Epidemiological Assessment Research Articles

Elimination of lymphatic filariasis: Where do we stand so far?

Lymphatic filariasis (LF), an asymptomatic, acute, and chronic condition in human beings, is the second most common vector-borne disease after malaria. According to the World Health Organization, there are 120 million LF cases detected in 81 tropical and subtropical countries, and one billion people are at risk. Therefore, the Global Program to Eliminate Lymphatic Filariasis was launched in 2000, with the primary objective of stopping LF transmission among all at-risk groups using mass drug administration (MDA), managing morbidities, and preventing LF-related impairments using a minimum treatment package. Additionally, other programs such as epidemiological assessment including National Filaria Control Program and World Health Organization recommended routine and pre-MDA microfilaremia surveys also implemented to stop the LF transmission. The routine filaria surveys were also carried out in around 2 000-4 000 individuals/month throughout the year whereas pre-MDA surveys were also conducted every year in approximately 4 000 individuals in four fixed and four random sites. Furthermore, the Transmission Assessment Survey was also conducted to check the risk of LF among primary school children. Moreover, potential diagnostic methods, systematic surveillance regimes, the Direct Network Report system, and regular trainings and awareness may be also effective in preventing the recurrence of LF. Hence, this review emphasizes the potential advocacy tools and various strategies as well as procedures for monitoring, which could be impactful in eliminating LF.

Об эффективности неспецифической профилактики инфекций, передаваемых иксодовыми клещами, на территории г. Томска

Epidemiological assessment studied of the value of acaricidal treatments in the prevention of TBI in Tomsk during 2018–2022 and the data of federal statistical observation forms No. 2, and No. 27 were analyzed. Quantitative assessment of the effectiveness of nonspecific prevention was performed using the Spearman correlation coefficient. Evaluation of the effectiveness of nonspecific prophylactic measures aimed at preventing TBI infestation showed that with the existing volumes of acaricidal treatments (up to 800.0 ha), there is no significant reduction in the number of ixodid ticks (correlation coefficient 0.32, p?<?0.05) and the incidence of TBI (correlation coefficient 0.40, p?<?0.05). A reliable relationship between the number of victims of tick bites on the territory of Tomsk and the number of morbidity of TBI (correlation coefficient 0.55, p?<?0.05) was revealed, where the increase in the frequency of contacts of the population with ixodid ticks leads to an increase in the morbidity of TBI diseases. Keywords: tick-borne encephalitis, ixodid tick borrelioses, anti-tick treatments, hard ticks.

CT-085 Assessment of Prognostic Factors, Colonization, and Infection Epidemiology in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

CT-085 Assessment of Prognostic Factors, Colonization, and Infection Epidemiology in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation

COVID-19 infection and risk analysis: a short introduction

This work is part of a study about COVID-19 pandemic in Mozambique. Here we reproduce the first part of such study were a general introduction about the background and motivational aspects of COVID-19 in the world is made. Also, the relevance of mathematical and statistical modeling, the concepts of risk, risk analysis and spatial epidemiology are detailed. An introductory briefing on risk measures in epidemiology is performed. In the present work, we deal with risk assessment in epidemiology, we address aspects such as uncertainty and variability, types of risk assessment and its steps, methods, and relevant conditions for the quality of risk assessment. At the moment, the considered data set is still incomplete, only preliminary estimated models and preliminary results were obtained. A continuation of this manuscript will illustrate the models estimated and applied to the modeling of infectious diseases, presenting those with a mathematical and statistical approach to COVID-19 infection. Also, we will present the mapping of diseases. The preliminary results obtained with the provisional data set agree with similar performed studies.

Ecosystemic epidemiological, epizootological, and sanitary-hygienic assessment of human and animal echinococcosis in the North Caucasus region

Introduction. Echinococcosis in animals and humans is a planetary problemю One of those zoonoses have acquired the status of epidemiological and sanitary-hygienic risks for the health in various social groups of the population and animals of more than 80 species.
 The purpose of the work is an ecosystemic epizootological, epidemiological, and sanitary-hygienic assessment of animal and human echinococcosis in Karachay-Cherkessia.
 Materials and methods. The studies were carried out in 2014–2022. The objects of study were the intestines of eighteen dog corpses slaughtered in compliance with the International Rules for Humane Treatment of Animals (2012), and the liver and lungs of 150 slaughtered sheep. Monitoring of echinococcosis in dogs and sheep was carried out by the method of complete helminthological dissection of organs and tissues according to K.I. Scriabin (1928). The number of taeniid-type eggs in the faeces of dogs and in 500 water samples of the basin of the river Kuban was determined according to the guidelines of Temporary norms and rules (1986). Data on the incidence of cystic echinococcosis in the population are summarized on the base of a comparative analysis of quarterly and annual reports of the sanitary medical services in 7 subjects of the North Caucasus Federal District with the materials of the State reports of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing of Russia.
 Results. The index of occurrence of invasion of the cystic form of echinococcus in the liver, lungs, and spleen in sheep in the planar zone was 18%, in the foothill zone – 24%, in the mountain zone – 28% (on average, about 25%). Transparent cysts of echinococcus extracted from the liver, lungs, and other organs of sheep contained protoscolexes in 100% of the samples, which indicates the likelihood of natural foci involving dogs and wild predators in the region, violations of the terms of deworming of priotary dogs, lack of sanitary and preventive work among the population. The region belongs to the group of subjects with low rates of zoonoses due to effective anti-epidemic measures. At the same time, the natural reservoirs of Karachay-Cherkessia are natural biotopes of taeniosis, where the contamination of water samples with taeniid eggs ranges from 11 to 37%.
 Limitations. The study is limited only by the analysis of statistical data on human echinococcosis in Karachay-Cherkessia and other subjects of the North Caucasus Federal District; other densely populated regions of the Russian Federation have not been studied and not affected.
 Conclusion. According to the epidemic situation in terms of echinococcosis in the population, the Karachay-Cherkess Republic can be attributed to relatively prosperous regions of Russia, but to the zone of epidemiological risk, since there is an increase in the number of dogs with tape echinococcosis and sheep infected with fertile cysts. Sanitary and hygienic pollution of the river Kuban and its tributaries with eggs of cestodes is a threat to the spread of echinococcosis among animals and humans.

Evaluation of Food Security of Women Referring to Healthcare Centers Affiliated to Mashhad University of Medical Sciences during 2017-2019

Background: Food security is one of the basic needs of humans and is regarded as a priority in the development goals of all countries. This study aimed at an epidemiological assessment of food security in healthcare centers affiliated with Mashhad University of Medical Sciences (MUMS).
 Methods: In this analytical cross-sectional study, information on food security, body mass index (BMI), physical activity, education, smoking, hypertension, domestic violence, psychological status, and demographic characteristics were extracted using SINA health records. A total of 60625 mothers referring to MUMS healthcare centers were studied from May 2017 to June 2019. Food security was measured using the Household Food Insecurity Access Scale (HFIAS). Multinominal logistic regression was run to assess the relationship between study variables and food security adjusted for important potential confounders.
 Results: The mean age of participants was 42.01±14.3 years. Also, 64.7% (N=39209) of the participants had food security; 25.3% (N=15321) suffered from mild food insecurity; 6.7% (N=4044) suffered from moderate, and 3.4% (N=2051) suffered from severe food insecurity. Physical activity, BMI, education, nationality, smoking, and psychological distress were significantly associated with odds of severe food insecurity in comparison to normal food security (P<0.05). However, there was no significant association between having diabetes, hypertension, fast foods, and domestic violence, and odds of severe food insecurity.
 Conclusions: Nearly two-thirds of households had food security and a positive significant association was observed between variables and odds of food insecurity. Further research, however, is needed to consolidate the findings

Exploratory structural equation modeling: a streamlined step by step approach using the R Project software

Confirmatory Factor Analysis (CFA) has been a popular yet limited approach to assessing latent factor structures. Despite items rarely loading exclusively on one latent factor in multifactorial scales, CFA assumes all indicators/items should load uniquely on their allocated latent dimensions. To address this weakness, Exploratory Structural Equation Modeling (ESEM) combines exploratory factor analyses (EFA) and CFA procedures, allowing cross-loadings to occur when assessing hypothesized models. Although such advantages have enhanced ESEM popularity, its adoption is often limited by software rigidity and complex coding difficulties. To address these obstacles, the current tutorial presents a streamlined, step-by-step approach using the open-source software R while providing both R and Mplus ESEM syntax. The tutorial demonstrates the sequence of the ESEM stages by examining the frequently debated Strengths and Difficulties Questionnaire (SDQ) factor structure, using openly accessible data from the Longitudinal Study of Australian Children (LSAC). As ESEM may allow a better understanding of the complex associations in multidimensional scales, this tutorial may optimize the epidemiological and clinical assessment of common yet multifaceted psychiatric presentations.

Children's Oncology Group's 2023 blueprint for research: Epidemiology.

The Children's Oncology Group (COG) Epidemiology Committee has a primary focus on better understanding the etiologies of childhood cancers. Over the past 10years, the committee has leveraged the Childhood Cancer Research Network, and now more recently Project:EveryChild (PEC), to conduct epidemiologic assessments of various childhood cancers, including osteosarcoma, neuroblastoma, germ cell tumors, Ewing sarcoma, rhabdomyosarcoma, and Langerhans cell histiocytosis. More recent studies have utilized questionnaire data collected as part of PEC to focus on specific characteristics and/or features, including the presence of congenital disorders and the availability of stored cord blood. Members of the COG Epidemiology Committee have also been involved in other large-scale National Institutes of Health efforts, including the Childhood Cancer Data Initiative and the Gabriella Miller Kids First Pediatric Research Program, which are improving our understanding of the factors associated with childhood cancer risk. Future plans will focus on addressing questions surrounding health disparities, utilizing novel biospecimens in COG epidemiology studies, exploring the role of environmental factors on the etiologies and outcomes of childhood cancer, collaborating with other COG committees to expand the role of epidemiology in childhood cancer research, and building new epidemiologic studies from the Molecular Characterization Initiative-all with the ultimate goal of developing novel prevention and intervention strategies for childhood cancer.

Enhancing onchocerciasis elimination program management: A biological approach to deciding when to begin Stop Mass Drug Administration activities.

Understanding when it is the appropriate time to stop administering the drugs in a chemotherapy-centered treatment program such as onchocerciasis remains a challenge due to cost, imperfect testing procedures, and a lack of long-term experience. Different approaches for assessing when a program can begin the extensive stop-treatment surveys have been recommended, and tested, with varying results. We describe here a practical approach that is based on information on both transmission as well as infection. This new protocol first defines operational transmission zones (OTZs) based on vector breeding sites followed by an epidemiological assessment of the resident populations adjacent to these breeding sites. Basing decisions to stop MDA treatment based on breeding site locations (i.e., transmission zones) rather than on political administrative units, is a practical, cost-effective approach. Importantly, this biology-based approach is more closely related to the actual state of onchocerciasis transmission.

Bayesian estimation and prediction for network meta-analysis with contrast-based approach.

Network meta-analysis is gaining prominence in clinical epidemiology and health technology assessments that enable comprehensive assessment of comparative effectiveness for multiple available treatments. In network meta-analysis, Bayesian methods have been one of the standard approaches for the arm-based approach and are widely applied in practical data analyses. Also, for most cases in these applications, proper noninformative priors are adopted, which does not incorporate subjective prior knowledge into the analyses, and reference Bayesian analyses are major choices. In this article, we provide generic Bayesian analysis methods for the contrast-based approach of network meta-analysis, where the generic Bayesian methods can treat proper and improper prior distributions. The proposed methods enable direct sampling from the posterior and posterior predictive distributions without formal iterative computations such as Markov chain Monte Carlo, and technical convergence checks are not required. In addition, representative noninformative priors that can be treated in the proposed framework involving the Jeffreys prior are provided. We also provide an easy-to-handle R statistical package, BANMA, to implement these Bayesian analyses via simple commands. The proposed Bayesian methods are illustrated using various noninformative priors through applications to two real network meta-analyses.

Non-Hodgkin Lymphoma - Nodal and Extranodal: 20-Year Comparative Mortality, Survival & Biologic Behavior Analysis by Age, Sex, Race, Stage, Cell Morphology/Histology, Cohort Entry Time-Period and Disease Duration: A Systematic Review of 384,651 Total NHL Cases Including 261,144 Nodal and 123,507 Extranodal Cases for Diagnosis Years 1975-2016: (SEER*Stat 8.3.6).

-To update trends in incidence and prevalence in the United States of non-Hodgkin lymphoma, examine, compare and contrast short and long-term patterns of survival and mortality, and consider the outcome impacts of anatomic location of NHL nodal and extranodal subdivisions, utilizing selected ICD-O-3 histologic oncotypes stratified by age, sex, race/ethnicity, stage, cell behavioral morphology and histologic typology, cohort entry time-period and disease duration, employing the statistical database of the National Cancer Institute SEER*Stat 8.3.6 program for diagnosis years 1975-2016.4 Methods.- A retrospective, population-based cohort study using nationally representative data from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) program to evaluate 384,651 NHL cases for diagnosis years 1975-2016 comparing multiple variables of age, sex, race, stage, cell behavioral morphology, cohort entry time-period, disease duration and histologic oncotype. Relative survival statistics were analyzed in two cohorts: 1975-1995 and 1996-2016. Survival statistics were derived from SEER*Stat Database: Incidence - SEER 9 Regs Research Data, November 2018 Submission (1975-2016) <Katrina/Rita Population Adjustment> released April 2019, based on the November 2018 submission. - Incidence rates, relative frequency distributions, survival and mortality by age, sex, stage and cell behavioral morphology, of adult nodal (N) and extranodal (EN) NHL in 2 entrant time-periods as recorded in the SEER Program of the National Cancer Institute for diagnosis years 1975-2016 (SEER Stat 8.3.6) are summarized. Shifts in trends over time are identified, and the findings are correlated with prognosis, including short and long-term observed (actual), expected and relative survival, median observed and relative survival, mortality rates and excess death rates per 1000 people. - Trends in SEER incidence, prevalence, survival and mortality by age, sex, race, stage, cell behavioral morphology, cohort entry time-period, relative frequency and percent distribution, were examined to provide a current epidemiologic and medical-actuarial risk assessment framework for nodal (N) and extranodal (EN) non-Hodgkin's lymphoma in the 1975-2016 timeframe.

Health Impacts from PM2.5 Exposure Using Environmental Epidemiology and Health Risk Assessment: A Review

Exposure to PM2.5 has been known to cause a variety of serious health consequences. Quantifying and investigating the health effects of PM2.5 pollution are imperative to understand and collect scientific evidence for supporting policies and associated actions. In this paper, we reviewed published environ-mental epidemiological studies and health risk assessments evaluating the health impacts of PM2.5 exposure in the PubMed database to identify the attributes of each method and aggregate the health impact results to perform analyses and summaries. Forty-two studies were identified after applying our search strategy, inclusion, and exclusion criteria. The epidemiological studies found an increased risk of several diseases from short- and long-term exposure, such as cardiovascular and respiratory diseases, lung cancer, stroke, pneumonia, depression, and diabetes. However, several conditions remain to be explored as the associations remain unclear, such as asthma, bronchitis, breast cancer, Parkinson’s disease for long-term exposure, chronic obstructive pulmonary disease, stillbirth, and hypertension for short-term exposure. Health risk assessment (HRA) studies at a global scale found more than 4 million deaths from diseases associated with PM2.5 exposure. These studies also emphasized the importance and benefits of health guidelines that demonstrated to help avoid the number of fatalities significantly, especially guidelines from the World Health Organization (WHO) that showed the highest benefit. HRA studies in Thailand also showed that the country's air quality needs to be improved to avoid deaths and hospital admission cases. We also found that cohort studies for the Thai population are required to improve the quality of data and limit overestimation from using global estimates. Finally, the benefits and limitations of each study approach were collated to assist future studies in determining the most suited instruments for their purposes.

Associations between healthcare costs and care experiences among older adults with and without cancer

IntroductionCare coordination and patient-provider communication are important for older adults with cancer, as they likely have additional, non-cancer chronic conditions requiring consultation across multiple providers. Suboptimal care coordination and patient-provider communication can lead to costly and preventable adverse outcomes. This study examines Medicare expenditures associated with patient-reported care coordination and patient-provider communication among older adults with and without cancer. Materials and MethodsWe explore SEER-CAHPS® (Surveillance, Epidemiology and End Results-Consumer Assessment of Healthcare Providers and Systems) linked data for differences in health care expenditures by care coordination and patient-provider communication experiences for beneficiaries with and without cancer. The cancer cohort included beneficiaries with ten prevalent cancer types diagnosed 2011–2019 at least six months before completing a CAHPS survey. Medicare expenditures were abstracted from Medicare claims data. Care coordination and patient-provider communication composite scores (range 0–100, higher scores indicate better experiences) were patient-reported in the CAHPS® survey. We estimated expenditure differences per one-point change in composite scores for patients with and without cancer. ResultsOur analysis included 16,778 matched beneficiaries with and without a previously diagnosed cancer (N = 33,556). Higher care coordination and patient-provider communication scores were inversely associated with Medicare expenditures among beneficiaries with and without cancer in the six months prior to survey response, ranging from -$83 (standard error [SE] = $7) to -$90 (SE = $6) per month. Six months post-survey, expenditures estimates ranging -$88 (SE = $6) to -$106 (SE = $8) were found. DiscussionWe found that lower Medicare expenditures were associated with higher care coordination and patient-provider communication scores. As the number of survivors living longer both with and beyond their cancer grows, addressing their multifaceted care and improving outcomes will be critical.

Associations between delirium and SARS-CoV-2 pandemic visitor restrictions among hospitalized patients

ObjectivesDelirium is associated with increased morbidity and mortality, but environmental and behavioral factors may decrease the risk of developing delirium and thus must be considered. To investigate trends in delirium prevalence and examine associations of visitor restrictions with delirium diagnoses among all patients hospitalized during and prior to the novel coronavirus SARS-CoV-2 (COVID-19) pandemic. Study designRetrospective epidemiological assessment. MethodsThe medical records of all patients (n = 33,141) hospitalized within a three-hospital academic medical center system in a large Midwestern metropolitan area from March 20, 2019, through March 19, 2021, were analyzed. ResultsThe overall prevalence of delirium during COVID-19 was 11.26% (confidence interval [CI]: 10.79%, 11.73%) compared to 9.28% (CI: 8.82%, 9.73%) before COVID-19. From our adjusted logistic regression analyses, we observed that the odds of delirium among non-isolated patients were significantly higher during COVID-19 visitor restrictions (adjusted odds ratio [aOR]: 1.354; 95% CI: 1.233, 1.488; P < 0.0001) than before. The odds of delirium among isolated patients were not significantly higher during COVID-19 visitor restrictions (aOR: 1.145; 95% CI: 0.974, 1.346; P = 0.1006) than before. ConclusionsMedically isolated patients remained at high risk of developing delirium both prior to and during COVID-19 era visitor restrictions. However, non-medically isolated patients had a significantly increased risk of delirium during the social isolation of visitor restrictions compared to prior to visitor restrictions.

Exposure of students (pupils) and employees of educational institutions in the Leningrad region to natural sources of radiation. Part 1: Results of a comprehensive survey

Currently, there is no methodological support for radiation monitoring and sanitary and epidemiological assessment of radon concentration (or radon EEC) and other parameters of the radiation situation in existing operated buildings. The paper presents a review of the protocols for conducting measurements of indoor Leningrad region with previously found elevated levels of radon concentration using long-term measurements. The survey revealed that highest values of indoor radon ECC were obtained using instant measurements in several educational institutions both in the normal operation mode of the buildings (up to 1106 Bq/m3) and after leaving the premises for 12 hours with closed windows and doors (up to 1586 Bq/m3) according to the requirements of paragraph 6.5 of MU 2.6.1.2838-11. High values of radon concentration were also obtained using long-term and short-term measurements (up to 4900 and 1420 Bq/m3, respectively). In addition, high values of radon flux density were detected (up to 2030 mBq/(m2·s)). The established hygienic norms for ambient dose equivalent rate indoors and outdoors were not exceeded in the surveyed educational institutions. The levels of gross alphaand beta activities in tap water sampled from the surveyed educational institutions were below the control levels, and an exceedance of intervention level for activity concentration of radon in analyzed samples was not detected. The results of the survey will be used for hygienic assessment of doses and health risks for students (pupils) and employees of several educational institutions of the Leningrad region due to exposure to radon and its progeny and can be used to improve the method for indoor radon concentration monitoring in existing operated public buildings in the Russian Federation, which in turn will make it possible to obtain correct values of public doses and health risks.

New onset or relapsing neuromyelitis optica temporally associated with SARS-CoV-2 infection and COVID-19 vaccination: a systematic review.

Neuromyelitis optica spectrum disorder (NMOSD) is a rare chronic neuroinflammatory autoimmune condition. Since the onset of the COVID-19 pandemic, there have been reports of NMOSD clinical manifestations following both SARS-CoV-2 infections and COVID-19 vaccinations. This study aims to systematically review the published literature of NMOSD clinical manifestations associated with SARS-CoV-2 infections and COVID-19 vaccinations. A Boolean search of the medical literature was conducted between December 1, 2019 to September 1, 2022, utilizing Medline, Cochrane Library, Embase, Trip Database, Clinicaltrials.gov, Scopus, and Web of Science databases. Articles were collated and managed on Covidence® software. The authors independently appraised the articles for meeting study criteria and followed PRISMA guidelines. The literature search included all case reports and case series that met study criteria and involved NMOSD following either the SARS-CoV-2 infection or the COVID-19 vaccination. A total of 702 articles were imported for screening. After removing 352 duplicates and 313 articles based on exclusion criteria, 34 articles were analyzed. A total of 41 cases were selected, including 15 patients that developed new onset NMOSD following a SARS-CoV-2 infection, 21 patients that developed de novo NMOSD following COVID-19 vaccination, 3 patients with known NMOSD that experienced a relapse following vaccination, and 2 patients with presumed Multiple Sclerosis (MS) that was unmasked as NMOSD post-vaccination. There was a female preponderance of 76% among all NMOSD cases. The median time interval between the initial SARS-CoV-2 infection symptoms and NMOSD symptom onset was 14 days (range 3-120 days) and the median interval between COVID-19 vaccination and onset of NMO symptoms was 10 days (range 1 to 97 days). Transverse myelitis was the most common neurological manifestation in all patient groups (27/41). Management encompassed acute treatments such as high dose intravenous methylprednisolone, plasmapheresis, and intravenous immunoglobulin (IVIG) and maintenance immunotherapies. The majority of patients experienced a favorable outcome with complete or partial recovery, but 3 patients died. This systematic review suggests that there is an association between NMOSD and SARS-CoV-2 infections and COVID-19 vaccinations. This association requires further study using quantitative epidemiological assessments in a large population to better quantify the risk.

Fibrolamellar hepatocellular carcinoma: An epidemiologic and 5-year cancer survival assessment based off SEER data

The fibrolamellar variant of hepatocellular carcinoma makes up a small percentage of liver tumors. Despite being a subset, it has been noted in the literature to have variations in terms of its epidemiology and intervention recommendations. Using the Surveillance, Epidemiology, and End Results database, 339 cases from 1988 to 2016 were studied. Favorable prognostic epidemiological factors included male sex, younger ages, and white race. Those who underwent any lymph node resection (combined with liver resection) did better than those without lymph node resection; chemotherapy proved beneficial for those where surgery was contraindicated. To our knowledge, this report is the largest conglomerate dataset analyzing prognostic profiles and treatment strategies for fibrolamellar hepatocellular carcinoma.

Epidemiologic assessment of dental health in the military exposed to toxic chemicals

Relevance. Destruction of toxic chemicals is impregnated with hazardous working conditions. In this regard, health monitoring in such workers is subject to more stringent requirements. Occupation-related difficulties in dental care availability cause faster dental health deterioration in the military. This adds relevance to finding and developing modern, rational and effective therapy and prevention measures tailored to specific working conditions the sites of toxic waste destruction.The objective is to evaluate the prevalence and structure of dental diseases and oral cavity disorders in the military exposed to toxic chemicals.Methods. A total of 178 male and female contracted military aged 27-50 years were examined within general medical examination required for admission to work with toxic chemicals. Standard dental methods were used during the examination: interview, visual, physical, and instrumental examinations. Examination data were fed into individual military medical records (form No. 2), as well as into earlier record forms.Results and discussion. Examined patients showed high prevalence of dental diseases (99.4 %), in particular, diseases of dental hard tissues and complicated dental caries. No less than half of the examined (54.5 %) required orthopedic dental treatment. More than 80 % of the examined revealed poor oral hygiene.Conclusion. Considering the high demand (90 %) for sanitation among the military, causing the 25% level of complicated f caries, with average tooth crown destruction score of 0.9 and absence of a staff dentist due to the small size of military units, it is deemed reasonable to involve specialists based on a prior agreed schedule and ensure compliance with developed methods and recommendations.

A Customized Novel Blocking ELISA for Detection of Bat-Origin Swine Acute Diarrhea Syndrome Coronavirus Infection.

Swine acute diarrhea syndrome coronavirus (SADS-CoV) is a newly discovered emerging alphacoronavirus. SADS-CoV shares over 90% genome sequence identity with bat alphacoronavirus HKU2. SADS-CoV was associated with severe diarrhea and high mortality rates in piglets. Accurate serological diagnosis of SADS-CoV infection is key in managing the emerging SADS-CoV. However, thus far there have been no effective antibody-based diagnostic tests for diagnose of SADS-CoV exposure. Here, monoclonal antibody (MAb) 6E8 against SADS-CoV N protein accurately recognized SADS-CoV infection. Then, MAb 6E8 was utilized as a blocking antibody to develop blocking ELISA (bELISA). We customized the rN coating antigen with concentration 0.25 μg/mL. According to receiver operator characteristic curve analysis, the cutoff value of the bELISA was determined as 38.19% when the max Youden index was 0.955, and specificity was 100%, and sensitivity was 95.5%. Specificity testing showed that there was no cross-reactivity with other serum positive swine enteric coronaviruses, such as porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine deltacoronavirus (PDCoV), porcine rotavirus (PoRV), and porcine sapelovirus (PSV). In conclusion, we customized a novel and high-quality blocking ELISA for detection of SADS-CoV infection, and the current bELISA will be linked to a clinical and epidemiological assessment of SADS-CoV infection. IMPORTANCE SADS-CoV was reported to be of high potential for dissemination among various of host species. Accurate serological diagnosis of SADS-CoV infection is key in managing the emerging SADS-CoV. However, thus far there have been no effective antibody-based diagnostic tests for diagnose of SADS-CoV exposure. We customed a novel and high-quality bELISA assay for detection of SADS-CoV N protein antibodies, and the current bELISA will be linked to a clinical and epidemiological assessment of SADS-CoV infection.

Optimal Treatment of Proximal Humeral Fractures in the Elderly: Risks and Management Challenges.

Proximal humeral fractures (PHFs) are a common type of fracture, particularly in older adults, accounting for approximately 5-6% of all fractures. This article provides a comprehensive review of PHFs, focusing on epidemiology, injury mechanism, clinical and radiographic assessment, classification systems, and treatment options. The incidence of PHFs varies across regions, with rates ranging from 45.7 to 60.1 per 100,000 person-years. Females are more susceptible to PHFs than males, and the incidence is highest in women over the age of 85. The injury mechanism of PHFs is typically bimodal, with high-energy injuries predominant in younger individuals and low-energy injuries in the elderly. Clinical assessment of PHFs involves obtaining a thorough history, physical examination, and evaluation of associated injuries, particularly neurovascular injuries. Radiographic imaging helps assess fracture displacement and plan for treatment. The Neer classification system is the most commonly used classification for PHFs, although other systems, such as AO/OTA, Codman-Hertel, and Resch classifications, also exist. The choice of treatment depends on factors such as patient age, activity level, fracture pattern, and surgeon expertise. Nonoperative management is typically preferred for elderly patients with minimal displacement, while operative fixation is considered for more complex fractures. Nonoperative treatment involves sling immobilization followed by physiotherapy, with good outcomes reported for certain fracture patterns. Operative management options include closed reduction and percutaneous pinning (CRPP), open reduction and internal fixation (ORIF), or arthroplasty. CRPP is suitable for specific fracture patterns, but the quality of reduction is crucial for favorable outcomes. ORIF is used when CRPP is not feasible, and various surgical approaches are available, each with its advantages and potential complications. PHFs are a significant clinical challenge due to their prevalence and complexity. Treatment decisions should be patient centered based on patient factors and fracture severity.