Incidence Of Disease Research Articles

High stress hyperglycemia ratio predicts adverse clinical outcome in patients with coronary three-vessel disease: a large-scale cohort study

BackgroundCoronary three-vessel disease (CTVD) accounts for one-third of the overall incidence of coronary artery disease, with heightened mortality rates compared to single-vessel lesions, including common trunk lesions. Dysregulated glucose metabolism exacerbates atherosclerosis and increases cardiovascular risk. The stress hyperglycemia ratio (SHR) is proposed as an indicator of glucose metabolism status but its association with cardiovascular outcomes in CTVD patients undergoing percutaneous coronary intervention (PCI) remains unclear.Methods10,532 CTVD patients undergoing PCI were consecutively enrolled. SHR was calculated using the formula: admission blood glucose (mmol/L)/[1.59×HbA1c (%)–2.59]. Patients were divided into two groups (SHR Low and SHR High) according to the optimal cutoff value of SHR. Multivariable Cox regression models were used to assess the relationship between SHR and long-term prognosis. The primary endpoint was cardiovascular (CV) events, composing of cardiac death and non-fatal myocardial infarction (MI).ResultsDuring the median follow-up time of 3 years, a total of 279 cases (2.6%) of CV events were recorded. Multivariable Cox analyses showed that high SHR was associated with a significantly higher risk of CV events [Hazard Ratio (HR) 1.99, 95% Confidence interval (CI) 1.58–2.52, P < 0.001). This association remained consistent in patients with (HR 1.50, 95% CI 1.08–2.10, P = 0.016) and without diabetes (HR 1.97, 95% CI 1.42–2.72, P < 0.001). Additionally, adding SHR to the base model of traditional risk factors led to a significant improvement in the C-index, net reclassification and integrated discrimination.ConclusionsSHR was a significant predictor for adverse CV outcomes in CTVD patients with or without diabetes, which suggested that it could aid in the risk stratification in this particular population regardless of glucose metabolism status.

ANCA Kidney Risk Score Performance in a German Cohort of Patients with Histologically Confirmed ANCA-Associated Renal Vasculitis.

Predicting the outcome of ANCA-associated vasculitis (AAV) is a difficult task. One of the most promising prognostic scores, the ANCA Renal Risk Score (ARRS), has recently been updated and renamed to ANCA Kidney Risk Score (AKRiS). We wanted to test its performance in our population. 164 patients were included and categorized in subgroups analogous to that of both scores. Multivariable logistic regression analysis was applied to assess the risk of renal failure. Additionally, baseline data and outcome were compared between the subgroups of each score to retrieve useful clinical information. Stratified by AKRiS risk category, the proportions of patients who developed end-stage kidney disease (ESKD) at 36 months were 9.8%, 29.1%, 63.0%, and 83.3%, respectively (p < 0.001).Those belonging to the higher risk groups showed more pronounced proteinuria and anemia at diagnosis (p=0.001, p<0.001, respectively). Although our patients exhibited a more severe disease phenotype than those of AARS and AKRiS, both scores performed equally well: The Harrell´s C Index was similar (0.8381 vs. 0.8337). Beyond that, we found differences and similarities in the risk associations between the subgroups of both scores and disease activity or patient outcome, with some of them being described for the first time. For example, there was a higher risk of renal failure with anemia but not with C-reactive protein and the Birmingham Vasculitis Activity Score (BVAS) and an increased incidence of relapsing disease in the lower risk categories of ARRS. Here, we present the first external AKRiS validation confirming the improved ESKD prediction of the revised score in our cohort. Furthermore, we highlighted associations between risc score categories and patient mortality or vasculitis relapse.

Outcomes of very young women and adolescent (VYWAA) with breast cancer (BC) in rural and urban Saskatchewan: A population-based cohort study.

1571 Background: BC is uncommon in VYWAA (≤ 35 years) and accounts for about 1.8% of all BC. As BC screening is typically recommended for women aged 50-74 years there is a risk of delayed diagnosis of BC in VYWAA especially those with rural residence. The current study aims to assess outcomes of a cohort of VYWAA with BC in relation to their place of residence in the province of Saskatchewan over a period of 20 years. Methods: In this population-based retrospective cohort study all women ≤ 35 years with histologically documented epithelial BC during 2000-2019 were evaluated. Survival of the entire cohort and its subgroups was estimated using the Kaplan−Meier method, and the survival distribution of different groups was compared by the log rank test. A multivariate Cox proportional hazard model was performed. Various clinical and demographic variables were examined for their prognostic importance of overall survival (OS) for all stages and disease-free survival (DFS) for early-stage BC. Results: 248 eligible women with a median age of 32 years were identified, 24% were &lt;30 years of age. Of all patients, 51% had node positive disease, 7% had DCIS, 15% stage I, 42% stage II, 22% stage III and 11% had stage IV disease at initial presentation. Among them 42% had hormone receptor +, 28% had HER2 + and 23% had triple negative BC (TNBC).16% developed BC within 1-year of pregnancy. 53% were rural resident and 47% were urban resident. Significant differences were noted between the two groups regarding smoking history (42 vs. 25%), HER2+BC (35% vs. 20%) and mean platelet count (285 vs. 258). Median follow up for all women was 91 months with a total follow up period of 294 months. Median DFS of VYWAA with stage I to III disease has not reached. 10-year estimated DFS of all women was 66%. 10-year DFS for stage I and II was 73% and 75%, respectively, vs. 43% for stage III (p&lt;0.001). Median OS of entire cohort with stage 0-IV BC has not reached. 10-year OS of all VYWAA was 69%. 10 years OS of urban women was 79% compared to 65% for rural resident (p=0.041). 10-year OS of women age &gt;30 years was 74% compared to 62% for age 26-30 years and 55% for age &lt;26 (p=0.35).10 years OS of VYWAA with non-TNBC was 73% compared to 63% for with TNBC (p=0.028). On multivariate analysis for women with early-stage disease, stage III BC, HR, 3.0 (1.80-4.92) and grade III BC were significantly correlated with inferior DFS. On a multivariate analysis for OS of all VYWAA with stage 0 to IV disease, rural residence, HR, 1.75 (1.08-2.81); TNBC, HR, 2.25 (1.34-3.80), and stage IV disease, HR, 8.1 (4.72-13.94) were correlated with inferior OS. Conclusions: Very young women and adolescent with BC have a high incidence of node-positive disease and HER2+ and TNBC subtypes. TNBC and grade III disease were associated with inferior DFS in stage I-III disease whereas stage IV BC, TNBC and rural residence were correlated with inferior survival in women with stage 0-IV disease.

Plagues upon the Earth: Disease and the Course of Human History

Paul W. Rhode of University of Michigan and NBER reviews “Plagues upon the Earth: Disease and the Course of Human History” by Kyle Harper. The EconLit abstract of this book begins: “Explores the ways that human history has shaped disease ecology and pathogen evolution and how disease ecology and pathogen evolution have shaped human history in turn, detailing how the emergence, incidence, and consequences of disease in both individuals and populations are inseparable from a wider array of social and environmental factors.”

Randomized clinical trial of infliximab versus vedolizumab for immune checkpoint inhibitor related colitis.

2661 Background: Immune-mediated diarrhea and colitis (IMDC) is an inflammatory consequence of immunotherapy that frequently necessitates discontinuation of immunotherapy. Current management strategies are adopted from inflammatory bowel disease practice and rely on selective immunosuppressive therapy (SIT) with infliximab or vedolizumab as first-line in more severe cases. While this practice is widely accepted, evidence supporting SIT use is limited to retrospective studies. Here we present the preliminary findings of 22 patients from the first clinical trial comparing the efficacy and safety of infliximab and vedolizumab in treating IMDC. Methods: We conducted a randomized controlled trial of infliximab and vedolizumab in the treatment of IMDC. To be included, patients must have received immunotherapy and developed immune-mediated diarrhea or colitis at CTCAE grade ≥2. Infusions were given around weeks 0, 2, and 6, and disease activity and incidence of adverse events were recorded over 12 weeks of follow-up. Remission was defined as symptom improvement to CTCAE grade ≤1 by week 2. Fecal transplantation or ustekinumab would be considered for patients who are refractory to two SIT doses. Results: 22 patients have been enrolled thus far, three of whom were removed from the study and one who withdrew consent at 2 months. Ten patients were randomized to the infliximab arm and nine to the vedolizumab arm. At two weeks, clinical remission rates are similarly high across infliximab (90%) and vedolizumab (88.9%) groups, with the one patient in the vedolizumab group having symptom improvement but failing to meet criteria for clinical remission and one in the infliximab group with treatment failure. Symptom improvement was typically seen in a median of 3 days (IQR: 1.5-5.5) across both groups. Eight patients (80%) in the infliximab group and seven patients (77.8%) in the vedolizumab group had steroid-free remission at one month. Four patients (40%) from the infliximab group and three (33.3%) from the vedolizumab group had symptom recurrence in a median of 43 days across both groups (IQR: 39-93). Three patients from either group were able to resume immunotherapy. In terms of safety, both groups had a similar rate of mild adverse events (AEs), most of which were deemed unrelated to SIT use. Conclusions: This is the first randomized controlled trial to evaluate the safety and efficacy of infliximab and vedolizumab in the management of IMDC. Our results suggest that both agents are equally effective at controlling symptoms within two weeks of the first infusion, with a small number of patients receiving either having recurrent disease. The two drugs have a comparable safety profile with primarily mild AEs occurring. Our preliminary findings suggest that both drugs can be used effectively in first-line treatment of IMDC, but further data is necessary to ascertain long-term outcomes. Clinical trial information: NCT04407247 .

How the "Olive Oil Polyphenols" Health Claim Depends on Anthracnose and Olive Fly on Fruits.

Olive anthracnose, caused by Colletotrichum fungi, and the olive fruit fly Bactrocera olea are, respectively, the most important fungal disease and pest affecting olive fruits worldwide, leading to detrimental effects on the yield and quality of fruits and olive oil. This study focuses on the content of hydroxytyrosol (HYT) and its derivatives (the "olive oil polyphenols" health claim) in olive oils extracted from fruits of 'Galega Vulgar' and 'Cobrançosa' cultivars, naturally affected by olive anthracnose and olive fly. The olives, with different damage levels, were harvested from organic rainfed orchards, located in the center of Portugal, at four harvest times over three years. Galega oils extracted from olives with a higher anthracnose and olive fly incidence showed no conformity for the extra virgin olive oil (EVOO) and virgin olive oil (VOO) categories, presenting high acidity and negative sensory notes accompanied by the disappearance of oleacein. Conversely, no sensory defects were observed in Cobrançosa oils, regardless of disease and pest incidence levels, and quality criteria were still in accordance with the EVOO category. The total HYT and tyrosol (TYR) content (>5 mg/20 g) allows for the use of the "olive oil polyphenols" health claim on the label of all the analyzed Cobrançosa olive oils.

COVID-19 Pandemic on COPD Healthcare Utilization, Exacerbations and Mortality: A Population Study.

Existing work suggests that patients with COPD (pwCOPD) presented less frequently to the emergency department (ED) and were less likely to be hospitalized during the COVID-19 pandemic but it is unclear if this was due to improved health and disease management or to increased barriers/avoidance of healthcare. The objective of this study is to determine the impact of the pandemic on inpatient and outpatient healthcare utilization, disease incidence, and mortality rates in pwCOPD. A retrospective population-based analysis using linked administrative datasets from Alberta, Canada18 months before and after March 12, 2020 was conducted to measure hospitalization, ED and outpatient visits, and COPD outpatient exacerbations during these time periods. Mortality data was also analyzed pre- versus post-pandemic, taking confirmed COVID-19 infection within 30 days into account. Subgroup analysis based on COPD exacerbation risk stratification was undertaken to determine if healthcare utilization differed based on exacerbation risk. Finally, sex-based analysis of healthcare utilization during the pandemic was also completed. Hospitalization/ED visits and outpatient treatment for acute exacerbations of COPD dropped while total outpatient COPD visits, including both virtual and in-person, increased during the pandemic for pwCOPD. Mortality rate increased even after adjusting for COVID-19-associated deaths. Sex-based subgroup analysis showed a greater drop in acute care utilization for females but the rise in mortality was seen for both sexes with men experiencing greater rate of mortality than women. Overall pwCOPD accessed acute care resources less during the pandemic which may have contributed to a rise in non-COVID all-cause mortality.

The ADnet Bayesian belief network for alder decline: Integrating empirical data and expert knowledge

The globalization in plant material trading has caused the emergence of invasive pests in many ecosystems, such as the alder pathogen Phytophthora ×alni in European riparian forests. Due to the ecological importance of alder to the functioning of rivers and the increasing incidence of P. ×alni-induced alder decline, effective and accessible decision tools are required to help managers and stakeholders control the disease. This study proposes a Bayesian belief network methodology to integrate diverse information on the factors affecting the survival and infection ability of P. ×alni in riparian habitats to help predict and manage disease incidence. The resulting Alder Decline Network (ADnet) management tool integrates information about alder decline from scientific literature, expert knowledge and empirical data. Expert knowledge was gathered through elicitation techniques that included 19 experts from 12 institutions and 8 countries. An original dataset was created covering 1189 European locations, from which P. ×alni occurrence was modeled based on bioclimatic variables. ADnet uncertainty was evaluated through its sensitivity to changes in states and three scenario analyses. The ADnet tool indicated that mild temperatures and high precipitation are key factors favoring pathogen survival. Flood timing, water velocity, and soil type have the strongest influence on disease incidence. ADnet can support ecosystem management decisions and knowledge transfer to address P. ×alni-induced alder decline at local or regional levels across Europe. Management actions such as avoiding the planting of potentially infected trees or removing man-made structures that increase the flooding period in disease-affected sites could decrease the incidence of alder disease in riparian forests and limit its spread. The coverage of the ADnet tool can be expanded by updating data on the pathogen's occurrence, particularly from its distributional limits. Research on the role of genetic variability in alder susceptibility and pathogen virulence may also help improve future ADnet versions.

How Generalizable Are Findings from a Community-Based Prospective Cohort Study? Extending Estimates from the Adult Changes in Thought Study to Its Source Population

Background: The Adult Changes in Thought (ACT) study is a cohort of Kaiser Permanente Washington members ages 65+ that began in 1994. Objective: We wanted to know how well ACT participants represented all older adults in the region, and how well ACT findings on eye disease and its relationship with Alzheimer’s disease generalized to all older adults in the Seattle Metropolitan Region. Methods: We used participation weights derived from pooling ACT and Behavioral Risk Factor Surveillance System (BRFSS) data to estimate prevalences of common eye diseases and their associations with Alzheimer’s disease incidence. Cox proportional hazards models accounted for age, education, smoking, sex, and APOE genotype. Confidence intervals for weighted analyses were bootstrapped to account for error in estimating the weights. Results: ACT participants were fairly similar to older adults in the region. The largest differences were more self-reported current cholesterol medication use in BRFSS and higher proportions with low education in ACT. Incorporating the weights had little impact on prevalence estimates for age-related macular degeneration or glaucoma. Weighted estimates were slightly higher for diabetic retinopathy (weighted 5.7% (95% Confidence Interval 4.3, 7.1); unweighted 4.1% (3.6, 4.6)) and cataract history (weighted 51.8% (49.6, 54.3); unweighted 48.6% (47.3, 49.9)). The weighted hazard ratio for recent diabetic retinopathy diagnosis and Alzheimer’s disease was 1.84 (0.34, 4.29), versus 1.32 (0.87, 2.00) in unweighted ACT. Conclusions: Most, but not all, associations were similar after participation weighting. Even in community-based cohorts, extending inferences to broader populations may benefit from evaluation with participation weights.

A case series of forearm compartment syndrome complicating transradial cardiac catheterization

BackgroundAcute compartment syndrome following a transradial coronary approach is rare. However, as the incidence of coronary arterial disease increases due to lifestyle factors and multiple comorbidities, transradial coronary angiography has become more common for diagnostic and therapeutic purposes in cardiovascular centers. Despite its rarity, we encountered two cases of acute compartment syndrome within a 1-week interval in the cardiology unit of a tertiary hospital.Case presentationThe first case involved a 75-year-old woman diagnosed with non-ST elevation myocardial infarction (NSTEMI). A coronary angiogram was performed via an uncomplicated right radial artery puncture. Following the procedure, the patient experienced significant swelling in the right forearm. An emergency fasciotomy release of the right forearm was conducted, revealing a gushing hematoma upon entering the flexor compartment. Fortunately, the wound healed well two months postoperatively with no functional deficits. In the second case, an 80-year-old man presented with severe angina pectoris upon exertion and was diagnosed with NSTEMI. The following day, he developed compartment syndrome in the left forearm, necessitating an emergency fasciotomy. Intraoperative examination revealed muscle bulging within the forearm compartments accompanied by extensive hematoma. Postoperatively, a deranged coagulation profile caused oozing from the wound. However, since there was no arterial bleeding, a compression dressing was applied. This led to a gradual drop in hemoglobin levels and worsened his heart condition. Despite resuscitative efforts and attempts to correct the coagulopathy, the patient experienced cardiorespiratory arrest and succumbed to ischemic heart disease in failure.ConclusionClinicians must remain vigilant in identifying this potentially limb-threatening condition. Patients with pre-existing anticoagulant therapy and underlying atherosclerotic disease are at a higher risk of bleeding complications. Implementing effective hemostasis techniques and promptly managing swelling can help prevent the occurrence of compartment syndrome. Timely assessment and maintaining a high level of clinical suspicion are paramount. If necessary, early consideration of decompressive fasciotomy is essential to avert catastrophic outcomes.

Trends in the prevalence and incidence of chronic obstructive pulmonary disease among adults aged ≥50 years in the United States, 2000–2020

Trends in the prevalence and incidence of chronic obstructive pulmonary disease among adults aged ≥50 years in the United States, 2000–2020

Identification of Hydrocarbon Sulfonates as Previously Overlooked Transthyretin Ligands in the Environment.

Incidences of thyroid disease, which has long been hypothesized to be partially caused by exposure to thyroid hormone disrupting chemicals (TDCs), have rapidly increased in recent years. However, known TDCs can only explain a small portion (∼1%) of in vitro human transthyretin (hTTR) binding activities in environmental samples, indicating the existence of unknown hTTR ligands. In this study, we aimed to identify the major environmental hTTR ligands by employing protein Affinity Purification with Nontargeted Analysis (APNA). hTTR binding activities were detected in all 11 indoor dust and 9 out of 10 sewage sludge samples by the FITC-T4 displacement assay. By using APNA, 31 putative hTTR ligands were detected including perfluorooctanesulfonate (PFOS). Two of the most abundant ligands were identified as hydrocarbon surfactants (e.g., dodecyl benzenesulfonate). Moreover, another abundant ligand was surprisingly identified as a disulfonate fluorescent brightener, 4,4'-bis(2-sulfostyryl)biphenyl sodium (CBS). CBS was validated as a nM-affinity hTTR ligand with an IC50 of 345 nM. In total, hydrocarbon surfactants and fluorescent brighteners explain 1.92-17.0 and 5.74-54.3% of hTTR binding activities in dust and sludge samples, respectively, whereas PFOS only contributed <0.0001%. Our study revealed for the first time that hydrocarbon sulfonates are previously overlooked hTTR ligands in the environment.

CORRELATION OF CARDIAC MARKERS WITH THYROID STIMULATING HORMONE IN SUBCLINICAL HYPOTHYROIDELDERLY

Cardiac markers (CPK-MB and TroponinT (TnT)) are often used to differentiate between cardiac and non cardiac chest pain. Subclinical hypothyroidism (SCH) has increased incidence of cardiovascular risk factors and disease. Elderly have an increased incidence of SCH. However, no study has specifically examined the association between cardiac markers and SCH in elderly population. Aims and Objectives: To determine the association of cardiac markers with thyroid stimulating hormone (TSH) in elderly patientswith subclinical hypothyroids and euthyroid. Method: The present study was designed as a retrospective cross-sectional study conducted in Biochemistry department of Adesh institute of medical sciences and research (AIMSR) Bathinda from a period of May 2023 to April 2024.The data was obtained from the lab computers and the subjects were divided into four groups. Group 1 included patients who had MI and SCH. Group 2 consisted of patients who had MI and were euthyroid. Group 3 were those who presented with chest pain only (no MI) and SCH. Group 4 were those who had acute chest pain (no MI) and were found to be euthyroid. Results:Our study showed significant correlation of TSH with CPK-MB (r=0.69, p=0.001)and Troponin T ( r=0.201, p= 0.04) in Group 1 while a non significant correlation was found in Group 2, CPK-MB (r=0.06, p=0.67) and Troponin T (r= 0.156, p= 0.57). There was a significant correlation of TSH with CPK-MB (r=0.71, p=0.02) and Troponin T (r=0.84, p= 0.001) in Group 3. A nonsignificant correlation was found in Group 4, between TSH and CPK-MB (r=0.116, p=0.68) and Troponin T (r= 0.001, p= 0.99). Conclusion: Elevations of TSH levels may cause a significant rise in the cardiac markers in SCH elderly as compared to euthyroid.

Metabolic dysfunction-associated steatotic liver disease related cirrhosis and incidence of portal vein thrombosis.

There is heterogeneous data on whether metabolic-associated steatohepatitis is an independent risk factor for portal vein thrombosis (PVT). We aim to compare the incidence of PVT in patients with cirrhosis with and without metabolic dysfunction-associated steatotic liver disease (MASLD). This is a single-center retrospective study of patients with cirrhosis seen between 1 January 2016 and 31 January 2021. Patients with a history of hepatocellular cancer, liver transplant, Budd-Chiari syndrome, and intra-abdominal malignancies were excluded. Patients with cirrhosis were followed from their first hepatology visit for 180 days to determine the incidence of PVT. Cox proportional hazard regression was used to determine the relationship between MASLD with PVT. We analyzed data from 2785 patients with cirrhosis who met inclusion and exclusion criteria [mean age: 61.0 ± 12.3 years, 44.3% female, 63.8% Whites and mean model for end-stage liver disease-sodium (MELD-Na) score: 11.7 ± 6.1]. MASLD was present in 21.7% of patients. A total of 89 patients developed PVT during the follow-up, which was fewer in patients with MASLD [2.0% vs. 3.5%, P = 0.04, unadjusted heart rate (HR): 0.60, 95% confidence interval (CI): 0.27-0.96, P = 0.04]. After adjusting for the demographics, MASLD-related comorbid conditions and MELD-Na score, MASLD was associated with a lower incidence of PVT as compared to non-MASLD cirrhosis (HR: 0.44, 95% CI: 0.21-0.92, P = 0.03). After adjusting for the indicators of Child-Pugh Turcotte score, the risk of PVT in patients with MASLD compared to non-MASLD was not statistically significant (HR: 0.50, 95% CI: 0.22-1.13, P = 0.096). PVT incidence was lower in patients with MASLD cirrhosis as compared to non-MASLD cirrhosis. However, the difference was not significantly different after adjusting for liver decompensation.

Harnessing the power of native biocontrol agents against wilt disease of Pigeonpea incited by Fusarium udum

Fusarium wilt, caused by (Fusarium udum Butler), is a significant threat to pigeonpea crops worldwide, leading to substantial yield losses. Traditional approaches like fungicides and resistant cultivars are not practical due to the persistent and evolving nature of the pathogen. Therefore, native biocontrol agents are considered to be more sustainable solution, as they adapt well to local soil and climatic conditions. In this study, five isolates of F. udum infecting pigeonpea were isolated from various cultivars and characterized morphologically and molecularly. The isolate from the ICP 8858 cultivar displayed the highest virulence of 90%. Besides, 100 endophytic bacteria, 100 rhizosphere bacteria and three Trichoderma spp. were isolated and tested against F. udum isolated from ICP 8858 under in vitro conditions. Out of the 200 bacteria tested, nine showed highest inhibition, including Rb-4 (Bacillus sp.), Rb-11 (B. subtilis), Rb-14 (B. megaterium), Rb-18 (B. subtilis), Rb-19 (B. velezensis), Eb-8 (Bacillus sp.), Eb-11 (B. subtilis), Eb-13 (P. aeruginosa), and Eb-21 (P. aeruginosa). Similarly, Trichoderma spp. were identified as T. harzianum, T. asperellum and Trichoderma sp. Notably, Rb-18 (B. subtilis) and Eb-21 (P. aeruginosa) exhibited promising characteristics such as the production of hydrogen cyanide (HCN), cellulase, siderophores, ammonia and nutrient solubilization. Furthermore, treating pigeonpea seedlings with these beneficial microorganisms led to increased levels of key enzymes (POD, PPO, and PAL) associated with resistance to Fusarium wilt, compared to untreated controls. In field trials conducted for four seasons, the application of these potential biocontrol agents as seed treatments on the susceptible ICP2376 cultivar led to the lowest disease incidence. Specifically, treatments T2 (33.33) (P. aeruginosa) and T3 (35.41) (T. harzianium) exhibited the lowest disease incidence, followed by T6 (36.5) (Carbendizim), T1 (36.66) (B. subtilis), T4 (52.91) (T. asperellum) and T5 (53.33) (Trichoderma sp.). Results of this study revealed that, P. aeruginosa (Eb-21), B. subtilis (Rb-18) and T. harzianum can be used for plant growth promotion and management of Fusarium wilt of pigeonpea.

Synergistic effects of intercropping green beans with okra on the bacteria blight disease

Green bean is a widely consumed as vegetable mostly for its nutritional, health and economic values. In Cameroon, the production is hindered by bacterial blight disease cause by Xanthomonas campestris. The aim of this study is to evaluate the synergistic effects of intercropping green bean with okra on bacterial blight disease of green beans. Beans varieties (local green bean, jackpot green bean and dolly green bean) were planted in a field in a Randomized Complete Block Design with six treatments and three replicates in Department of Crop Production Technology of the University of Bamenda research farms. The first, second and third treatments consisted of inter-cropping of dolly green bean, jackpot green beans and local green with okra and fourth, fifth and sixth consisted of mono-cropped of dolly green bean, jackpot green beans and local green beans varieties which serves as the control experiments. Data was collected for disease incidence, disease severity, and number of pods and weight of pods were recorded in all the fields. Pathogenicity assessment was conducted in the green house by inoculating healthy green bean plants with bacterial blight isolate and lesion area measured. Significant variations (P≤0.05) were observed in disease incidence, disease severity and yield. The highest mean disease incident (100 %) severity (64 %)and low number of pods (4.3) were recorded in monocropped fields and the intercropped fields had lowest mean disease incidence(40 %), severity (23 %)and high number of pods (27.3 ).Inter-cropping green beans with okra can be recommended to control bacterial blight disease of green beans varieties.

Sentinel Enhanced Dengue Surveillance System - Puerto Rico, 2012-2022.

Dengue is the most prevalent mosquitoborne viral illness worldwide and is endemic in Puerto Rico. Dengue's clinical spectrum can range from mild, undifferentiated febrile illness to hemorrhagic manifestations, shock, multiorgan failure, and death in severe cases. The disease presentation is nonspecific; therefore, various other illnesses (e.g., arboviral and respiratory pathogens) can cause similar clinical symptoms. Enhanced surveillance is necessary to determine disease prevalence, to characterize the epidemiology of severe disease, and to evaluate diagnostic and treatment practices to improve patient outcomes. The Sentinel Enhanced Dengue Surveillance System (SEDSS) was established to monitor trends of dengue and dengue-like acute febrile illnesses (AFIs), characterize the clinical course of disease, and serve as an early warning system for viral infections with epidemic potential. May 2012-December 2022. SEDSS conducts enhanced surveillance for dengue and other relevant AFIs in Puerto Rico. This report includes aggregated data collected from May 2012 through December 2022. SEDSS was launched in May 2012 with patients with AFIs from five health care facilities enrolled. The facilities included two emergency departments in tertiary acute care hospitals in the San Juan-Caguas-Guaynabo metropolitan area and Ponce, two secondary acute care hospitals in Carolina and Guayama, and one outpatient acute care clinic in Ponce. Patients arriving at any SEDSS site were eligible for enrollment if they reported having fever within the past 7 days. During the Zika epidemic (June 2016-June 2018), patients were eligible for enrollment if they had either rash and conjunctivitis, rash and arthralgia, or fever. Eligibility was expanded in April 2020 to include reported cough or shortness of breath within the past 14 days. Blood, urine, nasopharyngeal, and oropharyngeal specimens were collected at enrollment from all participants who consented. Diagnostic testing for dengue virus (DENV) serotypes 1-4, chikungunya virus, Zika virus, influenza A and B viruses, SARS-CoV-2, and five other respiratory viruses was performed by the CDC laboratory in San Juan. During May 2012-December 2022, a total of 43,608 participants with diagnosed AFI were enrolled in SEDSS; a majority of participants (45.0%) were from Ponce. During the surveillance period, there were 1,432 confirmed or probable cases of dengue, 2,293 confirmed or probable cases of chikungunya, and 1,918 confirmed or probable cases of Zika. The epidemic curves of the three arboviruses indicate dengue is endemic; outbreaks of chikungunya and Zika were sporadic, with case counts peaking in late 2014 and 2016, respectively. The majority of commonly identified respiratory pathogens were influenza A virus (3,756), SARS-CoV-2 (1,586), human adenovirus (1,550), respiratory syncytial virus (1,489), influenza B virus (1,430), and human parainfluenza virus type 1 or 3 (1,401). A total of 5,502 participants had confirmed or probable arbovirus infection, 11,922 had confirmed respiratory virus infection, and 26,503 had AFI without any of the arboviruses or respiratory viruses examined. Dengue is endemic in Puerto Rico; however, incidence rates varied widely during the reporting period, with the last notable outbreak occurring during 2012-2013. DENV-1 was the predominant virus during the surveillance period; sporadic cases of DENV-4 also were reported. Puerto Rico experienced large outbreaks of chikungunya that peaked in 2014 and of Zika that peaked in 2016; few cases of both viruses have been reported since. Influenza A and respiratory syncytial virus seasonality patterns are distinct, with respiratory syncytial virus incidence typically reaching its annual peak a few weeks before influenza A. The emergence of SARS-CoV-2 led to a reduction in the circulation of other acute respiratory viruses. SEDSS is the only site-based enhanced surveillance system designed to gather information on AFI cases in Puerto Rico. This report illustrates that SEDSS can be adapted to detect dengue, Zika, chikungunya, COVID-19, and influenza outbreaks, along with other seasonal acute respiratory viruses, underscoring the importance of recognizing signs and symptoms of relevant diseases and understanding transmission dynamics among these viruses. This report also describes fluctuations in disease incidence, highlighting the value of active surveillance, testing for a panel of acute respiratory viruses, and the importance of flexible and responsive surveillance systems in addressing evolving public health challenges. Various vector control strategies and vaccines are being considered or implemented in Puerto Rico, and data from ongoing trials and SEDSS might be integrated to better understand epidemiologic factors underlying transmission and risk mitigation approaches. Data from SEDSS might guide sampling strategies and implementation of future trials to prevent arbovirus transmission, particularly during the expansion of SEDSS throughout the island to improve geographic representation.

Aedes aegypti Knockdown Resistance Mutations and Dengue Virus Infection in Haiti.

Haiti is home to approximately 11 million people and has a high incidence of vector-borne disease, including more than 70,000 cases of dengue per year. Vector control is difficult in Haiti and adulticide spray of malathion is the main method of control employed during the outbreak of disease although pyrethroids are used in both bed net campaigns and in widely available aerosol cans for personal use. However, limited pathogen or insecticide resistance surveillance data are available for making operational decisions. In this study, we assessed Aedes aegypti from serial surveillance collections from 3 locations for the presence of dengue virus serotypes 1-3 (DENV1-3) by polymerase chain reaction and assessed, by melt curve analysis, samples from 10 locations in 2 departments for the presence of two mutations (V1016I and F1534C), that in combination, are linked to strong pyrethroid insecticide resistance. Only one of the 32 tested pools was positive for the presence of dengue virus. The two knockdown resistance (kdr) mutations were present in all locations. The 1016I mutation frequency varied from 0.29 to 0.91 and was in all sites lower than the 0.58-1.00 frequency of the 1534C mutation. We also observed that the genotype homozygous for both mutations (IICC), which has been linked to strong pyrethroid resistance, varied from 13 to 86% in each population. Notably, 3 locations - Ti Cousin and Christianville in Ouest department and Camp Coq in Nord department had more than 30% of the tested population without the presence of kdr mutations. These results indicate that the kdr markers of pyrethroid resistance are present in Haiti, at high frequency in several locations and, based on previous studies linking kdr genotypes and phenotypic resistance, that operational interventions with pyrethroids are not likely to be as effective as expected.

Increased incidence and diverse manifestations of multiple evanescent white dot syndrome during the COVID-19 pandemic

The advent of coronavirus disease 2019 (COVID-19) pandemic has affected the incidence and course of various diseases and numerous studies have investigated ocular involvement associated with COVID-19 and corresponding vaccines. In this study, we compared the incidence of multiple evanescent white dot syndrome (MEWDS) before and during the COVID-19 pandemic at a single center in Korea and analyzed the demographic and clinical features of patients with MEWDS presenting during the COVID-19 pandemic. We categorized patients with MEWDS into two groups according to date of diagnosis. Pre-COVID19 group included patients diagnosed during the pre-pandemic period (between March 11, 2017, and March 10, 2020), whereas post-COVID19 group included patients diagnosed during the pandemic period (between March 11, 2020, and March 10, 2023). 6 and 12 patients were included in pre-COVID19 group and post-COVID19 group, respectively. Among all hospital visits during the pre-pandemic and pandemic periods, 0.011% and 0.030% were due to MEWDS, indicating a significant increase during the pandemic (p = 0.029, B = 2.756). The annual incidence of patients with MEWDS in 2017–2022 were 0.73, 0.75, 0.78, 1.32, 2.49, and 2.07 per 10,000 population, respectively, corresponding to a significant increase (p = 0.039, B = 1.316). Our results imply that the incidence and manifestation of MEWDS are likely to become more diverse in the COVID-19 pandemic era.

Effect of Population-Level Blood Pressure Treatment Strategies on Cardiovascular and Cognitive Outcomes.

The large and increasing number of adults living with dementia is a pressing societal priority, which may be partially mitigated through improved population-level blood pressure (BP) control. We explored how tighter population-level BP control affects the incidence of atherosclerotic cardiovascular disease (ASCVD) events and dementia. Using an open-source ASCVD and dementia simulation analysis platform, the Michigan Chronic Disease Simulation Model, we evaluated how optimal implementation of 2 BP treatments based on the Eighth Joint National Committee recommendations and SPRINT (Systolic Blood Pressure Intervention Trial) protocol would influence population-level ASCVD events, global cognitive performance, and all-cause dementia. We simulated 3 populations (usual care, Eighth Joint National Committee based, SPRINT based) using nationally representative data to annually update risk factors and assign ASCVD events, global cognitive performance scores, and dementia, applying different BP treatments in each population. We tabulated total ASCVD events, global cognitive performance, all-cause dementia, optimal brain health, and years lived in each state per population. Optimal implementation of SPRINT-based BP treatment strategy, compared with usual care, reduced ASCVD events in the United States by ≈77 000 per year and produced 0.4 more years of stroke- or myocardial infarction-free survival when averaged across all Americans. Population-level gains in years lived free of ASCVD events were greater for SPRINT-based than Eighth Joint National Committee-based treatment. Survival and years spent with optimal brain health improved with optimal SPRINT-based BP treatment implementation versus usual care: the average patient with hypertension lived 0.19 additional years and 0.3 additional years in optimal brain health. SPRINT-based BP treatment increased the number of years lived without dementia (by an average of 0.13 years/person with hypertension), but increased the total number of individuals with dementia, mainly through more adults surviving to advanced ages. Tighter BP control likely benefits most individuals but is unlikely to reduce dementia prevalence and might even increase the number of older adults living with dementia.