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To systematically review the prevalence, risk factors and timing of onset of hip displacement in children with a post-neonatal (PNN) brain injury with regards to hip surveillance recommendations. A search of PubMed, MEDLINE, Embase, CINAHL and Web of Science was conducted on 22nd February 2022. Studies were included if they reported presence of, and risk factors for, hip displacement in children with PNN brain injury. Data was extracted on patient characteristics, and analyzed in terms of risk factors of interest and timing of development of hip displacement. Six studies met the inclusion criteria (n = 408 participants). All were cohort studies: five retrospective and one prospective. Rates of hip displacement ranged from 1% to 100%, and were higher in children with diffuse brain injury at an early age, who were non-ambulant and had spastic quadriplegia. Hip displacement and hip dislocation were first identified at one and three months respectively following PNN brain injury. Evidence on hip displacement in children with PNN brain injury is sparse and low quality. Children who remain non-ambulant after diffuse PNN brain injury before five years of age appear most at risk of developing progressive hip displacement and earlier hip surveillance is recommended. As for children with cerebral palsy (CP), children with a post-neonatal (PNN) brain injury who are non-ambulant are most at risk of progressive hip displacement. Children with a diffuse brain injury before five years of age appear to be at greater risk. Hip displacement can occur very early and progress rapidly following PNN brain injury. [ABSTRACT FROM AUTHOR]

Background: Ultrasound surveillance for hepatocellular carcinoma (HCC) may improve early tumour detection but may additionally result in surveillance‐related harm through increased evaluation of non‐HCC lesions. The incidence of these outcomes has not been reported outside North America. Aims: We aimed to report the outcomes of HCC surveillance with respect to both surveillance‐related benefits and harms. Methods: We reviewed all HCC surveillance ultrasounds at a large Victorian tertiary hospital network in 2017 and followed their outcomes until 2021. Surveillance‐related benefits were defined as early‐stage HCC detection. Surveillance‐related harm was defined as contrast imaging, biopsies or surgery performed to evaluate non‐HCC liver lesions or false‐positive alpha‐fetoprotein levels. Results: Five hundred and fifty‐three patients were included (mean age 54.5 ± 12.3 years, males 67.5%, cirrhosis 50.3%). The most common liver disease aetiology was hepatitis B (53.9%). Over a median of 4.7 years follow‐up, early‐stage HCC was detected in 3.3% (5.4% in cirrhotic vs 1.1% in non‐cirrhotic patients, P < 0.01). 75% of all HCCs were early‐stage. Surveillance‐related harm occurred in 12.5% (15.5% in cirrhotic vs 9.5% in non‐cirrhotic patients, P < 0.04), although most harm was mild (12.1%). In subgroup analysis, the detection of early‐stage HCC ranged between 0% (screened outside of guideline criteria and alcoholic cirrhotic patients) and 7.2% (hepatitis C cirrhosis). Harm occurred between 9% (non‐cirrhotic hepatitis B) and 20.8% (thrombocytopenia). Conclusion: In our study, HCC surveillance was associated with early tumour detection, although many patients experienced mild surveillance‐related harm. Novel surveillance strategies and pathways are required to improve detection in high‐risk patients and minimise harm in low‐risk patients. [ABSTRACT FROM AUTHOR]

Borrelia miyamotoi, transmitted by Ixodes spp. ticks, was recognized as an agent of hard tick relapsing fever in the United States in 2013. Nine state health departments in the Northeast and Midwest have conducted public health surveillance for this emerging condition by using a shared, working surveillance case definition. During 2013-2019, a total of 300 cases were identified through surveillance; 166 (55%) were classified as confirmed and 134 (45%) as possible. Median age of case-patients was 52 years (range 1-86 years); 52% were male. Most cases (70%) occurred during June-September, with a peak in August. Fever and headache were common symptoms; 28% of case-patients reported recurring fevers, 55% had arthralgia, and 16% had a rash. Thirteen percent of patients were hospitalized, and no deaths were reported. Ongoing surveillance will improve understanding of the incidence and clinical severity of this emerging disease. [ABSTRACT FROM AUTHOR]

Aim: This study describes the study design, study participants, participation rate and underreporting in the Danish National Surveys of Diet and Physical Activity (DANSDA) from 1995 to 2011–2013. Methods: DANSDA are government-funded surveys of food and nutrient intake, physical activity and lifestyle, undertaken to support nutritional policy, risk assessment and public health research. The surveys are cross-sectional based on primarily simple random samples (ages 1–80 years in 1995, 4–75 years in 2000–2013) drawn from the Danish Civil Registration System. Approximately 4800 individuals in 1995, 8200 in 2000–2002, 8400 in 2003–2008 and 7300 in 2011–2013 were invited to participate. Participants completed a seven-day food diary, a physical activity questionnaire (2000–2008), a step diary (2011–2013) and a face-to-face interview. Self-reported anthropometrics (1995–2013) were supplemented with device-based measures (2011–2013). Pedometers were included in 2011–2013. Results: The number of participants included per survey round was 3100-4400. Participant rates decreased from 66% (1995) to 54% (2011–2013). Non-participation was primarily refusal. Ages 18–30 years, 61–75 years (2000–2013), 61–80 years (1995) and low educated and individuals living alone were underrepresented. Underreporting of energy intake among adults ranged from 14% (1995) to 26% (2008). Conclusions: The methods in DANSDA have been developed to include device-based measures on physical activity and anthropometrics. This has improved the applicability of the results of the survey. The participation rate has fallen, which has affected sample representativity, and underreporting has increased. Future DANSDA surveys should explore and consider new initiatives to counteract non-response and underreporting, with the aim of enhancing data representativeness and applicability. [ABSTRACT FROM AUTHOR]

Aim: The aim is to report the design and baseline data of the 'National Surveillance of the Work Environment of Employees in Denmark' study (NASWEED). Methods: NASWEED consist of (a) bi-annual cross-sectional samples, based on probability samples of wage earners of the general working population in Denmark from 2021 onwards (surveillance), (b) a prospective cohort of all previous respondents every two years (epidemiology, questionnaire follow-up) and (c) longitudinal follow-up in Danish registers about work and health (epidemiology, register follow-up). Between February and May 2021, a stratified (38 occupational industries) probability sample of 63,391 Danish residents aged 15–69 years who were employed for at least 34 hours per month received an invitation to participate, of whom 30,099 (47.5%) completed the questionnaire, 897 (1.4%) partially completed the questionnaire and 32,395 (51.1%) did not respond. Baseline was completed in June 2021. NASWEED covers various topics about the work environment (psychosocial, ergonomic, chemical, biological, safety, accidents, working from home, etc), health behaviours and somatic and mental health-related conditions. Statistical analyses will mainly build on survey procedures with model-assisted weights to ensure that the sample will yield representative estimates of the general working population. Discussion: NASWEED will monitor the development of the work environment and health in Denmark until 2030. The survey data will be included in epidemiological studies with repeated measurement of the work environment, health variables and covariates, and follow-ups in national registers to investigate the prospective association in the years and decades to come between the work environment and workers' health and labour market participation. [ABSTRACT FROM AUTHOR]

Objectives: The prevalence of hepatitis B in the Republic of Korea has declined, yet the disease burden persists. After various changes in targets and methods, the national hepatitis B surveillance system now exclusively monitors acute cases. We aimed to assess the alignment of this system with its intended purpose and to recommend improvements supporting the national strategic plan for viral hepatitis management. Methods: This study assessed acute hepatitis B cases reported to the Korean Disease Control and Prevention Agency's mandatory surveillance system over a 10-year period (2013-2022). It evaluated 5 factors from the Centers for Disease Control and Prevention's Updated Guidelines for Evaluating Public Health Surveillance Systems: simplicity, positive predictive value, data quality, timeliness, and usefulness. Results: The nonspecific nature of acute hepatitis B symptoms, along with the complexity of diagnostic criteria, indicated a high potential for misreporting. The surveillance system demonstrated a high positive predictive value (94.4%), with data quality and timeliness also rated high. However, data following the onset of the coronavirus disease 2019 pandemic indicate the need for improvement. Moreover, given the relative importance of specific characteristics of chronic infectious diseases, only limited interventions are implementable through the current surveillance system. Conclusion: The evaluation of the Republic of Korea's acute hepatitis B surveillance system revealed high positive predictive value, data quality, and timeliness. However, improvements can be made in the misreporting of chronic cases and the system's usefulness. More accurate reflection of the characteristics of acute hepatitis B cases is essential for better management of viral hepatitis. [ABSTRACT FROM AUTHOR]

The extensive history of pandemics has spanned many centuries, profoundly impacting societies, economies, and public health, and thereby shaping the course of history in various ways. Advances in medicine, science, and public health practices have played a pivotal role in mitigating the effects of pandemics over time. This review explores the scientific landscape of contemporary pandemics, examining their diverse and complex nature. It goes beyond the biological aspects of pandemics to consider socioeconomic, environmental, and technological factors. Through a scientific lens, this study aims to understand the complexities of pandemics and contribute to the expanding knowledge base that helps humanity strengthen its defenses against global health threats. By elucidating the enigmas of pandemics, the study hopes to foster a more resilient and prepared global health environment. Highlighting the importance of a multidisciplinary, cross-disciplinary, and transdisciplinary approach, this exploration emphasizes the critical need to integrate biological, socioeconomic, environmental, and technological domains to develop more robust defenses against these global health challenges. [ABSTRACT FROM AUTHOR]

Imaging may inadvertently reveal pathologies unrelated to their performing purpose, known as incidental findings (IF). This study aimed to assess the prevalence, clinical significance, and documentation of IFs in chest and abdominopelvic computed tomography (CT) scans of trauma patients. This observational study was conducted at two urban level-1 trauma centers from March 2019 through April 2022. Official radiology reports of trauma patients who underwent chest and/or abdominopelvic CT scans at the emergency department (ED) were explored, and IF were extracted. Predictive factors of the presence of IFs and their documenting were investigated. Out of 656 chest and 658 abdominopelvic CT scans, 167 (25.37%) and 212 (32.31%) scans harbored at least one IF, respectively. Patients with IFs tended to be of higher age and female in both chest (age: 48 [IQR: 35–62] vs. 34 [IQR: 25–42.5]; female: 31.14% vs 14.66%, p < 0.001 for both) and abdominopelvic CT scans (age: 41 [IQR: 30–57.5] vs 33 [IQR: 25–43], female: 26.42% vs. 13.96%, p < 0.001 for both). As for documentation of significant IFs, only 49 of 112 chest IFs (43.8%) and 55 of 176 abdominopelvic IFs (31.3%) were documented. Investigating factors associated with documentation of clinically significant IFs, shorter length of hospital stay (1.5 (IQR: 0–4) vs. 3 (IQR: 2–8), p = 0.003), and discharging by ED physicians (documentation rate: 13.2% vs 42.6%, p < 0.001) were associated with poorer documentation of IFs only in abdominopelvic scans. CT imaging in ED trauma patients often reveals incidental findings, especially in older patients. Over 50% of these findings are clinically significant, yet they are frequently ignored and not documented. Physicians need to be more vigilant in recognizing and documenting these incidental findings and informing patients of the need for further evaluation. [ABSTRACT FROM AUTHOR]

Cerebral palsy is a disorder of posture and movement. Multiple postural management interventions exist to prevent complications and improve outcomes. In this short review we followed a systematic approach to appraise the quality of evidence supporting each intervention and assessed the effectiveness across the International Classification of Functioning, Disability and Health (ICF) outcomes. Evidence-based recommendations are essential for assisting clinicians in selecting and implementing interventions aligned with the individual's goals. This review aims to summarize and evaluate the evidence supporting postural interventions for CP published after Gough's review in 2009. Additionally, it aims to provide clinical bottom lines according to GMFCS or MACS levels. We conducted our search for systematic reviews or population register studies evaluating postural management interventions in people with cerebral palsy using an umbrella systematic review design. We assessed the quality of evidence for each intervention and made recommendations using GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) and the Evidence Alert Traffic Light approaches. From a total of 955 citations identified 33 unique studies met our inclusion criteria. The 33 studies included 41 interventions, measuring 22,835 participants, across 207 RCTs and 1 population register study. Of the 41 interventions, 14 were postural control interventions to improve movement; 11 were tone management interventions to improve movement or prevent deformity; 2 were postural management interventions to support upright posture; and 14 were postural management interventions to prevent deformity. Several postural control interventions are effective for improving movement, and several postural management interventions may prevent deformity, with hip surveillance having the best evidence. [ABSTRACT FROM AUTHOR]

This article explores the role of US federal policy in modernizing public health agency case investigation and contact tracing capabilities. It emphasizes the importance of interoperable surveillance systems that facilitate the exchange of accurate and timely data between healthcare providers and public health agencies. The article acknowledges the challenges faced by public health agencies in collecting and managing data for case investigation and contact tracing, including the need for adaptable data systems and the omission of critical data elements. It examines various federal policies and initiatives aimed at improving data exchange and surveillance capabilities, such as the Pandemic and All-Hazards Preparedness Act, the 21st Century Cures Act, the Data Modernization Initiative, and the Public Health Data Systems Task Force. The article highlights the significance of certification in enhancing data quality and completeness, as well as addressing cybersecurity and privacy concerns. It underscores the necessity of developing systems and procedures that enable secure and rapid sharing of public health data, particularly in the context of biodefense. The article also emphasizes the need for policy changes to enhance interoperability and the collection, management, and analysis of data for public health agencies. It suggests that Congress should reauthorize and strengthen the Public Health Emergency Preparedness and Response Act (PAHPA) to ensure the Department of Health and Human Services (HHS) is accountable for implementing interoperable surveillance system capabilities. Additionally, the article recommends adequate funding to support public health agencies in improving surveillance system interoperability and participating in data exchange networks. It proposes that federal agencies should collaborate with the private [Extracted from the article]

Background Hospital- onset bacteraemia and fungaemia (HOB) is being explored as a surveillance and quality metric. The objectives of the current study were to determine sources and preventability of HOB in hospitalised patients in the USA and to identify factors associated with perceived preventability. Methods We conducted a cross- sectional study of HOB events at 10 academic and three community hospitals using structured chart review. HOB was defined as a blood culture on or after hospital day 4 with growth of one or more bacterial or fungal organisms. HOB events were stratified by commensal and non- commensal organisms. Medical resident physicians, infectious disease fellows or infection preventionists reviewed charts to determine HOB source, and infectious disease physicians with training in infection prevention/hospital epidemiology rated preventability from 1 to 6 (1=definitely preventable to 6=definitely not preventable) using a structured guide. Ratings of 1--3 were collectively considered 'potentially preventable' and 4--6 'potentially not preventable'. Results Among 1789 HOB events with noncommensal organisms, gastrointestinal (including neutropenic translocation) (35%) and endovascular (32%) were the most common sources. Overall, 636/1789 (36%) non- commensal and 238/320 (74%) commensal HOB events were rated potentially preventable. In logistic regression analysis among non- commensal HOB events, events attributed to intravascular catheter- related infection, indwelling urinary catheter- related infection and surgical site infection had higher odds of being rated preventable while events with neutropenia, immunosuppression, gastrointestinal sources, polymicrobial cultures and Discussion Factors identified as associated with higher or lower preventability should be used to guide inclusion, exclusion and risk adjustment for an HOB- related quality metric. [ABSTRACT FROM AUTHOR]

Legionella is the pathogen that causes Legionnaires' disease, an increasingly prevalent and sometimes fatal disease worldwide. In 2021, 97% of cases in Europe were caused by Legionella pneumophila. We present a mathematical model that can be used by public health officials to assess the effectiveness and efficiency of different Legionella monitoring and control strategies to inform government requirements to prevent community-acquired Legionnaires' disease in non-hospital buildings. This simulation model was built using comprehensive data from multiple scientific and field-based sources. It is a tool for estimating the relative economic and human costs of monitoring and control efforts targeting either L. pneumophila or Legionella species and was designed to analyze the potential application of each approach to specific building classes across Italy. The model results consistently showed that targeting L. pneumophila is not only sufficient but preferable in optimizing total cost (direct and economic) for similar human health benefits, even when stress-tested with extreme inputs. This cost–benefit analytical tool allows the user to run different real-life scenarios with a broad range of epidemiological and prevalence assumptions across different geographies in Italy. With appropriate modifications, this tool can be localized and applied to other countries, states, or provinces. [ABSTRACT FROM AUTHOR]

In this editorial accompanying manuscript the by Klatte and colleagues, Drs Singh, and Nipp review the data behind universal germline testing in pancreatic adenocarcinoma, and review possible reasons for and solutions continued inadequate rates of germline testing in our community. Making germline testing for all patients with pancreatic adenocarcinoma is critical and will require cross-disciplinary collaboration and innovation. [ABSTRACT FROM AUTHOR]

Objectives: Parkinson disease (PD) is the third leading cause of mortality among middle‐aged and older individuals in China. This study aimed to explore the trends and distribution features of PD mortality in China from 2013 to 2021 and make predictions for the next few decades. Methods: Relevant data were obtained from the Chinese Center for Disease Control and Prevention Disease Surveillance Point system. The joinpoint regression model was used to evaluate trends. The R software was used to predict future trends. Results: Age‐standardized mortality rate (ASMR) of PD increased from 0.59 per 100,000 individuals to 1.22 per 100,000 individuals from 2013 to 2021, with an average annual percent change (AAPC) of 9.50 (95% CI: 8.24–10.78). The all‐age ASMR of PD were higher in male individuals than in female individuals, and ASMR increased with age. The number of deaths and ASMR increased gradually from west to east and from rural to urban areas. Furthermore, ASMR is expected to increase to 2.66 per 100,000 individuals by 2040. Conclusions: The heightened focus on the ASMR of PD among male individuals, urban areas, eastern China, and individuals aged ≥85 years has become a key determinant in further decreasing mortality, thereby exhibiting novel challenges to effective strategies for disease prevention and control. [ABSTRACT FROM AUTHOR]

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Tobacco surveillance in the United States is robust but cannot be quickly modified to capture newly identified tobacco products or behaviors. We present an example of a rapidly deployed nonprobability survey using social media recruitment that collected data on rapidly changing tobacco use behaviors. We recruited 15- to 17-year old current vapers from NY, USA, using targeted social media advertisements to complete the New York Adolescent Vaping Survey (NY AVS), which asked about vaping behaviors not addressed in existing probability surveillance surveys. We used the New York Youth Risk Behavior Survey (NY YRBS) to apply calibration weights to ensure that the distribution of the demographic characteristics accurately reflected the population distribution. We found systematic differences in demographic variable distributions between the probability-based NY YRBS and the convenience sample of the NY AVS that were reconciled in the weighting calibration. We found no statistically significant differences between the NY YRBS and NY AVS estimates after calibration for two outcome variables of interest. Recruiting a sample of adolescents using social media advertising to conduct a rapid survey on vaping provided valuable data that complemented traditional surveillance surveys; this approach could be used to fill future knowledge gaps in youth tobacco surveillance. [ABSTRACT FROM AUTHOR]

Whole genome sequencing (WGS) has become a vital tool in clinical microbiology, playing an important role in outbreak investigations, molecular surveillance, and identification of bacterial species, resistance mechanisms and virulence factors. However, the complexity of WGS data presents challenges in interpretation and reporting, requiring tailored strategies to enhance efficiency and impact. This study explores the diverse needs of key stakeholders in healthcare, including clinical management, laboratory work, public surveillance and epidemiology, infection prevention and control, and academic research, regarding WGS-based reporting of clinically relevant bacterial species. In order to determine preferences regarding WGS reports, human-centered design approach was employed, involving an online survey and a subsequent workshop with stakeholders. The survey gathered responses from 64 participants representing the above mentioned healthcare sectors across geographical regions. Key findings include the identification of barriers related to data accessibility, integration with patient records, and the complexity of interpreting WGS results. As the participants designed their ideal report using nine pre-defined sections of a typical WGS report, differences in needs regarding report structure and content across stakeholders became evident. The workshop discussions further highlighted the need to feature critical findings and quality metrics prominently in reports, as well as the demand for flexible report designs. Commonalities were observed across stakeholder-specific reporting templates, such as the uniform ranking of certain report sections, but preferences regarding the depth of content within these sections varied. Using these findings, we suggest stakeholder-specific structures which should be considered when designing customized reporting templates. In conclusion, this study underscores the importance of tailoring WGS-based reports of clinically relevant bacteria to meet the distinct needs of diverse healthcare stakeholders. The evolving landscape of digital reporting increases the opportunities with respect to WGS reporting and its utility in managing infectious diseases and public health surveillance. [ABSTRACT FROM AUTHOR]

Purpose: We aim to examine if respondent-driven sampling (RDS) is a feasible and efficient method to recruit Black and Latina/Hispanic transgender women into HIV research. Methods: As part of the National HIV Behavioral Surveillance Study among transgender women in New York City in 2019, RDS was implemented with a focus on recruiting Black and Latina/Hispanic transgender women. We identified factors independently associated with (1) peer recruitment and (2) presenting to the study with a photo coupon. Results: A total of 269 transgender women were enrolled, 94% of whom were Black or Latina/Hispanic. In terms of peer recruitment, 47% recruited at least one eligible peer. Compared with those who were aged 18–29 years, those aged 30–39 years (adjusted prevalence ratio [aPR]: 2.04; 95% confidence interval [CI]: 1.35–3.07) and those aged 50 years or older (aPR: 1.97; 95% CI: 1.32–2.94) were more likely to recruit an eligible peer. Peer recruitment was also associated with utilizing HIV prevention services in the past 12 months (aPR: 1.62; 95% CI: 1.18–2.23). We did not find any differences in presenting the study with a photo recruitment coupon versus a physical recruitment coupon. Conclusion: RDS was feasible and efficient in recruiting Black and Latina/Hispanic transgender women. Providing gender-affirming environments as well as allowing peer recruitment through photo coupons may have facilitated peer recruitment and study participation. Our findings regarding factors associated with peer recruitment could aid in future study design and may help in addressing the lack of HIV research among Black and Latina/Hispanic transgender women. [ABSTRACT FROM AUTHOR]

This review article will present a comprehensive examination of the use of modeling, spatial analysis, and geographic information systems (GIS) in the surveillance of viruses in wastewater. With the advent of global health challenges like the COVID-19 pandemic, wastewater surveillance has emerged as a crucial tool for the early detection and management of viral outbreaks. This review will explore the application of various modeling techniques that enable the prediction and understanding of virus concentrations and spread patterns in wastewater systems. It highlights the role of spatial analysis in mapping the geographic distribution of viral loads, providing insights into the dynamics of virus transmission within communities. The integration of GIS in wastewater surveillance will be explored, emphasizing the utility of such systems in visualizing data, enhancing sampling site selection, and ensuring equitable monitoring across diverse populations. The review will also discuss the innovative combination of GIS with remote sensing data and predictive modeling, offering a multi-faceted approach to understand virus spread. Challenges such as data quality, privacy concerns, and the necessity for interdisciplinary collaboration will be addressed. This review concludes by underscoring the transformative potential of these analytical tools in public health, advocating for continued research and innovation to strengthen preparedness and response strategies for future viral threats. This article aims to provide a foundational understanding for researchers and public health officials, fostering advancements in the field of wastewater-based epidemiology. [ABSTRACT FROM AUTHOR]

The vast array of omics data in microbiology presents significant opportunities for studying bacterial pathogenesis and creating computational tools for predicting pathogenic potential. However, the field lacks a comprehensive, curated resource that catalogs bacterial strains and their ability to cause human infections. Current methods for identifying pathogenicity determinants often introduce biases and miss critical aspects of bacterial pathogenesis. In response to this gap, we introduce BacSPaD (Bacterial Strains' Pathogenicity Database), a thoroughly curated database focusing on pathogenicity annotations for a wide range of high-quality, complete bacterial genomes. Our rule-based annotation workflow combines metadata from trusted sources with automated keyword matching, extensive manual curation, and detailed literature review. Our analysis classified 5502 genomes as pathogenic to humans (HP) and 490 as non-pathogenic to humans (NHP), encompassing 532 species, 193 genera, and 96 families. Statistical analysis demonstrated a significant but moderate correlation between virulence factors and HP classification, highlighting the complexity of bacterial pathogenicity and the need for ongoing research. This resource is poised to enhance our understanding of bacterial pathogenicity mechanisms and aid in the development of predictive models. To improve accessibility and provide key visualization statistics, we developed a user-friendly web interface. [ABSTRACT FROM AUTHOR]

Background: The Corona Virus Disease 2019 (COVID-19) pandemic overwhelmed health systems and disrupted the delivery of health services globally. Community Health Workers (CHWs) play a critical role in linking communities to health systems, supporting the prevention and control of diseases in many low- and middle-income countries. However, their roles, barriers, and facilitators in the response and control of the COVID-19 pandemic have not been well documented. We described the roles of CHWs in the COVID-19 response, including the barriers and facilitators. Methods: A cross-sectional study design was used to assess the COVID-19 response in the Democratic Republic of Congo (DRC), Nigeria, Senegal, and Uganda. This involved 110 key informant interviews with policymakers, health facility managers, district health managers, and CHWs to understand the role of CHWs in the COVID 19 response, selected purposively. The total sample size was based on information saturation in each of the countries. A document review on the COVID-19 response was also conducted. We searched Google, Google Scholar, and PubMed for published and grey literature. Data from the selected documents were extracted into a Google master matrix in MS Excel and analyzed thematically. Results: In COVID-19 Control, CHWs supported community-based surveillance, contact tracing, risk communication, community mobilization, and home-based care. To support the continuity of other non-COVID-19 services, the CHWs conducted community mobilization, sensitizations, outreaches, referrals, and patient follow-ups. CHWs were challenged by movement restrictions, especially in the initial stages of the lockdown, inadequate PPE, increased workload, low allowances, and motivation. CHW were facilitated by trainings, the development of guidelines, development partners' support/funding, and the provision of personal protective equipment (PPE) and tools. Conclusion: CHWs supported both the COVID-19 control and continuity of non-COVID-19 health care during the COVID-19 pandemic. CHWs are a critical resource that must be adequately supported to build resilient health systems. [ABSTRACT FROM AUTHOR]

Background: Studies have long documented the presence of malaria and typhoid fever in sub-Saharan Africa (SSA). However, studies on these diseases have primarily concentrated on rural settings, neglecting the potential impact on urban areas. This knowledge gap hinders effective surveillance and intervention strategies. To bridge this gap, this study investigated the prevalence of malaria and typhoid co-infections in an urban environment. Methods: This study, conducted at Lead City University Hospital in Ibadan, Nigeria (West Africa's largest metropolis), analysed medical records of over 3195 patients seen between April and June 2023. Descriptive statistics and chi-square tests were used to understand how these co-infections were distributed across different age and gender groups. Results: The prevalence of co-infection peaked in May (9.7%), followed by June (8.9%) and April (5.7%). Notably, children aged 6–12 years exhibited the highest co-infection rate (18.5%), while those under five had the lowest (6.3%). Gender analysis indicated a slight difference, with 8.8% of females and 7.1% of males co-infected. Malaria prevalence was highest at the beginning of the rainy season and significantly decreased over time. Conversely, typhoid fever displayed the opposite trend, increasing with the rainy season. Children under five years old were most susceptible to malaria, while typhoid fever predominantly affected adults over 25 years old, with prevalence decreasing significantly with age. Conclusion: This study sheds light on the previously overlooked risk of malaria and typhoid co-infections in urban settings. These findings highlight the need for enhanced surveillance and targeted public health interventions, particularly for vulnerable groups like young children during peak transmission seasons. [ABSTRACT FROM AUTHOR]

Aims: We aimed to develop an elaborative nomogram that predicts cancer-specific survival (CSS) in American and Chinese octogenarians treated with radical resection for CRC. Methods: The patient data of newly diagnosed patients aged 80 years or older who underwent radical resection for CRC from 2010 to 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database and then randomly divided into a training cohort and a validation cohort. The patients collected from our hospital were defined as the external validation cohort. Univariate and multivariate Cox regression was used to select independent predictive factors for the construction of a nomogram to predict 1-, 2- and 3-year CSS. Results: The multivariate Cox regression model identified age, T stage, N stage, perineural invasion, chemotherapy, tumour deposits, carcinoembryonic antigen level, number of lymph node metastases, and number of solid organ metastases as independent predictors of survival. The C-index of the nomogram for 1-, 2- and 3-year CSS was 0.758, 0.762, and 0.727, respectively, demonstrating significant clinical value and substantial reliability compared to the TNM stage. The calibration curve and area under the curve also indicated considerable predictive accuracy. In addition, decision curve analysis demonstrated desirable net benefits in clinical application. Conclusion: We constructed a nomogram for predicting the CSS of individual octogenarian patients with CRC who underwent radical resection. The nomogram performed better than the TNM staging system in this particular population and could guide clinicians in clinical follow-up and individual therapeutic plan formulation. Highlights: This study explored the exclusive characteristics of octogenarians treated with radical resection for colorectal cancer. This study is the first to develop a nomogram for predicting the cancer-specific survival of individual octogenarian patients after radical resection for colorectal cancer with the substantial reliability (C-index: 0.758 compared to the AJCC pathological staging system (C-index: 0.713). Internal validation of this nomogram in a cohort of American patients (N = 1644) and external validation in a cohort of Chinese patients (N = 368) confirmed its accuracy. [ABSTRACT FROM AUTHOR]

In an era where air pollution poses a significant threat to both the environment and public health, we present a network-based approach to unravel the dynamics of extreme pollution events. Leveraging data from 741 monitoring stations in the contiguous United States, we have created dynamic networks using time-lagged correlations of hourly particulate matter (PM2.5) data. The established spatial correlation networks reveal significant PM2.5 anomalies during the 2020 and 2021 wildfire seasons, demonstrating the approach's sensitivity to detecting regional pollution phenomena. The methodology also provides insights into smoke transport and network response, highlighting the persistence of air quality issues beyond visible smoke periods. Additionally, we explored meteorological variables' impacts on network connectivity. This study enhances understanding of spatiotemporal pollution patterns, positioning spatial correlation networks as valuable tools for environmental monitoring and public health surveillance. [ABSTRACT FROM AUTHOR]

Syndromic surveillance is a type of public health surveillance that utilizes nonspecific indicators or symptoms associated with a particular disease or condition to detect and track disease outbreaks early. However, data completeness has been a significant challenge for syndromic surveillance systems in many countries. Incomplete data may make it difficult to accurately identify anomalies or trends in surveillance data. In this study, a new disease mapping method based on a high‐accuracy, low‐rank tensor completion (HaLRTC) algorithm is proposed to estimate the quarterly positivity rate of the human influenza virus (IFV) based on highly insufficient 2010–2015 respiratory syndromic surveillance data from the subtropical monsoon region of China. The HaLRTC algorithm is a spatiotemporal interpolation method applied to fill in missing or incomplete data using a low‐rank tensor structure. The results show that the accuracy (R2 = 0.880, RMSE = 0.037) of the proposed method is much higher than that of three traditional disease mapping methods: Cokriging, hierarchical Bayesian, and sandwich estimation methods. This study provides a new disease mapping approach to improve the quality and completeness of data in syndrome surveillance or other familiar systems with a large proportion of missing data. [ABSTRACT FROM AUTHOR]

Simple Summary: Imaging surveillance of patients with high-risk melanoma makes intuitive sense, but supporting data are limited. As a result, guidelines are variable. Future improvements in imaging and the arrival of effective treatments for high-risk melanoma will likely clarify and expand the role of imaging in such patients. The most recent (eighth) edition of the American Joint Committee on Cancer (AJCC) staging system divides invasive cutaneous melanoma into two broad groups: "low-risk" (stage IA–IIA) and "high-risk" (stage IIB–IV). While surveillance imaging for high-risk melanoma patients makes intuitive sense, supporting data are limited in that they are mostly respective and used varying methods, schedules, and endpoints. As a result, there is a lack of uniformity across different dermatologic and oncologic organizations regarding recommendations for follow-up, especially regarding imaging. That said, the bulk of retrospective and prospective data support imaging follow-up for high-risk patients. Currently, it seems that either positron emission tomography (PET) or whole-body computerized tomography (CT) are reasonable options for follow-up, with brain magnetic resonance imaging (MRI) preferred for the detection of brain metastases in patients who can undergo it. The current era of effective systemic therapies (ESTs), which can improve disease-free survival (DFS) and overall survival (OS) beyond lead-time bias, has emphasized the role of imaging in detecting various patterns of EST response and treatment relapse, as well as the importance of radiologic tumor burden. [ABSTRACT FROM AUTHOR]

Simple Summary: About 5–10% of breast cancers are related to heredity. Very often, affected individuals will carry only a single mutation defect in any of the hereditary breast and ovarian cancer syndrome (HBCO)-related genes. Breast cancer patients who are double heterozygous (DH) for different HBCO-related genes are rare. In this study, we provide real-world data for the Chinese population based on our high-risk referral patients from the Hong Kong Hereditary Breast Cancer Family Registry. DH germline mutations were identified in nine patients (0.25%) and associated with a higher prevalence of bilateral breast cancers in the Chinese population compared to other populations. A more stringent surveillance program and possibly a more aggressive treatment plan for all DH families could be tailored to specific family needs in the local area. Double pathogenic mutations occurring in an individual are considered a rare event. The introduction of a multiple-gene panel at Hong Kong Hereditary Breast Cancer Family Registry has allowed the identification of pathogenic variants in multiple genes, providing more information on clinical management and surveillance to the proband and their family members. Breast cancer patients who are double heterozygous (DH) for different hereditary breast and ovarian cancer syndrome (HBCO)-related genes were identified from a cohort of 3649 Chinese patients. Nine patients (0.25%) were observed to have germline DH mutations in ATM, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, MSH6, PALB2, and TP53. Three probands were diagnosed with unilateral breast cancer, two patients were diagnosed with bilateral breast cancer, and four patients had multiple primary cancers. The median age for breast cancer diagnosis was an early age of 36 years. Chinese DH carriers did not show worse phenotypes or have a significantly downhill clinical presentation. However, seven out of nine (77.8%) of our DH carriers harbored a BRCA1 mutation, and four of them (44.4%) developed bilateral breast cancer, suggesting Chinese DH individuals may have a higher chance of having bilateral breast cancer than other populations (p = 0.0237). [ABSTRACT FROM AUTHOR]

Background Cholera is a public health priority in Ethiopia. The Ethiopian National Cholera Plan elaborates a multi-year scheme of oral cholera vaccine (OCV) use. Aligned with this, a preemptive OCV campaign was conducted under our Ethiopia Cholera Control and Prevention project. Here, we present the OCV vaccination outcomes. Method Cholera high-priority hotspots in the Oromia Region, Shashemene Town (ST) and Shashemene Woreda (SW), were selected. Four kebelles (Abosto, Alelu, Arada, and Awasho) in ST and 4 clusters (Faji Gole, Harabate, Toga, and Chabi) in SW were study sites with OCV areas nested within. A total of 40 000 and 60 000 people in ST and SW, respectively, were targeted for a 2-dose OCV (Euvichol-Plus) campaign in 11–15 May (first round [R1]) and 27–31 May (second round [R2]) 2022. Daily administrative OCV coverage and a coverage survey in 277 randomly selected households were conducted. Results The administrative OCV coverage was high: 102.0% for R1 and 100.5% for R2 in ST and 99.1% (R1) and 100.0% (R1) in SW. The coverage survey showed 78.0% (95% confidence interval [CI]: 73.1–82.9) of household members with 2-dose OCV and 16.8% (95% CI: 12.4–21.3) with no OCV in ST; and 83.1% (95% CI: 79.6–86.5) with 2-dose OCV and 11.8% (95% CI: 8.8–14.8) with no OCV in SW. The 2-dose coverages in 1–4-, 5–14-, and ≥15-year age groups were 88.3% (95% CI: 70.6–96.1), 88.9% (95% CI: 82.1–95.7), and 71.3% (95% CI: 64.2–78.3), respectively, in ST and 78.2% (95% CI: 68.8–87.7), 91.0% (95% CI: 86.6–95.3), and 78.7% (95% CI: 73.2–84.1) in SW. Conclusions High 2-dose OCV coverage was achieved. Cholera surveillance is needed to assess the vaccine impact and effectiveness. [ABSTRACT FROM AUTHOR]

Background The Ethiopian government has developed the multisectoral cholera elimination plan (NCP) with an aim of reducing cholera incidence and case fatality rate (CFR). To better understand and monitor the progress of this plan, a comprehensive review of national cholera epidemiology is needed. Methods Reported data on cholera/acute watery diarrhea (AWD) cases in the past 20 years were extracted from the Ethiopian Public Health Institute and World Health Organization databases. Descriptive statistics, Pearson χ2, and logistic regression analyses were conducted. Results From January 2001 to November 2023, a total of 215 205 cholera/AWD cases, 2355 deaths with a cumulative CFR of 1.10% (95% confidence interval [CI], 1.092–1.095), and a mean annual incidence rate of 8.9/100 000 (95% CI, 6.5–11.3) were reported. Two major upsurges of cholera epidemics were found in the last two decades with mean attack rate (AR) of 20.57/100 000 in 2006–2010 and 14.83/100 000 in 2016–2020. Another resurgence of outbreaks occured in 2021–2023 (mean AR, 8.63/100 000). In 2015–2023, 54.0% (53 990/99 945) of cases were aged 15–44 years. National cholera CFR (3.13% [95% CI: 2.1–4.5]) was the highest in 2022. The 2015–2023 cumulative cholera CFR was different across regions: Benishangul Gumuz (6.07%), Gambela (1.89%), Sidama (1.42%), Southern Nation, Nationalities, and Peoples' (1.34%), Oromia (1.10%), and Amhara (1.09%). Cholera/AWD patients in older adults (≥45 years), severe dehydration, peak rainy season (June–August), and outpatients were associated with higher risk of death. Conclusions Cholera has been a public health problem in Ethiopia with case fatalities still above the global target. Case management needs to be improved particularly in outpatients and older populations. Outbreak preparedness should be rolled out well in advance of the typical rainy seasons. Significant investments are essential to advance the cholera surveillance system at healthcare setting and community level. Underlying factors of cholera deaths per areas should be further investigated to guide appropriate interventions to meet the NCP target by 2028. [ABSTRACT FROM AUTHOR]

Cholera remains a significant public health concern in Ethiopia. More than 15.9 million Ethiopians, constituting 15% of the total population, live in areas with a history of recurrent cholera outbreaks. The last 9 years of national cholera surveillance data show the country has been experiencing cholera outbreaks every year. The current cholera outbreak, starting in August 2022, has affected the entire country, with 841 reported cases and a 3.13% case fatality rate (CFR) in 2022, and >30 000 cases with nearly a 1.4% CFR in 2023. In line with "Ending Cholera—A Global Roadmap to 2030," the government of Ethiopia is committed to eliminate cholera in the country and has prepared its "National Cholera Elimination Plan (NCP): 2022–2028" with aims to achieve zero local transmission in cholera hotspot areas by 2028 and 90% fatality reduction from the recent (2020–2022) average of 1.8% CFR. The plan is multisectoral, has a clear coordination platform, contains all interventions with in-depth situational analysis, is concordant with existing plans and strategies, and is cascaded at the regional level and implemented with existing government and public structures. Nationwide, total 118 cholera hotspot woredas (districts) were identified, and a comprehensive situation analysis of the existing cholera outbreak response capacity was assessed. This multisectoral and multiyear NCP has forecasted around US$404 million budget estimates with >90% allocated to improving the country's water, sanitation, and hygiene (US$222 million; 55% of total NCP budget) and case management (US$149 million; 37%). The cholera vaccination strategy included in the NCP exhibited a 5-year oral cholera vaccine (OCV) introduction plan with 2 doses (30 604 889 doses) and single dose (3 031 266 doses) in selected cholera hotspot areas. However, its implementation is challenged due to a lack of financial support, inability to get the requested vaccine for targeted hotspot woredas (due to the current shortage of doses in the OCV global stockpile), recurrent cholera outbreaks, and high humanitarian needs in the country. It is recommended to have a sustainable financial mechanism to support implementation, follow the requested vaccine doses, and reorganize the planned coordination platform to foster the implementation. [ABSTRACT FROM AUTHOR]

Background Protein-based vaccines for coronavirus disease 2019 (COVID-19) provide a traditional vaccine platform with long-lasting protection for non–severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogens and may complement messenger RNA vaccines as a booster dose. While NVX-CoV2373 showed substantial early efficacy, the durability of protection has not been delineated. Methods The PREVENT-19 vaccine trial used a blinded crossover design; the original placebo arm received NVX-CoV2373 after efficacy was established. Using novel statistical methods that integrate surveillance data of circulating strains with post-crossover cases, we estimated placebo-controlled vaccine efficacy and durability of NVX-CoV2373 against both pre-Delta and Delta strains of SARS-CoV-2. Results Vaccine efficacy against pre-Delta strains of COVID-19 was 89% (95% CI, 75–95%) and 87% (72–94%) at 0 and 90 days after 2 doses of NVX-CoV2373, respectively, with no evidence of waning (P =.93). Vaccine efficacy against the Delta strain was 88% (71–95%), 82% (56–92%), and 77% (44–90%) at 40, 120, and 180 days, respectively, with evidence of waning (P <.01). In sensitivity analyses, the estimated Delta vaccine efficacy at 120 days ranged from 66% (15–86%) to 89% (74–95%) per various assumptions of the surveillance data. Conclusions NVX-CoV2373 has high initial efficacy against pre-Delta and Delta strains of COVID-19 with little evidence of waning for pre-Delta strains through 90 days and moderate waning against Delta strains over 180 days. [ABSTRACT FROM AUTHOR]

Developing and implementing an epidemiological surveillance plan was necessary during the COVID-19 pandemic to ensure safe dental practice. This was due to the high risk faced by this occupational group during the COVID-19 pandemic. This study aimed to determine the factors associated with COVID-19 diagnosis in a Peruvian dental school's integrated teaching and care service. A cross-sectional study was conducted with a population made up of the records of students, teachers, and administrative personnel in a COVID-19 epidemiological surveillance plan of a dental school during the years 2021 to 2022. The year 2022 was positively associated with a positive diagnosis of COVID-19 (aPR: 1.51; 95% CI: 1.10–2.07; p = 0.010) and not having had contact with a patient with COVID-19 was negatively associated with being diagnosed with that disease (aPR: 0.20; 95% CI: 0.14–0.27; p < 0.001). In conclusion, 2022 was positively associated with having a positive COVID-19 diagnosis. In addition, not having had contact with a COVID-19 patient was negatively associated with the disease diagnosis and with the development of moderate to severe COVID-19. [ABSTRACT FROM AUTHOR]

Background: Early childhood caries (ECC) is a major global health issue affecting millions of children. Mitigating this problem requires up-to-date information from reliable surveillance systems. This enables evidence-based decision-making to devise oral health policies. The World Health Organization (WHO) advocates the adoption of mobile technologies in oral disease surveillance because of their efficiency and ease of application. The study describes developing an electronic, oral health surveillance system (EOHSS) for preschoolers in Egypt, using the District Health Information System (DHIS2) open-source platform along with its Android App, and assesses its feasibility in data acquisition. Methods: The DHIS2 Server was configured for the DHIS2 Tracker Android Capture App to allow individual-level data entry. The EOHSS indicators were selected in line with the WHO Action Plan 2030. Two modalities for the EOHSS were developed based on clinical data capture: face-to-face and tele/asynchronous. Eight dentists in the pilot team collected 214 events using modality-specific electronic devices. The pilot's team's feedback was obtained regarding the EOHSS's feasibility in collecting data, and a time-motion study was conducted to assess workflow over two weeks. Independent t-test and Statistical Process Control techniques were used for data analysis. Results: The pilot team reported positive feedback on the structure of the EOHSS. Workflow adaptations were made to prioritize surveillance tasks by collecting data from caregivers before acquiring clinical data from children to improve work efficiency. A shorter data capture time was required during face-to-face modality (4.2 ± 0.7 min) compared to telemodality (5.1 ± 0.9 min), p < 0.001). The acquisition of clinical data accounted for 16.9% and 21.1% of the time needed for both modalities, respectively. The time required by the face-to-face modality showed random variation, and the tele-modality tasks showed a reduced time trend to perform tasks. Conclusions: The DHIS2 provides a feasible solution for developing electronic, oral health surveillance systems. The one-minute difference in data capture time in telemodality compared to face-to-face indicates that despite being slightly more time-consuming, telemodality still shows promise for remote oral health assessments that is particularly valuable in areas with limited access to dental professionals, potentially expanding the reach of oral health screening programs. [ABSTRACT FROM AUTHOR]

Estimating the COVID‐19 infection fatality rate, inferring the latent incidence and predicting the future epidemic evolution are critical to public health surveillance, but often challenging due to limited data availability or quality. Recently, a Bayesian framework combining time series deconvolution of deaths with a parametric Susceptible–Infectious–Recovered (SIR) model was proposed by Irons and Raftery, 2021. We assess the parameter identifiability of the model using the profile likelihood approach and simulations, when only the time series of deaths and seroprevalence survey data are available. The robustness of the model to the more complex but also more realistic Susceptible–Exposed–Infectious–Recovered (SEIR)‐based epidemics is evaluated through simulations; the influence of potential biases in the serosurveys on the inference is also investigated. We use a stationary first‐order autoregressive prior to account for the variability of transmission rate over time. The results suggest that the model is relatively robust to SEIR‐based epidemics, especially when the reproductive number is low, given sufficient information from serosurveys or priors. However, the lack of parameter identifiability under limited data availability cannot be neglected. We apply the model to infer the COVID‐19 infections in Ontario and Quebec, Canada during the Omicron era. [ABSTRACT FROM AUTHOR]

Background: Physical activity surveillance systems are important for public health monitoring but rely mostly on self-report measurement of physical activity. Integration of device-based measurements in such systems can improve population estimates, however this is still relatively uncommon in existing surveillance systems. This systematic review aims to create an overview of the methodology used in existing device-based national PA surveillance systems. Methods: Four literature databases (PubMed, Embase.com, SPORTDiscus and Web of Science) were searched, supplemented with backward tracking. Articles were included if they reported on population-based (inter)national surveillance systems measuring PA, sedentary time and/or adherence to PA guidelines. When available and in English, the methodological reports of the identified surveillance studies were also included for data extraction. Results: This systematic literature search followed the PRISMA guidelines and yielded 34 articles and an additional 18 methodological reports, reporting on 28 studies, which in turn reported on one or multiple waves of 15 different national and 1 international surveillance system. The included studies showed substantial variation between (waves of) systems in number of participants, response rates, population representativeness and recruitment. In contrast, the methods were similar on data reduction definitions (e.g. minimal number of valid days, non-wear time and necessary wear time for a valid day). Conclusions: The results of this review indicate that few countries use device-based PA measurement in their surveillance system. The employed methodology is diverse, which hampers comparability between countries and calls for more standardized methods as well as standardized reporting on these methods. The results from this review can help inform the integration of device-based PA measurement in (inter)national surveillance systems. [ABSTRACT FROM AUTHOR]

The objective of our study was to reanalyse the Ethiopia STEPwise approach to Surveillance Noncommunicable Disease Risk Factors survey (NCD STEPS), using causal path diagrams constructed using expert subject matter knowledge in conjunction with graphical model theory to map the underlying causal network of modifiable factors associated with prediabetes/diabetes and hypertension. We used data from the 2015 Ethiopia NCD STEPS representative cross‐sectional survey (males; n = 3977 and females; n = 5823 aged 15–69 years) and performed directed acyclic graph‐informed logistic regression analyses. In both sexes, a 1‐unit higher in body mass index (BMI) and waist circumference (WC) were positively associated with prediabetes/diabetes (BMI: males: adjusted odds ratio [aOR]: 1.07 [95% confidence interval: 1.0, 1.1], females aOR: 1.03 [1.0, 1.1]; WC: males: aOR: 1.1 [0.9, 1.2], females: aOR: 1.2 [1.1, 1.3]) and hypertension (BMI: males: aOR: 1.2 [1.1, 1.2], females aOR: 1.1 [1.0, 1.1]; WC: males: aOR: 1.6 [1.4, 1.8], females: aOR: 1.3 [1.2, 1.5]). Although residing in urban settings was associated with higher odds of hypertension in both males (aOR: 1.79 [1.49, 2.16]) and females (aOR: 1.70 [1.49, 1.95]), it was only associated with prediabetes/diabetes in males (aOR: 1.56 [1.25, 1.96]). Males and females in pastoralist areas had lower odds of prediabetes/diabetes compared with their agrarian counterparts (males: aOR: 0.27 [0.14, 0.52], females: aOR: 0.31 [0.16, 0.58]). Physical activity was associated with lower odds of prediabetes/diabetes among females (aOR: 0.75 [0.58, 0.97]). Other diet‐related modifiable factors such as consumption of fruit and vegetable, alcohol or salt were not associated with either prediabetes/diabetes or hypertension. Our findings highlight the need to implement interventions that prevent overweight/obesity and nutrition‐related NCDs, particularly in urban areas. Key messages: Body mass index and waist circumference were positively associated with hypertension and prediabetes/diabetes for both sexes. Residing in urban settings was associated with increased odds of hypertension in both sexes, and with prediabetes/diabetes in males. Physical activity was associated with lower odds of prediabetes/diabetes among women.Diet‐related factors (consumption of fruit and vegetables, alcohol, and salt) were not associated with either hypertension or prediabetes/diabetes.There is a need for longitudinal, nationally representative dietary surveys, which enable the derivation of relevant indicators of the nutrition transition in Ethiopia. [ABSTRACT FROM AUTHOR]

Background Contact tracing is a public health intervention implemented in synergy with other preventive measures to curb epidemics, like the coronavirus pandemic. The development and use of digital devices have increased worldwide to enhance the contact tracing process. The aim of the study was to evaluate the effectiveness and impact of tracking coronavirus disease 2019 (COVID-19) patients using digital solutions. Methods Observational studies on digital contact tracing (DCT), published 2020–21, in English were identified through a systematic literature review performed on nine online databases. An ad hoc form was used for data extraction of relevant information. Quality assessment of the included studies was performed with validated tools. A qualitative synthesis of the findings is reported. Results Over 8000 records were identified and 37 were included in the study: 24 modelling and 13 population-based studies. DCT improved the identification of close contacts of COVID-19 cases and reduced the effective reproduction number of COVID-19-related infections and deaths by over 60%. It impacted positively on societal and economic costs, in terms of lockdowns and use of resources, including staffing. Privacy and security issues were reported in 27 studies. Conclusions DCT contributed to curbing the COVID-19 pandemic, especially with the high uptake rate of the devices and in combination with other public health measures, especially conventional contact tracing. The main barriers to the implementation of the devices are uptake rate, security and privacy issues. Public health digitalization and contact tracing are the keys to countries' emergency preparedness for future health crises. [ABSTRACT FROM AUTHOR]

The article proposes an international legal instrument to combat future zoonotic outbreaks. It discusses the need for interconnected and accessible veterinarian reporting, a globally shared zoonotic data and surveillance system, international partnerships involving veterinarians, zoonotic eradication programs, scientific cooperation, vaccination distribution and administration, local level surveillance and partnerships, outreach and education, and collaboration with the private sector.

Introduction: Grade 3 solitary fibrous tumor, previously known as anaplastic hemangiopericytoma, is a rare and highly malignant intracranial tumor with a limited understanding of its natural history and treatment outcomes. Methods: We conducted a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database spanning 2000–2019 to evaluate the clinical characteristics and treatment modalities that influence overall survival in this tumor entity. A cohort of 249 patients with intracranial grade 3 solitary fibrous tumors was identified. Univariate and multivariable Cox proportional hazard models were employed to determine significant prognostic factors for overall survival. Kaplan-Meier models were used to visualize survival curves, and a nomogram was constructed to predict survival probabilities at 6- and 12-month following diagnosis. Results: Our findings indicated that patient age (<65 years), localized or regional disease burden, surgical resection, and radiation therapy were significant predictors of better overall survival. Combination therapies showed improved survival, with surgery and radiation therapy having the most significant impact. However, chemotherapy alone or in combination did not demonstrate a significant survival benefit, likely due to the limited sample size. The nomogram provided personalized prognostic predictions based on significant clinical factors. Conclusions: These data emphasize the importance of surgical resection and radiation therapy in the management of grade 3 solitary fibrous tumors, supporting the use of combination therapies to improve overall survival in this rare and aggressive intracranial neoplasm. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study evaluated the impact of local treatment modalities in the management of large non-small cell lung cancer (NSCLC) tumors using a nationwide population-based dataset. MATERIAL AND METHODS: Patients with NSCLC tumors >7 cm that were cN0-1M0 in the Surveillance, Epidemiology, and End Results (SEER) registry from 2010 to 2015 were stratified by local management strategy (surgery, radiation therapy, no local treatment) and evaluated using Kaplan–Meier survival analyses, Cox proportional-hazard methods, and propensity-matched analysis. RESULTS: A total of 3156 patients were identified, of which 1580 (50.1%) underwent surgical resection, 920 (29.2%) received radiation only, 655 (20.7%) received no local treatment. Overall, the 5-year survival of patients undergoing surgical resection was 40.7%, compared to 14.7% and 5.3% for the radiation only and no local treatment groups, respectively (P < .001). Surgery with or without radiation continued to have an independent association with improved survival in multivariable analysis (HR 0.23, P < .0001). Other factors associated with improved survival included younger age, negative nodal disease, and chemotherapy use. In propensity-matched sub-analyses, 5-year survival remained significantly better after surgery alone compared to radiation alone (38.5% vs. 13.6%, P < .001), while survival after radiation alone was better than no local treatment, though both were largely poor (12.4% vs. 7.5%, P < .001). CONCLUSIONS: Survival of patients with large NSCLC managed non-surgically is very poor. Despite the significant long-term survival benefit with surgical intervention, nearly half of the study cohort did not undergo surgery. Patients and clinicians can use these results to estimate specific potential benefits when considering possible treatment strategies for large NSCLC tumors. [ABSTRACT FROM AUTHOR]

Summary The reliable and timely recognition of outbreaks is a key component of public health surveillance for foodborne diseases. Whole genome sequencing (WGS) offers high resolution typing of foodborne bacterial pathogens and facilitates the accurate detection of outbreaks. This detection relies on grouping WGS data into clusters at an appropriate genetic threshold. However, methods and tools for selecting and adjusting such thresholds according to the required resolution of surveillance and epidemiological context are lacking. Here we present DODGE (Dynamic Outbreak Detection for Genomic Epidemiology), an algorithm to dynamically select and compare these genetic thresholds. DODGE can analyse expanding datasets over time and clusters that are predicted to correspond to outbreaks (or "investigation clusters") can be named with established genomic nomenclature systems to facilitate integrated analysis across jurisdictions. DODGE was tested in two real-world Salmonella genomic surveillance datasets of different duration, 2 months from Australia and 9 years from the United Kingdom. In both cases only a minority of isolates were identified as investigation clusters. Two known outbreaks in the United Kingdom dataset were detected by DODGE and were recognized at an earlier timepoint than the outbreaks were reported. These findings demonstrated the potential of the DODGE approach to improve the effectiveness and timeliness of genomic surveillance for foodborne diseases and the effectiveness of the algorithm developed. Availability and implementation DODGE is freely available at https://github.com/LanLab/dodge and can easily be installed using Conda. [ABSTRACT FROM AUTHOR]

Traumatic arteriovenous fistula (AVF) is not a common disorder, and dermatological signs and heart failure caused by AVF are rarely reported. We present the case of a 55-year-old woman who was referred for congestive heart failure symptoms. Echocardiography revealed preserved left ventricular ejection fraction. Due to edema of the right leg with a long-standing leg ulcer and palpable femoral thrill, duplex ultrasonography was performed. It showed an AVF between the right superficial femoral artery (SFA) and the right femoral vein (FV). The patient recalled a 32-year-old gunshot injury that was not medically treated. After the diagnosis of AVF she was referred to a surgeon for an AVF ligation, with subsequent resolution of her symptoms. The differential diagnosis of leg ulcer with leg edema should include the possibility of AVF as a cause. [ABSTRACT FROM AUTHOR]

Background: No data exist at the population level on what tests are used to aid in the diagnosis of autism spectrum disorder in community practice. Objectives: To describe autism spectrum disorder testing practices to inform autism spectrum disorder identification efforts. Methods: Data are from the Autism and Developmental Disabilities Monitoring Network, a multi‐site surveillance system reporting prevalence estimates and characteristics of 8‐year‐old children with autism spectrum disorder. Percentages of children with autism spectrum disorder who received any autism spectrum disorder test or a 'gold standard' test were calculated by site, sex, race, median household income, and intellectual ability status. Risk ratios were calculated to compare group differences. Results: Of 5058 8‐year‐old children with autism spectrum disorder across 11 sites, 3236 (64.0%) had a record of any autism spectrum disorder test and 2136 (42.2%) had a 'gold standard' ADOS or ADI‐R test. Overall, 115 children (2.3%) had both the ADOS and ADI‐R in their records. Differences persisted across race, median household income, and intellectual ability status. Asian/Pacific Islander children had the highest percent receiving any ASD test (71.8%; other groups range: 57.4–66.0%) and White children had the highest percent receiving 'gold standard' tests (46.4%; other groups range: 35.6–43.2%). Children in low‐income neighbourhoods had a lower percent of any test (62.5%) and 'gold standard' tests (39.4%) compared to medium (70.2% and 47.5%, respectively) and high (69.6% and 46.8%, respectively) income neighbourhoods. Children with intellectual disability had a lower percent of any ASD test (81.7%) and 'gold standard' tests (52.6%) compared to children without intellectual disability (84.0% and 57.6%, respectively). Conclusions: Autism spectrum disorder testing practices vary widely by site and differ by race and presence of co‐occurring intellectual disability, suggesting opportunities to standardise and/or improve autism spectrum disorder identification practices. [ABSTRACT FROM AUTHOR]

Early observations that only a small proportion of U.S. adults were engaging in enough aerobic physical activity to provide substantial health benefit helped shape our public health messaging for physical activity. This messaging has consistently indicated that most adults should increase their activity levels. However, it has been difficult to accurately estimate the proportion of adults who engage in sufficient levels of aerobic activity in the population, with survey-based estimates ranging from 22% in 1994 to 54% in 2018 and widely differing estimates from device-based measures. Recent accelerometer-based studies of physical activity and mortality risk provide new evidence that at least 50% of U.S. adults engage in enough aerobic physical activity to be at low risk for premature mortality. We argue that this observation should lend greater confidence to our current survey-based surveillance estimates, which indicate that a large proportion of adults is physically active. This new insight may also provide clues that could further strengthen our public health messaging for physical activity by placing more emphasis on the maintenance of healthy activity levels throughout life and possibly by using descriptive social norms as an additional intervention element--while continuing current efforts to encourage the adoption of healthy activity levels for less active adults in the population. [ABSTRACT FROM AUTHOR]

Background: Robust surveillance of injury aetiology and epidemiology is recognised as fundamental for effective injury reduction and management programmes. However, while sex-specific differences in injury type and nature are noted in the literature, it is unclear if these are reflected in surveillance practices, and how the athlete is affected. Objective: Therefore, this study aimed to systematically review contact breast injuries (CBIs) among adult female athletes. Methods: The following databases were searched: PubMed, EMBASE, SPORTDiscus including MEDLINE, Web of Science and Scopus. The literature search was conducted in May 2023 and the search was limited to articles in the English and German language. Studies including female athletes, aged 18 years and above, in any sports (team or individual) at any level (amateur, semi-professional and professional), where an occurrence of CBI was documented were included. Studies were included irrespective of their investigated timeframes (e.g. the whole career, one or multiple seasons). Findings were categorised (e.g. sport, level of competition and investigated timeframe of the study) to enable possible comparisons. Case studies were excluded due to the non-generalisability of findings. Results: Of the six studies included, rugby codes (rugby union, rugby league and rugby sevens) had the highest occurrence rate (62.0%) of CBIs among eight different investigated sports (rugby codes 62.0%, softball 59.5%, Australian Football League (AFL) 51.0%, water polo 50.0%, soccer 46.7%, basketball 27.6–48.8%, volleyball 34.6%, boxing 0.0%). Between 25.6% and 62.0% of participants reported incurring a CBI and between 0.0% and 42.9% of CBIs were reported to a medical professional or support staff. The reported treatment rate for CBIs ranged between 0.0% and 2.1%, The main mechanisms for CBIs (where reported) were contact with another athlete (AFL 37.6%, rugby codes 56%) the ball (AFL 31.6%, rugby codes 25.5%) and the ground (AFL 6.6%, rugby codes 22%). Between 18.2% and 48% of the participants reported that CBIs negatively affected their performance. Risk factors increasing CBIs were positional differences, larger breast size and higher body mass index (BMI). In-season injury data collection and surveillance supported through education of both players and medical staff were identified to be of relevance for future CBI prevention. None of the studies reported incidence rate. Conclusion: Despite the frequent occurrence of CBIs among female athletes, reporting and treatment remains low. Awareness and education of all stakeholders are fundamental to ensuring better breast safety in female sport. Identifying the mechanics, severity and risk factors of CBIs through thorough injury surveillance must be a focus of further research. Registration: The study was preregistered on Open Science Framework (OSF). [ABSTRACT FROM AUTHOR]

Surveillance of health-related physical fitness can improve decision-making and intervention strategies promoting health for children and adolescents. However, no study has comprehensively analyzed surveillance/monitoring systems for physical fitness globally. This review sought to address this gap by identifying: (1) national-level surveillance/monitoring systems for physical fitness among children and adolescents globally, (2) the main barriers and challenges to implementing surveillance/monitoring systems, and (3) governmental actions related to existing surveillance/monitoring systems. We used a scoping review to search, obtain, group, summarize, and analyze available evidence. Our review involved three stages: (1) identification of surveillance systems through a systematic literature review, with complementary search of the grey literature (e.g., reference lists, Google Scholar, webpages, recommendations), (2) systematic consultation with relevant experts using a Delphi method to confirm/add systems and to gather and analyze information on the barriers and challenges to implementing systems, and (3) Web searches for public documents on government sites and surveillance/monitoring system pages, and direct internet searches to identify relevant governmental actions related to surveillance systems. A total of 15 fitness surveillance/monitoring systems met our inclusion criteria. Experts identified a lack of government support and funding, and the low priority of fitness on the public health agenda as the main barriers/challenges to implementation. Several governmental actions related to surveillance systems were identified, including policies, strategies, programs, and guidelines. We propose a Global Observatory of Physical Fitness to help address these issues. [ABSTRACT FROM AUTHOR]

Recent emerging zoonotic disease outbreaks, such as that of SARS-CoV-2, have demonstrated the need for wider companion animal disease surveillance. We tested 1000 dogs and cats belonging to employees of a US veterinary hospital network that were exposed to human COVID-19 cases in the household between 1 January 2020 and 10 March 2022 for SARS-CoV-2 and surveyed their owners about clinical signs and risk factors. The seropositivity was 33% for 747 dogs and 27% for 253 cats. Pet seropositivity correlated with the US human case rates over time, exhibiting peaks corresponding with the major COVID-19 surges. Antibodies persisted longer than previously documented (828 days in dogs; 650 days in cats). Increasing age and duration of proximity to infected people were associated with increased seropositivity in dogs but not cats. Cats were more likely to have clinical signs, but an association between seropositivity and the presence of clinical signs was not found in either species. [ABSTRACT FROM AUTHOR]

Contact tracing is essential to help monitor and control the spread of the highly contagious COVID-19 virus. Many universities across the United States have developed and implemented contact tracing programs during the COVID-19 pandemic. In this viewpoint article, we characterized and reflected on the unique challenges of contact tracing in college students based on our extensive experience at a large urban private university. Three challenges of contact tracing were identified, including 1) contact tracers' difficulty building trust with students, 2) students' unwillingness to disclose information due to fear of consequences, and 3) students acting carelessly and not following guidelines. We made recommendations to address these challenges to enhance the practice of contact tracing to protect the health of this young adult population. [ABSTRACT FROM AUTHOR]

Background: We evaluate the public health surveillance program, Screen, Test, and Protect (STP) designed to control and prevent COVID-19 at a large academic university in the United States. Methods: STP was established at the University of Florida in May 2020. This report details STP's full-time workforce, centralized database, and testing and vaccination programs. We evaluate the program's success in controlling COVID-19 during the 2020–2021 academic school year. Results: COVID-19 cases rose among the campus community in the first few weeks of campus reopening in Fall 2020. Test positivity levels returned to prefall semester levels within one month, however. A few additional, yet smaller, waves occurred during the 2020–2021 school year and were successfully controlled without any campus-wide closures. Conclusions: This program may serve as a framework for other institutions managing the ongoing COVID-19 crisis, in addition to setting the standard for programmatic management of future emerging infectious diseases at universities. [ABSTRACT FROM AUTHOR]

Objectives: Persons with disabilities (PWD) often experience risks associated with HIV/AIDS including unmet needs and overlooked stigmatization. This could be attributed to certain misconceptions such as PWDs are asexual, and cannot enjoy sexual pleasure, among others. Therefore, this paper sought to investigate the extent of disability inclusion in recent National Strategic Plans (NSPs) for HIV/AIDS in West African countries. Methods: This study was a policy review of NSPs in 13 African countries. Relevant indicators in the UN Convention on the Rights of Persons with Disabilities and the UNAIDS International Guidelines on HIV and Human Rights were used. Six indicators (identification of people living with disability (PLWD) as a key population, the inclusion of principles related to PWD within the NSPs on HIV/AIDS, protecting the rights of PWD, recognition of PWD as a vulnerable population at higher risk of HIV and in need of special protection, providing HIV-related support services for PWD and monitoring and evaluating the impact of HIV on PWD). Results: Findings from this study revealed that only 30% of West African countries recognized disability as an issue of concern. Also, 38.5% of these countries recognize the vulnerability of people with disabilities to HIV. However, only a few (7.6%) provided support in the context of special needs, monitoring, and surveillance specifically for persons with disabilities. Conclusion: Most of the West African NSPs are outdated and due for renewal. Therefore, it is necessary to integrate the needs of persons with disabilities within the context of HIV/AIDS in the NSPs. More importantly, support and services should also be prioritized among the vulnerable groups to optimize inclusion. [ABSTRACT FROM AUTHOR]