scholarly journals European Non-Polio Enterovirus Network: Introduction of Hospital-Based Surveillance Network to Understand the True Disease Burden of Non-Polio Enterovirus and Parechovirus Infections in Europe

2021 ◽  
Vol 9 (9) ◽  
pp. 1827
Author(s):  
Heli Harvala ◽  
Kimberley S. M. Benschop ◽  
Natasa Berginc ◽  
Sofie Midgley ◽  
Katja Wolthers ◽  
...  
Keyword(s):  
Pilot Study ◽  
Disease Burden ◽  
Neurological Diseases ◽  
Foot And Mouth Disease ◽  
Case Definition ◽  
Prevention Measures ◽  
Surveillance Network ◽  
Cross Sectional ◽  
Study Protocols ◽  
Wide Range

Background. Non-polio enteroviruses (EVs) and human parechoviruses (PeVs) cause a wide range of human infections. Limited data on their true disease burden exist as standardized European-wide surveillance is lacking. Aims. Our aim is to estimate the disease burden of EV and PeV infections in Europe via establishment of standardized surveillance for hand, foot and mouth disease (HFMD) and respiratory and neurological infections caused by these viruses. We will also assess the sensitivity of assays implemented in the network of participating laboratories so that all EV and PeV types are adequately detected. Plan. The European Non-Polio Enterovirus Network (ENPEN) has developed standardized protocols for a prospective, multi-center and cross-sectional hospital-based pilot study. Protocols include guidance for diagnosis, case definition, detection, characterization and reporting of EV and PeV infections associated with HFMD and respiratory and neurological diseases. Over 30 sites from 17 European countries have already registered to this one pilot study, likely to be commenced in 2022. Benefits. This surveillance will allow European-wide comparison of data on EV and PeV infection. These data will also be used to determine the burden of EV and PeV infections, which is needed to guide the further prevention measures and policies.

scholarly journals Robust Step Detection from Different Waist-Worn Sensor Positions: Implications for Clinical Studies

2020 ◽  
Vol 4 (1) ◽  
pp. 50-58
Author(s):  
Matthias  Tietsch ◽  
Amir Muaremi ◽  
Ieuan Clay ◽  
Felix Kluge ◽  
Holger Hoefling ◽  
...  
Keyword(s):  
Clinical Study ◽  
Clinical Studies ◽  
Neurological Diseases ◽  
Human Gait ◽  
Robust Solution ◽  
Step Detection ◽  
Study Protocols ◽  
Study Results ◽  
Wide Range ◽  
The Impact

Analyzing human gait with inertial sensors provides valuable insights into a wide range of health impairments, including many musculoskeletal and neurological diseases. A representative and reliable assessment of gait requires continuous monitoring over long periods and ideally takes place in the subjects’ habitual environment (real-world). An inconsistent sensor wearing position can affect gait characterization and influence clinical study results, thus clinical study protocols are typically highly proscriptive, instructing all participants to wear the sensor in a uniform manner. This restrictive approach improves data quality but reduces overall adherence. In this work, we analyze the impact of altering the sensor wearing position around the waist on sensor signal and step detection. We demonstrate that an asymmetrically worn sensor leads to additional odd-harmonic frequency components in the frequency spectrum. We propose a robust solution for step detection based on autocorrelation to overcome sensor position variation (sensitivity = 0.99, precision = 0.99). The proposed solution reduces the impact of inconsistent sensor positioning on gait characterization in clinical studies, thus providing more flexibility to protocol implementation and more freedom to participants to wear the sensor in the position most comfortable to them. This work is a first step towards truly position-agnostic gait assessment in clinical settings.

scholarly journals Molecular epidemiology of an enterovirus A71 outbreak associated with severe neurological disease, Spain, 2016

2019 ◽  
Vol 24 (7) ◽  
Author(s):  
Rubén González-Sanz ◽  
Didac Casas-Alba ◽  
Cristian Launes ◽  
Carmen Muñoz-Almagro ◽  
María Montserrat Ruiz-García ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Phylogenetic Analyses ◽  
Clinical Manifestations ◽  
Foot And Mouth Disease ◽  
Neurological Complications ◽  
Asia Pacific ◽  
Enterovirus A71 ◽  
Hospitalised Patients ◽  
Wide Range ◽  
Large Outbreak

Introduction Enterovirus A71 (EV-A71) is an emerging pathogen that causes a wide range of disorders including severe neurological manifestations. In the past 20 years, this virus has been associated with large outbreaks of hand, foot and mouth disease with neurological complications in the Asia-Pacific region, while in Europe mainly sporadic cases have been reported. In spring 2016, however, an EV-A71 outbreak associated with severe neurological cases was reported in Catalonia and spread further to other Spanish regions. Aim Our objective was to investigate the epidemiology and clinical characteristics of the outbreak. Methods We carried out a retrospective study which included 233 EV-A71-positive samples collected during 2016 from hospitalised patients. We analysed the clinical manifestations associated with EV-A71 infections and performed phylogenetic analyses of the 3’-VP1 and 3Dpol regions from all Spanish strains and a set of EV-A71 from other countries. Results Most EV-A71 infections were reported in children (mean age: 2.6 years) and the highest incidence was between May and July 2016 (83%). Most isolates (218/233) were classified as subgenogroup C1 and 217 of them were grouped in one cluster phylogenetically related to a new recombinant variant strain associated with severe neurological diseases in Germany and France in 2015 and 2016. Moreover, we found a clear association of EV-A71-C1 infection with severe neurological disorders, brainstem encephalitis being the most commonly reported. Conclusion An emerging recombinant variant of EV-A71-C1 was responsible for the large outbreak in 2016 in Spain that was associated with many severe neurological cases.

scholarly journals Developing and validating a primary care EMR-based frailty definition using machine learning

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Tyler Williamson ◽  
Sylvia Aponte-Hao ◽  
Bria Mele ◽  
Brendan Cord Lethebe ◽  
Charles Leduc ◽  
...  
Keyword(s):  
Machine Learning ◽  
Primary Care ◽  
Sensitivity And Specificity ◽  
Health Spending ◽  
Case Definition ◽  
Complex Nature ◽  
Case Definitions ◽  
Surveillance Network ◽  
Clinical Frailty Scale ◽  
Cross Sectional

Introduction. Individuals who have been identified as frail have an increased state of vulnerability, often leading to adverse health events, increased health spending, and potentially detrimental outcomes. Objective. The objective of this work is to develop and validate a case definition for frailty that can be used in a primary care electronic medical record database. Methods. This is a cross-sectional validation study using data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) in Southern Alberta. 52 CPCSSN sentinels assessed a random sample of their own patients using the Rockwood Clinical Frailty scale, resulting in a total of 875 patients to be used as reference standard. Patients must be over the age of 65 and have had a clinic visit within the last 24 months. The case definition for frailty was developed using machine learning methods using CPCSSN records for the 875 patients. Results. Of the 875 patients, 155 (17.7%) were frail and 720 (84.2%) were not frail. Validation metrics of the case definition were: sensitivity and specificity of 0.28, 95% CI (0.21 to 0.36) and 0.94, 95% CI (0.93 to 0.96), respectively; PPV and NPV of 0.53, 95% CI (0.42 to 0.64) and 0.86, 95% CI (0.83 to 0.88), respectively. Conclusion. The low sensitivity and specificity results could be because frailty as a construct remains under-developed and relatively poorly understood due to its complex nature. These results contribute to the literature by demonstrating that case definitions for frailty require expert consensus and potentially more sophisticated algorithms to be successful

scholarly journals 751. Acute Respiratory Illness Hospitalizations Among Young Children: Multi-Center Viral Surveillance Network, United States, 2015–2016

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S270-S270
Author(s):  
Brian Rha ◽  
Angela P Campbell ◽  
Darius McDaniel ◽  
Rangaraj Selvarangan ◽  
Natasha Halasa ◽  
...  
Keyword(s):  
Young Children ◽  
Viral Infections ◽  
Respiratory Illness ◽  
Supplemental Oxygen ◽  
Case Definition ◽  
Molecular Diagnostic ◽  
Prevention Measures ◽  
Research Support ◽  
Surveillance Network ◽  
Syncytial Virus

Abstract Background Viral infections are a significant cause of severe acute respiratory illnesses (ARI) in young children. Understanding the current epidemiology of these viruses is important for informing treatment and prevention measures. We describe the New Vaccine Surveillance Network (NVSN) and report preliminary results from 2015 to 2016. Methods Prospective active surveillance for hospitalized ARI was conducted from November 1, 2015 to June 30, 2016 among children <5 years of age at seven pediatric hospital sites (figure) using a broad case definition based on admission diagnoses. Parent interviews and medical chart reviews were performed, and mid-turbinate nasal and throat flocked swabs and/or tracheal aspirates were tested for adenovirus, human metapneumovirus (HMPV), influenza, parainfluenza viruses (PIV) 1–3, respiratory syncytial virus (RSV), and rhinovirus/enterovirus using molecular diagnostic assays at each site. Asymptomatic controls <5 years of age were also enrolled. Results Among 2,974 hospitalized children with ARI whose specimens were tested for viruses, 2,228 (75%) were <2 years old, with 745 (25%) 0–2 months, and 309 (10%) 3–5 months old. The majority were male (58%; n = 1,732) and 63% (n = 1,093) had no documented comorbid conditions. The median length of stay was 2 days; 1,683 (57%) received supplemental oxygen, 435 (15%) were admitted to intensive care, 95 (3%) required mechanical ventilation, and 1 (<1%) died. Viruses were detected in 2,242 (75%) children with ARI, with >1 virus detected in 234 (8%). RSV was detected in 1,039 (35%) children with ARI, HMPV in 245 (8%), influenza in 104 (4%), and PIV-1, PIV-2, and PIV-3 in 49 (2%), 2 (<1%), and 78 (3%), respectively. Rhinovirus/enterovirus was detected in 849 (29%) and adenovirus in 118 (4%) children with ARI, but were also detected in 18% (n = 227) and 5% (n = 60), respectively, of the 1,243 controls tested; the other viruses were more rarely detected in controls. Conclusion During the 2015–2016 season, viral detections were common in young children hospitalized for ARI at seven US sites. NVSN combines clinical data with current molecular laboratory techniques to describe respiratory virus epidemiology in cases of hospitalized pediatric ARI in order to inform current and future prevention, treatment, and healthcare utilization measures. Disclosures N. Halasa, Sanofi Pasteur: Investigator, Research support. GSK: Consultant, Consulting fee. Moderna: Consultant, Consulting fee. J. Englund, Gilead: Consultant and Investigator, Consulting fee and Research support. Novavax: Investigator, Research support. GlaxoSmithKline: Investigator, Research support. Alios: Investigator, Research support. MedImmune: Investigator, Research support. J. V. Williams, Quidel: Board Member, Consulting fee. GlaxoSmithKline: Consultant, Consulting fee.

First steps to a clinical research unit for developmental research in paediatric cardiology: conception and progress of the LEADER project (Long Term Early Development Research) in CHD

2019 ◽  
Vol 29 (5) ◽  
pp. 672-678
Author(s):  
Constanze Pfitzer ◽  
Hannah Ferentzi ◽  
Lisa-Maria Rosenthal ◽  
Peter Kramer ◽  
Felix Berger ◽  
...  
Keyword(s):  
At Risk ◽  
Longitudinal Study ◽  
Pilot Study ◽  
Cardiopulmonary Resuscitation ◽  
Clinical Research ◽  
Longitudinal Research ◽  
Research Unit ◽  
Cross Sectional ◽  
Study Protocols ◽  
Clinical Research Unit

AbstractObjective:We developed the Long-term Early Development Research (LEADER) project to investigate the development of children with CHD and/or after cardiopulmonary resuscitation. Both populations are at risk for delays in motor, cognitive, and language development. However, few studies to date have investigated the longitudinal development in these children.Methods:To establish a clinical research unit, we planned three studies: a cross-sectional study in children after cardiopulmonary resuscitation (LEADER-REA Pilot Study), a longitudinal study in children after cardiopulmonary resuscitation, with a focus on evaluating various biomarkers as predictors for developmental outcome (LEADER-CPR study), and a longitudinal study in children with ventricular septal defect, tetralogy of Fallot, or transposition of the great arteries after cardiac surgery (LEADER-CHD study).Results:Implementation of all three LEADER studies was successful and study protocols were conducted as planned. Findings from the LEADER-REA Pilot study have been recently published and data collection for both prospective trials is ongoing. Descriptive analysis of the first 20 assessments of the LEADER-CHD study showed no severe deficits in overall cognitive, motor, and language developments in the children.Conclusions:Children with CHD and/or after cardiopulmonary resuscitation are at risk for developmental delay. Therefore, a detailed developmental assessment is necessary as a pre-requisite for individual developmental support. Our LEADER project has been shown to be feasible in a clinical setting and is the first step towards the establishment of a clinical research unit in our clinic with a focus on longitudinal research.

scholarly journals Multinational Prevalence of Neurological Phenotypes in Patients Hospitalized with COVID-19

2021 ◽  
Author(s):  
Trang T. Le ◽  
Alba Gutiérrez-Sacristán ◽  
Jiyeon Son ◽  
Chuan Hong ◽  
Andrew M. South ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Severe Disease ◽  
Neurological Complications ◽  
Cross Sectional Study ◽  
Cerebrovascular Diseases ◽  
Disorders Of Consciousness ◽  
Polymerase Chain Reaction Test ◽  
Disease Category ◽  
Cross Sectional ◽  
Wide Range

AbstractOBJECTIVENeurological complications can worsen outcomes in COVID-19. We defined the prevalence of a wide range of neurological conditions among patients hospitalized with COVID-19 in geographically diverse multinational populations.METHODSUsing electronic health record (EHR) data from 348 participating hospitals across 6 countries and 3 continents between January and September 2020, we performed a cross-sectional study of hospitalized adult and pediatric patients with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test, both with and without severe COVID-19. We assessed the frequency of each disease category and 3-character International Classification of Disease (ICD) code of neurological diseases by countries, sites, time before and after admission for COVID-19, and COVID-19 severity.RESULTSAmong the 35,177 hospitalized patients with SARS-CoV-2 infection, there was increased prevalence of disorders of consciousness (5.8%, 95% confidence interval [CI]: 3.7%-7.8%, pFDR<.001) and unspecified disorders of the brain (8.1%, 95%CI: 5.7%-10.5%, pFDR<.001), compared to pre-admission prevalence. During hospitalization, patients who experienced severe COVID-19 status had 22% (95%CI: 19%-25%) increase in the relative risk (RR) of disorders of consciousness, 24% (95%CI: 13%-35%) increase in other cerebrovascular diseases, 34% (95%CI: 20%-50%) increase in nontraumatic intracranial hemorrhage, 37% (95%CI: 17%-60%) increase in encephalitis and/or myelitis, and 72% (95%CI: 67%-77%) increase in myopathy compared to those who never experienced severe disease.INTERPRETATIONUsing an international network and common EHR data elements, we highlight an increase in the prevalence of central and peripheral neurological phenotypes in patients hospitalized with SARS-CoV-2 infection, particularly among those with severe disease.

Attitudes of Nursing Students towards Suicide Prevention: A Study from Central India

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Deepak Ghormode ◽  
Pramod Gupta ◽  
Devendra Ratnani ◽  
S. K. Singh
Keyword(s):  
Nursing Students ◽  
Suicide Prevention ◽  
Suicide Attempts ◽  
Central India ◽  
Prevention Measures ◽  
Cross Sectional ◽  
Favourable Attitude ◽  
Cross Sectional Design ◽  
Suicide Prevention Training ◽  
Training Programmes

Background: Managing patients with suicide attempts effectively requires overcoming barriers to their care. The attitudes and beliefs of the healthcare professionals have significant effect on the outcome of the treatment and implementation of the preventive strategies. Objectives: Aim of the study was to assess the attitude of nursing students toward suicide prevention. Materials and Methods: The study had a cross sectional design of 284 nursing students who were randomly recruited from the two institutions. Attitude toward suicide prevention scale was administered.  Results: Most were young single females, from rural locality, who were pursuing either BSc Nursing or GNM courses. Very few had previous exposure to suicide prevention training programmes. Nearly half of the students showed favourable attitude towards patients with suicidal attempt, considering it as their responsibility and their efforts as rewarding. Nearly half students also showed empathy towards these patients not considering the attempts as just attention seeking ones. Nearly one third were uncertain whether the patients reveal their plans of attempt and whether the suicide prevention measures were draining of the resources. Half of the subjects showed pessimism towards modifying the risk factors of unemployment and poverty. Conclusions: Only half of the nursing students showed favourable attitude working with patients with suicide attempts. More educational and training programs on suicide prevention are therefore needed in these students for better prevention and management of these patients.

A Cross Sectional Survey of Chicken Astroviruses Antibody in Broiler and Sonali (Cross-Bred) Chickens in Selected Areas in Bangladesh

2020 ◽  
Vol 43 (1) ◽  
pp. 75-80
Author(s):  
Md Zulfekar Ali ◽  
Mohammad Moktader Moula ◽  
Zafar Ahmed Bhuiyan ◽  
Muhammad Tariq Javed
Keyword(s):  
Age Groups ◽  
Winter Season ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Blood Samples ◽  
Elisa Kit ◽  
Published Report ◽  
Poultry Birds ◽  
Wide Range ◽  
Group B

AbstractChicken astroviruses (CAstV) are enteric viruses of poultry causing gastroenteritis, malabsorption, gout and white chick disease commonly known as runting-stunting syndrome (RSS). It can affect the wide range of poultry birds, especially chicken, turkey and duck worldwide. To our best knowledge there is no published report on presence of antibodies against CAstV in Bangladesh. Therefore, the study aimed to detect the presence of CAstV antibodies in broilers and sonali chickens (a cross-bread) in Bangladesh through a cross-sectional survey. A total of 454 blood samples from 66 flocks of broiler (n=343) and sonali chickens (n=111) of different ages were obtained during 2017 from four districts. The birds were healthy but were not vaccinated against CAstV. The samples were tested for specific antibodies against CAstV Group B by using commercially available ELISA kit. Overall, 16.74% (76/454) samples and 34.84% (23/66) flocks were positive for CAstV antibodies. The seroprevalence of CAstV was significantly (p=0.001) higher in sonali chickens (36.96%) than broiler (10.20%), while it was significantly higher (p=0.001) in birds of Bogura district (36.94%) than the other three districts. Regarding the age groups, seroprevalence was insignificantly (p=0.192) higher in sonali chicken before laying age (45%) than during laying age (27.45%). Regarding the seasons, CAstV infection was prevalent significantly (p=0.001) higher in winter season. Thus, the present study indicated the presence of CAstV in poultry in Bangladesh, so further studies are required to find out the magnitude of the problem in the country.

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