Last data update: Jun 17, 2024. (Total: 47034 publications since 2009)
Records 1-30 (of 34 Records) |
Query Trace: Seo Y [original query] |
---|
Notes from the field: COVID-19 pandemic-related changes in blood lead screening - Chicago, Illinois, 2017-2022
Spencer H , Jorgensen E , Seo J , Robinson C . MMWR Morb Mortal Wkly Rep 2023 72 (50) 1353-1354 Lead is an environmental hazard that can cause serious harm to young children. Early childhood lead exposure can damage the brain and nervous system, slow growth and development, and cause hearing and speech problems (1). Screening for elevated blood lead levels (BLL) is essential for routine care of young children. At the onset of the COVID-19 pandemic, substantial disruptions to health care access occurred for routine, preventive care (2). At the onset of the pandemic (January–May 2020), 34% fewer U.S. children aged <6 years received blood lead level testing than during the same months in 2019 (3). The Chicago Department of Public Health (CDPH) characterized patterns of blood lead testing among young children in Chicago from the onset of the pandemic in 2019 through 2022. |
Prevalence of HPV infection among Thai schoolgirls in the north-eastern provinces in 2018: implications for HPV immunization policy
Vongpunsawad S , Rhee C , Nilyanimit P , Poudyal N , Jiamsiri S , Ahn HS , Lee J , Seo HW , Klinsupa W , Park S , Premsri N , Namwat C , Silaporn P , Excler JL , Kim DR , Markowitz LE , Unger ER , Rerks-Ngarm S , Lynch J , Poovorawan Y . IJID Reg 2023 7 110-115 OBJECTIVE: The aim of this study was to determine the prevalence of high-risk (HR) and vaccine-type human papillomavirus (HPV) infection among Thai schoolgirls who were not included in the national HPV immunization program. METHODS: Cross-sectional surveys were conducted among grade 10 (15-16 years old) and grade 12 (17-18 years old) schoolgirls in two provinces of Thailand. Urine samples were collected using the Colli-Pee(Ⓡ) device from November 2018 to February 2019. The samples were initially tested using Cobas(Ⓡ) 4800. Subsequently, all Cobas-positive samples and 1:1 matched Cobas-negative samples were tested by Anyplex(Ⓡ) assay. Prevalences of any HPV, any HR HPV, vaccine-type HPV, and individual HR HPV types were estimated by school grade. RESULTS: Prevalences of any HPV and any HR HPV were 11.6% and 8.6% for grade 10, and 18.5% and 12.4% for grade 12 schoolgirls, respectively. Prevalences of bivalent vaccine-type HPV infection in grades 10 and 12 were 3.4% and 4.5%, respectively. Prevalences of quadrivalent and nonavalent vaccine-type HPV infections were 4.0%/6.6% and 6.4%/10.4% in grades 10 and 12, respectively. HPV16 was the most common type detected, followed by HPV58, 51, and 52. Circulating HR HPV types were similar between the school grades. CONCLUSION: A substantial burden of HR HPV infections was found among unvaccinated high school girls in Thailand. |
Pregnancy and infant outcomes by trimester of SARS-CoV-2 infection in pregnancy-SET-NET, 22 jurisdictions, January 25, 2020-December 31, 2020.
Neelam V , Reeves EL , Woodworth KR , O'Malley Olsen E , Reynolds MR , Rende J , Wingate H , Manning SE , Romitti P , Ojo KD , Silcox K , Barton J , Mobley E , Longcore ND , Sokale A , Lush M , Delgado-Lopez C , Diedhiou A , Mbotha D , Simon W , Reynolds B , Hamdan TS , Beauregard S , Ellis EM , Seo JY , Bennett A , Ellington S , Hall AJ , Azziz-Baumgartner E , Tong VT , Gilboa SM . Birth Defects Res 2022 115 (2) 145-159 OBJECTIVES: We describe clinical characteristics, pregnancy, and infant outcomes in pregnant people with laboratory-confirmed SARS-CoV-2 infection by trimester of infection. STUDY DESIGN: We analyzed data from the Surveillance for Emerging Threats to Mothers and Babies Network and included people with infection in 2020, with known timing of infection and pregnancy outcome. Outcomes are described by trimester of infection. Pregnancy outcomes included live birth and pregnancy loss (<20 weeks and ≥20 weeks gestation). Infant outcomes included preterm birth (<37 weeks gestation), small for gestational age, birth defects, and neonatal intensive care unit admission. Adjusted prevalence ratios (aPR) were calculated for pregnancy and selected infant outcomes by trimester of infection, controlling for demographics. RESULTS: Of 35,200 people included in this analysis, 50.8% of pregnant people had infection in the third trimester, 30.8% in the second, and 18.3% in the first. Third trimester infection was associated with a higher frequency of preterm birth compared to first or second trimester infection combined (17.8% vs. 11.8%; aPR 1.44 95% CI: 1.35-1.54). Prevalence of birth defects was 553.4/10,000 live births, with no difference by trimester of infection. CONCLUSIONS: There were no signals for increased birth defects among infants in this population relative to national baseline estimates, regardless of timing of infection. However, the prevalence of preterm birth in people with SARS-CoV-2 infection in pregnancy in our analysis was higher relative to national baseline data (10.0-10.2%), particularly among people with third trimester infection. Consequences of COVID-19 during pregnancy support recommended COVID-19 prevention strategies, including vaccination. |
Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: a systematic analysis
Li Y , Wang X , Blau DM , Caballero MT , Feikin DR , Gill CJ , Madhi SA , Omer SB , Simões EAF , Campbell H , Pariente AB , Bardach D , Bassat Q , Casalegno JS , Chakhunashvili G , Crawford N , Danilenko D , Do LAH , Echavarria M , Gentile A , Gordon A , Heikkinen T , Huang QS , Jullien S , Krishnan A , Lopez EL , Markić J , Mira-Iglesias A , Moore HC , Moyes J , Mwananyanda L , Nokes DJ , Noordeen F , Obodai E , Palani N , Romero C , Salimi V , Satav A , Seo E , Shchomak Z , Singleton R , Stolyarov K , Stoszek SK , von Gottberg A , Wurzel D , Yoshida LM , Yung CF , Zar HJ , Nair H . Lancet 2022 399 (10340) 2047-2064 BACKGROUND: Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory infection in young children. We previously estimated that in 2015, 33·1 million episodes of RSV-associated acute lower respiratory infection occurred in children aged 0-60 months, resulting in a total of 118 200 deaths worldwide. Since then, several community surveillance studies have been done to obtain a more precise estimation of RSV associated community deaths. We aimed to update RSV-associated acute lower respiratory infection morbidity and mortality at global, regional, and national levels in children aged 0-60 months for 2019, with focus on overall mortality and narrower infant age groups that are targeted by RSV prophylactics in development. METHODS: In this systematic analysis, we expanded our global RSV disease burden dataset by obtaining new data from an updated search for papers published between Jan 1, 2017, and Dec 31, 2020, from MEDLINE, Embase, Global Health, CINAHL, Web of Science, LILACS, OpenGrey, CNKI, Wanfang, and ChongqingVIP. We also included unpublished data from RSV GEN collaborators. Eligible studies reported data for children aged 0-60 months with RSV as primary infection with acute lower respiratory infection in community settings, or acute lower respiratory infection necessitating hospital admission; reported data for at least 12 consecutive months, except for in-hospital case fatality ratio (CFR) or for where RSV seasonality is well-defined; and reported incidence rate, hospital admission rate, RSV positive proportion in acute lower respiratory infection hospital admission, or in-hospital CFR. Studies were excluded if case definition was not clearly defined or not consistently applied, RSV infection was not laboratory confirmed or based on serology alone, or if the report included fewer than 50 cases of acute lower respiratory infection. We applied a generalised linear mixed-effects model (GLMM) to estimate RSV-associated acute lower respiratory infection incidence, hospital admission, and in-hospital mortality both globally and regionally (by country development status and by World Bank Income Classification) in 2019. We estimated country-level RSV-associated acute lower respiratory infection incidence through a risk-factor based model. We developed new models (through GLMM) that incorporated the latest RSV community mortality data for estimating overall RSV mortality. This review was registered in PROSPERO (CRD42021252400). FINDINGS: In addition to 317 studies included in our previous review, we identified and included 113 new eligible studies and unpublished data from 51 studies, for a total of 481 studies. We estimated that globally in 2019, there were 33·0 million RSV-associated acute lower respiratory infection episodes (uncertainty range [UR] 25·4-44·6 million), 3·6 million RSV-associated acute lower respiratory infection hospital admissions (2·9-4·6 million), 26 300 RSV-associated acute lower respiratory infection in-hospital deaths (15 100-49 100), and 101 400 RSV-attributable overall deaths (84 500-125 200) in children aged 0-60 months. In infants aged 0-6 months, we estimated that there were 6·6 million RSV-associated acute lower respiratory infection episodes (4·6-9·7 million), 1·4 million RSV-associated acute lower respiratory infection hospital admissions (1·0-2·0 million), 13 300 RSV-associated acute lower respiratory infection in-hospital deaths (6800-28 100), and 45 700 RSV-attributable overall deaths (38 400-55 900). 2·0% of deaths in children aged 0-60 months (UR 1·6-2·4) and 3·6% of deaths in children aged 28 days to 6 months (3·0-4·4) were attributable to RSV. More than 95% of RSV-associated acute lower respiratory infection episodes and more than 97% of RSV-attributable deaths across all age bands were in low-income and middle-income countries (LMICs). INTERPRETATION: RSV contributes substantially to morbidity and mortality burden globally in children aged 0-60 months, especially during the first 6 months of life and in LMICs. We highlight the striking overall mortality burden of RSV disease worldwide, with one in every 50 deaths in children aged 0-60 months and one in every 28 deaths in children aged 28 days to 6 months attributable to RSV. For every RSV-associated acute lower respiratory infection in-hospital death, we estimate approximately three more deaths attributable to RSV in the community. RSV passive immunisation programmes targeting protection during the first 6 months of life could have a substantial effect on reducing RSV disease burden, although more data are needed to understand the implications of the potential age-shifts in peak RSV burden to older age when these are implemented. FUNDING: EU Innovative Medicines Initiative Respiratory Syncytial Virus Consortium in Europe (RESCEU). |
A community intervention effectiveness study of single dose or two doses of bivalent HPV vaccine (CERVARIX) in female school students in Thailand
Jiamsiri S , Rhee C , Ahn HS , Poudyal N , Seo HW , Klinsupa W , Nilyanimit P , Premsri N , Namwat C , Vonpunsawad S , Chon Y , Park S , Kim DR , Unger ER , Markowitz L , Poovorawan Y , Rerks-Ngarm S , Excler JL , Lynch J . PLoS One 2022 17 (4) e0267294 Human papillomavirus (HPV) is a common infection principally spread through sexual activity. Most HPV infections are asymptomatic and resolve spontaneously. However, persistent infection may progress to cervical cancer. Highly efficacious HPV vaccines have been available since 2006, yet uptake into national programs has been slow in part due to cost. WHO guidelines call for a two-dose (0,6 month) schedule for girls 9-14 years of age. Post-hoc analyses of randomized trials have found high vaccine effectiveness following a single dose of vaccine. In order to provide additional data on the potential impact of single dose HPV vaccination in a real-world setting, we are conducting an effectiveness study among Thai schoolgirls. This is an observational study of a single dose (SD) or two doses (2D) of the bivalent HPV vaccine CERVARIX (GlaxoSmithKline plc.) administered in a school-based program to 8-9,000 Grade 8 female students in two provinces of Thailand beginning in 2018; one province is assigned the SD, and the other the standard 2D regimen. The reduction in HPV vaccine-type prevalence will be assessed in each province two and four years after vaccination by comparing HPV prevalence in urine samples obtained through cross-sectional surveys of the immunized grade cohort as they age and compared to a historical "baseline" HPV prevalence of same age students. |
Development and evaluation of a structured guide to assess the preventability of hospital-onset bacteremia and fungemia
Schrank GM , Sick-Samuels A , Bleasdale SC , Jacob JT , Dantes R , Gokhale RH , Mayer J , Mehrotra P , Mehta SA , MenaLora AJ , Ray SM , Rhee C , Salinas JL , Seo SK , Shane AL , Nadimpalli G , Milstone AM , Robinson G , Brown CH , Harris AD , Leekha S . Infect Control Hosp Epidemiol 2022 43 (10) 1-7 OBJECTIVE: To assess preventability of hospital-onset bacteremia and fungemia (HOB), we developed and evaluated a structured rating guide accounting for intrinsic patient and extrinsic healthcare-related risks. DESIGN: HOB preventability rating guide was compared against a reference standard expert panel. PARTICIPANTS: A 10-member panel of clinical experts was assembled as the standard of preventability assessment, and 2 physician reviewers applied the rating guide for comparison. METHODS: The expert panel independently rated 82 hypothetical HOB scenarios using a 6-point Likert scale collapsed into 3 categories: preventable, uncertain, or not preventable. Consensus was defined as concurrence on the same category among 70% experts. Scenarios without consensus were deliberated and followed by a second round of rating.Two reviewers independently applied the rating guide to adjudicate the same 82 scenarios in 2 rounds, with interim revisions. Interrater reliability was evaluated using the (kappa) statistic. RESULTS: Expert panel consensus criteria were met for 52 scenarios (63%) after 2 rounds.After 2 rounds, guide-based rating matched expert panel consensus in 40 of 52 (77%) and 39 of 52 (75%) cases for reviewers 1 and 2, respectively. Agreement rates between the 2 reviewers were 84% overall (, 0.76; 95% confidence interval [CI], 0.64-0.88]) and 87% (, 0.79; 95% CI, 0.65-0.94) for the 52 scenarios with expert consensus. CONCLUSIONS: Preventability ratings of HOB scenarios by 2 reviewers using a rating guide matched expert consensus in most cases with moderately high interreviewer reliability. Although diversity of expert opinions and uncertainty of preventability merit further exploration, this is a step toward standardized assessment of HOB preventability. |
A broad-spectrum and highly potent human monoclonal antibody cocktail for rabies prophylaxis.
Kim PK , Ahn JS , Kim CM , Seo JM , Keum SJ , Lee HJ , Choo MJ , Kim MS , Lee JY , Maeng KE , Shin JY , Yi KS , Osinubi MOV , Franka R , Greenberg L , Shampur M , Rupprecht CE , Lee SY . PLoS One 2021 16 (9) e0256779 ![]() Post-exposure prophylaxis (PEP) is highly effective in preventing disease progression of rabies when used in timely and appropriate manner. The key treatment for PEP is infiltration of rabies immune globulin (RIG) into lesion site after bite exposure, besides wound care and vaccination. Unfortunately, however, RIG is expensive and its supply is limited. Currently, several anti-rabies virus monoclonal antibody (mAb) products are under development as alternatives to RIG, and two recently received regulatory approval in India. In this study, fully human mAbs that recognize different rabies virus glycoprotein conformational antigenic site (II and III) were created from peripheral blood mononuclear cells of heathy vaccinated subjects. These mAbs neutralized a diverse range of lyssavirus types. As at least two anti-rabies virus mAbs are recommended for use in human PEP to ensure broad coverage against diverse lyssaviruses and to minimize possible escape variants, two most potent mAbs, NP-19-9 and 11B6, were selected to be used as cocktail treatment. These two mAbs were broadly reactive to different types of lyssaviruses isolates, and were shown to have no interference with each other. These results suggest that NP-19-9 and 11B6 are potent candidates to be used for PEP, suggesting further studies involving clinical studies in human. |
Occupational physical activity and cardiovascular disease in the United States
Quinn TD , Yorio PL , Smith PM , Seo Y , Whitfield GP , Barone Gibbs B . Occup Environ Med 2021 78 (10) 724-730 BACKGROUND: Emerging evidence, predominately from European and Asian countries, describes opposing effects of occupational physical activity (OPA) and leisure-time physical activity (LTPA) on cardiovascular health. This analysis examined cardiovascular disease (CVD) prevalence associated with OPA and LTPA. METHODS: This cross-sectional analysis of 2015 National Health Interview Survey data (n=16 974) employed logistic regression to estimate odds (OR) of self-reported CVD (coronary heart disease, heart attack, stroke or angina) with self-reported total occupational activity (TOA), occupational exertion (OE), occupational standing and walking (OSW) and LTPA. OPA was measured using two questions: 'How often does your job involve…' (1) 'repeated lifting, pushing, pulling or bending?' (OE) and (2) 'standing or walking around?' (OSW) with responses on a 5-item Likert scale (0=never, 4=always). TOA was categorised similarly after summing OE and OSW scores. LTPA was defined as 0, 1-149 or ≥150 min/week of moderate-to-vigorous activity. All models adjusted for common socioeconomic variables and additional analyses were stratified by sex, smoking status and LTPA. RESULTS: Odds for CVD were higher when 'always' performing TOA (OR 1.99 95% CI 1.12 to 3.53), OE (OR 2.15, 95% CI 1.45 to 3.19) or OSW (OR 1.84, 95% CI 1.07 to 3.17) compared with 'never'. When restricting to never-smokers, odds for CVD were higher when 'always' performing TOA (OR 3.00, 95% CI 1.38 to 6.51) and OE (OR 3.00, 95% CI 1.80 to 5.02) versus 'never'. CONCLUSION: Associations of high OPA with CVD were equally apparent across sexes, stronger in lower LTPA levels and stronger in never-smokers. While uncontrolled confounding is still possible, even after extensive adjustment, the seemingly paradoxical adverse associations with OPA and CVD should be investigated further. |
Media Reports as a Tool for Timely Monitoring of COVID-19-Related Deaths Among First Responders-United States, April 2020.
Kelly-Reif K , Rinsky JL , Chiu SK , Burrer S , de Perio MA , Trotter AG , Miura SS , Seo JY , Hong R , Friedman L , Hand J , Richardson G , Sokol T , Sparer-Fine EH , Laing J , Oliveri A , McGreevy K , Borjan M , Harduar-Morano L , Luckhaupt SE . Public Health Rep 2021 136 (3) 315-319 We aimed to describe coronavirus disease 2019 (COVID-19) deaths among first responders early in the COVID-19 pandemic. We used media reports to gather timely information about COVID-19-related deaths among first responders during March 30-April 30, 2020, and evaluated the sensitivity of media scanning compared with traditional surveillance. We abstracted information about demographic characteristics, occupation, underlying conditions, and exposure source. Twelve of 19 US public health jurisdictions with data on reported deaths provided verification, and 7 jurisdictions reported whether additional deaths had occurred; we calculated the sensitivity of media scanning among these 7 jurisdictions. We identified 97 COVID-19-related first-responder deaths during the study period through media and jurisdiction reports. Participating jurisdictions reported 5 deaths not reported by the media. Sixty-six decedents worked in law enforcement, and 31 decedents worked in fire/emergency medical services. Media reports rarely noted underlying conditions. The media scan sensitivity was 88% (95% CI, 73%-96%) in the subset of 7 jurisdictions. Media reports demonstrated high sensitivity in documenting COVID-19-related deaths among first responders; however, information on risk factors was scarce. Routine collection of data on industry and occupation could improve understanding of COVID-19 morbidity and mortality among all workers. |
Risk Factors for Severe Acute Respiratory Syndrome Coronavirus 2 Infection in Homeless Shelters in Chicago, Illinois-March-May, 2020.
Ghinai I , Davis ES , Mayer S , Toews KA , Huggett TD , Snow-Hill N , Perez O , Hayden MK , Tehrani S , Landi AJ , Crane S , Bell E , Hermes JM , Desai K , Godbee M , Jhaveri N , Borah B , Cable T , Sami S , Nozicka L , Chang YS , Jagadish A , Chee M , Thigpen B , Llerena C , Tran M , Surabhi DM , Smith ED , Remus RG , Staszcuk R , Figueroa E , Leo P , Detmer WM , Lyon E , Carreon S , Hoferka S , Ritger KA , Jasmin W , Nagireddy P , Seo JY , Fricchione MJ , Kerins JL , Black SR , Butler LM , Howard K , McCauley M , Fraley T , Arwady MA , Gretsch S , Cunningham M , Pacilli M , Ruestow PS , Mosites E , Avery E , Longcoy J , Lynch EB , Layden JE . Open Forum Infect Dis 2020 7 (11) ofaa477 BACKGROUND: People experiencing homelessness are at increased risk of coronavirus disease 2019 (COVID-19), but little is known about specific risk factors for infection within homeless shelters. METHODS: We performed widespread severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction testing and collected risk factor information at all homeless shelters in Chicago with at least 1 reported case of COVID-19 (n = 21). Multivariable, mixed-effects log-binomial models were built to estimate adjusted prevalence ratios (aPRs) for SARS-CoV-2 infection for both individual- and facility-level risk factors. RESULTS: During March 1 to May 1, 2020, 1717 shelter residents and staff were tested for SARS-CoV-2; 472 (27%) persons tested positive. Prevalence of infection was higher for residents (431 of 1435, 30%) than for staff (41 of 282, 15%) (prevalence ratio = 2.52; 95% confidence interval [CI], 1.78-3.58). The majority of residents with SARS-CoV-2 infection (293 of 406 with available information about symptoms, 72%) reported no symptoms at the time of specimen collection or within the following 2 weeks. Among residents, sharing a room with a large number of people was associated with increased likelihood of infection (aPR for sharing with >20 people compared with single rooms = 1.76; 95% CI, 1.11-2.80), and current smoking was associated with reduced likelihood of infection (aPR = 0.71; 95% CI, 0.60-0.85). At the facility level, a higher proportion of residents leaving and returning each day was associated with increased prevalence (aPR = 1.08; 95% CI, 1.01-1.16), whereas an increase in the number of private bathrooms was associated with reduced prevalence (aPR for 1 additional private bathroom per 100 people = 0.92; 95% CI, 0.87-0.98). CONCLUSIONS: We identified a high prevalence of SARS-CoV-2 infections in homeless shelters. Reducing the number of residents sharing dormitories might reduce the likelihood of SARS-CoV-2 infection. When community transmission is high, limiting movement of persons experiencing homelessness into and out of shelters might also be beneficial. |
The Severe Typhoid Fever in Africa Program: Study design and methodology to assess disease severity, host immunity, and carriage associated with invasive salmonellosis
Park SE , Toy T , Cruz Espinoza LM , Panzner U , Mogeni OD , Im J , Poudyal N , Pak GD , Seo H , Chon Y , Schutt-Gerowitt H , Mogasale V , Ramani E , Dey A , Park JY , Kim JH , Seo HJ , Jeon HJ , Haselbeck A , Conway Roy K , MacWright W , Adu-Sarkodie Y , Owusu-Dabo E , Osei I , Owusu M , Rakotozandrindrainy R , Soura AB , Kabore LP , Teferi M , Okeke IN , Kehinde A , Popoola O , Jacobs J , Lunguya Metila O , Meyer CG , Crump JA , Elias S , Maclennan CA , Parry CM , Baker S , Mintz ED , Breiman RF , Clemens JD , Marks F . Clin Infect Dis 2019 69 S422-s434 BACKGROUND: Invasive salmonellosis is a common community-acquired bacteremia in persons residing in sub-Saharan Africa. However, there is a paucity of data on severe typhoid fever and its associated acute and chronic host immune response and carriage. The Severe Typhoid Fever in Africa (SETA) program, a multicountry surveillance study, aimed to address these research gaps and contribute to the control and prevention of invasive salmonellosis. METHODS: A prospective healthcare facility-based surveillance with active screening of enteric fever and clinically suspected severe typhoid fever with complications was performed using a standardized protocol across the study sites in Burkina Faso, the Democratic Republic of Congo (DRC), Ethiopia, Ghana, Madagascar, and Nigeria. Defined inclusion criteria were used for screening of eligible patients for enrollment into the study. Enrolled patients with confirmed invasive salmonellosis by blood culture or patients with clinically suspected severe typhoid fever with perforation were eligible for clinical follow-up. Asymptomatic neighborhood controls and immediate household contacts of each case were enrolled as a comparison group to assess the level of Salmonella-specific antibodies and shedding patterns. Healthcare utilization surveys were performed to permit adjustment of incidence estimations. Postmortem questionnaires were conducted in medically underserved areas to assess death attributed to invasive Salmonella infections in selected sites. RESULTS: Research data generated through SETA aimed to address scientific knowledge gaps concerning the severe typhoid fever and mortality, long-term host immune responses, and bacterial shedding and carriage associated with natural infection by invasive salmonellae. CONCLUSIONS: SETA supports public health policy on typhoid immunization strategy in Africa. |
Investigating effects of cold water hand immersion on selective attention in normobaric hypoxia
Gerhart HD , Seo Y , Kim JH , Followay B , Vaughan J , Quinn T , Gunstad J , Glickman EL . Int J Environ Res Public Health 2019 16 (16) This study investigated the effect of cold-water hand immersion on selective attention as measured by the Stroop Color Word Test in nomorbaric normoxia and hypoxia. Ten healthy men rested for 60 min, after which they immersed their non-dominant hand into 5 degrees C water for 15 min. The interference score of the Stroop Color Word Test and thermal sensation were measured at baseline in the final 5 min of resting and in the final 5 min of cold water hand immersion. The interference score was not influenced by hypoxia but was found to be significantly improved compared to resting in both conditions during cold water hand immersion. Selective attention improved during 15 min of cold-water hand immersion, with increased thermal sensations rated as "very cool" of the immersed arm. Cold-water hand immersion may be helpful in improving cognitive function in normoxia and normobaric hypoxia. |
Intersegmental differences in facial warmth sensitivity during rest, passive heat and exercise
Kim JH , Seo Y , Quinn T , Yorio P , Roberge R . Int J Hyperthermia 2019 36 (1) 654-659 Background: Increased facial warmth sensations could lead to thermal discomfort, and different facial regions may demonstrate concurrent temperature differences. The study aim was examining facial warmth sensitivity differences by facial region under differing environmental conditions. Methods: Twelve men had heat flux measurements of six facial regions during 30 min each of rest in thermoneutral conditions (25 degrees C, 30% relative humidity (RH)), rest in warm conditions (40 degrees C, 30% RH), and cycling at 400 W of metabolic heat production (40 degrees C, 30% RH). Results: The forehead demonstrated highest temperatures at termination of all study conditions; lowest temperatures were noted for the nose under thermoneutral conditions and chin during warmth and exercise conditions. Five of six facial regions demonstrated significant differences in warmth sensitivity, decreasing to two of six regions during warm conditions and one of six regions during exercise, with the upper lip most sensitive in all conditions. Body thermal comfort (TC) perceptions, regressed individually on mean facial temperature (Tface) vs. core temperature (Tco), indicated that Tface was significantly more related than Tco to perceived TC (p = .001). Perceived TC, regressed individually on perceived overall body thermal sensation (TS) vs. facial TS, demonstrated that Tface was significantly more related to perceived TC (p = .004). Conclusion: There were regional differences in facial warmth sensitivity together with different facial temperatures moving toward equilibration when the body is subjected to heat-producing activities. Perceptions of TC were more strongly related to Tface than to Tco or overall body TS. |
Heat stress assessment during intermittent work under different environmental conditions and clothing combinations of effective wet bulb globe temperature (WBGT)
Seo Y , Powell J , Strauch A , Roberge R , Kenny GP , Kim JH . J Occup Environ Hyg 2019 16 (7) 1-10 This study examined whether different combinations of ambient temperature and relative humidity for the effective wet bulb globe temperature, in conjunction with two different levels of clothing adjustment factors, elicit a similar level of heat strain consistent with the current threshold limit value guidelines. Twelve healthy, physically active men performed four 15-min sessions of cycling at a fixed rate of metabolic heat production of 350 watts. Each trial was separated by a 15-min recovery period under four conditions: (1) Cotton coveralls + dry condition (WD: 45.5 degrees C dry-bulb, 15% relative humidity); (2) Cotton coveralls + humid condition (WH: 31 degrees C dry-bulb, 84% relative humidity); (3) Protective clothing + dry condition (PD: 30 degrees C dry-bulb, 15% relative humidity); and (4) Protective clothing + humid condition (PH: 20 degrees C dry-bulb, 80% relative humidity). Gloves (mining or chemical) and headgear (helmet or powered air-purifying respirator) were removed during recovery with hydration ad libitum. Rectal temperature (Tre), skin temperature (Tsk), physiological heat strain (PSI), perceptual heat strain (PeSI), and body heat content were calculated. At the end of the 2-hr trials, Tre remained below 38 degrees C and the magnitude of Tre elevation was not greater than 1 degrees C in all conditions (WD: 0.9, WH: 0.8, WH: 0.7, and PD: 0.6 degrees C). However, Tsk was significantly increased by approximately 2.1 +/- 0.8 degrees C across all conditions (all p </= 0.001). The increase in Tsk was the highest in WD followed by PD, WH, and PH conditions (all p </= 0.001). Although PSI and PeSI did not indicate severe heat strain during the 2-hr intermittent work period, PSI and PeSI were significantly increased over time (p </= 0.001). This study showed that core temperature and heat strain indices (PSI and PeSI) increased similarly across the four conditions. However, given that core temperature increased continuously during the work session, it is likely that the American Conference of Governmental Industrial Hygienist's TLV((R)) upper limit core temperature of 38.0 degrees C may be surpassed during extended work periods under all conditions. |
Cold-induced vasodilation responses before and after exercise in normobaric normoxia and hypoxia
Gerhart HD , Seo Y , Vaughan J , Followay B , Barkley JE , Quinn T , Kim JH , Glickman EL . Eur J Appl Physiol 2019 119 (7) 1547-1556 PURPOSE: Cold-induced vasodilation (CIVD) is known to protect humans against local cold injuries and improve manual dexterity. The current study examined the effects of metabolic heat production on cold-induced vasodilation responses in normobaric hypoxia and normoxia. METHODS: Ten participants immersed their non-dominant hand into 5 degrees C water for 15 min. Minimum finger temperature (Tmin), maximum finger temperature (Tmax), onset time, amplitude, and peak time were measured before and after exercise under normoxia (21% O2) and two levels of normobaric hypoxia (17% O2 and 13% O2). RESULTS: Neither Tmin nor amplitude was affected by hypoxia. However, Tmax was significantly decreased by hypoxia while reduction in onset time and peak time trended towards significance. Tmin, Tmax, and amplitude were significantly higher during post-exercise CIVD than pre-exercise CIVD. CONCLUSION: The CIVD response may be negatively affected by the introduction of hypoxia whereas metabolic heat production via exercise may counteract adverse effects of hypoxia and improve CIVD responses. |
Using trunk posture to monitor heat strain at work
Quinn TD , Seo Y , Yorio PL , Aljaroudi A , Coca A , Kim Jung-Hyun , Roberge RJ , Williams WJ . Ergonomics 2018 61 (11) 1-9 AbstractThis study aimed to determine if trunk posture during walking is related to increases in rectal temperature (Tre). 24 males treadmill walked in one of four conditions (1): 30 min at 3.0 mph and 0% grade, 20C and 50% relative humidity (RH), wearing healthcare worker (HCW) PPE; (2): 30 min at 3.0 mph and 0% grade, 27.5C and 60% RH, HCW PPE; (3): 30 min at 3.0 mph and 0% grade, 32.5C and 70% RH, HCW PPE; and (4): 40 min at 40% VO2max, 30C and 70% RH, wearing firefighter PPE. Trunk posture (Zephyr BioHarness 3) and Tre were measured continuously. Tre was positively related to trunk posture, controlling for covariates (B=3.49, p<.001). BMI and age moderated this relationship (Tre age, B = 0.76, p<.001; Tre*BMI, B=1.85, p<.001). Trunk posture measurement may be useful in monitoring fall potential and magnitude of heat stress of workers in hot environments.Practitioner Summary: Occupational hyperthermia increases worker risk for heat illness and injury but is difficult to monitor in the field. This investigation shows that trunk posture is independently and positively related to core temperature. Non-invasive measurement or visual inspection of trunk posture could provide novel insight on individual heat strain level. |
Hospital epidemiologists' and infection preventionists' opinions regarding hospital-onset bacteremia and fungemia as a potential healthcare-associated infection metric
Dantes RB , Abbo LM , Anderson D , Hall L , Han JH , Harris AD , Leekha S , Milstone AM , Morgan DJ , Safdar N , Schweizer ML , Sengupta S , Seo SK , Rock C . Infect Control Hosp Epidemiol 2019 40 (5) 1-5 OBJECTIVE: To ascertain opinions regarding etiology and preventability of hospital-onset bacteremia and fungemia (HOB) and perspectives on HOB as a potential outcome measure reflecting quality of infection prevention and hospital care. DESIGN: Cross-sectional survey. PARTICIPANTS: Hospital epidemiologists and infection preventionist members of the Society for Healthcare Epidemiology of America (SHEA) Research Network. METHODS: A web-based, multiple-choice survey was administered via the SHEA Research Network to 133 hospitals. RESULTS: A total of 89 surveys were completed (67% response rate). Overall, 60% of respondents defined HOB as a positive blood culture on or after hospital day 3. Central line-associated bloodstream infections and intra-abdominal infections were perceived as the most frequent etiologies. Moreover, 61% thought that most HOB events are preventable, and 54% viewed HOB as a measure reflecting a hospital's quality of care. Also, 29% of respondents' hospitals already collect HOB data for internal purposes. Given a choice to publicly report central-line-associated bloodstream infections (CLABSIs) and/or HOB, 57% favored reporting either HOB alone (22%) or in addition to CLABSI (35%) and 34% favored CLABSI alone. CONCLUSIONS: Among the majority of SHEA Research Network respondents, HOB is perceived as preventable, reflective of quality of care, and potentially acceptable as a publicly reported quality metric. Further studies on HOB are needed, including validation as a quality measure, assessment of risk adjustment, and formation of evidence-based bundles and toolkits to facilitate measurement and improvement of HOB rates. |
The phylogeography and incidence of multi-drug resistant typhoid fever in sub-Saharan Africa.
Park SE , Pham DT , Boinett C , Wong VK , Pak GD , Panzner U , Espinoza LMC , von Kalckreuth V , Im J , Schutt-Gerowitt H , Crump JA , Breiman RF , Adu-Sarkodie Y , Owusu-Dabo E , Rakotozandrindrainy R , Soura AB , Aseffa A , Gasmelseed N , Keddy KH , May J , Sow AG , Aaby P , Biggs HM , Hertz JT , Montgomery JM , Cosmas L , Fields B , Sarpong N , Razafindrabe TJL , Raminosoa TM , Kabore LP , Sampo E , Teferi M , Yeshitela B , El Tayeb MA , Sooka A , Meyer CG , Krumkamp R , Dekker DM , Jaeger A , Poppert S , Tall A , Niang A , Bjerregaard-Andersen M , Valborg Løfberg S , Seo HJ , Jeon HJ , Deerin JF , Park J , Konings F , Ali M , Clemens JD , Hughes P , Sendagala JN , Vudriko T , Downing R , Ikumapayi UN , Mackenzie GA , Obaro S , Argimon S , Aanensen DM , Page A , Keane JA , Duchene S , Dyson Z , Holt KE , Dougan G , Marks F , Baker S . Nat Commun 2018 9 (1) 5094 ![]() ![]() There is paucity of data regarding the geographical distribution, incidence, and phylogenetics of multi-drug resistant (MDR) Salmonella Typhi in sub-Saharan Africa. Here we present a phylogenetic reconstruction of whole genome sequenced 249 contemporaneous S. Typhi isolated between 2008-2015 in 11 sub-Saharan African countries, in context of the 2,057 global S. Typhi genomic framework. Despite the broad genetic diversity, the majority of organisms (225/249; 90%) belong to only three genotypes, 4.3.1 (H58) (99/249; 40%), 3.1.1 (97/249; 39%), and 2.3.2 (29/249; 12%). Genotypes 4.3.1 and 3.1.1 are confined within East and West Africa, respectively. MDR phenotype is found in over 50% of organisms restricted within these dominant genotypes. High incidences of MDR S. Typhi are calculated in locations with a high burden of typhoid, specifically in children aged <15 years. Antimicrobial stewardship, MDR surveillance, and the introduction of typhoid conjugate vaccines will be critical for the control of MDR typhoid in Africa. |
Comparison of thermal manikin modeling and human subjects' response during use of cooling devices under personal protective ensembles in the heat
Quinn T , Kim JH , Seo Y , Coca A . Prehosp Disaster Med 2018 33 (3) 279-287 IntroductionPersonal protective equipment (PPE) recommended for use in West Africa during the Ebola outbreak increased risk for heat illness, and countermeasures addressing this issue would be valuable.Hypothesis/ProblemThe purpose of this study was to examine the physiological impact and heat perception of four different personal cooling devices (PCDs) under impermeable PPE during low-intensity exercise in a hot and humid environment using thermal manikin modeling and human testing. METHODS: Six healthy male subjects walked on a treadmill in a hot/humid environment (32 degrees C/92% relative humidity [RH]) at three metabolic equivalents (METs) for 60 minutes wearing PPE recommended for use in West Africa and one of four different personal cooling devices (PCDs; PCD1, PCD2, PCD3, and PCD4) or no PCD for control (CON). The same ensembles were tested with thermal manikin modeling software in the same conditions to compare the results. RESULTS: All PCDs seemed to reduce physiological heat stress characteristics when worn under PPE compared to CON. Both the manikin and human testing provided similar results in core temperature (Tc) and heat sensation (HS) in both magnitude and relationship. While the manikin and human data provided similar skin temperature (Tsk) characterization, Tsk estimation by the manikin seemed to be slightly over-estimated. Weight loss, as estimated by the manikin, was under-estimated compared to the human measurement. CONCLUSION: Personal cooling device use in conjunction with impermeable PPE may be advantageous in mitigating physiological and perceptual burdens of heat stress. Evaluation of PCDs worn under PPE can be done effectively via human or manikin testing; however, Tsk may be over-estimated and weight loss may be under-estimated. Thermal manikin testing of PCDs may provide fast and accurate information to persons recommending or using PCDs with PPE. QuinnT, KimJH, SeoY, CocaA. Comparison of thermal manikin modeling and human subjects' response during use of cooling devices under personal protective ensembles in the heat. Prehosp Disaster Med. 2018;33(3):279-287. |
Effects of 5-day heat acclimation on workers wearing personal protective clothing
Seo Y , Quinn TD , Kim J-H , Powell JB , Roberge RJ , Coca A . J Exerc Nutr 2018 1 (1) 1-10 Introduction: Elevated ambient temperature and personal protective clothing (PPC) induce physiological strain which may be counteracted by heat acclimation. The purpose of this study was to determine if 5-day heat acclimation training (HAT) improves thermal and perceptual responses while wearing chemical, biological, radiological, and nuclear (CBRN) PPC. Methods: Nine healthy men completed a heat stress test (walking for one hour with CBRN PPC) in 35 degrees C and 50% relative humidity (RH) before and after 5-day HAT. The HAT consisted of five consecutive days of two 45-minute cycling sessions (50% VO2max) wearing athletic clothing separated by a 15 min rest in 45 degrees C and 20% RH. Results of the pre- and post- HAT heat stress tests were compared. Results: Heat acclimation was seen through 5-day HAT; however, thermoregulatory responses did not improve while wearing CBRN PPC. Improvement (p<0.05, day 1 vs. day 5 HAT) in skin temperature (38.0+/-0.5 degrees C vs. 37.6+/-0.5 degrees C), body temperature (38.6+/-0.4 degrees C vs. 38.3+/-0.4 degrees C), sweat rate (2.26+/-0.3kg vs. 2.64+/-0.3kg), RPE (15.8+/-2.4 vs. 13.9+/-3.1), and heat perception (5.7+/-0.6 vs. 4.9+/-1.0) were noted. However, no physiological or perceptual improvements (p>0.05) were found in the post-HAT heat stress test. Conclusions: Heat acclimation adaptations may be blunted by CBRN PPC, thus requiring differing or extended HAT. |
The effect of inspiratory resistance on exercise performance and perception in moderate normobaric hypoxia
Seo Y , Vaughan J , Quinn TD , Followay B , Roberge R , Glickman EL , Kim JH . High Alt Med Biol 2017 18 (4) 417-424 Seo, Yongsuk, Jeremiah Vaughan, Tyler D. Quinn, Brittany Followay, Raymond Roberge, Ellen L. Glickman, and Jung-Hyun Kim. The effect of inspiratory resistance on exercise performance and perception in moderate normobaric hypoxia. High Alt Med Biol. 00:000-000, 2017. PURPOSE: Respirators are simple and efficient in protecting workers against toxic airborne substances; however, their use may limit the physical performance of workers. The purpose of this study was to determine the effect of inspiratory resistance on physical performance and breathing perception in normobaric hypoxia. METHOD: Nine healthy men wore a tight-fitting respiratory mask outfitted with one of four different inspiratory resistors (R) (0, 1.5, 4.5, 7.5 cm H2O/L/Sec) while exercising at normobaric hypoxia (17% O2) at submaximal exercise workloads of 50, 100, and 150 W on a cycle ergometer for 10 minutes each, followed by a maximal oxygen uptake (VO2max) test to exhaustion. RESULTS: Maximal power output at R7.5 was significantly lower than R0 (p = 0.016) and R1.5 (p = 0.035). Respiration rate was significantly reduced at R4.5 (p = 0.011) and R7.5 (p ≤ 0.001) compared with R0. Minute ventilation was significantly decreased in R7.5 compared with R0 (p = 0.003), R1.5 (p = 0.010), and R4.5 (p = 0.016), whereas VO2 was not significantly changed. Breathing comfort (BC) and breathing effort (BE) were significantly impaired in R7.5 (BC: p = 0.025, BE: p = 0.001) and R4.5 (BC: p = 0.007, BE: p = 0.001) compared with R0, but rating of perceived exertion (RPE) remained unchanged. CONCLUSIONS: Added inspiratory resistance limited maximal power output and increased perceptions of BC and BE in normobaric hypoxia. However, low-to-moderate inspiratory resistance did not have a deleterious effect on VO2 or RPE at submaximal or maximal exercise. Perceptual and physiological characteristics of respirators of varying inspiratory resistances should be considered by manufacturers and end users during design and respirator selection processes. |
Cerebral hemodynamics and executive function during exercise and recovery in normobaric hypoxia
Stavres J , Gerhart HD , Kim JH , Glickman EL , Seo Y . Aerosp Med Hum Perform 2017 88 (10) 911-917 BACKGROUND: Hypoxia and exercise each exhibit opposing effects on executive function, and the mechanisms for this are not entirely clear. This study examined the influence of cerebral oxygenation and perfusion on executive function during exercise and recovery in normobaric hypoxia (NH) and normoxia (N). METHODS: There were 18 subjects who completed cycling trials in NH (12.5% FIo2) and N (20.93% FIo2). Right prefrontal cortex (PFC) oxyhemoglobin (O2Hb) and middle cerebral artery blood velocity (MCAbv) were collected during executive function challenges [mathematical processing and running memory continuous performance task (RMCPT)] at baseline, following 30 min of acclimation, during 20 min of cycling (60% Vo2max), and at 1, 15, 30, and 45 min following exercise. RESULTS: Results indicated effects of time for Math, RMCPT, and O2Hb; but not for MCAbv. Results also indicated effects of condition for O2Hb. Math scores were improved by 8.0% during exercise and remained elevated at 30 min of recovery (12.5%), RMCPT scores significantly improved at all time points (7.5-11.9%), and O2Hb increased by 662.2% and 440.9% during exercise in N and NH, respectively, and remained elevated through 15 min of recovery in both conditions. DISCUSSION: These results support the influence of PFC oxygenation and perfusion on executive function during exercise and recovery in N and NH.Stavres J, Gerhart HD, Kim J-H, Glickman EL, Seo Y. Cerebral hemodynamics and executive function during exercise and recovery in normobaric hypoxia. Aerosp Med Hum Perform 2017; 88(10):911-917. |
Umbilical temperature correlation with core and skin temperatures at rest, in the heat and during physical activity
Roberge RJ , Kim JH , Yorio P , Coca A , Seo Y , Quinn T , Aljaroudi A , Powell JB . Int J Hyperthermia 2017 37 (7) 724-732 Purpose: to determine the correlation of umbilical temperatures (Tumb) with simultaneously recorded chest wall temperature (Tchest) and rectal temperature (Trectal) in adults during rest, heat exposure and exercise. Methods: A total of 28 healthy men, wearing different types of clothing (athletic garb, a spandex full body heating garment, firefighter bunker gear) had average and peak umbilical, chest wall and rectal temperature measurements taken during sedentary temperature stabilisation stages, heat exposure periods and active exercise phases. Results: Curvilinear relationships were noted between Tchest and Tumb compared with Trectal and their association became noticeably positive and linear at approximately 35.5degreeC. Polynomial regression analysis of Trectal with linear and quadratic forms of Tchest and Tumb indicated an overall R2 of 0.657 and 0.767, respectively. Bivariate analysis of a restricted data set (where Tchest and Tumb>35.5degree), indicated that Tumb was significantly associated with Trectal (raverage=0.710, p<0.001; rpeak=0.841, p<0.001) and Tchest was also significantly associated with Trectal, but less so (raverage=0.570, p<0.001; rpeak=0.699, p<0.001). Conclusions: the umbilicus offers a non-invasive, peripheral site for measurement of temperature that more closely correlated with body core temperature than Tchest when core temperature was >35.5degreeC. |
Does acute normobaric hypoxia induce anapyrexia in adult humans?
Seo Y , Gerhart HD , Vaughan J , Kim JH , Glickman EL . High Alt Med Biol 2017 18 (2) 185-190 Seo, Yongsuk, Hayden D. Gerhart, Jeremiah Vaughan, Jung-Hyun Kim, and Ellen L. Glickman. Does acute normobaric hypoxia induce anapyrexia in adult humans? High Alt Med Biol 00:000-000, 2017.-Exposure to hypoxia is known to induce a reduction in core body temperature as a protective mechanism, which has been shown in both animals and humans. The purpose of this study was to test if acute exposure to normobaric hypoxia (NH) induces anapyrexia in adult humans in association with decreased peripheral oxygen saturation (SpO2). Ten healthy male subjects were seated in atmospheres of normobaric normoxia 21% (NN21), NH 17% (NH17), and 13% (NH13) O2 for 60 minutes in a counterbalanced manner. Rectal temperature (Tre) was continuously monitored together with the quantification of metabolic heat production (MHP) and body heat storage (S). Baseline physiological measurements showed no differences between the three conditions. SpO2 was significantly decreased in NH17 and NH13 compared with NN21 (p ≤ 0.001). Tre decreased following 60 minutes of resting in all conditions, but, independent of the conditions, showed no association between Tre and levels of hypoxic SpO2. There was also no significant difference in either MHP or S between conditions. The present results showed no evidence of hypoxia-induced anapyrexia in adult humans during 1 hour of resting after exposure to NH either at 13% or 17% O2. |
Incidence of invasive salmonella disease in sub-Saharan Africa: a multicentre population-based surveillance study
Marks F , von Kalckreuth V , Aaby P , Adu-Sarkodie Y , El Tayeb MA , Ali M , Aseffa A , Baker S , Biggs HM , Bjerregaard-Andersen M , Breiman RF , Campbell JI , Cosmas L , Crump JA , Espinoza LM , Deerin JF , Dekker DM , Fields BS , Gasmelseed N , Hertz JT , Van Minh Hoang N , Im J , Jaeger A , Jeon HJ , Kabore LP , Keddy KH , Konings F , Krumkamp R , Ley B , Lofberg SV , May J , Meyer CG , Mintz ED , Montgomery JM , Niang AA , Nichols C , Olack B , Pak GD , Panzner U , Park JK , Park SE , Rabezanahary H , Rakotozandrindrainy R , Raminosoa TM , Razafindrabe TJL , Sampo E , Schütt-Gerowitt H , Sow AG , Sarpong N , Seo HJ , Sooka A , Soura AB , Tall A , Teferi M , Thriemer K , Warren MR , Yeshitela B , Clemens JD , Wierzba TF . Lancet Glob Health 2017 5 (3) e310-e323 BACKGROUND: Available incidence data for invasive salmonella disease in sub-Saharan Africa are scarce. Standardised, multicountry data are required to better understand the nature and burden of disease in Africa. We aimed to measure the adjusted incidence estimates of typhoid fever and invasive non-typhoidal salmonella (iNTS) disease in sub-Saharan Africa, and the antimicrobial susceptibility profiles of the causative agents. METHODS: We established a systematic, standardised surveillance of blood culture-based febrile illness in 13 African sentinel sites with previous reports of typhoid fever: Burkina Faso (two sites), Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar (two sites), Senegal, South Africa, Sudan, and Tanzania (two sites). We used census data and health-care records to define study catchment areas and populations. Eligible participants were either inpatients or outpatients who resided within the catchment area and presented with tympanic (≥38.0 degrees C) or axillary temperature (≥37.5 degrees C). Inpatients with a reported history of fever for 72 h or longer were excluded. We also implemented a health-care utilisation survey in a sample of households randomly selected from each study area to investigate health-seeking behaviour in cases of self-reported fever lasting less than 3 days. Typhoid fever and iNTS disease incidences were corrected for health-care-seeking behaviour and recruitment. FINDINGS: Between March 1, 2010, and Jan 31, 2014, 135 Salmonella enterica serotype Typhi (S Typhi) and 94 iNTS isolates were cultured from the blood of 13 431 febrile patients. Salmonella spp accounted for 33% or more of all bacterial pathogens at nine sites. The adjusted incidence rate (AIR) of S Typhi per 100 000 person-years of observation ranged from 0 (95% CI 0-0) in Sudan to 383 (274-535) at one site in Burkina Faso; the AIR of iNTS ranged from 0 in Sudan, Ethiopia, Madagascar (Isotry site), and South Africa to 237 (178-316) at the second site in Burkina Faso. The AIR of iNTS and typhoid fever in individuals younger than 15 years old was typically higher than in those aged 15 years or older. Multidrug-resistant S Typhi was isolated in Ghana, Kenya, and Tanzania (both sites combined), and multidrug-resistant iNTS was isolated in Burkina Faso (both sites combined), Ghana, Kenya, and Guinea-Bissau. INTERPRETATION: Typhoid fever and iNTS disease are major causes of invasive bacterial febrile illness in the sampled locations, most commonly affecting children in both low and high population density settings. The development of iNTS vaccines and the introduction of S Typhi conjugate vaccines should be considered for high-incidence settings, such as those identified in this study. FUNDING: Bill & Melinda Gates Foundation. |
Executive Summary: Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America
Barlam TF , Cosgrove SE , Abbo LM , MacDougall C , Schuetz AN , Septimus EJ , Srinivasan A , Dellit TH , Falck-Ytter YT , Fishman NO , Hamilton CW , Jenkins TC , Lipsett PA , Malani PN , May LS , Moran GJ , Neuhauser MM , Newland JG , Ohl CA , Samore MH , Seo SK , Trivedi KK . Clin Infect Dis 2016 62 (10) 1197-202 Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties. These recommendations address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics. |
Implementing an antibiotic stewardship program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America
Barlam TF , Cosgrove SE , Abbo LM , MacDougall C , Schuetz AN , Septimus EJ , Srinivasan A , Dellit TH , Falck-Ytter YT , Fishman NO , Hamilton CW , Jenkins TC , Lipsett PA , Malani PN , May LS , Moran GJ , Neuhauser MM , Newland JG , Ohl CA , Samore MH , Seo SK , Trivedi KK . Clin Infect Dis 2016 62 (10) e51-77 Evidence-based guidelines for implementation and measurement of antibiotic stewardship interventions in inpatient populations including long-term care were prepared by a multidisciplinary expert panel of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. The panel included clinicians and investigators representing internal medicine, emergency medicine, microbiology, critical care, surgery, epidemiology, pharmacy, and adult and pediatric infectious diseases specialties. These recommendations address the best approaches for antibiotic stewardship programs to influence the optimal use of antibiotics. |
Comparison of estimated core body temperature measured with the BioHarness and rectal temperature under several heat stress conditions
Seo Y , DiLeo T , Powell JB , Kim JH , Roberge RJ , Coca A . J Occup Environ Hyg 2016 13 (8) 0 PURPOSE: Monitoring and measuring core body temperature is important to prevent or minimize physiological strain and cognitive dysfunction for workers such as first responders (e.g., firefighters) and military personnel. The purpose of this study is to compare estimated core body temperature (Tco-est), determined by heart rate (HR) data from a wearable chest strap physiology monitor, to standard rectal thermometry (Tre) under different conditions. METHODS: Tco-est and Tre measurements were obtained in thermoneutral and heat stress conditions (high temperature and relative humidity) during four different experiments including treadmill exercise, cycling exercise, passive heat stress, and treadmill exercise while wearing personal protective equipment (PPE). RESULTS: Overall, the mean Tco-est did not differ significantly from Tre across the four conditions. During exercise at low-moderate work rates under heat stress conditions, Tco-est was consistently higher than Tre at all-time points. Tco-est underestimated temperature compared to Tre at rest in heat stress conditions and at a low work rate under heat stress while wearing PPE. The mean differences between the two measurements ranged from -0.1+/-0.4 to 0.3+/-0.4 degrees C and Tco-est correlated well with HR (r = 0.795 - 0.849) and mean body temperature (r = 0.637 - 0.861). CONCLUSION: These results indicate that, the comparison of Tco-est to Tre may result in over- or under-estimation which could possibly lead to heat-related illness during monitoring in certain conditions. Modifications to the current algorithm should be considered to address such issues. |
Development of a TaqMan Array Card for Acute Febrile Illness Outbreak Investigation and Surveillance of Emerging Pathogens including Ebola Virus.
Liu J , Ochieng C , Wiersma S , Stroher U , Towner JS , Whitmer S , Nichol ST , Moore CC , Kersh GJ , Kato C , Sexton C , Petersen J , Massung R , Hercik C , Crump JA , Kibiki G , Maro A , Mujaga B , Gratz J , Jacob ST , Banura P , Scheld WM , Juma B , Onyango CO , Montgomery JM , Houpt E , Fields B . J Clin Microbiol 2015 54 (1) 49-58 ![]() Acute febrile illness (AFI) is associated with substantial morbidity and mortality worldwide yet an etiologic agent is often not identified. Convalescent serology is impractical, blood culture is slow, and many pathogens are fastidious or impossible to cultivate. We developed a real-time PCR based TaqMan Array Card (TAC) that can test six to eight samples within 2.5 hours from sample to results and simultaneously detect 26 AFI associated organisms, including 15 viruses (Chikungunya, Crimean-Congo hemorrhagic fever virus, Dengue, Ebola virus, Bundibugyo virus, Sudan virus, Hantaviruses (HTN and SEO), Hepatitis E, Marburg, Nipah virus, O'nyong-nyong virus, Rift Valley fever virus, West Nile virus, Yellow fever virus), eight bacteria (Bartonella spp., Brucella spp., Coxiella burnetii, Leptospira spp., Rickettsia spp., Salmonella enterica and Salmonella enterica serovar Typhi, Yersinia pestis), and three protozoa (Leishmania spp., Plasmodium spp., Trypanosoma brucei). Two extrinsic controls (Phocine Herpesvirus 1 and bacteriophage MS2) were included to assure extraction and amplification efficiency. Analytical validation was performed on spiked specimens for linearity, intra-assay precision, inter-assay precision, limit of detection, and specificity. The performance of the card on clinical specimens was evaluated with 1,050 blood samples by comparison to the individual real-time PCR assays, and TAC exhibited overall 88% (278/315, 95% confidence interval 84% to 92%) sensitivity and 99% (5261/5326, 98% to 99%) specificity. This TaqMan Array Card can be used in field settings as a rapid screen for outbreak investigation or pathogen surveillance, including Ebola virus. |
The influence of exercise on cognitive performance in normobaric hypoxia
Seo Y , Burns K , Fennell C , Kim JH , Gunstad J , Glickman E , McDaniel J . High Alt Med Biol 2015 16 (4) 298-305 Although previous reports indicate that exercise improves cognitive function in normoxia, the influence of exercise on cognitive function in hypoxia is unknown. The purpose of this study was to determine if the impaired cognitive function in hypoxia can be restored by low to moderate intensity exercise. Sixteen young healthy men completed the ANAM versions of the Go/No-Go task (GNT) and Running Memory Continuous Performance Task (RMCPT) in normoxia to serve as baseline (B-Norm) (21% O2). Following 60 minutes of exposure to normobaric hypoxia (B-Hypo) (12.5% O2), these tests were repeated at rest and during cycling exercise at 40% and 60% of adjusted Vo2max. At B-Hypo, the % correct (p≤0.001) and throughput score (p≤0.001) in RMCPT were significantly impaired compared to B-Norm. During exercise at 40% (p=0.023) and 60% (p=0.006) of adjusted Vo2max, the throughput score in RMCPT improved compared to B-Hypo, and there was no significant difference in throughput score between the two exercise intensities. Mean reaction time also improved at both exercise intensities compared to B-Hypo (p≤0.028). Both peripheral oxygen saturation (Spo2) and regional cerebral oxygen saturation (rSo2) significantly decreased during B-Hypo (p≤0.001) and further decreased at 40% (p≤0.05) and 60% (p≤0.039) exercise. There was no significant difference in Spo2 or rSo2 between two exercise intensities. These data indicate that low to moderate exercise (i.e., 40%-60% adjusted Vo2max) may attenuate the risk of impaired cognitive function that occurs in hypoxic conditions. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Jun 17, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure