increased cases maybe because fewer children have been vaccinated over the last number of years in both countries. This article is a narrative review of cases discussing the measles outbreak among partially vaccinated and unvaccinated children and adults in the United States and Canada in 2018 and 2019.

Notes on some crinoid associated decapod crustaceans (Crustacea: Decapoda) of Lakshadweep Archipelago, Central Indian Ocean

Decapod crustaceans symbiotic with echinoderms (sea stars, brittle stars, feather stars, basket stars, sea cucumbers, and sea urchins) possess remarkable diversification in the Indo-Pacific. In the present study, seven species of decapod crustaceans symbiotic with crinoids are recorded based on collections from selected Islands (Agatti, Amini, Bangaram, Kavaratti, Kalpeni, and Minicoy) of Lakshadweep Archipelago. Of these decapods, five caridean shrimps (Alpheidae: Synalpheus carinatus (de Man, 1888), S. comatularum (Haswell, 1882), S. stimpsonii (de Man, 1888); Palaemonidae: Palaemonella pottsi (Borradaile, 1915), Pontoniopsis comanthi (Borradaile, 1915), one brachyuran crab [Pilumnidae: Permanotus purpureus (Gordon, 1934)] and one squat lobster [Galatheidae: Allogalathea elegans (Adams White, 1848)] were identified. The caridean shrimps have associated with the crinoids Comaster multifidus (Müller, 1841), Phanogenia gracilis (Hartlaub, 1893), P. distincta (Carpenter, 1888), P. multibrachiata (Carpenter, 1888) and Stephanometra indica (Smith, 1876). The brachyuran crab was observed in association with the crinoid Phanogenia gracilis whereas the squat lobsters were associated with Stephanometra tenuipinna (Hartlaub, 1890) and S. indica. Except S. stimpsonii and P. purpureus, all other species were recorded for the first time from India. Here, we provide details on morphology, distribution, habitat, and hosts for all species. We recommend further exploration of the sub-shallow coral reef areas of Lakshadweep as there will be many species that certainly remain to be discovered.

BIOIMPEDANCE SPECTROSCOPY IS NOT ASSOCIATED WITH A CLINICAL DIAGNOSIS OF BREAST CANCER-RELATED LYMPHEDEMA

The objective of this study was to evaluate the accuracy of bioimpedance spectroscopy measurements (L-Dex) in the diagnosis of breast cancer-related lymphedema. A retrospective review of a prospectively maintained database was performed of all patients that underwent surgical treatment for breast cancer at a tertiary medical center. Patients who had preoperative and postoperative evaluation for possible lymphedema by limb circumference measurements and bioimpedance were eligible for inclusion in the study. No significant demographic differences were found between the group of patients clinically diagnosed with lymphedema (N=134) and those without a clinical diagnosis of lymphedema (N=261). The ability of bioimpedance to diagnose lymphedema based on the manufacturer's criteria demonstrated low sensitivity, which was 7.5% when lymphedema was defined as an absolute L-Dex value greater than 10, and 24.6% when defined as a relative change of &gt;10 between preoperative and postoperative measurements. This corresponded with a positive predictive value of 61-71% and a negative predictive value of 67-70%. We are unable to recommend the use of bioimpedance as a screening tool or for measurement of breast cancer-related lymphedema.