Effective Control Research Articles

Arduino performance in control systems for converting air-to-water

Humans are unable to function without water. Water is therefore necessary for living. This study will address the advantages of converting air into drinkable water based on this premise. Regarding the condensation process itself, it is not the best option to use it in remote locations because it needs a lot of energy and equipment. Consequently, thermoelectric technology was used in this study to replace the condensation process. This tool's easier thermoelectric operation makes it suitable for usage in remote locations. The design of an effective Arduino program control system should take into account the effects of temperature and humidity condition parameters on the environment to maximize water production. This will allow the performance between supporting sensors and the main components to be automatically optimized under a variety of environmental conditions and produce water without wasting excessive energy. As a result, the trial where the average temperature was 30°C and the average humidity was 81% produced the highest results for the researchers when they calculated the environmental condition factors that were already known. Within the hour-long study session, 6 milliliters of water were created. In addition to the efficiency with which the Arduino program is commanded, from all sensors to the primary thermoelectric components, it can execute commands automatically and optimally. It can also resolve issues that affect the air-to-water converter controller's performance in a way that ensures proper operation of all controllers by taking into account the relevant factors. to the fullest without squandering too much energy

Effective Air Pollution Monitoring System for Eco Balance

Air pollution in urban areas is increasingly driven by vehicle emissions, which release harmful gases include such things as carbon monoxide (CO), nitrogen oxides (NOx), hydrocarbons (HC), and particulate matter (PM). These pollutants pose significant risks to both environmental quality and public health, highlighting the urgent need for effective monitoring and control systems. This project presents the development of an automated Effective Air Pollution Monitoring System for Eco Balance, designed to detect exhaust gas levels in real-time as vehicles pass designated points. The system employs advanced sensors to monitor pollutant concentrations and utilizes a camera- based recognition system to capture the number plates of vehicles that exceed permissible emission levels. The collected data, including pollution metrics and vehicle details, is transmitted to the Regional Transport Office (RTO) for necessary enforcement actions. By promoting compliance with emission standards, this automated system aims to significantly reduce vehicle-related air pollution, fostering a cleaner and healthier urban environment

Unveiling environmental transmission risks: comparative analysis of azole resistance in Aspergillus fumigatus clinical and environmental isolates from Yunnan, China.

Azole resistance in Aspergillus fumigatus poses a significant clinical challenge globally. Our previous epidemiological analysis revealed a remarkably high frequency (~80%) of azole-resistant A. fumigatus in Yunnan's greenhouse environments, prompting increased local and regional research for targeted control strategies. In this study, we analyzed 94 clinical A. fumigatus isolates from Yunnan, comparing their susceptibility profiles and genotypic characteristics with environmental strains previously isolated. While the overall frequency of azole resistance in clinical isolates was lower than that in environmental samples, a significant prevalence of cross-resistance, with varying resistance patterns based on minimum inhibitory concentration (MIC) levels was observed, which exceeded rates in other regions of China. Specific mutation combinations in the cyp51A gene were linked to elevated MIC values in clinical and/or environmental samples, while some resistant strains with wild-type cyp51A remain unexplained, indicating a need for further investigation into their resistance mechanisms. The differences in unique genetic elements and the distinct genetic differentiation observed between clinical and environmental isolates can be attributed to Yunnan's unique geomorphology and potential genotype importation from other provinces and abroad. Extensive allele exchanges and sharing contributed to the selection of azole-resistant clinical isolates, suggesting a common environmental origin, and the transmission routes of local drug-resistant strains cannot be excluded. These findings emphasize the imperative for regional and targeted surveillance to monitor resistance trends and guide effective antifungal therapy, and management strategies to mitigate invasive aspergillosis risk in this region.IMPORTANCEAzole resistance in Aspergillus fumigatus is a major global health concern, with particularly high rates (~80%) observed in Yunnan's greenhouse environments. This study compares azole resistance in 94 clinical isolates from Yunnan with environmental strains, revealing lower clinical resistance but significant cross-resistance and distinct resistance patterns. Specific mutations in the cyp51A gene were associated with elevated minimum inhibitory concentration values, though some resistant strains had wild-type cyp51A, highlighting the need for further research. The unique genetic profiles and potential external genotype influences in Yunnan emphasize the need for targeted regional surveillance. Effective monitoring and control strategies are essential to manage and mitigate the risk of invasive aspergillosis.

Evaluation of the positional reproducibility of sedation versus non-sedation state in pediatric radiotherapy: a retrospective study

ObjectiveTo assess the positional reproducibility of sedated and non-sedated pediatric tumor patients during radiotherapy through a retrospective analysis of cone-beam computed tomography (CBCT) and planned computed tomography (CT) scan data.MethodsThe positional reproducibility of 40 pediatric tumor patients, aged 2 to 17 years with a median age of 4.5 years, who received radiotherapy under sedated and non-sedated states was retrospectively compared. The first CBCT images obtained during CT-based treatment planning were analyzed. The analysis encompassed six-dimensional positional changes, including vertical (Vrt), longitudinal (Lng), lateral (Lat), rotational (Rtn), pitch, and roll directions. Kolmogorov-Smirnov Z nonparametric rank-sum testing was employed to evaluate the positional deviations, considering absolute values regardless of directionality. Data were further stratified based on different fixation methods used during treatment.ResultsSedated patients exhibited significantly smaller positional deviations in Vrt, Lng, Lat, and Rtn directions in the body membrane group compared with their non-sedated counterparts (P<0.05). Similarly, sedated patients demonstrated reduced positional deviations in Vrt, Lng, Lat, Rtn, pitch and Roll directions in the head and neck group compared with non-sedated patients (P<0.05). Meanwhile, compared with vacuum bag plus body membrane fixation, the head and shoulder film fixation technique proved superior in terms of positional reproducibility during sedated treatment, specifically in Vrt, Lng, Lat, Pitch, and Roll directions (P<0.05). Similarly, compared with the alternative fixation method, the head and shoulder film fixation method showed better positional deviations in six-Dimensional directions in non-sedated patients (P<0.05).ConclusionWhile sedated radiotherapy may offer advantages in terms of positional reproducibility, the present study underscores the importance of considering non-sedated radiotherapy as a viable option for pediatric tumor patients. Non-sedated treatment not only provides effective tumor control but also mitigates the psychological trauma and long-term side effects associated with repeated sedative drug use. Future studies should further explore the optimal sedation and fixation strategies for pediatric radiotherapy.

How do industry and other actors undermine tobacco control policies post-adoption? A scoping review

Abstract Background Over recent decades, many countries have strengthened their tobacco control policies. To be effective, full implementation is needed. Tobacco industry interference is widely recognised as a key barrier to tobacco control progress and evidence-based models like the policy dystopia model (PDM) list industry strategies, focusing on those avoiding and undermining policy adoption. While prior research highlighted industry activities post-adoption, these have not been captured systematically. This review aimed to map the efforts of industry, front groups and other actors to undermine the implementation of policies, including marketing, packaging, smokefree and flavour measures. Methods We searched six literature databases, relevant bibliographies and grey literature, and consulted experts. We included articles describing one or more attempts to undermine adopted policies, including marketing, packaging, smokefree and flavour. The PDM served as starting point for coding; additional strategies were identified inductively. Strategies were charted against aims and policies. Results Several aims and strategies were identified which were similar across policies. Following policy adoption efforts to 1) overturn and 2) weaken measures, and 3) delay implementation continued. Legal strategies were utilised and there were attempts to influence stakeholders. In addition, tobacco industry and other actors sought to 4) undermine policy effectiveness by creating confusion, circumventing policies, and noncompliance, and 5) use implementation as an opportunity to enhance industry reputation. Conclusions Interference from tobacco industry and other actors threatens effective tobacco control policy implementation. The public health community must continue to monitor, expose and counter industry conduct after policy adoption. More research is needed to enhance our understanding of how industry interferes in policy implementation, and how this can be pre-empted and countered. Key messages • The interference from tobacco industry and other actors following policy adoption threatens effective tobacco control, and needs to be monitored, exposed and countered by the public health community. • Policymakers and civil servants need to be wary of efforts to undermine tobacco control policies and act to ensure effective policy implementation.

Determinants of tuberculosis site among 1035 cases in Frankfurt, 2008-2023: does lineage matter?

Abstract Extrapulmonary tuberculosis (EPTB) presents with nonspecific symptoms which can pose a diagnostic challenge. Currently, there are no clear predictors for EPTB. We aimed to identify these factors for better diagnosis and disease control. We included tuberculosis cases reported in Frankfurt from 2008-2023, with available clinical and whole genome sequencing data. According to WHO criteria, cases with pulmonary or combined pulmonary and extrapulmonary symptoms were categorised as pulmonary tuberculosis, while exclusively extrapulmonary symptoms were categorised as extrapulmonary tuberculosis. We assessed the association between EPTB and M. tuberculosis lineage, comorbidities and demographic characteristics using logistic regression, calculating crude and adjusted odds ratios (aOR). Of the 1035 reported tuberculosis cases, 272 had exclusively extrapulmonary disease and 136 had both pulmonary and extrapulmonary disease. In the univariable analysis, lineages 1 and 3 were significantly associated with extrapulmonary disease compared to lineage 4. However, this association was not observed in the multivariable analysis. In the final regression model, females were more likely to develop EPTB than men (aOR: 1.65, CI: 1.19-2.27). The odds of developing extrapulmonary disease were higher among patients born in the South-East Asian (aOR: 6.48, CI: 3.72-11.43) and Eastern Mediterranean (aOR: 5.54, CI: 3.41-9.11) than in other regions. Among the comorbidities, diabetes was found to be negatively associated with extrapulmonary disease (aOR: 0.50, CI: 0.26-0.91). Our results indicate that host factors such as geographic origin and sex are stronger predictors for extrapulmonary presentation of tuberculosis than a specific lineage. We recommend increasing physicians’ awareness of the nonspecific presentation of EPTB and adapting screening programmes, particularly for patients from South-East Asian and Eastern Mediterranean regions to foster more effective tuberculosis control measures. Key messages • Our study highlights the importance of considering host factors in predicting extrapulmonary tuberculosis, indicating their stronger influence compared to specific M. tuberculosis lineages. • Increased physicians’ awareness of the nonspecific symptoms of EPTB and targeted screening programs for high-risk populations are crucial for enhancing tuberculosis control measures.

Efficacy and safety of catheter ablation for paroxysmal atrial fibrillation as first-line therapy vs. after drug failure -analysis from Japan Nationwide Ablation (J-AB) Registry-

Abstract Background Catheter ablation is an effective rhythm control therapy for atrial fibrillation (AF). Recent advancements in technology have improved the efficacy and safety of this procedure. Current European Society of Cardiology and Japanese Circulation Society guidelines recommend that catheter ablation (CA) for patients with paroxysmal AF (PAF) after failure of drug therapy is classified as Class I, and CA as first-line therapy is categorized as Class IIa. However, there are limited clinical studies directly comparing these groups. Objective This study aimed to compare the efficacy and safety of CA as first-line therapy vs. those after failed drug therapy using data from the Japan Nationwide Ablation (J-AB) Registry led by the Japanese Heart Rhythm Society. Methods Detailed data of patients who underwent catheter ablation for PAF extracted from the J-AB registry were analyzed. Patients were divided into two groups: those who underwent CA as first-line therapy (First-line group) or those who underwent CA after failed drug therapy (Drug failure group). Patients’ characteristics, efficacy and safety of CA were compared between the two groups. Efficacy was assessed by evaluating the recurrence rate of any atrial arrhythmia within one year after the 90-day blanking period, and major safety outcomes were set as severe bleeding complication, stroke, and gastrointestinal disorders during the perioperative period. Result This analysis included 5,011 cases with a median age of 69 years (range 61-75) and 35% females. Comparing patient characteristics between the first-line therapy group (n = 3,447) and the drug failure group (n = 1,564), there are no statistically significant differences between the two groups except in left atrium diameter in echocardiogram (LAD) (38 [34-42] mm vs. 38 [34-43] mm, P <0.001), serum creatinine levels (0.8 [0.7-1.0] mg/dl vs. 0.9 [0.7-1.0] mg/dl, P <0.001), and beta-blocker usage (38.2% vs. 46.7%, P <0.01). A total of 501 recurrence events were observed in this analysis during a median follow-up of 365 [254-390] days. Recurrence rates did not statistically differ between the two groups (log-rank P=0.49). After adjusting for contributing factors with age, gender, body mass index, LAD, and left ventricular ejection fraction in echocardiogram using a multivariate Cox proportional hazards model, efficacy outcomes showed no significant difference between the two groups (adjusted hazard ratio; 1.06 95% confidence interval; 0.88-1.28, P = 0.55). Besides, the two groups had no significant difference in major safety outcomes. Conclusions Catheter ablation as the first-line therapy for paroxysmal atrial fibrillation showed a similar recurrence rate of atrial arrhythmias and adverse events compared to those who underwent catheter ablation after drug failure.

Impact of infectious diseases associated with passenger ships on ports: a systematic review

Abstract Background In an enclosed ship environment, close contact between passengers and crew members is inevitable. As a result, passenger ships can be a suitable environment for the transmission of infections between people. In this context, it is essential to establish effective prevention and control measures to protect the health of passengers and crew members while ensuring that shipping minimizes its contribution to the global spread of disease. The aim of this review is to provide knowledge on the impact of infectious diseases on board large passenger ships on the port, the port community and other land-based operations to better understand the effectiveness of the prevention, mitigation and management (PMM) measures implemented, in particular ship-to-shore communication. Methods A systematic literature review was conducted according to the PRISMA guidelines, searching three databases and including additional articles from hand searches up to November 2023. Peer-reviewed studies of infectious disease outbreaks on large passenger ships that described ship-shore interaction, port preparedness, impact on the port community, and impact on other modes of transportation were included. Results A total of 555 publications were initially identified. Finally, 22 articles were included. Most studies reported on COVID-19 outbreaks on cruise ships; other communicable diseases reported were influenza, gastroenteritis and varicella. The articles highlighted the importance of comprehensive management plans and proactive risk assessment during infectious disease outbreaks. Conclusions Effective stakeholder collaboration, ship-to-shore communication, and coordination of medical transport, isolation, and quarantine measures are essential components of infectious disease PMM in maritime passenger shipping and ship-to-shore operations. The findings suggest that further research is needed to improve the evidence and knowledge about this important issue. Key messages • Proactive risk assessment, comprehensive management plans and effective collaboration are critical to preventing, mitigating and managing infectious diseases on passenger ships. • Overall, very little evidence of effective practices and capacities related to the interaction of passenger ships with land-based operations, stakeholders and port communities.

5.C. Scientific session: Strengthen resilience against emerging vector-borne diseases through the ECDC Fellowship Programmes

Abstract Over the past decade, climate change has impacted the transmission of a wide range of vector-borne diseases (VBDs) in Europe, where locally transmitted outbreaks have occurred. It has been implicated in the observed expansion of competent disease vectors in Europe such as Aedes albopictus, which transmits diseases such as Zika, Dengue and Chikungunya. Climate may influence the life cycle of vectors, and the reproduction rate of viral particles inside vectors and human hosts, which means that upsurges in temperature can reduce the incubation period of these pathogens and the life cycle of vectors, thus boosting transmission risk through elevated vector populations. Moreover, globalization and international air travel contribute to pathogen and vector dispersion internationally. Risk mapping suggests further expansion of the species in northern Europe due to climate change. The above underscores the necessity for more proactive measures, such as developing an effective vector control program by monitoring the density and distribution of hosts and pathogens at urban, national, and cross-border levels. Additionally, establishing early warning systems based on integrated human and zoonotic and entomological surveillance is crucial to detect alerts promptly and comprehend where and when infections may emerge or spread. Furthermore, cross-border collaboration and harmonization of vector-borne surveillance systems across European countries may improve preparedness, control and response to mosquito-borne diseases. Preparedness and response require significant efforts from EU Member States and neighbouring countries. Only through a multidisciplinary approach, involving multiple sectors, can we truly prepare to address public health threats. To contribute to strengthening resilience against cross-border public health and emerging health threats in EU Member States and neighbouring countries, the European Centre of Disease Prevention and Control (ECDC) has established three fellowship training programmes. These programmes aim to create and maintain a network of highly qualified epidemiologists, microbiologists and public health professionals and strengthen the public health epidemiology workforce at EU and neighbor countries. This workshop will offer attendees a comprehensive overview of the ECDC’s fellowship programmes, describe how they function and explain their role in preparing for health threats. It will provide examples of three projects carried out by fellows on the implementation of preparedness, response and control measures for emerging vector-borne diseases in European countries at local, national and multinational levels. Those will set the scene for an in-depth analysis of the key challenges faced and can help promote awareness that integrated, multidisciplinary interventions are both feasible and effective in reducing the threat of vector-borne infectious diseases spreading in Europe and neighboring countries. Key messages • ECDC fellowship programmes aim to strengthen resilience against emerging public health threats in EU Member States and neighboring countries. • Fellows are engaged in national and cross-border integrated and multidisciplinary interventions to strengthen preparedness and mitigate the spread of emerging vector-borne diseases.

Association between average glucose concentration or glucose variability and acute kidney injury among CAD patients with prediabetes

Abstract Background Prediabetes, impacting approximately 10% of adults, lacks comprehensive attention, and there is limited data on effective glycemic control strategies. Meta-analysis suggests that intensive glycemic control is linked to a lower incidence of major adverse cardiovascular events, mainly driven by decreased reinfarction and reduced microvascular complications in coronary artery disease (CAD) patients. However, despite these associations, existing evidence does not conclusively establish the efficacy of intensive glycemic control in enhancing cardio-renal outcomes. Purpose In the present study, we aimed to validate the utility of intensive glycaemic control on acute kidney injury (AKI) prevention using a prospective, pragmatic clinical data of patients with CAD. Methods This study utilized data from the Prospective Registry of the Current Status of Care for Patients with Coronary Artery Disease database, a nationwide and pragmatic registry project initiated on January 17th, 2022. Data, including demographics, medical history, and lab results, were collected from electronic medical records. The time-weighted average glucose (TWAG) and glucose variability (CV) for each patient to assess glycaemic control, and outcomes including AKI were assessed. Statistical analysis involved logistic models and sensitivity analyses. SAS 9.4 and R software were used, with p<0.05 considered significant. Results Between January 2022 and June 2023, 2,454 CAD patients with prediabetes were included for final analysis. Among them, the average age was 62.6 ± 10.3 years, of whom 27.1% were females. In univariate model, the incidence of AKI was 1.51 (1.36,1.68) times higher in patients with an increasing TWAG per mmol/L. After the stepwise adjusting of covariates, the OR was 1.50 (1.35,1.67). CV of glucose also had positive association with AKI. An increasing of 0.1 unit of CV increased the risk of about 44%. When adjusting the TWAG and CV of glucose at the same time, both still had positive association with AKI. A restricted cubic splines plot showed an increasing trend of the ORs for AKI as both TWAG and CV of glucose increased. Subgroups analyses also showed stable positive association between TWAG, CV and AKI. Conclusions Our study reveals an association between TWAG or CV and AKI in individuals with both CAD and prediabetes. These findings underscore the importance of continuous glucose monitoring and the implementation of intensive glycaemic control for CAD patients coexistence of prediabetes.Restricted cubic splines function

Prognostic value of left atrial strain for outcome of catheter ablation in patients with atrial fibrillation and moderately enlarged left atrium

Abstract Background Atrial fibrillation catheter ablation (AFCA) is an effective rhythm control method for patients with AF, but AF recurrence is higher in patients with a large left atrium (LA). We explored whether pre-procedural LA strain has incremental prognostic value for the long-term rhythm outcomes of AFCA in patients with AF and moderately enlarged LA size (45≤LA diameter<50mm). Methods We included 2,269 patients who underwent de novo AF catheter ablation (men 72.2%, 59.1[±10.7] years, paroxysmal AF 64.0%). We divided grouped into 5 mm increments and determined the appropriate cut-off of LA diameter (45mm) predicting the difference in long-term rhythm outcome by the log-likelihood values of multivariate Cox proportional hazard models. Patients with moderately enlarged LA size (45≤LA diameter<50mm, n=413) with borderline rhythm outcomes were used for analysis. Results In the cohort of 413 patients who underwent AFCA with moderately enlarged LA size, AF was recurred in 208 patients (43.7%) after AFCA. We determined the appropriate cut-off of LA strain (12.5) predicting the difference in long-term rhythm outcome by the log-likelihood values of multivariate Cox proportional hazard models. During 24 months [10-50] follow-up, patients with low LA strain (<12.5) were showed worsen rhythm outcome than high LA strain (Log-rank p<0.001). Patients with AF recurrence after AFCA were independently associated with low LA strain (HR 1.539 [1.130-2.094], p=0.006), and paroxysmal AF (OR 0.651 [0.469-0.905], p=0.011). Furthermore, the likelihood ratio test demonstrated a significant influence of adding LA strain by TTE (χ2 = 13.90 [P < 0.001]). Conclusions LA strain using baseline echocardiography has a predictive power for AF recurrence after AFCA in patients with moderately enlarged LA size (45≤LA diameter<50mm).

A Satellite-Based Indicator for Diagnosing Particulate Nitrate Sensitivity to Precursor Emissions: Application to East Asia, Europe, and North America.

Particulate nitrate is a major component of fine particulate matter (PM2.5) and a key target for improving air quality. Its formation is varyingly sensitive to emissions of nitrogen oxides (NOx ≡ NO + NO2), ammonia (NH3), and volatile organic compounds (VOCs). Diagnosing the dominant sensitivity is critical for effective pollution control. Here, we show that satellite observations of the NO2 column and the NH3/NO2 column ratio can effectively diagnose the dominant sensitivity regimes in polluted regions of East Asia, Europe, and North America, in different seasons, though with reduced performance in the summer. We demarcate the different sensitivity regimes using the GEOS-Chem chemical transport model and apply the method to satellite observations from the OMI (NO2) and IASI (NH3) in 2017. We find that the dominant sensitivity regimes vary across regions and remain largely consistent across seasons. Sensitivity to NH3 emissions dominates in the northern North China Plain (NCP), the Yangtze River Delta, South Korea, most of Europe, Los Angeles, and the eastern United States. Sensitivity to NOx emissions dominates in central China, the Po Valley in Italy, the central United States, and the Central Valley in California. Sensitivity to VOCs emissions dominates only in the southern NCP in the winter. These results agree well with those of previous local studies. Our satellite-based indicator provides a simple tool for air quality managers to choose emission control strategies for decreasing PM2.5 nitrate pollution.

Monitoring of mosquito breeding sites in the municipality of Cascais, Portugal

Abstract Culex pipiens is the primary West Nile Virus vector in Portugal. Additionally, in 2017, Aedes albopictus, vector of various arboviruses, was detected in Northern Portugal. To mitigate viral transmission risks, effective surveillance is crucial, including monitoring egg, larva, and pupa stages. Located on the west of Lisbon, Cascais implemented a surveillance based on monitoring invasive species at Points of Entry and, complementarily, on detecting and intervening in breeding sites. Active searches for new breeding sites and monitoring those that were already identified are conducted weekly during the peak mosquito season (May to October) and biweekly during the colder season (November to April), following the methodology outlined below: • Upon detection, samples of immature stages are collected for submission to the National Institute of Health (INSA); • Corrective measures are requested to the managing entities of the locations where the sites are found; • Date of action, location, collection point, date of report, and status (pending or intervened) are recorded on a database; • Locations with pending status undergo continuous monitoring. In 2023, 16 artificial breeding sites were identified. These findings resulted from 23 actions conducted across 8 locations. 35 samples of immatures were collected, followed by their submission and notification to the respective managing entities. Recurrent detections were noted in 9 breeding sites. The managing entities implemented measures at 13 of the identified sites, leaving 3 with pending intervention. The identification of breeding sites demands continuous monitoring efforts and requires an effective coordination between the Public Health services and the management entities. Based on the achieved outcomes, it is evident that the implementation of corrective measures has been successful, making a significant contribution to reducing mosquito density. Key messages • Effective surveillance and intervention strategies are crucial in mitigating West Nile Virus and arbovirus transmission risks in Portugal. • Continuous monitoring and coordination between public health services and management entities are key for maintaining effective vector control measures.

Point Prevalence Survey of HAIs as a key component of Infection Prevention and Control programs

Abstract Healthcare-Associated Infections (HAIs) are a global concern, requiring surveillance strategies as Point Prevalence Surveys (PPS) to estimate their burden and investigate associated risk factors for targeted interventions in high-risk areas. This study aims to assess the prevalence of HAIs, identify determinants and evaluate antimicrobial use in a teaching hospital in Rome. A PPS was carried out from June 19th to 23rd, 2023, in accordance with the European Centre for Disease Prevention and Control (ECDC) protocol for HAIs and antimicrobial use in European acute care hospitals (version 6.1). Pearson’s chi-squared test was employed to investigate correlations between potential risk factors and HAIs. The survey included 829 patients with an average age of 56.3 years (SD: ±24.6). Of these, 48.4% were female and over half had visited the hospital’s Emergency Department (53.7%). The prevalence of active HAIs was 8.7%, with 72 patients diagnosed. Furthermore, 51.0% of all patients received at least one systemic antimicrobial agent, and 16.7% of those treated had an HAI. Penicillins (39.7%) and third-generation cephalosporins (37.8%) were the most frequently prescribed antimicrobials. The primary HAIs were bloodstream infections (34.1%), followed by urinary tract (27.3%), surgical site (23.9%), lower respiratory tract (6.8%), and gastrointestinal infections (7.9%). Escherichia coli (13.2%), Staphylococcus aureus (9.2%), and Clostridium difficile (6.6%) were the most frequently isolated pathogens. Intensive Care Unit admission, use of medical device, recent antibiotic therapy and prior hospitalization or surgery significantly correlated (p < 0.05) with increased HAIs risk. The detected prevalence of HAIs is lower than the national rates observed in 2022 (10.2%), which have increased since 2016. HAIs surveillance is essential for developing effective infection prevention and control programs and for optimizing resource allocation in hospital settings. Key messages • Surveillance of Healthcare-Associated Infections is crucial for developing targeted Infection Prevention and Control programs and optimizing hospital resource allocation. • Point Prevalence Surveys offer essential information for assessing the burden of Healthcare-Associated Infections and directing intervention strategies in hospitals.

Community Healthcare-Associated Infections: Enhancing Control with Software and Tailored Protocols

Abstract Issue/Problem Healthcare-associated infections are major global public health challenges. In Portugal, the prevalence of resistant Enterobacteriaceae is particularly alarming. Studies typically focus on hospitals and long-term care facilities, neglecting community settings where patients, particularly the elderly with multiple comorbidities, often transition between hospital and home. Description of the problem Effective control measures are vital across all healthcare environments. In home care, sporadic implementation of Contact Precautions, due to the lack of specific guidelines and challenges in accessing colonization information, has been a major gap. This project aimed to close this gap by integrating a software, previously used only in hospitals, to enhance infection control in domiciliary care. The intervention adapted contact transmission-based precautions for home settings and used data from the previous year’s infections and colonization to tailor recommendations for each patient, preventing transmission between homes and enhancing caregiver education. Results Preliminary data from a two-month monitoring period involved 40 patients under the care of three domiciliary teams. Eleven had records of infections involving 19 microorganisms, including 7 Enterobacteriaceae, five of which were carbapenemase producers. This led to five customized recommendations for improved precautions. The intervention also heightened nurses’ awareness of patients’ microbiological histories, evidenced by increased inquiries to the infection control team. Lessons Adapting measures to the unique dynamics of home care, distinct from hospital settings, is critical. Involvement of care teams in decision-making ensures practical adherence and enhances measure effectiveness. Regular monitoring is crucial for compliance, making this approach a model for other settings. Key messages • Adapting hospital protocols to community settings and offering close support to caregiving teams increases compliance. • Implementing software that facilitates communication about infection and colonization enhances infection control effectiveness in community settings.

Using Social Network Analysis during COVID-19 contact tracing in Libya, 2020

Abstract Background Social network analysis (SNA) may provide valuable insights into individual-level transmission dynamics, allowing for targeted contact tracing interventions. We used SNA to understand the variability in SARS-CoV-2 transmission at the case level during the first wave in Libya. Methods We analyzed the spread of COVID-19 in Libya from March to August 2020 using contact tracing data from 287 confirmed cases. We created a network to visualize the transmission patterns, representing each case as a node and connections as links. We focused on direct contacts identified through contact tracing and calculated network measures such as out-degree centrality, in-degree centrality, and betweenness centrality. Gephi software was used for data visualization and understanding the network structure. Results Of the 287 COVID-19 cases, 264 (92%) had nodes with zero outdegrees, indicating that they did not contribute to infection transmission. The remaining 23 (8%) had non-zero out-degree measures and transmitter infection to other cases, 10 (4%) of whom were super-spreaders (outdegree≥5) causing 70% of the transmission. Six (2%) had no epidemiological contact, indicated by zero in-degree centrality measures; 63% had zero betweenness centrality measures, suggesting they did not act as intermediaries connecting separate transmission chains within the network. The network contained nine clusters of connected nodes, with the largest having 91 (24%) cases; the mean path length between cases was 1.846, and the network diameter was 4. Conclusions The study revealed distinct clusters of connected cases, along with the presence of super-spreaders. This network structure underscores the critical role of early identification and isolation of individuals with high transmission potential to effectively contain outbreaks. This revised conclusion directly references the findings of nine clusters and super-spreaders, demonstrating how these results support the importance of early intervention. Key messages • Social network analysis identifies clusters and super-spreaders in COVID-19 transmission, emphasizing the need for targeted interventions. • Connected clusters and super-spreaders highlight the importance of contact tracing and early isolation for effective control of COVID-19 outbreaks.

Distribution of the Culex pipiens mosquito in mainland Portugal: a geospatial modelling study

Abstract Background The mosquito Culex pipiens is a vector for several pathogens, such as the West Nile virus. As the most abundant mosquito in Portugal, understanding its spatial distribution can support vector-borne diseases control and robust public health planning, given the mainland’s favourable climate for this vector. Information on its spatial distribution at a national level is limited, especially its association with climate variables. Thus we aimed to predict the suitability of Culex pipiens distribution in mainland Portugal, considering climate factors. Methods We used presence records for adult and larvae of Culex pipiens mosquitoes sampled across mainland Portugal from January 2017 to October 2023, as part of the Portuguese Vector Surveillance Network program (REVIVE). Between May-October, in random locations and throughout the year in point-of-entry sites, adult mosquito collection used CDC light traps and BG-Sentinel traps, and larvae collection used dippers in breeding sites. Sampling bias was corrected by filtering presence sites, retaining one record per each cell grid of 1 km2. Climatic data (including temperature, precipitation and elevation) were used as predictors in a maximum entropy (MaxEnt) model of the Culex pipiens geographical distribution. Results From the dataset of 6859 records, 1416 unique sites were obtained after filtering. Suitable habitats seem to be mainly distributed on the coast, particularly in Minho, Porto and Lisbon metropolitan areas, and Tagus Valley, with precipitation as the most important predictor. Conclusions Most West Nile Virus case reports come from the south of Portugal, but the potential distribution of Culex pipiens covers the whole mainland territory, with seemingly higher distribution on the north coast. However, bias due to convenience sampling could be present. West Nile vector surveillance should be a priority across all regions to accurately assess transmission risk and implement effective control measures. Key messages • The suitability of Culex pipiens distribution covers the entire mainland of Portugal, with higher presence in the north. • The distribution of Culex pipiens in the country points towards a need for developing region-specific strategies regarding West Nile Virus prevention and control.

The role of communication in the successful implementation of the Slovenian NCCP

Abstract Issue Cancer remains a significant global public health challenge, necessitating comprehensive strategies for effective control and management. Slovenian National Cancer Control Programme (NCCP) addresses this challenge by prioritizing proactive communication with various stakeholders engaged in cancer care planning, delivery and advocacy. The communication strategy within this programme plays a pivotal role in its successful implementation. Description of the problem Active engagement and collaboration among stakeholders is crucial for achieving the programme’s objectives. NCCP seeks to address this challenge through various communication activities by fostering dialogue, sharing best practices, and facilitating networking opportunities among oncology professionals throughout Slovenia. Additionally, it seeks to strengthen partnerships with sectors beyond health and prioritizes engagement with cancer patient advocacy groups. Results The programme has devised a long-term communication strategy, guiding annual communication plans to engage stakeholders and foster support for its objectives. Notable communication activities in the period 2022-2024 include: organizing annual meetings for different oncology stakeholders including cancer patient associations, hosting impactful professional events, conducting visits to regional cancer hospitals, distributing e-newsletters and managing a NCCP website. Initial outcomes indicate strengthened communication and collaboration among professionals and institutions in the field of oncology nationwide. Engagement with patient advocacy groups has facilitated discussions on topics important to patients. Lessons Effective communication with diverse stakeholders is crucial for comprehensive cancer control. Collaborating across sectors enhances the impact of cancer control initiatives. Enhanced networking fosters innovation and synergy among oncology professionals, positioning Slovenia for greater success in cancer control. Key messages • Slovenia’s NCCP prioritizes proactive communication, fostering collaboration among stakeholders. Annual events, newsletter, and partnerships strengthen awareness and drive comprehensive cancer control. • Long-term communication strategy of Slovenia’s NCCP drives stakeholder engagement, and supports strategic objectives. This proactive approach strengthens comprehensive cancer control efforts.

SINAVE’s quality: completeness for Meningococcal Disease – Northern Portugal, 2020-2022

Abstract Due to Meningococcal’s Disease (MD) severity and impact in public health, in Portugal it is mandatory to notify the suspicious cases to implement effective control measures. MD cases are notified in the National Surveillance System (SINAVE), which triggers epidemiological investigation, risk assessment and community intervention. The quality of SINAVE is defined by various attributes, being their evaluation crucial to improve and guarantee quality standards. Our goal is to evaluate the external and internal completeness of SINAVE for MD in northern Portugal from 2020 to 2022. We have conducted a cross-sectional study, using MD cases from 2020 to 2022. External Completeness was estimated using a two-source capture-recapture method, with data from SINAVE and Diagnostic-Related Group (DRG) cases. Hospital readmissions’, duplicates and cases from other regions were excluded. Internal completeness of SINAVE was accessed for each case and for each non-mandatory variable. For external completeness (EC) analysis, 21 of the 23 DRG cases were eligible for matching. Out of 31 SINAVE confirmed cases, 20 were eligible for matching. EC of SINAVE was 66,7%. For internal completeness (IC) analysis, we excluded 7 cases that did not meet the criteria for inclusion. The mean IC was 73,5% (min 38,5%, max 85,7%) when analysing by case. When assessing each of the 30 non-mandatory variables of the reports, 7 (23,3%) had an IC of 100% and 13 (43,3%) had an IC of 0%, the mean value was 49,7%. SINAVE assessment, as a routine, is crucial to identify the need for improvement. Completeness is fundamental to ensure an effective public health response. Our results confirm under-reporting and incomplete report of MD. There is a need to strengthen the improvement of data quality of SINAVE. Future studies may be important to estimate true incidence of MD and compare the results for other diseases in order to improve public health actions. Key messages • Meningococcal disease requires timely public health intervention. • valuation of the surveillance system is crucial, with completeness playing an important role for data quality and prompt response.

Investigating Transmission Patterns and Genome Sequencing of SARS-CoV-2 in University College Dublin

Abstract Background This study describes the investigation and management of multiple outbreaks of SARS-Cov2 during the second and third wave of the pandemic at University College Dublin, Ireland from September 2020 to September 2021. Methods Relevant data were gathered as part of the public health outbreak investigations led by the UCD Internal Covid Control Team (ICCT) in collaboration with the public health teams of the Health Service Executive (HSE). Results are presented for PCR (polymerase chain reaction) confirmed cases and their close contacts, reported to the UCD ICCT between September 2020 to September 2021. Results There were 214 cases notified to ICCT. Among these, 153 cases were in residence on-campus cases. 73 epidemiologically linked clusters identified, where the number of cases linked with each cluster varied between 1 to 27. Additional cases during this period had no obvious epidemiological link to the identified clusters. Of 902 close contacts with PCR test results, 31.5% (n = 284) tested positive. 77% (n = 219) self-reported with mild to moderately symptoms while 23% (n = 65) self-reported as asymptomatic. Retrospective Whole Genome Sequence (WGS) analysis was undertaken after the outbreaks had subsided. The test positive cases were grouped into 6 clusters, and it was shown that many of the apparent sporadic cases were included in these clusters. Conclusions The proportion of close contacts testing positive varied significantly throughout the pandemic, with testing policy and type of exposure having the greatest impact. Whole genome sequencing can give a better understanding of webs of transmission to complement epidemiological investigations. It is now possible to undertake sequencing in real time where it can make a contribution to outbreak control and resolution. Public Health professionals should become familiar with WGS and bioinformatics as useful tools in their armory for the control of all communicable diseases not only SARS-CoV-2. Key messages • Combined epidemiological investigations and Whole Genome Sequencing (WGS) provide crucial insights into campus COVID-19 outbreaks, guiding effective control measures. • WGS integration enhances understanding of transmission patterns, identifies clusters, and equips public health professionals with data-driven approaches for outbreak management beyond SARS-CoV-2.