Virus Infection Rates Research Articles

Lower disease control rates and survival outcomes among Blacks with pharyngeal squamous cell carcinomas compared with Whites: a retrospective analysis at the University of Florida

Disparate clinical outcomes for pharyngeal squamous cell carcinoma (PSCC) of the oropharynx (OPSCC) and hypopharynx (HPSCC) have been observed in Black compared with White patients. Higher tobacco and alcohol use has been associated with decreased survival in Black patients with PSCC. Higher human papilloma virus (HPV) infection rates, associated with specific subsites of the oropharynx, are linked to improved overall survival (OS). Using an institutional cohort of Black and White patients with PSCC, we performed a retrospective analysis using multiple disease endpoints including local control (LC), local-regional control (LRC), freedom from distant metastases (DMFS), OS,cause-specific survival (CSS), and recorded tobacco and alcohol use. 1419 patients [Black (n = 111) and White (n = 1,308)] treated for PSCC from 1973 to 2013 were evaluated. PSCC 5- and 10-year LC, LRC, and DMFS and CSS rates were lower for Blacks. Notably, Black patients with OPSCC had higher stage cancers, higher percentage of soft palate tumors, and lower percentage of base of tongue cancers, were more likely to receive radiotherapy, and hadhigher tobacco and alcohol use. OS was significantly lower in Black patients at both anatomic sites, with the greatest difference observed for OPSCC. Multivariate analysis showed race and tobacco independently predicted DMFS, OS, and CSS; however, tobacco use had a greater impact on DMFS (HR 2.5, p = 0.021) than race (HR 1.9, p = 0.027). Overall, we propose that the higher burden of tobacco use along with a lower rate of tumors arising from traditional HPV-related subsites were important contributors to disparate disease outcomes seen in our Black patients.

Impact of inhaled pollutants on response to viral infection in controlled exposures

Air pollutants are a major source of increased risk of disease, hospitalization, morbidity, and mortality worldwide. The respiratory tract is a primary target of potential concurrent exposure to both inhaled pollutants and pathogens, including viruses. Although there are various associative studies linking adverse outcomes to co- or subsequent exposures to inhaled pollutants and viruses, knowledge about causal linkages and mechanisms by which pollutant exposure may alter human respiratory responses to viral infection is more limited. In this article, we review what is known about the impact of pollutant exposure on antiviral host defense responses and describe potential mechanisms by which pollutants can alter the viral infection cycle. This review focuses on evidence from human observational and controlled exposure, ex vivo, and in vitro studies. Overall, there are a myriad of points throughout the viral infection cycle that inhaled pollutants can alter to modulate appropriate host defense responses. These alterations may contribute to observed increases in rates of viral infection and associated morbidity and mortality in areas of the world with high ambient pollution levels or in people using tobacco products. Although the understanding of mechanisms of interaction is advancing through controlled in vivo and in vitro exposure models, more studies are needed because emerging infectious pathogens, such as severe acute respiratory syndrome coronavirus 2, present a significant threat to public health.

Transmission ability of Zika virus with artificially infected Aedes albopictus in Korea

AbstractZika virus (ZIKV), a virus mainly occurring in South America, is now globally distributed. Understanding the pathogen transmission cycle in a vector is exceptionally important in developing disease control strategies. In this study, we performed ZIKV microinjection in Aedes albopictus (Skuese), to estimate its vertical and horizontal transmission ability. The virus infection rate was confirmed by real‐time qPCR in the F1 generation derived from the ZIKV‐injected Ae. albopictus. The minimum infection rate (MIR) of the F1 generation was highest when they were injected with the virus at 6–12 h (MIR: 16.1) and lowest at 12–24 h (MIR: 4.7) after feeding. In the developmental stage of the F1 progeny, MIR values were 1.0, 1.3, and 6.7 in each egg, larval, and adult stage, respectively, but ZIKV was not detected in the pupa stage. Virus transmission ability was not significantly different between the collection areas (Tongyeong and Jeju). Ae. albopictus demonstrated a high venereal transmission rate of ZIKV and was detected in males (6 pool/7 pool) and females (6 pool/7 pool), confirming that ZIKV can be transmitted from infected mosquitoes to uninfected mosquitoes via mating. This is the first study of the administration of a ZIKV microinjection to Ae. albopictus in Korea and suggests a possibility of a potential mechanism for the virus to survive during adverse conditions via vertical transmission.

Spread of COVID-19 in Zambia: An assessment of environmental and socioeconomic factors using a classification tree approach

The global pandemic emergent from SARS-COV-2 (COVID-19) has continued to cause both health and socio-economic challenges worldwide. However, there is limited information on the factors affecting the dynamics of COVID-19, especially in developing countries, including African countries. In this study, we have focused on understanding the association of COVID-19 cases with environmental and socioeconomic factors in Zambia - a sub-Saharan African country. We used Zambia's district-level COVID-19 data, covering 18 March 2020 (i.e., from first reported cases) to 17 July 2020. Geospatial approaches were used to organize, extract and establish the dataset, while a classification tree (CT) technique was employed to analyze the factors associated with the COVID-19 cases. The analyses were conducted in two stages: (1) the binary analysis of occurrences of COVID-19 (i.e., COVID-19 or No COVID-19), and (2) a risk level analysis which grouped the number of cases into four risk levels (high, moderate, low and very low). The results showed that the distribution of COVID-19 cases in Zambia was significantly influenced by the socioeconomic factors compared to environmental factors. More specifically, the binary model showed that distance to the airport, population density and distance to the town centres were the most combination influential factors, while the risk level analysis indicated that areas with high rates of human immuno-deficient virus (HIV) infection had relatively high chances of having many COVID-19 cases compared to areas with low HIV rates. The districts that are far from major urban establishments and that experience higher temperatures have lower chances of having COVID-19 cases. This study makes two major contributions towards the understanding of COVID-19 dynamics: (1) the methodology presented here can be effectively applied in other areas to understand the association of environmental and socioeconomic factors with COVID-19 cases, and (2), the findings from this study present the empirical evidence of the relationship between COVID-19 cases and their associated environmental and socioeconomic factors. Further studies are needed to understand the relationship of this disease and the associated factors in different cultural settings, seasons and age groups, especially as the COVID-19 cases increase and spread in many countries.

Enhancing Linkage to Hepatitis C Virus Treatment Following Pregnancy in Women Identified During Perinatal Care.

Amid the current US opioid crisis, hepatitis C virus (HCV) infection rates continue to rise in young adults, including among pregnant women, yet few studies describe linkage to care and treatment in pregnant or postpartum women with HCV infection. We used electronic health record data to estimate HCV treatment rates for postpartum women before (January 2014‐September 2016) and during (October 2016‐March 2018) implementation of a maternal–infant HCV linkage program in combination with a multidisciplinary clinic to colocate mother and infant care. Using Poisson regression models, we compared HCV treatment initiation rates, adjusting for demographics, substance use, and treatment. From January 2014 through March 2018, 343 women who were HCV seropositive delivered at our institution. Of these, 95% completed HCV nucleic acid testing and 255 women had chronic HCV infection. Mean age was 30 years, 96% were publicly insured, and 94% had documented substance use. HCV treatment initiation increased from 28/164 (17.1%) women with chronic HCV infection in the preintervention period to 16/66 (24.2%) with the linkage‐only intervention and 13/25 (52.0%) with the linkage intervention and colocated care. Adjusted analyses demonstrated that women delivering during the intervention period initiated HCV treatment at 2.40 times (95% confidence interval [CI], 1.10‐5.25; linkage only) and 3.36 times (95% CI, 1.57‐7.17; linkage and colocated care) the rate of women delivering preintervention. Women on buprenorphine had higher HCV treatment initiation rates compared with those on methadone (rate ratio, 2.10; 95% CI, 1.05‐4.21). Conclusion: HCV linkage to care and treatment rates improved in the setting of mother–infant linkage and colocated care interventions. Perinatal care may represent a critical venue to identify, link, and treat women for HCV infection to improve their own health and prevent transmission to subsequent pregnancies.

SUSTAINED RELEASE APPROACHES TOWARDS THE CHEMOTHERAPY OF TUBERCULOSIS

Tuberculosis is a most important killer of young adults worldwide and the global blight of multi-drug resistant tuberculosis is reaching epidemic proportions. It is endemic in most developing countries and resurgent in developed and developing countries with high rates of human immune insufficiency virus infection. This article reviews the current situation in terms of drug delivery approaches for tuberculosis chemotherapy. A number of novel implant, microparticulate and a variety of other carrier-based drug delivery systems incorporating the principal anti-tuberculosis agents have been made-up that either target the site of tuberculosis infection or reduce the dosing occurrence with the aim of improving patient outcomes. These developments in drug delivery represent attractive options with noteworthy merit, on the other hand, there is a necessity to manufacture an oral system, which directly addresses issues of unacceptable rifampicin bioavailability in fixed-dose combinations. This is fostered by the need to deliver medications to patients more efficiently and with fewer side effects, especially in developing countries. The fabrication of a polymeric once-daily oral multi particulate fixed-dose combination of the principal anti-tuberculosis drugs, which attains segregated delivery of rifampicin and isoniazid for improved rifampicin bioavailability, could be a step in the right direction in addressing issues of treatment failure due to patient non-compliance.

Lived experiences of people living with HIV: a descriptive qualitative analysis of their perceptions of themselves, their social spheres, healthcare professionals and the challenges they face daily

BackgroundHuman immunodeficiency virus (HIV) infection rates have been gradually increasing in Istanbul, Turkey. Many people living with HIV (PLWH) here encounter difficulties, for example, in adapting to the chronic disease and obtaining continuous access to healthcare services. In this study, we aimed to explore the challenges PLWH face in their daily lives and understand their perceptions of themselves, healthcare professionals and services, and their social spheres via their expressed lived experiences in the healthcare setting.MethodIndividual semi-structured in-depth interviews were conducted face-to-face with 20 PLWH in Istanbul. All the interviews were voice-recorded and transcribed verbatim except one, upon participant request, for which the interviewer took notes. These logs and the interviewer’s notes were analyzed thematically using the inductive content analysis method.ResultsThe themes concerned experiences in three distinct contexts: 1) Interactions with healthcare providers; 2) Participants’ responses to their HIV diagnosis; and 3) Interactions with their social networks. Firstly, the results highlighted that the participants perceived that healthcare professionals did not inform them about the diagnosis properly, failed to protect patients’ confidentiality and exhibited discriminative behaviors towards them. Secondly, after the diagnosis the participants had difficulty in coping with their unsettled emotional state. While many ceased sexual activities and isolated themselves, some sought support. Lastly, living with HIV affected their relationships with their families and friends either positively or negatively. Moreover, they had to face the difficulties concerning spouse/partner notification issues about which many needed professional support.ConclusionHealthcare professionals’ discriminative or inappropriate attitudes and customs in healthcare institutions are perceived to impair PLWH’s utilization of healthcare services. Structural factors such as social pressure, societal ignorance about HIV, limited access to HIV prevention, and regulatory barriers might contribute to these challenges. The results suggest that it is necessary to raise healthcare professionals’ and society’s awareness about HIV and develop national policies to establish a well-functioning referral system and appropriate spouse/partner notification services.

Seasonal Variation in Viral Infection Rates and Cell Sizes of Infected Prokaryotes in a Large and Deep Freshwater Lake (Lake Biwa, Japan).

As viruses regulate prokaryotic abundance and the carbon cycle by infecting and lysing their prokaryotic hosts, the volume of infected prokaryotes is an important parameter for understanding the impact of viruses on aquatic environments. However, literature regarding the seasonal and spatial variations in the cell volume of infected prokaryotes is limited, despite the volume of the prokaryotic community varying dynamically with season and water column depth. Here, we conducted a field survey for two annual cycles in a large and deep freshwater lake (Lake Biwa, Japan), where large prokaryotes inhabit the deeper layer during the stratified period. We used transmission electron microscopy to reveal the seasonal and spatial variation in the frequency of viral infection and cell volume of infected prokaryotes. We found that the viral infection rate in the surface layer increased when estimated contact rates increased during the middle of the stratified period, whereas the infection rate in the deeper layer increased despite low estimated contact rates during the end of the stratified period. In addition, in the deeper layer, the fraction of large prokaryotes in the total and infected prokaryotic communities increased progressively while the number of intracellular viral particles increased. We suggest different ways in which the viral abundance is maintained in the two water layers. In the surface layer, it is speculated that viral abundance is supported by the high viral infection rate because of the high activity of prokaryotes, whereas in the deeper layer, it might be supported by the larger number of intracellular viral particles released from large prokaryotes. Moreover, large prokaryotes could contribute as important sources of organic substrates via viral lysis in the deeper layer, where labile dissolved organic matter is depleted.

A Review of the Global Impact of the COVID-19 Pandemic on Public Mental Health, with a Comparison Between the USA, Australia, and Poland with Taiwan and Thailand.

Coronavirus may have a negative impact not only on physical, but also on mental wellbeing. Despite the different approaches of countries to stop the spread of the virus and different infection rates, the dynamically developing pandemic has already affected the entire world. The consequences of the coronavirus for our mental health can be divided into those related to strategies for the prevention of infection, like isolation, quarantine, limitation of social contacts, and remote work, and those related to the direct impact of infection on our nervous system. This review aims to highlight the global effects of the Coronavirus Disease 2019 (COVID-19) pandemic on public mental health following social restrictions, to identify how infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may have direct neurophysiological effects and to compare the impact on public mental health between the USA, Australia, and Poland with Taiwan and Thailand.

Novel small molecular inhibitor of Pit-Oct-Unc transcription factor 1 suppresses hepatocellular carcinoma cell proliferation

Hepatocellular carcinoma (HCC) is one of the most prevalent fatal malignancies in the Chinese population, due to high rates of hepatitis virus infection. Molecular targeted drugs such as sorafenib are the anti-tumor agents of choice for HCC treatment, but their results are generally unsatisfactory. In the present study the use of Pit-Oct-Unc transcription factor 1 (OCT1/POU2F1) as a potential therapeutic target for HCC was investigated, and a novel small molecular inhibitor of OCT1 (SMIO-1) was designed and its therapeutic efficacy against HCC was assessed. OCT1 expression was higher in HCC specimens than in corresponding non-tumor tissues, and higher OCT1 was associated with poorer prognosis in advanced HCC patients undergoing sorafenib treatment. For the first time, the novel SMIO-1 was investigated in conjunction with OCT1 via molecular docking. Interaction between SMIO-1 and OCT1 was confirmed via OCT1 point mutation. Treatment with SMIO-1 repressed OCT1 transcription factor activation by disrupting the interaction between OCT1 and its cofactors. It also repressed the proliferation and metastasis of HCC cells, and inhibited proliferation-related and metastasis-related genes downstream of OCT1. Therefore, SMIO-1 is a promising strategy for HCC treatment.

열회수형 환기장치 적용 시 다중이용시설의 환기횟수에 따른 냉·난방부하와 감염률

Recently, confirmed patients of COVID-19 continue to occur in multi-use facilities, and cases of aerosol infection increase in non-ventilated spaces. As ventilation rate increases, the virus infection rate decreases exponentially, but forced ventilation for reducing the infection rate leads to energy loss. In this paper, a cafe was selected the same as the previous paper. TRNSYS18 was used to calculate the heating and cooling loads according to ventilation rates and methods. Based on this, the correlation with the infection rate was analyzed. During heating operation, the heating loads increased as ventilation rate increased, and the heating sensible loads were particularly affected. Ventilating with 3 ACH, the heating loads increased by 14 times for forced ventilation, compared to non-ventilated. Applying ERV, the heating loads increased by 3.5 and 3.3 times for the plate and rotary respectively. The cooling latent loads increased significantly as ventilation rate increased, compared to non-ventilated during cooling operation. Ventilating with 3 ACH, the cooling loads increased by 2 times for forced ventilation, 1.6 and 1.2 times for the plate and rotary respectively. When infected and non-infected people stay in the same space for 5 hours without wearing a mask, it is possible to keep the infection rate below 2% with 3 ACH. As a way to prevent the spread of COVID-19, ventilation is very effective, and considering energy savings, ERV introduction is essential.

Role of Inflammatory Cytokines in COVID-19 Patients: A Review on Molecular Mechanisms, Immune Functions, Immunopathology and Immunomodulatory Drugs to Counter Cytokine Storm.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a severe pandemic of the current century. The vicious tentacles of the disease have been disseminated worldwide with unknown complications and repercussions. Advanced COVID-19 syndrome is characterized by the uncontrolled and elevated release of pro-inflammatory cytokines and suppressed immunity, leading to the cytokine storm. The uncontrolled and dysregulated secretion of inflammatory and pro-inflammatory cytokines is positively associated with the severity of the viral infection and mortality rate. The secretion of various pro-inflammatory cytokines such as TNF-α, IL-1, and IL-6 leads to a hyperinflammatory response by recruiting macrophages, T and B cells in the lung alveolar cells. Moreover, it has been hypothesized that immune cells such as macrophages recruit inflammatory monocytes in the alveolar cells and allow the production of large amounts of cytokines in the alveoli, leading to a hyperinflammatory response in severely ill patients with COVID-19. This cascade of events may lead to multiple organ failure, acute respiratory distress, or pneumonia. Although the disease has a higher survival rate than other chronic diseases, the incidence of complications in the geriatric population are considerably high, with more systemic complications. This review sheds light on the pivotal roles played by various inflammatory markers in COVID-19-related complications. Different molecular pathways, such as the activation of JAK and JAK/STAT signaling are crucial in the progression of cytokine storm; hence, various mechanisms, immunological pathways, and functions of cytokines and other inflammatory markers have been discussed. A thorough understanding of cytokines’ molecular pathways and their activation procedures will add more insight into understanding immunopathology and designing appropriate drugs, therapies, and control measures to counter COVID-19. Recently, anti-inflammatory drugs and several antiviral drugs have been reported as effective therapeutic drug candidates to control hypercytokinemia or cytokine storm. Hence, the present review also discussed prospective anti-inflammatory and relevant immunomodulatory drugs currently in various trial phases and their possible implications.

Increasing cervical cancer screening at a non-government medical center in Lilongwe, Malawi.

Malawi has the highest incidence of and mortality rate due to cervical cancer in the world. This is largely because of inadequate screening and high rates of human immunodeficiency virus (HIV) infection, which greatly increases cervical cancer risk. We describe the implementation of a quality improvement program to increase use of cervical cancer screening at a non-government medical center in Lilongwe, Malawi. The intervention, developed and launched from March to August 2017, aimed to promote education among patients and clinicians about the importance of cervical cancer screening and improve accessibility of screening information within medical records. Visual inspection with acetic acid (VIA) was used to screen for cervical cancer. Women with a positive VIA were offered treatment using thermocoagulation. The number of VIA screenings conducted in 2016 (pre-intervention), 2017 (intervention), and 2018 (post-intervention) was 125, 234 and 456, respectively. Of the 815 women screened during this period, 36 (4.4%) had a VIA-positive result and 12 (1.5%) had suspect cancer. Of the VIA-positive women, 13 (36.1%) received same-day treatment with thermocoagulation. An interrupted time series regression revealed that there was a sustained increase in monthly screenings between the pre- and post-intervention period (β = 30.84; p = 0.006; 95% CI 9.72-51.97), suggesting that the intervention likely was effective in increasing cervical cancer screening. Our results demonstrate that focusing on developing sustainable solutions and improving system processes, without additional equipment or funding, significantly increased the number of women screened and should be considered in other settings to enhance cervical cancer prevention services.

POS-351 DIABETES, THE LEADING CAUSE OF END-STAGE RENAL DISEASE AND CHARACTERISTICS OF HEMODIALYSIS IN KSA

With the ever increasing number of end-stage renal disease (ESRD) in the Kingdom; there is a need for continuous analysis on the existing burden of disease and utilize the best possible modality based on the outcome of the study. Retrospective study on the incidence and prevalence of ESRD, dialysis patient demographics and modalities based on cross-sectional study of annual questionnaires from all dialysis centers in the Kingdom. At the end of 2019, there were a total of 19,522 Hemodialysis (HD) patients including 4,146 new patients, having a 6% net annual increase for the past 5 years from 278 dialysis centers registered to SCOT. Majority of the patients are from age groups of between 26 to 65 years (67%) while a total of 112 (0.57%) patients were pediatrics (under 15 years) and 1,924 patients were above 75 years old representing 10% of the current HD population. In addition, the gender composition shows 10,835 (56%) males and 8,687 (44%) females and were divided between 83% nationals and 17% residents. The leading causes of ESRD are diabetic nephropathy 8,420 (43%), hypertensive nephropathy 6,679 (34%) and followed by unknown etiology at 1,715 (9%). Since 2010, there was a constant increase in the number of ESRD patients caused by diabetic nephropathy having an average increase of 7.15% for the past 5 years while hypertensive nephropathy had 5.85% average increase during the same period. The prevalence of hypertension (HTN) and diabetes mellitus (DM) among HD patients showed 13,736 (71%) and 10,528 (54%) respectively while the trend of prevalence as well showed a constant increase in the number of patients with DM & HTN having an average increase of 10% annually for the past 5 years. There was a significant decrease in the Hepatitis C Virus (HCV) infection rate among HD patients with 8% in 2019 vs. 24.5% in 2010. The types of vascular access shows 12,072 (62%) are on arteriovenousfistula (AVF), 5,827 (30%) on permanent jugular catheter, 980 (5%) on vascular graft and 477 (2%) on femoral catheter. The leading cause of ESRD among the HD population is DM, having a significant increase during the past decade The increase in the age of dialysis over 50 years and reduction of pediatric group during the past decade showed better detection of chronic kidney disease. DM remained as the major concern as the leading cause of ESRD in Kingdom and needs to be tackled to settle a national project for CKD focusing on early prevention and management of DM and obesity.

Molecular surveillance of coxsackievirus A16 in southern China, 2008-2019.

A national surveillance system on hand, foot, and mouth disease (HFMD) was launched in 2008 in China. Since then, millions of HFMD cases have been reported each year, with enterovirus A71 (EV-A71), coxsackievirus A16 (CV-A16), and coxsackievirus A6 (CV-A6) as the major causative pathogens. Long-term surveillance of viral infection rates and genetic changes is essential for understanding the disease epidemiology pattern. Here, we analyzed molecular surveillance data on CV-A16 covering a period of 12 years (2008-2019) in Guangdong, China, one of the regions reporting the largest number of HFMD cases. Full VP1 sequences of 456 strains were determined to examine the genetic diversity and changes in the distribution of CV-A16 variants. Our study revealed an irregular pattern of CV-A16 infections in Guangdong. Different from the cyclic epidemics observed in some Asia-Pacific regions, there was a continuously high CV-A16 infection rate from 2008 to 2014, and after a period of lower epidemic activity in 2015-2017, an upsurge of CV-A16 infection was observed in 2018-2019. Cocirculation of subgenotypes B1a and B1b was observed, but while subgenotype B1a was predominant from 2008 to 2012, it appears to have been replaced by B1b, which has circulated as the predominant subgenotype since 2013. Phylogenetic analysis showed that most of the circulating CV-A16 strains are endemic, with occasional transmission between neighboring regions. The re-emergence of B1a in 2016-2019 in Guangdong was likely the result of introduction(s) from Southeast Asia. These results highlight the importance of continuous molecular surveillance from different areas, which will improve our understanding of the origin of the epidemic and facilitate the development of strategies for HFMD disease control.

Viral etiology and epidemiology of pediatric patients hospitalized for acute respiratory tract infections in Macao: a retrospective study from 2014 to 2017

BackgroundAcute respiratory infections (ARIs) are among the leading causes of hospitalization in children. Understanding the local dominant viral etiologies is important to inform infection control practices and clinical management. This study aimed to investigate the viral etiology and epidemiology of respiratory infections among pediatric inpatients in Macao.MethodsA retrospective study using electronic health records between 2014 and 2017 at Kiang Wu Hospital was performed. Nasopharyngeal swab specimens were obtained from hospitalized children aged 13 years or younger with respiratory tract diseases. xMAP multiplex assays were employed to detect respiratory agents including 10 respiratory viruses. Data were analyzed to describe the frequency and seasonality.ResultsOf the 4880 children enrolled in the study, 3767 (77.1%) were positive for at least one of the 13 viral pathogens tested, of which 2707 (55.5%) being male and 2635 (70.0%) under 2 years old. Among the positive results, there were 3091 (82.0%) single infections and 676 (18.0%) multiple infections. The predominant viruses included human rhinovirus/enterovirus (HRV/EV 27.4%), adenovirus (ADV, 15.8%), respiratory syncytial virus B (RSVB, 7.8%) and respiratory syncytial virus A (RSVA, 7.8%). The detection of viral infection was the most prevalent in autumn (960/1176, 81.6%), followed by spring (1095/1406, 77.9%), winter (768/992, 77.4%), and summer (944/1306, 72.3%), with HRV/EV and ADV being most commonly detected throughout the 4 years of study period. The detection rate of viral infection was highest among ARI patients presented with croup (123/141, 87.2%), followed by lower respiratory tract infection (1924/2356, 81.7%) and upper respiratory tract infection (1720/2383, 72.2%). FluA, FluB and ADV were positive factors for upper respiratory tract infections. On the other hand, infection with RSVA, RSVB, PIV3, PIV4, HMPV, and EV/RHV were positively associated with lower respiratory tract infections; and PIV1, PIV2, and PIV3 were positively associated with croup.ConclusionsThis is the first study in Macao to determine the viral etiology and epidemiology of pediatric patients hospitalized for ARIs. The study findings can contribute to the awareness of pathogen, appropriate preventative measure, accurate diagnosis, and proper clinical management of respiratory viral infections among children in Macao.

Rapid real-time detection method of ACLSV and ASSVd for apple quarantine field

Apples are produced using a high-density plantation system using M.9 rootstock in Korea. However, the virus infection rate of apples tends to be high because the rootstocks produced from virus-infected mother stocks were widely used and vegetative propagation based on the grafting is common with scion cultivars. The most effective way to control plant virus and viroid depends on conducting a massively rapid and precise diagnostic inspection. Therefore, this study aims to develop a real-time PCR assay that can be precisely and inexpensively tested for ACLSV and ASSVd. To expand the detection range, we developed a singleplex real-time PCR method targeting the conserved region of ACLSV and ASSVd, respectively. The detection methods using two kinds of fluorescent chemical dye, SYBR Green I and TaqMan probe, have been developed in this study. Comparing these methods developed with two dyes, the assay using SYBR Green I was efficient for detection as much as the method using TaqMan probe and faster. The field test demonstrated real-time detecting methods developed using SYBR Green I dye were applicable to reliable diagnosis and quantification for virus and viroid in quarantine fields.

Direct-acting antiviral treatment for Hepatitis C Virus in geriatric patients: a real-world retrospective comparison between early and late elderly patients.

IntroductionChronic hepatitis C virus (HCV) infection rates are high in the geriatric population considering that interferon-based therapy is usually intolerable. With the introduction of oral antiviral therapy for HCV, increased treatment tolerability and good treatment responses have been observed. However, treatment data regarding the geriatric population have been limited. Therefore, this retrospective study aimed to evaluate the efficacy and safety of direct-acting antiviral therapy for HCV in the geriatric population.Materials and MethodsThe primary end point was sustained virologic response (SVR) 12 weeks after treatment completion, whereas the secondary end points were treatment-related side effects and short-term survival rate following treatment.ResultsIn total, 492 patients (median age, 73 years; 43.9% males), including 278 early elderly patients, were enrolled. Among the included patients, 45% had cirrhosis. HCV genotypes 1 (72.4%) and 2 (25.4%) were the most common. The overall SVR rate was 96.7%, with no difference in SVR rates observed between early and late elderly groups (96.8% vs. 96.7%; p = 0.983). Both groups showed similar side effects, including dizziness (11.4%), and fatigue (8.7%), with three patients discontinuing therapy owing to side effects. Both groups had a similar 3-year survival rate. Significant factors associated with post-treatment survival included cirrhosis, albumin, and creatinine level.ConclusionsOur real-world data showed that both early and late elderly patients could undergo direct-acting antiviral treatment for HCV with excellent treatment outcomes.

Blessings or curses? The contribution of the blesser phenomenon to gender-based violence and intimate partner violence

This article examines the blesser phenomenon in South Africa, which gained rapid popularity in 2016. A large body of research exists that reveals that transactional sex is a significant theme within the phenomenon of blesser and blessee relationships. Scholarship has demonstrated that transactional sex has contributed to an increase in human immunodeficiency virus infection rates, especially amongst women aged 15–24 years, as well as a concerning increase in teenage pregnancy. Whilst these are dire realities of blesser–blessee relationships, the one that is most concerning in the current climate in South Africa is the increase in gender-based violence (GBV), intimate partner violence (IPV) and femicide. Therefore, this article concerns itself primarily with this epidemic as it seeks to demonstrate how the blesser phenomenon contributes to GBV and IPV. Blessees are the young women in the blesser–blessee relationships who experience trauma and shame because of the violence and abuse inflicted on them by the older male blessers. The article argues that the church should be seen to be taking decisive action in addressing the scourge of GBV and IPV. The narrative approach is used to give the blessees the opportunity to share their stories. By applying the techniques of narrative therapy, positive deconstruction and the art of holy listening, the study reaches its key outcome: to offer to the church a framework for a pastoral care and healing methodology to help our sisters in Christ to experience healing and to move from shame to self-worth. Contribution: The Blesser phenomen has never been dealt with in theology, especially from the African perspective. Both sides of the problem need pastoral care. The major issue is where do we begin? I started, pastorally working with the blessee, who is in relationship with an older man. The main question that could be pastorally followed is, why pursue an older man for provision? This is a major pastoral issue, especially in poor communities. The younger women are in need of finance, in order to complete their studies and eke out a living. Beside the Covid 19 pandemic, this is the second major issue affecting black townships.

The role of proteases in the invasion of SARS-CoV-2 virus into human host cells

The new coronavirus, which originally broke out in Wuhan, China, in December 2019, increase quickly around the world, causing a pandemic all over the world. The virus uses its spike protein to enter the human host cells. Protein S binds to the angiotensin-converting enzyme II (ACE2) receptor and enters the host cell. For the more successful binding, several proteases facilitate and optimize this binding, the most important of which are transmembrane protease serine 2 (TMPRSS2), furin, and cathepsin L proteases. After binding of protein S to the ACE2 receptor, cleavage of protein S is required for membrane fusion by protein S, which causes viral entry into host cells. This proteolytic activity may be cathepsin L-dependent and occurs with changes in pH in cell endosomes, or it may occur through serine proteases activity at the surface of the host cell membrane or within vesicles. Finally, the cell becomes infected with the virus. Several studies have tried to reduce the rate of viral infection by using inhibitors of these proteases .