Spread Of Infection Research Articles

Local effects of non-pharmaceutical interventions on mitigation of COVID-19 spread through decreased human mobilities in Japan: a prefecture-level mediation analysis.

To control the COVID-19 epidemic, the Japanese government and the local governments have repeatedly implemented non-pharmaceutical interventions (NPIs) throughout 2020-2022. Using Bayesian state-space mediation models, we examined the effect of repeated NPIs on infection spread mitigation, mediated by human mobility changes in each prefecture during three epidemic phases: from April 1, 2020 to February 28, 2021; from March 1, 2021 to December 16, 2021; and from December 17, 2021 to December 31, 2022. In the first phase, controlling downtown populations at nighttime was effective in mitigating the infection spread in almost all prefectures. In the second and third phases, the effect was not clear, especially in metropolitan prefectures. Controlling visitors from the central prefectures of metropolitan areas was effective in mitigating infection spread in the surrounding prefectures during all phases. These results suggest that the local spread of infection can be mitigated by focusing on nighttime human mobility control in downtown areas before the epidemic spreads widely and transmission routes become more diverse, and that the geospatial spread of infection can be prevented by controlling the flows of people from large cities to other areas.

The Implications of Handwashing and Skin Hygiene on Infectious Disease Dynamics: The African Scenario

Infectious diseases are largely preventable, yet they continue to pose a significant threat to public health, particularly among vulnerable populations in developing countries. Basic hygiene practices, especially hand and skin hygiene, have been shown to significantly reduce the risk of the cross-transmission of infections, including those caused by multi-drug-resistant organisms. In light of the growing global concern about antimicrobial resistance, there is an urgent need to review and reinforce these practices. This study provides a general overview of the role that hand hygiene practices play in decreasing infectious diseases by conducting a comprehensive review. Multiple online databases, including Google Scholar, Scopus, and Web of Science, were searched using relevant keywords such as “hygiene practices”, “infectious diseases”, “public health”, “Africa”, and “sanitation”. After filtering the search results for relevancy, selected studies were narratively synthesized to present the latest data on hand hygiene and its impact on infectious diseases. Strengthening hand and skin hygiene, along with environmental sanitation and preventive measures, can help reduce the spread of nosocomial infections. By emphasizing the importance of these fundamental hygiene practices, particularly in regions where the burden of infectious diseases is highest, the development of antibiotic-resistant diseases can be prevented, improving patient safety, and enhancing public health outcomes. Adopting comprehensive hygiene policies, including regular handwashing, is crucial for reducing the prevalence of infectious diseases and improving health outcomes in developing countries.

ANFIS Fuzzy convolutional neural network model for leaf disease detection

Leaf disease detection is critical in agriculture, as it directly impacts crop health, yield, and quality. Early and accurate detection of leaf diseases can prevent the spread of infections, reduce the need for chemical treatments, and minimize crop losses. This not only ensures food security but also supports sustainable farming practices. Effective leaf disease detection systems empower farmers with the knowledge to take timely actions, leading to healthier crops and more efficient resource management. In an era of increasing global food demand and environmental challenges, advanced leaf disease detection technologies are indispensable for modern agriculture. This study presents an innovative approach for detecting pepper bell leaf disease using an ANFIS Fuzzy convolutional neural network (CNN) integrated with local binary pattern (LBP) features. Experiments involve using the models without LBP, as well as, with LBP features. For both sets of experiments, the proposed ANFIS CNN model performs superbly. It shows an accuracy score of 0.8478 without using LBP features while its precision, recall, and F1 scores are 0.8959, 0.9045, and 0.8953, respectively. Incorporating LBP features, the proposed model achieved exceptional performance, with accuracy, precision, recall, and an F1 score of higher than 99%. Comprehensive comparisons with state-of-the-art techniques further highlight the superiority of the proposed method. Additionally, cross-validation was applied to ensure the robustness and reliability of the results. This approach demonstrates a significant advancement in agricultural disease detection, promising enhanced accuracy and efficiency in real-world applications.

Analysis of GCRV Pathogenesis and Therapeutic Measures Through Proteomic and Metabolomic Investigations in GCRV-Infected Tissues of Grass Carp (Ctenopharyngodon idella)

Hemorrhagic disease caused by grass carp reovirus (GCRV) infection is a major problem affecting the grass carp aquaculture industry. Therefore, inhibiting the spread of GCRV infection is of great economic significance. Herein, we sequenced five tissues (gill, liver, intestine, kidney, and muscle) from grass carp before and after GCRV infection using data-independent acquisition proteomic and untargeted metabolomic technologies, and quantitatively identified 10,808 proteins and 4040 metabolites. Then, we analyzed the differentially expressed proteins (DEPs) and metabolites (DEMs) before and after GCRV infection in the five tissues. Gene ontology analysis revealed that the five tissue DEPs were enriched in metabolic, including carbohydrate and lipid metabolic processes. Chemical taxonomy analysis showed that the categories of DEMs mainly included carbohydrates and lipids, such as fatty acids, glycerophospholipids, steroids, and their derivatives. Both the proteomic and the metabolomic data showed that GCRV affected the carbohydrate and lipid metabolism in the host. Shared pathway analysis was performed at both the protein and metabolic levels, showing significant enrichment of the glycolysis and pentose phosphate pathways (p < 0.001). Further analysis of glycolysis and pentose phosphate pathway inhibitors revealed that these two pathways are important for GCRV replication. As the kidney was the most affected among the five tissues, we analyzed the butanoate metabolism in the kidney, which revealed that most of the differentially expressed proteins and differently expressed metabolites in the butanoate metabolism were related to the TCA cycle. Further investigation showed that fumaric acid, an intermediate product in the TCA cycle, significantly inhibited GCRV replication in the CIK cells (p < 0.001), and that this inhibitory effect may be related to its induction of interferon system activation. The addition of fumaric acid to feed increased the survival rate of juvenile grass carp by 19.60% during GCRV infection, and protected the tissues of those infected with GCRV, making it a potential anti-GCRV feed additive. Our results provide new perspectives on GCRV pathogenesis and antiviral strategies for grass carp.

Fractional-Order Mathematical Modeling of Methicillin- Resistant Staphylococcus aureus Transmission in Hospitals

This article investigates the environmental contamination and antibiotic exposure effect on the transmission dynamics of the Methicillin-Resistant Staphylococcus aureus (MRSA) model in hospitals using the fractional Adams–Bashforth–Moulton Method (ABMM). This epidemic model simulates the dynamics of patient populations, bacterial contamination, and healthcare worker safety under varying conditions. This model provides critical insights into the interactions between hospital practices, environmental factors, and infection dynamics, demonstrating the importance of symmetry in balancing hospital admission and discharge rates to manage infection spread effectively. The analysis extends to the impact of environmental bacterial density and hospital admission rates on patient colonization. Increasing admission rates introduce more susceptible patients, exacerbating infection spread when bacterial density is high. Conversely, lower admission rates and bacterial density result in a more controlled infection environment. The model further investigates how varying discharge rates influence colonization dynamics, highlighting that effective discharge practices can mitigate infection spread, especially in high-bacterial density scenarios. It must be noted that this model is studied fractionally for the first time. Overall, this model provides critical insights into the interactions between hospital practices, environmental factors, and infection dynamics, offering valuable guidance for infection control strategies and hospital policy formulation. By adjusting fractional order constant (σ) values and analyzing different scenarios, this research aids in understanding and managing bacterial infections in healthcare settings. The proposed method is able to provide the results presented in the figures within this study considering the influence of many factors.

Live imaging of airway epithelium reveals that mucociliary clearance modulates SARS-CoV-2 spread

SARS-CoV-2 initiates infection in the conducting airways, where mucociliary clearance inhibits pathogen penetration. However, it is unclear how mucociliary clearance impacts SARS-CoV-2 spread after infection is established. To investigate viral spread at this site, we perform live imaging of SARS-CoV-2 infected differentiated primary human bronchial epithelium cultures for up to 12 days. Using a fluorescent reporter virus and markers for cilia and mucus, we longitudinally monitor mucus motion, ciliary motion, and infection. Infected cell numbers peak at 4 days post infection, forming characteristic foci that tracked mucus movement. Inhibition of MCC using physical and genetic perturbations limits foci. Later in infection, mucociliary clearance deteriorates. Increased mucus secretion accompanies ciliary motion defects, but mucociliary clearance and vectorial infection spread resume after mucus removal, suggesting that mucus secretion may mediate MCC deterioration. Our work shows that while MCC can facilitate SARS-CoV-2 spread after initial infection, subsequent MCC decreases inhibit spread, revealing a complex interplay between SARS-CoV-2 and MCC.

Enhanced antimicrobial efficacy of hydroxyapatite-based composites for healthcare applications

Hydroxyapatite (HAp) and hydroxyapatite-based materials show promising potential in the healthcare sector due to their distinctive properties such as biocompatibility, antimicrobial efficacy, non-toxicity, and robust mechanical characteristics. This makes HAp materials play an important role in hindering infection spreading in healthcare provider institutions. This study assesses the antimicrobial efficacy of the developed hydroxyapatite-based composites incorporating copper, zinc, and silver nanoparticles. The synthesized HAp and its modified composite variants (Cu/HAp, Zn/HAp, and Ag/HAp) with varying ratios ranging from 0 to 15% (wt) were characterized using XRD, XPS, SEM, and TEM analyses. Furthermore, the antibacterial and antifungal properties of the synthesized HAp and HAp-based composites were evaluated. The antibacterial effectiveness of the HAp and its composites was evaluated using a modified disc diffusion test, where the resulting inhibition zones on the agar surface were observed. All the HAp and HAp-based composites (HAp, Cu/HAp, Zn/HAp, and Ag/HAp materials) elicited in the formation of inhibitory zones. The most substantial inhibition values were observed for the 5% Ag/HAp formulation, with values of 19.7 and 13.8, against E. coli and S. aureus, respectively. The 5% Ag/HAp concentration may strike an ideal balance, providing high antimicrobial activity without adverse effects on biocompatibility or material stability. These findings underscore the recommendation of the proposed HAp-based composites for infection control measures through their application on medical instruments, textiles, healthcare personnel attire, and patient garments.

Ultra-Sensitive Dengue NS1 Protein Detection via Asymmetric Source-Drain, Heterojunction and Dual-Dielectric Cavities in a Uniform Tunnel FET Biosensor

In this paper, we present a unique Asymmetric Source-Drain Heterojunction Dual-Dielectric Uniform Tunnel Field Effect Transistor (A-SD-HJ-DD-UTFET) based biosensor tailored for the early detection of dengue NS1 protein during the acute phase of infection offering early diagnosis and potentially life-saving intervention. The proposed biosensor design features simplified fabrication, a narrow drain region, and a dual material control gate, enhancing specificity and sensitivity for dengue virus detection. Using a heterojunction configuration, this device optimizes electron flow for improved detection accuracy. The roles of Tunnel Gate (TG) and Auxiliary Gate (AG) are studied in terms of band energy, electric field, electrostatic potential, and other sensitivity parameters. Sentaurus TCAD tool is utilized for analysing the characteristics of the proposed A-SD-HJ-DD-UTFET biosensor. Simulation results indicate that the designed A-SD-HJ-DD-UTFET biosensor achieves a superior Subthreshold Swing (SS) of 15.4 mV/dec and an enhanced ION/IOFF sensitivity of about 2.25 × 10¹¹ with a maximum ON and minimum OFF state currents of 2.28 × 10-4 A/μm and 1.28 × 10-16 A/μm respectively for detecting NS1 protein of dengue. Additionally, it boasts a high switch ratio in the order of 1012. The proposed biosensor outperforms conventional devices, including the state-of-the-art Junctionless (JL)-TFET biosensors. The superior electrical characteristics of the proposed A-SD-HJ-DD-UTFET biosensor make it a promising device for early detection of the dengue NS1 protein, providing a potent solution for mitigating the spread of dengue infections.

Role of admission rapid antigen testing (RATs) for COVID-19 on patients transferred from acute hospitals to a post-acute rehabilitation setting.

BackgroundRapid antigen tests (RATs) are suitable for point-of -care testing, require no laboratory time and give immediate results. However, are RATs useful for detecting asymptomatic COVID-19 infection when compared with polymerase chain reaction (PCR) testing in healthcare settings? AimThe aim of this study was to implement a reliable testing system utilising RATs to promptly detect COVID-19 infection in predominantly asymptomatic patients transferred from acute hospitals to a post-acute rehabilitation unit (PARU). MethodsRAT testing was carried out on all new admissions without a history of confirmed Covid-19 infection within three months of admission. PCR testing was carried out on all patients with a positive RAT for confirmation purposes. The cycle threshold (Ct) values of COVID-19 detected results on PCR testing were examined to determine the utility of the RATs. ResultsA total of 1,403 patients were transferred to the PARU from January to December 2023. The results of the study revealed an 85% accuracy of RATs with a 15% rate of false negative results at the time of admission. All patients that had a positive RAT at the time of admission also had a positive PCR test. ConclusionThis testing algorithm resulted in early detection and prompt isolation of positive cases reducing the likely spread of COVID-19 infection, hospital outbreaks and bed/ward closures.

Monitoring of Viral Infections in Vegetable Crops in Agroecosystems of Ukraine

Information on the abundance and diversity of phytopathogenic viruses in Ukraine is very variable and limited. There is a high importance of a complex study of the species composition and ways of spreading crop viruses, as well as the development of epiphytotic forecasting systems, which will help to limit the ranges of these viruses and save crop yields. Consequently, the aim of our study was to explore the species composition and frequency of mono- and mixed virus infection of vegetable crops in Ukrainian agrocenoses and to identify the possible etiology of its occurrence. Methods. The samples were analyzed for the presence of viral antigens by enzyme-linked immunosorbent assay in sandwich and indirect modifications. For the detection of viral antigens in ELISA, test systems manufactured by Loewe were used. To identify the virus, the material was homogenized and purified, and then registered on a reader. Results. The frequency of vegetable crops damaged by diseases of viral etiology increased by 25–27% compared to the previous years of the study. Serological analysis showed that 59% of the studied samples of the Cucurbitaceae family and 54% of the Solanaceae family were affected by the main viral diseases most common in Ukraine. The seed way of transmission of vegetable viruses in Ukraine was demonstrated as one of the sources of viruses in agrocenoses. The presence of antigens to cucumber mosaic virus (CMV) in 14.3% of the studied seeds, zucchini yellow mosaic virus (ZYMV) – 11.2%, and tomato mosaic virus (ToMV) – 12.6% was shown. This allows us to suggest that sowing those seeds in the future will contribute to the spread of these viruses across Ukraine. Analysis of soil samples showed the presence of antigens of cucumber mosaic virus, tobacco mosaic virus, and potato virus X. The lowest level of antigens to CMV was detected in the soils of Vinnytsia region, to PVX – in the Kyiv and Cherkasy regions, and to TMV – in the Odesa region. Conclusions. Vegetable agrocenoses in Ukraine are more often affected by viruses belonging to the Tobamovirus, Cucumovirus, Potyvirus, and Tospovirus genera of the Bromoviridae, Potyviridae, and Bunyaviridae families. In addition to the increasing areas of viral monoinfection, there is an active spread of mixed infection, or "superinfection", in Ukrainian agrocenosis. Mixed infections are mainly formed during the growth and development of the tested vegetable crops. All of this leads to further significant spread of not only mono- but also mixed virus infection of vegetable crops.

Expression of Toll-like Receptor Genes and Antiviral Cytokines in Macrophage-like Cells in Response to Indole-3-carboxylic Acid Derivative

Ongoing outbreaks and often rapid spread of infections caused by coronaviruses, influenza, Nipah, Dengue, Marburg, monkeypox, and other viruses are a concern for health authorities in most countries. Therefore, the search for and study of new antiviral compounds are in great demand today. Since almost all viruses with pandemic potential have immunotoxic properties of various origins, particular attention is paid to the search and development of immunomodulatory drugs. We have synthesised a new compound related to indole-3-carboxylic acid derivatives (hereinafter referred to as the XXV) that has antiviral and interferon-inducing activity. The purpose of this work is to study the effect of the XXV on the stimulation of the expression of toll-like receptor genes, interferons, and immunoregulatory cytokines in a macrophage-like cell model. In this study, real-time PCR methods were used to obtain data on the transcriptional activity of genes in macrophage-like cells. Stimulation of the genes of toll-like receptors TLR2, TLR3, TLR4, TLR7, TLR8, and TLR9 was detected. A high-fold increase in stimulation (from 6.5 to 16,000) of the expression of the TLR3 and TLR4 genes was detected after 4 h of exposure to the XXV. Increased activity of interferon (IFNA1, IFNA2, IFNB1, IFNK, and IFNλ1) genes with simultaneous stimulation of the expression of interferon receptor (IFNAR1 and IFNAR2) genes and signalling molecule (JAK1 and ISG15) genes was detected. Increased fold stimulation of the expression of the cytokine genes IL6, TNFA, IL12A, and IL12B was also observed. Thus, it is shown that the XXV is an activator of TLR genes of innate immunity, which trigger signalling mechanisms of pathogen “recognition” and lead to stimulation of the expression of genes of proinflammatory cytokines and interferons.

Antimicrobial Performance of Different Metals

Health care associated infections or nosocomial infections (NI) is the fourth leading cause of disease and the most common complication affecting hospitalised patients in addition to a minimum of 175,000 deaths every year in industrialised countries. The Center for Disease Control and Prevention (CDC) states that influenza is transmitted from person to person primarily via large virus-laden droplets or through direct or indirect contact with respiratory secretions when touching surfaces contaminated with influenza virus and approximately 80% of the infections are transmitted via touch surfaces. In the year 2020 the Coronavirus (Covid 19) spread has affected the global community and also caused a great concern for the people and health care workers with a global infected population of more than five million. With the ongoing population rise in the cities growing drug resistant bacteria, increasing infection rate in hospitals and communities, ageing world population strongly indicates the need to minimise the spread of infections via touch surfaces. Metals (and products manufactured from them) such as copper and silver are known to exhibit antimicrobial properties. These metals, or composites containing them, can be used as additives and incorporated into other materials such as paints, plastics and powder coatings to imbue these materials with antimicrobial properties. In this paper we present the inherent antimicrobial properties of a copper containing alloy, two alloys of hospital grade steel (304 and 316), extruded aluminium (606013), anodized aluminium (606013) and zinc clad aluminium (3003-7072). Additionally, these materials were coated in epoxy resin powder coating with and without silver based antimicrobial additive. The ability of these metal alloys to reduce the population of inoculated microorganism numbers was assessed via the international standard (ISO) 22196:2011 Measurement of antimicrobial activity on plastics and other non-porous surfaces.

ФАРМАКОЭКОНОМИЧЕСКИЕ ПОДХОДЫ К АНАЛИЗУ СТОИМОСТИ АНТИРЕТРОВИРУСНЫХ ПРЕПАРАТОВ, ПРИМЕНЯЕМЫЕ В ТЕРАПИИ ВИЧ-ИНФИЦИРОВАННЫХ ПАЦИЕНТОВ

The legislation in force in the Russian Federation guarantees HIV patients protection of their rights in labor, education and other spheres of life, as well as free counseling, diagnosis and treatment of HIV infection. The continued increase in the number of infected people and, more importantly, the emergence of the HIV epidemic from risk groups into the general population highlights the need for additional improvement in the effectiveness of measures taken to counter the spread of infection. In this regard, it is necessary to use the most rational measures, both from the point of view of efficiency and safety, and from the point of view of costs. The most suitable tool for solving these problems is pharmacoeconomical analysis. At the same time, conducting pharmacoeconomical analysis in the field of HIV infection, as well as in any other nosology, involves the need to take into account certain features at the stages of planning and implementation of the study. It is necessary to highlight some key features of the methodology of pharmacoeconomical analysis in the assessment of healthcare technologies in the field of HIV infection, in particular, cost minimization analysis, which involves choosing a medical technology with minimal costs by comparing the monetary value of alternative technologies, provided the same therapeutic effectiveness. The main object of the study was the documented medical histories of HIV-infected patients, statistical and analytical methods of analysis were used and it was established that in the Russian Federation and in Kuzbass there are all drugs for the treatment of patients with HIV infection included in modern lists of treatment standards according to clinical recommendations. The difference in the cost of antiretroviral drugs at the price of government funding has been established, which affects the costs of treating HIV-infected patients.

Synergistic potential of Leu10-teixobactin and cefepime against multidrug-resistant Staphylococcus aureus

Staphylococcus aureus (S. aureus) is a significant Gram-positive opportunistic pathogen behind many debilitating infections. β-lactam antibiotics are conventionally prescribed for treating S. aureus infections. However, the adaptability of S. aureus in evolving resistance to multiple β-lactams contributed to the persistence and spread of infections, exemplified in the emergence of methicillin-resistant S. aureus (MRSA). In the present study, we investigated the efficacies of the synthetic teixobactin analogue, Leu10-teixobactin, combined with the penicillinase-resistant cephalosporin cefepime against MRSA strains. The Leu10-teixobactin and cefepime combination exerted synergism against most strains tested in broth microdilution assay. Time-kill profiles showed that both Leu10-teixobactin and cefepime predominantly exhibited synergistic activity, with > 2.0-log10CFU decrease compared to monotherapy at 24 h. Moreover, biofilm assays revealed a significant inhibition of biofilm production in ATCC™43300 cells treated with sub-MICs of Leu10-teixobactin and cefepime. Subsequent electron microscopy studies showed more extensive damage with the combination therapy compared to monotherapies, including aberrant bacterial morphology, vesicle formation and substantial lysis, indicating combined damage to the cell wall. Quantitative real-time PCR revealed marked perturbation of genes mecA, sarA, atlA, and icaA, substantiating the apparent mode of combined antibacterial action of both antibiotics against peptidoglycan synthesis and initial biofilm production. Hence, the study highlights the prospective utility of the Leu10-teixobactin-cefepime combination in treating MRSA infections via β-lactam potentiation.

Non-surgical management of methicillin-sensitive Staphylococcus aureus bacteremia-related mediastinitis

Background: Acute mediastinitis is rarely caused by haematogenous spread of a remote infection. In this respect, since the only medical therapy is usually unsuccessful, treating acute mediastinitis with no source of infection detected is very challenging and management not standardized. In this case report, we describe non-surgical management experience of acute mediastinitis caused by methicillin-sensitive Staphylococcus aureus. Case presentation: In a 79-year-old man judged not eligible for cardiac surgery, we attempted the infection source control through vacuum-assisted closure therapy, together with antimicrobial therapy. We observed gradual clinical, laboratory and radiologic improvements: reduced swelling and normalization of the white blood cell count and C-reactive protein level were associated with reduction in size of a periaortic abscess. Conclusion: We managed a clinical condition with high mortality risk with chronic antimicrobial therapy alone, a strategy that is rarely considered. With this medical strategy we achieved an optimal response to a clinical picture that does not allow any other approach.

The role and needs of teachers/schools in infection, prevention and control post covid-19

Abstract Introduction COVID-19 highlighted the importance of infection prevention and control (IPC) across all settings. As children are important transmitters of infection, teachers and schools play an important role in infection prevention. The aim of this study is to understand attitudes towards, and knowledge of IPC in schools post-Covid, and highlight any gaps in the training and resources needed. Methods An online survey of 1000 primary and secondary school teachers was carried out across England. Pearson’s chi-squared test, corrected for survey design, was used to test for differences in proportions across levels of categorical variables. Two qualitative workshops with eight head teachers were carried out to gather more in-depth information. Results 1000 teachers completed the survey across a range of teaching roles. Respondents reported that IPC measures are now less frequently implemented than during the pandemic. 71% of respondents say their role has changed since the pandemic, now having more responsibility for pupil health and hygiene; higher in primary versus secondary school teachers (31% v 25%; p < 0.05). 1/3 felt this change was permanent; 84% had no IPC training. Knowledge gaps were identified in the areas of IPC roles within schools, and IPC measures. 72% teachers claim they feel better prepared to deal with a public health outbreak compared to pre-pandemic, although 22% do not have an updated IPC policy; 35% had unmet needs. Conclusions Schools and teachers play a pivotal role in preventing the spread of communicable disease, highlighted during the COVID-19 pandemic. Teachers need, and more importantly want, more IPC training. Training and updated policies would support the educational workforce who feel their needs are not being met. Providing more streamlined, consistent, clear and concise information from trusted sources is required. Key messages • It is imperative to understand educators’ role in IPC in schools as they are key players in supporting local and national efforts to reduce the spread of infections. • Teachers desire further training with comprehensive information, and up-to-date policies to support their infection prevention and control efforts in educational settings.

Effective decision-making in public health organizations: reference to the COVID-19 pandemic.

The role of public health organizations during the COVID-19 pandemic was crucial. These groups acted to slow the spread of infection through the implementation of initiatives, policies, research and more. However, the rapidly changing and uncertain climate of the pandemic resulted in suboptimal processes and decision-making within these organizations. These already complex organizations and networks of people became even more nuanced. Thus, organizational decision-making processes must be improved upon based on previous experiences and lessons learnt. With minimal peer-reviewed literature available, resources for effective organizational decision-making in these organizations are scarce. This served as the impetus for this review. To conduct this literature review, both peer-reviewed and grey literature were incorporated to better understand effective organizational decision-making practices for public health organizations. Recommendations found in the literature review were identified, coded and themed to provide a novel decision-making framework to be used by public health executives. Nine key themes of effective organizational decision-making were identified, including utilize decision-making tools, define the problem and acknowledge an imminent decision, establish decision rights, outline a clear escalation path, create a supportive organizational culture, set decision objectives and goals, and evaluate decision alternatives. These findings in conjunction with existing decision-making models were used to create a seven-step effective decision-making framework for public health organizations. The review and analysis of effective organizational decision-making practices is instructive. Public health executives and decision-makers should incorporate the themes identified and employ the proposed decision-making framework to encourage improved decision-making practices.

Identification of Critical Nodes for Delay Propagation in Susceptible-Exposed-Infected-Recovered (SEIR) and Genetic Algorithm (GA) Route Networks

In response to the challenges associated with forecasting the trajectory of flight delay propagation, pinpointing pivotal nodes within the route network, and the substantial costs involved in enhancing operational efficiency, this study introduces an innovative approach to identifying critical nodes that influence delay propagation across route networks. The methodology commences by establishing a route network model for East China, leveraging the principles of complex network theory. It then incorporates the SEIR (Susceptible-Exposed-Infected-Recovered) model, typically used for analyzing the dynamics of infectious disease spread, to examine the propagation of delays between routes. Subsequently, the approach employs a GA to identify key nodes, which are then compared against those identified by network topology indices. The simulation outcomes demonstrate that the GA’s identification of key nodes offers superior insights into the overall network’s susceptibility to infection, thereby presenting operational managers with novel perspectives for analyzing the spread of flight delays.

The Pores of Kohn, an Overlooked Pulmonary Structure: A Review

Many studies from the early 20th century on the significance of the pores of Kohn were assessed based on the pathogenesis and pathology of pneumococci pneumonia occurring in man. The pneumococci were carried in the edema fluid directly from alveolus to alveolus through the pores of Kohn and from bronchiole to bronchiole as a result of repeated aspirations, aided by breathing, coughing, and gravity. With the emerging minimally invasive and non-invasive techniques experimentations and the current medications; tackling exacerbations and improving the pulmonary function in various lung diseases remains a dilemma for clinicians and researchers. In this article, we aim to review specifically the pores of Kohn as this is the portal for the spread of infection but also lung recruitment during breathing.

37 Adverse events associated with paediatric emergency medicine virtual clinic visits

Abstract Background Emergency medical care inherently carries a potential for adverse events. With the increase in virtual medical care due to its ease of access and ability to limit the spread of infection, there is a need to evaluate the safety of paediatric emergency medicine virtual clinics. Objectives To elucidate the frequency of adverse events occurring within 7 days of accessing medical care provided by a Paediatric Emergency Medicine Virtual Clinic. We then seek to characterize the severity, nature, and preventability of the adverse events and to provide a knowledge base for future work related to patient safety in the virtual emergency care domain. Design/Methods This study was a prospective cohort study where the primary outcome was the proportion of patients who experienced an adverse event within 7 days of accessing care through a virtual emergency clinic. Data was collected through telephone interviews and chart analysis with the use of a validated adverse events trigger tool to determine which charts required independent physician review. The final data was categorized using descriptive statistics, and logistic regression analysis was conducted to examine potential predictors of adverse events. Results Of 593 eligible families, 232 (39%) consented to participate and completed the interview process. Of these families, 89 were flagged for further review, and subsequent analysis concluded that 5 (2.2%) had experienced an adverse event. Of the adverse events, 4 (80%) were considered preventable and the most common type of adverse event was sub-optimal follow up (60%). The median patient age was 3.0 years (IQR 1.0-5.0). There were no clinically significant differences between the patients who experienced an adverse event and those that did not across the parameters studied (age, sex, gender, medical complexity, length of symptoms, language of fluency, and self-identification of visible minority status). Conclusion 2.2% of patients, approximately 1 in 45, experienced adverse events related to the care they received at the virtual clinic. The majority of these adverse events were preventable. That said, the rates of events were within the published norm, suggesting the virtual clinic provides a viable option in paediatric emergency medicine.