Epidemic Rates Research Articles

Effect of vaccine dose intervals: Considering immunity levels, vaccine efficacy, and strain variants for disease control strategy

In this study, we present an immuno-epidemic model to understand mitigation options during an epidemic break. The model incorporates comorbidity and multiple-vaccine doses through a system of coupled integro-differential equations to analyze the epidemic rate and intensity from a knowledge of the basic reproduction number and time-distributed rate functions. Our modeling results show that the interval between vaccine doses is a key control parameter that can be tuned to significantly influence disease spread. We show that multiple doses induce a hysteresis effect in immunity levels that offers a better mitigation alternative compared to frequent vaccination which is less cost-effective while being more intrusive. Optimal dosing intervals, emphasizing the cost-effectiveness of each vaccination effort, and determined by various factors such as the level of immunity and efficacy of vaccines against different strains, appear to be crucial in disease management. The model is sufficiently generic that can be extended to accommodate specific disease forms.

Epidemiological Features of Obesity and Type 2 Diabetes Mellitus in the Russian Federation

Relevance. Obesity is associated with the risk of developing insulin resistance and type 2 diabetes mellitus (type 2 DM). Over the past 40 years, no country in the world has seen a decrease in the incidence of either obesity or diabetes. The epidemic growth rates of type 2 DM in the world, including in the Russian Federation, emphasize the close relationship of these endocrinopathies and identify obesity as one of the determinants of diabetes development. Aim. To study the intensity, dynamics and features of the formation of primary morbidity of obesity and type 2 DM among various population groups, as well as to identify correlations between the studied parameters in the groups. Materials and methods. A retrospective analysis of the primary incidence of obesity and type 2 DM in Russia in 2010–2021 was carried out. The source of the analyzed information was the statistical collections of the Ministry of Health of the Russian Federation «Morbidity of the population». To identify the relationship between the studied parameters, a correlation analysis was performed with the calculation of the Pearson coefficient (r). The interpretation of the closeness of the correlation was performed on the Chaddock scale. Results. The number of cases of obesity amounted to 4 428 975, type 2 DM – 3 839 772 in Russia in 2010–2021. The incidence of obesity among the entire population was 253,61 per 100 ths, type 2 DM – 220,47 per 100 ths population. The Siberian FD (377,29 per 100 ths) should be singled out as an epidemiologically significant obesity district, and for type 2 DM – the Southern FD (249,34 per 100 ths). The incidence of type 2 DM among adults was 274,22 per 100 ths, while the leading positions were taken by the Ural FD (313,56 per 100 ths) and the Southern FD (308,94 per 100 ths). In terms of obesity among adults, it should be noted that the Siberian FD is 359,21 per 100 ths (the excess of the incidence rate in Russia is 1,68 times). Among the elderly, the incidence of obesity in Russia was 1,15 times higher than in adults (247,15 per 100 ths), while in the Siberian FD the incidence was 1,23 times higher than in adults (440,9 per 100 ths). In the elderly population group, the maximum incidence of type 2 DM was noted in the Ural FD – 591,11 per 100 ths. The incidence of obesity among the children from 0 to 14 years was 370,99 per 100 ths, while the most unfavorable epidemic situation was noted in the North-Western FD (476,86 per 100 ths – exceeding the level in Russia by 1,29 times). Among the children from 15 to 17, the incidence of obesity was 697,67 per 100 ths, the maximum level was in the North-Western FD (869,1 per 100 ths) and the Southern FD (866,43 per 100 ths). In parallel, the North-Western FD is also leading in terms of type 2 DM (3,16 per 100 ths) among the teenagers 15–17 years old. Positive correlations between obesity and type 2 DM were established among the entire population of Russia in 2020 (r = 0,364 – weak level) and in 2021 (r = 0,260 – very weak level). Conclusion. A close association of obesity with the development of type 2 DM has been confirmed. In Russia, in parallel with the growth of obesity, there is an increase in type 2 DM. Special attention should be paid to the child population, since there is a pronounced trend towards an increase in the incidence of obesity among the children 0–14 years old and 15–17 years old. The level of type 2 DM is also increasing among the teenagers. A statistically significant correlation was obtained between obesity and type 2 DM among the entire population.

The Follow up of the Anxiety Levels of Elderlies During the 'COVID-19' Pandemic: A Prospective Primary Care Study

Abstract Background and Objectives: The COVID-19 outbreak became the first pandemic caused by coronaviruses. As the epidemic spread rate gradually increased in Turkey, curfews were imposed on individuals aged 65 and over. We thought that both the pandemic and the curfew caused anxiety in the elderly. This study investigated the prevalence of anxiety in the elderly and the follow up of the axiety level during curfew. Other purpose of the study was to determine the factors affecting anxiety. Method: We evaluated older people’s anxiety status with an interval of 15 days and 6 months during the pandemic by using Geriatric anxiety scale. People aged 65 and over among the enrolled population of the FHC were contacted by telephone. Results: The mean scores of the first Geriatric anxiety scale were 1.0 ± 2.4, second score applied at the 15th days was 0.5 ± 2.1, the third score applied at the sixth month was 0.3 ± 1.8. There was a significant difference between the three measurements (p = 0.002). Conclusions: Total anxiety scores of our sample were low and there was a significant difference between the three measurements performed 15th days and sixth month was a decrease in anxiety. Gender, education level, living alone, house type was found related with changes in anxiety.

Quantification of the time-varying epidemic growth rate and of the delays between symptom onset and presenting to healthcare for the mpox epidemic in the UK in 2022

The mpox epidemic in the UK began in May 2022, with rates of new cases unexpectedly and rapidly declining during August 2022. Interpreting trends in infection requires disentangling the underlying growth rate of cases from the delay from symptom onset to presenting to healthcare. We developed a nowcasting Bayesian method which incorporates time-varying delays (EpiLine) to quantify the changes in the delay from symptom onset to healthcare presentation and the underlying mpox growth rate over the period May-August 2022 in the UK. We show that the mean delay between symptom onset and healthcare presentation for mpox in the UK decreased from 22 days in early May 2022 to 10 days by early June and 8 days in August 2022. When we account for these dynamic delays, the time-varying growth rate declined gradually and continuously in the UK during the May-August 2022 period. Not accounting for varying time delays would have incorrectly characterised the growth rate by a sharp increase followed by a rapid decline in mpox cases. Our results highlight the importance of correctly quantifying the delay between symptom onset to healthcare presentation when characterising the epidemic growth of mpox in the UK. The gradual reduction in the rate of epidemic spread, which pre-dated the vaccine roll-out, is consistent with gradual risk reduction or acquired immunity amongst the highest risk individuals. Our study highlights the need for public health agencies to record the delays from symptom onset to healthcare presentation early in an outbreak.

Adherence strategy based on evolutionary games in epidemic spreading

In light of the dynamic interaction between epidemic spreading and behavior responses, the development of a comprehensive epidemic model is both crucial and challenging. In this paper, based on the evolutionary game theory, we investigate the co-evolution of adherence strategy decision-making and epidemic spreading, with a particular focus on the role of conformity. Considering individual self-determination and population imitation, we analyze two distinct strategy updating rules: profit-driven decision-making and conformity-driven decision-making. We also account for the influence of neighbors’ strategies on epidemic spread rates. Extensive simulations are conducted to analyze epidemic phase transitions and the distribution of infected individuals at the stationary state of the epidemic. By analyzing the adoption of strategies under different scenarios of conformity fractions, we find that conformity widens the disparity between different strategies over time. In conclusion, our results demonstrate that conformity promotes the adherence strategy, which helps reduce the size of the epidemic.

Psychosocial stressors of adolescents with E-cigarette, or vaping, product-use associated lung injury: A qualitative study

Background and objectivesAdolescent electronic cigarette (EC) use has reached epidemic rates and has been linked to numerous mental health and psychosocial stressors (PS). There is limited qualitative data on PS for adolescents with e-cigarette, or vaping, product-use associated lung injury (EVALI), a severe complication of EC use. MethodsAll patients hospitalized at Children’s Medical Center in Dallas, Texas from 2018 to 2022 and met CDC case definitions for EVALI were included in the analysis. PS were extracted from the electronic health record and analyzed for recurring themes using the HEADSS assessment as a framework. Results were summarized using descriptive statistics, and representative quotations were selected to highlight each theme. ResultsForty-three adolescents (mean age 16.3 years; 62.8 % male; 39.5 % Non-Hispanic White, 60.5 % Hispanic) were included in the analysis, and 40 (93 %) reported PS. The most common themes were family (51 %; “restraining order issued against 28-year-old brother”), polysubstance use (77 %; “experimenting with…ecstasy, LSD, CCC, misusing Adderall”), and mental health (63 %; “has been suicidal since he was ‘a toddler’”). Less commonly, patients reported PS related to peers (28 %; “spending the entire day at the cemetery where his best friend was buried”), school (49 %; “attending his second alternative school”), and the legal system (19 %; “placed in juvenile detention, released, and will be on probation”). ConclusionsAdolescents with EVALI had PS that were chronic, severe, and involving multiple domains. These findings emphasize the importance of psychosocial screening in adolescents and coordinating interdisciplinary care with mental health and social services.

Optimization of N Fertilizer and Synergistic Intercropping to Enhance the Productivity Advantage of Faba Bean and Effective Control of Chocolate Spot Epidemics.

Intercropping of wheat/faba bean is a common practice within the legume-cereal family. However, the benefits of nitrogen (N) fertilizer-optimized synergistic intercropping in improving faba bean productivity while controlling the prevalence of chocolate spot disease have not been established. This study conducted continuous field experiments spanning two planting seasons to investigate two key findings: (i) Optimizing N fertilizer application can enhance the productivity of intercropped faba bean. (ii) The percentage severity index (PSI) during the period of maximum prevalence rate (Rmax) of faba bean chocolate spot disease poses a substantial challenge to faba bean yield. The results indicated that the land equivalent ratio and transgressive overyielding index for each intercropping treatment increased with higher N fertilizer application, exceeding a value of 1, and the land saving proportion also exceeded 0. Intercropping primarily enhances productivity, as measured by the harvest index (HI), by amplifying the complementary effect rather than the selection effect, thus improving the net benefit of intercropping. The HI of single and intercropped faba bean increased with the N1 and N2 treatments in both planting seasons. However, the HI of single and intercropped faba bean at the N3 level decreased significantly, ranging from 17.85 to 29.62%. Furthermore, a notable negative correlation was established between the PSI during critical epidemic (initial epidemic, maximum epidemic rate, and late epidemic) periods and observed and expected faba bean yields. As the PSI increased, faba bean yields decreased, and the PSI of intercropping at different periods was lower than that observed in the single cropping. Additionally, intercropping with the optimized N fertilizer treatment (N2 treatment) exhibited an enhanced relative control effect on chocolate spot disease in faba bean, ranging from 35.21 to 52.36%. This finding confirmed the productivity advantage of intercropping faba bean. In conclusion, this study suggested that optimizing N fertilizer application can enhance the productivity of intercropped faba bean. Wheat/faba bean intercropping effectively controlled the PSI during the period of Rmax, which would otherwise threaten faba bean yield. Consequently, this practice ensured sustained advantages of wheat/faba bean intercropping.

Markovian Approach for Exploring Competitive Diseases with Heterogeneity-Evidence from COVID-19 and Influenza in China.

Due to the complex interactions between multiple infectious diseases, the spreading of diseases in human bodies can vary when people are exposed to multiple sources of infection at the same time. Typically, there is heterogeneity in individuals' responses to diseases, and the transmission routes of different diseases also vary. Therefore, this paper proposes an SIS disease spreading model with individual heterogeneity and transmission route heterogeneity under the simultaneous action of two competitive infectious diseases. We derive the theoretical epidemic spreading threshold using quenched mean-field theory and perform numerical analysis under the Markovian method. Numerical results confirm the reliability of the theoretical threshold and show the inhibitory effect of the proportion of fully competitive individuals on epidemic spreading. The results also show that the diversity of disease transmission routes promotes disease spreading, and this effect gradually weakens when the epidemic spreading rate is high enough. Finally, we find a negative correlation between the theoretical spreading threshold and the average degree of the network. We demonstrate the practical application of the model by comparing simulation outputs to temporal trends of two competitive infectious diseases, COVID-19 and seasonal influenza in China.

Global warming significantly increases the risk of Pierce’s disease epidemics in European vineyards

Pierce’s disease (PD) is a vector-borne disease caused by the bacteria Xylella fastidiosa, which affects grapevines in the Americas. Currently, vineyards in continental Europe, the world’s largest producer of quality wine, have not yet been affected by PD. However, climate change may alter this situation. Here we incorporate the latest regional climate change projections into a climate-driven epidemiological model to assess the risk of PD epidemics in Europe for different levels of global warming. We found a significant increase in risk above +2∘C\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$+\\,2\\,^{\\circ }\\hbox {C}$$\\end{document} in the main wine-producing regions of France, Italy and Portugal, in addition to a critical tipping point above +3∘C\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$+\\,3\\,^{\\circ }\\hbox {C}$$\\end{document} for the possible spread of PD beyond the Mediterranean. The model identifies decreasing risk trends in Spain, as well as contrasting patterns across the continent with different velocities of risk change and epidemic growth rates. Although there is some uncertainty in model projections over time, spatial patterns of risk are consistent across different climate models. Our study provides a comprehensive analysis of the future of PD at multiple spatial scales (country, Protected Designation of Origin and vineyard), revealing where, why and when PD could become a new threat to the European wine industry.

Using Passive Surveillance to Maintain Elimination as a Public Health Problem for Neglected Tropical Diseases: A Model-Based Exploration.

Great progress is being made toward the goal of elimination as a public health problem for neglected tropical diseases such as leprosy, human African trypanosomiasis, Buruli ulcer, and visceral leishmaniasis, which relies on intensified disease management and case finding. However, strategies for maintaining this goal are still under discussion. Passive surveillance is a core pillar of a long-term, sustainable surveillance program. We use a generic model of disease transmission with slow epidemic growth rates and cases detected through severe symptoms and passive detection to evaluate under what circumstances passive detection alone can keep transmission under control. Reducing the period of infectiousness due to decreasing time to treatment has a small effect on reducing transmission. Therefore, to prevent resurgence, passive surveillance needs to be very efficient. For some diseases, the treatment time and level of passive detection needed to prevent resurgence is unlikely to be obtainable. The success of a passive surveillance program crucially depends on what proportion of cases are detected, how much of their infectious period is reduced, and the underlying reproduction number of the disease. Modeling suggests that relying on passive detection alone is unlikely to be enough to maintain elimination goals.

“They make it too hard and too many hoops to jump”: system and organizational barriers to drug treatment during epidemic rates of opioid overdose

IntroductionThe United States is currently facing an opioid overdose crisis. Research suggests that multiple interventions are needed to reduce overdose deaths including increasing access and retention to medications to treat opioid use disorders (MOUD, i.e., methadone, buprenorphine, and naltrexone) and increasing the distribution and use of naloxone, a medication that can reverse the respiratory depression that occurs during opioid overdoses. However, barriers to MOUD initiation and retention persist and discontinuations of MOUD carry a heightened risk of overdose. Many times, MOUD is not sought as a first line of treatment by people with opioid use disorder (OUD), many of whom seek treatment from medically managed withdrawal (detox) programs. Among those who do initiate MOUD, retention is generally low. The present study examines the treatment experiences of people who use opioids in three states, Connecticut, Kentucky, and Wisconsin.MethodsWe conducted in-depth interviews with people who use opioids in a rural, urban, and suburban area of three states: Connecticut, Kentucky and Wisconsin. Data analysis was collaborative and key themes were identified through multiple readings, coding of transcripts and discussion with all research team members.ResultsResults reveal a number of systemic issues that reduce the likelihood that people initiate and are retained on MOUD including the ubiquity of detox as a first step in drug treatment, abstinence requirements and requiring patients to attend group treatment. MOUD-related stigma was a significant factor in the kinds of treatment participants chose and their experiences in treatment.ConclusionsInterventions to reduce MOUD stigma are needed to encourage MOUD as a first course of treatment. Eliminating abstinence-based rules for MOUD treatment may improve treatment retention and decrease overdose risk.

Qualitative Evaluation Informs the Implementation of a Telehealth Program to Manage Chronic Pain

In response to the opioid epidemic and high rates of chronic pain among the veteran population, the U.S. Department of Veterans Affairs implemented the TelePain-Empower Veterans Program (EVP), a nonpharmacological pain management program for veterans. Delivered virtually, TelePain-EVP incorporates integrated health components (Whole Health, Acceptance and Commitment Therapy, and Mindful Movement) through interdisciplinary personalized coaching. The objective of this quality improvement project was to evaluate the implementation of TelePain-EVP to identify determinants to implementation, benefits and challenges to participation, and recommendations for future direction. We used a qualitative descriptive design to conduct semistructured telephone interviews with TelePain-EVP leaders (n = 3), staff (n = 10), and veterans (n = 22). The interview guides aligned with the Consolidated Framework for Implementation Research (CFIR). Thematic content analysis organized and characterized findings. Several CFIR domains emerged as determinants relevant to program implementation, including innovation (eg, design); individuals (eg, deliverers, recipients); inner (eg, communications) and outer settings (eg, local conditions); and implementation process (eg, reflecting and evaluating). Identified determinants included facilitators (eg, virtual delivery) and barriers (eg, staff shortages). Participants reported improvements in pain management coping skills, interpersonal relationships, and sense of community, but no self-reported reductions in pain or medication use. Program improvement recommendations included using centralized staff to address vacancies, collecting electronic data, offering structured training, and providing course materials to veteran participants. Qualitative data can inform the sustained implementation of TelePain-EVP and other similar telehealth pain management programs. These descriptive data should be triangulated with quantitative data to objectively assess participant TelePain-EVP outcomes and associated participant characteristics. PerspectiveA qualitative evaluation of a telehealth program to manage chronic pain, guided by the CFIR framework, identified determinants of program implementation. Additionally, participants reported improvements in pain management coping skills, interpersonal relationships, and sense of community, but no self-reported reductions in pain or medication use.

The emerging role of nitric oxide in the synaptic dysfunction of vascular dementia.

With an increase in global aging, the number of people affected by cerebrovascular diseases is also increasing, and the incidence of vascular dementia-closely related to cerebrovascular risk-is increasing at an epidemic rate. However, few therapeutic options exist that can markedly improve the cognitive impairment and prognosis of vascular dementia patients. Similarly in Alzheimer's disease and other neurological disorders, synaptic dysfunction is recognized as the main reason for cognitive decline. Nitric oxide is one of the ubiquitous gaseous cellular messengers involved in multiple physiological and pathological processes of the central nervous system. Recently, nitric oxide has been implicated in regulating synaptic plasticity and plays an important role in the pathogenesis of vascular dementia. This review introduces in detail the emerging role of nitric oxide in physiological and pathological states of vascular dementia and summarizes the diverse effects of nitric oxide on different aspects of synaptic dysfunction, neuroinflammation, oxidative stress, and blood-brain barrier dysfunction that underlie the progress of vascular dementia. Additionally, we propose that targeting the nitric oxide-sGC-cGMP pathway using certain specific approaches may provide a novel therapeutic strategy for vascular dementia.

Condom Use Behavior among Female Sex Worker Clients in Makassar City

Indonesia has not yet emerged as one of the countries with the highest HIV/AIDS epidemic rate in the world. The United Nations Organization for AIDS, namely the United Nations Joint Program on HIV and AIDS, said that over the past two years, Indonesia's position has not changed, namely that it is still the country with the fastest AIDS epidemic in Asia. HIV-AIDS transmission in Indonesia is growing rapidly, one of the triggers is risky sexual behavior, including sexual behavior among female sex worker clients. This study aims to analyze the factors that influence condom use behavior among female sex worker clients in Makaassar. This research uses quantitative methods with an explanatory research design with a cross sectional approach. Qualitative data carried out as triangulation was used to support the results of quantitative analysis extracted from female sex workers and pimps as a cross check of answers from female sex worker customers. The method used was in-depth interviews and Focus Group Discussions on female sex workers and pimps. The sample size was 66 people. Data analysis was univariate, bivariate with chi-square and multivariate with logistic regression. The results show that the majority of respondents (71.2 %) behave consistently in using condoms.

Covid-19 Pandemisi Sırasında Doğum Şeklinin Robson Sınıflandırma Sistemine Göre Değerlendirilmesi

Aim: To show the change in the rates of vaginal delivery and cesarean section during the Covid-19 Pandemic in Ankara City Hospital. Materials and Method: This cross-sectional study included pregnant women who gave birth between 37 and 42 gestational weeks. Cesarean birth rates for each of the 10 Robson categories, compared between Covid-19 and before Covid-19 groups. Results: 21366 pregnant women were included in the study. The cesarean section rates were examined by dividing the patients who gave birth during covid -19 into two groups those who were infected with covid and those who were not. During the Covid-19 pandemic, women with previous CS (Robson group 5) and the nulliparous women who had spontaneous labor with a cephalic presentation at term (Robson group 1) were the most common contributors to the global CS rate, 21,68% and 6.5%, respectively regardless of being infected with Covid-19. Similarly, Robson group 5 makes the greatest contribution to the overall cesarean section rate (% 21,68) when we evaluate the patients by separating them as covid positive and covid negative. Conclusion: At the beginning of the epidemic higher rates of cesarean section are expected in the group of pregnant women with Covid-19 infection due to our limited knowledge. Although the mother's infection complicates the delivery, the timing and mode of delivery should be individualized according to the clinical condition of the pregnant woman, the week of gestation, and the condition of the fetus.

Diabetes Susceptibility Assessment Using the Indian Diabetes Risk Score: A Cross-Sectional Analytical Study on Young Medical Students in Chennai, South India.

Background Youth must identify their diabetes risk factors because the disease is currently affecting young people at an epidemic rate. The Indian Diabetes Risk Score (IDRS) is a reliable and affordable method for determining a person's risk of developing diabetes. This study aims to evaluate the ability of the IDRS to predict type 2 diabetes mellitus (T2DM) and investigate the relationship between diabetes risk and other variables in young medical students. Methodology In this cross-sectional analytical survey of a cohort of 670 undergraduate medical scholars over six months, a meticulously designed semi-structured questionnaire was administered. The questionnaire captured sociodemographic specifics, substance use habits (tobacco and alcohol), dietary patterns, and physical activity patterns in line with the WHO STEPwise approach to non-communicable disease risk factor surveillance and the IDRS tool. Results There was an equal proportion of males and females. The majority were in their second year of study. Overall, 5.2% of students reported tobacco use, while alcohol consumption was reported by 25.6% of the cohort. Furthermore, IDRS score insights revealed that 80.2% of the participants exhibited low diabetes risk, 18.9% were categorized as moderate risk, and 0.9% demonstrated high risk. Gender (adjusted prevalence ratio (PR) = 1.8, 95% confidence interval (CI) 1.3-2.7)and tobacco usage (adjusted PR = 1.6 (1.1 to 2.2)) were found to be significantly associated with higher IDRS scores on multivariable analysis. Conclusions Illuminating the landscape of risk determinants among medical students in Chennai, this study accentuates the pressing need for bespoke interventions, underpinned by behavioral change theories. Such strategies can potentially catalyze healthier lifestyle shifts, shaping favorable public health trajectories in the foreseeable future.

Gaidai reliability method for long-term coronavirus modelling

Background Novel coronavirus disease has been recently a concern for worldwide public health. To determine epidemic rate probability at any time in any region of interest, one needs efficient bio-system reliability approach, particularly suitable for multi-regional environmental and health systems, observed over a sufficient period of time, resulting in a reliable long-term forecast of novel coronavirus infection rate. Traditional statistical methods dealing with temporal observations of multi-regional processes do not have the multi-dimensionality advantage, that suggested methodology offers, namely dealing efficiently with multiple regions at the same time and accounting for cross-correlations between different regional observations. Methods Modern multi-dimensional novel statistical method was directly applied to raw clinical data, able to deal with territorial mapping. Novel reliability method based on statistical extreme value theory has been suggested to deal with challenging epidemic forecast. Authors used MATLAB optimization software. Results This paper described a novel bio-system reliability approach, particularly suitable for multi-country environmental and health systems, observed over a sufficient period of time, resulting in a reliable long-term forecast of extreme novel coronavirus death rate probability. Namely, accurate maximum recorded patient numbers are predicted for the years to come for the analyzed provinces. Conclusions The suggested method performed well by supplying not only an estimate but 95% confidence interval as well. Note that suggested methodology is not limited to any specific epidemics or any specific terrain, namely its truly general. The only assumption and limitation is bio-system stationarity, alternatively trend analysis should be performed first. The suggested methodology can be used in various public health applications, based on their clinical survey data.

Evaluating niraparib versus active symptom control in patients with previously treated mesothelioma (NERO): a study protocol for a multicentre, randomised, two-arm, open-label phase II trial in UK secondary care centres

BackgroundMalignant mesothelioma is a rapidly lethal cancer that has been increasing at an epidemic rate over the last three decades. Targeted therapies for mesothelioma have been lacking. A previous study...

Diagnostic Efficacy of Plasma-Based Real-Time PCR for Schistosomiasis Japonica in Mice before and after Treatment with Praziquantel.

The prevalence of schistosomiasis japonica in China is now characterized by a low epidemic rate and low-intensity infections. Some diagnostic methods with high sensitivity and specificity are urgently needed to better monitor this disease in the current situation. In this study, the detection efficacy of a real-time fluorescent quantitative PCR (qPCR) assay was assessed for schistosomiasis japonica in mice, and before and after treatment with praziquantel (PZQ). Our results showed that the sensitivity of the qPCR was 99.3% (152/153, 95% CI: 96.41-99.98%) and its specificity was 100% (77/77, 95% CI: 95.32-100%) in mice infected with different numbers of Schistosoma japonicum. After the oral administration of PZQ, mice infected with 10 cercariae or 40 cercariae were all Schistosoma japonicum-negative 6 weeks after treatment. However, the negativity rates on a soluble egg antigen (SEA)-based enzyme-linked immunosorbent assay (ELISA) were only 34.8% (8/23, 10 cercariae group) and 6.7% (1/15, 40 cercariae group) at the sixth week after PZQ treatment. These results demonstrated that the qPCR method had good sensitivity and specificity, and suggested that its sensitivity correlated with the infection intensity in mice. Moreover, this method had better potential utility for evaluating the treatment efficacy of PZQ in schistosome-infected mice than SEA-based ELISA.

Instantaneous reproduction number and epidemic growth rate for predicting COVID-19 waves: the first 2 years of the pandemic in Spain.

Several indicators were employed to manage the COVID-19 pandemic. In this study, our objective was to compare the instantaneous reproductive number and the epidemic growth rate in the Spanish population. Data on daily numbers of cases, admissions into hospitals, admissions into ICUs, and deaths due to COVID-19 in Spain from March 2020 to March 2022 were obtained. The four "pandemic state indicators", which are daily numbers of cases, admissions into hospitals, admissions into ICUs, and deaths due to COVID-19 in Spain from March 2020 to March 2022 were obtained from the Instituto de Salud Carlos III. The epidemic growth rate was estimated as the derivative of the natural logarithm of daily cases with respect to time. Both the reproductive number and the growth rate, as "pandemic trend indicators," were evaluated according to their capacity to anticipate waves as "pandemic state indicators." Using both the reproductive number and the epidemic growth rate, we were able to anticipate most COVID-19 waves. In most waves, the more severe the presentation of COVID-19, the more effective the pandemic trend indicators would be. Besides daily number of cases or other measures of disease frequency, the epidemic growth rate and the reproductive number have different roles in measuring the trend of an epidemic. Naïve interpretations and the use of any indicator as a unique value to make decisions should be discouraged.