Implementation Of Control Measures Research Articles

Mof-derived carbon aerogel for rapid on-site extraction of chlorophenols based on drone-liquid circulation system

The rapid on-site extraction of chlorophenols (CPs) from environmental water sample is crucial for the scientific assessment of environmental risks and the implementation of control measures. However, this process presents significant technical challenges. In this study, a solid phase microextraction (SPME) device of drone-liquid circulation system was designed. The device utilized a ZIF-8/agarose derived carbon aerogel coated fiber (ZIF-8/AG-CA-F) for on-site extraction of CPs. Compared to commercial fiber, the ZIF-8/AG-CA-F demonstrated rapid and efficient capacity towards the four selected analytes due to its interconnected hollow porous structure and rich functional groups. The fiber carried by the designed on-site device was used for extracting CPs in actual river water sample. With the help of the micro-pump, the diffusion of the analytes towards the sorptive phase was promoted by accelerating the flow rate of the water sample. The combined effect of SPME fiber and the device accelerates the extraction rate, providing a new approach for rapid and efficient on-site determination of organic pollutants.

Development of a Conceptual Model to Identify and Rank Environmental and Health Costs of Work-Related Diseases Using Delphi Study and Analytic Network Process

Introduction: Improving health and the environment is one of the components of development, social welfare, and economic growth. Another influential factor in increasing health costs and reducing social welfare is work-related accidents and diseases, which impose high costs on individuals, industries, and the national economies of countries. Therefore, using multi-criteria decision-making methods, the present study provided a conceptual model to identify and rank work-related diseases’ environmental and health costs. Material and Methods: The present study was conducted in 2023. A classification model for the economic evaluation of environmental and health costs of occupational diseases was developed to achieve the study’s aim. In the current research, the Delphi method was used to identify health and environmental criteria, and the Analytic Network Process (ANP) was used to weight the sub-criteria. Finally, the cost of health and the environment was estimated based on the available information. Naft Tehran Hospital (NSHT) was also selected as a case study site. Results: The results showed that the drug and medical equipment cost factor, with a weight of 0.312 in the treatment sector, and the particular and infectious waste cost factor, with a weight of 0.085, were the most critical factors in the economic evaluation. Also, the parametric model results showed that 99.84% of the total costs are related to health costs, and 0.16% are related to environmental costs. In general, the results of this research showed that 61.3% of the costs of the health sector are related to the two sectors of medicine and medical equipment and the cost of service personnel, and 91.7% of the costs of the environmental sector are related to wastewater treatment and the cost of electricity consumption. Conclusion: This study presented a semi-quantitative model to estimate health and environmental costs caused by occupational diseases. The results can create a novel scientific insight into implementing control measures using the optimal point of cost-benefit parameters. Implementing this integrated model can be a practical and effective step in allocating resources and prioritizing interventions.

Analysing driver behaviour and crash frequency at railway level crossings using connected vehicle and GIS data

Railway level crossings (RLCs) pose unique safety challenges as crucial intersections between vehicular traffic and railways. This study examines the effects of driver behavior on the safety performance of RLCs (within a 150-meter radius) in New South Wales, Australia. Historical databases on crashes, train operations, and inventory for RLCs were integrated. Also, vehicle movement raw data, including acceleration, deceleration, G-force, and speed, were extracted using the connected vehicle data. Then, the driver’s harsh braking and stiff steering events were identified. A random effect Hurdle Poisson model was adopted to account for the excessive zeros and unobserved heterogeneity. We identified risk factors affecting the likelihood and number of crashes at RLCs across two severity levels. Results of the non-injury crashes suggested that street, active control types, harsh braking, and stiff steering were associated with a higher likelihood of zero crash observations, while train frequency showed the opposite effect. It was also revealed that multiple tracks contributed to the increase in the number of non-injury crashes. Interestingly, after crossing the hurdle, harsh braking at RLC is associated with more non-injury crashes. As for the injury crashes, active control and stiff steering were associated with a higher likelihood of observing zeros. Nevertheless, once crossed the hurdle, intersecting with a highway, having multiple rail tracks and harsh braking events show increasing effects on the frequency of injury crashes. The findings of this study emphasize the need for targeted driver education programs and a larger-scale implementation of active control measures. It is hoped that these actionable insights can assist policymakers in prioritizing safety interventions at RLCs.

Health risk modeling and risk factors of fluorosis in the fluoride endemic village of Maharashtra: A cross-sectional study.

Fluorosis, a debilitating disease, causes dental mottling and bone deformities among other adverse health effects. The current epidemiological study focused on the prevalence and risk factors of fluorosis in the fluoride endemic village, Dongargaon, Maharashtra, India. The clinical diagnosis of subjects showed 96.49% prevalence of dental fluorosis, and 63.16% prevalence of skeletal fluorosis. Duration of exposure, age of subjects and physiological symptoms like chronic joint pain were found to be significantly correlated with skeletal fluorosis (p < 0.05). Fluoride in drinking water showed seasonal variation with highest level in winter (6.54 mg/L) and lowest level in monsoon (0.54 mg/L). Consequently, the mean urinary fluoride concentration was also highest in winter (9.37 mg/L) and lowest in monsoon (3.88 mg/L). Multilogit regression analysis demonstrated that subjects excreting urinary fluoride above 4 mg/L had 7.25 times higher odds of developing skeletal fluorosis (p < 0.05). Health risk assessment showed a high value of hazard quotient, indicating a high probability of adverse health effects. The estimated daily ingestion of 8.80 mg F and a predicted bone uptake of 0.19 mg/kg/day raised significant health concerns for the studied population. Exposure and bone F uptake modeling suggested that the predicted mean fluoride concentrations of 4018.77 ± 1762.45 mg/kg bone ash in asymptomatic, and 5535.12 ± 1526.30 mg/kg bone ash in symptomatic subjects were significantly different (p < 0.05). The comprehensive risk evaluation in the study clearly brings out the high risk of fluoride exposure and adverse effects in Dongargaon village for the first time. Further, urinary fluoride was shown to have significant association with the risk of skeletal fluorosis. The study warrants implementation of immediate control measures at the study site.

Measles secondary vaccine failure in a childcare setting: an outbreak report.

The Sunshine Coast Public Health Unit (SCPHU) identified a measles case in a childcare educator (CE) with secondary vaccine failure (SVF). The CE had been exposed to a confirmed measles case in a hospital emergency department and later developed symptoms including fever, cough, malaise, and a rash. Diagnostic tests confirmed measles virus infection. Sunshine Coast Public Health Unit (SCPHU) implemented control measures including contact tracing, vaccination, post-exposure prophylaxis, and quarantine for susceptible contacts. Out of 372 identified contacts, 72 were identified as susceptible, all of whom were infants and children. Despite the CE having close contact to all susceptible infants and children, no onward transmission occurred. This suggests that SVF cases pose a lower risk of spreading measles compared to immunologically naïve individuals. This report highlights the importance of prioritising immunologically naïve cases in outbreak responses.

Retrospective epidemiologic and genomic surveillance of arboviruses in 2023 in Brazil reveals high co-circulation of chikungunya and dengue viruses

BackgroundThe rapid spread and increase of chikungunya (CHIKV) and dengue (DENV) cases in Brazilian regions in 2023 has raised concerns about the impact of arboviruses on public health. Epidemiological and genomic surveillance was performed to estimate the introduction and spread of CHIKV and DENV in Brazil.MethodsThis study obtained results from the Hermes Pardini (HP), a private medical laboratory, and the Health Department of Minas Gerais state (SES-MG). We investigated the positivity rates of CHIKV and DENV by analyzing the results of 139,457 samples tested for CHIKV (44,029 in 2022 and 95,428 in 2023) and 491,528 samples tested for DENV (163,674 in 2022 and 327,854 in 2023) across the five representative geographical regions of Brazil. Genome sequencing was performed on 80 CHIKV and 153 DENV samples that had been positive for RT-PCR tests.ResultsIn our sampling, the data from CHIKV tests indicated that the Northeast region had the highest regional positivity rate in 2022 (58.1%). However, in 2023, the Southeast region recorded the highest positivity rate (40.5%). With regard to DENV, the South region exhibited the highest regional positivity rate in both 2022 (40.8%) and 2023 (22.7%), followed by the Southeast region in both years (34.8% in 2022; 21.4% in 2023). During the first 30 epidemiological weeks of 2023 in the state of Minas Gerais (MG), there was a 5.8-fold increase in CHIKV cases and a 3.5-fold increase in DENV compared to the same period in 2022. Analysis of 151 new DENV-1 and 80 CHIKV genomes revealed the presence of three main clusters of CHIKV and circulation of several DENV lineages in MG. All CHIKV clades are closely related to genomes from previous Brazilian outbreaks in the Northeast, suggesting importation events from this region to MG. We detected the RNA of both viruses in approximately 12.75% of the confirmed positive cases, suggesting an increase of co-infection with DENV and CHIKV during the period of analysis.ConclusionsThese high rates of re-emergence and co-infection with both arboviruses provide useful data for implementing control measures of Aedes vectors and the urgent implementation of public health politics to reduce the numbers of CHIKV and DENV cases in the country.

Machine-learning models to predict myopia in children and adolescents.

To explore machine-learning applications in myopia prediction and analyze the influencing factors of myopia. Stratified cluster random sampling was used to select elementary school students in Shenzhen, China for inclusion in this case-control study. Myopia screening, ocular biological parameter measurements, and questionnaires were conducted. Random forest (RF), decision tree (DT), extreme gradient boosting trees (XGBoost), support vector machine (SVM), and logistic regression (LR) algorithms were used to construct five myopia prediction models using R software (version 4.3.0). These myopia prediction models were used to investigate the relationship between ocular biological parameters, environmental factors, behavioral factors, genetic factors, and myopia. This study included 2,947 elementary school students, with a myopia prevalence rate of 47.2%. All five prediction models had an area under the receiver operating characteristic curve (AUC) above 0.75, with prediction accuracy and precision exceeding 0.70. The AUCs in the testing set were 0.846, 0.837, 0.833, and 0.815 for SVM, LR, RF, and XGBoost, respectively, indicating their superior predictive performance to that of DT (0.791). In the RF model, the five most important variables were axial length, age, sex, maternal myopia, and feeding pattern. LR identified axial length was the most significant risk factor for myopia [odds ratio (OR) =8.203], followed by sex (OR = 2.349), maternal myopia (OR = 1.437), Reading and writing posture (OR = 1.270), infant feeding pattern (OR = 1.207), and age (OR = 1.168); corneal radius (OR = 0.034) and anterior chamber depth (OR = 0.516) served as protective factors. Myopia prediction models based on machine learning demonstrated favorable predictive performance and accurately identified myopia risk factors, and may therefore aid in the implementation of myopia prevention and control measures among high-risk individuals.

Crimean-Congo haemorrhagic fever among healthcare workers in Iran 2000-2023, a report of National Reference Laboratory.

Crimean-Congo haemorrhagic fever (CCHF) is a lethal acute viral zoonosis with a case fatality rate of 5-50%. Due to the potential of human-to human transmission of the disease, healthcare workers (HCWs) are at risk of occupational exposure to CCHF virus. Little is known about CCHF virus route of transmission and risks in Iranian HCWs. Therefore this study was designed to identify the routes of exposure to the CCHF virus among Iranian HCWs. From Oct 2000 to Feb 2023, 96 CCHF suspected healthcare workers referred to national reference laboratory were tested for CCHF virus infection by the use of RT-PCR and IgM Capture Enzyme-Linked Immunosorbent Assay (MAC-ELISA) and exposure history of cases were investigated to determine the CCHF virus routes of transmission in nosocomial settings. Twelve CCHF confirmed cases were identified including seven nurses and five physicians, with the median age of 32.5 years (range 23-53 years) and the median incubation period of 6.8 days (range from 1 to 22 days). None of the cases reported a history of tick bite or close contact with tissues or animal blood. The cases were from Razavi Khorasan (seven cases), Sistan and Baluchistan (two cases), Isfahan (one case), South Khorasan (one case) and Fars (one case). Percutaneous exposure (needle stick) (three cases), mucosal exposure (blood splash in to face) (three cases) and skin contact with blood (three cases) constituted the most prevalent routes of transmission. Since 2013, no CCHF cases have been identified among Iranian HCWs. In healthcare settings, physicians and nurses are at risk of nosocomial CCHF virus infection. The routes of transmission mainly include direct exposures via needle-stick, mucosal or direct contact with the skin to infected blood. Continuous education and implementation of infection prevention and control measures are key factors to minimize the incidence of healthcare related CCHF.

Uncovering the toll of the first three COVID-19 waves: excess mortality and social patterns in Belgium

BackgroundThis study aims to assess which population groups experienced the heaviest mortality burden during the first three COVID-19 waves in Belgium; and investigate potential changes in social differences in all-cause mortality during the epidemic and compared to the pre-COVID period.MethodsExhaustive all-cause mortality information (2015–2021) from the Belgian population register was linked to demographic and socioeconomic census and register data. Annual cohorts consisting of 6.5 million to 6.8 million persons were created selecting persons aged 35 and older. Excess mortality was investigated comparing the 137,354 deaths observed during the first three COVID-19 waves with mortality in the reference period 2015–2019. Methods of analysis include direct standardization and Poisson regression analyses.ResultsElderly men experienced the highest absolute mortality burden during all three COVID-waves, followed by elderly women, middle-aged men, and middle-aged women. Care home residents consistently experienced higher mortality rates during the first and second wave compared to peers living in other living arrangements. In wave 3, care home residents showed significant absolute mortality deficits compared to the reference period. When adjusting for all demographic and socioeconomic factors, the traditional pattern of educational and income mortality inequalities was found among the elderly population during the COVID-waves. In contrast, the educational mortality gap among middle-aged persons deepened during COVID-waves 2 and 3 with excess mortality between 19 and 30% observed among mainly lower-educated persons. Income mortality inequalities among middle-aged women and men remained stable or even diminished for some specific groups in some waves.ConclusionThe widening educational mortality gap among middle-aged persons in successive waves suggest an important role of knowledge and associated educational resources during the COVID-19 epidemic. Belgium’s broad implementation of public health control and prevention measures may have successfully averted a further widening of social mortality inequality between income groups and among the elderly population.

CRISPR-Cas13a-Based Lateral Flow Assay for Detection of Bovine Leukemia Virus.

Bovine leukemia virus (BLV) is the causative agent of enzootic bovine leukosis (EBL), which presents worldwide prevalence. BLV caused substantial economic loss in China around the 1980s; then, it could not be detected for some time, until recently. Due to its latent and chronic characteristics, the efficient and accurate detection of BLV is of utmost significance to the timely implementation of control measures. Therefore, this study harnessed the recombinase-aided amplification (RAA), clustered regularly interspaced short palindromic repeats (CRISPR)-associated protein 13a (Cas13a) technology, and lateral flow (LF) strips to develop an efficient method for detection of BLV. In this method, isothermal amplification of the targeted pol gene is performed at 37 °C with a detection threshold of 1 copy/µL, and the procedure is completed in 100 min. This assay demonstrated high selectivity for BLV, as indicated by the absence of a cross-reaction with six common bovine pathogens. Remarkably, 100 blood samples from dairy cows were tested in parallel with a conventional quantitative polymerase chain reaction (qPCR) and this method and the results showed 100% agreement. Furthermore, this method exhibited good repeatability. In conclusion, in this study, we established a sensitive and specific method for BLV detection, which shows promise for application in BLV surveillance.

The Extra Length of Stay, Costs, and Mortality Associated With Healthcare-Associated Infections: A Case-Control Study.

This study aims to compare the mortality rate, length of stay (LOS), and hospitalization cost in patients with and without healthcare-associated infections (HCAIs). This prospective cohort study is conducted on 396 matched patients admitted to a tertiary teaching hospital with 800 beds in the southwest of Iran from July 2021 to January 2022. The cases were patients admitted during the study period who had, at minimum, one type of HCAI. For a comparison group, we considered all patients without HCAIs who hospitalized in the same ward and at the same time with the same age and gender in a ratio of one case to three controls. Descriptive analyses were done based on direct medical costs, LOS, and mortality rate in patients. The magnitude of the relationship between potential risk factors and HCAI was quantified using logistic regression. The most common HCAI and microorganisms were urinary tract infection (UTI) and Escherichia coli, respectively. The mean LOS for infected patients was 20.3 (±16) days, compared to 8.7 (±8.6) days for noninfected patients (p value ≤ 0.05). Lengths of stay (odds ratio [OR] = 1.09; 95% CI = 1.06-1.19; p value = 0.000), ICU lengths of stay (OR = 1.08; 95% CI = 1.02-1.15; p value = 0.003), presence of central Catheter (OR = 0.127; 95% CI = 0.51-0.319; p value = 0.000), and urinary catheter (OR = 0.225; 95% CI = 0.122-0.415; p value = 0.000), mechanical ventilation (OR = 0.136; 95% CI = 0.57-0.325; p value = 0.000), receipt of immunosuppressors (OR = 1.99; 95% CI = 11.12-3.56; p value = 0.01), were Significantly associated with HCAI. Patients with infections had a more costly hospital stay than noninfected patients (mean diff: $2037.46 ([SD]: 482.25$) (p value = 0.000). The highest cost component was the cost of medication expenditure (mean: $1612.66 ([SD]: $2542.27). UTI was the most common HCAI in our study. An infection acquired during a hospital stay may be associated with higher hospitalization costs, prolonged hospitalization, and an increase in the rate of mortality. Longer lengths of stay, presence of central and urinary Catheters, receipt of immunosuppressors, use of mechanical ventilator were common risk factors for HCAI. This study reveals that the median reimbursement cost per hospitalization of patients with HCAIs was higher than patients without HCAIs. This highlights the necessity for implementation of HCAI prevention and control measures.

Costs and benefits of a formal quality framework for colonoscopy: Economic evaluation.

Background and study aims Reduction of colorectal cancer morbidity and mortality is one of the primary objectives of colonoscopy. Post-colonoscopy colorectal cancers (PCCRCs) are critical outcome parameters. Analysis of PCCRC rates can validate quality assurance measures in colonoscopy. We assessed the effectiveness of implementing a gastroenterologist-led quality framework that monitors key procedure quality indicators (i.e., bowel preparation quality, adenoma detection rates, or patient satisfaction) by comparing the PCCRC rate before and after implementation. Patients and methods Individuals who had a colonoscopy between 2010 and 2017 at a single tertiary center in Queensland, Australia, were included and divided into two groups: baseline (2010-2014) and redesign phase (2015-2017). Data linkage of the state-wide cancer registry and hospital records enabled identification of subjects who developed colorectal cancers within 5 years of a negative colonoscopy. Costs associated with quality improvement were assessed for effectiveness. Results A total of 19,383 individuals had a colonoscopy during the study period. Seventeen PCCRCs were detected. The PCCRC rate was 0.376 per 1,000 person-years and the average 5-year PCCRC risk ranged from 0.165% to 0.051%. The rate of PCCRCs was higher at the beginning (0.166%; 95% confidence interval [CI] 0.15%-0.17%) compared with the later period with full implementation of quality control measures (0.027%; 95% CI 0.023%-0.03%). The quality process determined an incremental cost-effectiveness ratio of -$5,670.53 per PCCRC avoided. Conclusions This large cohort study demonstrated that a formal gastroenterologist-led quality assurance framework embedded into the routine operations of a clinical department not only reduces interval cancers but is also cost-effective regarding life years gained and quality-adjusted life years.

Prevalence and risk factors of bovine leptospirosis in the Ecuadorian Amazon

Background and Aim: Leptospirosis is an infectious zoonotic disease that significantly affects animal health, particularly the reproduction of ruminants. However, some aspects of epidemiology and clinical characteristics have not been clarified. This study aimed to estimate the prevalence and identify risk factors of leptospirosis in female bovines at reproductive age in the Ecuadorian Amazon rainforest. Materials and Methods: A total of 213 bovines were studied in the Amazon province of Zamora Chinchipe, in which a microscopic agglutination test was used to diagnose a panel of eight serovars of Leptospira borgpetersenii (Sejroe) and Leptospira interrogans, Australis, Bataviae, Canicola, Tarassovi, Icterohaemorrhagiae, Wolffi, and Hardjo. An epidemiological survey was conducted to identify risk factors by animal and herd and clinical symptoms associated with Leptospira spp. infection; and blood samples were collected to determine the differences between seropositive and seronegative animals regarding hematocrit, hemoglobin (Hb), mean corpuscular Hb concentration, total red blood cell count, total platelet count, leukocytes, total proteins, creatinine, and ureic nitrogen. Results: The prevalence of bovine leptospirosis was 12.21% (26/213), with positive reactions in the Australis, Sejroe, Bataviae, Canicola, and Tarassovi serovars. No variables were considered risk factors, nor clinical signs associated with the infection, nor were there differences in the hematological parameters between the seropositive and seronegative animals. Conclusion: These findings indicate the persistence of Leptospira on cattle farms in the Ecuadorian Amazon and highlight the interaction between domestic and wild species. It is crucial to implement control measures and improvements in management practices under the One Health approach to reduce accidental infections from contact with wildlife; the awareness of farmers is essential for effective prevention. Keywords: amazon region, bovine, leptospirosis.

Treatment and delay control strategy for a non-linear rift valley fever epidemic model

Rift Valley Fever (RVF) is a viral disease affecting animals and humans, causing symptoms such as fever, liver damage, and bleeding, particularly prevalent in Africa. This study focuses on numerical solutions for a non-linear delayed dynamic epidemiological model of RVF. It extends a control problem incorporating the susceptible, infected, treated, recovered vector to analyze the impact of measures such as mosquito repellent and treatment. The goal is to examine how time delays in implementing control measures affect the dynamics of an epidemic. The model considers delay factors such as mosquito replication, hospitalization, travel restrictions, and isolation due to the lack of proper vaccination. The study explores the model’s aspects, including the reproduction number, equilibrium points, and stability. Local and global implications are examined using techniques such as the Lyapunov function and the Brauer-F lemma. Numerical analysis employs the non-standard finite difference method, establishing the local stability of the equilibrium through the effective reproduction number Rrvf and sensitivity analysis. The research highlights the importance of treatment and delay strategies in reducing RVF transmission, emphasizing the critical need for immunization and preventive measures.

Prevalence of gastrointestinal and blood parasites in horses of Nakhon Si Thammarat province, Thailand

Background and Aim: The global prevalence of gastrointestinal (GI) and blood parasite infections in horses is a significant concern due to their substantial impact on morbidity, mortality, and economic losses in the horse industry. In Thailand, limited research has been conducted on these parasites in horse populations, and data from southern Thailand are lacking. Consequently, this study aimed to estimate the prevalence of GI and blood parasites in horses in Nakhon Si Thammarat province, Thailand. Materials and Methods: In total, 79 fecal and blood samples were collected from horses across 11 farms in Nakhon Si Thammarat province. The fecal examination was conducted using simple flotation, formalin-ethyl acetate sedimentation, and a modified McMaster technique. Conventional polymerase chain reaction (PCR) was used to identify blood and strongyle parasites. The influence of sex, age, and body condition score on the prevalence of GI parasites was also analyzed. Results: Six GI parasites were detected: four nematodes (Oxyuris equi, Parascaris equorum, strongyles, and Strongyloides westeri), one trematode (Gastrodiscus aegyptiacus), and one protozoan (Eimeria leuckarti). The overall prevalence of GI parasites was 74.7%, with single strongyle infections accounting for the highest proportion at 50.6%, followed by co-infections of strongyles and G. aegyptiacus at 10.1%. All 11 pooled strongyle samples were positive for cyathostomins and Strongylus vulgaris using conventional PCR with specific primers. Sex was significantly associated with the overall prevalence of GI parasites, whereas both sex and age were significant risk factors for infection by strongyle parasites. Theileria equi was the only blood parasite species detected in the surveyed horses, with a prevalence of 1.3% (n = 1/79). Conclusion: This study is the first to estimate the prevalence of GI and blood parasites in horses from Nakhon Si Thammarat province, Thailand. These findings highlight the importance of implementing control measures against GI parasites and are pivotal for developing effective infection prevention strategies. Keywords: blood parasites, gastrointestinal parasites, horses, southern Thailand.

Synthesis and Characterization of Lauha Bhasma

The preparation of ayurvedic bhasma is particularly challenging, as mass production in modern facilities often lacks the standardized equipment needed to ensure consistent quality, leading to concerns about toxic elements like mercury and arsenic in the final products. Addressing these concerns necessitates the standardization of the synthesis process through the implementation of stringent quality control measures at every stage of preparation. This study is dedicated to the synthesis and comprehensive characterization of lauha (iron) bhasma, employing both traditional methodologies and advanced analytical techniques. The synthesis process began with samanya shodhana (general purification), followed by vishesh shodhana (special purification) and marana (incineration) The resultant product then underwent amrutikaran, involving heating with aloe vera extract at an elevated temperature of 750°C.The synthesized lauha bhasma was meticulously characterized using a combination of classical Ayurvedic techniques and modern analytical methods, including Fourier Transform Infrared Spectroscopy (FTIR), Atomic Absorption Spectroscopy (AAS), X-ray Diffraction (XRD), Brunauer-Emmett-Teller (BET) surface analysis, Scanning Electron Microscopy (SEM), Particle Size Distribution (PSD), and Energy Dispersive X-ray (EDX) analysis. The final product, post-Amrutikaran, successfully passed all traditional Ayurvedic evaluations, affirming the proper formation of bhasma. XRD analysis revealed the formation of rhombohedral α-Fe₂O₃ with only trace amounts of free iron, indicating high purity. SEM and PSD analyses demonstrated the creation of nanosized particles ranging from 50 to 200 nm, complemented by a specific surface area of 12.55 m²/g as determined by BET studies. Crucially, EDX analysis confirmed that the amrutikaran process effectively eliminated mercury from the bhasma, ensuring its safety and compliance with stringent quality standards.

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

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

Home-based nursing care: what do we know about multidrug-resistant organisms in this setting?

Abstract Background The burden and complexity of home-based nursing care have intensified due to earlier discharges from hospitals and patients living longer at home with increasing co-morbidities. This growing population of vulnerable patients, combined with the worldwide increase in the prevalence of multidrug-resistant organisms (MDROs), poses a new burden on home-based nursing staff. Home-based nursing care differs significantly from hospitals and nursing homes, challenging implementation of infection prevention and control (IPC) measures. It is therefore important to gain insight into the attitudes, experiences and needs of home-based nursing staff. Also, to better understand the scope of MDRO carriage and transmission in this setting, including its challenges. Methods Cross-sectional studies were conducted in the Netherlands including a survey and focusgroup study among home-based nursing staff, supplemented by a report of cases of MDRO clusters. Results We have identified several factors adding to the complexity of responding to an MDRO outbreak with involvement of home-based nursing care. First, inapplicable recommendations in guidelines/protocols or from infection preventionists, often aimed at intramural care. Second, nursing staff questioned the proportionality of IPC measures, potentially influenced by behaviour of colleagues and patients. Third, inadequate information transfers about patients carrying MDROs. Fourth, uncertainty about the roles and responsibilities of involved healthcare professionals. Finally, the need for organisational support in providing education and sufficient resources, and clarity about financial aspects. Conclusions Insights from these studies have aided in aligning upcoming MDRO guidelines for home-based nursing care in the Netherlands, which factor in the above mentioned complexity. Furthermore, these findings can aid in future strategies to prevent or respond early in MDRO outbreaks with involvement of home-based nursing care.

Investigation of a Norovirus GII outbreak in a primary school in Portugal,2023

Abstract Background The onset of acute gastroenteritis cases among students in a primary school class on September 19, 2023, prompted an immediate response from the local Public Health unit. A collaborative effort was initiated to investigate and contain the outbreak. Methods Epidemiological questionnaires were distributed to 166 students and 8 staff members, defining cases as individuals exhibiting symptoms including diarrhoea, vomiting, or nausea between September 19th and September 24th, 2023. Additionally, stool samples were collected from three individuals. Results Out of 166 students and 8 staff members, 39 individuals met the case definition, resulting in attack rates of 22% (37/166) and 25% (2/8) among students and staff, respectively. Laboratory analysis confirmed two cases of Norovirus GII among the tested specimens, with five students requiring medical attention. Conclusions Our investigation underscores the significance of continuous epidemiological surveillance and swift implementation of infection control measures in school settings. The detection of Norovirus transmission emphasizes the necessity for rigorous adherence to infection control best practices. Our findings advocate for sustained technical support from public health authorities to prevent and manage similar outbreaks effectively. Key messages • Study on Norovirus outbreak in a primary school highlights the imperative of infection control measures, emphasizing the importance of ongoing support from public health authorities. • The Norovirus outbreak investigation underscores the vital role of surveillance and swift response in containing infectious diseases within educational settings safeguarding all.

Comparison of pathogenicity and host responses of emerging porcine reproductive and respiratory syndrome virus variants in piglets.

The high mutation rate of porcine reproductive and respiratory syndrome virus (PRRSV) poses significant challenges to its accurate diagnosis and the implementation of effective control measures. This research explores the pathogenic profiles of two emerging PRRSV stains: the NADC30-like strain SD53 and the highly pathogenic strain HuN4. Our investigation reveals that SD53 initiates distinct immunopathological responses in vivo compared with those provoked by HuN4. By conducting a transcriptome analysis of differential gene expression in the lungs and lymph nodes of infected piglets, we unveil the intricate molecular mechanisms underlying the contrasting pathogenicity of these two strains. The comprehensive insights yielded by this study are instrumental in advancing our understanding of the dominant NADC30-like PRRSV strain, which has become increasingly prevalent in China's swine industry.