Epidemiological Data Research Articles

Pipkin fractures: fracture type-specific management.

Femoral head fractures are rare, which limits the experience of individual surgeons with these injuries. This overview examines historical data, injury mechanisms, and classification systems, as well as epidemiological data from larger patient cohorts. Significant controversies persist regarding the optimal surgical approach and fracture-type-specific treatment for Pipkin fractures. The literature is often inconsistent, as many studies fail to differentiate between specific fracture types and instead report aggregated results, leading to ambiguous conclusions about the most effective treatment strategies. Thus, this article reviews fracture-type-specific outcomes of both non-operative and operative treatments over the past 25 years and summarizes their clinical implications, with the aim of assisting surgeons in their decision-making processes.

Global impact of antimicrobial resistance on cancer care: Challenges and strategies in low- and middle-income countries

Antimicrobial resistance (AMR) is a fast-rising global health warning that causes significant challenges to the treatment and management of infectious diseases, especially in cancer patients, who are a large number of the vulnerable populations. This work underlines the complicated problems faced by the low- and middle-income countries (LMICs) in cancer care due to AMR. The burden of both cancer and AMR is sadly high, so therefore this review sheds light into the possible potential strategies to win against these challenges and set up better cancer treatment for improved outcomes in these countries. This sheds more light and gives a deeper understanding of recent research works, epidemiological data, and relevant case studies. Furthermore, examining the interconnectivity between AMR and cancer care, narrowing it down to some particular challenges and vulnerabilities encountered by cancer patients in LMICs. The study identifies key strategies such as implementing better antimicrobial stewardship programs, improving infection prevention and control, promoting new drug development, and enhancing global interactions as important steps in reducing the effect of AMR on cancer care in LMICs. This emphasizes the urgent need for targeted interventions, context-specific solutions, building sustainable development, and global interactions to address the complex challenges posed by AMR in cancer care within LMICs.

Nosocomial Outbreak of SARS-CoV-2 in a Hospital Ward during the Omicron Variant-Dominant Wave with a Review of the Relevant Literature.

Clusters of nosocomial coronavirus disease 2019 (COVID-19) have been reported globally during the recent pandemic. Unfortunately, these clusters negatively affect inpatient morbidity, mortality, and hospital functioning. Using epidemiological data and whole-genome sequencing (WGS) of SARS-CoV-2, this study investigated the outbreak of COVID-19 at a university hospital. Eight inpatients and 13 healthcare workers tested positive for SARS-CoV-2 during a 1-month period. WGS of the virus in 11 patients revealed that the two variants of concern belonging to the Omicron sublineages, BA.2.3 and BA1.1.2, caused an outbreak when the proportion of the Omicron lineage in the community changed. When variants of concern undergo mutation, a response to the outbreak should be made with multiple variants in mind, even in the absence of epidemiological data showing close contact or other potential vectors of infection. Awareness of infection prevention and control should be raised to safeguard patient safety.

Analysis of the impact of coronavirus infection on human health: epidemiological data, vaccination strategies, psychological aspect, consequences (literature review)

The COVID-19 (COronaVIrus Disease 2019) pandemic has caused widespread morbidity, mortality, and socioeconomic crisis around the world. Since its first outbreak in 2019, COVID-19 has evolved continuously, leading to the emergence of several variants that have gained greater transmission efficiency, severity, and immune evasion properties. Vaccination has proven to be an important strategy to control the spread of the virus and mitigate its impact. The development of multiple COVID-19 vaccines within 1 year of the virus's emergence was unprecedented. The purpose of the article was to analyze and summarize the scientific literature on the impact of COVID-19 on global health, including epidemiological data, vaccination strategies, psychological impact of the pandemic, and human health outcomes. The analysis found that COVID-19 vaccination has been very effective in reducing morbidity, hospitalizations and intensive care unit admissions. However, ongoing surveillance, monitoring of options and adaptive vaccination strategies are crucial to maximize the benefits of vaccination and effectively control the spread of the virus. Globally, the dramatic and rapid spread of COVID-19 has triggered social changes that have led to an increased burden of mental health and fear-related behaviors. The physical and social distancing imposed in many parts of the world has had a significant impact on how the general population communicates and interacts with each other. Extreme avoidance of the lack of social contact has created a sense of "disconnection" that has been further exacerbated by the inability to meet friends and family at social gatherings and supportive places such as churches, restaurants, workplaces, and sports facilities. The closure of schools and many businesses, along with rising unemployment, further exacerbated feelings of isolation, financial hardship, anxiety, and depression. The article provides information on the mental impact of COVID-19 on patients, namely, the virus contributes to mental distress, anxiety, depression, suicide risk, post-traumatic stress disorder, cognitive impairment and sleep disorders. Keywords: COVID, spread, vaccines, anxiety, depression.

Gastroenteropancreatic neuroendocrine neoplasms: epidemiology, genetics, and treatment.

The incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP NEN) is increasing at a rapid pace and is becoming an increasingly important consideration in clinical care. Epidemiological data from multiple countries indicate that the incidence of gastroenteropancreatic neuroendocrine neoplasms (GEP NEN) exhibits regional, site-specific, and gender-based variations. While the genetics and pathogenesis of some GEP NEN, particularly pancreatic NENs, have been investigated, there are still many mechanisms that require further investigation. The management of GEP NEN is diverse, but surgery remains the primary option for most cases. Peptide receptor radionuclide therapy (PRRT) is an effective treatment, and several clinical trials are exploring the potential of immunotherapy and targeted therapy, as well as combination therapy.

Aquaporin-4 IgG Antibody Detection in Neuromyelitis Optic Spectrum Disorder

Objective: To develop a sensitive and reliable diagnostic approach for optic neuromyelitis (ONM), an overexpressing cell line capable of detecting aquaporin 4 (AQP4) antibodies was established. Subsequently, immunofluorescence was employed to detect AQP4 antibodies in serum and cerebrospinal fluid (CSF) samples from patients. Additionally, the clinical utility of AQP4 antibodies in the detection of ONM patients was analyzed. Methods: An aquaporin 4 expression plasmid was constructed and transfected into cell lines. Subsequently, indirect immunofluorescence was utilized to detect anti-AQP4 antibodies in serum and cerebrospinal fluid samples. Results: The indirect immunofluorescence detection system exhibited high sensitivity in the detection of 2241 clinical samples, with a positive rate of 16.8%. The positive proportion was in line with epidemiological data, and the positive situation was consistent with clinical symptoms. Conclusion: The engineered cell line exhibits superior detection performance for identifying antibodies present in serum and cerebrospinal fluid samples. The capability to detect anti-aquaporin 4 antibodies is pivotal for improving the efficiency of screening and diagnosing neuromyelitis optica, thereby possessing considerable potential for clinical application.

Prevalence, Characteristics, and Treatment Strategy of Different Types of Heart Failure in Patients With Nonvalvular Atrial Fibrillation.

Atrial fibrillation (AF) is the most common arrhythmia in patients with heart failure (HF). Epidemiological data regarding HF in patients with AF are lacking. We describe the epidemiology, clinical features, treatment strategies, and in-hospital outcomes in patients with AF and HF. Patients with HF and nonvalvular AF in the Improving Care for Cardiovascular Disease in China-AF cohort from February 2015 to December 2019 were included. Patients were stratified by left ventricular ejection fraction into HF with reduced EF, HF with mildly reduced EF, and HF with preserved EF groups. The primary outcome was the occurrence of hospitalization for major adverse cardiovascular events, including death, cardiogenic shock, cardiac arrest, and stroke. Overall, 16 562 patients with AF and HF were included (mean age: 72.35±11.07 years; 46.1% female). HF with preserved EF (63.1%) accounted for the largest proportion, followed by HF with mildly reduced EF (19.0%) and HF with reduced EF (17.9%). Different HF subtypes in patients with AF had unique baseline demographic and clinical characteristics after multinomial logistic regression analysis. Compared with the HF with preserved EF group, hospitalization for major adverse cardiovascular events was increased in the HF with mildly reduced EF group (odds ratio=1.55 [95% CI, 1.18-2.03]) and HF with reduced EF group (odds ratio 1.60 [95% CI, 1.21-2.13]) after adjusting for confounders. In this large Chinese AF registry, the distribution of HF differed from the non-AF population. Patients with AF with different types of HF have unique demographic and clinical characteristics. Occurrence rates of in-hospital outcomes were higher in patients with HF with mildly reduced EF and patients with HF with reduced EF compared with the HF with preserved EF group. URL: http://www.clinicaltrials.gov; Unique identifier: NCT02309398.

Radiotherapy for hypopharyngeal carcinoma in Senegal: Experience of the main cancer care facility

Objectives: To describe the epidemiological, diagnostic, therapeutic, and prognostic factors associated with patients treated for hypopharyngeal carcinoma at the Radiotherapy Department of the National Hospital Center Dalal Jamm. Patients and Methods: Data from 50 consecutive patients treated for hypopharyngeal carcinoma between 2018 and 2022 were retrospectively analyzed. All patients received three-dimensional conformal radiotherapy (3DCRT) with or without chemotherapy. Epidemiological and diagnostic data, treatment details, and therapeutic outcomes were collected in an Excel 2016 database created for the study. Statistical analyses were performed using SPSS version 20.0. Overall survival estimates were generated using the Kaplan-Meier method. Statistical significance was considered at p = 0.05. Uni- and multivariate analyses were conducted to identify prognostic factors associated with survival. Results: The average age of the patients was 44 years (± 14.4 years), with a male-to-female ratio of 0.56. Sixteen percent of the patients were active smokers and 4% were alcohol consumers. The mean delay to the first consultation was 6 months, and dysphagia was the primary symptom (92%). The majority of patients (89.8%) were classified as stage IVa, and 10% had metastases at diagnosis. Treatment consisted of curative concurrent chemoradiotherapy (95.92%), preceded by induction chemotherapy in 58% of patients. A radiation dose of 70 Gy was utilized in 75% of cases. The 2-year overall survival rate was 25%. Multivariate analysis indicated that the presence of feeding gastrostomy (p=0.044), use of induction chemotherapy (p=0.012), and radiation dose less than 70 Gy (p=0.020) were associated with poorer survival. Conclusion: Concurrent chemoradiotherapy using 3D conformal techniques improved management, although outcomes remain unsatisfactory. Prospective cohort studies are imperative to identify specific risk factors in our population. Additionally, timely access to appropriate treatment modalities could enhance prognosis.

Reproductive factors and mammographic density within the International Consortium of Mammographic Density: A cross-sectional study

BackgroundElevated mammographic density (MD) for a woman’s age and body mass index (BMI) is an established breast cancer risk factor. The relationship of parity, age at first birth, and breastfeeding with MD is less clear. We examined the associations of these factors with MD within the International Consortium of Mammographic Density (ICMD).MethodsICMD is a consortium of 27 studies with pooled individual-level epidemiological and MD data from 11,755 women without breast cancer aged 35–85 years from 22 countries, capturing 40 country-& ethnicity-specific population groups. MD was measured using the area-based tool Cumulus. Meta-analyses across population groups and pooled analyses were used to examine linear regression associations of square-root (√) transformed MD measures (percent MD (PMD), dense area (DA), and non-dense area (NDA)) with parity, age at first birth, ever/never breastfed and lifetime breastfeeding duration. Models were adjusted for age at mammogram, age at menarche, BMI, menopausal status, use of hormone replacement therapy, calibration method, mammogram view and reader, and parity and age at first birth when not the association of interest.ResultsAmong 10,988 women included in these analyses, 90.1% (n = 9,895) were parous, of whom 13% (n = 1,286) had ≥ five births. The mean age at first birth was 24.3 years (Standard deviation = 5.1). Increasing parity (per birth) was inversely associated with √PMD (β: − 0.05, 95% confidence interval (CI): − 0.07, − 0.03) and √DA (β: − 0.08, 95% CI: − 0.12, − 0.05) with this trend evident until at least nine births. Women who were older at first birth (per five-year increase) had higher √PMD (β:0.06, 95% CI:0.03, 0.10) and √DA (β:0.06, 95% CI:0.02, 0.10), and lower √NDA (β: − 0.06, 95% CI: − 0.11, − 0.01). In stratified analyses, this association was only evident in women who were post-menopausal at MD assessment. Among parous women, no associations were found between ever/never breastfed or lifetime breastfeeding duration (per six-month increase) and √MD.ConclusionsAssociations with higher parity and older age at first birth with √MD were consistent with the direction of their respective associations with breast cancer risk. Further research is needed to understand reproductive factor-related differences in the composition of breast tissue and their associations with breast cancer risk.

"Understanding and treating baras (vitiligo) in unani medicine: historical perspectives, pathophysiology, and therapeutic approaches".

Vitiligo, also known as a in Unani medicine, causes patches of depigmented skin due to the loss of melanocytes. According to ancient Unani scholars, factors like excessive phlegm in the blood and weakened color-controlling power were believed to be the cause. This study dives into the historical insights of luminaries like Majūsī and Hakim Akbar Arzānī, alongside modern medical understanding. It explores the pathophysiology, epidemiology, and clinical features of vitiligo, while also addressing confusing definitions, dietary influences, and demographic patterns. We take a close look at the classification, prognosis, and investigative methods. The aim of this research is to bring together traditional and modern perspectives to fully understand vitiligo, covering its cultural, historical, and scientific aspects. By incorporating epidemiological data, dietary considerations, and insights into the underlying mechanisms, we enhance diagnostic and treatment approaches. In conclusion, this study establishes a cohesive connection between the historical wisdom of Unani medicine and the current scientific discourse on vitiligo. By merging these perspectives, we gain a comprehensive understanding of the condition, enabling a more holistic approach to diagnosis and management. As dermatological research continues to evolve, the integration of traditional and modern insights becomes crucial in effectively addressing complex skin disorders like vitiligo.

Epidemiology of traumatic spinal cord injury in Ireland, 2017-2022.

Retrospective population based study on traumatic spinal cord injury (SCI) in Ireland. To gather the most recent epidemiological data prior to the implementation of a new national trauma strategy. Also, to consider if the COVID-19 pandemic impacted on SCI epidemiology in Ireland. Republic of Ireland. All patients with TSCI discharged from the National Rehabilitation Hospital (NRH), the national acute SCI unit and two neurosciences centres were included. The International Spinal Cord Injury Core Data Set was collected on all patients at discharge from rehabilitation between 2017 and 2022. Overall crude incidence of TSCI was 14 per million per year, ranging between 11.3 and 18.4. 12.7% of patients did not survive to discharge from hospital. In those completing rehabilitation, the mean age of injury onset was 50.1 years (SD 19.9). Males accounted for 75.7%. The most common impairment was incomplete tetraplegia, 45.3% of all TSCI. Leading aetiology was falls, 53.9% of injuries. Patients with incomplete tetraplegia and those whose cause of injury were falls were older than those with all other impairments and injury aetiologies (p < 0.001). Overall incidence of TSCI is similar to our previous studies. Also similar is the predominant pattern of older people sustaining falls resulting in incomplete tetraplegia.

Prokinetic agents in adult intensive care unit patients (PATIENCE)-An international inception cohort study protocol.

Feeding intolerance is common in critically ill patients and can lead to malnutrition. Prokinetic agents may be used to enhance the uptake of nutrition. However, the evidence on the effectiveness and safety of prokinetic agents is sparse, and there is a lack of data on their use in intensive care units (ICU). We will conduct an international 14-day inception cohort study of 1000 acutely admitted adult ICU patients. Data will be collected from ICU admission and daily during ICU stay for up to 90 days. The primary outcome will be the proportion of ICU patients who receive prokinetic agents. Secondary outcomes include mortality, days alive without life support, days alive out of ICU, days alive out of hospital (all within 90 days) and the number of patients with one or more serious adverse events. We will present data on the use of prokinetic agents descriptively and use Cox regressions with death and ICU discharge as competing events to evaluate the association between patient characteristics and the use of prokinetic agents. We will use extended Cox models with time-varying covariates and linear regression models to assess the associations between the use of prokinetic agents and the secondary outcomes. The outlined international cohort study will provide valuable epidemiological data on the use of prokinetic agents in adult, acutely admitted ICU patients.

Algorithm 1047: FdeSolver, a Julia Package for Solving Fractional Differential Equations

We introduce FdeSolver, an open-source Julia package designed to solve fractional-order differential equations efficiently. The available solutions are based on product-integration rules, predictor–corrector algorithms, and the Newton-Raphson method. The package covers solutions for one-dimensional equations with orders of positive real numbers. For higher-dimensional systems, it supports orders up to one. Incommensurate derivatives are allowed and defined in the Caputo sense. Here, we summarize the implementation for a representative class of problems and compare it with available alternatives in Julia and MATLAB. Moreover, FdeSolver leverages the power and flexibility of the Julia environment to offer enhanced computational performance, and our development emphasizes adherence to the best practices of open research software. To highlight its practical utility, we demonstrate its capability in simulating microbial community dynamics and modeling the spread of COVID-19. This latter application involves fitting the order of derivatives grounded on real-world epidemiological data. Overall, these results highlight the efficiency, reliability, and practicality of the FdeSolver Julia package.

A systematic review and meta-analysis of the prevalence of Parkinson's disease in lower to upper-middle-income countries.

Parkinson's disease (PD) is a common neurodegenerative disease that is a growing public health challenge. Estimates of the burden of PD have focused on data from high-income countries, with lower-income countries poorly described. We reviewed and examined the prevalence of PD reported by studies in low- to upper-middle-income countries. A systematic literature search was performed in the Medline/PubMed, Embase, LILACS, and Web of Science databases. Age group, sex, and geographic region were considered when analyzing the data. Of the 4327 assessed articles, 57 met the inclusion criteria for qualitative review, and 36 were included in the meta-analysis. Heterogeneity measures were high both as a whole and in each geographic region. Data analysis by geographic region showed that reported prevalence differed across regions, ranging from 49 per 100,000 (Sub-Saharan Africa) to 1081 per 100,000 (Latin America and the Caribbean). There was an increasing prevalence of PD with advancing age (per 100,000): 7 in 40-49 years, 158 in 50-59 years, 603 in 60-69 years, 1251 in 70-79 years, and 2181 in over the age of 80. The prevalence of PD in men and women was similar. There was a greater PD prevalence in populations with a higher 5-year GDP per capita and a higher life expectancy. Our findings suggest a higher prevalence of PD in lower and upper-middle-income countries than previously reported. Comparisons between regions are difficult, as the sociocultural differences and lack of methodological standardization hinder understanding key epidemiological data in varied populations.

Global Insights and Trends in Research on Dermatophytes and Dermatophytosis: A Bibliometric Analysis.

Dermatophytosis, caused by dermatophytes, affects up to 25% of people globally, with higher rates observed in Africa and Asia. While these infections are usually superficial, they can become severe in immunocompromised individuals. Despite their high prevalence, scientific research on dermatophytes is limited and the epidemiological data available are insufficient. In addition, diagnostic methods are not standardised and there are challenges with resistance to antifungals. This study aimed to conduct a bibliometric analysis of scientific publications related to dermatophytes and dermatophytosis to assess research output and trends. A bibliometric analysis of publications from 2000 to 2023 in Web of Science and Scopus examined trends, citation counts, publication types, key journals, top authors and institutions and funding sources. The analysis revealed a significant increase in dermatophyte-related publications, with 15,868 articles retrieved from the Web of Science and 23,189 from Scopus. Research articles dominated the output, constituting 76.2% in Web of Science and 80% in Scopus. Peak publication years were 2019, 2021 and 2022 in Web of Science, and 2020, 2021 and 2023 in Scopus, with lower output between 2000 and 2002. The United States and India were the leading contributors, followed by Brazil and China, though citation metrics varied. Although there has been a rise in the number of publications, the amount of research conducted on dermatophytes is still very limited in comparison with other types of fungal diseases. Dermatophyte-related research has increased over the past 2 decades. However, research gaps remain, particularly compared with other fungal diseases. Advances in diagnostics, antifungal testing and taxonomic classification are urgently needed. The study underscores the need for continued research and global collaboration to address these issues.

Epidemiological survey of two morphotypes of Demodex folliculorum (Prostigmata: Demodicidade) in young people from southern Spain

Different morphotypes of Demodex from humans have been described. Among them, molecular studies have made it possible to discern between the Demodex folliculorum and Demodex brevis. Further studies showed two morphotypes of D. folliculorum harboured two different habits (human skin and human eyelashes), both of them with finger-shaped terminal opisthosoma difficult to differentiate and that can be assigned to D. folliculorum,Thus, a complete morphometric study of the species, which in this study are referred to as Demodex folliculorum species complex, was carried out. From this morphometric and meristic study two distinct morphological forms (short and long) could be identified within the Demodex folliculorum species complex. These forms differ significantly in four out of the six biometric parameters we analysed: gnathosomal length and width, podosomal width, and opisthosomal length. Moreover, a comprehensive survey of the two morphotypes from different habitats (skin and eyelashes), was carried out in young people of Southern Spain. Therefore, an analysis of 104 asymptomatic students, which were contact lens wearers, and the presence of D. folliculorum was carried out. A statistical analysis based on Bayesian zero inflated Poisson GLM has been applied to our sample data. For the age group considered (18–24 years old), the overall D. folliculorum prevalence for skin face or eye infections (at least one of them) was 19.31 % (51 people), with a statistically significant higher prevalence in males men. Furthermore, there is a slight statistical correlation between the presence of Demodex in silicone hydrogel soft contact lens wearers. This study confirms: i) the existence of two morphotypes of D. folliculorum that appear segregated due to the parasitization microhabitats,ii) a higher prevalence of mites in men than in women, iii) the existence of a high number of statistically supported double infections (skin-eyelashes). It also provides epidemiological data on the prevalence of long and short forms of D. folliculorum in a healthy young population.

Improving the integration of epidemiological data into human health risk assessment: What risk assessors told us they want

One of the practical contributions of epidemiology studies is to inform risk assessment and management to protect public health. However, there is a perception among some that environmental and occupational epidemiology is falling short of satisfying the needs of risk assessors. The specific reasons for this are not clearly understood. To help identify the points of dissatisfaction and possible areas for mutual learning, we conducted a survey of risk assessors, seeking their opinions of epidemiology research. We present a few quantitative measures and a thematic analysis of responses to open-ended questions. Survey results suggest that some risk assessors (with some adamant exceptions) believe that epidemiology has great potential to contribute to risk assessment but can be deficient in many ways. For example, respondents identified the lack of full disclosure of methods, deficiencies in exposure assessment, the absence of comprehensive uncertainty analyses, and the failure to investigate or explore thresholds of effects as some of the common shortcomings. These could be straightforward to address. Respondents also brought up a wide collection of more complicated and subtle concerns that could lead to further improvement of useful results. We identify areas where mutually-educating interdisciplinary dialogue seems particularly promising. Epidemiology research is expensive, and risk management decisions even more so; therefore, it is desirable for the risk assessment and epidemiologic communities to work toward making epidemiologic research more useful for informing decisions.

The Spectrum of Adrenal Lesions in a Tertiary Referral Center.

Adrenal tumors are a common finding in clinical practice, and only detailed evaluation may reveal secretory and metabolic abnormalities or their malignant character. We aimed to highlight epidemiological data, rates of malignancy, clinical or secretory characteristics, and the cardiometabolic implications of adrenal masses. We conducted a retrospective analysis using data from the medical files of 474 patients with adrenal pathology hospitalized between January 2007 and January 2020, before the COVID-19 pandemic, using the ICD-10 codes. After applying inclusion and exclusion criteria, a total of 264 patients with adrenal tumors were enrolled in the study. Patients underwent clinical examination, abdominal imaging, and hormonal evaluation, and some of them underwent a pathological exam after adrenalectomy. Median age at diagnosis was 56 (17) years, with 81.06% of patients being female. The median follow-up period was 41.5 (70) months, ranging from 6 months to 13 years. Adrenal tumors were most frequently seen in older female patients, with 83.47% of them being over 40 years old. The malignancy rate was 4.54%. Hormonally nonfunctioning tumors (71.95%) predominated, and overt hypercortisolism was present in 10.61% of patients, as was mild autonomous cortisol secretion in 5.31% of patients, primary hyperaldosteronism in 8.71% of patients, and adrenal paraganglioma in 3.41% of patients. Cardiometabolic comorbid conditions were similar in patients with functioning and nonfunctioning tumors. All patients with adrenal tumors should receive a complete hormonal workup and detailed malignancy risk assessment. Even though a hormonally active tumor predisposes to cardiometabolic comorbid conditions, a nonfunctioning lesion may also be associated with such disorders and needs thorough assessment.

The Forecasting of the Spread of Infectious Diseases Based on Conditional Generative Adversarial Networks

New epidemics encourage the development of new mathematical models of the spread and forecasting of infectious diseases. Statistical epidemiology data are characterized by incomplete and inexact time series, which leads to an unstable and non-unique forecasting of infectious diseases. In this paper, a model of a conditional generative adversarial neural network (CGAN) for modeling and forecasting COVID-19 in St. Petersburg is constructed. It takes 20 processed historical statistics as a condition and is based on the solution of the minimax problem. The CGAN builds a short-term forecast of the number of newly diagnosed COVID-19 cases in the region for 5 days ahead. The CGAN approach allows modeling the distribution of statistical data, which allows obtaining the required amount of training data from the resulting distribution. When comparing the forecasting results with the classical differential SEIR-HCD model and a recurrent neural network with the same input parameters, it was shown that the forecast errors of all three models are in the same range. It is shown that the prediction error of the bagging model based on three models is lower than the results of each model separately.

Introduction of nirsevimab in Catalonia, Spain: description of the incidence of bronchiolitis and respiratory syncytial virus in the 2023/2024 season.

Respiratory syncytial virus (RSV) causes most of the cases of bronchiolitis and thousands of deaths annually, particularly in infants less than 6months old. In Catalonia (Spain), infants born between April 2023 and March 2024 aged 0-6months during their first RSV season have been candidates to receive nirsevimab, the novel monoclonal antibody against RSV, since October 2023. We aimed to analyse the dynamics of all-causes bronchiolitis diagnoses and RSV community infections in the current season and compare them to pre-nirsevimab epidemics. We collected epidemiological data from the Information System for Surveillance of Infections in Catalonia (SIVIC) on daily all-causes bronchiolitis clinical diagnoses and RSV-confirmed cases provided by rapid antigen tests in primary care practices. We calculated the rate ratio (RR) for the incidence of all-causes bronchiolitis for children aged 0-11m-old with respect to 12-35m-old between September 2014 and January 2024. We analysed the RR of the incidence of RSV-confirmed infection for 0-11m-old and 12-35m-old with respect to the > 35m-old, from January 2021 to January 2024. We then computed the relative difference of the RR, designated as percentage of reduction of risk, between season 2023/2024 and former epidemics. With a global coverage recorded rate for nirsevimab of 82.2% in January 2024, the age-specific 0-11m-old RR (95% CI) of RSV infection incidence for > 35m-old was 1.7 (1.5-2.0) in season 2023/2024. The RR (95% CI) had been 7.4 (5.6-9.9), 8.8 (6.9-11.3), and 7.1 (5.7-8.9) in 2020/2021, 2021/2022, and 2022/2023, respectively. Regarding the incidence of all-causes bronchiolitis for the 0-11m-old group compared to the 12-35m-old, the pre-pandemic (2014/2015-2019/2020) and 2022/2023 RR (95% CI) were 9.4 (9.2-9.6) and 6.0 (5.7-6.2), respectively, significantly higher than the RR of 3.6 (3.4-3.8) for the most recent season, 2023/2024. Conclusion: Concurring with the introduction of nirsevimab, the risk of RSV infection for infants aged 0-11m-old compared to > 35m-old has been reduced by 75.6% (73.4-77.5) in last season, and the risk for all-causes bronchiolitis for 12-35m-old by 61.9% (60.9-62.9) from the pre-pandemic period and by 39.8% (39.3-40.2) from the 2022/2023 epidemic, despite high RSV community transmission, especially in older infants What is Known: • RSV is responsible for approximately 70% of bronchiolitis cases and causes severe disease, particularly in infants < 6months of age. • Nirsevimab effectiveness against RSV-associated disease, particularly hospitalisations, was expected to be around 80%; other Spanish regions, such as Galicia and Valencia, and European countries including Luxembourg and Germany, have already reported good results in implementing nirsevimab to prevent RSV-associated hospitalisations and PICU stays. What is New: • We provide insight into the community incidence of RSV and all-causes bronchiolitis for season 2023/2024, when nirsevimab has been introduced to the Catalan population, using. primary healthcare data, which enabled us to assess the burden of RSV infections and bronchiolitis in the commonly seasonally saturated primary healthcare practices. • Our study reveals that the risk of all-causes bronchiolitis for infants aged 0-11m-old compared to older infants was reduced by 40% compared to the previous season and 62% compared to pre-pandemic standards, and for RSV infection it was reduced by 76%.