High Priority Group Research Articles

Development of a TaqMan probe-based multiplex real-time PCR for the simultaneous detection of four clinically important filamentous fungi.

World Health Organization developed the first fungal priority pathogens list (WHO FPPL) in 2022. Aspergillus fumigatus, Mucorales, Fusarium spp., and Histoplasma spp. are the four types of pathogenic fungi with filamentous morphology in the critical priority group and high priority group of WHO FPPL. These four filamentous fungal infections have become more common and severe in immunocompromised patients with the increase in susceptible populations in recent decades, which resulted in a substantial burden on the public health system. However, prompt and precise identification of them during infection remains challenging. Our study established successfully a TaqMan probe-based multiplex real-time qPCR assay for four clinically important filamentous fungi, A. fumigatus, Fusarium spp., Mucorales, and Histoplasma capsulatum, with high sensitivity and specificity, which shows promising potential for prompt and precise diagnosis against fungal infection.

Recognizing high-priority disinfection byproducts based on experimental and predicted endocrine disrupting data: Virtual screening and in vitro study

So far, about 130 disinfection by-products (DBPs) and several DBPs-groups have had their potential endocrine-disrupting effects tested on some endocrine endpoints. However, it is still not clear which specific DBPs, DBPs-groups/subgroups may be the most toxic substances or groups/subgroups for any given endocrine endpoint. In this study, we attempt to address this issue. First, a list of relevant DBPs was updated, and 1187 DBPs belonging to 4 main-groups (aliphatic, aromatic, alicyclic, heterocyclic) and 84 subgroups were described. Then, the high-priority endocrine endpoints, DBPs-groups/subgroups, and specific DBPs were determined from 18 endpoints, 4 main-groups, 84 subgroups, and 1187 specific DBPs by a virtual-screening method. The results demonstrate that most of DBPs could not disturb the endocrine endpoints in question because the proportion of active compounds associated with the endocrine endpoints ranged from 0 (human thyroid receptor beta) to 32% (human transthyretin (hTTR)). All the endpoints with a proportion of active compounds greater than 10% belonged to the thyroid system, highlighting that the potential disrupting effects of DBPs on the thyroid system should be given more attention. The aromatic and alicyclic DBPs may have higher priority than that of aliphatic and heterocyclic DBPs by considering the activity rate and potential for disrupting effects. There were 2 (halophenols and estrogen DBPs), 12, and 24 subgroups that belonged to high, moderate, and low priority classes, respectively. For individual DBPs, there were 23 (2%), 193 (16%), and 971 (82%) DBPs belonging to the high, moderate, and low priority groups, respectively. Lastly, the hTTR binding affinity of 4 DBPs was determined by an in vitro assay and all the tested DBPs exhibited dose-dependent binding potency with hTTR, which was consistent with the predicted result. Thus, more efforts should be performed to reveal the potential endocrine disruption of those high research-priority main-groups, subgroups, and individual DBPs.

예비특수교사의 AI⋅디지털 역량에 대한 인식 및 우선순위 분석

The purpose of this study was to derive priorities by investigating the awareness of AI⋅digital competencies for pre-service special education teachers and analyzing the importance and performance of each AI⋅digital sub-competence. To achieve the purpose of the study, a survey was conducted on 95 pre-service special education teachers using the AI⋅digital competence system of pre-service and in-service teachers developed through the AIEDAP project. IPA analysis was performed for data analysis, Borich needs analysis was calculated, and LF model analysis was performed. Results were as follows; First, the AI⋅digital competencies of pre-service special education teachers were shown to be at the beginner or intermediate level, and the competencies in the areas of teaching performance were somewhat low. Second, as a result of the LF model analysis, there were 8 required competencies in the highest priority group that were located in the HH quadrant and showed high Borich needs. Third, high-priority competencies mainly corresponded to education practice areas, especially, the areas of education-context analysis and teaching performance. The implications of the research results were discussed focusing on the diagnosis of the AI⋅digital competencies of pre-service special education teachers, the necessity of programs to enhance AI⋅digital competencies, and considerations when constructing programs. The limitations of the study and suggestions for future research were discussed.

Differences in antibiotic use between COPD and non-COPD residents based on the health information system.

To compare the differences in antibiotic use between COPD and non-COPD residents, and to explore the effect of COPD on antibiotic use. Participants aged 40 years old or over from the Songjiang Adult Cohort were included. Information on prescription and baseline survey was collected based on the health information system. A logit-negative binomial Hurdle model was used to explore correlations between COPD and percentage of antibiotic use and average rate of antibiotic prescribing of different types of antibiotic. Multinomial logistic regression was used to assess the association between COPD and antimicrobial combination therapy and routes of administration. A total of 34576 individuals were included and 1594 (4.6%) were COPD patients. During the 6 years' follow-up, the percentage of antibiotic use for COPD patients was 98.4%, which was 7.88 (95%CI: 5.24-11.85) times of that for non-COPD patients after adjusting for potential confounders. The prescribing rate was 3220 prescriptions (95%CI: 3063.6-3385.2) per 1000 person-years for COPD patients, which was 1.96 (95%CI: 1.87-2.06) times of that for non-COPD patients. Other beta-lactam antibacterials, Macrolides, lincosamides and streptogramins, and quinolone antibacterials were the most commonly used types of antibiotic. Except for aminoglycoside antibacterials, both percentage of antibiotic use and rate of antibiotic prescription were increased in COPD patients. COPD patients were more likely to be prescribed a maximum of two antibiotics (OR=1.34, 95%CI: 1.20-1.50); and were more likely to use antibiotics intravenously (OR=2.77, 95%CI: 2.47-3.11). COPD patients were more likely to have increased antibiotic use in a large-scale population-based adult cohort, suggesting COPD patients are a high-priority group for the management of antibiotic use in communities.

Adoption and Sustained Use of Primary Care Video Visits Among Veterans with VA Video-Enabled Tablets.

In 2020, the U.S. Department of Veterans Affairs (VA) expanded an initiative to distribute video-enabled tablets to Veterans with limited virtual care access. We examined patient characteristics associated with adoption and sustained use of video-based primary care among Veterans. We conducted a retrospective cohort study of Veterans who received VA-issued tablets between 3/11/2020-9/10/2020. We used generalized linear models to evaluate the sociodemographic and clinical factors associated with video-based primary care adoption (i.e., likelihood of having a primary care video visit) and sustained use (i.e., rate of video care) in the six months after a Veteran received a VA-issued tablet. Of the 36,077 Veterans who received a tablet, 69% had at least one video-based visit within six months, and 24% had a video-based visit in primary care. Veterans with a history of housing instability or a mental health condition, and those meeting VA enrollment criteria for low-income were significantly less likely to adopt video-based primary care. However, among Veterans who had a video visit in primary care (e.g., those with at least one video visit), older Veterans, and Veterans with a mental health condition had more sustained use (higher rate) than younger Veterans or those without a mental health condition. We found no differences in adoption of video-based primary care by rurality, age, race, ethnicity, or low/moderate disability and high disability priority groups compared to Veterans with no special enrollment category. VA's tablet initiative has supported many Veterans with complex needs in accessing primary care by video. While Veterans with certain social and clinical challenges were less likely to have a video visit, those who adopted video telehealth generally had similar or higher rates of sustained use. These patterns suggest opportunities for tailored interventions that focus on needs specific to initial uptake vs. sustained use of video care.

Mucorales fungi suppress nitric oxide production by macrophages.

In October 2022, Mucorales fungi were listed in the "High Priority Group" on the first-ever list of fungal priority pathogens by the World Health Organization. As the causative agent of mucormycosis, Mucorales have become of great clinical and public health importance with growing mucormycosis numbers, notably with the exponential rise of COVID-19-associated mucormycosis cases. Despite the dire need, there are limited therapeutic options to treat mucormycosis. Our research fills in critical gaps of knowledge about how Mucorales fungi evade the host immune system. Specifically, we offer evidence that Mucorales block nitric oxide production, which is a key mediator and signaling molecule of the mammalian innate immune response to microbial pathogens. Our work offers new insight into immune evasion mechanisms by Mucorales fungi.

Youth Exposure and Response to the FDA Health Warning Label on Electronic Cigarettes Packaging: Policy Implications.

Youth represent a high-priority group for e-cigarette health communication. This study examined youth exposure to the Food and Drug Administration (FDA) e-cigarette warning label over 4 years and its association with change in youth harm perception and intention. We pooled data from the 2018-2021 National Youth Tobacco Survey (age 10-17; n = 67 159). Participants were divided into four groups: never users (58.5%), susceptible nonusers (16.3%), former users (12.7%), and current users (12.5%). We examined the prevalence, time-trend, correlates, and association of youth exposure to the warning with addictiveness and harm perception, intention to use e-cigarettes, and intention to quit all tobacco products. Only 24.5% of youth were exposed to the warning. Exposure increased from 14.9% in 2018 to 30.8% in 2019, then declined to 25.2% in 2021. Hispanic (adjusted odds ratio (aOR) = 0.76 [95% CI = 0.641 to 0.89]) and non-Hispanic black current users (0.53 [0.40 to 0.69]) were less likely to be exposed to the warning than white current users. Youth exposure was positively associated with a higher perception of e-cigarette addictiveness (1.12 [1.04 to 1.19]) and intention to quit all tobacco products (1.28 [1.13 to 1.46]). However, exposure was negatively associated with harm perception (0.91 [0.85 to 0.96]) and the intention to use e-cigarettes among e-cigarette nonusers (2.38 [1.99 to 2.84]). The decline in youth exposure to the warning indicates wear-out effects. Strengthening the label by using compelling designs, adding themes on e-cigarette harm to youth, periodically rotating warning content, and using culturally tailored messaging may improve its impact on youth and address racial/ethnic disparities. The FDA e-cigarette label reached only 24.5% of youth, and exposure to the warning declined to indicate wear-out effects. Exposure was significantly lower among minorities. Exposure was associated with a higher perception of e-cigarette addictiveness and intention to quit all tobacco products. Still, it did not increase harm perception or reduce intention to use e-cigarettes among nonusers. Strengthening the label by using more compelling designs, including diverse themes focusing on e-cigarette harm relevant to youth, and periodically rotating warning content may improve its impact on youth. Continued surveillance of the implementation of e-cigarette policies is needed to ensure that they equally affect youth across racial/ethnic subpopulations.

Beyond the numbers: An in-depth look at Cameroon's fifth national COVID-19 vaccination campaign through geographical and gender lenses

BackgroundCameroon has been struggling with low Covid-19 vaccination coverage, with only 4.5 % of the population receiving the primary series as of November 2022. The COVID-19 Vaccine Delivery Partnership (CoVDP) conducted a high-level mission to Cameroon to assess progress and advocate for actions to address bottlenecks. The objective of the mission was to administer at least 3,000,000 doses of vaccines during the 5th Mass vaccination campaign. This study examines the factors contributing to the success of the campaign and uses a geographical and gender lens to assess the results. MethodsThe study is a secondary analysis of data from the DHIS2 collected during the 5th mass vaccination campaign for Covid-19. Descriptive statistics were used to assess coverages per location and gender expressed in OR. sccess factors, and chi-squared tests were used to assess differences in vaccine distribution across regions and by gender. ResultsThis 5th vaccination campaign benefitted from a strong political commitment facilitated by CoVDP's mission, international support, collaboration, planning, supervision, and demand generation.The campaign recorded 2 019 118 administered vaccine doses, a staggering 46-fold increase in vaccinated individuals relative to the first round, with vaccination coverage reaching 10.1 % of the general population. However, the study reveals regional and gender disparities in vaccination coverage. Men had higher odds of being vaccinated than women in the three Sahel regions. Among individuals with comorbidities, the national coverage rate was only 14 %, and the Far North and East regions exhibited the lowest coverage rates. Janssen was the most used vaccine, and the total AEFI cases reported were 2 per 1000 vaccine doses. ConclusionThe 5th COVID-19 vaccination campaign in Cameroon saw a strong political commitment and was the most successful so far. Despite the gains, there was gender disparity in coverage in some regions. It is important to continue the established momentum, ensure equitable access in the Sahel regions, and reach high-priority groups with primary series and booster doses.

Perceived Need for Mental Health Services Among Healthcare Workers During the Coronavirus disease-19 Pandemic in Turkey: A Multicenter Cross-sectional Study.

The coronavirus disease-2019 pandemic has contributed to work-related psychosocial risks in healthcare workers. This study evaluated the perceived need for mental health services and related factors in Turkish healthcare workers practicing in pandemic hospitals. Cross-sectional study. Data were collected from face-to-face interviews with healthcare workers at 19 pandemic hospitals in 13 provinces between September and November 2021. The study survey included the evaluation of the perceived need for and utilization of mental health services in the previous year, as well as sociodemographic, health-related, and work-related characteristics, the General Health Questionnaire-12, the World Health Organization Quality of Life-BREF (WHOQoL-BREF) questionnaire, and the Fear of coronavirus disease-2019 scale (FCV-19S). Of 1,556 participants, 522 (33.5%) reported a perceived need for mental health services, but only 133 (8.5%) reported receiving these services. Multiple logistic regression analysis of the perceived need for mental health services revealed significant relationships with lower age, female sex, being a current smoker, having a chronic disease, having a mental disorder, coronavirus disease-2019 contact within the last three months in settings other than the home or workplace, a positive coronavirus disease-2019 vaccination history, being a physician, being a non-physician healthcare professional, and coronavirus disease-2019 contact within the last three months at work. After adjustment for these characteristics, higher General Health Questionnaire-12 and FCV-19S scores and lower WHOQoL-BREF domain scores were related to the perceived need for mental health services in logistic regression analyses. The findings indicate a substantial need for mental health services amongst Turkish healthcare workers during the pandemic and outline participants' characteristics regarding high-priority groups for the intervention. Future research may focus on developing actions and evaluating their efficiency.

Safety of COVID-19 booster dose: is the juice worth the squeeze?

Safety of COVID-19 booster dose: is the juice worth the squeeze?

Epidemiology, Modern Diagnostics, and the Management of Mucorales Infections.

Mucormycosis is an uncommon, yet deadly invasive fungal infection caused by the Mucorales moulds. These pathogens are a WHO-assigned high-priority pathogen group, as mucormycosis incidence is increasing, and there is unacceptably high mortality with current antifungal therapies. Current diagnostic methods have inadequate sensitivity and specificity and may have issues with accessibility or turnaround time. Patients with diabetes mellitus and immune compromise are predisposed to infection with these environmental fungi, but COVID-19 has established itself as a new risk factor. Mucorales also cause healthcare-associated outbreaks, and clusters associated with natural disasters have also been identified. Robust epidemiological surveillance into burden of disease, at-risk populations, and emerging pathogens is required. Emerging serological and molecular techniques may offer a faster route to diagnosis, while newly developed antifungal agents show promise in preliminary studies. Equitable access to these emerging diagnostic techniques and antifungal therapies will be key in identifying and treating mucormycosis, as delayed initiation of therapy is associated with higher mortality.

Efficacy and Durability of Immune Response after Receipt of HPV Vaccines in People Living with HIV.

People living with HIV (PLH) experience higher rates of HPV infection as well as an increased risk of HPV-related disease, including malignancies. Although they are considered a high-priority group for HPV vaccination, there are limited data regarding the long-term immunogenicity and efficacy of HPV vaccines in this population. Seroconversion rates and geometric mean titers elicited by vaccination are lower in PLH compared to immunocompetent participants, especially in individuals with CD4 counts below 200 cells/mm3 and a detectable viral load. The significance of these differences is still unclear, as a correlate of protection has not been identified. Few studies have focused on demonstrating vaccine efficacy in PLH, with variable results depending on the age at vaccination and baseline seropositivity. Although waning humoral immunity for HPV seems to be more rapid in this population, there is evidence that suggests that seropositivity lasts at least 2-4 years following vaccination. Further research is needed to determine the differences between vaccine formulations and the impact of administrating additional doses on durability of immune protection.

Anti-cancer effect of COVID-19 vaccines in mice models

AimsWithout any doubt, vaccination was the best choice for Coronavirus disease 2019 (COVID-19) pandemic control. According to the American Society of Clinical Oncology (ASCO) and European Society for Medical Oncology (ESMO), people with cancer or a history of cancer have a higher risk of dying from Covid-19 than ordinary people; hence, they should be considered a high-priority group for vaccination. On the other hand, the effect of the Covid-19 vaccination on cancer is not transparent enough. This study is one of the first in vivo studies that try to show the impact of Sinopharm (S) and AstraZeneca (A) vaccines on breast cancer, the most common cancer among women worldwide. Materials and methodsVaccination was performed with one and two doses of Sinopharm (S1/S2) or AstraZeneca (A1/A2) on the 4T1 triple-negative breast cancer (TNBC) mice model. The tumor size and body weight of mice were monitored every two days. After one month, mice were euthanized, and the existence of Tumor-infiltrating lymphocytes (TILs) and expression of the important markers in the tumor site was assessed. Metastasis in the vital organs was also investigated. Key findingsStrikingly, all of the vaccinated mice showed a decrease in tumor size and this decrease was highest after two vaccinations. Moreover, we observed more TILs in the tumor after vaccination. Vaccinated mice demonstrated a decrease in the expression of tumor markers (VEGF, Ki-67, MMP-2/9), CD4/CD8 ratio, and metastasis to the vital organs. SignificanceOur results strongly suggest that COVID-19 vaccinations decrease tumor growth and metastasis.

Latent Tuberculosis Infection Diagnosis Using QuantiFERON-TB Gold Plus Kit Among Correctional Workers: A Cross-Sectional Study in Francisco Beltrão-PR, Brazil.

Correctional workers form a high-priority group for tuberculosis control measures because of their high exposure and risk. This cross-sectional study conducted in April and May 2022 included 71 criminal police officers from the State Penitentiary of Francisco Beltrão-PR, Brazil. Their sociodemographic and laboratory data were collected. Latent tuberculosis infection (LTBI) was assessed using a QuantiFERON-TB Gold Plus in-tube test kit. Binary logistic regression was applied to calculate the odds ratios (ORs) and 95% confidence intervals (CI) of the LTBI predictors. The prevalence of LTBI was 22.6% (95% CI, 12.8-32.2%). Factors associated with LTBI were age > 43 years (OR, 0.18; 95% CI, 0.04-0.70; p < 0.014) and the use of medications (OR, 5.13; 95% CI, 1.40-18.87; p < 0.014). The prevalence was close to that estimated worldwide for LTBI in correctional workers, reinforcing the need for occupational health control measures consisting of regular screening and treatment of positive cases of latent infection among correctional workers to reduce the risk of illness and spread of infection in the penitentiary system and community.

Breast Cancer Management in the Era of Covid-19; Key Issues, Contemporary Strategies, and Future Implications.

During the COVID-19 pandemic, several priority diseases were not getting sufficient attention. Whilst breast cancer is a fatal disease affecting millions worldwide, identification and management of these patients did not initially attract critical attention to minimize the impact of lockdown, post-lockdown, and other measures. Breast cancer patients' conditions may not remain stable without proper care, worsening their prognosis. Proper care includes the timely instigation of surgery, systemic therapy, and psychological support. This includes low-and middle-income countries where there are already concerns with available personnel and medicines to adequately identify and treat these patients. Consequently, there was a need to summarize the current scenario regarding managing breast cancer care during COVID-19 across all countries, including any guidelines developed. We systematically searched three scientific databases and found 76 eligible articles covering the medical strategies of high-income countries versus LMICs. Typically, diagnostic facilities in hospitals were affected at the beginning of the pandemic following the lockdown and other measures. This resulted in more advanced-stage cancers being detected at initial presentation across countries, negatively impacting patient outcomes. Other than increased telemedicine, instigating neo-adjuvant endocrine therapy more often, reducing non-essential visits, and increasing the application of neo-adjuvant chemotherapy to meet the challenges, encouragingly, there was no other significant difference among patients in high-income versus LMICs. Numerous guidelines regarding patient management evolved during the pandemic to address the challenges posed by lockdowns and other measures, which were subsequently adopted by various high-income countries and LMICs to improve patient care. The psychological impact of COVID-19 and associated lockdown measures, especially during the peak of COVID-19 waves, and the subsequent effect on the patient's mental health must also be considered in this high-priority group. We will continue to monitor the situation to provide direction in future pandemics.

Этиотропная активность комбинированного препарата «Эшрифаг» in vitro

The intensification of the production of livestock and poultry products determines the strengthening of biological control and containment of the morbidity of animals, including birds, as well as the spread of infections that determine sanitary and epizootic distress. Coli-salmonella infection is widespread. By their antibiotic resistance, the microorganisms Escherichia coli and Salmonella spp. they belong to a high and critical priority group, most of the existing antibiotics for which are not active. To implement the tasks facing veterinary science and practice, formed by the global problem of combating epizootics of escherichiosis and salmonellosis, ensuring sanitary well-being, including products, a drug based on bacteriophages «EshriPhage» has been developed. Commission tests of the etiotropic activity of the combined agent «EshriPhage» in vitro in the spot test revealed a high level of epizootically significant isolates of coli-salmonella infection. Data are presented that allow us to recommend the widespread introduction of EshriPhage into practice and the further development of methods of epizootic control over bacterioses using bacteriophages.

Unusual infections and diabetes: dangerous fungi

Unusual infections and diabetes: dangerous fungi

Availability and prioritisation of COVID-19 vaccines among patients with advanced chronic kidney disease and kidney failure during the height of the pandemic: a global survey by the International Society of Nephrology

ObjectivePatients with advanced chronic kidney disease (CKD) or kidney failure receiving replacement therapy (KFRT) are highly vulnerable to COVID-19 infection, morbidity and mortality. Vaccination is effective, but access differs around...

Customer Knowledge Management in Enterprise Software Development Companies: Organizational, Human and Technological Perspective

Abstract In this study, Knowledge-Based View (KBV) and Theory of Technology in a Generic Customer Knowledge Management (CKM) Framework were assimilated to demonstrate the Organizational, Human and Technological antecedent factors that enable CKM processes to improve software product quality. A Theoretical CKM Framework was developed by extracting Human, Organizational and Technological factors from the literature, then, the “Technique for Order of Preference by Similarity to Ideal Solution” (TOPSIS) Multi-Criteria Decision Making (MCDM) method was applied to find the importance level of factors to CKM development in software companies. The weight and priority of factors were determined by 31 experts in enterprise software development companies. The results show that, from an expert viewpoint, CKM antecedent factors are categorized into high priority and low priority groups. Organizational factors such as “Customer Involvement”, “Customer-Centric Culture” and “CKM Strategy Development” are high priority.

Time to redefine a primary vaccination series?

Time to redefine a primary vaccination series?