Infectious Research Articles

Choroidal vascularity index in health and systemic diseases: a systematic review

Abstract Background The choroid, a highly vascular structure within the eye, is significantly influenced by various systemic conditions. The advent of enhanced depth optical coherence tomography has improved our ability to evaluate choroidal pathophysiology. The choroidal vascularity index (CVI), a noninvasive and reliable tool, serves as an effective means of assessing the choroidal vascular structure. Recent studies have increasingly focused on exploring CVI alterations under different systemic conditions. This study aims to provide a comprehensive summary of the latest research findings in this area. Methods A systematic literature review was conducted on October 1, 2023, using two databases, MEDLINE (via PubMed) and Scopus. Search terms were tailored specifically for each database to ensure a thorough exploration of relevant literature. The studies identified were qualitatively assessed, with particular emphasis on outcomes related to CVI and choroidal thickness. Results A total of 48 studies were included in the review, encompassing a diverse range of systemic conditions such as diabetes, central nervous system disorders, cardiovascular diseases, autoimmune disorders, and infectious diseases. Notable reductions in CVI were observed in diabetic retinopathy, autoimmune diseases, and neurodegenerative disorders. Additionally, the review highlighted variations in CVI values related to the severity of systemic diseases, indicating its potential use as a biomarker for disease progression. Conclusion This review highlights the significant correlation between variations in the choroidal vascularity index and diverse systemic conditions affecting hemodynamics. An enhanced understanding of CVI provides deeper insights into the pathophysiological mechanisms underlying these disorders and positions CVI as a promising biomarker for early detection and monitoring. Nevertheless, its clinical utility warrants careful assessment. Future research should address the potential limitations of CVI to fully capitalize on its diagnostic and prognostic potential.

Advancing the role of pharmacists in infectious diseases: Fostering critical thinking and collaboration

Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Gambaran Faktor Risiko Kejadian Stunting pada Ibu dengan Anak Balita Stunting di Wilayah Kerja Puskesmas Baregbeg

Stunting is one of the main nutritional issues that Indonesian toddlers face. The prevalence of stunting in toddlers (children under five years old) was 30.8% in 2018, according to the Basic Health Research (Riskesdas) results. This dropped to 27.67% in 2019 (Indonesian Nutrition Status Survey (SSGI), 2019), and then increased to 24.4% in 2021 (SSGI, 2021). The purpose of this study is to identify the risk factors for stunting in women in the Ciamis Regency working area of the Baregbeg Community Health Center who have stunted children under five in 2024. Descriptive research using a cross-sectional design was the methodology employed. Using a questionnaire, the study's population composed of all the mothers of 36 kids with stunting in the Baregbeg Health Center's working area. The majority of stunted toddlers had a history of exclusive breastfeeding (80.56%), middle class mothers in a middle educational level (55.56%), low parental income (86.11%), low birth weight babies (86.11%), infectious diarrheal diseases (86.11%), poor diet (77.78%), and an unvarried diet (88.88%), based to the research's results. To help to prevent potential problems with the child's growth and development, it is advised that moms of stunted children give their children greater care.

Orange Peel Lactiplantibacillus plantarum: Development of A Mucoadhesive Nasal Spray with Antimicrobial and Anti-Inflammatory Activity

Background/Objectives: Due to the high frequency and severity of upper respiratory bacterial infections, probiotics could offer a new medical approach. We explored the antibacterial and anti-inflammatory properties of the new strain Lactiplantibacillus plantarum BIA and formulated a nasal spray. Methods: L. plantarum BIA was isolated from orange peel and taxonomically identified through 16S rRNA gene sequencing. Its antibacterial activity was tested against Pseudomonas aeruginosa, Streptococcus pyogenes, Bacillus subtilis, Escherichia coli, and Staphylococcus aureus, while anti-inflammatory potential was evaluated by Griess assay. BIA genome was fully sequenced and analyzed to assess its safety. BIA was formulated in a freeze-dried matrix, containing prebiotics and cryoprotectants, to be reconstituted with a polymer solution. Solutions containing two types of hydroxypropyl methylcellulose (HPMC) and hyaluronic acid were evaluated as resuspending media and compared in terms of pH, viscosity, and mucoadhesion ability. The biological activity of BIA formulated as nasal spray was verified together with the stability of the selected formulations. Results: L. plantarum BIA inhibited human pathogens’ growth and showed anti-inflammatory activity and a safe profile. In the best-performing formulation, the probiotic is lyophilized in 10% fructooligosaccharides, 0.1% ascorbic acid, and 0.5% lactose and reconstituted with HPMC high viscosity 1% w/v. This composition ensured the probiotic’s viability for up to six months in its dried form and one week after reconstitution. It also allowed interaction with the nasal mucosa, preserving its antimicrobial and anti-inflammatory activities. Conclusion: The developed nasal spray could become a promising formulation in the field of nasal infectious and inflammatory diseases.

Microbiome modulators in the treatment of infectious diseases: insights from clinical trials

Microbiome modulators in the treatment of infectious diseases: insights from clinical trials

A hill tribe community advisory board in Northern Thailand: lessons learned one year on

AbstractNorthern Thailand and its neighbouring regions are home to several minority ethnic groups known as hill tribes, each with their own language and customs. Hill tribe communities live mostly in remote agricultural communities, face barriers in accessing health, and have a lower socio-economic status compared to the main Thai ethnic group. Due to their increased risk of infectious diseases, they are often participants in our research projects.To make sure our work is in line with the interests of hill tribe communities and respects their beliefs and customs, we set up a hill tribe community advisory board. We consult the members before, during, and after our projects are carried out. This manuscript recounts how we set up the community advisory board and our reflections following one year of activities. Our experience strongly supports engaging with community advisory boards when working with minority ethnic groups in lower and middle-income settings. In particular, we found that over time, as researchers and members familiarise with one another and their respective environments, exchanges gain meaning and benefits increase, stressing the advantages of long-term collaborations over short or project-based ones.

Engineering Escherichia coli-Derived Nanoparticles for Vaccine Development

The development of effective vaccines necessitates a delicate balance between maximizing immunogenicity and minimizing safety concerns. Subunit vaccines, while generally considered safe, often fail to elicit robust and durable immune responses. Nanotechnology presents a promising approach to address this dilemma, enabling subunit antigens to mimic critical aspects of native pathogens, such as nanoscale dimensions, geometry, and highly repetitive antigen display. Various expression systems, including Escherichia coli (E. coli), yeast, baculovirus/insect cells, and Chinese hamster ovary (CHO) cells, have been explored for the production of nanoparticle vaccines. Among these, E. coli stands out due to its cost-effectiveness, scalability, rapid production cycle, and high yields. However, the E. coli manufacturing platform faces challenges related to its unfavorable redox environment for disulfide bond formation, lack of post-translational modifications, and difficulties in achieving proper protein folding. This review focuses on molecular and protein engineering strategies to enhance protein solubility in E. coli and facilitate the in vitro reassembly of virus-like particles (VLPs). We also discuss approaches for antigen display on nanocarrier surfaces and methods to stabilize these carriers. These bioengineering approaches, in combination with advanced nanocarrier design, hold significant potential for developing highly effective and affordable E. coli-derived nanovaccines, paving the way for improved protection against a wide range of infectious diseases.

Interest and Expectations for a Herpes Vaccine Among People Diagnosed with Genital HSV 1-2 Infection: Results from an Italian Survey

Genital herpes simplex virus (HSV) is associated with a reduction in quality of life and adverse outcomes. The aim of this study is to assess the interest and expectations for a therapeutic HSV vaccine among individuals diagnosed with genital herpes in Italy. A retrospective survey was conducted at the Infectious Diseases Unit of the IRCCS San Raffaele Scientific Institute, Milan, Italy. The study collected data on demographics, clinical history and interest in HSV vaccination. The results showed that 87.5% of participants were interested in a therapeutic vaccine, with interest higher among younger people and those with frequent genital herpes recurrences. Participants most expected the vaccine to reduce the pain associated with outbreaks, followed by a reduction in the frequency and duration of recurrences. These findings underscore the strong demand for a therapeutic HSV vaccine, especially among those who experience recurrent outbreaks, and highlight the importance of considering patient expectations when developing preventive and therapeutic strategies for genital herpes.

Worldwide Clinical and Real-World Exposure to Baricitinib

Introduction: Baricitinib (BARI), an oral selective JAK inhibitor, is approved in many geographies for adults with rheumatoid arthritis or alopecia areata and for patients as young as age 2 years with atopic dermatitis or juvenile idiopathic arthritis. It is also approved in the US for hospitalized patients with COVID-19 infection. We report the worldwide clinical trial and real-world exposure to BARI across a range of diseases, ages and racial backgrounds. Methods: Real-world patient exposure estimates were calculated based on total mg sold, average daily dose, and average length of therapy as reported to regulatory agencies through the cumulative timeframe ending Jan. 31, 2024. Clinical trial exposures were based on actual exposures from completed trials through Feb. 13, 2024, and estimates were made for ongoing blinded trials based on the enrolment/randomization schemes Results: In the real-world setting, an estimated 1,836,600 patients have been exposed to the following BARI doses: 1 mg, ~2,000 (0.1%); 2 mg, ~524,900 (28.6%); 4 mg, ~1,309,600 (71.3%). Of these estimated exposures, ~ 57% were for COVID-19 with the remaining for all other indications combined. Across 59 clinical trials (completed and ongoing), an estimated 14,660 subjects (548 healthy volunteers and 14,112 patients) have received BARI since June 2008. Exposures from completed studies include 10,276 patients (62% female), 399 of whom were <18 yrs of age (≤1 month, N=4; 1 month - ≤2 yrs, N=24; >2 - ≤12 yrs, N=111; >12 - ≤18 yrs, N=260), 8820 were >18 to ≤65 yrs, 1027 were >65 yrs, and 30 had age unknown. An additional 467 adolescent and pediatric patients down to the age of 2 have been treated with BARI for atopic dermatitis in an ongoing clinical trial, bringing the total number of patients <18 years of age to 866 across dermatologic, rheumatologic, other autoimmunologic, and acute infectious diseases (excluding alopecia areata for which there is an ongoing pediatric trial). Clinical trial exposures by racial and ethnic background are as follows: Asian, N=2,491; Black, N=450; Caucasian, N=6,237; other, N=496; multiple, N=135; unknown, N=467. Conclusion: There has been extensive real-world exposure to BARI across indications and populations, and BARI is a well-studied molecule in clinical trials, across varied disease states, racial populations and ages. Since average daily dose and length of therapy may vary over time, real-world exposures are only an estimate of total patients receiving BARI. Exposures in clinical trials include patients as young as less than 1 month of age up to patients over the age of 65 years. While these exposures do not indicate efficacy or safety, they provide data to establish the overall profile of the drug and can inform on its performance over time across a variety of populations.

Individual and System Level Factors Contributing to Guideline Non-Adherent Surgical Antibiotic Prophylaxis at a Tertiary Health Care System: A Qualitative Analysis

Background Antibiotics play a crucial role in preventing surgical site infections, yet adherence to Infectious Disease Society of America (IDSA) guidelines varies widely. This qualitative study aimed to explore factors influencing perioperative antibiotic administration and assess the potential impact of a clinical decision support (CDS) tool on guideline adherence. Methods In this qualitative study, perioperative personnel with diverse roles (surgeons, anesthesiologists, certified nurse anesthetists, trainees, and pharmacists) were interviewed using a semi-structured interview format from September 2023 through April 2024. Interviews were then analyzed for codes which were assigned to concepts using the constant comparison method for assessment of factors that were described as barriers or facilitators of guideline adherence. Results After piloting with three interviews, we conducted nine sessions with a total of 17 participants: 7 attending anesthesiologists, 3 resident trainees, 2 perioperative pharmacists, 3 Certified Registered Nurse Anesthetists (CRNAs), and 2 attending surgeons. Key themes emerged: (1) Limited familiarity with Infectious Disease Society of America (IDSA) antibiotic guidelines, (2) Lack of standardization and optimization of antibiotic decision-making process, (3) Challenges with managing beta-lactam allergies, (4) Difficulty optimizing vancomycin timing, and (5) Perceived benefit of a Clinical Decision Support (CDS) tool in enhancing workflow and guideline adherence. Conclusions Non-adherence to antibiotic guidelines in the perioperative setting often results from a lack of structured workflow. Our interviews provide a foundation for developing a clinical decision support tool tailored to provider needs, aiming to improve user satisfaction and promote better adherence to perioperative antibiotic guidelines.

Excess mortality of infected ectotherms induced by warming depends on pathogen kingdom and evolutionary history

Climate change is causing extreme heating events and leading to more infectious disease outbreaks, putting species persistence at risk. The extent to which warming temperatures and infection may together impair host health is unclear. Using a meta-analysis of >190 effect sizes representing 101 ectothermic animal host–pathogen systems, we demonstrate that warming significantly increased the mortality of hosts infected by bacterial pathogens. Pathogens that have been evolutionarily established within the host species showed higher virulence under warmer temperatures, too. Conversely, the effect of warming on novel infections—from pathogens without a shared evolutionary history with the host species—were more pronounced with larger differences between compared temperatures. We found that compared to established infections, novel infections were more deadly at lower/baseline temperatures. Moreover, we revealed that the virulence of fungal pathogens increased only when temperatures were shifted upwards towards the pathogen thermal optimum. The magnitude of all these significant effects was not impacted by host life-stage, immune complexity, pathogen inoculation methods, or exposure time. Overall, our findings reveal distinct patterns in changes of pathogen virulence during warming. We highlight the importance of pathogen taxa, thermal optima, and evolutionary history in determining the impact of global change on infection outcomes.

Abstract IA007: Respiratory viral infection promotes the awakening and outgrowth of dormant metastatic breast cancer cells in lungs

Abstract Breast cancer is the second most common cancer globally. Most deaths from breast cancer are due to metastatic disease which often follows long periods of clinical dormancy. Understanding the mechanisms that disrupt the quiescence of dormant disseminated cancer cells (DCC) is crucial for addressing metastatic progression. Infection with respiratory viruses (e.g. influenza or SARS-CoV-2) is common and triggers an inflammatory response locally and systemically. Here we show that influenza virus infection leads to loss of the pro-dormancy mesenchymal phenotype in breast DCC in the lung, causing DCC proliferation within days of infection, and a greater than 100-fold expansion of carcinoma cells into metastatic lesions within two weeks. Such DCC phenotypic change and expansion is interleukin-6 (IL-6)-dependent. We further show that CD4 T cells are required for the maintenance of pulmonary metastatic burden post-influenza virus infection, in part through attenuation of CD8 cell responses in the lungs. Single-cell RNA-seq analyses reveal DCC-dependent impairment of T-cell activation in the lungs of infected mice. SARS-CoV-2 infected mice also showed increased breast DCC expansion in lungs post-infection. Expanding our findings to human observational data, we observed that cancer survivors contracting a SARS-CoV-2 infection have substantially increased risks of lung metastatic progression and cancer-related death compared to cancer survivors who did not. These discoveries underscore the significant impact of respiratory viral infections on the resurgence of metastatic cancer, offering novel insights into the interconnection between infectious diseases and cancer metastasis. Citation Format: Shi B. Chia, Bryan J. Johnson, Junxiao Hu, Roel Vermeulen, Marc Chadeau-Hyam, Fernando Guntoro, Hugh Montgomery, Meher Boorgula, Varsha Sreekanth, Andrew Goodspeed, Bennett Davenport, Felipe Valenca-Pereira, Vadym Zaberezhnyy, Wolfgang E Schleicher, Dexiang Gao, Andreia N. Cadar, Michael Papanicolaou, Afshin Beheshti, Stephen B. Baylin, James Costello, Jenna M. Bartley, Thomas E. Morrison, Julio A. Aguirre-Ghiso, Mercedes Rincon, James DeGregori. Respiratory viral infection promotes the awakening and outgrowth of dormant metastatic breast cancer cells in lungs [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Tumor-body Interactions: The Roles of Micro- and Macroenvironment in Cancer; 2024 Nov 17-20; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(22_Suppl):Abstract nr IA007.

Emergency hand surgery in the course of time : Clinical and economic aspects of inpatient and outpatient cases at auniversity hospital in the last decade

Hand surgery departments nowadays face the challenge of operating profitably, training new specialists, managing increasing case numbers and implementing the required shift towards outpatient care in clinical practice. The aim of this study was to describe the demographic and economic indicators of auniversity hospital and to examine the development of inpatient and outpatient case numbers over the past decade. Aretrospective data analysis was carried out for patients treated for hand injuries in the period from 2013 to 2023. The main diagnoses of cases were identified and descriptively analyzed using the International Classification of Diseases (ICD). In order to demonstrate acorrelation, alinear regression model was calculated and ap-value <0.05 was considered significant. In total, 2918 cases were included over adecade starting in 2013. Out of these 776 cases were treated on an outpatient basis and two thirds of the patients were male. The patients were generally healthy with an average American Society of Anesthesiologists (ASA) status of 1.6 ± 0.6 and with apatient clinical complexity level (PCCL) of 0 in 79% of cases. Patient numbers increased continuously from 161 cases in 2013 to 393 cases in 2022 (p < 0.001). The most common main diagnosis was infectious hand diseases (L02.4-M65.14). This resulted in the most frequently assigned diagnosis-related group (DRG) being I32E (319 cases). For inpatient cases the average incision-to-suture time was 51:51 min and for outpatient cases 26:03 min. The revenue was on average 4372.90 € per inpatient case and 300.77 € per outpatient case. The rate of examinations by the German Medical Service of Health Funds (Medizinischer Dienst) was 19% over the entire observational period. The increasing case numbers in the outpatient and inpatient sectors indicate acentralization and consolidation of hand surgical expertise in the region. There are significant revenue differences between outpatient and inpatient cases.

Point-of-Care Diagnostics Using Self-heating Elements from Smart Food Packaging: Moving Towards Instrument-Free Nucleic Acid-Based Detection.

Compromising between accuracy and rapidity is an important issue in analytics and diagnostics, often preventing timely and appropriate reactions to disease. This issue is particularly critical for infectious diseases, where reliable and rapid diagnosis is crucial for effective treatment and easier containment, thereby reducing economic and societal impacts. Diagnostic technologies are vital in disease modeling, tracking, treatment decision making, and epidemic containment. At the point-of-care level in modern healthcare, accurate diagnostics, especially those involving genetic-level analysis and nucleic acid amplification techniques, are still needed. However, implementing these techniques in remote or non-laboratory settings poses challenges because of the need for trained personnel and specialized equipment, as all nucleic acid-based diagnostic techniques, such as polymerase chain reaction and isothermal nucleic acid amplification, require temperature cycling or elevated and stabilized temperatures. However, in smart food packaging, there are approved and commercially available methods that use temperature regulation to enable autonomous heat generation without external sources, such as chemical heaters with phase change materials. These approaches could be applied in diagnostics, facilitating point-of-care, electricity-free molecular diagnostics, especially with nucleic acid-based detection methods such as isothermal nucleic acid amplification. In this review, we explore the potential interplay between self-heating elements, isothermal nucleic acid amplification techniques, and phase change materials. This paves the way for the development of truly portable, electricity-free, point-of-care diagnostic tools, particularly advantageous for on-site detection in resource-limited remote settings and for home use.

Results of monitoring probable cases of acute severe hepatitis of unknown etiology in children in Мoscow in 2022

In the spring 2022, the number of cases of severe acute hepatitis of unknown etiology was unusual increased in Europe. As an immediate response, the World health organization recommended active efforts to identify such cases at the international level. For monitoring of acute hepatitis in Moscow, patients with suspected liver disease were sent to Infectious Diseases Clinical Hospital No. 1. The goal: study of the structure of diseases occurring with liver damage in children hospitalized in 2022. Materials and methods: analysis of medical records of children hospitalized with a diagnosis of hepatitis from May 1 to December 31, 2022. Еpidemiological data (age, gender, parenteral manipulations, contacts with patients, travel abroad), clinical (fever, jaundice, etc.), laboratory parameters were assessed. Results: A total of 164 completed cases of hepatitis in children aged 5 months to 17 years were analyzed. 36 children met the criteria for probable severe acute hepatitis of unknown etiology. Age median was 7 years [2.25;11]. Girls made up more than half (21 (58.3%). Non-infectious genesis was established in 15 (41.6%). The infectious disease was verified in 11 (30.5%), of which adenoviral infection was detected in 2 children. In 9 (25%) children the etiology of hepatitis was not established. Conclusion. Various infectious and non-infectious diseases among hospitalized children lead to a significant increase in liver transaminases. Most acute hepatitis with unspecified etiology proceeded as an acute infectious disease and ended in recovery. The role of adenoviruses in the development of severe hepatitis in children was not confirmed in our study.

Predictors of the continuous use of an infectious disease self-management app for epidemiological investigations: a survey of young and middle-aged adults in South Korean citizens.

In the wake of the coronavirus disease-19 (COVID-19) pandemic, research on the difficulties faced by epidemiologists conducting epidemiological investigations has been progressing steadily. However, few studies have developed applications (apps) that can directly support epidemiological investigations via information and communication (ICT) technology, and conducted usability evaluations on them via user responses. This has caused difficulties when developing such technologies. We introduced and evaluated two mobile apps that support epidemiological investigations. This study attempted to identify the predictors affecting the acceptance of infectious disease self-management apps. We developed two infectious disease self-management smartphone apps for epidemiological investigations: KODARI (the Korean version) and MEDARI (in English version). We collected data from 248 users of KODARI by surveying Korean citizens. This study was conducted from November 15 to December 14, 2022. We used multiple regression analysis to identify the variables that affected continuous intention to use the KODARI app. We conducted two independent-samples t-tests to determine whether there were any differences in the perception of each variable in relation to demographic and COVID-19-related user characteristics. The factors that affected continuous intention to use the KODARI app, in order of relative importance, were: price value, satisfaction, performance expectancy, and facilitating conditions. Overall, male participants were more satisfied with the KODARI app than female ones, and more willing to continue using it. The male participants also evaluated facilitating conditions more positively than the female ones did. Married participants rated the app higher than single ones in terms of price value, performance expectancy, and continued intention to use. The study suggests factors that increase the use of health apps and suggests that use of these apps may increase further in the event of a future pandemics. These results are expected to help researchers study other infectious disease apps in the context of public health surveillance.

Cerebral disorders as a complication of whooping cough in a child under one year old

Whooping cough is a widespread infectious disease, the manifestations of which vary from nonspecific cough to life-threatening conditions with the development of apnea, hypoxic damage to the central nervous system, and respiratory failure, especially in young children. Against the background of a severe form of whooping cough, hemorrhages of various types can be observed, including in the brain. The team of authors describes a clinical case of cerebral impairment in a child under one year of age, which is associated with whooping cough. A day after discharge from the infectious diseases hospital, the child developed a generalized convulsive attack. Clinical, instrumental and objective data allowed us to establish a diagnosis: acute disorder of cerebral and spinal circulation of the hemorrhagic type. Subarachnoid hemorrhage. Severe anemia. Convulsive syndrome. Whooping cough. Subsequently, the development of signs of hydrocephalus was observed over time, with the further formation of multiple cysts and hemiatrophy of the right hemisphere of the brain.

Accuracy of Mentzer index for predicting iron deficiency anemia in adults

Background: It is of great clinical significance to differentiate between causes of microcytic, hypo chromatic anemias, iron deficiency anemia being one of them as it will improve with iron supplements. Complete blood picture is unable to differentiate. Iron studies and Hemoglobin electrophoresis are expensive tests. This necessitates the need of a cost-effective test and therefore we tried to determine the effectiveness of mentzer index in predicting iron deficiency anemia. Methods: It was an Observational, Cross-sectional study, conducted in Department of General Medicine, Federal government polyclinic hospital, Islamabad. Patients with microcytic hypochromic anemia, both from indoor and outdoor were included in study. Iron deficiency Anemia was diagnosed by iron studies (serum ferritin, Serum Iron, TIBC and transferrin saturation) and then mentzer index was calculated to check accuracy. Patient with normocytic or macrocytic anemia or other cell lines deficiency, patients with infectious diseases or inflammatory process were excluded from study. Results: A total of 155 patients were included in the study. Out of all the patients 145(93.5%) had mentzer index of &gt; 13 while 10(6.5%) had mentzer index of &lt;13. All of 150 patients (100%) had transferrin saturation lessthan 20 % indicating iron deficiency anemia against 93.5% picked up by Mentzer index. The receiver operator curves (ROC) showed that the MCV was the most important predictor of anemia while calculating mentzer index. The AUC value for MCV was 0.886(CI: 95%, 0.806-0.966, p value &lt;0.000). MCV value between 52.6 to 63.5 fl predicted that the Mentzer index would be above 13, thus suggesting iron deficiency anemia with a sensitivity of more than 86%. Conclusion: Study findings support the use of Mentzer index, particularly MCV, as a valuable tool for predicting iron deficiency anemia.

Measuring Vaccine Responses in the Multiplex Era.

Vaccine studies in psychoneuroimmunology (PNI) provide insight into biopsychosocial interactions and their role in infectious diseases. Methodologies to measure vaccine responses are therefore of critical importance for PNI researchers. In this chapter, traditional and modern immunoassays for the assessment of vaccine responses are discussed, highlighting how multiplex techniques provide researchers with greater capacity and opportunity for novel research relating to vaccine outcomes.

Stigma in tuberculosis patients: a cross-sectional study in the southeast region of Turkey.

Since tuberculosis (TB) is an infectious disease, it affects patients not only physically but also socially and patients are reported to experience stigma. This study was conducted to determine the stigma levels of patients in a tuberculosis dispensary in the southeastern region of Turkey. The study was conducted between December 2020 and June 2021 with 79 patients who agreed to participate. 'Questionnaire' and 'Tuberculosis-Related Stigma Scale' (TSS) were used for data collection. The score obtained from the scale ranges between '33 and 132' and the higher the score, the higher the 'stigma level'. It was determined that 54.4% of the patients were male, 45.6% were primary school and the mean age was 44.98 ± 16.09 years. It was found that 60.8% of the patients had pulmonary TB, 40.5% had been on treatment for 3-6 months, 45.6% described the society's view of TB patients as 'bad, negative, and excluding', 64.8% had adverse effects on their communication with their family and close environment after being diagnosed with TB. The mean TSS score of the patients was 103.51 ± 10.65. TB patients were found to have 'very high' levels of stigma. The mean total stigma is higher in smokers, particularly in cases of pulmonary and extrapulmonary tuberculosis, as well as in those whose professional lives are affected.