Low Fatality Rate Research Articles

020. A Preliminary Study of Post-Reconstructive Basal Cell Carcinoma Scars with Hyperbaric Oxygen Therapy Using Bates-Jensen Wound Assessment Tool Erick Latun1, Mendy Hatibie Oley2, Stevy Suoth2

Background: Non-melanoma skin cancer is 18-20 times more common among Caucasians and has a lower fatality rate. The study also indicated that women have more basal cell carcinoma than men. Treatments for basal cell carcinoma include surgery and on-surgical methods. Hyperbaric oxygen therapy is meant to speed up wound healing and prevent scarring. Through the use of the Bates-Jensen Wound Assesment Tool, basal cell carcinoma patients who undergo adjuvant hyperbaric oxygen therapy will be assessed in this study. Methods: The Bates-Jensen Wound Assessment Tool were used to collect data in this preliminary study. Participants who met the criteria were interviewed and given questionnaires to complete. According to the variable type, data is processed descriptively. Results: Six participants who fulfilled the inclusion criteria were interviewed about their Bates-Jensen Wound Assessment Tool showed to have good outcome with low score after the use of hyperbaric oxygen therapy. Conclusion: The Bates-Jensen Wound Assessment Tool is projected to be lower in severity in patients receiving hyperbaric oxygen therapy than in other control groups in this study.

Whooping cough – a recurrent epidemic

Abstract Background Whooping cough (WC), or Pertussis, is a vaccine-preventable and highly contagious infectious disease. Although it has a relatively low fatality rate, approximately 13% of reported cases develop secondary bacterial pneumonia. This was because of several recurrent epidemics across Europe in the last decades, with the latest beginning in mid-2023 and still ongoing. The Central Region of Portugal is currently being affected, and this study aims to describe the current epidemic at the regional level. Methods Data from epidemiological inquiries of confirmed and probable cases of WC pertaining to the Central Region of Portugal from January 2020 till April 2024 was gathered from the mandatory report national epidemiological surveillance system (SINAVE). Both a temporal comparison of number of cases and a statistical space-time scan with permutation were conducted (software SaTScan v10.) Results A comparison by month of reported cases shows an increase in cases from September 2023 until December 2023 followed by an exponential increase from January 2024 until April 2024 denoting an ongoing epidemic. In the statistical space-time analysis of 107 reported cases between September 2023 and April 2024, 8 nonsignificant clusters were identified with different locations involved in non-overlapping periods. Conclusions The finding of several unrelated clusters, even though nonsignificant, during a short time period indicates that Pertussis transmission is ongoing at the local level probably through asymptomatic or barely symptomatic cases that act as reservoirs. Clinicians must hold a high clinical suspicion for a timely diagnosis, treatment and report and health authorities must reinforce control measures to limit the spread of this disease. Key messages • Pertussis remains a disease of significant concern recurrent outbreaks across Europe show that public health local authorities have an important role in timely management of cases and outbreaks. • Local level transmission and intervention may play a pivotal role in the epidemiologic dynamic of Pertussis.

Pattern dynamics in a predator–prey model with Smith growth function and prey refuge in predator poisoned environment

In this article, we investigate temporal as well as spatiotemporal dynamics of a predator–prey system where prey grows according to Smith growth function and prey refuges in predator poisoned environment. Self as well as cross diffusion are taken into consideration to describe spatial moment of the species which make the system more realistic. This study aims to investigate the role of prey refuge, toxin-carrying carcass and the impact of cross-diffusion on the spatial distribution of species densities and associated patterns. The existence of equilibria and their stability conditions for non-spatial system are derived. We discuss the occurrence of Hopf bifurcation and detect the stability of limit cycle by computing first Lyapunov number. Temporal dynamics of the system is studied by varying the significant parameters. Study reveals that both prey refuge and fatality rate of predator due to toxin-carrying carcass, initially makes the system stable for low refuge and fatality rate but predator population goes to extinction as those effects increase. Turing instability conditions are listed and different instability regions so formed are discussed. In Turing region, pattern selection with the help of amplitude equation via weakly nonlinear analysis are performed which also numerically supported. Intensity of refuge and fatality rate due to toxin carrying carcass result paradox with real ecological world due to the presence of cross diffusion. Various kind of patterns such as mixture of stripe and spot, spot, irregular chaotic patterns emerge due to Hopf and Turing instability. Particularly, spatiotemporal chaos is a controversial topic because of its significant consequences for population dynamics. The results of this work are expected to contribute to a better understanding the level of prey refuge, use of toxin-carrying carcass considering movement in population and effect of cross-diffusion.

COVID-19-infected cases in Thailand during the Omicron wave using the capture-recapture method

Thailand is among many countries, severely affected by the COVID-19 pandemic. In December 2021, the Thai Ministry of Public Health announced the discovery of the first imported case of the Omicron variant, and the local transmission of the Omicron variant was confirmed. The Omicron variant spread rapidly but was less dangerous than the Delta. Some patients experienced mild or no symptoms and self-treated without requiring medical assistance. Lower fatality rates during the Omicron outbreak were reported compared with previous variants. Information concerning hidden COVID-19-infected patients is beneficial and will lead to a better understanding of the disease outbreak mechanism. This study proposed the lower bound estimator under the capture-recapture (CR) method to estimate the true value of COVID-19 infections in Thailand during the Omicron wave. The Chao lower bound estimator for the Poisson mixture model was created to take into account the fact that populations can be different based on how cases and deaths have been spread out over time. The approximate variance of the estimator was constructed for a confidence interval of 95%, focusing on the ratio of total estimated infected cases to observed cases in March 2022. The average ratio was 2.99 (95% CI: 2.96 to 3.01), suggesting that for every 100 observed patients, at least 199 infected patients were underreported.

Risk Stratification Of Signs Of Possible Serious Bacterial Infection For Prediction Of Mortality Among Young Infants

Objective: Possible serious bacterial infection (PSBI) is one of the leading causes of infant mortality. Based on WHO multi-centric study, signs of PSBI are categorized into: signs of clinical severe infection (CSI) and signs of critical illness (CI). Assessment of signs of PSBI helps to divide infants into risk groups for appropriate management and prognostication. This study aimed to assess risk stratification of signs of PSBI among young infants (0- 59 days of age) by correlating signs of PSBI with mortality. Methods: In this hospital-based prospective cohort study, 220 young infants with signs of PSBI were recruited. Infants were categorized into two: those with signs of CSI and those with signs of CI. Correlation of each sign of PSBI was done with mortality. Time to death was assessed by using the Kaplan Meier survival analysis. Results: 220 infants were analyzed for outcomes. Signs of CSI including fever, fast breathing, poor feeding, and movement only on stimulation had a low fatality rate; however low body temperature and severe chest pain was associated with high mortality of 20% and 9%, respectively. CI signs – convulsion, no movement at all, and no feeding at all were associated with high death rates of 14%, 63.7%, and 47.4% respectively. The majority of deaths were occurred within 48 hours of presentation. Conclusions: Mortality was high in infants with low body temperature, chest pain, or any sign of CI. Risk stratification based on clinical signs could help prioritize infants in need for urgent intervention and thus decrease infant mortality.

A novel deterioration prediction system for mild COVID-19 patients in Korea: a retrospective study

The ongoing coronavirus disease 2019 (COVID-19) pandemic presents serious public health threats. Omicron, the current most prevalent strain of COVID-19, has a low fatality rate and very high transmissibility, so the number of patients with mild symptoms of COVID-19 is rapidly increasing. This change of pandemic challenges medical systems worldwide in many aspects, including sharp increases in demands for hospital infrastructure, critical shortages in medical equipment, and medical staff. Predicting deterioration in mild patients could alleviate these problems. A novel scoring system was proposed for predicting the deterioration of patients whose condition may worsen rapidly and those who all still mild or asymptomatic. Retrospective cohorts of 954 and 2,035 patients that quarantined in the Residential Treatment Center were assembled for derivation and external validation of mild COVID-19, respectively. Deterioration was defined as transfer to a local hospital due to worsening condition of the patients during the 2-week isolation period. A total of 15 variables: sex, age, seven pre-existing conditions (diabetes, hypertension, cardiovascular disease, respiratory disease, liver disease, kidney disease, and organ transplant), and five vital signs (systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), body temperature, and oxygen saturation (SpO2)) were collected. A scoring system was developed using seven variables (age, pulse rate, SpO2, SBP, DBP, temperature, and hypertension) with significant differences between the transfer and not transfer groups in logistic regression. The proposed system was compared with existing scoring systems that assess the severity of patient conditions. The performance of the proposed scoring system to predict deterioration in patients with mild COVID-19 showed an area under the receiver operating characteristic (AUC) of 0.868. This is a statistically significant improvement compared to the performance of the previous patient condition assessment scoring systems. During external validation, the proposed system showed the best and most robust predictive performance (AUC = 0.768; accuracy = 0.899). In conclusion, we proposed a novel scoring system for predicting patients with mild COVID-19 who will experience deterioration which could predict the deterioration of the patient’s condition early with high predictive performance. Furthermore, because the scoring system does not require special calculations, it can be easily measured to predict the deterioration of a patients’ condition. This system can be used as effective tool for early detection of deterioration in mild COVID-19 patients.

A small opening in the storm clouds: overview of the registry-based study on the management of thyroid storm.

Due to the high mortality rate of TS, effective guidance for its diagnosis and treatment is essential. The diagnostic criteria introduced by the JTA in 2012, along with the Burch-Wartofsky Point Scale, constitute valuable tools for the diagnosis of TS. In 2016, Guidelines on the management of TS were produced by the JTA and the JES. Recently, a prospective multicenter register-based study compared the prognosis and outcome of 110 new-onset TS patients with the results of previous comparable studies and evaluated the efficacy of the Guidelines. The study revealed higher APACHE II scores and significant correlations between lower BMI, post-resuscitation shock, and fever with outcomes and, overall, improved TS prognosis. Most patients in the study received methimazole and potassium iodide, the timely administration of which was linked to lower fatality rates. Adherence to treatment guidelines correlates with lower mortality rates, emphasizing the importance of experienced multidisciplinary teams in ICU settings and the necessity for periodic review of the guidelines to enhance therapeutic approaches and reduce mortality.

The COVID-19 pandemic as a modifier of DGBI symptom severity: A systematic review and meta-analysis.

This SRMA reviewed and assessedthe changes in the severity of disorders of gut-brain interaction (DGBI) symptoms during the COVID-19 pandemic, and evaluated factors associated with symptom severity changes. Electronic databases were searched until February 2024, for articles reporting on changes in symptom severity in DGBI patients during the COVID-19 pandemic. The proportion of DGBI patients who reported a change in their symptom severity were pooled using a random-effects model, and subgroup analyses were conducted to assess the effect of socio-cultural modifiers on symptom severity in DGBI. Twelve studies including 3610 DGBI patients found that 31.4% (95% CI, 15.9-52.5) of DGBI patients experienced symptom deterioration, while 24.3% (95% CI, 10.2-47.5) experienced improvement. Countries with high gross domestic product (GDP) had a 43.5% (95% CI, 16.3-75.2) likelihood of symptom deterioration, compared to 9.2% (95% CI, 1.4-42.2) in lower GDP countries. Similarly, countries with low COVID fatality rates had a 60.1% (95% CI, 19.7-90.3) likelihood of symptom deterioration, compared to 18.3% (95% CI, 7.8-36.9) in higher fatality rate countries. Countries with lenient COVID policies had a 58.4% (95% CI, 14.1-92.3) likelihood of symptom deterioration, compared to 19% (95% CI, 8.2-38.1) in countries with stricter policies. Patients in high vaccine hesitancy countries had a 51.4% (95% CI, 19.5-82.2) likelihood of symptom deterioration, compared to 10.6% (95% CI, 2.7-33.4) in low vaccine hesitancy countries. This meta-analysis reveals that a significantly higher proportion of DGBI patients experienced deterioration of symptoms during the COVID-19 pandemic. Various sociocultural, economic and environmental factors potentially modify the effects of the COVID-19 pandemic on DGBI.

Characteristics and outcomes of a hospitalized cohort with reduced mortality from COVID-19, White Mountain apache tribal lands, April 1 – July 31, 2020

BackgroundWidespread transmission of COVID-19 continues to threaten public health, particularly of rural, American Indian communities. Although COVID-19 risk factors for severe disease and clinical characteristics are well described in the general population, there has been little shared on hospitalized American Indian populations.MethodsIn this observational study, we performed chart extractions on all persons hospitalized with COVID-19 from April 1 through July 31, 2020 among an exclusively American Indian population living on or near Tribal lands in eastern Arizona. We provide descriptive statistics for the cohort stratified by presentation, comparing those who self-presented or were referred by an outreach program. Exploratory analyses were performed to identify risk factors for morbidity and mortality.ResultsDuring the observation period, 2262 persons were diagnosed with COVID-19 and 490 (22%) were hospitalized. Hospitalized persons had a median age of 54 years; 92% had at least one comorbidity, 72% had greater than one comorbidity, and 60% had a BMI of > 30. Most persons required supplemental oxygen (83%), but the majority (62%) only required nasal cannula and only 11% were intubated. The case fatality rates were 1.7% for the population, 7.1% among hospitalizations, and 9.3% among hospitalized patients 50 years and older. All rates that are significantly lower than those reported nationally during the same period.ConclusionsWe observed a cohort of American Indian patients hospitalized secondary to COVID-19 with greater number of comorbidities compared to the general population but with lower mortality rates. We posit that the primary driver of mortality reduction for this population and the hospitalized cohort was a community-based referral program that led to disproportionately lower fatality rates among the oldest persons.

A Review of Mpox Outbreak and Public Health Response in Spain.

In May 2022, an unprecedented Mpox outbreak was reported in several non-endemic countries with unknown epidemiological links. Since May 2022, more than 20,000 cases have been reported in Europe. Spain has been the most affected country in Europe. We aim to describe the Mpox epidemiological profile in Spain, identify its outbreak risks, and describe public health interventions implemented by the Spanish authorities. A literature review was conducted, using specific selection criteria to obtain relevant publications describing Mpox clinical presentation and risk factors and the public health response in Spain to the ongoing outbreak. 63.1% of the cases presented an anogenital rash, considered a specific and early symptom in this outbreak. Low case fatality rate is observed, mainly in risk groups, such as the immunocompromised population. Patients evolution was generally favorable, although 3-8% required hospitalization and two deaths occurred; 40% of patients were previously diagnosed with HIV infection. Most of the cases were seen among young population and concentrated in men who had sex with other men, mainly with multiple sexual partners, who did not practice safe sex such as using condoms, and those attending mass event parties. To date, the Mpox outbreak is not considered a public health emergency of international concern. The epidemiological trend of the virus in Spain shows that public health response interventions (health education, contact tracing, vaccination, etc.) have adequately controlled the epidemic curve in high-risk populations and avoided spreading the virus to other groups within the community.

Study on intentional control strategy of COVID-19

With the ongoing evolution of the novel coronavirus pathogen and continuous improvements in our social environment, the mortality rate of COVID-19 is on a decline. In response to this, we introduce an adaptive control strategy known as intentional control, which offers cost-efficiency and superior control effectiveness. The classical SEIR model faces limitations in accurately representing close contacts and sub-close contacts and fails to distinguish their varying levels of infectivity. To address this, our study modifies the classical model by incorporating close contact (E) and a sub-close contact (E2) while reworking the infectious mechanism. Once the model is formulated, we employ various statistical methods to identify crucial parameters, including R2, adjusted R2, and standard deviation. For disease control, we implement an intentional control program with four distinct grades. We develop and apply a scheme in MATLAB for our proposed model, generating diverse simulation results based on realistic parameter values for discussion. Additionally, we explore a range of strategy combinations to differentiate their effectiveness under various social conditions, aiming to identify an optimal approach. Comparing the intentional control strategy to random control, our findings consistently demonstrate the superiority of intentional control across all scenarios. Furthermore, the results indicate that our approach better aligns with the characteristics of the novel coronavirus, characterized by an “extremely low fatality rate and strong infectivity,” while offering detailed insights into the transmission dynamics among different compartments.

Predicting herd immunity achievement: a time-series analysis of vaccination and fatality rates using 1,075 days of COVID-19 data.

The COVID-19 pandemic, driven by SARS-CoV-2, has made vaccination a critical strategy for global control. However, vaccine hesitancy, particularly among certain age groups, remains a significant barrier to achieving herd immunity. This study uses Poisson regression and ARIMA time-series modeling to identify factors contributing to vaccine hesitancy, understand age-specific vaccination preferences, and assess the impact of bivalent vaccines on reducing hesitancy and fatality rates. It also predicts the time required to achieve herd immunity by analyzing factors such as vaccine dosing intervals, age-specific preferences, and changes in fatality rates. The study finds that individuals recovering from COVID-19 often delay vaccination due to perceived immunity. There is a preference for combining BNT162b2 and CoronaVac vaccines. The BNT162b2 bivalent vaccine has significantly reduced vaccine hesitancy and is linked with lower fatality rates, particularly in those aged 80 and above. However, it tends to induce more severe side effects compared to Sinovac. Vaccine hesitancy is most prevalent among the youngest (0-11) and oldest (80+) age groups, posing a challenge to reaching 90% vaccination coverage. Vaccine hesitancy is a major obstacle to herd immunity. Effective strategies include creating urgency, offering incentives, and prioritizing vulnerable age groups. Despite these challenges, the government should have continued to encourage vaccinations while gradually lifting COVID-19 control measures, balancing public health safety with the return to normal life, as was observed in the transition period during the latter stages of the pandemic.

Global trends in COVID-19 incidence and case fatality rates (2019-2023): a retrospective analysis.

Analyzing and comparing COVID-19 infection and case-fatality rates across different regions can help improve our response to future pandemics. We used public data from the WHO to calculate and compare the COVID-19 infection and case-fatality rates in different continents and income levels from 2019 to 2023. The Global prevalence of COVID-19 increased from 0.011 to 0.098, while case fatality rates declined from 0.024 to 0.009. Europe reported the highest cumulative infection rate (0.326), with Africa showing the lowest (0.011). Conversely, Africa experienced the highest cumulative case fatality rates (0.020), with Oceania the lowest (0.002). Infection rates in Asia showed a steady increase in contrast to other continents which observed initial rises followed by decreases. A correlation between economic status and infection rates was identified; high-income countries had the highest cumulative infection rate (0.353) and lowest case fatality rate (0.006). Low-income countries showed low cumulative infection rates (0.006) but the highest case fatality rate (0.016). Initially, high and upper-middle-income countries experienced elevated initial infection and case fatality rates, which subsequently underwent significant reductions. COVID-19 rates varied significantly by continent and income level. Europe and the Americas faced surges in infections and low case fatality rates. In contrast, Africa experienced low infection rates and higher case fatality rates, with lower- and middle-income nations exceeding case fatality rates in high-income countries over time.

Optimal non-pharmaceutical interventions considering limited healthcare system capacity and economic costs in the Republic of Korea

Due to the relatively low severity and fatality rates of the omicron variant of COVID-19, strict non-pharmaceutical interventions (NPIs) with high economic costs may not be necessary. We develop a mathematical model of the COVID-19 outbreak in Korea that considers NPIs, variants, medical capacity, and economic costs. Using optimal control theory, we propose an optimal strategy for the omicron period. To suggest a realistic strategy, we consider limited hospital beds for severe cases and incorporate it as a penalty term in the objective functional using a logistic function. This transforms the constrained problem into an unconstrained one. Given that the solution to the optimal control problem is continuous, we propose the adoption of a sub-optimal control as a more practically implementable alternative. Our study demonstrates how to strategically balance the trade-off between minimizing the economic cost for NPIs and ensuring that the number of severe cases in hospitals is manageable.

Comparative transcriptome analysis of SARS-CoV-2, SARS-CoV, MERS-CoV, and HCoV-229E identifying potential IFN/ISGs targets for inhibiting virus replication.

Since its outbreak in December 2019, SARS-CoV-2 has spread rapidly across the world, posing significant threats and challenges to global public health. SARS-CoV-2, together with SARS-CoV and MERS-CoV, is a highly pathogenic coronavirus that contributes to fatal pneumonia. Understanding the similarities and differences at the transcriptome level between SARS-CoV-2, SARS-CoV, as well as MERS-CoV is critical for developing effective strategies against these viruses. In this article, we comparatively analyzed publicly available transcriptome data of human cell lines infected with highly pathogenic SARS-CoV-2, SARS-CoV, MERS-CoV, and lowly pathogenic HCoV-229E. The host gene expression profiles during human coronavirus (HCoV) infections were generated, and the pathways and biological functions involved in immune responses, antiviral efficacy, and organ damage were intensively elucidated. Our results indicated that SARS-CoV-2 induced a stronger immune response versus the other two highly pathogenic HCoVs. Specifically, SARS-CoV-2 induced robust type I and type III IFN responses, marked by higher upregulation of type I and type III IFNs, as well as numerous interferon-stimulated genes (ISGs). Further Ingenuity Pathway Analysis (IPA) revealed the important role of ISGs for impeding SARS-CoV-2 infection, and the interferon/ISGs could be potential targets for therapeutic interventions. Moreover, our results uncovered that SARS-CoV-2 infection was linked to an enhanced risk of multi-organ toxicity in contrast to the other two highly pathogenic HCoVs. These findings provided valuable insights into the pathogenic mechanism of SARS-CoV-2, which showed a similar pathological feature but a lower fatality rate compared to SARS-CoV and MERS-CoV.

PP27 The Private Healthcare Responses Against COVID-19 Emergencies In Brazil

IntroductionThe Corona Virus Disease 2019 (COVID-19) pandemic is the biggest public health crisis of all time. Private health care plays a major role in health globally. We conducted a study to document the engagement of a Brazilian private health care organization to influence decisions to private and public health emergencies of COVID-19.MethodsThis retrospective study evaluated the outputs of the health technology assessment (HTA) group of Unimed-BH, a private Health Maintenance Organization (HMO) with 1.5 million participants in Belo Horizonte, Minas Gerais state. The study evaluated the impacts on the overview of health local decisions in the municipality and the national supplementary health agency (ANS) during the period from March 2020 to December 2022.ResultsDuring the pandemic, Unimed-BH made all its sanitary decisions based on scientific research, such as the use of masks and appropriate medications. Even though some medicines, such as regdanvimab, were authorized for emergency use by the Brazilian Health Regulatory Agency (ANVISA), Unimed-BH did not recommend their use due to uncertain evidence, and months later, ANVISA withdrew the registration.Unimed-BH also conducted a systematic review of ivermectin for COVID-19 treatment, which showed no effect, and therefore did not recommend its use. Additionally, Unimed-BH provided weekly updates on COVID-19 data, including suspected and confirmed cases, hospitalizations, and deaths in their customer portfolio. The organization also actively supported the decisions made by ANS and municipal managers using evidence and statistics on the pandemic. The Unimed-BH HTA group produced a total of 167 reports from March 2020 to December 2022.ConclusionsBelo Horizonte had the lowest in-hospital mortality rates with COVID-19 in Brazil. Unimed-BH’s HTA reports provided evidence-based assessments for decision-making, proposed partnership with policymakers, fomented information transparency, and strict follow-up on pandemic numbers, which may have contributed to the lower fatality rate in our city. These findings underscore the importance of private healthcare organizations in responding to COVID-19 emergencies, and their potential to support evidence-based decision-making and minimize the impact of the pandemic.

Severe cutaneous adverse reactions due to antibiotics therapy: a pharmacovigilance analysis of FDA adverse event reporting system events

ABSTRACT Background The aim of this study was to monitor, identify and evaluate severe cutaneous adverse reactions (SCAR) induced by antibiotics in patients. Methods Disproportionality algorithms were performed in data mining to screen suspected SCAR after using nine categories of antibiotics based on the FDA’s Adverse Event Reporting System (FAERS) from January 2004 to December 2022. The drug information and demographic characteristics of antibiotic-associated SCAR were also investigated. Results The FAERS database received 12,212 antibiotic-associated SCAR cases. Approximately half of the SCAR patients were females, the majority of them were adults aged 18–65 years (48.35%), and 47.68% of SCAR patients required hospitalization. The highest SCAR signals RORs (95% CI) for antibiotics were: sulfonamides 23.30 (22.05–24.62), glycopeptides 21.27 (20.26–22.33), penicillins 16.00 (15.44–16.59), carbapenems 10.46 (9.57–11.44), and cephalosporins 13.27 (12.57–14.00). Cefotaxime, sulfamethoxazole/trimethoprim, cefixime, vancomycin, piperacillin, ceftriaxone, amoxicillin, and meropenem had stronger associations with the SCAR than the other antibiotics. However, sulfonamides-associated SCAR cases had the lowest fatality rate (6.23%), penicillin-associated SCAR cases had the highest hospitalization rate (54.16%), and carbapenem-associated SCAR cases seemingly resulted in the highest risk of death (19.03%). Conclusion Data mining of FAERS identified 30 antibiotic-associated SCAR signals, and provided a referable evidence of the occurrence, characteristics and prognosis of antibiotic-related SCARs.

An assessment of the safety and efficiency of log trucks with increased weight limits on interstate highways in Wisconsin and Minnesota, USA

ABSTRACT Design standards for the Federal Interstate Highway System in the US are generally higher than those on other roads within most states, making it the safest road system in the US. Federal law prevents states from enforcing vehicle weight limits on interstate highways that deviate from established Federal weight limits or state-specific grandfathered weight limits or exceptions. As a result, trucks hauling logs at state-legal limits must travel on other roads, passing through towns/cities and school zones where they may encounter on-coming traffic and intersections. All these encounters increase the risk of an accident. This study compared fatality rates of log trucks to other heavy trucks in the lower 48 states, road damage cost estimates for interstate and non-interstate roads and assessed the impact of relaxing interstate weight limits on various factors for hauling logs along three travel corridors in Wisconsin and Minnesota, USA. On a per-load basis, log trucks have a lower fatality rate than other heavy trucks in 83% of the lower 48 states. Due to the higher design standards, pavement damage costs are lowest on interstate highways as compared to other road types. Allowing state-legal, loaded log trucks access to federal interstate highways would improve the overall safety and efficiency of timber transportation and reduce pavement damage costs and CO2 emissions within the study areas. Overall, the study findings suggest that allowing state-legal, loaded log trucks to operate on interstate highways would improve the safety and efficiency of timber transportation in Wisconsin and Minnesota.

Importance of basic life support training in rural India.

Basic life support (BLS) provided right away can lower fatality rates. Cardiac arrest typically results in death within minutes if it is untreated. Therefore, it is of interest to assess how BLS training affected villagers. The pre-experimental one-group pre-test post-test design was chosen for the investigation. A non-probability volunteer sampling technique was adopted to collect a sample of 220 village residents who met the inclusion requirements. The participants received training in basic life support that is achieved by using a real-life role model, hands-on CPR instruction. Checklist served as a standardized method for assessing the BLS training program. The pre-test and post-test's means were 23.05 and 56.51, respectively, and their respective standard deviations were 11.89 and 8.27. The 'z test' calculation result is 12.36) The results showed that BLS training was more successful for villagers and that they required regular BLS training programs to maintain their BLS skill level.

COVID-19 incidence and outcomes among patients with kidney replacement therapy.

We aimed to investigate the incidence, fatality, and associated factors in patients with hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KT) hospitalized for coronavirus disease 2019 (COVID-19) infection and reimbursed from the National Health Security Office (NHSO). The retrospective cohort analysis was conducted from an electronic-claimed database, and COVID-19 vaccination status was evaluated in patients with HD, PD, and KT from January 2020 to December 2021. There were 85,305 patients reimbursed for HD, PD, and KT by the NHSO. The rates of COVID-19 infection, COVID-19 vaccination, comorbidities, fatalities, and the cost of treatment were evaluated. COVID-19 infection was observed in 1,799 of 36,982 HD cases (4.9%), 1,531 of 45,453 PD cases (3.4%), and 95 of 2,870 KT cases (3.3%). Patients receiving COVID-19 vaccinations were most common in the KT group, followed by those with HD and PD (76.93% vs. 70.65% vs. 51.34%, respectively). KT patients had a lower fatality rate compared to those with PD and HD (8.42% vs. 18.41% vs. 21.40%, respectively). Advanced age, diabetes, cardiovascular diseases, and COVID-19 vaccination status were associated with fatality. The adjusted odds ratios of fatality after receiving one or two doses of vaccines were 0.7 (95% confidence interval [CI], 0.6-0.9) and 0.3 (95% CI, 0.2-0.4), respectively. The cost of treatment was highest in patients with HD, followed by PD and KT. The incidence of COVID-19 infection was higher in patients with HD than in those with PD or KT. COVID-19 vaccination following the national health policy should be encouraged for these patients to prevent fatality.