Preventive Measures Research Articles

Phenotypic and molecular characterisation of Salmonella spp. isolates in healthy poultry

ABSTRACT 1. Epidemiological surveillance of Salmonella spp. serves as a primary tool for maintaining the health of poultry flocks. Characterising circulating serotypes is crucial for implementing control and prevention measures. This study conducted phenotypic and molecular characterisation of S. enterica Pullorum, S. enterica Heidelberg, and S. enterica Corvalis isolated from broiler chickens during slaughtering. 2. All strains were susceptible to gentamicin, neomycin and norfloxacin. However, resistance rates exceeded 50% for ciprofloxacin and tiamulin, irrespective of the serotype. Approximately 64% of strains were classified as multidrug-resistant, with S. enterica Heidelberg strains exhibiting significantly higher overall resistance. The isolates demonstrated the ability to adhere and produce biofilm at a minimum of three temperatures, with S. enterica Pullorum capable of biofilm production at all temperatures encountered during poultry rearing. 3. Each strain possessed between two and seven different virulence-associated genes. Genetic similarity, as indicated by pulsed field gel electrophoresis, exceeded 90% for all three serotypes and strains were classified in the R5 ribotype by PCR, regardless of serotype. Sequencing revealed high similarity among all strains, with homology ranging from 99.61 to 100% and all were classified to a single cluster. 4. The results suggested a clonal relationship among the strains, indicating the possible circulation of a unique clonal group of S. enterica Pullorum in the southern region of Brazil.

Treatment with cardiac electronic implantable devices

Cardiac device therapy provides not only treatment options for bradyarrhythmia but also advanced treatment for heart failure and preventive measures against sudden cardiac death. In heart failure treatment it enables synergistic reverse remodelling and reduces pharmacological side effects. Cardiac resynchronization therapy (CRT) has revolutionized the treatment of reduced left ventricular ejection fraction (LVEF) and left bundle branch block by decreasing the mortality and morbidity with improvement of the quality of life and resilience. Conduction system pacing (CSP) as an alternative method of physiological stimulation can improve heart function and reduce the risk of pacemaker-induced cardiomyopathy. Leadless pacers and subcutaneous/extravascular defibrillators offer less invasive options with lower complication rates. The prevention of infections through preoperative and postoperative strategies enhances the safety of these therapies.

Change in Neurocognitive Function in Patients Who Receive CAR-T Cell Therapies: A Steep Hill to Climb

Immunotherapy with chimeric antigen receptor T (CAR-T) cell therapies has brought substantial improvement in clinical outcomes in patients with relapsed/refractory B cell neoplasms. However, complications such as cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) limit the therapeutic efficacy of this treatment approach. ICANS can have a broad range of clinical manifestations, while various scoring systems have been developed for its grading. Cognitive decline is prevalent in CAR-T therapy recipients including impaired attention, difficulty in item naming, and writing, agraphia, and executive dysfunction. In this review, we aim to present the diagnostic methods and tests that have been used for the recognition of cognitive impairment in these patients. Moreover, up-to-date data about the duration of cognitive impairment symptoms after the infusion are presented. More research on the risk factors, pathogenesis, preventive measures, and therapy of neurocognitive impairment is crucial for better outcomes for our patients.

Longitudinal analysis within one hospital in sub-Saharan Africa over 20 years reveals repeated replacements of dominant clones of Klebsiella pneumoniae and stresses the importance to include temporal patterns for vaccine design considerations

BackgroundInfections caused by multidrug-resistant gram-negative bacteria present a severe threat to global public health. The WHO defines drug-resistant Klebsiella pneumoniae as a priority pathogen for which alternative treatments are needed given the limited treatment options and the rapid acquisition of novel resistance mechanisms by this species. Longitudinal descriptions of genomic epidemiology of Klebsiella pneumoniae can inform management strategies but data from sub-Saharan Africa are lacking.MethodsWe present a longitudinal analysis of all invasive K. pneumoniae isolates from a single hospital in Blantyre, Malawi, southern Africa, from 1998 to 2020, combining clinical data with genome sequence analysis of the isolates.ResultsWe show that after a dramatic increase in the number of infections from 2016 K. pneumoniae becomes hyperendemic, driven by an increase in neonatal infections. Genomic data show repeated waves of clonal expansion of different, often ward-restricted, lineages, suggestive of hospital-associated transmission. We describe temporal trends in resistance and surface antigens, of relevance for vaccine development.ConclusionsOur data highlight a clear need for new interventions to prevent rather than treat K. pneumoniae infections in our setting. Whilst one option may be a vaccine, the majority of cases could be avoided by an increased focus on and investment in infection prevention and control measures, which would reduce all healthcare-associated infections and not just one.

Gas Level and Leakage Detection with Automatic Booking

Gas Level and Leakage Detection with Automatic Booking

Association between exposure to ambient air pollution, meteorological factors and atopic dermatitis consultations in Singapore—a stratified nationwide time-series analysis

Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting approximately 20% of children globally. While studies have been conducted elsewhere, air pollution and weather variability is not well studied in the tropics. This time-series study examines the association between air pollution and meteorological factors with the incidence of outpatient visits for AD obtained from the National Skin Centre (NSC) in Singapore. The total number of 1,440,844 consultation visits from the NSC from 2009 to 2019 was analysed. Using the distributed lag non-linear model and assuming a negative binomial distribution, the short-term temporal association between outpatient visits for AD and air quality and meteorological variability on a weekly time-scale were examined, while adjusting for long-term trends, seasonality and autocorrelation. The analysis was also stratified by gender and age to assess potential effect modification. The risk of AD consultation visits was 14% lower (RR10th percentile: 0.86, 95% CI 0.78–0.96) at the 10th percentile (11.9 µg/m3) of PM2.5 and 10% higher (RR90th percentile: 1.10, 95% CI 1.01–1.19) at the 90th percentile (24.4 µg/m3) compared to the median value (16.1 µg/m3). Similar results were observed for PM10 with lower risk at the 10th percentile and higher risk at the 90th percentile (RR10th percentile: 0.86, 95% CI 0.78–0.95, RR90th percentile: 1.10, 95% CI 1.01–1.19). For rainfall for values above the median, the risk of consultation visits was higher up to 7.4 mm in the PM2.5 model (RR74th percentile: 1.07, 95% CI 1.00–1.14) and up to 9 mm in the PM10 model (RR80th percentile: 1.12, 95% CI 1.00–1.25). This study found a close association between outpatient visits for AD with ambient particulate matter concentrations and rainfall. Seasonal variations in particulate matter and rainfall may be used to alert healthcare providers on the anticipated rise in AD cases and to time preventive measures to reduce the associated health burden.

Influence of pregnancy and mode of delivery on pelvic floor function: a review of literature.

Pelvic floor disorders (PFDs), such as pelvic organ prolapse (POP) and urinary incontinence (UI), severely affect women's quality of life. Among these, stress urinary incontinence (SUI) is the most common, impacting a significant proportion of women. In the US, the lifetime risk of undergoing surgery for UI or POP stands at 20%. Pregnancy-related factors, notably delivery method and UI occurrence during pregnancy, have a potent correlation with PFD onset. The pathophysiology of PFDs during pregnancy is complex, with factors like increased intra-abdominal pressure, changes in bladder neck mobility, and shifts in pelvic floor muscle strength and collagen metabolism playing pivotal roles. PFD risk factors span across pregnancy, labor, and the postnatal phase and include UI or fecal incontinence (FI) during pregnancy, advanced maternal age, elevated BMI, multiple births, instrumental and spontaneous vaginal deliveries, and newborns weighing over 4000 grams. Conversely, Cesarean deliveries are linked with a reduced long-term risk of UI and POP compared to vaginal births. Current prognostic models can predict the likelihood of PFD development based on variables such as delivery method, number of births, and familial history. Preventive measures encompass lifestyle changes like caffeine reduction and weight management, alongside pelvic floor muscle training (PFMT) during pregnancy. Thus, expectant mothers are advised to participate in physical activities, prominently including PFMT.

Prevention Strategies for the Crime of Adultery in the Light of Islamic Law

Adultery is a serious offense which is prohibited in Islam. Adultery may cause a lot of repercussions, among them sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs). These infections are sexually transmitted through vaginal, anal, and oral. The significance of the research emerged due to a large number of deaths emanating from HIV/AIDS and other infectious diseases caused by adultery; for example, statistically, about 374 million people living with STIs and more than 1 million sexually transmitted infections (STIs) are acquired every day worldwide. A qualitative data analysis has been deployed in this study that has been gathered from a variety of sources, they include books, journal articles, reports, conference papers, and websites. The information has been analyzed through an explanatory research approach by providing scholars’ opinions and their arguments on the subject matter. Most importantly, this research has established that Islam indeed has put in place some preventive measures to reduce the risk of multi-crimes occurring and their potential harmful effects on individuals and the society at large, and more so, in reference to our study including: self-accountability, lowering the gaze (by shifting away on what is illegal to look at), meet with a non-mahram woman in privacy, shaking hands with a non-mahram woman, tabarruj (make-up grooming), command women to stay at home, wear Hijab for modesty and chastity, indulge in marriage and accept polygamy, impose penalty for adulterous disobedient, among others. In this regard, it is therefore, recommended to implement the preventive strategies set by Islam for the crime of adultery to uphold societal mortality and preserve the wellbeing of the society at a broader spectrum.

Prevalence of sexually transmitted infections in women of the Czech Republic Armed Forces: a cross-sectional pilot study

IntroductionSexually transmitted infections (STIs) are an everlasting health issue globally. The military environment is recognised as a high-risk setting. Human papillomavirus (HPV), Chlamydia trachomatis and Neisseria gonorrhoeae are the most...

Expert recommendation for real-world study on the application of human papillomavirus vaccine in the Yangtze River Delta region

Cervical cancer has become a global public health problem that poses a serious threat to women's health. Human papillomavirus (HPV) vaccination is an important primary preventive measure for cervical cancer. With the accelerated application of the HPV vaccine in China, conducting real-world studies (RWS) on the application of HPV vaccines can guide the rational use of the vaccine, which is of great significance for the strategy and practice of accelerating the elimination of cervical cancer in China. The Yangtze River Delta Cervical Cancer and Female Lower Genital Tract Infection Prevention and Control Alliance and Yangtze River Delta Immunization Integration Working Group organized an expert group to develop the "Expert recommendation for real-world study on the application of HPV vaccine in the Yangtze River Delta region". Based on the current situation of medical informatization and HPV vaccination administration in China, as well as literature and cases from domestic and international studies, this study describes the data chain of HPV vaccination and evaluation, introduces the study design, study direction, database construction, data governance and statistical analysis of RWS, and provides expert recommendation on the problems in carrying out the practice of HPV vaccine RWS, aiming to guide the RWS of HPV vaccine application and promote the generation of real-world evidence (RWE) in China.

Tert-Butylhydroquinone Mitigates T-2-Toxin-Induced Testicular Dysfunction by Targeting Oxidative Stress, Inflammation, and Apoptosis in Rats

Tert-butylhydroquinone (tBHQ) has emerged as a promising candidate for mitigating the adverse effects of T-2-induced reproductive toxicity. The protective effects of tBHQ on rat sperm quality, testicular injury, apoptosis, and inflammation induced by T-2 toxin exposure were investigated. Histopathological examination of testicular tissues revealed severe damage in the T-2-treated group, characterized by disorganized germ cell arrangement, thinning of the convoluted seminiferous tubule walls, and significant cellular necrosis. However, tBHQ administration, either as a preventive or therapeutic measure, mitigated this structural damage. Image analysis confirmed an increase in the cross-sectional area and height of the convoluted seminiferous tubules in the tBHQ-treated groups compared to the T-2-treated group (p < 0.05), indicating tBHQ’s efficacy in alleviating testicular damage. Additionally, tBHQ treatment significantly inhibited T-2-induced apoptosis of testicular tissue cells, as evidenced by the results showing reduced apoptotic cell counts and downregulation of the BAX/BCL2 ratio and caspase-3 expression (p < 0.05). tBHQ significantly increased the concentrations of the antioxidant factors SOD, CAT, TAC, and GSH-PX. Furthermore, tBHQ attenuated the inflammatory response induced by T-2 exposure, as indicated by the decreased mRNA expression of the proinflammatory cytokines Tnf, Il1, and Il10 in testicular tissue (p < 0.05). Additionally, tBHQ treatment alleviated the decline in serum testosterone induced by the T-2 and promoted testosterone synthesis gene expression, including for the genes 17β-HSD and Cyp11a1, in rat testes (p < 0.05). These findings underscore tBHQ’s role as a therapeutic agent combatting T-2-induced reproductive toxicity, highlighting its antioxidative, anti-apoptotic, and anti-inflammatory properties. Further elucidation of tBHQ’s mechanisms of action may offer novel strategies for preventing and treating reproductive disorders induced by environmental toxins.

Pathophysiology and Advances in the Therapy of Cardiomyopathy in Patients with Diabetes Mellitus.

Diabetes mellitus (DM) is known as the first non-communicable global epidemic. It is estimated that 537 million people have DM, but the condition has been properly diagnosed in less than half of these patients. Despite numerous preventive measures, the number of DM cases is steadily increasing. The state of chronic hyperglycaemia in the body leads to numerous complications, including diabetic cardiomyopathy (DCM). A number of pathophysiological mechanisms are behind the development and progression of cardiomyopathy, including increased oxidative stress, chronic inflammation, increased synthesis of advanced glycation products and overexpression of the biosynthetic pathway of certain compounds, such as hexosamine. There is extensive research on the treatment of DCM, and there are a number of therapies that can stop the development of this complication. Among the compounds used to treat DCM are antiglycaemic drugs, hypoglycaemic drugs and drugs used to treat myocardial failure. An important element in combating DCM that should be kept in mind is a healthy lifestyle-a well-balanced diet and physical activity. There is also a group of compounds-including coenzyme Q10, antioxidants and modulators of signalling pathways and inflammatory processes, among others-that are being researched continuously, and their introduction into routine therapies is likely to result in greater control and more effective treatment of DM in the future. This paper summarises the latest recommendations for lifestyle and pharmacological treatment of cardiomyopathy in patients with DM.

Emerging and Reemerging Parasitic Diseases in Taiwan: A Retrospective Study of Clinical Case Reports in 2001~2018

Emerging and re-emerging parasitic diseases can cause significant economic burdens at national and global levels. However, governments often underestimate or ignore these diseases, especially in developed countries. This retrospective, case-oriented study analyzed parasitic diseases reported in Taiwan between 2001 and 2018. One hundred and thirty-two eligible clinical profiles of Taiwanese patients obtained from the NCBI, Scopus, Google Scholar, and Web of Science databases and local journals according to age, sex, source of infection, symptoms, risk factors, and geographical regions were analyzed. The analysis results showed that the number/frequency of cases caused by nematodes (46.97%) or protozoa (37.88%) was significantly higher than that of trematodes (9.85%) or cestodes (5.30%) (p < 0.0001). Northern Taiwan (46.97%) had a significantly higher rate than Southern Taiwan (33.33%), Central Taiwan (8.33%), and Eastern Taiwan (5.30%) (p < 0.05). The 15–65 age group (68.94%) had a significantly higher rate than the 65–90 age group (22.73%) and the 0–15 age group (8.33%) (p < 0.0001). Males (70.46%) had a significantly higher number/frequency of cases than females (29.54%) (p < 0.0001). People who acquired the infection through the food/soil route (32.58%) or who had a low immune status (32.58%) had a higher rate than travel-related infections (15.15%) (p < 0.001). The present study showed that emerging/reemerging parasitic infections continue to be of great concern to the lives and health of Taiwanese citizens and, if ignored, will threaten the health of the Taiwanese people; therefore, the delineation of preventive measures by health authorities is urgently warranted.

Machine learning insights into HIV outbreak predictions in Sub-Saharan Africa

Predicting and preventing HIV outbreaks in Sub-Saharan Africa, a region disproportionately affected by the epidemic remains a significant challenge. This review explores the effectiveness and challenges of using machine learning (ML) for forecasting HIV spread in high-risk areas. ML models have shown promise in identifying patterns and trends in HIV data, enabling more accurate predictions and targeted interventions. ML insights into HIV outbreak predictions leverage various data sources, including demographic, epidemiological, and behavioural data. By analysing these data, ML algorithms can identify high-risk populations and geographical areas susceptible to HIV transmission. This information is crucial for public health authorities to allocate resources efficiently and implement preventive measures effectively. Despite the potential benefits, several challenges exist in using ML for HIV outbreak predictions. These include data quality issues, such as incomplete or inaccurate data, which can affect the reliability of predictions. Additionally, the complexity of HIV transmission dynamics and the need for real-time data pose challenges for ML models. To address these challenges, researchers and practitioners are exploring innovative approaches, such as integrating multiple data sources and using advanced ML techniques. Collaborations between researchers, public health officials, and technology experts are also crucial for developing robust ML models for HIV outbreak predictions. In conclusion, while ML offers valuable insights into HIV outbreak predictions in Sub-Saharan Africa, addressing challenges such as data quality and model complexity is essential for its effective use. By overcoming these challenges, ML has the potential to significantly improve HIV prevention efforts and ultimately reduce the burden of the epidemic in the region. Keywords: Machine Learning, AI, HIV Outbreaks: Predictions, Insights.

The Impact of the Stimulus Packages on the Economy during COVID-19 in Bangladesh: A Mixed-Method Approach

With the unexpected onset of COVID-19, governments across the world responded with a range of preventive measures, including the imposition of lockdowns. To mitigate the adverse effects of lockdowns arising from supply chain shocks and employment loss, governments worldwide chose to implement policies to stimulate their economies and keep them working. This study assesses the impact and effectiveness of four of these packages in Bangladesh, employing a mixed-method approach. These packages include “salary support for workers in export-oriented RMG industries”, “working capital loans for affected industries and service sectors”, “working capital loans for cottage, micro, small, and medium enterprises”, and initiatives for “revitalizing the rural economy and job creation”. Each package was examined individually because of their differences in beneficiary groups, implementation methods, and individual objectives. Quantitative analysis involved propensity score matching (PSM), the difference in difference model (DID), and structural equation modelling (SEM). Stakeholders, including policy implementers, Bangladesh Bank officials, policy analysts, academics, workers, and beneficiaries, contributed to the qualitative analysis through extensive key-informant interviews, providing a comprehensive assessment of intervention outcomes. Ultimately, the results show that the packages achieved their socio-economic relief objectives for beneficiaries. The research examined both positive impacts and challenges in their implementation. It suggests that all four packages successfully achieved their goals, such as providing social and economic support, sustaining livelihoods, addressing marginalized groups’ needs, ensuring survival for large industries and small businesses, and promoting employment. In order to better address future shocks, establishing a beneficiary database integrated with the national system is recommended for smoother policy rollout. Despite acknowledged limitations, including challenges in beneficiary identification, data availability, and time constraints, the study’s unbiased estimations provide valuable insights to guide future policy directions in similar situations.

Перешкоди впровадженню теплових насосів у централізованому теплопостачанні

Today, heat pumps are recognized as one of the technologies that most contribute to the decarbonization of almost all spheres of modern society life, especially industry and energy. The integration of heat pumps into district heating is considered as an implementation of renewable energy technology that will enable the European Union (EU) to achieve its ambitious energy and climate policy goals for developing sustainable society. The purpose of this article is to analyze and systematize the EU experience in overcoming obstacles to the introduction of heat pump technologies in district heating and to determine the possibilities of its application in Ukraine. It was found that it is impossible to ensure the universal integration of heat pumps into district heating for all EU members, and an individual analysis is required for each EU country, taking all technical and environmental aspects into account. Obstacles to the large-scale implementation of heat pump technologies into district heating are of a complex nature. Complex obstacles require an integrated approach that simultaneously removes these obstacles and includes direct incentives, indirect taxes, technical standards, building codes, education, etc. An analysis of the experience of the EU countries (financial support, education and training, preferential tariffs for electricity for heat pump operation, EU regulations on energy efficiency of buildings, the EU directive on renewable energy sources, etc.) made it possible to identify obstacles to the widespread implementation of heat pumps in district heating. The main such obstacles are the high initial cost of heat pump equipment, the high cost of electricity, the high cost of connecting to electricity and heat networks, insufficient government incentives, the lack of domestic production of heat pumps and highly qualified personnel for their implementation. The proposed main preventive measures to overcome these obstacles are the creation of a State Program to stimulate the introduction of heat pumps; legislative support aimed at accelerating the introduction of heat pumps; creation of financial incentives for their implementation; state stimulation of production of heat pump equipment and professional training of operating personnel. This article is aimed at discussing directions for the formation of effective legislative and regulatory measures for comprehensive stimulation of the large-scale introduction of heat pumps in the district heating in Ukraine. Keywords: heat pumps, renewable energy sources, district heating, implementation, obstacles, overcoming.

Addressing the Concern of Orange-Yellow Fungus Growth on Palm Kernel Cake: Safeguarding Dairy Cattle Diets for Mycotoxin-Producing Fungi

Palm kernel cake (PKC), a byproduct of palm oil extraction, serves an important role in Ecuador’s animal feed industry. The emergence of yellow-orange fungal growth in PKC on some cattle farms in Ecuador sparked concerns within the cattle industry regarding a potential mycotoxin-producing fungus on this substrate. Due to the limited availability of analytical chemistry techniques in Ecuador for mycotoxin detection, we chose to isolate and identify the fungus to determine its association with mycotoxin-producing genera. Through molecular identification via ITS region sequencing, we identified the yellow-orange fungus as the yeast Candida ethanolica. Furthermore, we isolated two other fungi—the yeast Pichia kudriavzevii, and the fungus Geotrichum candidum. Molecular identification confirmed that all three species are not classified as mycotoxin-producing fungi but in contrast, the literature indicates that all three have demonstrated antifungal activity against Aspergillus and Penicillium species, genera associated with mycotoxin production. This suggests their potential use in biocontrol to counter the colonization of harmful fungi. We discuss preventive measures against the fungal invasion of PKC and emphasize the importance of promptly identifying fungi on this substrate. Rapid recognition of mycotoxin-producing and pathogenic genera holds the promise of mitigating cattle intoxication and the dissemination of mycotoxins throughout the food chain.

308 Awardee Talk: Prevention and mitigation of pathogens in feed and feed manufacturing systems

Abstract Prior to 2013, pathogen transmission through feed was focused primarily on bacteria and biosecurity was used to prevent adulterant entry into the ingredients and the feed mills. Following the porcine epidemic diarrhea virus (PEDV) outbreak in 2013, research focused on pathogen mitigation and control quickly became a subject of interest. Since PEDV, multiple endemic viruses and foreign animal diseases have been found to be transmissible in feed or feed ingredients. As African swine fever virus (ASFV) spread closer to the United States and endemic pathogens are a continued pressure on production systems, it is imperative that prevention measures are included in the feed supply chain and options for mitigation are fully elucidated for times of need. Previous research has demonstrated that preventative measures such as boot baths, lines of separation, showers, and changing clothes are effective measures when appropriately maintained. However, these protocols can seem costly and burdensome to employees, especially when the risk of disease transmission appears low. Employee training is difficult as disease transmission is difficult to visualize and exhibit the importance of each measure. Glo Germ, a florescent substance, is a cost-effective training tool which can demonstrate the efficacy of prevention protocols and can identify areas where biosecurity measures have not been properly utilized. Preventative measures are the first line of defense for feed manufacturing systems, but understanding and using mitigation techniques in the event of contamination can limit pathogen spread and protect the rest of the feed supply chain. Pelleting, as a method of thermal inactivation process, has recently been demonstrated to lessen the quantity of detectable viral RNA and decrease the risk of infection. The pelleting process, however, is a point-in-time mitigant and does not decrease the risk of product re-contamination as feed continues down the supply chain. The use of chemical mitigants, like formaldehyde, medium-chain fatty acids, and organic acids, can decrease the presence of bacterial and viral pathogens with longer-lasting mitigation properties. These mitigants can either be used in the feed itself, or as an addition to flushing batches which help disperse the chemical mitigants throughout the feed manufacturing equipment, thus reducing the risk of product re-contamination. In the event more drastic measures must be taken to eliminate pathogen presence from feed mills, gaseous fumigation and the use of portable heaters show promise as methods to decontaminate feed manufacturing equipment without the use of water or complete equipment breakdown. Overall, effective training and implementation of preventative measures are needed to provide pathogen-free feed to production systems, but continued research in mitigation and mill decontamination will further protect the feed supply chain in the event of pathogen contamination.

The Psychological Impact on Romanian Women Infected with SARS-CoV-2 during Pregnancy.

It is well-known that the uncertainty about the COVID-19 pandemic has an indirect negative impact on pregnant women's mental health, given the fact that pregnant women are more vulnerable emotionally and psychologically than non-pregnant women. The aim of this study was to evaluate the maternal psychological impact on Romanian women who were infected with SARS-CoV-2 during pregnancy and their concerns and to determine which are the best measures to prevent negative outcomes. A 40-item questionnaire was created for data collection and was shared on social platforms (Facebook and Instagram) and also with obstetric communities between February 2021 and January 2023. Our cross-sectional survey recruited 317 Romanian pregnant women who suffered from SARS-CoV-2 infection. Among general questions about their life and pregnancy during the pandemic, the survey included questions about their SARS-CoV-2 infection during pregnancy, their concerns and how they perceived this period in order to evaluate their emotional status. Of 317 women recruited, 91% of them had a mild to moderate form of COVID-19, and 2% had serious symptoms. Only 9% of women were hospitalized, 4% of women considered that the SARS-CoV-2 infection affected their physical condition to a great extent, and 8% considered to be affected in terms of mental state to a great extent. The main negative feelings of pregnant women during the COVID-19 disease were the fear regarding the possibility of affecting the pregnancy and the concern for their life (51.4%). These increase the risk of developing anxiety or depression. Pregnant women who contracted SARS-CoV-2 infection faced negative feelings, especially those with a severe form of the disease or who recovered with difficulty after the disease. Patients who required hospitalization reported an impairment of the mental state to a great extent and to a very great extent with a frequency of approximately two times and four times higher than non-hospitalized patients, respectively (p < 0.05 and p < 0.001, respectively). Also, giving birth during SARS-CoV-2 and the difficulty of accessing medical services represented a high level of stress. Also, 47% of patients who reported difficulty accessing medical services during the illness evaluated their mental state significantly less favorably. Preventive measures are essential to minimizing the negative psychological impact of COVID-19 disease during pregnancy among pregnant women. The medical treatment of COVID-19 disease during pregnancy should be prioritized, but emotional and mental health support must also be provided.

Changes in the epidemiology and clinical characteristics of viral gastroenteritis among hospitalized children in the Mainland of China: a retrospective study from 2016 to 2020

BackgroundAcute gastroenteritis (AGE) causes significant morbidity in children worldwide; however, the disease burden of children hospitalized with viral gastroenteritis in China has been rarely described. Through this study, we analyzed the data of hospitalized children with viral gastroenteritis to explore the changes in the epidemiology and clinical characteristics of viral gastroenteritis in the mainland of China.MethodsData were extracted from Futang Children's Medical Development Research Center (FRCPD), between 2016 and 2020, across 27 hospitals in 7 regions. The demographics, geographic distribution, pathogenic examination results, complications, hospital admission date, length of hospital stays, hospitalization charges and outcomes were collected and analyzed.ResultsViral etiological agents included rotavirus (RV), adenovirus (ADV), norovirus (NV) and coxsackievirus (CV) that were detected in 25,274 (89.6%), 1,047 (3.7%), 441 (1.5%) and 83 (0.3%) cases. There was a higher prevalence of RV and NV infection among children younger than 3 years of age. RV and NV had the highest detection rates in winter, while ADV in summer. Children with viral gastroenteritis were often accompanied by other diseases, such as myocardial diseases (10.98–31.04%), upper respiratory tract diseases (1.20–20.15%), and seizures (2.41–14.51%). Among those cases, the co-infection rate with other pathogens was 6.28%, with Mycoplasma pneumoniae (M. pneumoniae), Epstein-Barr virus (EBV), and influenza virus (FLU) being the most common pathogens. The median length of stay was 5 days, and the median cost of hospitalization corresponded to587 US dollars.ConclusionsThis finding suggests that viral gastroenteritis, especially those caused by RV, is a prevalent illness among younger children. Co-infections and the presence of other diseases are common. The seasonality and regional variation of viral etiological agents highlight the need for targeted prevention and control measures. Although viral gastroenteritis rarely leads to death, it also results in a significant economic burden on healthcare systems.