The percentage of controlled chronic rhinosinusitis after treatment: a systematic review and meta-analysis

PURPOSE

Chronic rhinosinusitis (CRS) is a chronic disease with a high recurrence rate, and the aim of treating CRS is to maintain disease control. Recently, a series of CRS control instruments have been developed to assess the control levels. We pooled existing studies to evaluate the percentage of controlled CRS after treatment in patients with CRS.

METHODS

A systematic literature review and meta-analysis using PubMed, Google Scholar, Scopus, and Cochrane databases was conducted to identify studies assessing CRS control. Both comprehensive assessments and self-report of CRS control were included.

RESULTS

9 studies with 1931 patients after treatment and 295 patients before treatment were included. CRS control assessments of the 2012 European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS 2012), EPOS 2020, and Sinus Control Test (SCT) were comprehensive assessments utilized in the clinic practice. The self-report assessment included patient-reported global level of CRS control. These existing disease control instruments categorized patients into three (uncontrolled, partly controlled, and controlled) or five (not at all, a little, somewhat, very, and completely) control categories. Only 8% (95% CI 0.05-0.11) of patients with CRS stayed well controlled before treatment assessed by comprehensive assessments. About 35% (95% CI 0.22-0.49) of patients achieved well controlled after treatment when assessed by the comprehensive measures. Meanwhile, 40% (95% CI 0.28-0.52) of patients reported well controlled after treatment when using self-report.

CONCLUSION

About 35-40% of patients with CRS showed well controlled after treatment, which stressed the importance of identifying these undertreated patients with CRS.

Conceptualisation and implementation of integrated disease surveillance globally: a scoping review

OBJECTIVES

The objective of this study was to examine the conceptualisation and operationalisation of Integrated Disease Surveillance (IDS) systems globally and the evidence for their effectiveness. Furthermore, to determine whether the recommendations made by Morgan et al. are supported by the evidence and what the evidence is to inform country development of IDS.

STUDY DESIGN

The study incorporated a scoping review.

METHODS

This review summarised evidence meeting the following inclusion criteria: Participants: any health sector; Concept: IDS; and Context: global. We searched Medline, Embase, and Epistemonikos for English publications between 1998 and 2022. Standard review methods were applied. A bespoke conceptual framework guided the narrative analysis. This scoping review is part of a research programme with three key elements, with the other studies being a survey of the International Association of National Public Health Institutes members on the current status of their disease surveillance systems and a deeper analysis and case studies of the surveillance systems in seven countries, to highlight the opportunities and challenges of integration.

RESULTS

Eight reviews and five primary studies, which were assessed as being of low quality, were included, mostly examining IDS in Africa, the human sector, and communicable diseases. None reported on the effects on disease control or on the evolution of IDS during the COVID-19 pandemic. Descriptions of IDS and of integration varied. Prerequisites of effective IDS systems mostly related to the adequacy of core functions and resourcing requirements. Laws or regulations supporting system integration and data sharing were not addressed. The provision of core functions and resourcing requirements were described as inadequate, financing as non-sustainable, and governance as poor. Enablers included active data sharing, close cooperation between agencies, clear reporting channels, integration of vertical programs, increased staff training, and adopting mobile reporting. Whilst the conceptual framework for IDS and Morgan et al.'s proposed principles were to some extent reflected in the highlighted priorities for IDS in the literature, the evidence base remains weak.

CONCLUSIONS

Available evidence is fragmented, incomplete, and of poor quality. The review found a lack of robust evaluation studies on the impact of IDS on disease control. Whilst a lack of evidence does not imply a lack of benefit or effect, it should signal the need to evaluate the process and impact of integration in the future development of surveillance systems. A common IDS definition and articulation of the parts that constitute an IDS system are needed. Further robust impact evaluations, as well as country reviews and evaluations of their IDS systems, are required to improve the evidence base.

Maintenance of Investigator's Static Global Assessment Response with Once-Daily Crisaborole in Participants with Mild to Moderate Atopic Dermatitis

INTRODUCTION

Treatments for atopic dermatitis (AD) often fail to achieve lasting disease control. In the CrisADe CONTROL phase III study (ClinicalTrials.gov: NCT04040192), participants aged ≥ 3 months with mild to moderate AD treated with once-daily (QD) crisaborole, following initial treatment success with crisaborole twice daily (BID), had longer periods of flare-free maintenance, a higher number of flare-free days, and a lower number of flares compared with those who received vehicle. The study was an exploratory analysis of data on the maintenance of response per Investigator's Static Global Assessment (ISGA; ISGA score of 0 [clear] or 1 [almost clear]) during the CrisADe CONTROL study through week 52.

METHODS

Exploratory endpoints were the time to ISGA response during the open-label run-in period, and the maintenance of ISGA response and the severity and duration of flares during the double-blind maintenance period. Outcomes were stratified by age (participants aged 3 months to < 12 years and ≥ 12 years) and duration of crisaborole BID treatment (< 4 weeks or ≥ 4 weeks) during the open-label run-in period.

RESULTS

During the open-label run-in period, the median time to ISGA response was 41.5 days. From week 4 to week 52 of the double-blind maintenance period, the proportion of participants who maintained ISGA response was greater with crisaborole versus vehicle, and this difference was statistically significant up to week 36 (P < 0.05). Duration of flare periods during the maintenance period were 54.1 and 54.0 days for the vehicle and crisaborole-treated groups, respectively. Numerically fewer crisaborole-treated participants experienced a flare with an ISGA score of ≥ 2 compared with vehicle-treated participants (64.8% vs. 74.4%, respectively). Findings were comparable across most subgroups.

CONCLUSIONS

Adult and pediatric participants with mild to moderate AD at baseline who had achieved responder criteria (treatment success) with crisaborole BID during the run-in period maintained response per ISGA with crisaborole QD during the double-blind maintenance period through week 52.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT04040192.

Morpho-physio-biochemical, molecular, and phytoremedial responses of plants to red, blue, and green light: a review

Light is a basic requirement to drive carbon metabolism in plants and supports life on earth. Spectral quality greatly affects plant morphology, physiology, and metabolism of various biochemical pathways. Among visible light spectrum, red, blue, and green light wavelengths affect several mechanisms to contribute in plant growth and productivity. In addition, supplementation of red, blue, or green light with other wavelengths showed vivid effects on the plant biology. However, response of plants differs in different species and growing conditions. This review article provides a detailed view and interpretation of existing knowledge and clarifies underlying mechanisms that how red, blue, and green light spectra affect plant morpho-physiological, biochemical, and molecular parameters to make a significant contribution towards improved crop production, fruit quality, disease control, phytoremediation potential, and resource use efficiency.

Indoor air quality improvement with filtration and UV-C on mitigation of particulate matter and airborne bacteria: Monitoring and modeling

Indoor air, especially with suspended particulate matter (PM), can be a carrier of airborne infectious pathogens. Without sufficient ventilation, airborne infectious diseases can be transmitted from one person to another. Indoor air quality (IAQ) significantly impacts people's daily lives as people spend 90% of their time indoors. An industrial-grade air cleaner prototype (filtration + ultraviolet light) was previously upgraded to clean indoor air to improve IAQ on two metrics: particulate matter (PM) and viable airborne bacteria. Previous experiments were conducted to test its removal efficiency on PM and airborne bacteria between the inlet and treated air. However, the longer-term improvement on IAQ would be more informative. Therefore, this research focused on quantifying longer-term improvement in a testing environment (poultry facility) loaded with high and variable PM and airborne bacteria concentrations. A 25-day experiment was conducted to treat indoor air using an air cleaner prototype with intermittent ON and OFF days in which PM and viable airborne bacteria were measured to quantify the treatment effect. The results showed an average of 55% reduction of total suspended particulate (TSP) concentration between OFF days (110 μg/m3) and ON days (49 μg/m3). An average of 47% reduction of total airborne viable bacteria concentrations was achieved between OFF days (∼3200 CFU/m3) and ON days (∼2000 CFU/m3). A cross-validation (CV) model was established to predict PM concentrations with five input variables, including the status of the air cleaner, time (h), ambient temperature, indoor relative humidity, and day of the week to help simulate the air-cleaning effect of this prototype. The model can approximately predict the air quality trend, and future improvements may be made to improve its accuracy.

Continuity of primary care for type 2 diabetes and hypertension and its association with health outcomes and disease control: insights from Central Vietnam

BACKGROUND

Vietnam is undergoing a rapid epidemiological transition with a considerable burden of non-communicable diseases (NCDs), especially hypertension and diabetes (T2DM). Continuity of care (COC) is widely acknowledged as a benchmark for an efficient health system. This study aimed to determine the COC level for hypertension and T2DM within and across care levels and to investigate its associations with health outcomes and disease control.

METHODS

A cross-sectional study was conducted on 602 people with T2DM and/or hypertension managed in primary care settings. We utilized both the Nijmegen continuity of care questionnaire (NCQ) and the Bice - Boxerman continuity of care index (COCI) to comprehensively measure three domains of COC: interpersonal, informational, and management continuity. ANOVA, paired-sample t-test, and bivariate and multivariable logistic regression analysis were performed to examine the predictors of COC.

RESULTS

Mean values of COC indices were: NCQ: 3.59 and COCI: 0.77. The proportion of people with low NCQ levels was 68.8%, and that with low COCI levels was 47.3%. Primary care offered higher informational continuity than specialists (p < 0.01); management continuity was higher within the primary care team than between primary and specialist care (p < 0.001). Gender, living areas, hospital admission and emergency department encounters, frequency of health visits, disease duration, blood pressure and blood glucose levels, and disease control were demonstrated to be statistically associated with higher levels of COC.

CONCLUSIONS

Continuity of primary care is not sufficiently achieved for hypertension and diabetes mellitus in Vietnam. Strengthening robust primary care services, improving the collaboration between healthcare providers through multidisciplinary team-based care and integrated care approach, and promoting patient education programs and shared decision-making interventions are priorities to improve COC for chronic care.

Real-World Effectiveness of Dupilumab in Adult and Adolescent Patients with Atopic Dermatitis: 2-Year Interim Data from the PROSE Registry

INTRODUCTION

There is a scarcity of data beyond 1 year for the use of dupilumab to treat atopic dermatitis (AD) in a real-world setting. This study aimed to evaluate the 2-year effectiveness of dupilumab among adult and pediatric patients with moderate-to-severe AD included in a real-world, longitudinal database study.

METHODS

PROSE is an ongoing, prospective, observational, multi-center registry in the USA and Canada, designed to collect real-world data from patients aged ≥ 12 years with moderate-to-severe AD who initiate dupilumab in accordance with country-specific prescribing information. Assessments include body surface area affected by AD (BSA), Eczema Area and Severity Index (EASI), Dermatology Life Quality Index (DLQI), Pruritus Numerical Rating Scale (P-NRS), Patient-Oriented Eczema Measure (POEM), Patient Global Assessment of Disease (PGAD) questionnaire score, and occurrence of adverse events (AEs).

RESULTS

Of 764 patients who enrolled in PROSE, 632 (83%) remained in the study at the time of this interim analysis. Improvements were observed at the first post-baseline clinic visit (approximately 3 months) in the clinician-assessed measures (mean BSA and EASI scores); improvements were sustained throughout the 2-year period covered in the present study. Consistent and sustained improvements were also observed over the 2-year period in the patient-reported measures of P-NRS, POEM, and DLQI, and in the proportion of patients reporting "very good/excellent" in answer to the question in the PGAD questionnaire: "Considering all the ways in which your eczema affects you, indicate how well you are doing". Dupilumab treatment was well tolerated, with safety findings consistent with those previously reported in studies of dupilumab for the treatment of AD.

CONCLUSIONS

In the real-world PROSE registry, patients with moderate-to-severe AD experienced sustained improvement in disease control, symptoms, and quality of life up to 2 years after initiating dupilumab treatment. Safety data were consistent with the known safety profile of dupilumab.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT03428646. Video abstract (MP4 20,717 kb).

Heterogeneity in the definition of chronic rhinosinusitis disease control: a systematic review of the scientific literature

PURPOSE

Disease control is conceptually recognized to be an important outcome measure for chronic rhinosinusitis (CRS). However, inconsistent usage is a significant factor in disadoption of important concepts and it is presently unclear how consistently the construct of CRS 'control' is being defined/applied. The objective of this study was to determine the heterogeneity of CRS disease control definitions in the scientific literature.

METHODS

Systematic review of PubMed and Web of Science databases from inception through December 31, 2022. Included studies used CRS disease control as an explicitly stated outcome measure. The definitions of CRS disease control were collected.

RESULTS

Thirty-one studies were identified with more than half published in 2021 or later. Definitions of CRS control were variable, although 48.4% of studies used the EPOS (2012 or 2020) criteria to define control, 14 other unique definitions of CRS disease control were also implemented. Most studies included the burden CRS symptoms (80.6%), need for antibiotics or systemic corticosteroids (77.4%) or nasal endoscopy findings (61.3%) as criteria in their definitions of CRS disease control. However, the specific combination of these criteria and prior time periods over which they were assessed were highly variable.

CONCLUSION

CRS disease control is not consistently defined in the scientific literature. Although many studies conceptually treated 'control' as the goal of CRS treatment, 15 different criteria were used to define CRS disease control, representing significant heterogeneity. Scientific derivation of criteria and collaborative consensus building are needed for the development of a widely-accepted and -applied definition of CRS disease control.

The Rise of AI: How Artificial Intelligence is Revolutionizing Infectious Disease Control

Artificial Intelligence (AI) has proven to be an effective tool in predicting, detecting, and mitigating the spread of infectious diseases, especially during the COVID-19 pandemic. The technology is increasingly playing a role in preventing future health crises by predicting outbreaks, identifying high-risk areas, and aiding in vaccine development. AI can track and trace infected individuals and identify potential hotspots, help reduce the spread of infectious diseases, and monitor patient symptoms, enabling healthcare professionals to provide effective treatment.

Treatment of sheep prior to movement: its contribution to an effective scab (psoroptic mange) management strategy

BACKGROUND

Ovine psoroptic mange (sheep scab) is an important disease of sheep worldwide caused by the parasitic mite, Psoroptes ovis. It has a negative impact on animal welfare and leads to significant economic losses for the sheep industry. Effective and targeted management is required to limit its transmission.

METHODS

A stochastic metapopulation model of sheep scab transmission is used to investigate the contribution of the treatment of sheep prior to movements to sales, gatherings (predominantly markets) and away grazing to the reduction of prevalence of farms with scab in Great Britain.

RESULTS

Treatment prior to movement to gatherings resulted in an 86% reduction in the overall prevalence of farms with scab and was more effective at reducing the overall prevalence of farms with scab than treatment before other categories of movements. The relative risk of farms having scab infection was inversely related to the percentage of farms which treated, but this relationship was not linear, with the biggest declines in the prevalence of farms with scab being achieved by small percentages of farms treating; a 50% relative reduction in the farm prevalence was achieved with only 15% of farms treating prior to gathering movements.

CONCLUSIONS

The results suggest that pre-movement treatment of sheep could make an important contribution to national scab control and, in practice, the approach could be more highly targeted if used in conjunction with known geographic and management risk factors for scab.

Long-Term Effectiveness of Dupilumab in Patients with Atopic Dermatitis: Results up to 3 Years from the RELIEVE-AD Study

INTRODUCTION

Atopic dermatitis (AD) can require long-term therapy. Few real-world studies have evaluated long-term effectiveness from the patients' perspective. The aim of this study was to evaluate patient-reported outcomes (PROs) during long-term dupilumab treatment.

METHODS

Adults with moderate-to-severe AD who initiated dupilumab through the US manufacturer patient support program and participated in RELIEVE-AD (a prospective patient survey study with a 12-month follow-up) were recontacted 30-36 months post-initiation regardless of current dupilumab use. The online questionnaire consisted of PROs, including the Atopic Dermatitis Control Tool (ADCT), use of concomitant AD therapies, satisfaction with current therapy, global change in itch relative to before dupilumab initiation, non-itch skin symptoms (skin pain/soreness, hot/burning feeling, and sensitivity to touch), flares, Dermatology Life Quality Index, sleep problems, and the AD-specific Work Productivity and Activity Impairment Questionnaire.

RESULTS

Of 698 patients who initiated dupilumab (baseline) and were recontacted, 425 completed the 30-36-month survey. Significant reductions from baseline were reported in concomitant AD therapy use (P < 0.05); 54.4% reported not using other AD medications vs. 12.8% at baseline. At 30-36 months, all results (non-itch skin symptoms, flares, sleep problems, health-related quality of life work/activity impairment, disease control, and treatment satisfaction) were similar to or incrementally better than the 12-month timepoint, with significant improvements vs. baseline (P < 0.001). Global change in itch was reported as "very much better" by 75.3% of respondents. Adequate disease control (score < 7 on ADCT) was reported by 80.7% of respondents, and 86.8% were satisfied with the treatment.

CONCLUSIONS

In clinical practice settings, patient-reported benefits of dupilumab were maintained in survey respondents during long-term treatment up to 36 months while the use of concomitant AD therapies reduced.

Synthesis, characterization and antifungal potential of titanium dioxide nanoparticles against fungal disease (Ustilago tritici) of wheat (Triticum aestivum L.)

Nanoparticles (NPs) preparation using a green as well as environmentally acceptable processes has achieved a lot of attention in recent decade. The current study compared the synthesis of titania (TiO₂) nanoparticles synthesized from leaf extracts of two plant species (Trianthema portulacastrum, Chenopodium quinoa) and traditional approach by chemical preparation. The effects of no calcination on the physical characteristics of TiO₂ NPs as well as their antifungal effects were examined and compared with the already reported calcinated TiO₂ NPs. The produced TiO₂ NPs were evaluated using high-tech techniques such as X-ray diffraction (XRD), scanning electron microscope, energy dispersive spectroscopy (EDX), and elemental mapping. TiO₂ NPs prepared by sol-gel technique (T1) and prepared from extractions from leaves of T. portulacastrum (T2), and C. quinoa (T3) were either calcinated or non calcinated and tested against fungal disease (Ustilago tritici) of wheat for antifungal efficacy. The -peak (2θ) at 25.3 was confirmed by XRD to be connected with the anatase (101) form in both cases but before calcination, NPs were lacking the rutile and brookite peaks. The results showed that all types of TiO₂ NPs examined had good antifungal activity against U. tritici, but those made from C. quinoa plant extract have good antifungal activity against disease. TiO₂ NPs which are produced by the green methods (T2, T3) have the highest antifungal activity (58%, 57% respectively), while minimal activity (19%) was recorded when NPs were synthesized using the sol-gel method (T1) with 25 μl/mL. Non calcinated TiO₂ NPs have less antifungal potential than calcined TiO₂ NPs. It can be concluded that calcination may be preferred for efficient antifungal activity when using titania nanoparticles. The green technology may be used on a larger scale with less damaging TiO₂ NP production and can be utilized against fungal disease on wheat crop to reduce crop losses worldwide.

COVID-19 epidemic modelling for policy decision support in Victoria, Australia 2020-2021

BACKGROUND

Policy responses to COVID-19 in Victoria, Australia over 2020-2021 have been supported by evidence generated through mathematical modelling. This study describes the design, key findings, and process for policy translation of a series of modelling studies conducted for the Victorian Department of Health COVID-19 response team during this period.

METHODS

An agent-based model, Covasim, was used to simulate the impact of policy interventions on COVID-19 outbreaks and epidemic waves. The model was continually adapted to enable scenario analysis of settings or policies being considered at the time (e.g. elimination of community transmission versus disease control). Model scenarios were co-designed with government, to fill evidence gaps prior to key decisions.

RESULTS

Understanding outbreak risk following incursions was critical to eliminating community COVID-19 transmission. Analyses showed risk depended on whether the first detected case was the index case, a primary contact of the index case, or a 'mystery case'. There were benefits of early lockdown on first case detection and gradual easing of restrictions to minimise resurgence risk from undetected cases. As vaccination coverage increased and the focus shifted to controlling rather than eliminating community transmission, understanding health system demand was critical. Analyses showed that vaccines alone could not protect health systems and need to be complemented with other public health measures.

CONCLUSIONS

Model evidence offered the greatest value when decisions needed to be made pre-emptively, or for questions that could not be answered with empiric data and data analysis alone. Co-designing scenarios with policy-makers ensured relevance and increased policy translation.

Relationship between prognostic nutritional index and neutrophil lymphocyte ratio with overall survival in patients with metastatic colorectal cancer receiving regorafenib

Aim

In this study, we aimed to analyze the effect of prognostic nutritional index and neutrophile lymphocyte ratio on the overall survival (OS) in patients treated with regorafenib.

Materials and Methods

Metastatic colorectal cancer (CRC) patients who treated with regorafenib between 2016 and 2020 in a single center were evaluated retrospectively. ROC analysis was used for neutrophile lymphocyte ratio (NLR's) and prognostic nutritional index (PNI's) optimum cut-off value. The relationship between OS with PNI and NLR was investigated.

Results

Fifty-two patient's data were analyzed. The median age was 57 years, 22 (41.5%) of the patients were female. The optimal cut-off value of PNI for OS was 45.7 according to ROC curve analysis. The median NLR value was accepted as 2.7. Median OS was 8.3 months. Patients who have high PNI value than 45.7 had longer OS (12.09 months vs. 6.31 months hazard ratio [HR]: 0.37 95% confidence interval [CI]: 0.19-0.73 P = 0.003) and there was a tendency for longer OS with low NLR value then median (12.05 months vs. 6.14 months HR: 0.54 95% CI: 0.29-1.23 P = 0.057). Primary tumor resected patients had longer OS than nonresected patients (12.05 months vs. 6.30 months HR: 0.34 95% CI: 0.17-0.66 P = 0.001). In multivariate analysis, high PNI value more than 45.7 (HR: 0.40 95% CI: 0.18-0.88 P = 0.02) and resection of the primary tumor (HR: 0.40 95% CI: 0.21-0.80 P = 0.01) were the only independent factors for longer OS.

Conclusion

Metastatic CRC patients with high pretreatment PNI and primary tumor resected are more likely to have longer OS with regorafenib. PNI is more reliable index than NLR to predict OS in metastatic CRC patients treated with regorafenib.

Inborn Errors of Immunity and Worries During the Monkeypox Outbreak

Inborn errors of immunity (IEI) are disorders characterized by the impaired development and functioning of the immune system components. These errors can affect cellular immunity, humoral immunity, or both, predisposing patients to localized and systemic manifestations (for the most recent update on the classification of IEI, see [1](#ref-0001)). Among various signs and symptoms, increased susceptibility to infections and autoimmune and inflammatory conditions with a high tendency to involve the skin, lungs, and gut are most-documented. With the re-emergence of the monkeypox (MPX) outbreak in 2022 and a new picture that it has presented, i.e., the global spread of the disease and the high prevalence in patients with human immunodeficiency syndrome (HIV) [2](#ref-0002), worries are increasing about the possible threat of monkeypox virus (MPXV) to affect patients with IEI. As of November 04, 2022, 109 countries reported a total of more than 78,000 MPXV-infected cases, with a death rate of about 0.01% [3](#ref-0003). During this outbreak, males who have sex with other males (MSM) have constituted the majority of the MPXV-infected population [4,5](#ref-0004). Moreover, people with HIV account for about 40% of this population and exhibit a more severe disease course, as represented in the higher need for hospitalization [6](#ref-0006). To date, no infection with MPXV has been reported in patients with IEI; however, high susceptibility of immunocompromised people to this infection is alarming for people with IEI and their caregivers. Below address a few important questions concerning patients with IEI during this outbreak. This article is protected by copyright. All rights reserved.

Struggling to improve farm biosecurity: Do free advice and subsidies hit the target?

Biosafety measures (BSMs) often aim at reducing the likelihood of cross-species interactions at the wildlife-livestock interface. Examples include means to segregate wild ungulates from cattle at waterholes or at feeders. Subsidies or incentives for BSM implementation are expected to contribute to improved BSM acceptance. However, several recent experiences led us to write a cautionary commentary on the variable success of incentives in farm biosafety promotion. We list examples where, after offering farm-specific biosecurity action plans for free or subsidizing 100% of the cost of a given BSM, 25-40% of the farmers remained unwilling to invest efforts in farm biosafety and BSM maintenance. We suggest seeking a better understanding of farmers' motivations through social science research, to train farm veterinarians on biosecurity and on how to tailor biosafety communication, and to set up formal regional risk mitigation programs including financial, logistical, and educational assistance, as well as monitoring plans, through public-private collaboration.

Co-created community contracts support biosecurity changes in a region where African swine fever is endemic - Part I: The methodology

In Northern Uganda more people live in poverty than elsewhere in the country. Small-scale pig-keeping is common and African swine fever (ASF) is endemic, spreading along the smallholder value chain. Biosecurity measures remain the only way to prevent and control the spread of ASF in this context. Previous research in the study area has shown that many stakeholders are aware of ASF, how it is spread and methods for prevention and control, but biosecurity implementation remains limited. Participatory approaches have been suggested in order to increase community engagement in relation to animal disease control, ensuring that disease prevention or control actions are guided by local people's priorities and the promotion of local ownership of disease control. The objective of this study was to investigate the capacity of participatory action at community level with a broad inclusion of stakeholders to initiate change and greater stakeholder ownership to improve biosecurity in the smallholder pig value chain. Specific attention was paid to the feasibility of co-created community contracts for this purpose. The study was carried out in Northern Uganda in six purposively selected villages and included both farmers and traders. Centred on co-created community contracts on biosecurity, the study comprised repeated group discussions, semi-structured and structured group and individual interviews, as well as field observations. At the first meeting, participants were presented with suggested biosecurity measures adapted for farmers and traders respectively. Participants discussed each measure, agreed which ones to implement for one year, and co-created a community contract to this effect. During the study period, repeated interviews were undertaken and implementation support was provided. Interview data was coded and thematically analysed. Great diversity was observed between communities with regard to which and how many measures were selected, illustrating heterogeneity in the possibilities of biosecurity implementation and the complexity of livelihood challenges. The methodology appeared to be effective at instigating change, with all the communities changing some of their biosecurity behaviour during the study period. The intensified communication and cooperation around pigs in the communities reinforced the sense of group identity and the capacity-building offered at the first meeting supported implementation and appeared to be more important than the physical contract. Participants reported feeling empowered and described how they shared their knowledge, educated their peers and acted as catalysts for wider biosecurity change in their communities. These are promising results and indicate a positive attitude to both the agreed measures and the methodology.

Features and significance of the recent enormous COVID-19 epidemic in China

Few people in mainland China (MC) had been infected with COVID-19 before December 2022 due to the draconian zero-COVID policy of MC This article is protected by copyright. All rights reserved.

Gilteritinib: Repurposing of AXL-targeting kinase inhibitors against COVID-19

The Coronavirus disease-19 (COVID-19) is an ongoing infection outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel positive single-stranded, enveloped RNA virus belonging to the genus Betacoronavirus. During the pandemic, the SARS-CoV-2 subvariants evolved rapidly with enhanced transmissibility, and became a global public health threat as its alarmingly rising rate of infection led to excessive mortality[1](#ref-0001). According to the WHO data, COVID-19 caused more than 6 million deaths and affected 215 countries. Although vaccines are beneficial for preventing hospitalization, reducing severe illness and deaths from COVID-19, the constantly mutated Spike protein under high selection pressure leading to off-target or immune evasion which warrants additional therapeutic strategies. Therefore, it is important to identify and test potential therapeutic targets against proteins that are highly conserved among multiple coronaviruses for clinical drug development to combat SARS-COV-2. While research for new therapies continues, the cost-effective and rapid repurposing of existing therapeutics may provide a viable treatment alternative for COVID-19 This article is protected by copyright. All rights reserved.

Relationship between Eosinophilic and Neutrophilic Inflammation in Chinese Chronic Rhinosinusitis with Nasal Polyps

INTRODUCTION

Chronic rhinosinusitis with nasal polyps (CRSwNPs) in China is characterized by a mixed eosinophilic-neutrophilic inflammation, linking to a more heterogeneous clinical phenotype. However, the relationship between eosinophilic and neutrophilic inflammation in Chinese patients with CRSwNP remains largely unknown. We aimed to further characterize the correlation between neutrophils with eosinophils in relation to clinical characters and disease control status after endoscopic sinus surgery (ESS).

METHODS

A total of 242 patients were recruited and stratified based on tissue (≥10%) eosinophilia and (≥20/per high-power field) neutrophilia. Clinical characteristics and disease control status were compared between subgroups. Associations between tissue eosinophils and neutrophils were analyzed.

RESULTS

The uncontrolled patients accounted for 41.3%, 41.3%, 17.1%, and 22.2% in subjects with concomitant tissue eosinophilia and neutrophilia (EN-high), isolated eosinophilia (E-high), isolated neutrophilia (N-high), and no eosinophilia and neutrophilia (EN-low), respectively. Positive correlations between tissue eosinophils and neutrophils were observed in patients with CRSwNP as well as in EN-high and N-high subgroups but not in E-high and EN-low subgroups. The EN-high subgroup had higher tissue eosinophil numbers than the other three subgroups. Both EN-high and E-high subgroups had higher rates of uncontrolled subjects than the N-high and EN-low subgroups; however, there was no difference in the rate of uncontrolled subjects between EN-high and E-high subgroups and between N-high and EN-low subgroups.

CONCLUSION

Tissue neutrophils might have a potential interaction and mutual promotion effect with eosinophils in CRSwNP. However, tissue neutrophilia would not pose significant risk for poor disease control after ESS. Further larger, prospective studies are needed to confirm our findings.

Clinical and Economic Benefit of Achieving Disease Control in Psoriatic Arthritis and Ankylosing Spondylitis: A Retrospective Analysis from the OM1 Registry

BACKGROUND

There is limited evidence on the clinical and economic benefit of achieving disease control in psoriatic arthritis (PsA) and ankylosing spondylitis (AS), thus we aimed to assess the impact of disease control on healthcare resource use (HCRU) and direct medical costs among US patients with PsA or AS over 1 year.

METHODS

Data were derived from the US OM1 PsA/AS registries (PsA: 1/2013-12/2020; AS: 01/2013-4/2021) and the Optum Insight Clinformatics® Data Mart to identify adult patients with PsA or AS. Two cohorts were created: with disease control and without disease control. Disease control was defined as modified Disease Activity Index for Psoriatic Arthritis (DAPSA28) ≤ 4 for PsA and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) < 4 for AS. Outcomes were all-cause inpatient, outpatient, and emergency department (ED) visits and associated costs over a 1-year follow-up period. Mean costs per person per year (PPPY) were assessed descriptively and adjusted odds ratios (aOR) with 95% confidence intervals (CI) were estimated for the likelihood of HCRU by logistic regression.

RESULTS

The study included 1235 PsA (with disease control: N = 217; without: N = 1018) and 581 AS patients (with disease control: N = 342; without: N = 239). Patients without disease control were more likely to have an inpatient (aOR [95% CI]; PsA: 3.0 [0.9, 10.1]; AS: 7.7 [2.3, 25.1]) or ED (PsA: 1.6 [0.6, 4.2]; AS: 3.5 [1.5, 8.3]) visit than those with disease control. Those without disease control, vs. those with disease control, had greater PPPY costs associated with inpatient (PsA: $1550 vs. $443), outpatient (PsA: $1789 vs. $1327; AS: $2498 vs. $2023), and ED (PsA: $114 vs. $57; AS: $316 vs. $50) visits.

CONCLUSIONS

Findings from this study demonstrate lower disease activity among patients with PsA and AS is associated with less HCRU and lower costs over the following year.

Validation of the Urticaria Control Test (UCT) in Children With Chronic Urticaria

BACKGROUND

Few validated tools exist to evaluate chronic urticaria (CU) control in children. Although the Urticaria Control Test (UCT) exhibits favorable clinometric properties in adult CU, it is not yet validated in children.

OBJECTIVE

To evaluate the validity of the UCT for the assessment of pediatric CU.

METHODS

Children presenting with CU were consecutively recruited and completed both the UCT and the Children's Dermatology Life Quality Index (CDLQI) at study entry. Using the CDLQI as an anchor, we assessed the internal consistency, convergent and known-groups validity, and screening accuracy of the UCT at study entry and at follow-up.

RESULTS

A total of 52 children with CU were recruited. The UCT exhibited respectable internal consistency in the evaluation of CU (Cronbach's α, 0.73; 95% CI, 0.62-0.85). UCT and CDLQI scores strongly correlated (r = -0.74; P < .01). The UCT distinguished between different strata of disease severities established by the CDLQI (P < .01). Screening accuracy of the UCT was excellent in the discrimination of poorly controlled CU (area under the curve, 0.82). An optimal cutoff of less than or equal to 10 was determined for defining poorly controlled CU (sensitivity, 95.5%; specificity, 63.3%). Data at follow-up were consistent with data at study entry. Subgroup analyses of patients with chronic spontaneous urticaria were consistent with overall estimates of validity.

CONCLUSIONS

The UCT is a valid tool for the assessment of pediatric CU and chronic spontaneous urticaria, as evidenced by the acceptable internal consistency, convergent and known-groups validity, and screening accuracy at multiple time points.

[Progress of researches on medical big data analytics technology]

The use of the big data analytics technology to collect, summarize and analyze medical big data is effective to precisely mine and explore the underlying information, which greatly facilitates medical science research and clinical practices. Currently, the medical big data analytics technology mainly includes artificial intelligence, databases and programming languages, which have been widely employed in medical imaging, disease risk prediction, disease control, healthcare management, follow-up, and drug and therapy development. This review summarizes the currently available medical big data analytics technologies and their applications, with aims to facilitate the related studies.

Aggressive strains of the late wilt fungus of corn exist in Israel in mixed populations and can specialize in disrupting growth or plant health

Maize late wilt disease caused by the fungus Magnaporthiopsis maydis significantly damages crops in Israel and in other countries. Resistant maize cultivars are the preferred method for disease restraining. However, the pathogen populations of Spain and Egypt have varying aggressiveness, and virulent strains can overcome host resistance. In 2001 and from 2016 to -2019, 17 M. maydis strains were isolated from infected maize fields in Israel. The isolates' effects on seed germination, plant development, and disease symptoms severity were evaluated. The isolates from Israel display a diverse degree of aggressiveness that is not linked to their geographic distribution. The virulent strains are found in mixed populations, whereas less virulent M. maydis isolates exist. Aggressive strains harmed the development of plants and ears and caused severe wilting and death. In contrast, plants inoculated with less virulent strains exhibited only mild dehydration signs, and crop yield was similar to that of the non-infected control. Interestingly, different host cultivars can evoke specific virulence of M. maydis strains. Moreover, some pathogen strains significantly repress plant development, while the impact of other strains was evidenced by wilting symptoms. The current research further increases our understanding of the pathogen and our ability to control it.

A national surveillance of eosinophilic meningitis in Thailand

Introduction

Eosinophilic meningitis (EOM) is an emerging infectious disease worldwide. The most common cause of EOM is infection with Angiostrongylus cantonensis One possible method of monitoring and control of this infection is surveillance and prediction. There are limited data on national surveillance and predictive models on EOM. This study aimed to develop an online surveillance with a predictive model for EOM by using the national database.

Methods

We retrospectively retrieved reported cases of EOM from all provinces in Thailand and quantified them by month and year. Data were retrieved from Ministry of Public Health database. We developed a website application to explore the EOM cases in Thailand including regions and provinces using box plots. The website also provided the Autoregressive Integrated Moving Average (ARIMA) models and Seasonal ARIMA (SARIMA) models for predicting the disease cases from nation, region, and province levels. The suitable models were considered by minimum Akaike Information Criterion (AIC). The appropriate SARIMA model was used to predict the number of EOM cases.

Results

From 2003 to 2021, 3330 EOM cases were diagnosed and registered in the national database, with a peak in 2003 (median of 22 cases). We determined SARIMA(1,1,2)(2,0,0)[12] to be the most appropriate model, as it yielded the fitted values that were closest to the actual data. A predictive surveillance website was published on http://202.28.75.8/sample-apps/NationalEOM/.

Conclusions

We determined that web application can be used for monitoring and exploring the trend of EOM patients in Thailand. The predictive values matched the actual monthly numbers of EOM cases indicating a good fit of the predictive model.

Legionellosis risk-an overview of Legionella spp. habitats in Europe

An increase in the number of reports of legionellosis in the European Union and the European Economic Area have been recorded in recent years. The increase in cases is significant: from 6947 reports in 2015 to 11,298 in 2019. This is alarming as genus Legionella, which comprises a large group of bacteria inhabiting various aquatic systems, poses a serious threat to human health and life, since more than 20 species can cause legionellosis, with L. pneumophila being responsible for the majority of cases. The ability to colonize diverse ecosystems makes the eradication of these microorganisms difficult. A detailed understanding of the Legionella habitat may be helpful in the effective control of this pathogen. This paper provides an overview of Legionella environments in Europe: natural (lakes, groundwater, rivers, compost, soil) and anthropogenic (fountains, air humidifiers, water supply systems), and the role of Legionella spp. in nosocomial infections, which are potentially fatal for children, the elderly and immunocompromised patients.

Contemporary exploitation of natural products for arthropod-borne pathogen transmission-blocking interventions

An integrated approach to innovatively counter the transmission of various arthropod-borne diseases to humans would benefit from strategies that sustainably limit onward passage of infective life cycle stages of pathogens and parasites to the insect vectors and vice versa. Aiming to accelerate the impetus towards a disease-free world amid the challenges posed by climate change, discovery, mindful exploitation and integration of active natural products in design of pathogen transmission-blocking interventions is of high priority. Herein, we provide a review of natural compounds endowed with blockade potential against transmissible forms of human pathogens reported in the last 2 decades from 2000 to 2021. Finally, we propose various translational strategies that can exploit these pathogen transmission-blocking natural products into design of novel and sustainable disease control interventions. In summary, tapping these compounds will potentially aid in integrated combat mission to reduce disease transmission trends.

A novel risk score for disease control prediction of Chronic rhinosinusitis

Objectives

To assess the impact of risk factors on the disease control among chronic rhinosinusitis (CRS) patients, following 1 year of functional endoscopic sinus surgery (FESS), and combining the risk factors to formulate a convenient, visualised prediction model.

Design

A retrospective and nonconcurrent cohort study.

Setting and Participants

A total of 325 patients with CRS from June 2018 to July 2020 at the First Affiliated Hospital of Sun Yat‐sen University, the Third Affliated Hospital of Sun Yat‐sen University, the Seventh Affiliated Hospital of Sun Yat‐sen University.

Main Outcomes Measures

Outcomes were time to event measures: the disease control of CRS after surgery 1 year. The presence of nasal polyps, smoking habits, allergic rhinitis (AR), the ratio of tissue eosinophil (TER) and peripheral blood eosinophil count (PBEC) and asthma was assessed. The logistic regression models were used to conduct multivariate and univariate analyses. Asthma, TER, AR, PBEC were also included in the nomogram. The calibration curve and area under curve (AUC) were used to evaluate the forecast performance of the model.

Results

In univariate analyses, most of the covariates had significant associations with the endpoints, except for age, gender and smoking. The nomogram showed the highest accuracy with an AUC of 0.760 (95% CI, 0.688–0.830) in the training cohort.

Conclusions

In this cohort study that included the asthma, AR, TER, PBEC, which had significantly affected the disease control of CRS after surgery. The model provided relatively accurate prediction in the disease control of CRS after FESS and served as a visualised reference for daily diagnosis and treatment.

Wolbachia 16S rRNA haplotypes detected in wild Anopheles stephensi in eastern Ethiopia

BACKGROUND

About two out of three Ethiopians are at risk of malaria, a disease caused by the parasites Plasmodium falciparum and Plasmodium vivax. Anopheles stephensi, an invasive vector typically found in South Asia and the Middle East, was recently found to be distributed across eastern and central Ethiopia and is capable of transmitting both P. falciparum and P. vivax. The detection of this vector in the Horn of Africa (HOA) coupled with widespread insecticide resistance requires that new methods of vector control be investigated in order to control the spread of malaria. Wolbachia, a naturally occurring endosymbiotic bacterium of mosquitoes, has been identified as a potential vector control tool that can be explored for the control of malaria transmission. Wolbachia could be used to control the mosquito population through suppression or potentially decrease malaria transmission through population replacement. However, the presence of Wolbachia in wild An. stephensi in eastern Ethiopia is unknown. This study aimed to identify the presence and diversity of Wolbachia in An. stephensi across eastern Ethiopia.

METHODS

DNA was extracted from An. stephensi collected from eastern Ethiopia in 2018 and screened for Wolbachia using a 16S targeted PCR assay, as well as multilocus strain typing (MLST) PCR assays. Haplotype and phylogenetic analysis of the sequenced 16S amplicons were conducted to compare with Wolbachia from countries across Africa and Asia.

RESULTS

Twenty out of the 184 mosquitoes screened were positive for Wolbachia, with multiple haplotypes detected. In addition, phylogenetic analysis revealed two superclades, representing Wolbachia supergroups A and B (bootstrap values of 81 and 72, respectively) with no significant grouping of geographic location or species. A subclade with a bootstrap value of 89 separates the Ethiopian haplotype 2 from other sequences in that superclade.

CONCLUSIONS

These findings provide the first evidence of natural Wolbachia populations in wild An. stephensi in the HOA. They also identify the need for further research to confirm the endosymbiotic relationship between Wolbachia and An. stephensi and to investigate its utility for malaria control in the HOA.

UNC93B1 attenuates the cGAS-STING signaling pathway by targeting STING for autophagy-lysosome degradation

STING (stimulator of interferon genes) is a pivotal innate immune adaptor, and its functions during DNA virus infections have been extensively documented. However, its homeostatic regulation is not well understood. Our study demonstrates that UNC93B1 is a crucial checker for STING to prevent hyperactivation. Ectopic expression of UNC93B1 attenuates IFN-β promoter activity and the transcriptions of IFN-β, ISG54, and ISG56 genes. Moreover, UNC93B1 also blocks the IRF3 nuclear translocation induced by ectopic expression of both cGAS and STING and reduces the stability of STING by facilitating its autophagy-lysosome degradation, which can be reversed by lysosome inhibitors. Mechanistically, UNC93B1 interacts with STING and suppresses STING-activated downstream signaling by delivering STING to the lysosomes for degradation depending on its trafficking capability. UNC93B1 knockout (KO) in human embryonic kidney 293T (HEK293T) cells facilitates IFN-β promoter activity, IFN-β, ISG54, and ISG56 transcriptions IRF3 nuclear translocation induced by ectopic expression of cGAS and STING. Infected with herpes simplex virus-1 (HSV-1), UNC93B1 knockdown BJ cells or primary peritoneal macrophages from Unc93b1-deficient (Unc93b1^-/- ) mice show enhanced IFN-β, ISG54, and ISG56 transcriptions, TBK1 phosphorylation, and reduced STING degradation and viral replication. In addition, Unc93b1^-/- mice exhibit higher IFN-β, ISG54, and ISG56 transcriptions and lower mortality upon HSV-1 infection in vivo. Collectively, these findings demonstrate that UNC93B1 attenuates the cGAS-STING signaling pathway by targeting STING for autophagy-lysosome degradation and provide novel insights into the function of UNC93B1 in antiviral innate immunity. This article is protected by copyright. All rights reserved.

Implicit versus explicit vector management strategies in models for vector-borne disease epidemiology

Throughout the vector-borne disease modeling literature, there exist two general frameworks for incorporating vector management strategies (e.g. area-wide adulticide spraying and larval source reduction campaigns) into vector population models, namely, the "implicit" and "explicit" control frameworks. The more simplistic "implicit" framework facilitates derivation of mathematically rigorous results on disease suppression and optimal control, but the biological connection of these results to real-world "explicit" control actions that could guide specific management actions is vague at best. Here, we formally define a biological and mathematical relationship between implicit and explicit control, and we provide mathematical expressions relating the strength of implicit control to management-relevant properties of explicit control for four common intervention strategies. These expressions allow the optimal control and basic reproduction number analyses typically utilized in implicit control modeling to be interpreted directly in terms of real-world actions and real-world monetary costs. Our methods reveal that only certain sub-classes of explicit control protocols are able to be represented as implicit controls, and that implicit control is a meaningful approximation of explicit control only when resonance-like synergistic effects between multiple explicit controls have negligible effects on population reduction. When non-negligible synergy exists, implicit control results, despite their mathematical tidiness, fail to provide accurate predictions regarding vector control and disease spread. Collectively, these elements build an effective bridge between analytically interesting and mathematically tractable implicit control and the challenging, action-oriented explicit control.

Clinical trials as disease control? The political economy of sleeping sickness in the Democratic Republic of the Congo (1996-2016)

Human African Trypanosomiasis (HAT), commonly known as sleeping sickness, is closer than ever to being eliminated as a public health problem. The main narratives for the impressive drop in cases allude to drugs discovery and global financing and coordination. They raise questions about the relationship between well-funded international clinical research and much less well-endowed national disease control programmes. They need to be complemented with a solid understanding of how (and why) national programmes that do most of the frontline work are structured and operate. We analyse archives and in-depth interviews with key stakeholders and explore the role the national HAT programme played in the Democratic Republic of the Congo (DRC), a country that consistently accounts for over 60% of HAT cases worldwide. The programme grew strongly between 1996, when it was barely surviving, and 2016. Our political economy lens highlights how the leadership of the programme managed to carve itself substantial autonomy within the health system, forged new international alliances, and used clinical trials and international research to not only improve treatment and diagnosis but also to enhance its under-resourced disease control system. The DRC, a country often described as 'fragile', stands out as having an efficient national HAT programme that made full use of a window of opportunity that arose in the early 2000s when international researchers and donors responded to the ambition to simplify disease control and make HAT treatment more humane. We discuss the sustainability of both the vertical approach embodied in the DRC's national HAT programme and its funding model at a time when the number of HAT cases is at an all-time low and better integration within the health system is urgent. Our study provides insights for collaborations between unevenly-resourced international research efforts and national health programmes.

Letter to the editor: Post COVID-19 joint pain: Preliminary report of the relationship with antinuclear antibodies and inflammation

This case series of 15 patients shows in a cross-sectional design the association between antinuclear antibodies and joint pain in post covid syndrome. This article is protected by copyright. All rights reserved.

Nano- and micro-sized carnauba wax emulsions-based coatings incorporated with ginger essential oil and hydroxypropyl methylcellulose on papaya: Preservation of quality and delay of post-harvest fruit decay

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Nanoemulsion with 18% carnauba wax maintained papaya quality by retarding firmness loss, color changes, and reducing respiration rates, resulting in delayed ripening.

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Changes in flavor was not perceived by the panel in tasting samples.

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Coatings protection level was dependent on the storage conditions.

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GEO associated with carnauba nano-emulsions, showed a positive effect in reducing natural diseases.

Carnauba wax nano and micro-sized emulsions and hydroxypropyl methylcellulose coatings, alone or combined with ginger essential oils (GEO) were applied on papayas and evaluated under several storage conditions. In a first experiment, storage parameters were: 6 days at 22 °C, and 9 days at 13 °C followed by 5 days at 22 °C. In a second experiment, storage was: 5 days at 22 °C, and 10 days at 16 °C followed by 3 days at 22 °C. Coating effects were dependent on storage conditions. While fruits were in cold storage, there were few changes; however, at 22 °C, the differences between coatings became more evident. Nanoemulsions maintained papaya quality during storage by retarding firmness loss, color changes, and reducing respiration rates, resulting in delayed ripening. GEO exhibited some positive effect on fungal disease control. Nanoemulsion-based coatings improved shelf life by reducing weight loss, color development, and slowing ripening of papaya fruit.

Melatonin Use for SARS-CoV-2 Infection:Time to Diversify the Treatment Portfolio

We were pleased to read the publication by Lan and colleagues [1] which included a meta-analysis of the Randomized Controlled Trials (RTCs) in which melatonin was used as a treatment for COVID-19. This article is protected by copyright. All rights reserved.

Estimating the financial impact of livestock schistosomiasis on traditional subsistence and transhumance farmers keeping cattle, sheep and goats in northern Senegal

Background

Schistosomiasis is a disease that poses major threats to human and animal health, as well as the economy, especially in sub-Saharan Africa (SSA). Whilst many studies have evaluated the economic impact of schistosomiasis in humans, to date only one has been performed in livestock in SSA and none in Senegal. This study aimed to estimate the financial impact of livestock schistosomiasis in selected regions of Senegal.

Methods

Stochastic partial budget models were developed for traditional ruminant farmers in 12 villages in northern Senegal. The models were parameterised using data from a cross-sectional survey, focus group discussions, scientific literature and available statistics. Two scenarios were defined: scenario 1 modelled a situation in which farmers tested and treated their livestock for schistosomiasis, whilst scenario 2 modelled a situation in which there were no tests or treatment. The model was run with 10,000 iterations for 1 year; results were expressed in West African CFA francs (XOF; 1 XOF was equivalent to 0.0014 GBP at the time of analysis). Sensitivity analyses were conducted to assess the impact of uncertain variables on the disease costs.

Results

Farmers surveyed were aware of schistosomiasis in their ruminant livestock and reported hollowing around the eyes, diarrhoea and weight loss as the most common clinical signs in all species. For scenario 1, the median disease costs per year and head of cattle, sheep and goats were estimated at 13,408 XOF, 27,227 XOF and 27,694 XOF, respectively. For scenario 2, the disease costs per year and head of cattle, sheep and goats were estimated at 49,296 XOF, 70,072 XOF and 70,281 XOF, respectively.

Conclusions

Our findings suggest that the financial impact of livestock schistosomiasis on traditional subsistence and transhumance farmers is substantial. Consequently, treating livestock schistosomiasis has the potential to generate considerable benefits to farmers and their families. Given the dearth of data in this region, our study serves as a foundation for further in-depth studies to provide estimates of disease impact and as a baseline for future economic analyses. This will also enable One Health economic studies where the burden on both humans and animals is estimated and included in cross-sectoral cost–benefit and cost-effectiveness analyses of disease control strategies.

Graphical Abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-021-05147-w.

The German severe asthma patient: Baseline characteristics of patients in the German Severe Asthma Registry, and relationship with exacerbations and control

INTRODUCTION

The German Asthma Net Severe Asthma Registry is collecting long-term data from a large cohort of patients aged ≥6 years with severe asthma. This manuscript presents their baseline characteristics, and identifies relationships with exacerbations and/or poor asthma control.

METHODS

The registry is collecting routine clinical parameters including: demographics and medical history; disease characteristics (Asthma Control Questionnaire [ACQ]-5, forced expiratory volume in 1 s [FEV1]); exacerbations; and biomarkers (eosinophils, immunoglobulin E [IgE], fractional exhaled nitric oxide [FeNO]).

RESULTS

These analyses include data from 2011 patients at 72 sites (91.9% adult). Children (6-17 years) were more likely to be male, whereas more adults were female (males: children/adults 62%/41%). Most were receiving inhaled corticosteroid/long-acting β2-agonist combinations (78%/81%); 38.0% of adults were receiving systemic steroids. Asthma control was suboptimal in both groups: 21.5%/13.3% were controlled; 10.4%/49.1% were symptomatic; 33.1%/37.2% received emergency asthma treatment in the previous year. Median blood eosinophil (400/238 cells/μL) and IgE levels (494/186 IU/mL) were higher in children; FeNO was lower (19/35 ppb). Patients with ≥2 exacerbations in the previous year had lower FEV1 (absolute and % predicted) and IgE, and higher ACQ-5, FeNO and blood eosinophil levels (all p < 0.05). There was a weak, negative correlation between ACQ-5 and FEV1% predicted in adults (p < 0.001).

CONCLUSIONS

These analyses characterise the typical German patient with severe asthma, and provide information on their overall care. Their planned long-term follow-up will assess whether asthma control can be optimised, how best to do so, and most importantly how such optimisation can benefit patients.

Construction and characterization of two SARS-CoV-2 minigenome replicon systems

The ongoing COVID-19 pandemic severely impacts global public health and economies. In order to facilitate research on SARS-CoV-2 virology and antiviral discovery, a non-infectious viral replicon system operating under biosafety level 2 containment is warranted. We report herein the construction and characterization of two SARS-CoV-2 minigenome replicon systems. First, we constructed the IVT-CoV2-Rep cDNA template to generate a replicon mRNA with nanoluciferase (NLuc) reporter via in vitro transcription (IVT). The replicon mRNA transfection assay demonstrated a rapid and transient replication of IVT-CoV2-Rep in a variety of cell lines, which could be completely abolished by known SARS-CoV-2 replication inhibitors. Our data also suggests that the transient phenotype of IVT-CoV2-Rep is not due to host innate antiviral responses. In addition, we have developed a DNA-launched replicon BAC-CoV2-Rep, which supports the in-cell transcription of a replicon mRNA as initial replication template. The BAC-CoV2-Rep transient transfection system exhibited a much stronger and longer replicon signal compared to the IVT-CoV2-Rep version. We also found that a portion of the NLuc reporter signal was derived from the spliced BAC-CoV2-Rep mRNA and was resistant to antiviral treatment, especially during the early phase after transfection. In summary, the established SARS-CoV-2 transient replicon systems are suitable for basic and antiviral research, and hold promise for stable replicon cell line development with further optimization. This article is protected by copyright. All rights reserved.

Escaping from COVID-19 emergency accounting on previously infected subjects?

The efficacy of vaccination to prevent a huge widespread SARS-CoV2 infection is quite undoubtedly assessed by recent data and reports, yet the co-existence of naturally immunized (serum positive, SP) non-vaccinated people, SP vaccinated people and naïve (serum negative) people, should thoroughly revise our epidemiological overview and data interpretation about social contacts and even restriction measures. We are not merely talking about a blank immune population needing urgent vaccination but of a complex milieu of immunized subjects, whose thorough and expert knowledge may provide fundamental insights to improve the management of COVID-19 pandemic emergency. For example, upon vaccination, a good recommended practice is to evaluate both mucosal and serum immunity, by a quantitative salivary sIgAs and serum IgGs search, better if along a swab test, in order to group individuals called for vaccination in cohorts of susceptibility, which should enable physicians to take a decision about how many doses of vaccine and when, they should take into consideration, based on the previous immunity assessed from the subject. Actually, it seems that vaccines act quite exclusively as boosters This article is protected by copyright. All rights reserved.

Omicron variant of SARS-CoV-2: Genomics, transmissibility, and responses to current COVID-19 vaccines

Currently, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has spread worldwide as an Omicron variant. This variant is a heavily mutated virus and designated as a variant of concern by the World Health Organization (WHO). WHO cautioned that the Omicron variant of SARS‐CoV‐2 held a very high risk of infection, reigniting anxieties about the economy's recovery from the 2‐year pandemic. The extensively mutated Omicron variant is likely to spread internationally, posing a high risk of infection surges with serious repercussions in some areas. According to preliminary data, the Omicron variant of SARS‐CoV‐2 has a higher risk of reinfection. On the other hand, whether the current COVID‐19 vaccines could effectively resist the new strain is still under investigation. However, there is very limited information on the current situation of the Omicron variant, such as genomics, transmissibility, efficacy of vaccines, treatment, and management. This review focused on the genomics, transmission, and effectiveness of vaccines against the Omicron variant, which will be helpful for further investigation of a new variant of SARS‐CoV‐2.

Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Omicron variant is a heavily mutated virus and designated as a variant of concern.

This variant may evade vaccine‐induced immunity.

There might have increased risk of SARS‐CoV‐2 reinfection by the Omicron variant.

Antifungal Prospect of Bacillus cereus Postbiotic on Crustacean Pathogen, Lagenidium thermophilum

Pathogenic marine fungi, Lagenidium thermophilum is known causative agent in the crustacean industry. Current disinfection practice in hatchery has risks and negative impacts which prompts suitable substitute to synthetic antifungal agents. Thus, this study was conducted to evaluate the antifungal potential of postbiotic from four potential probiotics towards marine oomycetes, L. thermophilum IPMB 1401. The screening test showed that the Lactobacillus plantarum GS12 and Bacillus cereus GS15 postbiotics were positive for antifungal activity on L. thermophilum IPMB 1401. These two bacterial extracts have minimum inhibitory concentration （MIC） at 50%. The toxicity assay on MIC level of the postbiotic revealed that the cumulative mortality of brine shrimp nauplii exposed to B. cereus postbiotic was significantly lower compared to L. plantarum GS12 postbiotic and formalin. This indicates a high potential of B. cereus GS15 as a prospect for alternative control method for fungal infections in the crustacean culture industry.

Recent advances in E-monitoring of plant diseases

Infectious plant diseases are caused by pathogenic microorganisms, such as fungi, oomycetes, bacteria, viruses, phytoplasma, and nematodes. Plant diseases have a significant effect on the plant quality and yield and they can destroy the entire plant if they are not controlled in time. To minimize disease-related losses, it is essential to identify and control pathogens in the early stages. Plant disease control is thus a fundamental challenge both for global food security and sustainable agriculture. Conventional methods for plant diseases control have given place to electronic control (E-monitoring) due to their lack of portability, being time consuming, need for a specialized user, etc. E-monitoring using electronic nose (e-nose), biosensors, wearable sensors, and 'electronic eyes' has attracted increasing attention in recent years. Detection, identification, and quantification of pathogens based on electronic sensors (E-sensors) are both convenient and practical and may be used in combination with conventional methods. This paper discusses recent advances made in E-sensors as component parts in combination with wearable sensors, in electronic sensing systems to control and detect viruses, bacteria, pathogens and fungi. In addition, future challenges using sensors to manage plant diseases are investigated.

Impact of the Coronavirus Disease Pandemic on Health-Related Quality of Life of Patients with Inflammatory Bowel Disease

BACKGROUND

To learn from the crisis caused by the coronavirus disease (COVID-19) pandemic and be prepared for future pandemics, it is important to investigate the impact of this period on the wellbeing of patients with inflammatory bowel disease (IBD).

AIMS

To describe the health-related quality of life (HRQoL) and disease control of IBD patients during the first wave of the COVID-19 pandemic in The Netherlands.

METHODS

Between March 17 and July 1, 2020, patients aged 18 years and older with IBD from the Erasmus MC (Rotterdam, The Netherlands) were invited to complete online questionnaires at week 0, 2, 6 and 12. The Inflammatory Bowel Disease Questionnaire (IBDQ), the Inflammatory Bowel Disease Control-8 (IBD-control-8) and the numeric rating scale on fatigue were used. The evolution of the different outcomes over time was measured using mixed models.

RESULTS

Of 1151 invited patients, 851 patients (67% CD and 33% UC or IBD-U) participated in the study (response rate 74%). No relevant changes in total scores were found over time for the IBDQ (effect estimate 0.006, 95% CI [- 0.003 to 0.015]) and IBD-control-8 (effect estimate 0.004, 95% CI [0.998-1.011]). There was a slight, increasing trend in fatigue scores over time (effect estimate 0.011, 95% CI [0.004, 0.019]).

CONCLUSIONS

This first lock down due to the COVID-19 pandemic in The Netherlands did not impact on the HRQoL and disease control of patients with IBD. Up to date information may have contributed to a stable HRQoL in IBD patients even in an extreme period with restrictions and insecurities.

COVID-19 Propagation Model Based on Economic Development and Interventions

In order to understand the influencing factors affecting the COVID-19 propagation, and analyze the development trend of the epidemic situation in the world, COVID-19 propagation model to simulate the COVID-19 propagation in the population is proposed in this paper. First of all, this paper analyzes the economic factors and interventions affecting the COVID-19 propagation in various different countries. Then, the touch number for COVID-19 High-risk Population Dynamic Network in this paper was redefined, and it predicts and analyzes the development trend of the epidemic situation in different countries. The simulation data and the published confirmed data by the world health organization could fit well, which also verified the reliability of the model. Finally, this paper also analyzes the impact of public awareness of prevention on the control of the epidemic. The analysis shows that increasing the awareness of prevention, timely and early adoption of protective measures such as wearing masks, and reducing travel can greatly reduce the risk of infection and the outbreak scale.

Development and utility of a close contact information management system for the COVID-19 pandemic

BACKGROUND

Since the outbreak started in 2019, COVID-19 pandemic has a significant global impact. Due to the highly infective nature of SARS-CoV-2, the COVID-19 close contacts are at significant risk of contracting COVID-19. China's experience in successfully controlling COVID-19 emphasized the importance of managing close contacts because this strategy helps to limit potential infection sources, prevent the unconscious spread of COVID-19 and thus control this pandemic. As a result, to understand and consider the management of close contacts may be beneficial to other countries. However, managing close contacts is challenging owing to the huge number of close contacts and a lack of appropriate management tools and literature references.

METHODS

A new system called the COVID-19 Close Contact Information Management System was developed. Here we introduced the design, use, improvement and achievements of this system.

RESULTS

This system was designed from the standpoint of the Centers for Disease Control and Prevention in charge of managing close contacts. Two main functions and eight modules/themes were ultimately formed after two development stages. The system introduces what information need to be collected in the close contact management. Since the system allows information flow across cities, the geographical distance and administrative regional boundaries are no longer obstacles for managing close contacts, which promotes the management of each close contact. Moreover, when this system is used in conjunction with other data tools, it provides data assistance for understanding the COVID-19 characteristics and formulating targeted COVID-19 control policies. To date, the system has been widely used in Guangdong Province for over 1 year and has recorded tens of thousands of pieces of data. There is sufficient practical experience to suggest that the system is capable of meeting the professional work requirements for close contact management.

CONCLUSIONS

This system provides a new way to manage close contacts and restrict the spread of COVID-19 by combining information technology with disease prevention and control strategies in the realm of public health. We hope that this system will serve as an example and guide for those anticipating similar work in other countries in response to current and future public health incidents.

Discovery of florylpicoxamid, a mimic of a macrocyclic natural product

Natural products have routinely been used both as sources of and inspiration for new crop protection active ingredients. The natural product UK-2A has potent anti-fungal activity but lacks key attributes for field translation. Post-fermentation conversion of UK-2A to fenpicoxamid resulted in an active ingredient with a new target site of action for cereal and banana pathogens. Here we demonstrate the creation of a synthetic variant of fenpicoxamid via identification of the structural elements of UK-2A that are needed for anti-fungal activity. Florylpicoxamid is a non-macrocyclic active ingredient bearing two fewer stereocenters than fenpicoxamid, controls a broad spectrum of fungal diseases at low use rates and has a concise, scalable route which is aligned with green chemistry principles. The development of florylpicoxamid represents the first example of using a stepwise deconstruction of a macrocyclic natural product to design a fully synthetic crop protection active ingredient.

Model predictive control for optimal social distancing in a type SIR-switched model

Social distancing strategies have been adopted by governments to manage the COVID-19 pandemic, since the first outbreak began. However, further epidemic waves keep out the return of economic and social activities to their standard levels of intensity. Social distancing interventions based on control theory are needed to consider a formal dynamic characterization of the implemented SIR-type model to avoid unrealistic objectives and prevent further outbreaks. The objective of this work is twofold: to fully understand some dynamical aspects of SIR-type models under control actions (associated with second waves) and, based on it, to propose a switching non-linear model predictive control that optimize the non-pharmaceutical measures strategy. Opposite to other strategies, the objective here is not just to minimize the number of infected individuals at any time, but to minimize the final size of the epidemic while minimizing the time of social restrictions and avoiding the infected prevalence peak to overpass a maximum established by the healthcare system capacity. Simulations illustrate the benefits of the aforementioned proposal.

Realtime case study simulations of transmission of Pancreas Disease (PD) in Norwegian salmonid farming for disease control purposes

Pancreas Disease (PD) is a viral disease caused by Salmonid Alphavirus (SAV). It affects farmed salmonids in the North Atlantic, and leads to reduced feed intake and increased mortality with reduced production and welfare as a consequence. In 2013, the estimated cost of an outbreak on an average salmon farm was about 6.6 mil €. In Norway, PD has been notifiable since 2008, and regulations to mitigate disease spread are in place. However, despite the regulations, 140-170 farms are affected by PD every year. The aquaculture industry is growing continuously, introducing farms in new geographical areas, and fish are moved between hydrographically separated zones for trade and slaughter. All such movements and relocations need to be approved by the competent authorities. Thus, there is a demand for support to farmers and competent authorities when making decisions on disease management and especially on the effect of moving infected fish. We have used a disease-transmission model for outbreak-simulation in real time for assessing the probability of disease transmission from a farm that gets infected with PD. We have also simulated the effects of three different control-regimes: no stamping-out, delayed stamping-out or immediate stamping-out, on the transmission of PD to surrounding farms. Simulations showed that the immediate stamping out of an infected farm led to effective containment of an outbreak. No stamping out led to up to 32.1% of farms within 100 km of the index farm to become effected. We have used real production data for the model building and the scenario simulations, and the results illustrate that a risk assessment of horizontal disease transmission must be undertaken on a case-by-case basis, because the time and place of the outbreak has a large influence on the risk of transmission.

How long is long enough to secure disease control after low-dose-rate brachytherapy in combination with other modalities in intermediate-risk, localized prostate cancer?

PURPOSE

Previous studies have demonstrated excellent overall outcomes in patients who underwent low-dose-rate brachytherapy (LDR-BT) in intermediate-risk, localized prostate cancer (PCa). We thus investigated the appropriate length of time before completing prostate-specific antigen (PSA) monitoring after treatment.

PATIENTS AND METHODS

Between 2003 and 2014, 710 localized, intermediate-risk PCa patients underwent LDR-BT with or without supplemental external beam radiotherapy (EBRT). Data from 567 of those patients was analyzed in this study. Neoadjuvant hormonal therapy (NHT) was administered to 315 patients (55.6 %) and NHT with adjuvant hormonal therapy (AHT) to 59 patients (10.4 %), as per the protocol of a prospective randomized controlled trial (SHIP0804). We stratified patients by posttreatment PSA levels at specific times and assessed the factors for association with biochemical recurrence (BCR) and for clinical progression (CP).

RESULTS

The median follow-up was 109 months (range, 60-205 months). Of 529 patients who were BCR-free at 3 years after treatment, 56 subsequently developed BCR, and 47 developed CP. PSA at 3 and 5 years after treatment were significantly correlated with long-term oncological outcomes. No patients with 5-year PSA levels ≤0.1 ng/mL subsequently developed BCR or CP.

CONCLUSION

Discontinuation of PSA monitoring could be discussed with patients with intermediate-risk PCa as a reasonable option if PSA levels remain ≤0.1 ng/mL at 5 years after LDR-BT, either alone or with other combined modalities, as subsequent recurrences are quite rare.