Analysis of pathogen detection results of upper respiratory tract specimens from fever clinic patients

Objective: To explore the pathogen composition and distribution characteristics of pathogens in respiratory samples from patients with fever of unknown origin. Methods: A total of 96 respiratory samples of patients with unknown cause fever with respiratory symptoms were collected from four hospitals above grade II in Shijiazhuang area (Hebei Provincial Hospital of Traditional Chinese Medicine, Luancheng District People's Hospital, Luquan District People's Hospital, Shenze County Hospital) from January to April 2020, and multiplex-fluorescent polymerase chain reaction(PCR)was used to detect influenza A virus, influenza B virus, enterovirus, parainfluenza virus I/II/III/IV, respiratory adenovirus, human metapneumovirus, respiratory syncytial virus, human rhinovirus, human bocavirus, COVID-19, Mycoplasma pneumoniae, Chlamydia pneumoniae, Legionella pneumophila, Pseudomonas aeruginosa, Streptococcus pneumoniae, Klebsiella pneumoniae, Group A streptococcus, Haemophilus influenzae, Staphylococcus aureus nucleic acid detection, the results were analyzed for chi-square. Results: A total of 8 pathogens were detected in the upper respiratory tract samples of 96 fever patients, including 1 kind of virus, 6 kinds of bacterias, and Mycoplasma pneumoniae. There were 12 viruses including influenza virus and parainfluenza virus, Legionella pneumophila and Chlamydia pneumoniae were not detected. The pathogen detection rates in descending order were Streptococcus pneumoniae (58/96, 60.42%), Haemophilus influenzae(38/96, 39.58%), Klebsiella pneumoniae (14/96, 14.58%), Staphylococcus aureus (10/96, 10.42%), Mycoplasma pneumoniae (8/96, 8.33%), Pseudomonas aeruginosa (6/96, 6.25%), Group A streptococcus (4/96, 4.17%) and human rhinovirus (2/96, 2.08%). The proportions of single-pathogen infection and multi-pathogen mixed infection in fever clinic patients were similar, 41.67% (40/96) and 45.83% (44/96), respectively, and 12.50% (12/96)of the cases had no pathogens detected. The infection rate of Mycoplasma pneumoniae in female patients with fever (21.43%) was higher than that in male patients with fever (2.94%) (P < 0.05). There was no statistical difference between the distribution of of other pathogens and gender and age(P > 0.05). Conclusions: The upper respiratory tract pathogens were mainly bacterial infections, and occasional human rhinovirus and Mycoplasma pneumonia infections. In clinical diagnosis and treatment, comprehensive consideration should be given to the pathogen detection.

Surveillance of anti-SARS-CoV-2 antibodies in plasma pools and in immunoglobulin medicinal products manufactured since 2020 has shown high neutralizing activity against SARS-CoV-2 and current variants

Background: Patients with primary and secondary immunodeficiencies have shown an impaired humoral immune response to COVID-19 vaccination. It is therefore of paramount importance to investigate anti-SARS-CoV-2 antibody levels in plasma pools and in immunoglobulin (IgG) products used to treat these patients. AIM: To assess the evolution of anti-SARS-CoV-2 antibodies (S protein) in plasma pools and IgG products and its neutralizing activity to original-type virus (Wuhan) and the variants of concern (VOC), including Omicron. Method(s): Healthy donors plasma pools collected in the US and Europe, and the subsequent intravenous (Flebogamma DIFand Gamunex-C, Grifols) and subcutaneous (Xembify, Grifols) IgG manufactured batches were followed from March 2020. Anti-SARS-CoV-2 S protein IgG titers were determined in plasma pools and in IgG batches by ELISA. Neutralization assays analyzed the capacity of IgG products to neutralize original-type virus and VOC (Alpha, Beta, Delta, Omicron BA.1 and BA.5), using pseudo viruses expressing S protein. Results were expressed as the dilution producing 50% neutralization (ID50). Result(s): In plasma pools, anti-SARS-CoV-2 S antibodies continuously increased throughout the study period regardless of the geographic origin. In the US, the first positive plasma pools were collected at the end of 2020. Since July 2021, an exponential increase over 30-fold of anti-SARS-CoV-2 S antibodies was reported. This trend continued increasing until the end of study period. Similarly, IgG products showed a similar evolution of anti-SARS-CoV-2 S antibodies. As expected, IgG batches released at the end of 2020 presented low SARS-CoV-2 neutralization activity. However, IgG products manufactured since August 2021 showed high neutralization activity against original-type virus and the rest of VOC. Regarding Omicron BA.5, a 5 to 10-fold increase was observed over time. Conclusion(s): This study reported the onset of elevated anti-SARS-CoV-2 antibody titers in plasma pools and IgG products since mid-2021, reflecting the evolution of the pandemic and vaccine campaigns. Intravenous and subcutaneous IgG products efficiently neutralized the current circulating VOC, Omicron BA.5. Further research is warranted to assess whether a clinical protective titer against SARS-CoV-2 and passive immunization is achieved in patients with immunodeficiencies treated with IgG products.Copyright © 2023 Elsevier Inc.

Inflammation

Inflammation was described as early as 4000 BC in an Egyptian papyrus and is still a common problem despite continuous advancements in prevention and treatment methods. Over the years new strains of microorganisms causing infections appear such as the recently discovered new Covid-19 infection. The proper diagnosis and delineation of the site and extent of inflammation are crucial to the clinical management of infection and for monitoring the response to therapy. The strategy to reach diagnosis by imaging depends on understanding the pathophysiologic basis of different types of infection and the mechanisms of accumulation of the radiotracers for scintigraphic diagnosis. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2015, 2022.

Porcine Deltacoronaviruses: Origin, Evolution, Cross-Species Transmission and Zoonotic Potential.

Porcine deltacoronavirus (PDCoV) is an emerging enteropathogenic coronavirus of swine that causes acute diarrhoea, vomiting, dehydration and mortality in seronegative neonatal piglets. PDCoV was first reported in Hong Kong in 2012 and its etiological features were first characterized in the United States in 2014. Currently, PDCoV is a concern due to its broad host range, including humans. Chickens, turkey poults, and gnotobiotic calves can be experimentally infected by PDCoV. Therefore, as discussed in this review, a comprehensive understanding of the origin, evolution, cross-species transmission and zoonotic potential of epidemic PDCoV strains is urgently needed.

Reactivation of Parvovirus B19 Infection: An Uncommon Trigger of Macrophage Activation Syndrome in Adult-Onset Still's Disease.

A 40-year-old woman presented with four weeks of intermittent high-grade fever, cough, and joint pain, and two weeks of a generalized rash. She was found to have adult-onset Still's disease (AOSD) and rapidly developed macrophage activation syndrome (MAS) on the second day of admission. Among infectious etiologies, Epstein-Barr virus and members of the herpes virus family are common triggers of MAS. However, our patient was found to have reactivation/recurrence of parvovirus B19 infection as the cause; this is an uncommon trigger reported infrequently in the medical literature. Despite intensive treatment, the patient passed away.

The Use of Qualitative Methods to Guide the Development of the Border Resilience Scale in a Participatory Research Study.

U.S.-Mexico border residents experience pervasive social and ecological stressors that contribute to a high burden of chronic disease. However, the border region is primarily composed of high-density Mexican-origin neighborhoods, a characteristic that is most commonly health-promoting. Understanding factors that contribute to border stress and resilience is essential to informing the effective design of community-level health promotion strategies. La Vida en La Frontera is a mixed-methods, participatory study designed to understand factors that may contribute to border resilience in San Luis, Arizona. The study's initial qualitative phase included interviews with 30 Mexican-origin adults exploring community perceptions of the border environment, cross-border ties, and health-related concepts. Border residents described the border as a Mexican enclave characterized by individuals with a common language and shared cultural values and perspectives. Positive characteristics related to living in proximity to Mexico included close extended family relationships, access to Mexican food and products, and access to more affordable health care and other services. Based on these findings, we co-designed the 9-item Border Resilience Scale that measures agreement with the psychosocial benefits of these border attributes. Pilot data with 60 residents suggest there are positive sociocultural attributes associated with living in border communities. Further research should test if they mitigate environmental stressors and contribute to a health-promoting environment for residents.

A Customized Novel Blocking ELISA for Detection of Bat-Origin Swine Acute Diarrhea Syndrome Coronavirus Infection.

Swine acute diarrhea syndrome coronavirus (SADS-CoV) is a newly discovered emerging alphacoronavirus. SADS-CoV shares over 90% genome sequence identity with bat alphacoronavirus HKU2. SADS-CoV was associated with severe diarrhea and high mortality rates in piglets. Accurate serological diagnosis of SADS-CoV infection is key in managing the emerging SADS-CoV. However, thus far there have been no effective antibody-based diagnostic tests for diagnose of SADS-CoV exposure. Here, monoclonal antibody (MAb) 6E8 against SADS-CoV N protein accurately recognized SADS-CoV infection. Then, MAb 6E8 was utilized as a blocking antibody to develop blocking ELISA (bELISA). We customized the rN coating antigen with concentration 0.25 µg/mL. According to receiver operator characteristic curve analysis, the cutoff value of the bELISA was determined as 38.19% when the max Youden index was 0.955, and specificity was 100%, and sensitivity was 95.5%. Specificity testing showed that there was no cross-reactivity with other serum positive swine enteric coronaviruses, such as porcine epidemic diarrhea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine deltacoronavirus (PDCoV), porcine rotavirus (PoRV), and porcine sapelovirus (PSV). In conclusion, we customized a novel and high-quality blocking ELISA for detection of SADS-CoV infection, and the current bELISA will be linked to a clinical and epidemiological assessment of SADS-CoV infection. IMPORTANCE SADS-CoV was reported to be of high potential for dissemination among various of host species. Accurate serological diagnosis of SADS-CoV infection is key in managing the emerging SADS-CoV. However, thus far there have been no effective antibody-based diagnostic tests for diagnose of SADS-CoV exposure. We customed a novel and high-quality bELISA assay for detection of SADS-CoV N protein antibodies, and the current bELISA will be linked to a clinical and epidemiological assessment of SADS-CoV infection.

Corrigendum: COVID-19 pandemic's disproportionate impact on childhood bereavement for youth of color: reflections and recommendations.

[This corrects the article DOI: 10.3389/fped.2023.1063449.].

[What do we know about the origin of COVID-19 three years later?] / ¿Qué sabemos del origen del COVID-19 tres años después?

More than three years have passed since the first case of a new coronavirus infection (SARS-CoV-2) in the city of Wuhan (Hubei, China). The Wuhan Institute of Virology was founded in that city in 1956 and the country's first biosafety level 4 laboratory opened within that center in 2015. The coincidence that the first cases of infection emerged in the city where the virology institute's headquarters is located, the failure to 100% identify the virus' RNA in any of the coronaviruses isolated in bats, and the lack of evidence on a possible intermediate animal host in the contagion's transmission make it so that at present, there are doubts about the real origin of SARS-CoV-2. This article will review two theories: SARS-CoV-2 as a virus of zoonotic origin or as a leak from the high-level biosafety laboratory in Wuhan.

TRADE IN GOODS

As international trade became more sophisticated, the ‘traditional' trade in goods topics seemed to be entering an extinction phase and be substituted by other forms of trade regulation, such as technical barriers or sanitary measures. However, in recent years and for different reasons, many of them reclaimed their relevance. This chapter also discusses an essential tool for the operation of trade in goods, which is tariff classification, as well as an often overlooked but fundamental issue in trade in goods regulation, which are the rules of origin. Global value chain operations could not be conceived without rules of origin. Finally, the COVID 19 pandemic revealed how vulnerable international trade could be to import and export restrictions, such as quotas or licences, and how important trade facilitation could be to bolster trade and even to save lives. © Oxford University Press 2022. All rights reserved.

Shared E-Scooter Trajectory Analysis During the COVID-19 Pandemic in Austin, Texas.

By March of 2020, most cities worldwide had enacted stay-at-home public health orders to slow the spread of COVID-19. Restrictions on nonessential travel had extensive impacts across the transportation sector in the short term. This study explores the effects of COVID-19 on shared e-scooters by analyzing route trajectory data in the pre- and during-pandemic periods in Austin, TX, from a single provider. Although total shared e-scooter trips decreased during the pandemic, partially owing to vendors pulling out of the market, this study found average trip length increased, and temporal patterns of this mode did not meaningfully change. A count model of average daily trips by road segment found more trips on segments with sidewalks and bus stops during the pandemic than beforehand. More trips were observed on roads with lower vehicle miles traveled and fewer lanes, which might suggest more cautious travel behavior since there were fewer trips in residential neighborhoods. Stay-at-home orders and vendor e-scooter rebalancing operations inherently influence and can limit trip demand, but the unique trajectory data set and analysis provide cities with information on the road design preferences of vulnerable road users.

Hepatitis of unknown etiology in pediatric population

In recent months there has been an increase in cases reports of hepatitis of unknown origin. The most affected population are children under 5 years of age, but it has been described in adolescents up to 16 years of age. The clinical presentation consists of cholestatic hepatitis with a prodrome of diarrhea, nausea, and vomiting. Prognosis is generally benign but, on average, 13% of patients have required admission to an intensive care unit and 10% a liver transplant. Etiological studies have associated this entity to adenoviral infections, but hypotheses include other infectious agents, either as a triggering factor or as its main etiology, toxins, and even immunizations against SARS-CoV-2. In the following review we present the data available to date regarding the different pathogenesis theories.

Daily mobility patterns and costs 2019 in Ciudad Juarez, Chihuahua

This research presents the daily mobility patterns during 2019 in Ciudad Juarez, Chihuahua. Due to the lack of recent and available information, origin-destination surveys, traditional statistics and Dijkstra's algorithm using Geographic Information Systems, to analyze displacements throughout the urban area divided into 64 polygons. Descriptive patterns at the urban scale were determined from variables such as distances and times of each trip, origin and destination places, schedules, reasons, types of transportation, expenditure and household income. The results show the areas with the highest demand for mobility, as well as the preferences and costs involved in moving within the city before the mobility restrictions caused by COVID-19 and the construction of new continuous vehicular mobility projects, bike routes and a second BRT line.

Positron Emission Tomography with Computed Tomography in Evaluations of Classical Fever of Unknown Origin and Length of Hospitalization: A 10-Year Medical Record Review of a Tertiary Hospital

Background: Positron emission tomography with computed tomography (PET/CT) has proven its value for the differential diagnosis of fever of unknown origin (FUO). However, the extent to which PET/CT during FUO evaluation can shorten the length of hospital stay (LOS) remains unclear. Materials and Methods: A retrospective review of the medical records over a 10-year period from January 2009 to December 2018 of a tertiary university hospital was performed. The inclusion criteria were symptoms with fever persisting for >3 weeks before admission, as defined in classical FUO. Medical records in which PET/CT was performed after the final diagnosis, such as neoplastic causes, were excluded. Moreover, in the neoplasm category evaluated using PET/CT, only diagnostic PET/CT cases were enrolled;PET/CT cases for confirming metastasis or staging were excluded. Final diagnoses were categorized as infection, neoplasm, noninfectious non-neoplastic inflammatory disorder, miscellaneous, and uncategorizable. Each category was separated into evaluation with and without PET/CT for statistical analyses. Results: In total, 91 patients underwent evaluation for FUO and about one in three underwent PET/CT. Overall LOS was not different between the PET/CT and non-PET/CT groups;however, there were differences in LOS within the categories. For infectious causes, the mean LOS was 21.1 and 11.1 days in the PET/CT and non-PET/CT groups, respectively (P = 0.022). For neoplastic causes, the mean LOS was 11.4 and 36.0 days in the PET/CT and non-PET/CT Conclusion: Most patients with FUO were aged 50 - 60 years, and their family and work roles were crucial. A lower LOS may benefit both the patients' families and society at large. Interestingly, PET/CT may contribute to shortening the LOS during FUO evaluation when the causes are neoplastic, by approximately 24 days.

Entrepreneur?s Family Communication Questionnaire-Psychometric properties of the tool

Entrepreneurial success is related to many factors, among which, those relating to the psychological dimensions of the successful (or unsuccessful) entrepreneur are often overlooked and rarely studied. In particular, some of the most significant psychological determinants of entrepreneurial success may be rooted in the family of origin, such as the patterns of family communication. Family communication in relation to entrepreneurial success has been the object of some research but only in the context of communication within family businesses. The current study presents the theoretical basis and the stages of development of a tool to measure communication in en-trepreneurs' families, irrespective of the fact that those families run their own business or not. The main objective of the study was to evaluate the psychometric parameters (factor structure, reliability, validity) of the proposed Entrepreneur's Family Communication Questionnaire (EFCQ). The tool we propose, though inspired by other existing tools measuring the quality of communication within families, is new as it includes a scale specifically devoted to the quality of the communication related to entrepreneurial behaviors, and hence is expected to be useful in a more comprehensive study of psychological determinants of entrepreneurial success we are presently conducting. The validation study results we obtained are promising and confirm that the proposed tool has good psychometric parameters.

Courts Effective Response during Covid-19 Pandemic Unaltering the Rule of Law - a Critical Study

Corona is a new type of virus that emerged from China country in Asian continent which have created a strong death fear among the people. This Corona has occupied the entire globe within a short span of time many died for want of oxygen. It is the responsibility of the government to extend the constitutional rights such as the right to education, distribution of food, security, etc. Online classes started for all, and measurement is taken to supply food for everybody through the distribution process. To take care of safety and security lockdown imposed everything has come to a total stop in the transportation, shops, offices other than hospitals and related units,judiciary has made a vital role during this period. The police officials have a tough time moving with people as they are not listening to the words of police who advised, politely, requested them to follow, and pleaded. There afterward, taken action and arrested them later produced to the court. We shall keep our environment very clean to avoid the spread of Corona, health is wealth. Indian constitution is very powerful in India and the Disaster Management Act is also laid down in the constitutions. Without violating the constitutions that means unaltering the rule of law right to education has provided to the children through online mode, right to stay, all the citizens can choose the place of stay according to their choice hence during the period of COVID-19 even though they are in abroad they wanted to come back and stay in India for which court permitted and asked the government to follow the rules carefully so that Corona cannot spread due to them The Prime Minister being the head of constitution has to care for equal distribution of food even though in crisis. First survival then rules at that particular point of time court effectively responded means when the country is in crisis due to ACT OF GOD, COVID-19 pandemic by directing the government unaltering the rule of law provides education for all, that is possible only through online mode of education. Even though a lot of problems persist, the net is not available, people are not aware of the technology don't you think that it is a tough task we salute the nation for handling the situation with utmost care effectively and excellently.Copyright © 2020 Ubiquity Press. All rights reserved.

The Impact of Restricting Community Activities on COVID-19 Transmission: A Case Study in Sumatra Island, Indonesia

Sumatra Island is the third largest island with the second largest population in Indonesia which has the following eight provinces: Aceh, North Sumatra, West Sumatra, Riau, Jambi, South Sumatra, Bengkulu and Lampung. The connectivity of these eight provinces in the economic field is very strong. This encourages high mobility between these provinces. During this Covid-19 pandemic, the high mobility between provinces affects the level of spread of Covid-19 on the island of Sumatra. The central government ordered local governments to implement a community activity restriction program called PPKM. In this article, a study is conducted on the impact of the PKKM program on the spread of Covid 19 on the island of Sumatra, Indonesia. The spread of Covid-19 is modeled using the Susceptible-Infected-Recovered-Death (SIRD) model which considers the mobility factor of the population. The model parameters were estimated using Approximate Bayesian Computation (ABC). The results of the study using this model show that the application of PKKM in several provinces in Sumatra can reduce the level of spread of COVID-19. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Omics approaches in COVID-19: An overview

COVID-19 caused by the virus SARS-CoV2 exhibits its devastating consequences worldwide in terms of health and economic loss. SARS-CoV2 is a novel coronavirus whose mechanism of infection and development of symptoms in patients leading to mortalities are poorly understood. Although primarily a respiratory virus, people infected with SARS-CoV2 show a series of symptoms involving multiple human organs including cardiac abnormalities, neuronal dysfunction, etc. Developing effective drugs to control the pandemic is overwhelmingly important and urgent. Ongoing rigorous scientific research based on molecular biology, genetics, genomics, proteomics, and informatics are in progress to develop suitable therapy. Using the omics-based approach, the correlation of vast amount of COVID-19 patient-related experimental data with patient-specific medical information is necessary prerequisite to manage COVID-19 patients and develop successful therapy especially in rural and urban areas where access to proper healthcare is limited. Conclusive data of these coordinated approaches would immensely help to manage a large number of critically ill patients to improve the treatment outcome and reduce mortalities. © 2023 Elsevier Inc. All rights reserved.

Parkinson's Disease, SARS-CoV-2, and Frailty: Is There a Vicious Cycle Related to Hypovitaminosis D?

The literature has long established the association between aging and frailty, with emerging evidence pointing to a relationship between frailty and SARS-CoV-2 contagion. The possible neurological consequences of SARS-CoV-2 infection, associated with physical and cognitive frailty, could lead to a worsening of Parkinson's disease (PD) in infected patients or-more rarely-to an increase in the Parkinsonian symptomatology. A possible link between those clinical pictures could be identified in vitamin D deficiency, while the whole process would appear to be associated with alterations in the microbiota-intestine-brain axis that fall within the α-Synuclein Origin site and Connectome (SOC) model, and allow for the identification of a body-first PD and a brain-first PD. The model of care for this condition must consider intrinsic and extrinsic variables so that care by a multidisciplinary team can be successfully predicted. A multidimensional screening protocol specifically designed to identify people at risk or in the early stages of the disease should begin with the investigation of indices of frailty and microbiota-intestine-brain axis alterations, with a new focus on cases of hypovitaminosis D.

Plasma cell-free DNA promise monitoring and tissue injury assessment of COVID-19.

Coronavirus 2019 (COVID-19) is a complex disease that affects billions of people worldwide. Currently, effective etiological treatment of COVID-19 is still lacking; COVID-19 also causes damages to various organs that affects therapeutics and mortality of the patients. Surveillance of the treatment responses and organ injury assessment of COVID-19 patients are of high clinical value. In this study, we investigated the characteristic fragmentation patterns and explored the potential in tissue injury assessment of plasma cell-free DNA in COVID-19 patients. Through recruitment of 37 COVID-19 patients, 32 controls and analysis of 208 blood samples upon diagnosis and during treatment, we report gross abnormalities in cfDNA of COVID-19 patients, including elevated GC content, altered molecule size and end motif patterns. More importantly, such cfDNA fragmentation characteristics reflect patient-specific physiological changes during treatment. Further analysis on cfDNA tissue-of-origin tracing reveals frequent tissue injuries in COVID-19 patients, which is supported by clinical diagnoses. Hence, our work demonstrates and extends the translational merit of cfDNA fragmentation pattern as valuable analyte for effective treatment monitoring, as well as tissue injury assessment in COVID-19.