Lower Infection Rates Research Articles

Evaluation of PCV2 vaccine immunogenicity and efficacy using ELISpot to detect virus-specific memory B cells

BackgroundPorcine Circovirus 2 (PCV2) vaccination plays a crucial role in preventing porcine circovirus-associated disease (PCVAD). Nevertheless, pig farms face significant challenges in evaluating vaccination efficacy due to the inability of PCV2 vaccines to achieve sterilizing immunity and the variability among vaccine manufacturers. These challenges are further compounded by the limitations of conventional antibody detection methods, which fail to distinguish between maternally-derived antibodies (MDAs) and vaccine-induced antibodies. The accurate evaluation and selection of PCV2 vaccines is critical for the swine industry. The present study aimed to develop an Enzyme-linked immunospot (ELISpot) assay for directly detecting PCV2-specific memory B cells. This approach was used to assess the presence of PCV2-specific memory B cells in piglets with high levels of MDA vaccinated with different PCV2 vaccines, thus enabling the evaluation of vaccine immunogenicity at the cellular level. Furthermore, antibody levels and the viremia status were analyzed using Enzyme-linked immunosorbent assay (ELISA) and quantitative real-time polymerase chain reaction (qPCR) respectively to provide a comprehensive assessment of the ELISpot assay potential for evaluating the vaccine immunogenicity of PCV2 vaccines.ResultsThe findings revealed that the optimal conditions for the developed ELISpot assay included stimulation with R848 at a final concentration of 1 µg·mL⁻¹ for three days, a PCV2 Cap protein coating concentration of 1.25 µg·mL⁻¹, a biotinylated goat anti-pig IgG antibody concentration of 5 µg·mL⁻¹, and an HRP-streptavidin concentration of 0.25 µg·mL⁻¹. In high MDA piglets immunized with different vaccines, serum antibody detection showed that PCV2 antibody levels declined continuously over time in all vaccinated and saline-injected control groups, demonstrating similar trends. In contrast, ELISpot analysis demonstrated a significant increase in PCV2-specific memory B cell levels in all three vaccinated groups compared to the saline-injected group. Among the vaccines tested, Vaccine A induced the highest levels of specific memory B cells, followed by Vaccine B. This was consistent with the lower PCV2 infection rates and viremia levels observed in Vaccine A and Vaccine B groups, compared to Vaccine C and saline-injected control groups.ConclusionsWe established an ELISpot assay to quantify PCV2-specific memory B cells, revealing that vaccinated piglets with high MDA levels developed robust memory B cell responses. However, levels of PCV2 IgG antibodies in vaccinated piglets remained statistically indistinguishable from control piglets. These findings demonstrate that ELISpot-based profiling of PCV2-specific memory B cells overcomes the confounding effects of MDA in vaccine efficacy assessments. This approach reliably reflects the humoral immune response induced by vaccination and its relevance in combating natural PCV2 infection, providing valuable guidance for preventing and controlling PCVAD.

Enterobius vermicularis infection and its risk factors among rural schoolchildren in Zhejiang Province: a cross-sectional study

Pinworm infection, caused by Enterobius vermicularis, is highly prevalent in humans, with children being particularly susceptible. This cross-sectional study (2022–2024) investigated the epidemiology and risk factors of E. vermicularis infection among 1179 rural schoolchildren (3–9 years) across four districts in Zhejiang Province. In each district, two kindergartens and two primary schools were selected using simple random sampling. Pinworm infection was identified using adhesive cellophane tape perianal swabbing method. Data on demographics, hygiene habits, and school environment were collected through structured questionnaires. Simple logistic regression analysis was performed for each potential risk factor, and those variables with a P value less than 0.1 were selected for the multivariate logistic regression analysis. The overall infection rate was 4.07%, with the highest prevalence in Xinchang (9.79%), followed by Daishan (2.68%), Wucheng (2.44%), and Yongkang (1.64%). The positive rate among girls was higher than that of boys (5.41% vs. 2.81%, P = 0.020). Among girls, older subjects had a notably higher infection rate compared to younger ones (8.08% vs. 3.19%). Besides, the infection rate of primary school subjects was higher than that of kindergarten subjects (7.48% vs. 3.23%). No significant differences were found in the boys’ group. Furthermore, weekly classroom disinfection and monthly health education were associated with lower infection rates. This study underscores the prevalence of E. vermicularis infection in rural schoolchildren in Zhejiang Province and identifies significant risk factors. Strengthening hygiene education and sanitation practices, particularly targeting female students, may serve as effective measures against E. vermicularis infection.

WavelinQ EndoAVF Long Term Patency-A Follow-Up From A Prospective Study.

WavelinQ EndoAVF Long Term Patency-A Follow-Up From A Prospective Study.

Safety and immunogenicity of intranasal parainfluenza virus type 5 (PIV5)–vectored COVID-19 vaccine in adults and teens in an open-label phase 1 trial

COVID-19 continues causing substantial mortality despite existing FDA-approved COVID-19 vaccines. An effective COVID-19 vaccine providing durable immunity with minimal reactogenicity is needed. CVXGA1, a PIV5-based intranasal COVID-19 vaccine expressing the Spike (S) protein of SARS-CoV-2, was evaluated in this phase 1 study in adults and teens. CVXGA1 was well tolerated without serious adverse events (AEs) or fever reported. Solicited local and systemic AEs were mostly mild. CVXGA1 elicited S-specific serum and mucosal antibodies and CD8+ cytotoxic T lymphocyte responses in all groups. Significantly lower rates of symptomatic COVID-19 infection were reported in groups receiving high-dose CVXGA1 (HD) compared to that in the group receiving low-dose CVXGA1 (LD) during the SARS-CoV-2 delta and omicron waves. The data indicate that CVXGA1 is a potentially effective intranasal COVID-19 vaccine that is immunogenic with minimal reactogenicity.

In Vitro Micropropagation of Kale (Brassica oleracea var. sabellica L.)

In vitro micropropagation is used to rapidly shorten the breeding process of crops, such as kale, an internationally widespread winter vegetable. The aim of this study is to develop optimised micropropagation protocols for three kale varieties. First, it was determined which seed surface disinfection method resulted in the highest germination rate and the lowest infection rate. Secondly, it was investigated which of several existing Brassica protocols and one modified protocol from the literature provided the highest regeneration efficiency of kale explant types (cotyledons, hypocotyl, root, and intact seedlings as the control) after eight weeks of cultivation. Germination was highest and fastest after disinfection with 10% NaClO for 10 min for “Frostara” and at 5% for 2.5 min for “Schatteburg”. The infection rate and speed were lowest in treatments with 10% NaClO. The regeneration efficiency and number of newly formed leaves, roots, shoots, and stems varied between media, explant type, and kale variety. Most new leaves and shoots were formed when hypocotyls were used as explant type. Roots regenerated mostly more roots than shoots, stems, and leaves. A higher ratio of auxin to cytokinin in the culture medium partially increased leaf regeneration. The addition of AgNO3 increased shoot regeneration and reduced yellowing and leaf drop. Phenotypic anomalies occurred less frequently in media with lower hormone concentrations. All tested protocols are suitable for kale micropropagation, but regeneration was highly dependent on the medium for different varieties and explant types. Therefore, this study builds a basis for future micropropagation of kale and the development of variety-specific protocols for maximum commercial success.

Efficacy and safety of platelet-rich plasma versus conventional care in diabetic foot ulcers: a meta-analysis of randomized controlled trials.

This meta-analysis aims to assess the efficacy and safety of platelet-rich plasma (PRP) through topical application and local injection methods compared to conventional care in patients with diabetic foot ulcers (DFU). A comprehensive literature search was conducted across PubMed, Embase, and Web of Science databases up to November 2024. Randomized controlled trials evaluating the efficacy and safety of PRP versus conventional care in DFU patients were included. Pooled weighted mean differences (WMD) and risk ratios (RR) were calculated with 95% confidence intervals. Fifteen randomized controlled trials (1,010 patients) were included. The PRP group showed significantly improved complete healing rates compared to conventional care (RR: 1.53, 95% CI: 1.39-1.58, P < 0.001), with comparable effectiveness between topical application and local injection methods (P = 0.57). Notably, PRP demonstrated a shorter healing time compared to conventional care (WMD: -19.48 days, 95% CI: -27.91 to -11.05, P < 0.001). The PRP group exhibited lower wound infection rates and amputation rates (RR: 0.51, 95% CI: 0.35 to 0.75, P < 0.001; RR: 0.45, 95% CI: 0.26 to 0.79, P = 0.005). The PRP group did not lead to a higher incidence of treatment-related adverse events compared to conventional care (RR: 0.80, 95% CI: 0.05 to 12.30, P = 0.87). This meta-analysis confirms that PRP application, both topically and via local injection, improves the complete healing rate, reduces healing time, infection rates, and amputations, without increasing adverse events. These findings support the integration of PRP into clinical practice for the management of diabetic foot ulcers.

Ectopic pregnancies: laparoscopic versus vNOTES approach. Surgical and obstetric outcomes.

Extrauterine pregnancy (EP), represents a significant challenge in reproductive medicine, manifesting in approximately 2% of all pregnancies, primarily implanting within the fallopian tubes (95%). Surgery remains a cornerstone in the therapeutic options for ectopic pregnancies. The most common surgical approach at the moment is laparoscopy. However a relatively new surgical technique, vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) has evolved which is a vaginal entry to the abdomen in conjunction with endoscopy via the vagina. In this study we compare the surgical and obstetrical outcomes of these two techniques. The operation time using the vNOTES approach was significantly shorter when compared to a laparoscopic approach, mean surgical time was 35 versus 47min (p < 0.001). Both techniques had a very low complication and postoperative infection rate. Duration of hospital stay was not significantly lower in the vNOTES group but a trend was seen (p = 0.06). No significant differences were observed in the obstetric outcomes. This study shows that the vNOTES approach is a good and safe technique to operate ectopic pregnancies and can provide shorter operating time and duration of hospitalisation. Early data shows promising results on safety for future pregnancies but further research is warranted.

Bicondylar tibial plateau fracture dislocations with an intact anterolateral cortical Rim: Prevalence, fracture characteristics, and complications.

Bicondylar tibial plateau fracture dislocations with an intact anterolateral cortical Rim: Prevalence, fracture characteristics, and complications.

Short-term outcome after simultaneous pancreas-kidney transplantation with alemtuzumab vs. basiliximab induction: a single-center retrospective study

During the COVID-19 pandemic our center adjusted the standard induction therapy for normal immunological risk simultaneous pancreas-kidney (SPK) transplantations from T-cell depletion by alemtuzumab (ALEM) to IL-2 receptor blocking by basiliximab (IL2R). Here, we analyze the impact of this change on 1 year post-transplantation outcomes. Thirty-six adult patients who underwent SPK transplantation between June 2015 and June 2023 were included, of whom 21 before February 2020 (ALEM) and 15 after February 2020 (IL2R). Patients were stratified into two groups based on the induction therapy received. One death occurred during the follow up period. A total of three pancreas and two kidney grafts were lost. No differences between kidney and pancreas graft function or rejection rates were observed. Patients receiving IL2R induction had significantly lower 30 day postoperative complication rates (34 vs. 46%, p = 0.03) and experienced fewer bacterial infections (< 6 months: 47 vs. 81%, p = 0.03). Additionally, lower rates of viral (including CMV) and fungal infections were observed. IL2R patients also had a significantly shorter hospital admission durations (14 vs. 30 days, p < 0.001). In conclusion, IL2R induction in SPK recipients was associated with similar short-term graft function and potentially improved outcomes compared to ALEM, warranting cautious interpretation due to sample size.

Risk of severe bacterial infections including TB before and after immediate or deferred antiretroviral therapy: A multicenter, prospective, cohort study.

Risk of severe bacterial infections including TB before and after immediate or deferred antiretroviral therapy: A multicenter, prospective, cohort study.

Comparative analysis of lumbar cerebrospinal fluid drainage versus lumbar puncture effectiveness in patients with aneurysmal subarachnoid hemorrhage

Subarachnoid hemorrhage (SAH) from ruptured intracranial aneurysms causes significant morbidity and mortality. Although prophylactic lumbar cerebrospinal fluid (CSF) management is widely used, the relative benefits of continuous lumbar cerebrospinal fluid drainage compared to intermittent lumbar puncture remain undefined. This study compared clinical outcomes between these two approaches in patients with aneurysmal SAH. This single-center retrospective study included 222 patients with aneurysmal SAH treated between January 2023 and December 2023. Patients were assigned to continuous lumbar cerebrospinal fluid drainage (n = 103) or intermittent lumbar puncture (n = 119). The primary outcome was the modified Rankin Scale (mRS) score at 6 months, categorized as good (0–2) or poor (3–6). Secondary outcomes included secondary infarcts, intracranial infections, hydrocephalus, and mortality. At 6 months, the lumbar drainage group exhibited significantly better outcomes (79% vs. 58%, relative risk [RR] 1.36, 95% CI [0.70, 0.85], p = 0.002) and lower rates of intracranial infection (0% vs. 11%, p = 0.002) and hydrocephalus (6.8% vs. 23.5%, RR 0.29, 95% CI [0.03, 0.13], p = 0.001) compared to the lumbar puncture group. Secondary infarcts occurred in 17.4% of the lumbar drainage group versus 28% of the lumbar puncture group (RR 0.63, 95% CI [0.11, 0.26], p = 0.099). No significant difference in mortality was observed between the groups (5.8% vs. 7.5%, RR 0.79, 95% CI [-1.35, 0.79], p = 0.608). Continuous lumbar cerebrospinal fluid drainage was associated with improved clinical outcomes, fewer intracranial infections, and reduced hydrocephalus incidence compared to intermittent lumbar puncture in patients with aneurysmal SAH. These findings advocate for the early adoption of continuous lumbar cerebrospinal fluid drainage in clinical practice.

Construction of a preliminary digital parasite specimen database for parasitology education and research

Despite advances in non-morphology-based parasite diagnostic techniques, traditional microscopy-based morphologic analysis remains essential for diagnosing parasitic infections. Therefore, parasite morphology is a crucial aspect of pre-graduate medical education. However, parasite specimen acquisition in developed countries is challenging because of the low rate of parasitic infections owing to improved sanitation. Hence, we acquired 50 slide specimens (parasite eggs, adults, and arthropods) from the Kyoto University and Kyoto Prefectural University of Medicine and created virtual slide data. All specimens ranging from parasitic eggs, adult worms, ticks and insects (typically observed under low magnification) to malarial parasites (typically observed under high magnification) were scanned successfully. These virtual slides were compiled into a digital database with folders organized by taxon. Explanatory notes in English and Japanese were attached to each specimen to facilitate learning. The data were uploaded to a shared server for institutions to facilitate practical training and research. The shared server enables approximately 100 individuals to access the data simultaneously. This database is expected to serve as an important resource for education and research in parasite morphology as additional parasitic slides and information are added in the future, contributing to the development of international parasitology education and future research.

Use of antibiotic-impregnated discs in breast reconstruction among the obese population: A retrospective propensity score-matched analysis.

Use of antibiotic-impregnated discs in breast reconstruction among the obese population: A retrospective propensity score-matched analysis.

A Nationwide Analysis of Postpenile Prosthesis Infection: Do Hospital and Surgeon Volume Matter?

A Nationwide Analysis of Postpenile Prosthesis Infection: Do Hospital and Surgeon Volume Matter?

The Influence of Obesity on Unicondylar Knee Arthroplasty.

Some prior studies suggest obesity increases unicondylar knee arthroplasty (UKA) failure risk. This study evaluated obesity's impact on UKA outcomes at a single institution. We analyzed 4,973 primary cemented medial UKAs performed by eight surgeons from 2000 to 2022. The primary outcome was implant survivorship. Secondary outcomes included revision rates, reasons for revision, patient-reported outcomes, and clinical metrics. The mean age was 66 years (range, 33 to 96), 54.6% were women, body mass index (BMI) averaged 29.9 (range, 15.6 to 63.4), and follow-up averaged 5.1 years. Outcomes were stratified by BMI cutoffs (BMI: 30; 35; 40), yielding group sizes of ≤ 30 (N= 2,858), > 30 (N= 2,115), ≤ 35 (N= 4,137), > 35 (N= 836), ≤ 40 (N= 4,680), and > 40 (N= 293). At 5 and 10 years, implant survivorship was 95.7 and 92.8%, respectively. At 5 years, survivorship remained high but declined slightly with increased BMI for the 30 and 35 cutoffs (≤ 30: 96.7%, > 30: 94.2%, P < 0.001; ≤ 35: 95.8%, > 35: 94.9%; P= 0.005), while a slight, nonsignificant increase occurred for BMI > 40 (≤ 40: 95.7%, > 40: 96.0%; P= 0.325). Arthritis progression was the most common revision reason, and it increased with BMI. Infection rates remained low across all BMIs. There was no difference in the percentage of patients achieving a minimal clinically important difference using the Knee Osteoarthritis Outcome Score, Joint Replacement with each BMI cutoff, but Knee Osteoarthritis Outcome Score, Joint Replacement score changes were significantly greater in the higher BMI patients using the BMI 30 cutoff (P= 0.034). While higher BMI patients had marginally higher rates of revision, we remain enthusiastic about UKA in these patients due to low infection rates across all BMI cohorts and improvements in patient-reported outcome measures.

Feco-prevalence of Helicobacter Pylori among symptomatic patients in Al-Marj city

Helicobacter pylori is a bacterium that causes infections in a significant portion of the global population. This study aimed to determine the prevalence of H. pylori infection among dyspeptic patients and to investigate its association with age and sex in Al Marj City, Libya. A cross-sectional descriptive study was conducted at Tabebouk Laboratory from January 1, 2023, to December 31, 2024, involving 495 participants. Stool samples were analysed using a fluorescence immunoassay-based technique to detect H. pylori antigens. The overall prevalence of H. pylori infection was 50.3%, with males showing a higher infection rate (54.22%) than females (45.78%). The highest prevalence was observed in young adults aged 20-45 years (49.40%), followed by middle-aged and elderly individuals (≥46 years; 36.95%). Children and teenagers had significantly lower infection rates (6.83% each). No significant sex differences were found among children and teenagers. In conclusion, H. pylori infection rates were higher in males and most prevalent among young adults aged 20–45 years. These findings highlight the need for targeted public health strategies, especially in adult populations, to improve early detection and management of H. pylori-related gastrointestinal conditions.

Revolutionizing Burn Care: The Therapeutic Potential of Nile Tilapia Skin

Tilapia fish skin is emerging as a promising and cost-effective alternative for burn treatment, offering superior healing properties compared to traditional wound dressings such as Silver Sulfadiazine and Paraffin Gauze. Rich in collagen, omega-3 fatty acids, and bioactive compounds, Tilapia skin accelerates epithelialization, with studies by Lima Júnior et al. showing healing in 9.77–18.10 days compared to 11.20–21.30 days for conventional treatments (reducing healing time by up to 25%). It also reduces pain, potentially minimizes scarring, and lowers infection rates. Unlike conventional dressings that require frequent changes, Tilapia skin remains in place for a longer period, enhancing patient comfort and reducing pain and infection risks. Comparative analysis reveals that while Silver Sulfadiazine has antibacterial properties and Paraffin Gauze is easy to use, both lead to higher pain levels, slower healing, and increased scarring due to frequent dressing changes. Tilapia skin’s accessibility and affordability make it particularly beneficial for resource-limited settings. Additional advantages include its natural analgesic effect, strong microbial resistance, and dressing-free application, reducing the need for painkillers and minimizing medical interventions. However, challenges such as the need for specialized sterilization requirements, odor sensitivity, and adherence difficulties in some anatomical regions must be addressed. As research advances, Tilapia skin holds considerable potential in burn management, offering a biocompatible, efficient, and widely accessible solution for improved wound care worldwide.

High volume total hip arthroplasty surgeons have improved perioperative outcomes and short-term cumulative revision rates.

The relationship between total hip arthroplasty (THA) surgeon volume and outcomes is informative in this era of health care value optimisation. The purpose of this study was to evaluate outcomes based on modern-day surgeon practice volumes. The SPARCS database was queried for patients undergoing primary THA from 2010 to 2020. Annual case volume thresholds were 30 and 150, differentiating high-volume (HV), intermediate-volume (IV), and low-volume (LV) groups. Perioperative outcomes and all-cause cumulative revision rates were evaluated. There were 88,411, 142,201, and 53,276 in the HV, IV, and LV groups, respectively. HV surgeons had significantly lower 3-month prosthetic joint infection (PJI) rates (0.5 vs. 0.8 vs. 1.0%, p < 0.001). While controlling for confounders, multivariate regression revealed increased odds of PJI for IV (1.5) and LV (1.87) and increased all-cause revision hazard ratio for IV (1.1) and LV (1.3). Cumulative revision rates were lower for HV at 1 and 2 years, but rates converged with IV group at 9 years. HV surgeons have the most favourable short-term outcomes. However, in the long-term the difference in all-cause revision event rates becomes less apparent.

Comparative study of functional outcome of inter-trochanteric fractures in adult population treated with modified first generation proximal femoral nail versus second generation proximal femoral nail- PFN-A2

Background: Intertrochanteric fractures are fairly prevalent in elderly, owing to osteoporosis. High velocity trauma is a common cause in younger age groups. Surgical fixation is the choice of treatment. Closed reduction being minimally invasive has lower infection rates and higher union rate. Providing early mobility lowers morbidity. Over time, there have been multiple changes in the implant design. Two screws in femoral head are used in the first generation PFN, compared to a single helical bolt in the subsequent modification i.e. PFNA2. Methods: Prospective and comparative study was undertaken, from January 2023 to June 2024, including 52 adults (17 males and 35 females) of either sex, with intertrochanteric fracture femur. 26 patients underwent first generation PFN (group A) and 26 underwent PFNA2 (group B). Clinico-radiological evaluation was done at 6 weeks, 3-, 6- and 12-months following surgery. Functional evaluation was based on the mean Harris hip score (HHS). Post-operative pain based on VAS, early mobilization and complications were taken into consideration. Statistics was analysed with Statistical Package for The Social Sciences (IBM SPSS version 22). Results: There was 100% union rate. The average date of mobilization in group A patient was 1.9±0.8 days and in group B was 2.2±0.7 days. Group A has a statistically significant higher VAS score than group B at 24 hours post-surgery. Weight bearing as tolerated was started on day 1 post surgery in all patients. The mean HHS was significantly higher in group B (71.5±3.8) at 6 weeks follow-up, which on subsequent follow-ups was statistically insignificantly between the two groups. None of the patients had implant failure of any form. Conclusions: The final outcome was statistically insignificant. There was negligible difference between the first generation PFN and PFNA2 in terms of post-operative stability and fracture union. Hence, both PFN and PFNA2 are equally suitable devices for fixation of inter-trochanteric fracture.

Functional outcome in adults treated for both bone forearm fractures with intramedullary square nails

Background: The forearm fractures are considered intraarticular due to functional characteristics and spatial orientation. These fractures require anatomic reduction to maintain axial and rotational stability and preserve bone length with absolute stability for adequate healing to restore function. Open reduction and internal fixation is accepted as the treatment of choice for both bone forearm fractures according to many studies. However, it can result in complications like extensive soft tissue damage, evacuation of fracture hematoma, periosteal damage, radioulnar synostosis, neurovascular injury, compartment syndrome, delayed union, non-union, infection, refracture after implant removal. Intramedullary nailing is an alternative technique to avoid the above problems, with the advantages of minimal incision, no periosteal stripping, faster healing and biologic fixation. This study evaluates the functional outcome in adults treated for both bone forearm fractures with intramedullary square nail fixation at our institute. Methods: 113 patients with closed both bone forearm fractures were treated with Intramedullary square nail fixation between January 2014 to December 2023. There were 54 (22A) type fractures, 44 (22B) type fractures, 15 (22C) type fractures. Functional outcome was assessed based on Anderson’s criteria. Results: 105 patients had excellent to satisfactory results while fixation in 8 patients resulted in failures based on Anderson’s criteria. Conclusions: Intramedullary nailing is a simple, safe and effective method of alternative fixation of both bone forearm fractures that is associated with closed reduction, early union, biologic fixation, low infection rate, small cosmetic scars, less blood loss, shorter operating time, and less risk of compartment syndrome.