OBJECTIVE: To develop an investigation form for hemodialysis infection outbreak, and to identify sources of outbreak in early stage.
METHODS: After an exhaustive literature review, we used the Delphi method to determine the indicators and relative risk scores of the assessment tools through two rounds of specialist consultation and overall consideration of the opinions and suggestions of 18 specialists.
RESULTS: A total of 87 studies of hemodialysis infection outbreaks were eligible for inclusion. The mean authority coefficient (Cr) was 0.89. Kendall\'s W coefficient of the specialist consultation was 0.359 after two rounds of consultation (p <0.005), suggesting that the specialists had similar opinions. Based on 4 primary items and 13 secondary items of the source of hemodialysis infection outbreak, and tripartite distribution characteristics of infected patients, we constructed the investigation form.
CONCLUSIONS: The investigation form can be used at the early stage of the cluster of cases, it\'s a prerequisite for taking effective control measures, avoiding hemodialysis infection outbreak occurrence. However, the effect of the investigation form needs to be further evaluated.

Leptospirosis is an anthropozoonosis of economic and public health importance, caused by bacteria of the genus Leptospira. Horses are deemed important in its transmission chain due to their proximity to humans, and because the species is often asymptomatic, making these animals potential silent reservoirs. In this context, the objectives of this study were to determine the prevalence of seropositive horses for Leptospira spp., and to identify the presence of Leptospira spp. serogroups and antibody titers, the occurrence of areas with higher density of infection cases and demographic characteristics associated with seropositivity in the states of Paraíba (PB), Pernambuco (PE), Rio Grande do Norte (RN) and Ceará (CE), in the Northeast region of Brazil, during rainy (May and June) and dry (October and November) seasons from 2017 to 2019. Using the microscopic agglutination test (MAT), 1152 equine serum samples from 225 municipalities were analyzed. Anti-Leptospira antibodies were detected in 23.9 % (95 % CI= 21.4 - 26.3 %) of the samples in the three-year period, with a frequency of 30.4 % (95 % CI= 26.7 - 34.2 %) during the rainy period (with greater emphasis on the Ballum serogroup) and 17.4 % (95 % CI= 14.3 - 20.5 %) in the dry period (with greater emphasis on the Sejroe serogroup). Age of horses ≥ 6 years (6-10 years, 11-15 years and ≥ 16 years), rainy season, and animal belonging to Pernambuco state were factors with higher seropositivities. Regarding spatial distribution, a higher percentage of seropositive animals was observed in Pernambuco (P < 0.05), in interstate border areas, and large urban centers, with a spatial cluster detected in the dry season of 2018 with relative risk of 2.8 (P = 0.049) times higher in municipalities within the cluster. It is suggested that measures for controlling rodents and contact with wild animals in equine farming, both in rainy and dry periods, combined with care regarding the use of pastures shared with cattle and the adoption of immunoprophylaxis are important in preventing and controlling leptospirosis in horses in the Northeast region of Brazil.

Background: The aim of this study was to evaluate the association of oral health status and habits with the occurrence of ankylosing spondylitis (AS) in a nationwide population-based cohort in a longitudinal setting. Methods: A total of 2,415,963 individuals aged 40-79 years who underwent oral health examinations were included from the National Health Insurance Service-National Health Screening (NHIS-HEALS) cohort of Korea between 2003 and 2004. The occurrence of AS was analyzed according to the oral health status and oral hygiene habits. Results: Among 2,271,221 of the participants, AS occurred in 6366 (0.3%) participants over 16.7 years. The likelihood of AS was higher in participants who had periodontitis (hazard ratio [HR]: 1.33, 95% confidence interval [CI]: 1.20-1.46, p < 0.0001) and more missing teeth (HR: 1.68, 95% CI: 1.42-1.99, p < 0.0001). However, better oral hygiene habits such as frequent tooth brushing (HR: 0.77, 95% CI: 0.71-0.83, p < 0.0001) and a history of dental scaling within the last year (HR 0.88, 95% CI 0.82-0.95, p = 0.001) were associated with a lower occurrence of AS. Conclusions: Periodontitis and an increased number of missing teeth could be related to the occurrence of late-onset AS. Improved oral hygiene care may attenuate the likelihood of late-onset AS.

OBJECTIVE: To evaluate the effectiveness of comprehensive echinococcosis control measures with emphasis on management of infectious source in Sichuan Province from 2010 to 2022, so as to provide insights into formulation of future control interventions.
METHODS: Data pertaining to comprehensive echinococcosis control measures with emphasis on management of infectious source and echinococcosis surveillance in Sichuan Province from 2010 to 2022 were collected. The effectiveness of comprehensive echinococcosis control measures with emphasis on management of infectious source was evaluated with prevalence of human echinococcosis, detection of newly diagnosed echinococcosis patients, prevalence of Echinococcus infection in domestic dogs, prevalence of cystic echinococcosis in livestock, prevalence of alveolar echinococcosis in small mammals and awareness of echinococcosis control knowledge, and Spearman\'s rank correlation analysis.
RESULTS: The prevalence of human echinococcosis reduced from 1.08% in 2010 to 0.40% in 2022 in Sichuan Province (χ2 = 1 482.97, P < 0.05), with a reduction from 0.30% to 0.02% in the detection of newly diagnosed echinococcosis cases (χ2 = 2 776.41, P < 0.05), a reduction from 15.87% to 0.46% in the prevalence of Echinococcus infection in domestic dogs (χ2 = 20 823.96, P < 0.05), a reduction from 8.05% to 1.07% in the prevalence of cystic echinococcosis in livestock (χ2 = 1 296.02, P < 0.05), and the awareness of echinococcosis control knowledge increased from 50.65% to 95.24% (χ2 = 34 938.63, P < 0.05); in addition, there was a year-specific prevalence rate of alveolar echinococcosis in small mammals (χ2 = 164.07, P < 0.05). Spearman\'s rank correlation analysis revealed that the detection of newly diagnosed echinococcosis cases correlated positively with the prevalence of Echinococcus infections in domestic dogs (rs = 0.823, P < 0.05) and the prevalence of cystic echinococcosis in livestock (rs = 0.795, P < 0.05), and correlated negatively with the awareness of echinococcosis control knowledge (rs = - 0.918, P < 0.05), and the prevalence of Echinococcus infection in domestic dogs correlated positively with the prevalence of cystic echinococcosis in livestock (rs = 0.753, P < 0.05) and negatively with the awareness of echinococcosis control knowledge (rs = -0.747, P < 0.05); however, there was no correlation between the prevalence of Echinococcus infections in domestic dogs and the prevalence of alveolar echinococcosis in small mammals (rs = -0.750, P > 0.05).
CONCLUSIONS: The comprehensive echinococcosis control measures with emphasis on management of infectious source had achieved remarkable effectiveness in Sichuan Province; however, the transmission chain of echinococcosis has not been interrupted. Reinforced comprehensive echinococcosis control measures with emphasis on management of infectious source and sustained tracking evaluation of the effectiveness are recommended in Sichuan Province.
［摘要］ 目的 评价2010—2022年四川省以传染源控制为主的棘球蚴病综合防治措施实施效果, 从而为制定下一步防 控措施提供参考。方法 收集2010—2022年四川省以传染源控制为主的棘球蚴病综合防治措施和棘球蚴病监测数据, 以人群棘球蚴病患病率、新发现棘球蚴病患者检出率、家犬棘球绦虫感染率、家畜细粒棘球蚴病患病率、小型哺乳动物多 房棘球蚴病患病率、人群棘球蚴病防治知识知晓率为指标, 并采用Spearman等级相关进行相关性分析, 评价以传染源控 制为主的棘球蚴病综合防治措施实施效果。结果 2010—2022年, 四川省人群棘球蚴患病率从1.08%下降至0.40% (χ2 = 1 482.97, P < 0.05), 新发现棘球蚴病患者检出率从0.30%下降至0.02% (χ2 = 2 776.41, P < 0.05), 家犬棘球绦虫感 染率从15.87%下降至0.46% (χ2 = 20 823.96, P < 0.05), 家畜细粒棘球蚴病患病率从8.05%下降至1.07% (χ2 = 1 296.02, P < 0.05), 人群棘球蚴病防治知识知晓率从50.65%提高至95.24% (χ2 = 34 938.63, P < 0.05), 不同年份小型哺乳动物多 房棘球蚴病患病率差异有统计学意义 (χ2 = 164.07, P < 0.05)。Spearman等级相关分析显示, 新发现棘球蚴病患者检出率 与家犬棘球绦虫感染率 (rs = 0.823, P < 0.05) 及家畜细粒棘球蚴病患病率呈正相关 (rs = 0.795, P < 0.05), 与人群棘球蚴病 防治知识知晓率呈负相关 (rs = − 0.918, P < 0.05); 家犬棘球绦虫感染率与家畜细粒棘球蚴病患病率呈正相关 (rs = 0.753, P < 0.05), 与人群棘球蚴病防治知识知晓率呈负相关 (rs = −0.747, P < 0.05), 与小型哺乳动物多房棘球蚴病患病率无相关 性 (rs= −0.750, P > 0.05)。结论 四川省以传染源控制为主的棘球蚴病综合防治措施取得了显著成效, 但传播环节仍未 有效阻断; 需继续强化以传染源控制为主的棘球蚴病综合防治措施, 并持续跟踪评价防治措施效果。.

Toxoplasmosis is a parasitic disease caused by infection with the protozoan Toxoplasma gondii. In 2018, the first cases of people with clinical signs of acute febrile syndrome were reported, and in the same year, the largest outbreak of human toxoplasmosis ever described in the literature was reported. In this sense, the present work sought to describe the evolution of the outbreak cases in the municipality of Santa Maria, Rio Grande do Sul State, Brazil, as well as the studies conducted and published during and after the outbreak in the municipality (the period between 2018 and 2023). In addition, the discussion of public policies and their modifications after the notification of this outbreak. As a result of this research, verifying the evolution of notified and confirmed cases, the possibility of detection and genotypic characterization of T. gondii and the possibility of co-infections and evaluation of the humoral response is possible. With regard to public policies, the importance of detecting the agent through the heel prick test and increasing the monitoring of water quality to prevent outbreaks.

BACKGROUND: To develop an investigation form for postoperative infection outbreak (PIO), and to identify sources of the outbreak in the early stage.
METHODS: After an exhaustive literature review, we used the Delphi method to determine the indicators and relative risk scores of the assessment tools through 2 rounds of specialist consultation and overall consideration of the opinions and suggestions of 20 specialists.
RESULTS: A total of 203 studies of PIO were eligible for inclusion. The mean authority coefficient (Cr) was 0.87. Kendall\'s W coefficient of the specialist consultation was 0.704 after 2 rounds of consultation (P < .005), suggesting that the specialists had similar opinions. Based on 4 primary items and 19 secondary items of the source of PIO, and tripartite distribution characteristics of infected patients, we constructed the PIO investigation form.
CONCLUSIONS: The PIO investigation form can be used in the investigation of the early-stage cluster of cases, it\'s a prerequisite for taking effective control measures, avoiding PIO occurrence. However, the effect of the investigation form needs to be further evaluated.

Kettle holes are able to increase the soil and air humidity around them. Therefore, they create a perfect habitat for phytopathogenic fungi of the genera Fusarium and Alternaria to develop, sporulate, and immigrate into neighboring agricultural fields. In our study, we establish transects from the edges of different kettle holes and field edges up to 50 m into the fields to analyze the abundance and diversity of pathogenic fungi in these transition zones by culture-dependent and culture-independent methods. However, in 2019 and 2020, low precipitation and higher temperatures compared to the long-time average were measured, which led to limited infections of weeds in the transition zones with Fusarium and Alternaria. Therefore, the hypothesized significantly higher infection of wheat plants next to the kettle holes by a strong spread of fungal spores was not detected. Infestation patterns of Fusarium and Alternaria fungi on weeds and wheat ears were spatially different. In total, 9 different Fusarium species were found in the transition zone. The species diversity at kettle holes differed from 0 to 6 species. The trend toward increased dryness in the northeast German agricultural landscape and its impact on the changing severity of fungal infections is discussed.

OBJECTIVE: To develop an intelligent recognition model based on deep learning algorithms of unmanned aerial vehicle (UAV) images, and to preliminarily explore the value of this model for remote identification, monitoring and management of cattle, a source of Schistosoma japonicum infection.
METHODS: Oncomelania hupensis snail-infested marshlands around the Poyang Lake area were selected as the study area. Image datasets of the study area were captured by aerial photography with UAV and subjected to augmentation. Cattle in the sample database were annotated with the annotation software VGG Image Annotator to create the morphological recognition labels for cattle. A model was created for intelligent recognition of livestock based on deep learning-based Mask R-convolutional neural network (CNN) algorithms. The performance of the model for cattle recognition was evaluated with accuracy, precision, recall, F1 score and mean precision.
RESULTS: A total of 200 original UAV images were obtained, and 410 images were yielded following data augmentation. A total of 2 860 training samples of cattle recognition were labeled. The created deep learning-based Mask R-CNN model converged following 200 iterations, with an accuracy of 88.01%, precision of 92.33%, recall of 94.06%, F1 score of 93.19%, and mean precision of 92.27%, and the model was effective to detect and segment the morphological features of cattle.
CONCLUSIONS: The deep learning-based Mask R-CNN model is highly accurate for recognition of cattle based on UAV images, which is feasible for remote intelligent recognition, monitoring, and management of the source of S. japonicum infection.
［摘要］ 目的 建立一种基于无人机影像深度学习算法的智能识别模型, 初步评价其用于血吸虫病家畜传染源耕牛远 程识别和监测管理的效果。方法 以环鄱阳湖地区有螺洲滩作为研究区域, 采用无人机航拍采集该区域影像数据集。对数据集进行增强处理, 并使用数据标注工具 VGG Image Annotator 标记样本数据库中的耕牛, 建立耕牛形态识别标签。基于 Mask R-卷积神经网络 (CNN) 深度学习算法建立智能识别模型用于识别耕牛分布, 采用准确率、精确率、召回率、F1 得分和平均精确率等指标对模型识别耕牛效果进行评价。结果 共获取200幅无人机航拍原始影像, 对影像数据增强 处理后获得410幅影像, 标记耕牛识别训练样本2 860个。构建的 Mask R-CNN 深度学习识别模型在迭代200轮后收敛, 模型准确率为88.01%、精确率为92.33%、召回率为94.06%、F1得分为93.19%、平均精确率为92.27%, 可有效检测和分割 耕牛形态特征。结论 基于无人机影像深度学习算法构建的Mask R-CNN模型识别耕牛准确性较高, 可用于血吸虫病家 畜传染源远程智能识别、监测和管理。.

Traditionally, dengue is controlled by fogging, and the prime location for the control measure is at the patient\'s residence. However, when Malaysia was hit by the first wave of the Coronavirus disease (COVID-19), and the government-imposed movement control order, dengue cases have decreased by more than 30% from the previous year. This implies that residential areas may not be the prime locations for dengue-infected mosquitoes. The existing early warning system was focused on temporal prediction wherein the lack of consideration for spatial component at the microlevel and human mobility were not considered. Thus, we developed MozzHub, which is a web-based application system based on the bipartite network-based dengue model that is focused on identifying the source of dengue infection at a small spatial level (400 m) by integrating human mobility and environmental predictors. The model was earlier developed and validated; therefore, this study presents the design and implementation of the MozzHub system and the results of a preliminary pilot test and user acceptance of MozzHub in six district health offices in Malaysia. It was found that the MozzHub system is well received by the sample of end-users as it was demonstrated as a useful (77.4%), easy-to-operate system (80.6%), and has achieved adequate client satisfaction for its use (74.2%).

Background: Multi-drug resistance organisms (MDRO) often cause increased morbidity, mortality, and length of stays (LOS). However, there is uncertainty whether the infection of MDRO increase the morbidity, mortality, and ICU-LOS. Objective: This study was performed to determine the prevalence of MDRO in the ICU, the site of infection, and the association of MDRO or site of infection with mortality. The secondary outcome was determined by ascertaining the association of MDRO or site of infection with ICU-LOS. Methods: A retrospective cohort study was performed with adult sepsis patients in the ICU. Univariate and multivariate (MVA) logistic regression with cox regression modeling were performed to compute the association of MDRO with ICU mortality. MVA modelling was performed for ICU-LOS predictors. Results: Out of 228 patients, the isolated MDRO was 97 (42.5%), of which 78% were Gram-negative bacteria. The mortality rate among those with MDRO was 85 (37.3%). The hospital acquired infection (HAI) was a significant predictor for ICU-LOS in univariate linear regression (R2 = 0.034, p = 0.005). In MVA linear regression, both Enterococcus faecalis infection and Acinetobacter baumannii (AC)-MDRO were predictors for ICU-LOS with (R2 = 0.478, p < 0.05). In the univariate cox regression, only the infection with AC-MDRO was a risk factor for ICU-mortality with [HR = 1.802 (95% CI: 1.2−2.706; p = 0.005)]. Conclusions: Identifying risk factors for MDRO addresses the appropriate administration of empirical antibiotics and allows to effectively control the source of infection, which would reduce mortality and ICU-LOS. The usage of broad-spectrum antibiotics should be limited to those with substantial risk factors for acquiring MDRO.