Pregnancy and Crimean-Congo haemorrhagic fever

AbstractCrimean-Congo Hemorrhagic fever (CCHF) is a potentially fatal viral infection with reported case fatality rates of 5–30%. Humans become infected through tick bites, by contact with a patient with CCHF during the acute phase of infection, or by contact with blood or tissues from viraemic livestock. In this first report in the literature, we present the characteristics of three pregnant women with CCHF infection and the outcome of their babies. Transmission of the CCHF infection could be either intrauterine or perinatal. In endemic regions, CCHF infection should be considered in the differential diagnosis of HELLP syndrome (haemolytic anaemia, elevated liver enzymes, low platelet count), and obstetricians should be familiar with the characteristics of CCHF infection. In the aetiology of necrotising enterocolitis, CCHF should be considered

Burned-out testis tumour that metastasized to retroperitoneal lymph nodes: a case report

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Concentration of apricot juice using complex membrane technology

In this study, pressed apricot (Prunus armeniaca L.) juice was concentrated using complex membrane technology with different module combinations: UF-RO-OD, UF-RO-MD, UF-NF-OD and UF-NF-MD. In case of the best combination a cross-flow polyethylene ultrafiltration membrane (UF) was applied for clarification, after which preconcentration was done using reverse osmosis (RO) with a polyamide membrane, and the final concentration was completed by osmotic distillation (OD) using a polypropylene module. The UF-RO-OD procedure resulted in a final concentrate with a 65-70 °Brix dry solid content and an excellent quality juice with high polyphenol content and high antioxidant capacity.Nanofiltration (NF) and membrane distillation (MD) were not proper economic solutions.The influence of certain operation parameters was examined experimentally. Temperatures of UF and RO were: 25, 30, and 35 °C, and of OD 25 °C. Recycle flow rates were: UF: 1, 1.5, and 2 m3 h−1; RO: 200, 400, and 600 l h−1; OD: 20, 30 and 40 l h−1. The flow rates in the module were expressed by the Reynolds number, as well. Based on preliminary experiments, the transmembrane pressures of UF and RO filtration were 4 bar and 50 bar, respectively. Each experimental run was performed three times. The following optimal operation parameters provided the lowest total cost: UF: 35 °C, 2 m3 h−1, 4 bar; RO: 35 °C, 600 l h−1, 50 bar; OD: 20, 30 and 40 l h−1; temperature 25 °C.In addition, experiments were performed for apricot juice concentration by evaporation, which technique is widely applied in the industry using vacuum and low temperature.For description the UF filtration, a dynamic model and regression by SPSS 14.0 statistics software were applied

COST292 experimental framework for TRECVID 2008

In this paper, we give an overview of the four tasks submitted to TRECVID 2008 by COST292. The high-level feature extraction framework comprises four systems. The first system transforms a set of low-level descriptors into the semantic space using Latent Semantic Analysis and utilises neural networks for feature detection. The second system uses a multi-modal classifier based on SVMs and several descriptors. The third system uses three image classifiers based on ant colony optimisation, particle swarm optimisation and a multi-objective learning algorithm. The fourth system uses a Gaussian model for singing detection and a person detection algorithm. The search task is based on an interactive retrieval application combining retrieval functionalities in various modalities with a user interface supporting automatic and interactive search over all queries submitted. The rushes task submission is based on a spectral clustering approach for removing similar scenes based on eigenvalues of frame similarity matrix and and a redundancy removal strategy which depends on semantic features extraction such as camera motion and faces. Finally, the submission to the copy detection task is conducted by two different systems. The first system consists of a video module and an audio module. The second system is based on mid-level features that are related to the temporal structure of videos

COST292 experimental framework for TRECVID 2006

In this paper we give an overview of the four TRECVID tasks submitted by COST292, European network of institutions in the area of semantic multimodal analysis and retrieval of digital video media. Initially, we present shot boundary evaluation method based on results merged using a confidence measure. The two SB detectors user here are presented, one of the Technical University of Delft and one of the LaBRI, University of Bordeaux 1, followed by the description of the merging algorithm. The high-level feature extraction task comprises three separate systems. The first system, developed by the National Technical University of Athens (NTUA) utilises a set of MPEG-7 low-level descriptors and Latent Semantic Analysis to detect the features. The second system, developed by Bilkent University, uses a Bayesian classifier trained with a "bag of subregions" for each keyframe. The third system by the Middle East Technical University (METU) exploits textual information in the video using character recognition methodology. The system submitted to the search task is an interactive retrieval application developed by Queen Mary, University of London, University of Zilina and ITI from Thessaloniki, combining basic retrieval functionalities in various modalities (i.e. visual, audio, textual) with a user interface supporting the submission of queries using any combination of the available retrieval tools and the accumulation of relevant retrieval results over all queries submitted by a single user during a specified time interval. Finally, the rushes task submission comprises a video summarisation and browsing system specifically designed to intuitively and efficiently presents rushes material in video production environment. This system is a result of joint work of University of Bristol, Technical University of Delft and LaBRI, University of Bordeaux 1

Identification and Analysis of the Active Phytochemicals from the Anti-Cancer Botanical Extract Bezielle

Bezielle is a botanical extract that has selective anti-tumor activity, and has shown a promising efficacy in the early phases of clinical testing. Bezielle inhibits mitochondrial respiration and induces reactive oxygen species (ROS) in mitochondria of tumor cells but not in non-transformed cells. The generation of high ROS in tumor cells leads to heavy DNA damage and hyper-activation of PARP, followed by the inhibition of glycolysis. Bezielle therefore belongs to a group of drugs that target tumor cell mitochondria, but its cytotoxicity involves inhibition of both cellular energy producing pathways. We found that the cytotoxic activity of the Bezielle extract in vitro co-purified with a defined fraction containing multiple flavonoids. We have isolated several of these Bezielle flavonoids, and examined their possible roles in the selective anti-tumor cytotoxicity of Bezielle. Our results support the hypothesis that a major Scutellaria flavonoid, scutellarein, possesses many if not all of the biologically relevant properties of the total extract. Like Bezielle, scutellarein induced increasing levels of ROS of mitochondrial origin, progressive DNA damage, protein oxidation, depletion of reduced glutathione and ATP, and suppression of both OXPHOS and glycolysis. Like Bezielle, scutellarein was selectively cytotoxic towards cancer cells. Carthamidin, a flavonone found in Bezielle, also induced DNA damage and oxidative cell death. Two well known plant flavonoids, apigenin and luteolin, had limited and not selective cytotoxicity that did not depend on their pro-oxidant activities. We also provide evidence that the cytotoxicity of scutellarein was increased when other Bezielle flavonoids, not necessarily highly cytotoxic or selective on their own, were present. This indicates that the activity of total Bezielle extract might depend on a combination of several different compounds present within it

Co-infection and ICU-acquired infection in COIVD-19 ICU patients: a secondary analysis of the UNITE-COVID data set

Background: The COVID-19 pandemic presented major challenges for critical care facilities worldwide. Infections which develop alongside or subsequent to viral pneumonitis are a challenge under sporadic and pandemic conditions; however, data have suggested that patterns of these differ between COVID-19 and other viral pneumonitides. This secondary analysis aimed to explore patterns of co-infection and intensive care unit-acquired infections (ICU-AI) and the relationship to use of corticosteroids in a large, international cohort of critically ill COVID-19 patients.Methods: This is a multicenter, international, observational study, including adult patients with PCR-confirmed COVID-19 diagnosis admitted to ICUs at the peak of wave one of COVID-19 (February 15th to May 15th, 2020). Data collected included investigator-assessed co-infection at ICU admission, infection acquired in ICU, infection with multi-drug resistant organisms (MDRO) and antibiotic use. Frequencies were compared by Pearson's Chi-squared and continuous variables by Mann-Whitney U test. Propensity score matching for variables associated with ICU-acquired infection was undertaken using R library MatchIT using the "full" matching method.Results: Data were available from 4994 patients. Bacterial co-infection at admission was detected in 716 patients (14%), whilst 85% of patients received antibiotics at that stage. ICU-AI developed in 2715 (54%). The most common ICU-AI was bacterial pneumonia (44% of infections), whilst 9% of patients developed fungal pneumonia; 25% of infections involved MDRO. Patients developing infections in ICU had greater antimicrobial exposure than those without such infections. Incident density (ICU-AI per 1000 ICU days) was in considerable excess of reports from pre-pandemic surveillance. Corticosteroid use was heterogenous between ICUs. In univariate analysis, 58% of patients receiving corticosteroids and 43% of those not receiving steroids developed ICU-AI. Adjusting for potential confounders in the propensity-matched cohort, 71% of patients receiving corticosteroids developed ICU-AI vs 52% of those not receiving corticosteroids. Duration of corticosteroid therapy was also associated with development of ICU-AI and infection with an MDRO.Conclusions: In patients with severe COVID-19 in the first wave, co-infection at admission to ICU was relatively rare but antibiotic use was in substantial excess to that indication. ICU-AI were common and were significantly associated with use of corticosteroids

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Clinical and organizational factors associated with mortality during the peak of first COVID-19 wave: the global UNITE-COVID study

Purpose: To accommodate the unprecedented number of critically ill patients with pneumonia caused by coronavirus disease 2019 (COVID-19) expansion of the capacity of intensive care unit (ICU) to clinical areas not previously used for critical care was necessary. We describe the global burden of COVID-19 admissions and the clinical and organizational characteristics associated with outcomes in critically ill COVID-19 patients. Methods: Multicenter, international, point prevalence study, including adult patients with SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR) and a diagnosis of COVID-19 admitted to ICU between February 15th and May 15th, 2020. Results: 4994 patients from 280 ICUs in 46 countries were included. Included ICUs increased their total capacity from 4931 to 7630 beds, deploying personnel from other areas. Overall, 1986 (39.8%) patients were admitted to surge capacity beds. Invasive ventilation at admission was present in 2325 (46.5%) patients and was required during ICU stay in 85.8% of patients. 60-day mortality was 33.9% (IQR across units: 20%–50%) and ICU mortality 32.7%. Older age, invasive mechanical ventilation, and acute kidney injury (AKI) were associated with increased mortality. These associations were also confirmed specifically in mechanically ventilated patients. Admission to surge capacity beds was not associated with mortality, even after controlling for other factors. Conclusions: ICUs responded to the increase in COVID-19 patients by increasing bed availability and staff, admitting up to 40% of patients in surge capacity beds. Although mortality in this population was high, admission to a surge capacity bed was not associated with increased mortality. Older age, invasive mechanical ventilation, and AKI were identified as the strongest predictors of mortality

Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

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