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A total of 198 patients contributed to generate 1068 usable observations which allowed to build 3 predictive models based respectively on 31-variables signs and symptoms, 39-variables laboratory biomarkers and 91-variables as a composition of the two. A fourth "boosted mixed model" included 20 variables was selected from the model 3, achieved the best predictive performance (AUC = 0.84) without worsening the FN rate. Its clinical performance was applied in a narrative case report as an example.

This study developed a machine model with 84% prediction accuracy, which is able to assist clinicians in decision making process and contribute to develop new analytics to improve care at high technology readiness levels.

This study developed a machine model with 84% prediction accuracy, which is able to assist clinicians in decision making process and contribute to develop new analytics to improve care at high technology readiness levels.Infectious diseases are still a major global burden for modern society causing 13 million deaths annually. One way to reduce the morbidity and mortality rates from infectious diseases is through pre-emptive or targeted vaccinations. Current theoretical vaccination strategies based on contact networks, however, rely on highly specific individual contact information which is difficult and costly to obtain, in order to identify influential spreading individuals. https://www.selleckchem.com/products/grazoprevir.html Current approaches also focus only on direct contacts between individuals for spreading, and disregard indirect transmission where a pathogen can spread between one infected individual and one susceptible individual who visit the same location within a short time-frame without meeting. This paper presents a novel vaccination strategy which relies on coarse-grained contact information, both direct and indirect, that can be easily and efficiently collected. Rather than tracking exact contact degrees of individuals, our strategy uses the types of places people visit to estimate a range of contact degrees for individuals, considering both direct and indirect contacts. We conduct extensive computer simulations to evaluate the performance of our strategy in comparison to state-of-the-art vaccination strategies. Results show that, when considering indirect links, our lower cost vaccination strategy achieves comparable performance to the contact-degree based approach and outperforms other existing strategies without requiring over-detailed information.

Extended spectrum Beta-lactamases (ESBLs) and AmpC beta-lactamases (AmpC) are the common enzymes produced by gram negative bacilli, which are their main mechanisms of resistance to all generations of cephalosporins. Hence, this study aimed to determine the magnitude of ESBLs and AmpC producing gram negative bacilli (GNB) isolated from clinical specimens at International clinical Laboratories in Addis Ababa, Ethiopia.

A cross sectional study was conducted from January to May 2018. From different clinical specimens, 338 GNB were isolated and characterized. Bacterial species identification, antimicrobial susceptibility testing and screening for ESBLs and AmpC production were performed using Phoenix automated system (BD phoenix100). ESBLs production was confirmed using a combination disc method. All Cefoxitin resistant and confirmed ESBLs producing GNB were confirmed for AmpC beta-lactamases production by AmpC confirmatory Neo-Sensitabs discs (ROSCO tablet). Data were analyzed using SPSS version 20 software.

a-lactamases producing GNB calls the needs of strong intervention to minimize further occurrence and spread of such GNB. More importantly, the MDR level was high which suggests continuous monitoring & reviewing of antimicrobial policy in hospitals and the country at large.Diagnosis of scrub typhus, caused by the bacterium Orientia tsutsugamushi, is challenging because of the overlap of its non-specific symptoms with other infections coupled with the lack of sufficient data on the performance of diagnostic tests. Early diagnosis of scrub typhus is crucial to improve outcomes and this study evaluates the diagnostic performance of various tests. The present study aims at assessing the accuracy of various rapid diagnostic tests, serologic tests, and nucleic acid amplification methods on well-characterized patient samples. Adult patients with acute febrile illness and manifestations suggestive of scrub typhus confirmed by positive PCR in the blood, eschar or tissue were characterized as cases. Patients with acute febrile illness and a confirmed alternate etiology such as culture-confirmed typhoid, smear/PCR positive for malaria, PCR/NS1 antigen positive for dengue, PCR positive for influenza, PCR/MAT positive for leptospirosis, PCR positive for spotted fever were characterized as cher acute febrile illnesses such as dengue, leptospirosis and spotted fever due to the nonspecific binding of the pentavalent IgM. LAMP assay had 91.7% sensitivity and 77.2% specificity while qPCR provided excellent sensitivity (97%) and perfect specificity. In conclusion, ELISA and RDT detecting Orientia tsutsugamushi specific IgM antibodies have excellent sensitivity and specificity while the accuracy of IFA is suboptimal for the diagnosis of scrub typhus. Given its perfect specificity and superior sensitivity, qPCR is preferred for diagnostic confirmation in reference laboratories particularly for diagnosis of early disease with less than 7 days duration. This study provides a comprehensive evaluation of all currently available diagnostic tests for scrub typhus.It has been two months since Wuhan eased the lockdown and the people of Wuhan have been under great pressure during COVID-19. The psychological status among healthcare workers and residents were barely know due to the lack of research after Wuhan eased of the lockdown. The purpose of this study was to assess people's mental health and the changes after Wuhan eased the lockdown. A cross-sectional online study among citizens in Wuhan was conducted. Among 1417 participants, 387(27.0%) were frontline healthcare workers and 1035(73.0%) were residents from the general public. Their COVID-19 psychological status was evaluated using Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), and the PTSD Checklist-Civilian Version (PCL-C). Results show that 16.1%,22.3% and 17.2% healthcare workers and 21.2%, 16.7% and 17.2% general public had symptoms of depression, anxiety and PTSD ranging from moderate to severe. Anxiety levels were not significantly different between healthcare workers and the general public.

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