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Introduction: Dengue fever (DF) is a global health problem in tropical and subtropical regions across the globe. Pakistan has become one of the countries which are hit by its outbreaks for the past two decades with the first outbreak reported in 1994.It is a mosquito-borne infection which is transmitted to humans from the mosquito bite. Characteristics of dengue fever are thrombocytopenia, coagulopathy and increased capillary permeability. The disease spectrum ranges from mild fever to life threatening hemorrhagic shock syndrome; hemorrhagic manifestations are the most feared complications of the disease. Guidelines regarding fluid management in dengue fever have been established by Center for Disease Control (CDC) and local national bodies in Pakistan however comprehensive data regarding blood product usage is lacking. Understanding the rationale use of blood products can reduce burden on blood bank inventories as well as reduce unnecessary blood product exposure to the patients in dengue outbreak. Aims & Objectives: Assessment of compliance of physicians and transfusion provision authorities regarding blood products usage with local and international guidelines in managing dengue outbreak. Place and duration of study: This study was conducted at Chughtai Institute of Pathology, Lahore from September 2021 to November 2021. Material & Methods: It was a cross sectional study. Total 107 patients who were non-structural antigen1(NS1) positive confirmed dengue infection presented at Chughtai Blood Bank for request of any blood product were included in the study; individuals with existing cytopenia (known cases) unrelated to Dengue (NS1 antigen positive) were excluded. Data was recorded on a pre-designed Performa/questionnaire. Statistical analysis was performed using SPSS 23.0. Frequencies were calculated and expressed as percentages. Results: Mean Age of 107 patients was 53 years (±19.05) out of which 63(58.9%) were males and 44(41.1%) were females. Blood products requested were platelets in 93(86.9%) patients, platelets and fresh frozen plasma in 3(2.8%), platelets and whole blood in 9(8.4%) and whole blood in 2(1.9%) patients. Therapeutic platelet transfusions were done in 35(32.7%) patients and prophylactic platelet transfusions were done in 72(67.3%) patients. Conclusion: Lack of practicing evidence-based guidelines and inappropriate usage of blood products during dengue epidemic overburdens health care facilities and adds to the stress and panic. A well-coordinated centralized management system for dengue outbreak can play pivotal role in guiding rationale use of blood products.

Objectives: The Chinese government has greatly increased funding for disease control and prevention since the 2003 Severe Acute Respiration Syndrome crisis, but it is also concerned whether these increased resources have been used efficiently to improve public health services. We aimed to assess the efficiency of county-level Centers for Disease Control and Prevention (CDCs) of China and to identify strategies for optimising their performance.Methods: A total of 446 county-level CDCs were selected based on systematic sampling throughout China. The data envelopment analysis framework was used to calculate the efficiency score of sampled CDCs in 2010. The Charnes, Cooper and Rhodes (CCR) model was applied to calculate the overall and scale efficiency, and the Banker, Charnes and Cooper (BCC) model was used to assess technical efficiency. Models included three inputs and seven outputs. A projection analysis was conducted to identify the difference between projection value and actual value for inputs and outputs.Results: The average overall efficiency score of CDCs was 0.317, and the average technical efficiency score was 0.442 and 88.3% with decreasing returns to scale. Projection analysis indicated that all seven categories of outputs were underproduced. CDCs in the eastern region tended to perform better than CDCs in the middle and the western region.Conclusions: Most county-level CDCs in China were operated inefficiently. Emphasis should be put on increasing staff and general operating expenses through current governmental funding, upgrading healthcare providers' competencies and enhancing the standardisation of operational management, so that CDCs could utilise their resources more efficiently. [ABSTRACT FROM AUTHOR]

Background: Acquired immune deficiency syndrome (AIDS) is a serious worldwide public health problem and has become the focus of prevention and control in China, while the student population is the key population for AIDS prevention., Objective: The purpose of this study was to investigate the effects of cognitive behavioral therapy (CBT) on college students' AIDS-related cognitions, attitudes, and behaviors, and to find programmatic strategies for AIDS prevention in terms of changing college students' cognitions and behaviors., Methods: In a cluster randomized controlled trial, 233 undergraduate students were assigned to the CBT group (CBT-based intervention, n=92), the TAU group (treatment as usual, n=72), and the CON group (no intervention, n=59). AIDS-related knowledge, attitudes, and behaviors of participants were assessed at pre-intervention, post-intervention, and follow-up., Results: After one month of the study, AIDS-related knowledge, attitudes, and behaviors improved in both the TAU and CBT groups, while there were no significant changes in the CON group. The intervention effect was more significant and sustainable in the CBT group compared to the TAU group., Conclusions: The application of CBT in AIDS prevention among college students is feasible, acceptable, and effective. CBT can increase the level of knowledge about AIDS, improve AIDS-related attitudes, and increase willingness to use condoms. CBT is expected to replace traditional health education as an innovative tool for AIDS prevention because of its long-lasting and efficacious nature., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Highlights: [•] Immunogenicity of QIV was non-inferior versus TIV for shared strains in adults. [•] Immunogenicity of QIV was superior to TIV for the alternate-lineage B strain in adults. [•] Reactogenicity and safety of QIV consistent with seasonal influenza vaccine in adults. [Copyright &y& Elsevier]

Background: The present study aims to evaluate how the measures to contain the SARS-CoV-2 spreading affected the surgical site infections (SSIs) rate in patients who underwent nondeferrable breast cancer surgery (BCS)., Methods: This study is a retrospective analysis of prospectively collected data from a consecutive series of patients underwent nondeferrable BCS in a regional Italian Covid-free hub during two different period: March to April 2020 (pandemic cohort [PC]) and March till April 2019 (control cohort [CC]). SSIs were defined according to the criteria established by the Center for disease control and prevention (CDC) and additional treatment, serous discharge, erythema, purulent exudate, separation of deep tissues, isolation of bacteria, and stay (ASEPSIS) scoring systems., Results: One hundred ninety-nine patients were included in the present study: 100 and 99 patients who underwent nondeferrable BCS from March to April 2020 (PC) and from March to April 2019 (CC), respectively. The overall SSIs rate in this series was 9.1% according to CDC criteria and 6.5% according to ASEPSIS criteria. The SSIs incidence decreased during the pandemic period. Moreover, the SSIs rate according to ASEPSIS criteria was statistically lower in the PC than in the CC. We observed significant evidence of higher SSIs, both in terms of CDC and ASEPSIS score, in patients having undergone breast reconstruction compared with patients not undergoing immediate reconstruction., Conclusions: The restrictive measures issued during the lockdown period seemed to lower the SSIs rates in patients undergoing nondeferrable BCS., Competing Interests: The authors declare that they have no financial conflict of interest with regard to the content of this report.The authors declare that they have no conflicts of interest with regard to the content of this report., (Copyright © 2022 The Authors. Published on behalf of the Associazione Chirurghi Ospedalieri Italiani and Wolters Kluwer.)

This study aimed to better understand the current situation of risk assessment and identify the factors associated with competence of emergency responders in public health risk assessment. The participants were selected by a multi-stage, stratified cluster sampling method in Heilongjiang Centers for Disease Control and Prevention (CDC). The questionnaires that measured their perceptions on risk assessment competences were administered through the face-to-face survey. A final sample of 1889 staff was obtained. Of this sample, 78.6% of respondents rated their own risk assessment competences as "relatively low", contrasting with 21.4% rated as "relatively high". Most of the respondents (62.7%) did not participate in any risk assessment work. Only 13.7% and 42.7% of respondents reported participating in risk assessment training and were familiar with risk assessment tools. There existed statistical significance between risk assessment-related characteristics of respondents and their self-rated competences scores. Financial support from the government and administrative attention were regarded as the important factors contributing to risk assessment competences of CDC responders. Higher attention should be given to risk assessment training and enhancing the availability of surveillance data. Continuous efforts should be made to remove the financial and technical obstacles to improve the competences of risk assessment for public health emergency responders., Competing Interests: The authors declare no conflict of interest.