Search

Background: The Vi-diphtheria toxoid typhoid conjugate vaccine (Vi-DT) has shown promising results in preventing typhoid fever in children under 2 years of age. However, a thorough assessment of its safety and immunogenicity is required to inform vaccination strategies. This systematic review and metaanalysis aimed to determine the safety and immunogenicity of Vi-DT in children below 2 years. Methods: We systematically searched multiple databases, including PubMed, Web of Science, and Scopus, for relevant studies published up to September 2023. We included studies reporting on the safety and immunogenicity outcomes of Vi-DT compared to the control or Vi-tetanus toxoid conjugated vaccine (Vi-TT) in children below 2 years. We applied a random-effects model for meta-analysis using RevMan 5.4. We expressed the results as risk ratio (RR) with a 95% confidence interval (95%CI). Results: In this analysis, five studies were selected, encompassing 1,292 children under 2 years who received the Vi-DT vaccine. No significant difference in immediate reactions was observed within 30 min post-vaccination between Vi- DT and control groups (RR: 0.99 [95% CI: 0.19, 5.26]), nor between Vi-DT and Vi- TT groups. For solicited adverse events within 4 weeks, the VI-DT group showed no significant increase in adverse events compared to control (RR: 0.93 [95% CI: 0.78, 1.12]) or Vi-TT (RR: 0.86 [95% CI: 0.69, 1.07]). Similarly, within 7 days postvaccination, risk ratios indicated no significant differences in adverse events between the groups. The 4-week seroconversion rate was significantly higher in the Vi-DT group compared to the control (RR: 1.99 [95% CI: 1.07, 3.69]), but no difference was found between Vi-DT and Vi-TT. Adverse events associated with typhoid conjugate vaccines were predominantly non-serious, including fever and injection site reactions. Serious adverse events were rare but included conditions like pneumonia and gastroenteritis. Conclusion: This meta-analysis highlights Vi-DT safety and immunogenicity in six to 24-month-old children. The findings support the use of this Vi-DT to expand typhoid vaccination in endemic regions, in line with WHO's strategy. [ABSTRACT FROM AUTHOR]

Background: Cervical dystonia (CD) is the most common form of focal dystonia encountered in the clinic. Approximately one-third of CD patients have coexisting tremor in the head and hands. Assessment of tremor as regular or irregular in context of its oscillation trajectory, frequency, and amplitude is a major clinical challenge and can confound the diagnosis of CD. The misdiagnosis may lead to therapeutic failures, poor quality of life, and poor utilization of medical and financial resources. Methods: We analyzed the largest cohort of CD patients (n = 3117) available to date, collected from 37 movement disorder centers in North America, Europe, and Asia. We used machine learning to determine what clinical features from clinician reports predicted the presence of tremor as well as its regular or irregular appearance. Results: Out of 3,117 CD patients, 1,367 had neck tremor. The neck tremor was interpreted as irregular in 1,022, regular in 345, and mixed (both irregular and regular) in 442. A feature importance analysis determined that greater severityof CD, longer disease duration, and older age, in descending order, predicted the presence of neck tremor. The probability of neck tremor was reduced if the dystonia affected other body parts in addition to the neck. We also found a significantly heightened risk for developing neck tremor in women. An additional feature importance analysis indicated that increased severity of dystonia affecting other body parts, severity of CD, and prolonged disease duration was associated with a lower likelihood of regular neck tremor while increased age predicted a higher likelihood. Conclusion: Machine learning recognized the most relevant clinical features that can predict concurrent neck tremor and its irregularity in a large multicenter dystonia cohort. These results may facilitate a more accurate description of neck tremor and improved care path in CD. [ABSTRACT FROM AUTHOR]

Introduction: The implantable cardioverter‐defibrillator (ICD) was designed to detect and treat ventricular arrhythmias, which account for nearly half of all cardiovascular fatalities. Transvenous ICD (TV‐ICD) complications were reduced by introducing subcutaneous ICD (S‐ICD). S‐ICD can be implanted using a three (3IT)‐ or two (2IT)‐incision technique. This systematic review and meta‐analysis was conducted to compare the 3IT to the 2IT. Methods: We searched medical electronic databases of Cochrane Central, Embase, PubMed, Scopus, and Web of Science (WOS) from the study's inception until March 8, 2023. We compared 2IT and 3IT techniques of S‐ICDs in terms of procedural, safety, and efficacy outcomes. We used Review Manager software for the statistical analysis. We calculated the risk ratio (RR) with its 95% confidence interval (CI) for dichotomous variables; and the mean difference with its 95% CI for continuous variables. We measured the heterogeneity using the chi‐squared and I‐squared tests. If the data were heterogeneous, the random‐effect (RE) model was applied; otherwise, the fixed‐effect model (FE) was used. Results: We included three retrospective observational studies of 2076 patients, 1209 in the 2IT group and 867 in the 3IT. There was no statistically significant difference in erosion after S‐ICD when 2IT compared with 3IT (RR = 0.27, 95% CI: [0.07, 1.02]; P =.05) (I2 = 0%, P =.90). There was no difference in risk of infection, lead dislocation, or inappropriate shock with either incision technique (RR = 0.78, 95% CI: [0.48, 1.29]; P =.34) (I2 = 0%, P =.71) and (RR = 0.37, 95% CI: [0.02, 8.14]; P =.53) (I2 = 66%, P =.05) respectively. Our meta‐analysis showed that the efficacy of both techniques is comparable; Appropriate shock (RR = 0.94, 95% CI: [0.78, 1.12]; P =.48) (I2 = 0%, P =.81) and first shock efficacy (RR = 0.89, 95% CI: [0.44, 1.82]; P =.76) (I2 = 0%, P =.87). Conclusion: 2IT and 3IT of S‐ICD have comparable efficacy and complication rates; however, the 3IT exposes patients to an additional incision without any additional benefits. These findings may provide clinicians with a simpler method for subcutaneous ICD implantation and likely result in improved cosmetic outcomes. Before the 2IT technique can be considered the standard of care, randomized controlled trials (RCTs) must be conducted to assess its long‐term safety and efficacy. [ABSTRACT FROM AUTHOR]

Objectives: Parkinson's disease (PD) commonly affects visuospatial navigation causing postural instability and falls. Our overarching aim was to examine the visual and vestibular systems governing visuospatial navigation in PD. We hypothesize that PD affects vestibular and visual motion perception but to a different extent. The effects of PD on motion perception are dependent on the severity of the disease. Methods: The two‐alternative‐forced‐choice task objectively measured the motion perception during two experiments. One experiment examined the vestibular motion perception with en bloc movement of the platform. The second experiment tested the visual motion perception using an immersive virtual reality goggle. Results: We found that accuracy, threshold, and precision of vestibular perception were more impaired in advanced‐PD patients compared to those with a mild form of the disease. The parameters also correlated with the disease duration, overall axial motor impairment causing postural instability and falls, and subjective rating of the balance function. Such changes were present but less severe in visual motion perception. Conclusion: We conclude that PD affects motion perception in the visual and vestibular domains in a severity‐dependent manner. The impact of the disease in the vestibular domain is more severe compared to the visual domain. © 2020 International Parkinson and Movement Disorder Society [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. [ABSTRACT FROM AUTHOR]

Abstract: The electrospun fibers can have applications in diverse fields, such as tissue scaffolds, optical electronics, nanocatalysis, and sound absorption. Nanoscale fibers with a higher surface area can provide superior mechanical, physical, and thermal properties. Therefore, investigation of the factors affecting the electrospinning process, for various materials, is required. In this study, the design of experiments issued for optimization of electrospinning of polyvinyl alcohol (PVA). Analysis of variance (ANOVA) and the Taguchi orthogonal array L27OA are employed to analyze the influence of process control parameters. The variables studied are the applied voltages, solution concentrations, rotational speeds, collecting distances, and flow rates. A mathematical model of the polymer fiber diameter as a function of significant process parameters has been built using response surface methodology (RSM). The concentration percentage and the flow rate were determined to be the most significant process variables at 99% and 90% confidence levels, respectively. The predictive model provides 84.34% average model accuracy, which is considered acceptable as this study deals only with 27 of 243 trials needed for a full study based on principles of design of experiments. An additional ANOVA test and corresponding mathematical model have been developed to obtain the interaction effects for processing parameters. [ABSTRACT FROM AUTHOR]