scholarly journals Human tularemia in Italy. Is it a re-emerging disease?

2014 ◽  
Vol 143 (10) ◽  
pp. 2161-2169 ◽  
Author(s):  
D. D'ALESSANDRO ◽  
C. NAPOLI ◽  
A. NUSCA ◽  
A. BELLA ◽  
E. FUNARI
Keyword(s):  
Clinical Manifestations ◽  
Emerging Disease ◽  
Control Measures ◽  
Prevention Measures ◽  
Mortality And Morbidity ◽  
The Real ◽  
The Past ◽  
New Evidence ◽  
Discharge Database ◽  
Significant Mortality

SUMMARYTularemia is a contagious infectious disease due to Francisiella tularensis that can cause serious clinical manifestations and significant mortality if untreated. Although the frequency and significance of the disease has diminished over the last decades in Central Europe, over the past few years, there is new evidence suggesting that tularemia has re-emerged worldwide. To know the real epidemiology of the disease is at the root of correct control measures. In order to evaluate whether tularemia is re-emerging in Italy, data on mortality and morbidity (obtained by the National Institute of Statistics; ISTAT), Italian cases described in the scientific literature and data concerning hospitalizations for tularemia (obtained by the National Hospital Discharge Database) were analysed. From 1979 to 2010, ISTAT reported 474 cases and no deaths. The overall number of cases obtained from the literature review was at least 31% higher than that reported by ISTAT. Moreover, the number of cases reported by ISTAT was 3·5 times smaller than hospitalized cases. In Italy tularemia is sporadic, rarely endemic and self-limiting; but, although the trend of reported tularemia does not support the hypothesis of a re-emerging disease, the study demonstrates a wide underreporting of the disease. The real frequency of the disease should be carefully investigated and taken into account in order to implement specific prevention measures.

scholarly journals Cardiac Pacing in Cardioinhibitory Reflex Syncope: Clinical Use of Closed-loop Stimulation

2021 ◽  
Vol 10 (4) ◽  
pp. 244-249
Author(s):  
Marco Tomaino ◽  
Vincenzo Russo ◽  
Daniele Giacopelli ◽  
Alessio Gargaro ◽  
Michele Brignole
Keyword(s):  
Closed Loop ◽  
Carotid Sinus ◽  
Clinical Manifestations ◽  
Cardiac Pacing ◽  
Cardiac Monitoring ◽  
The Past ◽  
Reflex Syncope ◽  
Pacing Mode ◽  
New Evidence ◽  
Closed Loop Stimulation

Cardiac pacing has been studied extensively in patients with reflex syncope over the past two decades. The heterogeneity of the forms and clinical manifestations of reflex syncope explain the controversial results of older randomised clinical trials. New evidence from recent trials has changed medical practice, now leading to clear indications for pacing in patients with asystolic syncope documented during carotid sinus massage, implantable cardiac monitoring or tilt testing. Given that recent trials in reflex syncope have been performed using the closed-loop stimulation algorithm, the authors will briefly discuss this pacing mode, review hypotheses about the mechanisms underlying its activation during syncope and provide practical instructions for programming and troubleshooting.

scholarly journals Estimating the number of COVID-19-related infections, deaths and hospitalizations in Iran under different physical distancing and isolation scenarios: A compartmental mathematical modeling

2020 ◽  
Author(s):  
Hamid Sharifi ◽  
Yunes Jahani ◽  
Ali Mirzazadeh ◽  
Milad Ahmadi Gohari ◽  
Mehran Nakhaeizadeh ◽  
...  
Keyword(s):  
Public Awareness ◽  
Case Finding ◽  
Control Measures ◽  
Added Value ◽  
Prevention Measures ◽  
Multiple Sources ◽  
Infected People ◽  
The Past ◽  
The Impact ◽  
Different Levels

AbstractBackgroundIran is one of the countries that has been overwhelmed with COVID-19. We aimed to estimate the total number of COVID-19 related infections, deaths, and hospitalizations in Iran under different physical distancing and isolation scenarios.MethodsWe developed a Susceptible-Exposed-Infected-Removed (SEIR) model, parameterized to the COVID-19 pandemic in Iran. We used the model to quantify the magnitude of the outbreak in Iran and assess the effectiveness of isolation and physical distancing under five different scenarios (A: 0% isolation, through E: 40% isolation of all infected cases). We used Monte-Carlo simulation to calculate the 95% uncertainty intervals (UI).FindingsUnder scenario A, we estimated 5,196,000 (UI 1,753,000 - 10,220,000) infections to happen till mid-June with 966,000 (UI 467,800 - 1,702,000) hospitalizations and 111,000 (UI 53,400 - 200,000) deaths. Successful implantation of scenario E would reduce the number of infections by 90% (i.e. 550,000) and change the epidemic peak from 66,000 on June 9th to 9,400 on March 1st. Scenario E also reduces the hospitalizations by 92% (i.e. 74,500), and deaths by 93% (i.e. 7,800).InterpretationWith no approved vaccination or therapy, we found physical distancing and isolation that includes public awareness and case-finding/isolation of 40% of infected people can reduce the burden of COVID-19 in Iran by 90% by mid-June.FundingWe received no funding for this work.Research in contextEvidence before this studyIran has been heavily impacted by the COVID-19 outbreak, and the virus has now spread to all of its provinces. Iran has been implementing different levels of partial physical distancing and isolation policies in the past few months. We searched PubMed and preprint archives for articles published up to April 15, 2020 that included information about control measures against COVID-19 in Iran using the following terms: (“coronavirus” OR “2019-nCoV” OR “COVID-19”) AND “Iran” AND (“intervention” OR “prevention” OR “physical distancing” OR “social distancing”). We found no studies that had quantified the impact of policies in Iran.Added value of this studyGiven the scarcity of evidence on the magnitude of the outbreak and the burden of COVID-19 in Iran, we used multiple sources of data to estimate the number of COVID-19 infections, hospitalizations, and deaths under different physical distancing and isolation scenarios until mid-June. We showed that implementing no control measures could lead to over five million infections in Iran; ∼19% of whom would be hospitalized, and ∼2% would die. However, under our most optimistic scenario, these estimates could be reduced by ∼90%.Implications of all the available evidenceWith no effective vaccination or treatment, advocating and enforcing physical distancing and isolation along with public education on prevention measures could significantly reduce the burden of COVID-19 in Iran. Nonetheless, even under the most optimistic scenario, the burden of COVID-19 would be substantial and well beyond the current capacity of the healthcare system in Iran.

Russian and Soviet historiography of the life and work of Anatoly Fedorovich Koni in the 20th century

2020 ◽  
Vol 2020 (11-1) ◽  
pp. 263-279
Author(s):  
Alexander Kodintsev ◽  
Danil Rybin
Keyword(s):  
20Th Century ◽  
Systematic Study ◽  
The Real ◽  
The Past ◽  
Soviet Historiography

The study analyzes historical researches on the life and work of the outstanding Russian lawyer A. F. Koni. It is noted that several directions in the study of the personality of this figure can be distinguished. It is concluded that systematic study of the legacy of Koni in the context of the era, taking into account the accumulated knowledge, coupled with archival materials will recreate the real face of the remarkable humanist figure of Russia in the past era.

THE 2017 AMENDMENTS TO THE LAW REFORM (MARRIAGE AND DIVORCE) ACT 1976: A MILESTONE OR A STONE’S THROW IN THE DEVELOPMENT OF MALAYSIAN FAMILY LAW?

2020 ◽  
Vol 28 (2) ◽  
pp. 449-479
Author(s):  
Sridevi Thambapillay
Keyword(s):  
Child Custody ◽  
Family Law ◽  
Law Reform ◽  
The Real ◽  
The Past ◽  
Marriage And Divorce ◽  
Conversion To Islam ◽  
Family Issues ◽  
The Law ◽  
Muslim Family

The Law Reform (Marriage and Divorce) Act 1976 (LRA) which was passed in 1976 and came into force on 1st March 1982, standardized the laws concerning non-Muslim family matters. Many family issues concerning non-Muslim have emerged ever since, the most important being the effects of unilateral conversion to Islam by one of the parties to the marriage. There has been a lot of public hue and cry for amendments to be made to the LRA. After much deliberation, the Malaysian Parliament finally passed the amendments to the LRA in October 2017, which came into force in December 2018. Although the amendments have addressed selected family law issues, the most important amendment on child custody in a unilateral conversion to Islam was dropped from the Bill at the last minute. Howsoever, at the end of the day, the real question that needs to be addressed is whether the amendments have resolved the major issues that have arisen over the past four decades? Hence, the purpose of this article is as follows: first, to examine the brief background to the passing of the LRA, secondly, to analyse the 2017 amendments, thirdly, to identify the weaknesses that still exist in the LRA, and finally, to suggest recommendations to overcome these weaknesses by comparing the Malaysian position with the Singaporean position. In conclusion, it is submitted that despite the recent amendments to the LRA, much needs to be done to overcome all the remaining issues that have still not been addressed.

Scrub typhus (Orientia tsutsugamushi), A rapidly spreading epidemic in Chennai - A standalone lab experience

2016 ◽  
Vol 5 (09) ◽  
pp. 4896
Author(s):  
Sripriya C.S.* ◽  
Shanthi B. ◽  
Arockia Doss S. ◽  
Antonie Raj I. ◽  
Mohana Priya
Keyword(s):  
Scrub Typhus ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Orientia Tsutsugamushi ◽  
The Past ◽  
Igm Elisa ◽  
The Mean ◽  
Specific Symptoms ◽  
Symptoms And Signs

Scrub typhus (Orientia tsutsugamushi), is a strict intracellular bacterium which is reported to be a recent threat to parts of southern India. There is re-emergence of scrub typhus during the past few years in Chennai. Scrub typhus is an acute febrile illness which generally causes non-specific symptoms and signs. The clinical manifestations of this disease range from sub-clinical disease to organ failure to fatal disease. This study documents our laboratory experience in diagnosis of scrub typhus in patients with fever and suspected clinical symptoms of scrub typhus infection for a period of two years from April 2014 to April 2016 using immunochromatography and IgM ELISA methods. The study was conducted on 648 patients out of whom 188 patients were found to be positive for scrub typhus. Results also showed that pediatric (0 -12 years) and young adults (20 – 39 years) were more exposed to scrub typhus infection and female patients were more infected compared to male. The study also showed that the rate of infection was higher between September to February which also suggested that the infection rate is proportional to the climatic condition. Statistical analysis showed that the mean age of the patients in this study was 37.6, standard deviation was 18.97, CV % was 50.45. 

scholarly journals Defence Medical Rehabilitation Centre (DMRC) COVID-19 Recovery Service

2021 ◽  
pp. e001681
Author(s):  
Oliver O'Sullivan ◽  
R Barker-Davies ◽  
R Chamley ◽  
E Sellon ◽  
D Jenkins ◽  
...  
Keyword(s):  
Occupational Medicine ◽  
Armed Forces ◽  
Acute Illness ◽  
Medical Rehabilitation ◽  
Rehabilitation Centre ◽  
Operational Effectiveness ◽  
Mortality And Morbidity ◽  
Recovery Service ◽  
Significant Mortality

Coronavirus disease 2019 (COVID-19) causes significant mortality and morbidity, with an unknown impact in the medium to long term. Evidence from previous coronavirus epidemics indicates that there is likely to be a substantial burden of disease, potentially even in those with a mild acute illness. The clinical and occupational effects of COVID-19 are likely to impact on the operational effectiveness of the Armed Forces. Collaboration between Defence Primary Healthcare, Defence Secondary Healthcare, Defence Rehabilitation and Defence Occupational Medicine resulted in the Defence Medical Rehabilitation Centre COVID-19 Recovery Service (DCRS). This integrated clinical and occupational pathway uses cardiopulmonary assessment as a cornerstone to identify, diagnose and manage post-COVID-19 pathology.

scholarly journals Restoring the real world records in Men’s swimming without high-tech swimsuits

2020 ◽  
Vol 16 (4) ◽  
pp. 291-300
Author(s):  
Zhenyu Gao ◽  
Yixing Li ◽  
Zhengxin Wang
Keyword(s):  
Real World ◽  
Technical Skills ◽  
High Tech ◽  
Training Methods ◽  
Strong Indication ◽  
The Real ◽  
The Past ◽  
Optimal Estimates ◽  
World Records ◽  
And Training

AbstractThe recently concluded 2019 World Swimming Championships was another major swimming competition that witnessed some great progresses achieved by human athletes in many events. However, some world records created 10 years ago back in the era of high-tech swimsuits remained untouched. With the advancements in technical skills and training methods in the past decade, the inability to break those world records is a strong indication that records with the swimsuit bonus cannot reflect the real progressions achieved by human athletes in history. Many swimming professionals and enthusiasts are eager to know a measure of the real world records had the high-tech swimsuits never been allowed. This paper attempts to restore the real world records in Men’s swimming without high-tech swimsuits by integrating various advanced methods in probabilistic modeling and optimization. Through the modeling and separation of swimsuit bias, natural improvement, and athletes’ intrinsic performance, the result of this paper provides the optimal estimates and the 95% confidence intervals for the real world records. The proposed methodology can also be applied to a variety of similar studies with multi-factor considerations.

scholarly journals Phylogenetic Complexity of Morphologically Identified Anopheles squamosus in Southern Zambia

Insects ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 146
Author(s):  
Jordan Hoffman ◽  
Ilinca Ciubotariu ◽  
Limonty Simubali ◽  
Twig Mudenda ◽  
William Moss ◽  
...  
Keyword(s):  
Phylogenetic Relationships ◽  
Catchment Area ◽  
Control Strategies ◽  
Light Trap ◽  
Current Control ◽  
Control Measures ◽  
Morphological Identification ◽  
The Past ◽  
Blood Meal Source ◽  
Residual Malaria Transmission

Despite dramatic reductions in malaria cases in the catchment area of Macha Hospital, Choma District, Southern Province in Zambia, prevalence has remained near 1–2% by RDT for the past several years. To investigate residual malaria transmission in the area, this study focuses on the relative abundance, foraging behavior, and phylogenetic relationships of Anopheles squamosus specimens. In 2011, higher than expected rates of anthropophily were observed among “zoophilic” An. squamosus, a species that had sporadically been found to contain Plasmodium falciparum sporozoites. The importance of An. squamosus in the region was reaffirmed in 2016 when P. falciparum sporozoites were detected in numerous An. squamosus specimens. This study analyzed Centers for Disease Control (CDC) light trap collections of adult mosquitoes from two collection schemes: one performed as part of a reactive-test-and-treat program and the second performed along a geographical transect. Morphological identification, molecular verification of anopheline species, and blood meal source were determined on individual samples. Data from these collections supported earlier studies demonstrating An. squamosus to be primarily exophagic and zoophilic, allowing them to evade current control measures. The phylogenetic relationships generated from the specimens in this study illustrate the existence of well supported clade structure among An. squamosus specimens, which further emphasizes the importance of molecular identification of vectors. The primarily exophagic behavior of An. squamosus in these collections also highlights that indoor vector control strategies will not be sufficient for elimination of malaria in southern Zambia.

scholarly journals Trends and Source Contribution Characteristics of SO2, NOX, PM10 and PM2.5 Emissions in Sichuan Province from 2013 to 2017

Atmosphere ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 189
Author(s):  
Min He ◽  
Junhui Chen ◽  
Yuming He ◽  
Yuan Li ◽  
Qichao Long ◽  
...  
Keyword(s):  
Air Quality ◽  
Sichuan Province ◽  
Control Measures ◽  
So2 Emission ◽  
Source Contribution ◽  
The Past ◽  
Mobile Sources ◽  
Pm10 And Pm2.5 ◽  
Comparison Results ◽  
Pm2.5 Emissions

As one of the most populated regions in China, Sichuan province had been suffering from deteriorated air quality due to the dramatic growth of economy and vehicles in recent years. To deal with the increasingly serious air quality problem, Sichuan government agencies had made great efforts to formulate various control measures and policies during the past decade. In order to better understand the emission control progress in recent years and to guide further control policy formulation, the emission trends and source contribution characteristics of SO2, NOX, PM10 and PM2.5 from 2013 to 2017 were characterized by using emission factor approach in this study. The results indicated that SO2 emission decreased rapidly during 2013–2017 with total emission decreased by 52%. NOX emission decreased during 2013–2015 but started to increase slightly afterward. PM10 and PM2.5 emissions went down consistently during the study period, decreased by 26% and 25%, respectively. In summary, the contribution of power plants kept decreasing, while contribution of industrial combustion remained steady in the past 5 years. The contribution of industrial processes increased for SO2 emission, and decreased slightly for NOX, PM10 and PM2.5 emissions. The on-road mobile sources were the largest emission contributor for NOX, accounting for about 32–40%, and its contribution increased during 2013–2015 and then decreased. It was worth mentioning that nonroad mobile sources and natural gas fired boilers were becoming important NOX contributors in Sichuan. Fugitive dust were the key emission sources for PM10 and PM2.5, and the contribution kept increasing in the study period. Comparison results with other inventories, satellite data and ground observations indicated that emission trends developed in this research were relatively credible.

scholarly journals Universal Masking to Control Healthcare-Associated Transmission of SARS-CoV-2

2021 ◽  
pp. 1-24
Author(s):  
Eliza R. Thompson ◽  
Faith S. Williams ◽  
Pat A. Giacin ◽  
Shay Drummond ◽  
Eric Brown ◽  
...  
Keyword(s):  
Large Scale ◽  
Infection Prevention ◽  
Index Patient ◽  
Field Investigation ◽  
Point Prevalence ◽  
Control Measures ◽  
Prevention Measures ◽  
Infection Control Measures ◽  
Va Health Care System ◽  
Healthcare Associated

Abstract Objective: To assess extent of a healthcare-associated outbreak of SARS-CoV-2 and evaluate effectiveness of infection control measures, including universal masking Design: Outbreak investigation including 4 large-scale point-prevalence surveys Setting: Integrated VA Health Care System with 2 facilities and 330 beds Participants: Index patient and 250 exposed patients and staff Methods: We identified exposed patients and staff and classified them as probable and confirmed cases based on symptoms and testing. We performed a field investigation and assessment of patient and staff interactions to develop probable transmission routes. Infection prevention interventions implemented included droplet and contact precautions, employee quarantine, and universal masking with medical and cloth facemasks. Four point-prevalence surveys of patient and staff subsets were conducted using real-time reverse-transcriptase polymerase chain reaction for SARS-CoV-2. Results: Among 250 potentially exposed patients and staff, 14 confirmed cases of Covid-19 were identified. Patient roommates and staff with prolonged patient contact were most likely to be infected. The last potential date of transmission from staff to patient was day 22, the day universal masking was implemented. Subsequent point-prevalence surveys in 126 patients and 234 staff identified 0 patient cases and 5 staff cases of Covid-19, without evidence of healthcare-associated transmission. Conclusions: Universal masking with medical facemasks was effective in preventing further spread of SARS-CoV-2 in our facility in conjunction with other traditional infection prevention measures.

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