Secondary Cases Research Articles

Transformative advertising: well-being Instagram messaging

PurposeThe purpose of this study is to examine well-being messaging on Instagram to understand what constitutes transformative social media advertising with potential to enhance consumer lives and create change at a community and societal level.Design/methodology/approachA novel-phased approach using transformative advertising research and positive psychology is adopted for an in-depth examination of Lululemon, a well-being brand advocate. The study combines secondary case data, analysis of brand messaging on Instagram, interviews with brand followers, and six months of Instagram posts consumer responses.FindingsFour themes – inspiring personal journeys and potential, encouraging mindfulness and gratitude, supporting connection and community and advancing diversity and equity – are used to develop a typology of well-being advertising message elements on Instagram.Originality/valueThis study contributes to the call for research on transformative advertising by establishing that Instagram is a powerful platform for well-being messages, particularly from brands committed to social issues. Practical implications for brands and avenues for future research are provided.

Effects of Poor Sanitation and Public Awareness in Modeling Bacterial Infection amongst the Students of a Tertiary Institution in Kaura Namoda, Zamfara State, Nigeria

Acute bacterial infection of the intestine is caused by ingestion of food or water containing vibrio cholera. The symptoms include acute water diarrhea and vomiting which can result in severe dehydration or water loss. Sanitary conditions in the environment play an important role. Hence, the objective of this paper as to evaluate the effects of poor sanitation and public awareness in modeling bacterial infection amongst the students of a tertiary institution in Kaura Namoda, Zamfara State, Nigeria. We incorporated effectiveness of drug and awareness for proper hygiene and sanitation into our model. The disease free and endemic equilibrium were determined. The effective reproduction number was showed. Numerical results of the dynamics system of the transmission of bacterial infection were presented and we found that as the effective contact rate increases, the effective reproduction number increases. Also as the effectiveness of compliance of good hygiene increases, the effective reproduction number decreases by varying the contact rate. More so, as production rate of acute diarrhea bacteria increases, it increases the secondary cases of the infected individuals.

Research on the Correlation between Economic Factors and Quality of Life

This study is a pivotal examination of the intricate link between economic factors and residents' quality of life, underscoring its critical implications for policy-making and societal advancement. It delves into the multifaceted relationship between economic indicators like GDP, unemployment, income distribution, and quality of life elements such as health, education, and subjective well-being, particularly focusing on Qingdao, China from 2008 to 2018. Employing a hybrid methodology of quantitative and qualitative analysis, including secondary data and case studies, the research unveils a positive correlation between economic growth and improved living standards, while also highlighting the complexities and multidimensional aspects of this relationship. The findings suggest that while economic growth contributes to better quality of life, aspects like job creation, social equity, and public services are equally vital, advocating a balanced approach in policy-making to ensure equitable and sustainable societal development.

Vectorial Analysis of Deep Plane Face and Neck Lift.

The vector of aging and consequently the vector of lift in rhytidectomy has aided surgeons in improving movement of tissues during facial rejuvenation procedures. The goal was to analyze the vector of lift in patients undergoing primary and revisional facelift to achieve proper vectorial lifting. Patients undergoing deep-plane facelift surgery were included for analysis. Intraoperative photographs and measurements were taken of the skin, superficial musculoaponeurotic system (SMAS), and platysmal suture suspension with mastoid crevasse inset. Measurements were compared between patients who were undergoing primary vs secondary surgery, site of lift, age, and gender. Seventy-one patients (90% female, mean age 57.8) with a total of 142 hemifaces were analyzed, 57 (73%) of which were primary and 14 (27%) secondary facelifts. The average vector of SMAS lifting was 70.8°. Females had a more vertical vector than males (71.3° vs 65.4°; P < .01). The average vectors of platysmal and skin lift were 87.0° and 58.2°, respectively. There was intrapatient difference between hemifaces. Despite there being more intersuture disparity in secondary cases than primary cases (16.9° vs 4.5°; P < .05), the mean vector of lifting was similar between them. Proper release of the deep plane helps determine the appropriate vectors of lift, without relying on guidelines based on population averages. Each patient presents with a unique vector required to correct their descent. This technique provides an optimal result by directly suspending against the vectors of greatest descent.

A comparative study of clinical symptoms, demographic characteristics and laboratory parameters among primary and secondary dengue cases in a tertiary care hospital in Kolkata

A comparative study of clinical symptoms, demographic characteristics and laboratory parameters among primary and secondary dengue cases in a tertiary care hospital in Kolkata

Thrombotic Microangiopathy in Solid Organ Transplantation

Thrombotic Microangiopathy (TMA) is a syndrome characterized by microangiopathic hemolytic anemia (MAHA) and thrombocytopenia. The presence of schistocytes on peripheral smear, a negative Coombs test, elevated lactate dehydrogenase, increased reticulocyte count and low haptoglobin are often the clues for MAHA. The microvascular process often targets vasculature in kidneys, brain, gastrointestinal system, heart, and skin. A timely diagnosis and treatment are often crucial to prevent severe end organ damage and death. TMA is classified into primary and secondary forms. Primary TMA includes TTP and complement mediated or atypical hemolytic uremic syndrome (aHUS), often related to a mutation or deficiency and clinically expressed in the setting of a precipitant condition. Secondary TMA is a manifestation of underlying disorder and can occur in clinical scenarios associated with autoimmune disease, malignancy, infections, SOT (Solid Organ Transplant), pregnancy, HSCT (Hematopoietic Stem Cell Transplantation), medications, or methylmalonic acidemia. Transplant associated TMA (TA-TMA) can be complement mediated or aHUS and could be related to the ischemic reperfusion injury, induction regimen, calcineurin inhibitor (CNI) use, mammalian target of rapamycin (MTOR) inhibitor use, or could be infection related. Cost, access, and turnaround time are often the limitations for certain TTP and complement specific testing. Treatment should not be delayed while waiting for such tests. Treatment must be individualized based on the underlying cause of TMA. Terminal complement blockade utilizing monoclonal antibodies directed against C5 complement is the treatment for complement mediated TMA. C5 inhibitors have also been used successfully in treatment of secondary HUS cases where, unlike aHUS, defects in complement cannot be demonstrated. Such treatment has demonstrated improvement in renal function, MAHA and platelet counts.

Secondary Infertility (Kakvandhya)-A Single Case Study

Vandhyatwa (infertility) is the burning challenge in front of todays fastest and behind the money society. Approximately 8%-10% couples will suffer from infertility worldwide in between that 15-20 million cases are present in India alone. 57.33% are the primary infertility cases and 42.66% are secondary infertility cases observed in 26-30 years age group in India recently. Vandhyatwa is explained by ayurveda scholars in their own way but Aacharya Harita specifically mentioned total 6 types of Vandhyatwa in detail which covers all types of infertility according to modern science. As it is mentioned as lifestyle disorder by medical science, ayurveda plays key role to successful treatment of this. In present article the single case study of Kakvandhya (secondary infertility ) is explained.

Household secondary attack rate amongst the susceptible contacts of COVID-19 cases and its epidemiological profile: A retrospective study from central Gujarat, India.

Secondary attack rate (SAR) is a proportion of primary contacts developing the diseases within the incubation period upon exposure to a primary case among the total susceptible household contacts. The epidemiological profile and SAR will help in understanding the transmission dynamics of COVID-19 for further strengthening preventive and effective control measures. The study was conducted with the primary objective to estimate the household SAR of COVID-19 cases at Mahisagar District, Gujarat, and to study the epidemiological profile of primary and secondary cases of COVID-19. A retrospective study was conducted to estimate SAR among 245 confirmed cases of COVID-19 and 898 susceptible household contacts in Mahisagar district through telephonic interview and questionnaire by the Investigator team. The household SAR was calculated from the current study in Mahisagar district, Gujarat, and was 13.9%. Among primary cases, 74.7% males were affected, and among secondary cases, 52.8% females were affected. The SAR among elderly was 23.9%, and the SAR among children was 3.9%. 74.1% household contacts had developed disease among symptomatic contacts as compared to asymptomatic household contacts. The household SAR in Mahisagar district, Gujarat, was found to be 13.9%. In primary cases, more males, and in secondary cases, more females were found to be affected. The household SAR was increased in elderly as compared to the younger age group. The SAR was more among the contacts of symptomatic cases than asymptomatic cases. Overall hospitalization in public hospitals was more than that in private hospitals.

COVID-19 surveillance in a bone marrow transplantation unit: experience from a Brazilian tertiary-care teaching hospital.

In this work, we aimed to describe the strategy of the weekly SARS-CoV-2 RT-PCR surveillance program that was implemented in our bone marrow transplantation (BMT) unit. Our unit performed SARS-CoV-2 RT-PCR before admission and then weekly during hospitalization even if the patient was asymptomatic. From May 2021 to May 2022, we collected data from all patients that were admitted in the BMT unit to perform transplantation. The total of SARS-CoV-2 RT-PCR performed and the positive rate were described. During the study period, 65 patients were admitted for HSCT. A total of 414 SARS-CoV-2 RT-PCR were performed. Two cases were detected (positivity rate, 0.48%). After the positive test, both patients were isolated outside the BMT unit. We postulate that diagnosing these patients and isolating them outside the transplantation unit may have prevented secondary symptomatic cases.

The Regulation and Inequality Nexus in Microfinance and Tourism Sectors

This paper examines the complex nexus between regulation and inequality in Zimbabwe’s microfinance and tourism sectors. Rural Small to Medium Enterprises in Tourism (SMETs) is typical in the informal sector. However, SMETs in rural areas face financial, regulatory, and exclusionary constraints. This paper follows a qualitative literature review methodology guided by an exploratory design. In addition, one secondary case study was included to highlight the lived realities of SMETs. Findings indicate a complex connection between regulation and inequality in the economy. Overregulation leads to corruption, marginalization, and exclusion of small business activities. SMETs are constrained because they need access to finance for business growth. Thus, the nexus between the two variables profoundly impacts policy. The government must entangle the relationship for policy directions in the microfinance and tourism sectors. The paper concludes that the nexus between regulation and inequality needs urgent attention. The paper’s originality is based on using a systematic literature review to assess how regulations affect microfinance’s ability to fund rural SMETs so that these areas could have economic opportunities that would improve the livelihoods of people residing in these areas, thereby addressing inequalities. Furthermore, it contributes to the debates on the complex relationship between regulation and inequality of two sectors (microfinance and tourism) in Zimbabwe. It also informs future lines of research on the subject. Due to noted limitations on the research design used, more comprehensive empirical studies are required to understand the complexity of the nexus.

Epidemiology, clinical presentation, and outcome of mpox: A study of 381 cases in Saudi Arabia

ObjectivesThere are limited data on the clinical and epidemiological aspects of mpox in Saudi Arabia. This study investigates the characteristics of Mpox cases from May to September 2023. MethodsA total of 381 cases of Mpox were included in this study, diagnosed based on a combination of clinical symptoms and laboratory testing. ResultsThe majority of mpox cases were males (91.1%), with a mean age of (±SD) of 32.4 (±8.3) years; 356 (93.4%) did not report travel, 277 (72.7%) denied engaging in extra-marital sex, and 379 (99.5%) were not linked to secondary cases. Fever was reported in 371 (97.4%), whereas headache was present in 314 (82.4%). Cough (1.3%) and conjunctivitis (0.5%) were rare. The most commonly affected areas in terms of lesions were the palms and soles (297 cases, 78%), followed by the genitals (206 cases, 54%), face (198 cases, 52%), and mouth (160 cases, 42%). Of the 1325 identified contacts, 1134 (85.5%) were hospital contacts, and 191 (14.5%) were community contacts, and 393 (29.6%) were high-risk contact. Of the high-risk contacts, 284 (72.3%) accepted post-exposure vaccination. The genotyped samples were all subclade IIb (formerly the West Africa clade). ConclusionsThis study provides valuable insights into mpox characteristics in Saudi Arabia. The genome of monkeypox virus belonged to subclade IIb of the West Africa clade. Further analysis of the global tree sublineage is needed.

Extradural spinal melanoma: is it primary or metastatic? A case report with a brief review of literature

Melanocytic lesions involving the central nervous system are extremely rare and pose a diagnostic challenge owing melanoma being the third most common malignancy metastasizing to the spine. Morphology and immunohistochemistry are identical in both primary and secondary cases, and hence may not help in rendering a final diagnosis. Molecular alterations involving melanomas of the spine and melanomas elsewhere are distinct and help establish the appropriate diagnosis. We report an interesting case where molecular profiling of the tumor tissue helped render the final diagnosis.

Global Basic Reproduction Number of African Swine Fever in Wild Boar and a Mental Model to Explore the Disease Dynamics

Basic reproduction number (R0) is a mathematical expression used in epidemiology to address expected number of secondary cases. R0 helps to predict outbreak diffusion and preventive measures. As African swine fever (ASF) is a viral infectious disease, there are significant studies related to R0 of the ASF outbreak, but most of them are investigated in a zonal and geospecific boundary. This study explores the general overview of African swine fever virus (ASFV) R0 based on existing literature and examines for the global scale using a doubling time approach using wild boar outbreaks. Further, a qualitative mental model is developed to explore the ASF disease dynamics. It was found that the average R0 was 3.56 from existing literature. Based on the global scenario, ASFV spread in wild boar was above the threshold line (R0≥1). The recent growth trend (R0=5.87) flagging the very high risk. ASFV is threatening the world. The qualitative mental model highlighted the veterinary services as awareness and R&amp;D support are highlighted as the control measures. This study provides a reference to researchers and veterinarians in setting strategies of developing preventive measures and highlights the importance of awareness programs and R&amp;D support for mitigating the ASFV spread.

The etiology, diagnostics, and treatment of the spasm of the near reflex - a narrative review.

Physiological adaptation of the eye to the visual perception of near objects consists of the "near triad": convergence, accommodation, and pupil miosis. Normally, these tend to revert when one stops fixating on a near object. Spasm of the near reflex (SNR) is a pathological phenomenon, which manifests itself by the persistence of the above-mentioned adjustments, which prevents the eye from returning to its relaxed state. In this narrative review, we aim to summarize the etiology, diagnostics, treatment, and prevention of SNR. The literature review was performed by searching online databases. The clinical presentation of SNR is diverse; it presents as isolated accommodative spasm more frequently than impairment of all three components of the near triad. Patients usually present with fluctuations in visual acuity, blurred vision, diplopia, and asthenopia. The etiology is not fully understood. Potential causes include neuroanatomic, organic, and psychogenic disorders. The diagnosis is clinical, based on the constellation of symptoms and assessment of the near triad. The diagnostic golden standard is a cycloplegic examination of refraction, preferably using cyclopentolate hydrochloride (1%, 0.5%, or 0.1% solution). The first-line treatment requires the administration of a cycloplegic drug in combination with plus lenses, flipper lenses, optical fogging, or miotics. For secondary cases, causal treatment should be implemented. Prevention of SNR should be based on eliminating modifiable risk factors. We propose including screening for SNR symptoms in every ophthalmic examination, especially among patients with psychogenic or neural disorders, after brain trauma, or young adults spending much time in front of computer screens.

Variable Energy and Ultrasound-based Liposculpture of the Arms: Multicenter and Multidevice Study.

Incorporation of new technologies to assist the liposuction procedure is becoming increasingly common. These technologies allow for a softer technique, balanced shaping, elimination of excess adipose tissue, and skin tightening. Some of these technologies include ultrasound (US; US-assisted liposculpture, VASER-assisted liposuction), power suction (power-assisted liposuction), radiofrequency (RF; RF-assisted lipolysis), and laser (laser-assisted liposuction). In addition, some of these devices have been shown to reduce the incidence of hematomas/inflammation and shorten recovery time. We report our experience in high-definition liposculpture of the arms in addition to new technologies to improve skin retraction, comparing their results in terms of complications, satisfaction score, and aesthetic outcomes. We included patients with mild-to-moderate arm dermatochalasis (Duncan classification) fat deposits in the upper extremities who were considered candidates for third-generation US-assisted liposculpture, power-assisted liposuction, RF-assisted lipolysis/skin tightening, and laser-assisted liposuction. A total of 683 consecutive patients met the inclusion criteria for the study. Most of them were women (n = 605, 88%). Fat grafting was performed in 80 patients (11.7%). A significant portion of the patients were secondary cases (n = 223, 33%). Age ranged from 18 to 70 years (median = 38 years). BMI ranged from 17.8 to 34.8 kg/m2 (mean = 24.3 kg/m2). RF-assisted and laser-assisted high-definition liposculpture of the arms are both effective and reproducible techniques for patients who seek an athletic and slim arm contour. A low rate of complications and high satisfaction index support our findings.

Age-specific case data reveal varying dengue transmission intensity in US states and territories.

Dengue viruses (DENV) are endemic in the US territories of Puerto Rico, American Samoa, and the US Virgin Islands, with focal outbreaks also reported in the states of Florida and Hawaii. However, little is known about the intensity of dengue virus transmission over time and how dengue viruses have shaped the level of immunity in these populations, despite the importance of understanding how and why levels of immunity against dengue may change over time. These changes need to be considered when responding to future outbreaks and enacting dengue management strategies, such as guiding vaccine deployment. We used catalytic models fitted to case surveillance data stratified by age from the ArboNET national arboviral surveillance system to reconstruct the history of recent dengue virus transmission in Puerto Rico, American Samoa, US Virgin Islands, Florida, Hawaii, and Guam. We estimated average annual transmission intensity (i.e., force of infection) of DENV between 2010 and 2019 and the level of seroprevalence by age group in each population. We compared models and found that assuming all reported cases are secondary infections generally fit the surveillance data better than assuming all cases are primary infections. Using the secondary case model, we found that force of infection was highly heterogeneous between jurisdictions and over time within jurisdictions, ranging from 0.00008 (95% CrI: 0.00002-0.0004) in Florida to 0.08 (95% CrI: 0.044-0.14) in American Samoa during the 2010-2019 period. For early 2020, we estimated that seropositivity in 10 year-olds ranged from 0.09% (0.02%-0.54%) in Florida to 56.3% (43.7%-69.3%) in American Samoa. In the absence of serological data, age-specific case notification data collected through routine surveillance combined with mathematical modeling are powerful tools to monitor arbovirus circulation, estimate the level of population immunity, and design dengue management strategies.

Effect of an enhanced public health contact tracing intervention on the secondary transmission of SARS-CoV-2 in educational settings: The four-way decomposition analysis.

The aim of our study was to test the hypothesis that the community contact tracing strategy of testing contacts in households immediately instead of at the end of quarantine had an impact on the transmission of SARS-CoV-2 in schools in Reggio Emilia Province. We analysed surveillance data on notification of COVID-19 cases in schools between 1 September 2020 and 4 April 2021. We have applied a mediation analysis that allows for interaction between the intervention (before/after period) and the mediator. Median tracing delay decreased from 7 to 3.1 days and the percentage of the known infection source increased from 34-54.8% (incident rate ratio-IRR 1.61 1.40-1.86). Implementation of prompt contact tracing was associated with a 10% decrease in the number of secondary cases (excess relative risk -0.1 95% CI -0.35-0.15). Knowing the source of infection of the index case led to a decrease in secondary transmission (IRR 0.75 95% CI 0.63-0.91) while the decrease in tracing delay was associated with decreased risk of secondary cases (1/IRR 0.97 95% CI 0.94-1.01 per one day of delay). The direct effect of the intervention accounted for the 29% decrease in the number of secondary cases (excess relative risk -0.29 95%-0.61 to 0.03). Prompt contact testing in the community reduces the time of contact tracing and increases the ability to identify the source of infection in school outbreaks. Although there are strong reasons for thinking it is a causal link, observed differences can be also due to differences in the force of infection and to other control measures put in place. This project was carried out with the technical and financial support of the Italian Ministry of Health - CCM 2020 and Ricerca Corrente Annual Program 2023.

Superficial dedifferentiated liposarcoma: A clinicopathologic study

IntroductionDedifferentiation occurs in approximately 10% of atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDLPS), primarily in retroperitoneal or deep-seated tumors, conferring metastatic potential. Superficial dedifferentiated liposarcoma (sDDLPS) is rare, and its progression and natural history are poorly documented. MethodsWe performed a 15-year retrospective review of our pathology database to identify cases of DDLPS in the skin or subcutaneous tissue. Diagnosis of primary sDDLPS required evidence of non-lipogenic sarcoma in the skin or subcutis, with concurrent ALT/WDLPS and/or MDM2 amplification. ResultsWe identified 14 cases of DDLPS involving skin or subcutis: 7 primary sDDLPS and 7 secondary lesions (3 from recurrent deep DDLPS and 4 from metastasis). Primary sDDLPS cases (4 females, 3 males; median age: 74) mainly presented as undifferentiated spindle cell or pleomorphic sarcoma. Tumor grades were grade 2 (5 cases) and grade 3 (2 cases), with three cases also showing grade 1 areas. MDM2 amplification was confirmed in 6 sDDLPSs for which FISH was successfully performed. Follow-up available for 6 sDDLPS patients showed 2 local recurrences, treated with re-excision and radiation therapy, with all disease-free at last follow-up (5–126 months). Of the 7 secondary cases, 2 had ongoing disease after multiple recurrences, 1 was disease-free, and all 4 with cutaneous metastasis died of disease (follow-up range: 24–263 months). ConclusionThese findings emphasize the importance of distinguishing between primary sDDLPS and secondary lesions due to their distinct prognoses. Metastasis or superficial extensions from deep DDLP correlate with a considerably worse prognosis than those originating in superficial tissues.

Myelodysplasia-related gene mutations are associated with favorable prognosis in patients with TP53-mutant acute myeloid leukemia.

This study aimed to examine the characteristics and treatment outcomes of patients with TP53-mutant acute myeloid leukaemia (AML) and to explore potential prognostic factors. This retrospective analysis included 130 patients diagnosed with TP53-mutant AML at the Fujian Medical University Union Hospital between January 2016 and June 2023. Patients' ages ranged from 17 to 80 years, with a median age of 59 years. The proportions of de novo, therapy-related, and secondary AML cases were 71.5%, 7.7%, and 20.8%, respectively. Complex karyotypes were observed in 60.6% of patients, and the proportions of -5 or del(5q), -7 or del(7q), and - 17 or del(17p) were 41.7%, 27.9% and 14.4%, respectively. DNA methylation- and myelodysplasia-related (MR) gene mutations were observed in 36.9% and 25.4% of patients, respectively. These patients showed poor survival, with a median overall survival (OS) of 4.5 months, a 1-year OS rate of 32.5%, a 3-year OS rate of 18.8%, and a 5-year OS rate of 11.3%. The complete response rates for intensive chemotherapy (IC), hypomethylating agent (HMAs)-based therapies, and azacitidine plus venetoclax were 35.7%, 22.2%, and 37.5%, respectively. Patients who did or did not receive allogeneic haematopoietic stem cell transplantation (allo-HSCT) had similar prognoses (median OS: 6.0 vs. 3.9 months; P = 0.6415). Multivariate analysis indicated that MR gene mutations is an independent favorable prognostic factor of OS (HR = 0.366, 95% CI: 0.181-0.738, P = 0.005). In conclusion, patients with TP53-mutant AML have poor prognoses under current treatment strategies and MR gene mutations are associated with a more favorable survival. Therefore, further studies are needed to improve the survival rates in this population.

Polyurethane Implants in Revisional Breast Augmentation: A Prospective 5-Year Study.

Revisional surgery for aesthetic breast augmentation remains a challenging procedure. Polyurethane (PU) implants have been found to avoid capsular contracture recurrence as well as to prevent implant displacement by bio-integrating with the pocket. Our study aimed to assess the use of PU implants in breast revisional surgery and to provide an algorithm. Over a 5-year period, a prospective study was conducted involving consecutive patients undergoing implant revision. Patient demographics, previous breast procedures, and specific surgical details were documented. Postoperative outcomes were followed up. Out of 92 patients (184 breasts), 78 (156 breasts) were included in the analysis. The average age was 47.5, with a BMI of 22.3 and a mean follow-up of 5 years. A majority (63%) represented secondary revisional cases, while 37% were tertiary cases. Implant size averaged 296 cc, with 53% placed in retropectoral position and 47% prepectoral. Significantly more implants in secondary cases were changed from prepectoral to retropectoral (P = .005), and in tertiary changed from retropectoral to prepectoral (P = .002). Complete capsulectomy was performed in 61.5% and partial in 25.6%. Additional lipofilling was performed in 32%, and concurrent mastopexy in 40%. Revisional surgery in our series had a 1.9% acute complication rate, 4.5% longer-term reoperation rate for corrections, 0.6% implant exchange rate, and no recurrent capsular contracture. This is the first study to provide data on outcomes of revisional breast augmentation surgery with PU implants. It shows that polyurethane implants offer consistent stability and have low rates of recurrent capsular contracture in revisional surgery.