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526. Treatment Inconsistencies of Patients Hospitalized with COVID-19 during Four Waves in Almaty, Kazakhstan, 2020-2021

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Open Forum Infectious Diseases 2023年第SUPPLEMENT_2期10卷

作者： Saya Gazezova Roberta Horth Manar Smagul Lena Kasabekova Shokhruh Usmanov S A N A M ZIKRIYAROVA Dilyara Nabirova Central Asia Field Epidemiology Training Program Almaty Almaty Kazakhstan US Centers for Disease Control and Prevention Dulles Virginia Scientific and practical center of sanitary-epidemiological examination and monitoring branch of the National Center for Public Health Almaty Kazakhstan Almaty Almaty Kazakhstan Kazakh National Medical University named after S.D. Asfendiyarov Almaty Almaty Kazakhstan CDC Central Asia office Almaty Almaty Kazakhstan

Background Clinical management guidelines were continually changing during the COVID-19 pandemic to reflect best available evidence for a novel virus. In Kazakhstan, the treatment guidelines have been modified 16 times since the pandemic began. We assessed compliance with guidelines during four waves of COVID-19 in Kazakhstan.

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Development and Validation of an Explainable Machine Learning Model for Warning of Hepatitis E Virus-Related Acute Liver Failure

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Liver International 2025年第6期45卷 e70129页

作者： Dong, Rui Luo, Zhenghan Xue, Hong Shao, Jianguo Chen, Lin Jin, Wenjuan Yang, Lingmei Shen, Chao Xu, Minzhi Wu, Mengping Wang, Jie Department of Fundamental and Community Nursing School of Nursing Nanjing Medical University Nanjing China Department of Infectious Disease Prevention and Control Huadong Research Institute for Medicine and Biotechniques Nanjing China Department of Liver Disease Nantong Third People's Hospital Affiliated Nantong Hospital 3 of Nantong University Nantong China Nantong Institute of Liver Disease Nantong Third People's Hospital Affiliated Nantong Hospital 3 of Nantong University Nantong China Department of Infectious Disease The Affiliated Suzhou Ninth Hospital of Soochow University Suzhou China Department of Immunization Program Nanjing Municipal Center for Disease Control and Prevention Nanjing China Department of Big Data Center The Affiliated Lianyungang Hospital of Xuzhou Medical University/The First People’s Hospital of Lianyungang Lianyungang China Department of Nursing Taizhou School of Clinical Medicine The Affiliated Taizhou People's Hospital of Nanjing Medical University Nanjing Medical University Taizhou China

Background and Aims: Early identification of patients with acute hepatitis E (AHE) who are at high risk of progressing to hepatitis E virus-related acute liver failure (HEV-ALF) is crucial for enabling timely monitoring and intervention. This multicentre retrospective cohort study aimed to develop and validate an interpretable machine learning (ML) model for predicting the risk of HEV-ALF in hospitalised patients with AHE in tertiary care settings. Methods: The study cohort included patients admitted to seven tertiary medical centers in Jiangsu, China, between 01 January 2018 and 31 December 2024. Multiple ML algorithms were applied for feature selection and model training. The predictive performance of the models was evaluated in terms of discrimination, calibration and clinical net benefit. The interpretability of the final model was enhanced using the SHapley Additive exPlanations. Results: A total of 1912 participants were included in the study. Ten ML models were developed based on seven consensus-selected baseline features, with the survival gradient boosting machine (GBM) demonstrating superior performance compared to the traditional Cox proportional hazards regression model and other relevant models or scores. The GBM model achieved a Harrell's concordance index of 0.853 (95% CI: 0.791–0.914) in the external validation set. To facilitate clinical application, the GBM model was interpreted globally and locally and deployed as a web-based tool using the Streamlit-Python framework. Conclusions: The GBM model demonstrated excellent performance in predicting HEV-ALF risk in hospitalised patients with AHE, offering a promising tool for clinical decision-making. © 2025 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

关键词： acute liver failure hepatitis E virus machine learning risk prediction

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'Gender equity in mass drug administration for neglected tropical diseases: data from 16 countries' (vol 11, pg 370, 2019)

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INTERNATIONAL HEALTH 2019年第6期11卷 621-622页

作者： Cohn, Daniel A. Kelly, Maureen P. Bhandari, Kalpana Zoerhoff, Kathryn L. Batcho, Wilfrid E. Drabo, Francois Negussu, Nebiyu Marfo, Benjamin Goepogui, Andre Lemoine, Jean-Frantz Ganefa, Sitti Massangaie, Marilia Rimal, Pradip Gnandou, Issa Anagbogu, Ifeoma N. Ndiaye, Mamadou Bah, Yakuba Madina Mwingira, Upendo J. Awoussi, Marcel S. Tukahebwa, Edridah M. Stelmach, Rachel D. Mingkwan, Pia C. Pou, Bolivar Koroma, Joseph B. Rotondo, Lisa A. Kraemer, John D. Baker, Margaret C. RTI International 701 13th St NW Suite 750 Washington DC USA Corresponding author: Tel: +1-202-884-8000 E-mail: danielacohn@*** RTI International 701 13th St NW Suite 750 Washington DC USA RTI International 701 13th St NW Suite 750 Washington DC USA RTI International 701 13th St NW Suite 750 Washington DC USA National Communicable Disease Control Program Ministry of Health 01 BP 882 Cotonou Republic of Benin National Neglected Tropical Disease Control Program Disease Control Directorate Ministry of Health Ouagadougou Burkina Faso Neglected Tropical Diseases Team Disease Prevention and Control Directorate Federal Ministry of Health Addis Ababa Federal Democratic Republic of Ethiopia National NTD Program Ghana Health Service Accra Republic of Ghana National Onchocerciasis and Blindness and Neglected Tropical Disease Control Program National Prevention and Community Health Directorate Ministry of Health BP 585 Conakry Republic of Guinea National Malaria Control Program Ministry of Public Health and Population 30 Rue Mercier Laham Delmas 60 Republic of Haiti Sub-Directorate of Filariasis & Helminthiasis Control Directorate of Vector Borne Disease Control Directorate General of Communicable Disease and Environmental Health Ministry of Health Jl. Percetakan Negara No. 29 Jakarta Republic of Indonesia Department of Other Infectious Diseases Ministry of Health AV. Eduardo Mondlane e Salvador Allende Maputo Republic of Mozambique Epidemiology and Disease Control Division Department of Health Services Ministry of Health Teku Kathmandu Federal Democratic Republic of Nepal National Bilharzia and Soil-Transmitted Helminths Control Program Ministry of Public Health Niamey Republic of Niger Department of Public Health Neglected Tropical Diseases Division Federal Ministry of Health Federal Secretariat Complex Phase 3 Ahmadu Bello Way CBD Abuja Federal Republic of Nigeria Neglected Tropical Disease Control Program Disease Control Directorate Ministry of Health and

BackgroundGender equity in global health is a target of the Sustainable Development Goals and a requirement of just societies. Substantial progress has been made towards control and elimination of neglected tropical diseases (NTDs) via mass drug administration (MDA). However, little is known about whether MDA coverage is equitable. This study assesses the availability of gender-disaggregated data and whether systematic gender differences in MDA coverage *** data were analyzed for 4784 district-years in 16 countries from 2012 through 2016. The percentage of districts reporting gender-disaggregated data was calculated and male-female coverage *** of gender-disaggregated coverage data improved from 32% of districts in 2012 to 90% in 2016. In 2016, median female coverage was 85.5% compared with 79.3% for males. Female coverage was higher than male coverage for all diseases. However, within-country differences exist, with 64 (3.3%) districts reporting male coverage >10 percentage points higher than female *** of gender-disaggregated data is feasible. And NTD programs consistently achieve at least equal levels of coverage for women. Understanding gendered barriers to MDA for men and women remains a priority.

关键词： equity gender mass drug administration neglected tropical diseases public health Sustainable Development Goals

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Dolutegravir and pregnancy outcomes in women on antiretroviral therapy in Brazil: a retrospective national cohort study

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The Lancet HIV 2021年第1期8卷 e33-e41页

作者： Pereira, Gerson Fernando Mendes Kim, Ahra Jalil, Emilia M Fernandes Fonseca, Fernanda Shepherd, Bryan E Veloso, Valdilea G Rick, Fernanda Ribeiro, Rachel Pimenta, Maria Cristina Beber, Andrea Corrêa, Renato Girade Lima, Renato Maruri, Fernanda McGowan, Catherine C Schwartz Benzaken, Adele Grinsztejn, Beatriz Castilho, Jessica L Department of Surveillance Prevention and Control of STIs AIDS and Viral Hepatitis Ministry of Health Brasília Brazil Department of Biostatistics Vanderbilt University Medical Center Nashville TN United States Department of Medicine Division of Infectious Diseases Vanderbilt University Medical Center Nashville TN United States Fiocruz Instituto Nacional de Infectologia Evandro Chagas Rio de Janeiro Brazil AIDS Health Care Foundation Global Program São Paulo Brazil

Background: Dolutegravir has been widely available in Brazil since 2017. Following the signal that infants born to women with dolutegravir exposure at conception in Botswana had a higher risk of neural tube defects (NTDs), public health leaders initiated a national investigation to evaluate periconception dolutegravir exposure among all pregnant Brazilian women with HIV and its potential association with risk of NTDs, stillbirth, or miscarriage before 22 weeks (also called spontaneous abortion). Methods: In this retrospective, observational, national, cohort study, we identified all women with pregnancies and possible dolutegravir exposure within 8 weeks of estimated date of conception between Jan 1, 2017, and May 31, 2018, and approximately 3:1 matched pregnant women exposed to efavirenz between Jan 1, 2015, and May 31, 2018, using the Brazilian antiretroviral therapy database. We did detailed chart reviews for identified women. The primary outcomes were NTD and a composite measure of NTD, stillbirth, or miscarriage. NTD incidences were calculated with 95% CI. The composite outcome was examined with logistic regression using propensity score matching weights to balance confounders. Findings: Of 1427 included women, 382 were exposed to dolutegravir within 8 weeks of estimated date of conception. During pregnancy, 183 (48%) of 382 dolutegravir-exposed and 465 (44%) of 1045 efavirenz-exposed women received folic acid supplementation. There were 1452 birth outcomes. There were no NTDs in either dolutegravir-exposed (0, 95% CI 0–0·0010) or efavirenz-exposed groups (0, 95% CI 0–0·0036). There were 23 (6%) stillbirths or miscarriages in 384 dolutegravir-exposed fetuses and 28 (3%) in the 1068 efavirenz-exposed fetuses (p=0·0037). Logistic regression models did not consistently indicate an association between dolutegravir exposure and risk of stillbirths or miscarriages. After study closure, two confirmed NTD outcomes in fetuses with periconception dolutegravir exposure we

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The Epidemiology of Surgical Site Infections at a Tertiary Referral Hospital in a Low/Middle Income Country

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Journal of Global Antimicrobial Resistance 2024年 39卷 30-30页

作者： Challita, Caren Zahreddine, Nada Abdallah, Tamara Rizk, Nesrine Koura, Abdul Ghani Abou Slim, Ali Haddad, Nisirine Kanj, Souha Hoballah, Jamal Division of Infectious Diseases Department of Internal Medicine American University of Beirut Medical Center Beirut Lebanon Infection Prevention and Control Program American University of Beirut Medical Center Beirut Lebanon Division of Plastic and Reconstructive Surgery American University of Beirut Medical Center Beirut Lebanon Department of Pharmacy American University of Beirut Medical Center Beirut Lebanon Center for Infectious Diseases Research American University of Beirut Beirut Lebanon Division of Vascular and Endovascular Surgery Department of Surgery American University of Beirut Medical Center Beirut Lebanon

BACKGROUNDSurgical site infections (SSIs), a common cause of healthcare-associated infections, significantly contribute to mortality and morbidity. Epidemiological data of SSIs in the Middle East and North Africa is scarce. AIMWe aimed to examine the epidemiology, clinical features, and mortality of SSIs at a Lebanese tertiary referral hospital. METHODSA retrospective analysis of patient charts from 2019 to 2022 was conducted, identifying SSI cases based on Centers for Disease control and prevention/National Healthcare Safety Network definitions. Data included patient demographics, comorbidities, previous hospitalizations, risk factors, types of infections, and causative microorganisms, including multi-drug resistant organisms (MDROs). In 2021, the hospital introduced an SSI prevention bundle, incorporating updated surgical prophylaxis tailored to local epidemiology. RESULTSThe study identified 360 SSI cases. Patients had a median age of 54 years, 58% being female. Common comorbidities included hypertension (36%) and diabetes mellitus (23%). 41% had a history of malignancy. 42% were hospitalized within the last 12 months. Most surgeries were elective (81%), with a median post-operative stay of 4 days and a total hospital stay of 5 days. SSIs were classified as superficial (39%), deep/tissue (42%), or organ space (19%). In-hospital mortality rates at 30, 60, and 90 days were 1%, 2%, and 3%, respectively. Staphylococcus spp. was mostly isolated (24%), followed by Enterococcus spp. and Escherichia coli (13% each). The proportion of SSIs caused by MDROs decreased from 18% in 2019 to 4% in 2022. CONCLUSIONThese findings highlight the effectiveness of epidemiologically tailored prevention strategies in reducing MDRO-related SSIs.

关键词： Surgical site infections Epidemiology Multi-drug resistant organisms prevention strategies

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The phosphoproteome is a first responder in tiered cellular adaptation to chemical stress followed by proteomics and transcriptomics alteration

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Chemosphere 2023年 344卷 140329页

作者： Chen, Peiru Li, Yuan Long, Qi Zuo, Tao Zhang, Zhenpeng Guo, Jiabin Xu, Danyang Li, Kaixuan Liu, Shu Li, Suzhen Yin, Jian Chang, Lei Kukic, Predrag Liddell, Mark Tulum, Liz Carmichael, Paul Peng, Shuangqing Li, Jin Zhang, Qiang Xu, Ping Research Unit of Proteomics & Research and Development of New Drug of Chinese Academy of Medical Sciences Beijing Proteome Research Center Institute of Lifeomics Beijing102206 China Hebei Province Key Lab of Research and Application on Microbial Diversity College of Life Sciences Hebei University Baoding071002 China Department of Biomedicine Medical College Guizhou University Guiyang550025 China Guizhou Provincial People's Hospital Affiliated Hospital of Guizhou University Guiyang550002 China School of Basic Medicine Anhui Medical University Hefei230032 China Evaluation and Research Centre for Toxicology Institute of Disease Control and Prevention Academy of Military Medical Sciences Beijing100071 China Huazhong University of Science and Technology Wuhan430074 China Unilever Safety and Environmental Assurance Centre Colworth Science Park Sharnbrook Bedfordshire MK44 1LQ United Kingdom Gangarosa Department of Environmental Health Rollins School of Public Health Emory University AtlantaGA30322 United States Program of Environmental Toxicology School of Public Health China Medical University Shenyang110122 China

Next-generation risk assessment (NGRA) for environmental chemicals involves a weight of evidence (WoE) framework integrating a suite of new approach methodologies (NAMs) based on points of departure (PoD) obtained from in vitro assays. Among existing NAMs, the omic-based technologies are of particular importance based on the premise that any apical endpoint change indicative of impaired health must be underpinned by some alterations at the omics level, such as transcriptome, proteome, metabolome, epigenome and genome. Transcriptomic assay plays a leading role in providing relatively conservative PoDs compared with apical endpoints. However, it is unclear whether and how parameters measured with other omics techniques predict the cellular response to chemical perturbations, especially at exposure levels below the transcriptomically defined PoD. Multi-omics coverage may provide additional sensitive or confirmative biomarkers to complement and reduce the uncertainty in safety decisions made using targeted and transcriptomics assays. In the present study, we conducted multi-omics studies of transcriptomics, proteomics and phosphoproteomics on two prototype compounds, coumarin and 2,4-dichlorophenoxyacetic acid (2,4-D), with multiple chemical concentrations and time points, to understand the sensitivity of the three omics techniques in response to chemically-induced changes in HepG2. We demonstrated that, phosphoproteomics alterations occur not only earlier in time, but also more sensitive to lower concentrations than proteomics and transcriptomics when the HepG2 cells were exposed to various chemical treatments. The phosphoproteomics changes appear to approach maximum when the transcriptomics alterations begin to initiate. Therefore, it is proximal to the very early effects induced by chemical exposure. We concluded that phosphoproteomics can be utilized to provide a more complete coverage of chemical-induced cellular alteration and supplement transcriptomics-based heal

关键词： Risk assessment

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Impact of a psychoeducational intervention to improve caregiver knowledge and attitudes toward palliative cancer care

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Patient Education and Counseling 2025年 138卷 109222页

作者： Brenna Mossman Lisa Molix Damian R. Murray Laura M. Perry Seowoo Kim Michael Hoerger Department of Psychology Tulane University New Orleans LA USA Cancer Prevention and Control Program Lombardi Comprehensive Cancer Center Georgetown University Washington DC USA Department of Medicine Tulane University New Orleans LA USA Center for Health Outcomes Implementation and Community-Engaged Science Tulane University School of Medicine New Orleans LA USA Louisiana Cancer Research Center New Orleans LA USA Department of Psychiatry Tulane University New Orleans LA USA Department of Palliative Medicine & Supportive Care New Orleans LA USA

Objectives To evaluate the efficacy of a psychoeducational intervention in improving palliative care knowledge and attitudes among caregivers, patients’ close friends and families. Methods A total of 150 adult cancer caregivers participated in an online U.S.-based randomized clinical trial (RCT) between December 2021 and March 2022. Participants self-reported their baseline knowledge of palliative care, then viewed a psychoeducational video on palliative care (intervention condition) or nutrition (control condition). Participants then completed outcome measures of palliative care knowledge (aim 1; Palliative Care Knowledge Scale, PaCKS) and attitudes (aim 2; Palliative Care Attitudes Scale-9-Caregiver, PCAS-9C). Regression analyses examined whether group assignment significantly predicted palliative care knowledge and attitudes while controlling for self-reported baseline knowledge and key demographic and clinical characteristics. Results The PaCKS and PCAS-9C demonstrated excellent evidence of reliability, factor structure, and validity in this caregiver sample. The RCT succeeded on the primary outcome of increasing caregivers’ palliative care knowledge ( p  < .001). Attitudes were favorable and did not differ between groups. Conclusions This study demonstrates that a single-session, psychoeducational video can improve understanding of palliative care among close friends and families of those with cancer. Practice implications This work suggests future pathways for helping families make informed decisions about initiating palliative care.

关键词： Caregivers Neoplasms Oncology Palliative care Decision making Health education Attitude

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Mold Remediation in a Critical Access Hospital

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American Journal of Infection control 2020年第8期48卷 S27-S27页

作者： Pamela Douglas Matthew Gaas Program Manager Infection Prevention and Control CHI St. Joseph Health Quality Coordinator CHI St Joseph CAH

Background Mold in healthcare facilities can be detrimental to the health of patients, employees, and visitors. Remediation can also be costly to small facilities. Employee and patient perception of the facility can also be damaged. In Texas, due to multiple severe weather events including Hurricane Harvey, mold was found in a Critical Access Hospital. This mold grew in multiple areas of the hospital and created concerns regarding potential health issues. Methods Multiple construction and remediation activities were required to ensure the facility is a safe environment for providing care. Air quality testing was performed on periodic timeframes. Multiple town halls were required to provide information and progress updates to ease concerns about the environment for patients and employees safety. Results Mold in a healthcare facility can be costly financially and to the image of the hospital. Continuous remediation for a small hospital creates financial burdens that can impact the ability for the facility to remain open. In addition, the employee and patient perception of the facility can be damaged beyond repair. At the time of repairs there have not been any adverse patient events or employee harm noted. Conclusions Quick and continuous remediation is required after water intrusion from hurricanes or other natural water sources to minimize costs, harm, and prevent damage to the facilities image.

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168. Sexual and Reproductive Health Promotion Information for Sexual and Gender Minority Youth: A Systematic, Web-Based Content Analysis

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Journal of Adolescent Health 2020年第2期66卷 S85-S86页

作者： Jack Andrzejewski Catherine N. Rasberry Brian S. Mustanski Riley J. Steiner SDSU - UCSD Joint Doctoral Program in Public Health Centers for Disease Control and Prevention Northwestern University Feinberg School of Medicine

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Expanding access to cancer peer support: development of a website to deliver written peer support that meets patients' individual emotional and informational needs while reducing potential harms

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Procedia computer science 2022年 206卷 195-205页

作者： Katrin Bovbjerg Kristi Graves Margaret Waltz David Farrell Betina Yanez Anthony Chicaiza Rahma Omar Rebecca Thompson Mariska Kop Alyssa N Van Denburg Danielle Lorch Scott D Rowley Christine Rini Northwestern University Feinberg School of Medicine Dept of Medical Social Sciences 625 N. Michigan Ave 21-00 Chicago IL 60611 USA. Georgetown University Lombardi Comprehensive Cancer Center Cancer Prevention and Control Program 2115 Wisconsin Ave N Ste. 300 Washington DC 20007 USA. University of North Carolina School of Medicine Department of Social Medicine 333 S Columbia St Chapel Hill NC 27516 USA. People Designs Inc. 1304 Broad Street Durham NC 27705 USA. Robert H. Lurie Comprehensive Cancer Center of Northwestern University 675 N St Clair St. Floor 21 Suite 100 Chicago IL 60611 USA. John Theurer Cancer Center at Hackensack University Medical Center 92 2nd Street Hackensack NJ 07601 USA.

Cancer patients often want information from "peers" with the same diagnosis or treatment. To increase access to this valuable resource, we developed a website to deliver written peer support to cancer patients undergoing stem cell transplant. Because little evidence describes how to optimize benefits or reduce potential harms of written peer support, we gathered multiple forms of stakeholder feedback to inform the website's ethical approach, personalization, design, function, and content: a Community Advisory Board; a longitudinal study of patients' written peer support needs and motivations; focus groups; semi-structured interviews; and usability testing. Findings provide a rich foundation for website development.

关键词： hematopoietic stem cell transplant stakeholder engagement website development written peer support

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