Asymptomatic People Research Articles

Early Detection of Asymptomatic Covid-19 Infection with Artificial Neural Network Model Through Voice Recording of Forced Cough

SARS-CoV-2 is a virus that spreads the infection known as COVID-19, or Coronavirus 2019. According to data from the World Health Organization as of March 15, 2021, Indonesia has 1,419,455 cumulative cases and 38,426 cumulative deaths, ranking third among countries in terms of fatalities, behind Iran and India. Because COVID-19 was disseminated through direct contact with respiratory droplets from an infected individual, it spread swiftly and widely. According to the American Centers for Disease Control and Prevention, more than 50% of transmission rates are anticipated from asymptomatic individuals. The antigen tests have an accuracy of results ranging from 80–90% and are utilized for early detection of COVID-19. The cost of the antigen test is set to increase as of September 3, 2021, with prices ranging from IDR 99.000 to IDR 109.000; however, researchers are steadfastly searching for the best alternate methods for the early diagnosis of COVID-19. According to MIT News Office, a forced cough recording can identify an asymptomatic COVID-19 infection. Through the vocal recording of a forced cough, this study uses an artificial neural network (ANN) deep learning model to identify asymptomatic COVID-19 patients. The Artificial Neural Network (ANN) can distinguish asymptomatic people from forced cough recordings with an accuracy of up to 98% and a loss value of less than 3% by employing oversampling data. This model can be applied as a free, universal method for the early identification of COVID-19 infection.

Early-stage predictors of deterioration among 3145 nonsevere SARS-CoV-2-infected people community-isolated in Wuhan, China: A combination of machine learning algorithms and competing risk survival analyses.

To determine which early-stage variables best predicted the deterioration of coronavirus disease 2019 (COVID-19) among community-isolated people infected with severe acute respiratory syndrome coronavirus 2 and to test the performance of prediction using only inexpensive-to-measure variables. Medical records of 3145 people isolated in two Fangcang shelter hospitals (large-scale community isolation centers) from February to March 2020 were accessed. Two complementary methods-machine learning algorithms and competing risk survival analyses-were used to test potential predictors, including age, gender, severity upon admission, symptoms (general symptoms, respiratory symptoms, and gastrointestinal symptoms), computed tomography (CT) signs, and comorbid chronic diseases. All variables were measured upon (or shortly after) admission. The outcome was deterioration versus recovery of COVID-19. More than a quarter of the 3145 people did not present any symptoms, while one-third ended isolation due to deterioration. Machine learning models identified moderate severity upon admission, old age, and CT ground-glass opacity as the most important predictors of deterioration. Removing CT signs did not degrade the performance of models. Competing risk models identified age ≥ 35 years, male gender, moderate severity upon admission, cough, expectoration, CT patchy opacity, CT consolidation, comorbid diabetes, and comorbid cardiovascular or cerebrovascular diseases as significant predictors of deterioration, while a stuffy or runny nose as a predictor of recovery. Early-stage prediction of COVID-19 deterioration can be made with inexpensive-to-measure variables, such as demographic characteristics, severity upon admission, observable symptoms, and self-reported comorbid diseases, among asymptomatic people and mildly to moderately symptomatic patients.

Paving the way for evidence-based population screening for type 1 diabetes.

Since the 1980s, we have been gaining knowledge about the pathogenesis of type 1 diabetes and found that the measurement of diabetes-associated autoantibodies against insulin, glutamic acid decarboxylase, insulinoma-associated protein 2, and zinc transporter 8 has a central role in recognition of early stages of the disease in asymptomatic people. In the 1990s, large prospective studies were established in Finland (the Diabetes Prediction and Prevention [DIPP] study 1 Kupila A Muona P Simell T et al. Feasibility of genetic and immunological prediction of type I diabetes in a population-based birth cohort. Diabetologia. 2001; 44: 290-297 Crossref PubMed Scopus (268) Google Scholar ), Germany (the BABYDIAB study 2 Ziegler AG Hummel M Schenker M Bonifacio E Autoantibody appearance and risk for development of childhood diabetes in offspring of parents with type 1 diabetes: the 2-year analysis of the German BABYDIAB study. Diabetes. 1999; 48: 460-468 Crossref PubMed Scopus (536) Google Scholar ), Sweden (Diabetes Prediction in Skåne Study 3 Elding Larsson H A Swedish approach to the prevention of type 1 diabetes. Pediatr Diabetes. 2016; 17: 73-77 Crossref PubMed Scopus (13) Google Scholar ), and the USA (the Diabetes Autoimmunity Study in the Young [DAISY] 4 Rewers M Bugawan TL Norris JM et al. Newborn screening for HLA markers associated with IDDM: Diabetes Autoimmunity Study in the Young (DAISY). Diabetologia. 1996; 39: 807-812 Crossref PubMed Scopus (349) Google Scholar ) that followed up children with a high genetic risk of developing type 1 diabetes from birth until diagnosis of clinical type 1 diabetes. On the basis of these findings, confirmed positivity for multiple (at least two) autoantibodies predicts almost inevitable progression to clinical type 1 diabetes within 15 years from seroconversion 5 Insel RA Dunne JL Atkinson MA et al. Staging presymptomatic type 1 diabetes: a scientific statement of JDRF, the Endocrine Society, and the American Diabetes Association. Diabetes Care. 2015; 38: 1964-1974 Crossref PubMed Scopus (473) Google Scholar and thus allows the diagnosis before clinical symptoms develop. However, the disease's progression shows a high variability and mostly depends on the age at which seroconversion occurs, with prechoolers having a faster decline of residual β-cell function than adolescents. Therefore, to better understand the interaction between genetics and environmental factors in children with a high genetic risk of type 1 diabetes, further large prospective studies, such as TEDDY 6 TEDDY Study GroupThe Environmental Determinants of Diabetes in the Young (TEDDY) study: study design. Pediatr Diabetes. 2007; 8: 286-298 Crossref PubMed Scopus (219) Google Scholar or Diabetes Evaluation in Washington (DEW‑IT), 7 Wion E Brantley M Stevens J et al. Population-wide infant screening for HLA-based type 1 diabetes risk via dried blood spots from the public health infrastructure. Ann NY Acad Sci. 2003; 1005: 400-403 Crossref PubMed Scopus (24) Google Scholar were established in the USA in the early 2000s. Although maximum autoantibody conversion occurs between the first and second year of life, approximately 20% of children develop multiple antibodies after 5 years of age. Islet autoantibody screening in at-risk adolescents to predict type 1 diabetes until young adulthood: a prospective cohort studyScreening of adolescents at risk for type 1 diabetes only once at 10 years of age for islet autoantibodies was highly effective to detect type 1 diabetes by the age of 18 years, which in turn could enable prevention of diabetic ketoacidosis and participation in secondary prevention trials. Full-Text PDF

Predictors for Colorectal Polyps in an Asymptomatic Population Undergoing Medical Check-ups.

Colorectal cancer primarily arises from colorectal polyps. Early screening and removal is beneficial, especially in asymptomatic populations. This research aimed to reveal the risk factors detected in medical check-ups for colorectal polyps in asymptomatic people. Clinical data of 933 asymptomatic people who underwent colonoscopies from May 2014 to December 2021 was analyzed retrospectively. Data included sex, age, colonoscopy findings, polyp pathology, polyp number, and blood test results. The distribution of colorectal lesions was analyzed. Participants were divided into control and polyp groups, adenomatous and non-adenomatous polyp groups, and single and multiple adenoma groups. Participants' age, proportion of males, carcinoembryonic antigen (CEA), uric acid and glycosylated hemoglobin levels were significantly higher (P≤0.05) in the polyp group. Age (>40y), sex (male), and CEA level (>1.435ng/mL) were independent risk factors for polyps. CEA, uric acid, carbohydrate antigen 19-9, triglyceride, and total cholesterol levels were significantly higher (P<0.05) in the adenoma group than in the non-adenomatous group. CEA level (>1.435ng/mL) was an independent predictor for adenomas (P<0.05). Participants' age, proportion of males, CEA, glycosylated hemoglobin, and fasting blood glucose levels were significantly higher (P<0.05) in the multiple adenoma group than in the single group; the high-density lipoprotein cholesterol level was lower (P<0.05). No independent risk factors were found for the number of adenomas. Serum CEA level (>1.435ng/mL) was independent risk factor for colorectal polyps. It may be conducive to improve discriminative ability of colorectal cancer risk stratification model.

Cardiac MRI-Based Assessment of Myocardial Injury in Asymptomatic People Living With Human Immunodeficiency Virus: Correlation With nadir CD4 Count.

There are known cardiac manifestations of HIV, but the findings in asymptomatic subjects are still not fully explored. To evaluate for the presence of subclinical myocardial injury in asymptomatic people living with human immunodeficiency virus (PLWH) by cardiac MRI and to explore the possible association between subclinical myocardial injury and HIV-related clinical characteristics. Cross-sectional. A total of 80 asymptomatic PLWH (age: 53 years [47-56 years]; 90% male) and 50 age- and sex-matched healthy participants. A 3-T, cine sequence, T1, T2, and T2* mapping. Function analysis was derived from short axis, two-, three-, and four-chamber cine images by feature tracking. Regions of interest were manually selected in the midventricular septum T1, T2, and T2* mapping sequences. PLWH were evaluated for T1 increment (△T1 mapping = native T1 - cutoff values) and HIV-related clinical characteristics, particularly the nadir CD4 count. And PLWH were stratified into two groups according to the cutoff value of native T1: elevated native T1 and normal. T test, Wilcoxon rank-sum test, Chi-square test, Spearman rank correlation, and logistic regression. P <0.05 indicated statistical significance. Asymptomatic PLWH revealed significantly higher native myocardial T1 values (1241 ± 29 msec vs. 1189 ± 21 msec), T2 values (40.7 ± 1.5 msec vs. 37.9 ± 1.4 msec), and lower LVGRS (30.2% ± 6.2% vs. 35.8% ± 6.4%), LVGCS (-18.0% ± 2.5% vs. -19.5% ± 2.0%), and LVGLS (-16.0% ± 3.8% vs. -17.9% ± 2.6%) but showed no difference in T2* values (17.3 msec [16.3-19.1 msec] vs. 18.3 msec [16.5-19.3 msec], P = 0.201). A negative correlation between the native T1 increment in PLWH with subclinical myocardial injury and the nadir CD4 count (u = -0.316). Nadir CD4 count <500 cells/mm3 was associated with higher odds of elevated native T1 myocardial values (odds ratio, 6.12 [95% CI, 1.07-34.91]) in PLWH. Subclinical myocardial inflammation and dysfunction were present in asymptomatic PLWH, and a lower nadir CD4 count may be a risk factor for subclinical myocardial injury. 1. Stage 2.

Impact of public health and social measures on contact dynamics during a SARS-CoV-2 Omicron variant outbreak in Quanzhou, China, March to April 2022

ObjectivesTo evaluate the impact of early implementation of public health and social measures (PHSMs) on contact rates over time and explore contact behavior of asymptomatic versus symptomatic cases. MethodsWe used the largest contact tracing data in China thus far to estimate the mean contacts over time by age groups and contact settings. We used bootstrap with replacement to quantify the uncertainty of contact matrixes. The Pearson correlation was performed to demonstrate the number of contacts over time in relation to the evolution of restrictions. In addition, we analyzed the index cases with a high number of contacts and index cases that produced a high number of secondary cases. ResultsRapidly adapted PHSMs can reduce the mean contact rates in public places while increasing the mean contact rates within households. The mean contact rates were 11.81 (95% confidence interval, 11.61-12.01) for asymptomatic (at the time of investigation) cases and 6.70 (95% confidence interval, 6.54-6.87) for symptomatic cases. The percentage of asymptomatic cases (at the time of investigation) meeting >50 close contacts make up more than 65% of the overall cases. The percentage of asymptomatic cases producing >10 secondary cases account for more than 80% of the overall cases. ConclusionPHSMs may increase the contacts within the household, necessitating the need for pertinent prevention strategies at home. Asymptomatic cases can contribute significantly to Omicron transmission. By making asymptomatic people aware that they are already contagious, hence limiting their social contacts, it is possible to lower the transmission risk.

The Effect of Efavirenz on Reward Processing in Asymptomatic People Living with HIV: A Randomized Controlled Trial.

Functional magnetic resonance imaging (fMRI) studies have demonstrated that HIV-infection affects the fronto-striatal network. It has not been examined what impact efavirenz (EFV), an antiretroviral drug notorious for its neurocognitive effects, has on the reward system: a key subcomponent involved in depressive and apathy symptoms. Therefore, this study aims to investigate the effect of EFV on reward processing using a monetary incentive delay (MID) task. In this multicenter randomized controlled trial, asymptomatic adult participants stable on emtricitabine/tenofovirdisoproxil fumarate (FTC/TDF)/EFV were randomly assigned in a 2:1 ratio to switch to FTC/TDF/rilpivirine (RPV) (n = 30) or continue taking FTC/TDF/EFV (n = 13). At baseline and 12 weeks after therapy switch, both groups performed an MID task. Behavior and functional brain activity related to reward anticipation and reward outcome were assessed with blood-oxygen-level-dependent fMRI. Both groups were matched for age, education level, and time since HIV diagnosis and on EFV. At the behavioral level, both groups had faster response times and better response accuracy during rewarding versus nonrewarding trials, with no improvement resulting from switching FTC/TDF/EFV to FTC/TDF/RPV. No significant change in activation related to reward anticipation in the ventral striatum was found after switching therapy. Both groups had significantly higher activation levels over time, consistent with a potential learning effect. Similar activity related to reward outcome in the orbitofrontal cortex was found. Discontinuing FTC/TDF/EFV was not found to improve activity related to reward anticipation in asymptomatic people living with HIV, with similar cortical functioning during reward outcome processing. It is therefore likely that EFV does not affect motivational control. Further research is needed to determine whether EFV affects motivational control in HIV populations with different characteristics.

How big of an impact do asymptomatic people have on the dynamics of an epidemic?

Asymptomatic carriers serve as a potential source of transmission of epidemic diseases. Exposed people who develop symptoms only get tested and remain isolated in their homes or sometimes in hospitals when needed. In contrast, the asymptomatic individuals go untested and spread the disease silently as they roam freely throughout their entire infectious lifetime. The work intends to explore the role of asymptomatic carriers in the transmission of epidemic diseases and investigate suitable optimal control strategies. We propose a SEIAQR compartmental model subdividing the total population into six different compartments. To illustrate the model’s implication, we estimate the number of asymptomatic individuals using COVID-19 data during June 9–July 18, 2021 from Bangladesh. We then analyze the model to explore whether the epidemic subsides if the asymptomatic individuals are tested randomly and isolated. Finally, to gain a better understanding of the potential of this unidentified transmission route, we propose an optimal control model considering two different control strategies: personal protective measures and isolation of asymptomatic carriers through random testing. Our results show that simultaneous implementation of both control strategies can reduce the epidemic early. Most importantly, sustained effort in identifying and isolation of asymptotic individuals allows relaxation in personal protective measures.

Ultrasonographic Assessment of Normal Achilles Tendon Thickness and Width in the Asymptomatic Sudanese Population

Background: The goal of this study was to measure normal Achilles tendon (AT) thickness and width in adult asymptomatic Sudanese people using high-resolution ultrasound. Methods and Results: The study was conducted on members of a healthy Sudanese population (120 volunteers: 73/60.8% women and 47/39.2% men), who were chosen using simple random sampling. The study cases were all healthy people with no history of AT injuries or abnormalities. All patients were examined using a Toshiba Xairo200 linear transducer with a frequency range of 7-10MHz. All measurements were taken from a transverse scan at the calcaneus bone level of the AT insertion and 2 to 3cm above the calcaneus. The age group 20-27 had the most participants (44.2%), followed by 36-43 years (19.2%), 28-35 years (15.8%), 52-60 years (14.2%), and 44-51 years (6.7%). The study revealed that the mean age of participants was 34.19±12.29 years, height - 164±0.081 cm, weight - 67.22±15.97 kg, and BMI - 24.38±5.84 kg/m2. The mean thickness and width of the AT were 4.36±0.81 mm and 21.85±3.23 mm, respectively, at its insertion into the calcaneus, and 4.63±0.77 mm and 12.20±1.37 mm, respectively, at the level 2-3 cm above the insertion. We found significant differences according to gender between the AT thickness and width at insertion into the calcaneus and above insertion and no statistically significant differences between the AT measurement's right and left side data. Conclusion: The study found gender differences in the AT thickness and width at insertion into the calcaneus and 2-3 cm above the insertion. No statistically significant differences were detected between the AT measurement’s right and left side data.Age, weight, height, and BMI correlated with the thickness and width of the AT at its insertion into the calcaneus and 2-3 cm above. Furthermore, additional research should be conducted using an extended field-of-view technology to measure the length of the AT tendon in the Sudanese population.

Public Attitudes Towards COVID-19, Antibiotic Resistance, Preventive Measures: A Multi Center Cross-Sectional Study in the Arab Countries

Background and AimCOVID-19 has shown how crucial awareness of the need to protect public health is to global security. Antibiotic resistance due to antibiotic misuse is seen as a worldwide health issue. Antibiotic use was significant during the COVID-19 epidemic, according to several nations. This research aims to investigate public attitudes on COVID-19, antibiotic resistance, and preventive measures during the COVID-19 pandemic in the Middle East.MethodsAn online quantitative cross-sectional study in 17 Arabic nations was carried out between January 3 and March 4, 2022, using a structured questionnaire to evaluate participants’ knowledge of COVID-19, their attitudes toward the new standard during the pandemic, and their use of antibiotics, and their resistance to them. The research was available to all Arabic people over 18 nations in the middle east. A convenient snowball sampling technique was used. SPSS version 20.0 was used to analyze the data. To analyze the results, binominal logistic regression was utilized. Statistical significance was defined as a p value of 0.05.ResultsOf the 6145 responders, 24.1% believed COVID-19 might spread to asymptomatic people, whereas 13.6% thought using antibiotics would accelerate recovery from any illness. Moreover, half of the respondents said antibiotics only work against bacteria (64.6%). 70.8% of participants adopted the necessary safety measures. More than a third of respondents strongly supported placing foreign immigrants in quarantine (33%). However, more than 50% of those surveyed (52.5%) firmly supported using face masks in all public settings. Individuals with a medical education background had 2.6 times more appropriate understanding of antibiotic resistance than others. Furthermore, participants in the 30–49 age range had a better handle on the use of antibiotics and antibiotic resistance than other respondents by 1.1 times.ConclusionArab Health authorities should reconsider this health issue as soon about the inadequate level of awareness toward antibiotic use, resistance, and preventative practices during COVID-19. Many suggested strategies, especially solving the irregular antibiotic prescriptions during a COVID19 pandemic, should be implemented to increase public awareness of COVID19.

Pulse Oximetry Improves COVID-19 Screening Sensitivity by Detecting Asymptomatic and Afebrile Infections in a Case Control Study.

SARS-CoV-2 has spread quickly despite the implementation of various strategies to limit the spread of the disease. Current screening procedures are unable to detect asymptomatic infections. This study reports the prevalence of abnormal vital signs among incarcerated individuals with asymptomatic infections and proposes an enhanced screening algorithm that may detect asymptomatic infections. A case control study used a retrospective electronic chart review of COVID-19 infected people and matched controls housed in one Federal Bureau of Prisons institution. Data were collected on age, body mass index, medical history, temperature, blood oxygen saturation (SpO2), and symptoms. Fifty-seven laboratory-confirmed COVID-19 infections and 81 confirmed controls were identified. Asymptomatic infections were present in 35/57 people (61%) with a group minimum SpO2 94.4% (standard deviation [SD] 1.4) and a maximum oral temperature of 99.19°F (SD 0.36). An enhanced screening algorithm that uses pulse oximetry yields a sensitivity of 84.2%, 95% confidence interval [72.1-92.5]. Among asymptomatic people, there is a high prevalence of abnormal SpO2 and temperature measurements. A screening algorithm that uses both of these measures can detect asymptomatic infections with a low false positive rate.

A Novel and Noninvasive Risk Assessment Score and Its Child-to-Adult Trajectories to Screen Subclinical Renal Damage in Middle Age

This study aimed to develop a noninvasive, economical and effective subclinical renal damage (SRD) risk assessment tool to identify high-risk asymptomatic people from a large-scale population and improve current clinical SRD screening strategies. Based on the Hanzhong Adolescent Hypertension Cohort, SRD-associated variables were identified and the SRD risk assessment score model was established and further validated with machine learning algorithms. Longitudinal follow-up data were used to identify child-to-adult SRD risk score trajectories and to investigate the relationship between different trajectory groups and the incidence of SRD in middle age. Systolic blood pressure, diastolic blood pressure and body mass index were identified as SRD-associated variables. Based on these three variables, an SRD risk assessment score was developed, with excellent classification ability (AUC value of ROC curve: 0.778 for SRD estimation, 0.729 for 4-year SRD risk prediction), calibration (Hosmer-Lemeshow goodness-of-fit test p = 0.62 for SRD estimation, p = 0.34 for 4-year SRD risk prediction) and more potential clinical benefits. In addition, three child-to-adult SRD risk assessment score trajectories were identified: increasing, increasing-stable and stable. Further difference analysis and logistic regression analysis showed that these SRD risk assessment score trajectories were highly associated with the incidence of SRD in middle age. In brief, we constructed a novel and noninvasive SRD risk assessment tool with excellent performance to help identify high-risk asymptomatic people from a large-scale population and assist in SRD screening.

Variability of Active Cervical Range of Motion Within and Between Days in Healthy Participants: A Prospective Observational Study

ObjectiveThe purpose of this study was to determine the intraday and interday variability and systematic change over the day of active cervical range of motion (aCROM) measurements in asymptomatic persons using a clinically applicable measurement device. MethodsA prospective observational study was performed. Sixteen adults (8 men and 8 women, median age 51 years) without neck pain in the last 3 months were recruited in 2 physiotherapy practices. Active cervical range of motion was estimated using the Apple iPhone application “3D Range of Motion.” Measurements were performed 3 times a day for 7 days and spread over a period of 3 weeks. Mean values of aCROM were calculated. Intraday and interday variability was estimated by calculating limits of agreement. ResultsThe limits of agreement for intraday variability ranged from ±12.1° for left rotation to ±15.5° for total rotation. For interday variability, the limits of agreement ranged from ±14.2° for right rotation to ±20.1° for total rotation. No systematic change over the day was found. ConclusionThis study showed substantial intraday and interday variability of aCROM measurements in asymptomatic people. No trend toward an increased or decreased aCROM was observed during the course of the day. When interpreting aCROM values, clinicians should consider the degree of variation in aCROM measurements over time.

Real Decreto 601/2019 sobre justificación y optimización: aspectos prácticos

The Royal Decree 601/2019 of 18th october is the result of the partial transposition into the Spanish legal system of the EURATOM Directive 59/2013. This Royal Decree includes the mandates of the Directive related to the need to justify and optimize medical exposure, including that of asymptomatic people, proposal of stricter requirements regarding the information that must be provided to the patient, registration and notification of the doses of medical-radiological procedures, use of reference levels for diagnosis and the availability of dose-indicating devices. The article reviews the most relevant aspects and novelties related to the principles of justification, optimization, dose control and the obligations derived from the right to information and consent. This Royal Decree considers essential for radiologists to develop a high level of competence and a new list of responsibilities and functions, which are detailed and analysed in this article.

A cross sectional study on awareness about cancer screening methods for breast and cervical cancer in women of reproductive age from Jhansi, Uttar Pradesh

Background: Non-communicable diseases (NCDs) are responsible for 63% of all deaths in India of which 9% are due to cancers according to the World Health Organization (WHO) global profile 2018. One in eight men and one in eleven women die from the disease globally (Globocan 2020). To reduce the morbidity and mortality due to the disease early diagnosis of disease and risk factors by regular screening of asymptomatic people is recommended. Objectives of the study were: to assess the awareness about methods for breast and cervical cancer screening among women of reproductive age, and to assess their readiness to go for screening. Methods: In a health awareness session on cancer screening among women of reproductive age the participants (104 women) were given a self-designed questionnaire which was administered before the session. The questionnaire covered general awareness about cancer, the symptoms and the methods of screening for breast and cervical cancer. The results were expressed in frequency and percentages. Results: The mean age of participants was 29.8 years (range 21 years-45 years). 88% felt that early diagnosis would improve outcome. Only 11% had heard of Pap test and only 3 had gotten it done. Around 21% had heard about mammography and only 4% had heard about breast self-examination. 86% and 90% were ready to get themselves screened for cervical cancer and breast cancer respectively, if given the opportunity. Conclusions: This study highlights both the lack of knowledge and the high acceptance of cancer screening among women. Awareness campaigns at regular intervals backed by immediate access to screening facilities are required to address the problem.

The prevalence and burden of urogenital schistosomiasis: a case study of Mount Darwin and Makoni Districts in Zimbabwe

Globally, about 779 million people are estimated to be at risk of developing schistosomiasis and around 250 million people are infected. There are 120 million asymptomatic people and 20 million with severe disease. Schistosomiasis causes the highest morbidity and mortality among school-aged children. The main objective of the study was to determine the prevalence and burden of schistosomiasis in the Mount Darwin and Makoni Districts. Five hundred children from both schools aged 6–13 were included in the study. Urinary schistosomiasis was diagnosed using the urinary filtration method and the presence of egg(s) under microscopy in the urine sample indicated an infection, whereas the absence of eggs was ruled as no infection. Boys were more infected than girls in both schools, with Bemberi having 14.88% males infected and 10.47% females infected and Bandanyenje having 13% males infected and 10.76% females infected with Schistosoma haematobium. The age group 10–13 years old from Bemberi primary had a higher prevalence rate of 17.72% than Bandanyenje primary with a prevalence of 12%. There is a need for the provision of an adequate supply of safe drinking water, health education campaigns and regular screening, among this age group.

Evaluation to prevent influenza Evaluation of Control Measure Against Influenza Epidemic by Multiagent Simulation

Background: At the campus of Japan Coast Academy in January 2017, 37 of 150 students developed influenza (situation A). Besides, 18 of 56 students at the training ship and 13 of 109 students at the campus of the academy developed influenza in January 2019 at same time (situation B and C). The rare data of the three situations including behavioral history data of students, daily clinical data of influenza-positive students and social contact data of students were collected and directly analyzed. Then, using a proposed spatio-temporal Susceptible – Exposed – Pre-infectious – Infectious – Recovered (SEPIR) model, the incubation period and the infectivity rate from asymptomatic people were calculated. And multiagent simulation (MAS) of influenza epidemic has been performed using spatio-temporal SEPIR model and has been validated. Aim: Effective non-pharmaceutical interventions to prevent influenza epidemic is described. Methods: The epidemic is defined using ratio of daily patients in the community. Then, situation A and B are classified as epidemics, but situation C is not. Using the validated MAS, three measures of infection control (preventive measure such as wearing mask, school closure when 20 % of patients are discovered and that when first patients are discovered) against influenza in the two epidemic situations A and B are evaluated. The criteria for evaluation are the frequency of epidemic and the ratio of total patients. Results: The frequency of epidemic by the school closures as infection control measure is 100 %, whereas, those by the preventive measure are low (4.5 % and 22.9 %) in two epidemic situations. The ratio of total patients by the school closures are above 80 % and those by the preventive measure are low (7.6 % and 23.0 %) in two epidemic situations. Conclusions: MAS suggests that the preventive measure such as wearing masks, washing hands and better ventilating rooms is useful. Then, the preventive measure is recommended after winter vacation or three-day weekend in January not school closure.

Asymptomatic people with well-controlled HIV do not have abnormal left ventricular global longitudinal strain.

Previous studies have reported impairment in systolic and diastolic function in people with HIV (PWHIV). Our aim was to determine if echocardiographically measured left ventricular (LV) global longitudinal strain (GLS) is abnormal in asymptomatic PWHIV. A cross-sectional study of PWHIV (n = 98, 89% male, median age 53 years) and HIV-negative people (n = 50, median age 53 years) without known cardiovascular disease were recruited from a single centre. All participants completed a health/lifestyle questionnaire, provided a fasting blood sample, and underwent a comprehensive echocardiogram for assessment of diastolic and systolic LV function, including measurement of GLS. All PWHIV were receiving antiretroviral therapy (ART) for a median of 12 years (IQR: 6.9, 22.4), the majority with good virological control (87% suppressed) and without immunological compromise (median CD4 598 cells/µl, IQR: 388, 841). Compared with controls of similar age and gender, there was no difference in GLS [mean GLS -20.3% (SD 2.5%) vs. -21.0% (SD 2.5%), p = 0.14] or left ventricular ejection fractions [65.3% (SD 6.3) vs. 64.8% (SD 4.8), p = 0.62]. Following adjustment for covariates (gender, heart rate, systolic and diastolic blood pressure, and fasting glucose), the difference in GLS remained non-significant. There were no differences in LV diastolic function between the groups. Exposure to at least one mitochondrially toxic ART drug (didanosine, stavudine, zidovudine, or zalcitabine) was not associated with impairment of LV systolic function. No clinically significant impairment of myocardial systolic function, as measured by LV GLS, was detected in this predominantly Caucasian male population of PWHIV on long-term ART, with no history of cardiovascular disease.

Effects of perceived social support on health-related quality of life in asymptomatic and symptomatic people living with HIV in China: A cross-sectional study.

Improving health-related quality of life (HRQOL) in people living with HIV (PLWH) is one of the critical goals of HIV prevention and control in the following decades, and perceived social support (PSS) has always exhibited a positive influence on patients' HRQOL. This study aims to describe the gap in social support in improving HRQOL between symptomatic and asymptomatic PLWH. By analysing secondary data from an online survey, a multicenter, descriptive and crosssectional study was conducted. The correlation trend and differences between PSS and HRQOL among asymptomatic and symptomatic PLWH were determined. Information from 493 PLWH with ART medication was finally analyzed: 34.89% asymptomatic PLWH and 65.11% symptomatic PLWH. There were significant differences observed between the two groups in terms of family income (χ2=9.782, p=0.021), HIV-positive duration (χ2=19.541, p＜0.001), stage of disease (χ2=9.617, p=0.008), and comorbidities (χ2=26.119, P＜ 0.001). The mean score of HRQOL of PLWH for the whole domain of the questionnaire was 86.56 (SD=15.95). In six domains of QOL and PSS, the asymptomatic group had better conditions than the symptomatic group. There was a linear association between PSS and HRQOL, not only in the symptomatic group but also asymptomatic population, after adjusting for potential confounding factors. When the level of PSS was between 60 and 80, the HRQOL of the symptomatic group was similar to that of the asymptomatic group. While the score of PSS exceeded 80, the HRQOL of the symptomatic group was less sensitive to the changes in PSS. The social and environmental status of HRQOL in PLWH was most strongly correlated with their PSS. The value of PSS on the HRQOL in PLWH is confirmed, especially for asymptomatic subjects. Healthcare providers need a complete understanding of the gap in social support between the asymptomatic and symptomatic populations. The comprehensive strategies, including symptom management, active treatment, and social support, should be more efficient for improving the overall health of symptomatic PLWH.

Relationship of lumbar-hip kinematics during trunk flexion and sex, body mass index, and self-reported energy expenditure: a cross-sectional analysis

Purpose Physical activity (PA) is a well-known, simple and effective preventive and therapeutic intervention for low back pain (LBP). In spite of the growing interest in active lifestyles and its benefits, more needs to be known about the relationship between energy expenditure, body mass and lumbar-pelvic kinematics during the forward bending movement in a group of young asymptomatic people who met PA guidelines. Young people can be identified as a future risk group of civilisation diseases and lumbar-hip kinematics can be considered as a predictor of LBP occurrence. The aim of this study was to identify the association of sex, self-reported energy expenditure, body mass index, and lumbar-hip kinematics in young people. Methods Sixty-four students at pre-employment stage participated in the study. They declared moderate-to-high PA and activity-induced energy expenditure (AEE) was self-reported. Kinematic data of the lumbar spine, pelvis, and hip were collected during forward bending using a 3D motion capture system. Results Sex was found to be associated with pelvis (β=-0.38 p=0.002) and lumbar mobility (β=0.49, p&lt;0.001) during forward bending and BMI was related only to lumbar mobility (β=-0.41, p=0.001). Recreation AEE significantly predicted hip flexion mobility (β =0.38, p=0.002). Conclusions This study showed that among a sample of physically active young people, BMI, self-reported AEE, and sex can partially predict lumbar-hip kinematics during trunk flexion. Recreational PA can be regarded as improving hip mobility and thus making forward bending more effective and less prone to injury.