Objective: To identify the most commonly reported drugs associated with QT interval prolongation in the FDA Adverse Event Reporting System (FAERS) and evaluate their risk for QT interval prolongation. Methods: We employed the preferred term (PT) “electrocardiogram QT prolonged” from the Medical Dictionary for Regulatory Activities (MedDRA) 26.0 to identify adverse drug events (ADEs) of QT interval prolongation in the FAERS database from the period 2004-2022. Reporting odds ratio (ROR) was performed to quantify the signals of ADEs. Results: We listed the top 40 drugs that caused QT interval prolongation. The 3 drugs with the highest number of cases were quetiapine (1151 cases, ROR 7.62), olanzapine (754 cases, ROR 7.92), and citalopram (720 cases, ROR 13.63). The two most frequently reported first-level Anatomical Therapeutic Chemical (ATC) groups were the drugs for nervous system (n=19, 47.50%) and antiinfectives for systemic use (n=7, 17.50%). More females (7,536, 51.24%) than males (5,158, 35.07%) were involved. 3720 patients (25.29%) suffered serious clinical outcomes resulting in deaths or life-threatening conditions. Most drugs caused QT interval prolongation had early failure types according to the assessment of the Weibull’s shape parameter (WSP) analysis. Conclusions: Our study offered a list of drugs that frequently caused QT interval prolongation based on the FAERS system, along with a description of some risk profiles for QT interval prolongation brought on by these drugs. When prescribing these drugs in clinical practice, we should closely monitor the occurrence of ADE for QT interval prolongation. Keywords: QT interval prolongation, pharmacovigilance, FAERS, data mining

Background: Crimean-Congo hemorrhagic fever (CCHF) is a severe viral illness with high mortality rates. Nosocomial transmission poses a significant risk to healthcare workers (HCWs). Materials/methods: In this study, we evaluated the effectiveness of ribavirin in post-exposure prophylaxis (PEP) among HCWs with high-risk contacts. Exposures are grouped into 3 categories. The high-risk group consisted of HCWs who were directly exposed to blood or bodily fluids. We also included HCWs who participated in CPR without wearing appropriate PPE to the high-risk group. The moderate-risk group consisted of HCWs without a visible exposure to blood or bodily fluids but handled patient without appropriate PPE. Results: At least 38 HCWs had contact with the index fatal patient. None of the HCWs who had contact with the patient had appropriate PPE. Patient’s PCR and IgM were positive for CCHF. Among all known contacts, all HCWs in high and moderate risk groups (n:24) received PEP with ribavirin. No moderate or severe side effects were observed due to ribavirin. None of the HCWs developed nosocomial CCHF. Conclusions: There are still life-threatening gaps in the compliance of the HCWs to standard precautions. Ribavirin seems an effective and well tolerated agent for PEP of nosocomial CCHF.

Adolescents are the primary cohort for routine human papillomavirus (HPV) vaccination, but unvaccinated adults may also benefit. A lack of consensus on which adults to target and the presence of reimbursement barriers likely contribute to the lag in adult vaccinations, highlighting missed prevention opportunities. Understanding factors contributing to risk of HPV infection and disease could help in decision making on vaccination at an individual level. This review summarizes existing literature on risk factors for HPV infection and disease and includes 153 studies reporting relative risks or odds ratios for factors associated with HPV infection or disease in adults, published between 2009 and 2020. Despite inconsistent design and reporting of risk factors across studies, this review confirmed several risk factors associated with adult infection, including HIV positivity, number of sex partners, and smoking. These findings can support policymaking, guideline development, and clinical decision making for HPV vaccination and screening of high-risk adult groups.

Influenza constitutes a critical respiratory infection that imposes significant public health burdens. The precise influence of these pollutants on influenza activity remains unclear. This study aimed to investigate the effects of different air pollutants on the incidence of influenza-like illness (ILI), influenza A (Flu A), and influenza B (Flu B) in China based on nationwide data on air pollution and the influenza data from 554 sentinel hospitals across 30 provinces and municipalities from 2014 to 2017. Distributed Lag Nonlinear Model (DLNM) was employed to discern the lagged effects amid the concentrations of six distinct air pollutants, namely PM2.5, PM10, O 3, CO, SO 2, and NO 2, and the incidence of ILI, Flu A, as well as Flu B. Our analysis indicated that there was generally no distinction in the effects of air pollutants on the incidence of ILI, Flu A, and Flu B, although variations existed in terms of the specific level of risk associated with each of these categories. Specifically, elevated levels of PM2.5, PM10, CO, SO 2, and NO 2 were predominantly associated with an increased risk of influenza. In contrast, the effect of O 3 concentration on influenza was bidirectional whereby it promoted influenza outbreaks at low and high levels.

A document by Mary Anissa Sinnathamby. Click on the document to view its contents.

Epidemiological studies have explored the relationship between allergic diseases and cancer risk or prognosis in AllergoOncology. Some studies suggest an inverse association, but uncertainties remain, including in IgE-mediated diseases and glioma. Allergic disease stems from a Th2-biased immune response to allergens in predisposed atopic individuals. Allergic disorders vary in phenotype, genotype, and endotype, affecting their pathophysiology. Beyond clinical manifestation and commonly used clinical markers, there is ongoing research to identify novel biomarkers for allergy diagnosis, monitoring, severity assessment, and treatment. Gliomas, the most common and diverse brain tumours, have in parallel undergone changes in classification over time, with specific molecular biomarkers defining glioma subtypes. Gliomas exhibit a complex tumour-immune interphase and distinct immune microenvironment features. Immunotherapy and targeted therapy hold promise for primary brain tumour treatment, but require more specific and effective approaches. Animal studies indicate allergic airway inflammation may delay glioma progression. This collaborative European Academy of Allergy and Clinical Immunology (EAACI) and European Association of Neuro-Oncology (EANO) Position Paper summarizes recent advances and emerging biomarkers for refined allergy and adult-type diffuse glioma classification to inform future epidemiological and clinical studies. Future research is needed to enhance our understanding of immune-glioma interactions to ultimately improve patient prognosis and survival.

COVID-19 vaccination and pregnancy: getting the word outVictoria Male, Senior Lecturer in Reproductive Immunology, Imperial College LondonPregnancy is a risk factor for severe COVID-19, doubling the likelihood that an unvaccinated individual requires intensive care, invasive ventilation, or ECMO. Between March 2020 and December 2021 in the UK, COVID-19 emerged as the leading cause of death during pregnancy: among the 33 women who succumbed to the virus, none had been fully vaccinated (Knight et al, ISBN: 978-1-7392619-4-8). Furthermore, in unvaccinated individuals, SARS-CoV-2 during pregnancy can adversely affect infants, increasing the odds of preterm birth by 1.5-fold and those of stillbirth or neonatal death by approximately 3-fold (Male, Nat Rev Immunol, 2022, 22:277-82).In the face of these concerning statistics, COVID-19 vaccination in pregnancy seems a sensible precaution. Clinical trials and subsequent observational studies demonstrated that COVID-19 vaccination is safe and effective in the general population, but expectant parents naturally have an important additional question: is it safe for my baby?In the clinical trials of the COVID-19 vaccines, pregnancy was an exclusion criterion but nonetheless 102 participants became pregnant during mRNA vaccine trials, with miscarriage rates no different between the vaccinated and control groups. Early observational studies focussed on outcomes at birth which, during the pandemic, have been somewhat better in vaccinated individuals, particularly with respect to outcomes influenced by SARS-CoV2 infection (Prasad, Nat Comms, 2022, 13:2412*). A population-based cohort study published in this issue of BJOG (please add reference) is the latest in a mounting number of observational studies that examine the risk of early pregnancy loss following COVID-19 vaccination, controlling for gestational age and relevant medical and social confounders. This is the first to formally consider termination of pregnancy at the patient’s request as a competing risk, but whether or not this was including in the analysis, the authors found no increased risk of miscarriage associated with COVID-19 vaccination either during or before pregnancy.The evidence is now clear: COVID-19 vaccination is safe in pregnancy, but infection is not. Despite this, COVID-19 booster uptake among those eligible due to pregnancy remains low, peaking at 19% in the 2022-23 booster season. Some people are not aware their pregnancy makes them eligible for a booster and, among those who are, not all are informed of the extensive evidence on the safety and benefits of COVID-19 vaccination in pregnancy. Others believe their primary course of vaccination, or a previous infection, is sufficient to protect them. Although a primary course of vaccination continues to protect against severe disease, evidence on how long protection lasts, particularly in the face of new variants, is not yet available: as time elapses the benefit of a booster is expected to increase. Pertinently, people continue to die of flu during and shortly after pregnancy, despite having been exposed to the virus throughout their lives. In the UK, two women recently died this way: neither had received the recommended flu booster during pregnancy (Knight et al, ISBN: 978-1-7392619-4-8).While ongoing research remains important for confirming the safety of COVID-19 vaccination during pregnancy, it is unlikely that any new study will overturn the wealth of evidence we have already amassed. The challenge now is to get the word out.* For a regularly updated list of studies concerning the safety of COVID-19 vaccination in pregnancy, please see http://bit.ly/pregnancysafety

Objective: To better understand underlying factors of peripartum mortality we assessed variations in mortality by Robson 10-group classification. Design: Cross-sectional study. Setting: Prospectively collected perinatal e-registry data from 16 hospitals in Benin, Malawi, Tanzania and Uganda. Population: All women aged 13-49 who gave birth to a live or stillborn baby >1000g between July 2021 and December 2022. Methods: We compared peripartum mortality risk by Robson group and calculated proportional contributions to mortality. We assessed interactions between mortality and Caesarean sections using multivariable logistic regression and post-estimations margins. Main Outcome Measures: Peripartum mortality, defined as intrapartum stillbirths and very early (≤24 hours after birth) neonatal deaths. Results: We included 80 663 babies born to 78 085 women, of which 1 706 were intrapartum stillbirths and 617 very early neonatal deaths. Peripartum mortality was 5.2% (Benin), 1.6% (Malawi), 1.1% (Tanzania), and 3.7% (Uganda). The largest contributor to intrapartum stillbirths (27.8%) and very early neonatal deaths (23.3%) was Robson group 3 (multipara with cephalic term singleton in spontaneous labour) followed by group 10 (preterm birth). Intrapartum stillbirth risk in breech presentation (groups 6 and 7) was 5.1% in nullipara and 11.1% in multipara. A Caesarean section halved the odds of peripartum mortality in breech presentation in primipara (0.46; 95% CI 0.22-0.95). Conclusions: Our findings indicate a high share of peripartum mortality in lower obstetric risk groups and high mortality in breech deliveries and preterm births. This underscores the need to intensify actions to improve labour management.

Introduction: Exposure to respiratory viruses is a significant cause of morbidity and affects virus-specific antibody levels. Little is known about determinants associated with immune response to these viruses. We aimed to investigate the determinants of respiratory syncytial virus (RSV) and rhinovirus (RV) specific IgG responses in both children and adults. Methods: The study is based on the EGEA cohort, composed of 530 samples of children in EGEA1 (1991-95) and 1241 samples of adults in EGEA2 (2003-07). Cumulative RV-specific IgG responses (species A, B and C) and IgG responses to RSV-G protein were measured by micro-array technology. Multiple linear mixed models (random effect to account for familial dependence) were performed to assess associations between age, sex, body mass index (BMI), tobacco smoke exposure and season of blood sampling with RSV and RV-specific IgG levels. Results: In children (11.1±2.8 years old, 57% of boys), higher RV-specific IgG levels were associated with older age (only for RV-B), female sex and lower BMI, while only older age was associated with higher RSV-specific IgG levels. In adults (43.5±16.7 years old, 48% of men), younger age, female sex, lower BMI, active smoking and all seasons except summer were associated with higher RV-specific IgG levels. Older age, active smoking and all seasons except summer were associated with higher RSV-specific IgG levels. Conclusion: Personal and seasonal determinants of RSV- and RV-specific IgG levels seem to vary according to the respiratory virus type and between children and adults, suggesting different patterns of responses along the life course.

Background: Evidence on the effects of residential green spaces on asthma is contradictory. We investigated potential association between the amount of greenness in the residential area during pregnancy and early life and development of asthma in the first 27 years of life. Methods: The study population included all 2568 members of the Espoo Cohort Study, Finland. We calculated individual-level exposure to green space measured as cumulative Normalized Difference Vegetation Index (cumNDVI in unit-months) within 300 m of the participant’s residence during pregnancy and the first two years of life in both spring and summer seasons. The onset of asthma was assessed using information from the baseline and follow-up surveys. Results: Exposure to residential greenness in the spring season during pregnancy was associated with an increased risk of asthma up to 6 years of age, with an adjusted hazard ratio (aHR) of 3.72 (95% confidence interval (CI) 1.11-12.47) per a unit increase in cumNDVI. Increased greenness in the summer during pregnancy associated with asthma with an aHR of 1.41 (95% CI 0.85-2.32) up to 6 years. The effect was found to be related to increased greenness particularly during the third trimester of pregnancy, with an aHR of 2.37 (95% CI 1.36-4.14) per unit increase of cumNDVI. These associations were weaker at the ages of 12 and 27 years. No association was found between NDVI in the first two years of life and the development of asthma. Discussion: Our findings provide evidence that exposure to greenness during pregnancy increases the risk of developing asthma.

OBJECTIVES In the etiology of childhood cancers, many genetic and environmental factors play a role. One of these factors is cigarette smoking and the main source of tobacco smoke exposure of children is parental smoking. However, establishing a causal relationship between parental smoking and childhood cancers has proven challenging due to difficulties in accurately detecting tobacco smoke exposure METHODS To address this issue, we used hair cotinine analysis and a questionnaire to get information about tobacco smoke exposures of pediatric cancer patients and healthy children. 104 pediatric cancer patients and 99 healthy children participated in our study. Parental smoking behaviours (pre-conceptional, during pregnancy and current smoking) and environmental tobacco smoke (ETS) exposures of children are compared. RESULTS We have found no differences between two groups by means of maternal smoking behaviours. However, the rates of paternal pre-conceptional smoking and smoking during pregnancy were significantly low in cancer patients (p<0,05). These data suggests that social desirability bias among fathers of cancer patients may have contributed to this discrepancy. According to questionnaire cancer patients had significantly lower ETS exposures than healthy children (p<0,05). However, ETS exposure assessment through cotinine analysis demonstrated that cancer patients had higher exposure to ETS compared to healthy children (p<0.001). CONCLUSION Our findings provide evidence supporting the potential role of smoking as a risk factor for childhood cancers. This study also revealed that questionnaires could cause biases. We suggest that cotinine analysis along with validated questionnaires can be used to prevent biases in studies of tobacco smoke in the etiology of childhood cancers.

Cesarean Section Rates in India: A Retrospective Analysis of Districts and States from 2011 to 2019

This study addresses the lack of information about bleeding incidences, location and risk factors in children admitted to hospital. The primary objective of this study was to determine the incidence of bleeding in children admitted to hospital. Methods: In a retrospective observational cohort study, the first admittance of 13,842 children (<18 years old) to Odense University Hospital from 2015-2020 was analyzed. Bleeding episodes and the anatomical location of bleeding were identified in electronic health record (EHR) text using a combination of artificial intelligence and manual validation. The study determined cumulative bleeding incidence during admission with Kaplan-Meier analysis and the anatomical locations of bleedings in frequencies and numbers. Subgroup analyses included spontaneous and major bleeding, and bleeding during intensive care unit (ICU) stay. Results: Overall, 1869 children bled at admission and 1523 during admission. The most frequent locations of bleeding were cutaneous, internal, and gastrointestinal, comprising 70% of episodes. The cumulative incidence of bleeding during admission was 29.1% and 19.0% for any bleeding and spontaneous bleeding, respectively. Spontaneous and major bleeding occurred in 794 (6.6%) and 174 (1.5%) of children, and six bleedings contributed to death (all central nervous system bleeds). Bleedings occurred in 36% admissions complicated with ICU stay. Independent risk factors for bleeding were prematurity, hematological cancer, infection, congenital anomalies, anticoagulants, administration and ICU stay. Conclusions: The study found a high incidence of bleeding in admitted children, and fatal bleeding episodes were registered. Thus, bleeding risk shall be considered during admission of children.

Objective: This study investigated the efficacy of the prophylactic human papillomavirus (HPV) vaccine started at 2009- 2013 in Japan. Materials and Methods: The study involved 1529 eligible women aged 16 to 39 years who visited 11 outpatient clinics for various reasons in Japan. All these patients underwent an examination of HPV genotype and a Pap test using cervical cell samples. Two hundred ninty-nine women (19.6%) received the prophylactic HPV vaccine (bivalent :quadrivalent vaccine ratio = 2:1). Of the 5062 participants in the Japanese Human Papillomavirus Disease Education and Research Survey (J-HERS 2011), which was conducted in the pre-vaccination era, 3236 eligible participants were included as controls. Results: In the present study (J-HERS 2021), highest rate for HPV vaccination (53%) was observed in 22- to 27-year-old patients. Vaccinated ones showed 49% protection against low-grade intraepithelial lesions (LSIL) and atypical squamous cells not excluding high-grade squamous intraepithelial lesions (ASCH) or worse (LSIL/ASCH+), and 100% protection against high-grade squamous intraepithelial lesions (HSIL) or worse (HSIL+). The prevalences of HPV16 and HPV18 infections also significantly decreased (HPV16; 95% and HPV18; 100%), but there were no differences in HPV6 and HPV11 infections by the vaccination. The prevalences of HPV51 and HPV59 increased with vaccination, although these changes were not confirmed in the comparative study with J-HERS 2011. Comparisons between the pre-vaccination period (J-HERS 2011) and post-vaccination period (J-HERS 2021) revealed reduction rates of 43%, 51%, 88%, and 62% were observed for HPV16, HPV18, HPV16/18, and HPV31/58 infections, respectively. Similarly, reduction rates of 62% and 71% for LSIL/ASCH+ and HSIL+, respectively. The reduction rate for LSIL/ASCH+ was 88% in 16- to 21-year-old patients, whereas the rate for HSIL+ was 87% in 28- to 33-year-old patients. C onclusion: Bivalent or quadrivalent vaccines provided 100% protection against high-grade squamous cell lesions (suggestive of CIN2 or CIN3) in young women aged < 39 years at 9 to 12 years after initiation of the first nationwide HPV vaccination program in Japan. Cross-protection against HPV31 and HPV58 is likely to occur, although some HPV type replacements are inconsistent across vaccination regimens. This demonstrates a high effectiveness of HPV vaccine. In contrast, we worry about no reduction of cervical cancer in younger generation (born in 1997-2007) who are rarely vaccinated due to long term suspension of this vaccine recommendation in Japan.

Background: In adults, there is a link between socioeconomic status (SES) and cancer prognosis, notably due to increased time to diagnosis (TTD) in deprived population leading to the spread of the disease. In children, such an association has not been clearly reported. The objective of our study was to assess the impact of SES on TTD of childhood cancer and its potential consequences on cancer prognosis. Methods: We carried out a multicenter retrospective study based on the LOGAFTER multicentric database. We studied the SES at the individual and ecological levels. Results: Overall, 854 children were included. The median time to diagnosis was 28 days [12;64]. A usual care pathway did not seem to impact TTD, but the use of alternative medicine and an initial management by professionals not usually involved in the specific childhood cancer context increased TTD. None of the SES ecological variables were strictly associated with a significant impact on TTD. However, we noted strong trends for single-parent families and children whose fathers had died who presented with an increased TTD. Conclusions: In the current study, the impact of SES on TTD in children on both the individual and ecological levels was not clear. However, we noted some keys at the individual scale that require further investigation to explain a potential association between deprivation and TTD.

The precise effects of infection and maternal vaccination during pregnancy on the fetus remain uncertain. Therefore, this study aims to investigate the immunological responses triggered by SARS-CoV-2 exposure or vaccination in pregnant women. However, we also evaluated the vertical antibody transmission and the persistence of immunity in infants up to six months post-birth. The study recruited pregnant women admitted for labor and delivery in Fortaleza, Brazil, between January 2021 and March 2022. Participants aged 18 or older with flu-like symptoms were included. Nasopharyngeal swabs and blood samples were collected for COVID-19 testing and antibody detection for the viral Nucleocapsid (N) and Spike (S) of SARS-CoV-2. Participants were categorized as Unvaccinated or Vaccinated, and further divided based on PCR test results. Blood or plasma samples were collected at birth and from infants at six months postpartum. We included 76 mother-infant dyads, 11 in the unvaccinated/PCR-/IgG+, 39 in the unvaccinated/PCR+, 20 in the vaccinated/PCR- and 6 in the vaccinated/PCR+. Analysis of maternal serological profiles showed no significant differences in anti-N IgG levels between unvaccinated and vaccinated groups. However, anti-S IgG titers were significantly higher in vaccinated mothers. The ratio of anti-S IgG antibody transfer from vaccinated mothers to infants was notably higher, especially in the Unvaccinated/PCR+ group compared to the Vaccinated/PCR- group. Furthermore, infants born to vaccinated mothers maintained seroconversion at six months, while those born to unvaccinated mothers did not. Maternal vaccination, particularly during the second trimester, results in a significantly higher transplacental transfer ratio. This leads to elevated anti-S IgG antibody levels in cord blood and infants at six months of age. The study emphasizes the importance of vaccination protocols in optimizing antibody transfer and persistence.

Objective: Few studies have examined whether number of births is associated with women’s aging. This study aims to evaluate the association of number of births with women’s biological aging, premature mortality and life expectancy. Methods: A total of 272,494 participants from UK biobank who completed the questionnaire on number of live births were enrolled at baseline. The number of births was categorized into 6 groups, and participants with one live birth was the reference group. General linear regression model and cox proportional hazards model were performed to evaluate the association of number of births with women’s biological aging and premature mortality. Restricted cubic spline (RCS) was used to visualize dose-response relationship. Moreover, the latest Office for National Statistics life tables rom was used to calculate the life expectancy. Results: During a median follow-up of 11.9 years, a total of 10,992 cases of all-cause premature death were documented. After adjustment for potential confounders, compared to women had one birth, childless women had greater premature death (hazard ratio, HR=1.17, 95%CI: 1.09-1.25), whereas women with two or three children had lower risk of premature death (HR=0.87, 95%CI:0.82-0.93, HR=0.90, 95%CI: 0.82-0.99), which showed a U-shaped relationship visualized by RCS (P<0.05 for non-linearity). Further, at age 40, childless women had 1.41 years lower life expectancy, and women with two children was related to 1.10 years higher life expectancy. Moreover, compared to women had one birth, the women with two or three children had lower corrected estimated values of FI, ΔKDM-biological age and HD, and the women with five or more children had higher corrected estimated values of FI, ΔKDM-biological age, and HD (all the P<0.05). Conclusions: The association of number of live births with women’s biological aging, premature mortality and life expectancy had a U-shape relation. The childless or five more child women were more likely to be aging with increased risk of premature death and decreased life expectancy years. The double-child women decreased aging process with lower risk of premature death and high life expectancy.

Objective: To assess the effectiveness and safety of nirmatrelvir-ritonavir in the treatment of mild-to-moderate COVID-19 caused by the omicron BA. 2. 2 variant. Methods: An observational study was conducted retrospectively to review the outcomes of mild-to-moderate COVID-19 patients admitted between 26 April and 30 June, 2022. Patients’ baseline characteristics were collected and assessed. Participants in the intervention group were administered nirmatrelvir-ritonavir in addition to standard care, whereas those in the control group only received standard care. The primary outcome was the duration between symptoms onset or the initial positive RT-PCR test and the subsequent conversion to a negative result. Results: The analysis included 324 patients who were administered nirmatrelvir-ritonavir and an equal number of control patients. The patient characteristics in both groups were evenly matched. The average duration from symptoms onset or the initial positive RT-PCR to negative conversion was similar in both groups (16.2±5.0 vs. 16.1±6.3 days, P=0.83). Control patients exhibited slower conversion in comparison to patients who received nirmatrelvir-ritonavir treatment within 10 days of symptom onset. Conclusion: These findings suggest that administering nirmatrelvir-ritonavir within 10 days of symptom onset could potentially reduce the time it takes for SARS-CoV-2-infected patients to negative RT-PCR results, thereby expanding the current usage guidelines for nirmatrelvir-ritonavir.

Introduction : In intensive care units, COVID-19 viral pneumonia patients (VPP) present symptoms similar to those of other patients with non-viral infection (NV-ICU). To better manage VPP, it is therefore interesting to better understand the molecular pathophysiology of viral pneumonia and to search for biomarkers that may clarify the diagnosis. The secretome being a set of proteins secreted by cells in response to stimuli represents an opportunity to discover new biomarkers. Aims : Identify secretomic signatures of VPP with those NV-ICU. Methods : Plasma samples and clinical data from NV-ICU (n=104), VPP (n=30) or healthy donors (HD, n=20) were collected at Nantes Hospital (France) upon admission. Samples were enriched for the low-abundant proteins and analyzed using non-target mass spectrometry. Specifically deregulated proteins (DEP) in VPP versus NV-ICU were selected. Combinations of 2 to 4 DEPs were established. Results : The differences in secretome profiles of the VPP and NV-ICU groups were highlighted. Forty-one DEPs were specifically identified in VPP compared to NV-ICU. Five combinations of 3 proteins with a receiver operating characteristic curve presenting an area under the curve of 95.0% were identified. Conclusion: This study identifies five combinations of candidate biomarkers in VPP compared to NV-ICU that may help distinguish the underlying causal molecular alterations.

Abstract: The incidence of Pseudomonas aeruginosa causing nosocomial infections has increased in recent years, along with the emergence of resistant strains of bacteria causing mortality. Many recent studies have shown increased resistance to colistin, which is the last resort for treating multidrug-resistant P. aeruginosa. A cross-sectional descriptive study and convenience sample were conducted to determine the percentage of infections, rates of seven antibiotics, and colistin resistance in P. aeruginosa strains isolated in Can Tho Central General Hospital and relevant factors from June 2020 to April 2021. P. aeruginosa infection rate was 7.9%. The specimens contained 233 strains of P. aeruginosa isolated. Incident rates in males/females were 9.3%/6.2%, the most of 19-29 years. The highest rate was in urine specimens (9.8%) and sputum (8.8%). The male sex had a higher infection rate than the female, and urine samples accounted for the highest rate of P. aeruginosa infections (13.9%). The rate of P. aeruginosa infections was associated with gender and various species (p<0.05). The prevalence of P. aeruginosa infections showed an association with gender and types of specimens (p<0.05). The highest resistance rate in P. aeruginosa against ciprofloxacin was 60.5%, next to gentamicin and imipenem (52.4% and 50.2%). 3% P. aeruginosa against colistin. Keywords: Pseudomonas aeruginosa; drug resistance; Pseudomonas infection; colistin

Objective: To evaluate the accuracy of ICD-10 codes for placenta accreta spectrum (PAS). Design: Validation study. Setting: Quaternary obstetric center in the U.S. Population: Patients who had a delivery or dilation and evacuation between October 2015 and March 2020. Methods: We reviewed medical records of patients who were (1) assigned an ICD-10 code for PAS (O43.21-O43.23), (2) had a histopathologic diagnosis of PAS, and/or (3) underwent a cesarean delivery with subsequent review of placental pathology. Main Outcome Measures: Sensitivity, specificity, positive predictive value, and negative predictive value of the ICD-10 PAS code assignments. Results: Among 22,345 patients, 104 (0.46%) had an ICD-10 code for PAS and 51 (0.23%) had a histopathologic diagnosis of PAS. ICD-10 codes for PAS had a sensitivity of 88% (95% CI: 76-96%), specificity of 97% (95% CI: 91-99%), positive predictive value of 43% (95% CI: 34-53%), and negative predictive value of 100% (95% CI: 96-100%). The sensitivities of the individual ICD-10 codes for placenta accreta, increta, and percreta were 72% (95% CI: 47-90%), 47% (95% CI: 21-73%), and 67% (95% CI: 41-87%), respectively. Based on chart review, primary reasons for code misassignment included code assigned at referral for PAS ultrasound evaluation (28%) and code assigned based on antenatal imaging alone (27%). Conclusion: The sensitivity, specificity, and negative predictive value of ICD-10 codes for PAS were overall high, but the positive predictive value was moderate. These findings suggest that ICD-10 codes may be useful for research and surveillance of PAS, but opportunities may exist to improve accuracy.

Nipah Virus is a deadly zoonotic virus that causes a wide range of symptoms, from asymptomatic disease to acute respiratory distress and encephalitis, both of which can prove fatal. India has tackled outbreaks of Nipah virus constantly throughout the years, and is facing another rise in cases yet again. Although India has dealt with outbreaks of many infectious diseases in the past, it is imperative to focus fully on limiting the further spread of the lethal Nipah virus to limit mortality. Proper implementation of standard infective protocol as well as using a strict surveillance system are some important steps that must be taken in order to dismantle the looming possibility of full-blown worldwide endemics due to Nipah virus.

Human cervical, vaginal, vulval, penile, anal, and oropharyngeal cancers are all caused by the human papillomavirus (HPV). This review article focuses on HPV biology, virus-host interactions, cell transformation, cancer progression, and its co-infection with HIV, HSV, EBV, and other bacteria in cancer development. It explores HPV vaccination’s role in preventing high-risk HPV infections and cancers, emphasizes early detection and screening methods, discusses emerging strategies like specialized therapies and immuno-based interventions, and considers personalized medical care for HPV-linked cancers. Comprehensive coverage includes HPV-associated cancer epidemiology, regional variations, and India’s unique challenges. The cumulative efforts of scientists facilitate groundbreaking approaches toward reducing the adverse consequences of HPV-related malignancies among people and communities.

Objective: This study aims to determine the impact of maternal gestational diabetes mellitus (GDM) on peripubertal growth of offspring. Design: Population-based prospective cohort study. Setting: University Hospital. Population: 478 mother-offspring pairs from cohort Taiwan Birth Panel Study II (TBPS II). Methods: Maternal GDM status was tested at gestational weeks 24-28 using two-step or one-step oral glucose tolerance test. Offspring received follow-up questionnaire, physical examination, and bone age study at the age of 6 to 8. Associations between maternal GDM and offspring outcomes were analyzed using multiple linear or logistic regression models to adjust for maternal pre-gravid BMI, household income, maternal age at delivery, and maternal menarche age. Main Outcome Measures: Offspring bone age, serum sex hormone levels, Tanner stage for breast and testes, and penile length. Results: There were 43 (9.0%) children born from mothers with GDM, and 435 (91.0%) in the control group. In girls, there was a more advanced bone age in the GDM group (n=19) than the control group (n=203) after adjusting for potential confounding factors (0.48-year, 95% CI=0.002-0.97-year). For boys, the GDM group (n=24) showed no advancement in the bone age compared with the control group (n=232) (-0.13-year, 95% CI= -0.66-0.40). The serum sex hormone levels and secondary sexual characteristics of children in the GDM group were comparable to those in the control group. Conclusions: Girls born from GDM mothers had more advanced bone age at peripubertal stage than the control group. This phenomenon was not observed in boys, nor were other secondary sexual characteristics and serum sex hormone levels.