Risk Of Spread Research Articles

IDH-mutant astrocytomas with primitive neuronal component have a distinct methylation profile and a higher risk of leptomeningeal spread

IDH-mutant astrocytomas are diffuse gliomas that are defined by characteristic mutations in IDH1 or IDH2 and do not have complete 1p/19q co-deletion. The established grading criteria include histological features of brisk mitotic activity (grade 3) and necrosis and/or microvascular proliferation (grade 4). In addition, homozygous deletion of the CDKN2A/B locus has recently been implemented as a molecular marker for grade 4 IDH-mutant astrocytomas. Here, we describe a subgroup of high-grade IDH-mutant astrocytomas characterised by a primitive neuronal component based on histology and a distinct DNA methylation profile (n = 51, ASTRO PNC). Misinterpretation as carcinoma metastasis was common, since GFAP expression was absent in the primitive neuronal component, whereas TTF-1 expression was detected in 15/19 cases (79%) based on immunohistochemistry. Apart from mutations in IDH1, TP53, and ATRX, we observed enrichment for alterations in RB1 (n = 19/51, 37%) and MYCN (n = 14/51, 27%). Homozygous CDKN2A/B deletion (n = 1/51, 2%) and CDK4 amplification (n = 3/51, 6%) were relatively rare events. Clinical (n = 31 patients) and survival data (n = 23 patients) indicate a clinical behaviour similar to other CNS WHO grade 4 IDH-mutant astrocytomas, however with an increased risk for leptomeningeal (n = 7) and extra-axial (n = 2) spread. Taken together, ASTRO PNC is defined by a distinct molecular and histological appearance that can mimic metastatic disease and typically follows an aggressive clinical course.

Antenatal socioeconomic status of childhood family and the risk of pain spreading (ROPS) in early and mid-adulthood - a descriptive study from the northern Finland birth cohort 1966.

The Risk of Pain Spreading (ROPS) is a six-item tool capturing key data-driven prognostic factors for chronic pain and its spreading. Higher values on the ROPS indicate a higher risk. Early factors potentially associated with the ROPS are unknown. We aimed to examine the associations between antenatal socioeconomic status of childhood family (antenatal SES) and ROPS at ages 31 and 46years. The study was based on the Northern Finland Birth Cohort 1966 and previously formulated latent clusters of antenatal family SES: Highest status (the reference), Small, Larger, Average wealth, and Rural families. The ROPS ranged from zero (the reference) to two or more points out of six. A multinomial regression model was used to identify antenatal SES clusters associated with ROPS. At 31years (n=8252), only the Larger families cluster was associated with having accumulated points (two or more) (Odds ratio [OR]: 1.46, 95% Confidence Interval [CI]: 1.14-1.87) on the ROPS compared to the Highest status families cluster. Corresponding finding was observed at 46years (n=6245), but the Small families and Average wealth families clusters were also associated with this outcome. The association of Larger families cluster was, however, the strongest (OR 1.48, 95% CI 1.16-1.89). Offspring born into families with ≥5 members are likely to accumulate higher sums of key data-driven prognostic factors for worse pain across the life course until middle age. In future, associations between antenatal SES and pain would be important to be examined in a light of the ROPS.

Modelling the impact and cost-effectiveness of upcoming Zika virus vaccines on congenital Zika syndrome.

Zika virus (ZIKV) continues to circulate in Southeast Asia following the 2015-2016 global epidemic, posing an ongoing risk of importation and disease spread for Singapore, a tropical city-state in the region. The virus remains a threat to pregnant women and their fetuses due to the risk of Congenital Zika Syndrome (CZS). Vaccines currently in development offer hope for reducing ZIKV infections and CZS cases. We developed an agent-based compartmental model, incorporating Singapore's demographic dynamics, to simulate ZIKV epidemic trajectories and project the national disease burden of CZS over the next decade. We proposed eight vaccination strategies targeting females of child-bearing age and evaluated their cost-effectiveness-in terms of the incremental cost-effectiveness ratio (ICER)-across scenarios with varying vaccine efficacy, protection duration, coverage rate, vaccination cost, and pre-existing immunity levels in the population. Continuous high importation of ZIKV could lead to multiple small outbreaks in the next decade. Total CZS case numbers over the next decade were projected to be 68 (95% confidence interval [CI]: 66-70), 51 (95% CI: 49-52), and 32 (95% CI: 31-33) under scenarios of 0%, 2%, and 5% pre-existing immunity, respectively. While mass vaccination for females would avert up to 66 (95% CI: 64-69), 49 (95% CI: 48-50), and 31 (95% CI: 30-31) CZS cases, respectively, the cost-effectiveness of these strategies should be evaluated on a case-by-case basis. The pre-pregnancy vaccination strategy demonstrated consistent cost-effectiveness regardless of vaccine protection duration, vaccine efficacy, vaccine price, or pre-existing immunity level in the population. Localised outbreaks driven by importation are likely to persist in Singapore. The pre-pregnancy vaccination strategy is consistently cost-effective and should be considered. Mass vaccination may also be viable with the availability of a low-cost vaccine providing long-term protection.

Detecting novel plant pathogen threats to food system security by integrating the Plant Reactome and remote sensing.

Plant diseases constantly threaten crops and food systems, while global connectivity further increases the risks of spreading existing and exotic pathogens. Here, we first explore how an integrative approach involving plant pathway knowledgegraphs, differential gene expression data, and biochemical data informing Raman spectroscopy could be used to detect plant pathways responding to pathogen attacks. The Plant Reactome (https://plantreactome.gramene.org) demonstrates the potential to synthesize knowledgegraphs depicting plant-pathogen interactions, leveraging availability of publicly available OMIC data sets related to major diseases of rice and maize. Plant pathway signatures may then guide the development of drone and satellite remote-sensing methods for early monitoring of disease outbreaks across farms and landscapes. A review of current proximal- and remote-sensing technology demonstrates the potential for actionable early pathogen detection. We furthermore identify knowledge gaps that needto be addressed for developing these tools as components of effective strategies for safeguarding global food security against current and emerging pathogens.

Neoadjuvant chemoradiation therapy application in radical esophagectomy surgery: Safety and feasibility: A descriptive study in Vietnam.

Esophageal cancer (EC) ranks as the 7th most prevalent form of cancer and the 6th leading cause of cancer-related mortality globally. Neoadjuvant therapy, encompassing neoadjuvant chemotherapy or chemoradiotherapy, has shown promise in reducing the staging of EC and mitigating the risk of early systemic spread. This study seeks to assess the safety and viability of implementing neoadjuvant chemoradiotherapy (nCRT) in conjunction with radical esophagectomy surgery for Vietnamese patients diagnosed with locally advanced EC. Safety was evaluated based on the incidence of grade ≥3 treatment-related adverse events, while feasibility was assessed through indicators such as pathological complete response, major pathological response, and R0 resection rates. The study analyzed data from 30 patients, following specific inclusion criteria. Baseline characteristics analysis revealed a participant cohort entirely composed of males, wherein 83.3% were identified as smokers, with tumors predominantly located in the middle (46.7%) and lower (53.3%) regions of the thoracic esophagus. The predominance of clinical stages II and III was observed. The nCRT protocol resulted in a substantial reduction in dysphagia score, with a statistically significant P < .001. The median duration from the conclusion of radiation treatment to surgery was 62 days, with a median operative time of 302 minutes and a median estimated blood loss of 189 mL. Surgical complications primarily included anastomotic leakage and pneumonia, occurring in 23.3% and 16.7% of cases, respectively. R0 resection was achieved in 29 (96.7%) patients, with 43.4% attaining pathological complete response and 56.7% demonstrating tumor complete response. The study's outcomes emphasize the safety and feasibility of employing esophagectomy subsequent to nCRT in Vietnamese patients, as evidenced by the absence of mortality, low complication rates, and favorable surgical results. It also suggests the potential advantages of utilizing a lower daily Gy dose for enhanced safety and considering squamous cell carcinoma as a specific criterion for nCRT.

LEGAL RELATIONSHIP BETWEEN FUND DEPOSITORS AND MANAGING BANKS IN MUDHARABAH DEPOSIT AT ISLAMIC BANKS

Mudharabah deposits are a key product in Islamic banking, governed by Law Number 21 of 2008 on Islamic Banking. This product operates on a profit-sharing principle, distinguishing it from conventional deposits, which rely on interest-based systems. The profit-sharing mechanism helps Islamic banks avoid the negative spread risk faced by conventional banks and changes the legal relationship between depositors and banks. This study addresses the shift in the legal relationship from a creditor-debtor model, as seen in conventional banks, to a partnership-based model in Islamic banking, emphasizing equal profit sharing. The research aims to examine the legal construction of this partnership, where the depositor entrusts funds to the bank, which manages them in accordance with Sharia principles. Using a normative legal method, the study draws on data from legal documents and regulations to analyze the protections provided to depositors, focusing on compliance with Islamic law and the bank's fiduciary responsibility. The result highlights that depositors in Mudharabah schemes receive enhanced legal protection, benefiting from better governance, risk management, and adherence to Sharia principles.

Evolving Epidemiology of Mpox in Africa in 2024.

For decades after the identification of mpox in humans in the Democratic Republic of Congo (DRC) in 1970, the disease was largely confined to the rural areas of Central and West Africa and thus did not garner broad attention. On August 13, 2024, mpox was declared a Public Health Emergency of Continental Security (PHECS) by the Africa Centers for Disease Control and Prevention (Africa CDC), a notice that was followed the next day by a declaration of a Public Health Emergency of International Concern (PHEIC) by the World Health Organization. In this study we analyzed all mpox cases and deaths, based on clinical or laboratory diagnosis, that were reported to the Africa CDC from January 1, 2022, to October 30, 2024, to identify temporal variations, geographic distributions, and epidemiologic trends. From January 1, 2022, to August 18, 2024, a total of 45,652 mpox cases were clinically diagnosed and laboratory-confirmed in 12 African countries. These cases resulted in 1492 deaths (case fatality rate, 3.3%). From 2022 to 2024, weekly laboratory-confirmed mpox cases increased by a factor of 2.8 (from 176 to 489 cases), whereas all weekly reported cases (including those with a clinical diagnosis) increased by a factor of 4.3 (from 669 to 2900 cases). The DRC, which had reported approximately 88% of mpox cases in Africa in 2024, had 19,513 cases before the emergency declaration, with a case fatality rate of 3.1% - a weekly average of 591 cases as compared with 281 in 2023. In 2024, six African countries reported their first imported mpox infections, with Burundi also reporting local transmission. The high mpox disease burden in Africa, especially in the DRC - with a rising number of cases, high case fatality rate, and high degree of spread to other previously mpox-free African countries - is cause for increased international concern. Case detection, contact tracing, public health measures, and affordable vaccines are needed to implement interventions in the DRC to reduce the risk of global spread of the virus.

The risks of cholera importation and the forecasting system in epidemiological surveillance in the RF

The purpose of the study – to determine the effectiveness of proactive epidemiological surveillance of cholera on the territory of the Russian Federation in 2023-2024. Materials and methods. A risk-based approach based on the systematization of official information on the global incidence of cholera was used: Weekly Epidemiological Record of WHO; official and regional websites of WHO; Internet resources: ProMED-mail post; ECDC and other sources. The work was guided by the administrative documents of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in 2023-2024, and used materials from the operational epidemiological analysis of the reference centre for cholera monitoring on the territory of the Russian Federation. Genome-wide sequencing and genome assembly were performed on the MiSeq (Illumina) platform, genetic determinants were identified in WGSs using the BioEdit 7.2.5 and BLASTN 2.2.29 programs. Statistical processing of the obtained results was performed using a computer program (StatSoft STATISTICA 6.1.478 Russian). Results. The analysis of an array of data on the incidence of cholera in the world is carried out, a realistic forecast of the probability of cholera importation risks to the Russian Federation in 2023 is given. The anti-epidemic readiness of the bodies and organizations of Rospotrebnadzor and the Ministry of Health of the Russian Federation was checked, an operational response was carried out to two cases of cholera importation to the Tambov region and the city of Moscow from India in 2023 with their timely decoding, including genomic and phylogenetic characteristics of pathogens. Foci of infection have been localized and eliminated, and its spread was prevented. Cholera was monitored on the territory of the Russian Federation in 2024. Measures were taken to minimize the risks of importation and spread of this infection. Conclusion. Based on the analysis of the monitoring results for 2023-2024, the effectiveness of the system of proactive epidemiological surveillance based on early detection of cholera importation risks or their precursors, on forecasting, on prompt response in case of cholera epidemic complications and on control of facilities and factors contributing to the possible spread of infection has been proved. The stability of the epidemiological situation of cholera in the Russian Federation has been ensured.

P-360. Impact of a tiered masking intervention on healthcare worker illness and absenteeism during respiratory viral season

Abstract Background High community transmission of respiratory viruses can lead to employee illness, absenteeism, and the risk of spread to both patients and healthcare workers (HCWs). Masking in healthcare settings can mitigate these risks. Our hospital developed a policy to adjust the level of masking required based on current community transmission rates, intensifying or relaxing mandates as necessary. This study aims to evaluate the impact of our tiered masking policy on employee absenteeism. Weekly respiratory viral metrics and employee influenza-like illness for 2022 Methods Retrospective review of employee health data, public health respiratory virus surveillance metrics, and infection prevention masking requirements at a 151-bed safety-net hospital. Data from September to December 2022, when universal masking was in place, and September to December 2023, when our new masking policy was implemented was compared. In 2023, four masking levels were created: red always requires masks for HCWs and patients; orange requires them for HCWs; yellow requires masks for HCWs during patient contact; both orange and yellow recommends but doesn’t require masks for patients; green recommends but does not require masks for HCW and patients. Weekly public health respiratory surveillance data, masking requirements and employees reporting influenza-like illness (ILI) were tabulated and compared before and after our new masking policy. Weekly respiratory viral metrics and employee influenza-like illness for 2023 Results A total of 66 HCWs reported ILI during the 2022 respiratory viral season compared to 44 in 2023, a 33% reduction. Weekly respiratory viral metrics and HCW ILI is plotted in Figure 1 for 2022 and Figure 2 for 2023. When mask levels were raised to orange on October 6, HCW ILI slightly decreased. Masking changed to yellow on October 22 and correlated with a subsequent increase in ILI. Escalation to red on December 10 was followed by a decline in ILI. Conclusion A tiered masking policy in response to fluctuating community transmission appears to be an effective strategy in managing HCW absenteeism due to ILI. Despite higher percent positivity from multiple viruses, a 33% decrease in ILI occurred after implementation of the tiered masking policy, as compared the prior universal masking policy. A tiered masking policy based on percent positivity may be more effective than universal masking. Disclosures All Authors: No reported disclosures

Predicting brain tumour growth patterns using a novel MRI-based tumour spread map: application to radiotherapy planning.

The treatment of glioblastomas (GBM) with radiation therapy is extremely challenging due to their invasive nature and high recurrence rate within normal brain tissue. In this work, we present a new metric called the tumour spread (TS) map, which utilizes diffusion tensor imaging (DTI) to predict the probable direction of tumour cells spread along fiber tracts. We hypothesized that the TS map could serve as a predictive tool for identifying patterns of likely recurrence in patients with GBM and, therefore, be used to modify the delivery of radiation treatment to pre-emptively target regions at high risk of tumour spread. In this proof-of-concept study, we visualized the white matter fiber tract pathways within the brain using diffusion tensor tractography and developed an algorithm which mathematically calculates a relative probability index in each voxel, resulting in the generation of the TS map. Based on the information provided by the TS map, the original radiotherapy target volume was then modified to include areas with a higher probability of tumour spread and exclude other areas with a lower probability of spread. A volumetric modulated arc therapy (VMAT) treatment plan was then developed utilizing the modified target volumes and subsequently compared to that using the original target volumes. Follow-up anatomical imaging obtained 8 months post-surgery was assessed to validate our findings. A TS map was generated on a glioblastoma patient demonstrating a relative probability of tumour spread along fiber tracts throughout the brain. The modified planning target volume better covered brain regions with a higher risk of tumour spread while still demonstrating a 21% reduction in volume compared to the original planning target volume, resulting in greater preservation of normal tissue. The modified VMAT plan resulted in an average mean dose to four identified recurrences of 80% of the prescription dose, while the original VMAT plan delivered only 63% of the prescription dose as the average mean dose to the recurrences. The utilization of tractography and the generation of corresponding TS maps offer a promising approach to predicting patterns of tumour recurrence and optimizing treatment delivery. Further research is needed to validate the predictive value of the TS map on a larger cohort of patients and explore its potential in personalized treatment strategies for GBM patients.

Canine distemper outbreak and laryngeal paralysis in captive tigers (Panthera tigris)

The canine distemper virus (CDV) could infect various wildlife species worldwide. The viral infection in large felids directly impacts wildlife conservation. This study aimed to understand better the burden of CDV outbreaks in captive tiger populations in Thailand and a novel discovery of their clinical signs with a history of CDV exposure. We followed up on their infection from May 2016 to October 2020 with laboratory testing and veterinary medical records. The cumulative morbidity and mortality rates were relatively high. Moreover, 50% of the tigers survived at 2 years after infection. All suspected and confirmed cases of CDV infections were significantly associated with laryngeal inflammation, which developed into paralysis in almost 50% of cases. Altogether, 50% of all tiger cases with chronic infection developed stridor at 314 days after virus infection [95% CI: 302–320]. Therefore, laryngeal paralysis may result from CDV infection and degeneration, potentially affecting the peripheral and central nervous systems. This condition could pose a life-threatening risk to tigers. The virus could spread quickly by contact with bodily excretion among tigers and fomite contamination once it affects a specific population. Implementation of biosecurity measures and vaccination is essential to mitigate the risk of disease spread and infection rates in tiger populations.

Deciphering spread of quinolone resistance in mariculture ponds: Cross-species and cross-environment transmission of resistome.

Mariculture is known to harbor antibiotic resistance genes (ARGs), which can be released into marine ecosystems via oceanic farming ponds, posing a public health concern. In this study, metagenomic sequencing was used to decipher the profiles of quinolone-resistant microbiomes and the mechanisms of quinolone resistance in sediment, seawater, and fish gill samples from five mariculture ponds. Residues of both veterinary-specific (enrofloxacin and sarafloxacin) and prohibited quinolones (ofloxacin, ciprofloxacin, pefloxacin, norfloxacin, and lomefloxacin) were detected. We identified a total of 285 subtypes of ARGs across all samples. Pathogens played a crucial role in the prevalence and distribution of these ARGs. Out of the annotated 629 bacterial species, 42 were identified as pathogenic, predominantly belonging to the Proteobacteria phylum. Notably, the Acinetobacter genus was prevalent in the gills and exhibited correlations with various ARGs. The presence of the plasmid-mediated quinolone resistance (PMQR) genes in various bacterial species and the identification of sulfonamide resistance genes across different samples indicated the potential for cross-species and cross-environment transmission of ARGs. Metagenomic binning revealed that Exiguobacterium harbored five ARGs (vanA, vanB, fexA, msr(G), mefF), while Shewanella carried six ARGs (blaOXA-436, adeF, qacl, ANT (2'')-Ia, dfrA1, rsmA). Mutations in gyrA and parC contributed to quinolone resistance in these multidrug-resistant Exiguobacterium and Shewanella. Our findings suggest a potential for ARG transmission across various bacterial species and environments in mariculture. This study emphasized the risk of resistance spread within the mariculture ecosystem.

Dynamics and triggers of misinformation on vaccines.

The Covid-19 pandemic has sparked renewed attention to the risks of online misinformation, emphasizing its impact on individuals' quality of life through the spread of health-related myths and misconceptions. In this study, we analyze 6 years (2016-2021) of Italian vaccine debate across diverse social media platforms (Facebook, Instagram, Twitter, YouTube), encompassing all major news sources-both questionable and reliable. We first use the symbolic transfer entropy analysis of news production time-series to dynamically determine which category of sources, questionable or reliable, causally drives the agenda on vaccines. Then, leveraging deep learning models capable to accurately classify vaccine-related content based on the conveyed stance and discussed topic, respectively, we evaluate the focus on various topics by news sources promoting opposing views and compare the resulting user engagement. Our study uncovers misinformation not as a parasite of the news ecosystem that merely opposes the perspectives offered by mainstream media, but as an autonomous force capable of even overwhelming the production of vaccine-related content from the latter. While the pervasiveness of misinformation is evident in the significantly higher engagement of questionable sources compared to reliable ones (up to 11 times higher in median value), our findings underscore the need for consistent and thorough pro-vax coverage to counter this imbalance. This is especially important for sensitive topics, where the risk of misinformation spreading and potentially exacerbating negative attitudes toward vaccines is higher. While reliable sources have successfully promoted vaccine efficacy, reducing anti-vax impact, gaps in pro-vax coverage on vaccine safety led to the highest engagement with anti-vax content.

Asymptomatic carriage and molecular characterization of Staphylococcus aureus in pre-clinical and clinical medical students.

Medical students are exposed to the hospital environment and patients during their studies, increasing the risk of exposure to virulent and antibiotic-resistant isolates of Staphylococcus aureus. The aim of the study is to determine the prevalence of Staphylococcus aureus among medical students who have varying levels of exposure to the hospital environment to provide valuable insights into the risk of colonization and transmission. Nasal swabs and fingerprints were obtained and cultured on a selective medium for staphylococci. The obtained isolates were confirmed as methicillin-sensitive S. aureus (MSSA) or methicillin-resistant (MRSA) using PCR. Antibiotic resistance, the presence of virulence genes including enterotoxin encoding genes, and spa typing were performed. Among pre-clinical students, MSSA was detected on the nose in 45.2% and on the fingerprints in 10.6% of the participants. Among clinical students, MSSA was detected on the nose in 42.0% and on the fingerprints in 25.4%. Only one MRSA isolate was obtained. Genes seg and sei were the most frequently detected in both student groups, with their presence in over 40% of isolates among clinical students. The eta and etb genes were mainly detected from the nose in both student groups. In pre-clinical students, S. aureus carrying eta gene occurred in 6.4% and etb in 8.5%. In clinical students, the occurrence was 5.1% for eta and 8.5% for etb. The tst gene was identified only in the nose and fingerprints of the clinical student group. The most frequently observed resistance was to clindamycin and erythromycin. In total 58 different spa types were identified. High rates of asymptomatic MSSA carriage were observed in both groups of medical students. Detected MSSA strains showed a high degree of genetic variability, with a number of them carrying the virulence and antibiotic resistance genes. Although students do not exhibit increased risk to their patient's, increased hygiene is required in asymptomatic carriage personnel. The overall prevalence of MRSA was low, with a minimal risk of spread.

New perspective of diagnosis and treatment of hepatocellular carcinoma complicated with portal vein tumor thrombosis

Hepatocellular carcinoma (HCC) stands as the predominant type of primary liver cancer, frequently accompanied by portal vein tumor thrombosis (PVTT). PVTT is a harbinger of a grim prognosis, with current treatment modalities falling short of expectations. Delving deeper into the pathophysiology of PVTT, researchers have come to recognize that PVTT and HCC may originate from different clones. Previous clinical investigations have proposed various PVTT classification systems, offering a scientific basis for individualized and precise treatment. The innovative surgical approach of "thrombectomy first" is designed to mitigate the risk of tumor spread, thereby enhancing patient outcomes. Moreover, the multidisciplinary and integrated treatment model, including targeted therapy, immunotherapy and radiotherapy, has demonstrated promising efficacy for the treatment of PVTT. With the continuous progress and optimization of PVTT diagnostic technology, classification systems and precision treatment strategies, the prospects for long-term survival in HCC patients with PVTT are poised to see a significant uplift.

Risk of intrafascicular spread after deliberate exvivo intraneural injections of brachial plexus nerve roots.

We investigated the intraneural spread of injected fluid in brachial plexus nerve roots, examining the potentialfor intrafascicular spread and identifying influencing factors. Twelve deliberate ultrasound-guided intraneural injections were performed at the ventral rami of the brachial plexus nerve roots at their exits from the neuroforamina in six fresh, unembalmed, cryopreserved human cadavers.A 22-G, 30-degree bevel echogenic regional anaesthesia needle was used. Each injection contained 1 ml of heparinised erythrocytes as a marker. Nerve swelling observed on ultrasound images confirmed intraneural injection. Intraneural spread was observed in 12 ventral rami of the six brachial plexi: C5 (1), C6 (3), C7 (5), C8 (2), and T1 (1). Among these, intrafascicular spread was detected in eight cases, six in monofascicular roots and two in bifascicular roots, though none in roots with three or more fascicles. The fascicle diameters in these cases (2.1-3.8 mm) were at least twice the diameter of the needle orifice, measured at 0.9 mm, which was entirely inside the fascicles. In the four cases with intraneural but without intrafascicular spread, the fascicle diameters were about two times the diameter of the needle orifice in three instances, but the entire needle orifice was not always inside a fascicle. In contrast with multifascicular peripheral nerves, intrafascicular spread was possible after deliberate intraneural injections near the neuroforaminal canal exit of the brachial plexus nerve roots in several monofascicular or bifascicular ventral rami if the fascicle diameter was more than twice the needle opening length and the entire opening was inside the fascicle.

Progress in research of incidence of co-infection of HIV and Mycobacterium tuberculosis and influencing factors

The co-infection of HIV and Mycobacterium tuberculosis (MTB) poses a severe challenge for the prevention and control of infectious disease, resulting in poor clinical outcomes of the patients and risk for wide spread. As steady progress in global health, the co-infection of HIV/MTB has been basically controlled, and the new cases are generally declining. However, its incidence remained high in resource-limited areas. The incidence of the co-infection of HIV/MTB is associated with the interaction among individual, social, health service, and natural factors. Comprehensive measures are needed to reduce this disease burden. This paper summarized the epidemiological characteristics of the co-infection of HIV/MTB and influencing factors both at home and abroad to provide evidence for the identifications of high-risk populations and areas and development of targeted prevention measures for the purpose of reduce the incidence of co-infection of HIV/MTB.

The magnitude of legal wildlife trade and implications for species survival

The unsustainable use of wildlife is a primary driver of global biodiversity loss. No comprehensive global dataset exists on what species are in trade, their geographic origins, and trade's ultimate impacts, which limits our ability to sustainably manage trade. The United States is one of the world's largest importers of wildlife, with trade data compiled in the US Law Enforcement Management Information System (LEMIS). The LEMIS provides the most comprehensive publicly accessible wildlife trade database of non-the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) listed species. In total, 21,097 species and over 2.85 billion individuals were traded over the past 22 y (2000-2022). When LEMIS data are combined with CITES records, the United States imported over 29,445 wild species, including over 50% of all globally described species in some taxonomic groups. For most taxa, around half of the individuals are declared as sourced from the wild. Although the LEMIS provides the only means to assess trade volumes for many taxa, without any associated data on most wild populations, it is impossible to assess the impact on biodiversity, sustainability of trade, or any potential risk of pest or pathogen spread. These insights underscore the considerable underestimation of trade and the urgent need for other countries to adopt similar mechanisms to accurately record trade.

Filovirus infections: science and innovation

Epidemics of Filovirus Hemorrhagic Fevers demonstrate an increase in incidence, a reduction in the intervals between outbreaks, the emergence of a risk of infection spreading to non-endemic regions in recent years. Filovirus infections are associated with high mortality due to the complexity of pathogenesis, the variety of spread routes, and severe and often irreversible clinical manifestations. The review contains information reflecting modern ideas about the taxonomy and structure of the genome of filoviruses, epidemiology, pathogenesis, clinical presentation, diagnosis, methods of treatment and immunoprophylaxis of hemorrhagic fevers. According to the latest revision of family Filoviridae taxonomy by the International Committee on Taxonomy of Viruses (ICTV), the family includes eight genuses, 15 species and 16 viruses. The genome is represented by a negative RNA strand that includes seven genes encoding seven structural proteins. The area of infections includes Africa, South and Central Europe, Southeast Asia, China. The natural reservoir of filoviruses is the fruit-bats mammals. The infectious process is based on the aberrant production of proinflammatory cytokines. There are three periods of the disease: prodromal, generalization and terminal. The main method for diagnosing filovirus infections is recognized as a reverse transcription-polymerase chain reaction in real time. Etiotropic therapy is based on the use of monoclonal antibodies against viral glycoprotein. The World Health Organization has approved two vaccines against Filovirus Infections for use. Several vaccines approved for use have been developed and registered on the territory of the Russian Federation and China.

Knowledge, attitude and practice among healthcare professionals regarding the use of personal protective equipment at tertiary care hospitals in Peshawar

Background: Personal protective equipment is designed to safeguard healthcare workers and patients from potential risks during healthcare activities. The proper utilization of PPE serves as a crucial strategy for mitigating the transmission of infections within healthcare settings, thereby minimizing the risk of both healthcare-associated infections and community spread. In this study we tried to explore and assess the knowledge, attitude and practice of healthcare professionals regarding use of Personal protective equipment (PPE). Methods: A cross-sectional study was conducted at Northwest General Hospital (a private sector tertiary healthcare hospital) and Hayatabad Medical Complex (a public sector tertiary care hospital) from March to August 2023. Data was collected from 260 healthcare workers i.e. Doctors and Nurses from both institutions through a preformed questionnaire containing a total of 27 questions. Results: There was a slight positive correlation between increasing years of practice and knowledge regarding PPE (Pearson correlation = 0.017). There was a slight positive correlation between increasing years of practice and attitude (Pearson correlation = 0.035). There was a positive correlation between increasing years of practice and practice of PPE (Pearson correlation=0.147), and there was also a significant association (0.018) between increasing years of practice and practice of PPE Conclusion: Study shows that the healthcare professionals have good knowledge and attitude regarding use of PPE, but there are still gaps in practicing PPE.