Data-driven risk assessment of the incursion of African swine fever virus via pig products brought illegally into South Korea by travelers based on the temporal relationship between outbreaks in China

Since 2018, Asian countries have been affected by the African swine fever (ASF) virus, with major socioeconomic consequences. Moreover, the number of people traveling in Asian countries has been increasing, leading to an inevitable increase in the risk of ASF spread through livestock products carried by travelers. China and South Korea have close geo-economic ties and numerous international travelers. After the ASF outbreak in China in 2018, many illegally imported pig products (IIPPs) that were confiscated from travelers from China at the port of entry in South Korea tested positive for ASF. The detection of ASF virus (ASFV)-positive IIPPs highlights the need to further assess the risk of incursion by travelers and review the existing prevention strategies. Here, we investigated the temporal relationship between ASF outbreaks in China and the detection of ASFV-positive IIPPs in randomly confiscated samples from all ports of entry, such as flights and ships to South Korea, from 2018 to 2019 using a cross-correlation analysis. Based on the significantly correlated temporal lags between the bivariate time-series data, a risk assessment model, using the Bayesian framework, was built to estimate the distribution of the parameters for the risk assessment model and the monthly probability of ASF being introduced via IIPPs from China to South Korea. ASF outbreaks in China were significantly associated with the detection of ASFV-positive IIPPs in South Korea 5 months later. Hence, the monthly probability of ASFV-infected pig products imported from China via a traveler to South Korea was estimated to be 2.00 × 10−5, corresponding to a 0.98 mean monthly probability of at least one ASF-infected pig product arriving at ports of entry via travelers, from 2018 to 2019. To our knowledge, this study is the first attempt to estimate the risk of ASF introduction via pig products carried by international travelers to all ports from neighboring countries in the Asian region using commonly exchanged observed data. The data presented in this study can be used to refine the intervention strategies to combat the spread of transboundary animal diseases

Suggested Indications for Enucleation of Solid Pseudopapillary Neoplasms in Pediatric Patients

Background: Solid pseudopapillary neoplasms (SPNs) are rare, low-grade, malignant neoplasms that can occur in pediatric patients. Although complete resection of the tumor is the principle treatment, SPN enucleation (EN) has been reported to be effective in children. This study aimed to examine the feasibility and safety of EN by comparing it with conventional pancreatectomy (CP), and to present the indications for its use in pediatric patients.Methods: We retrospectively reviewed the medical records of 66 patients who underwent surgery for SPN at our institution from October 1992 to April 2018. Surgical methods, postoperative complications, hospital stay, and recurrence were compared.Results: Of the 66 patients, 15 (22.7%) were treated with EN and 51 (77.3%) were treated with CP. The mean duration of EN operation was 262 min (±145 min) and of CP was 345 min (±195 min). There was no statistically significant difference between the two methods (P = 0.13). To objectively compare the mass size between patients, we introduced a tumor size/intraperitoneal width ratio, which also revealed no significant difference between the 2 surgery groups (P = 0.21). The EN group had one case of recurrence at the resection site. The complications observed were fluid collection, splenic infarctions, hematomas, pancreatic fistulas, portal vein thromboses, and chylous drainage, among which pancreatic fistulas were the most frequent followed by moderate-severe fistulas in the EN group (P < 0.001). The mean postoperative fasting time (EN 17.0 ± 8.7 days vs. CP 5.1 ± 3.3 days, P < 0.001) and mean hospital stay (EN 23.4 ± 10.0 days vs. CP 13.2 ± 6.5 days, P = 0.002) showed statistically significant differences.Conclusion: Compared with CP treatment, EN of SPNs in children has the disadvantages of prolonged fasting times and hospital stays to recover from moderate pancreatic fistulas. However, if appropriate indications are applied, EN can be considered a safe and effective surgical procedure for children

Photovoltaic Performance of Dye-Sensitized Solar Cells Containing ZnO Microrods

At an elevated temperature of 90°C, a chemical bath deposition using an aqueous solution of Zn(NO3)2·6H2O and (CH2)6N4 resulted in the formation of both nanoflowers and microrods of ZnO on F-doped SnO2 glass with a seed layer. The nanoflowers and microrods were sensitized with dyes for application to the photoelectrodes of dye-sensitized solar cells (DSSCs). By extending the growth time of ZnO, the formation of nanoflowers was reduced and the formation of microrods favored. As the growth time was increased from 4 to 6 and then to 8 h, the open circuit voltage (Voc) values of the DSSCs were increased, whilst the short circuit current (Jsc) values varied only slightly. Changes in the dye-loading amount, dark current, and electrochemical impedance were monitored and they revealed that the increase in Voc was found to be due to a retardation of the charge recombination between photoinjected electrons and I3− ions and resulted from a reduction in the surface area of ZnO microrods. A reduced surface area decreased the dye contents adsorbed on the ZnO microrods, and thereby decreased the light harvesting efficiency (LHE). An increase in the electron collection efficiency attributed to the suppressed charge recombination counteracted the decreased LHE, resulting in comparable Jsc values regardless of the growth time. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.1

Epidemiological findings and policy implications from the nationwide schistosomiasis and intestinal helminthiasis survey in Sudan

Background The World Health Assembly endorsed the WHO Neglected Tropical Disease (NTD) Roadmap in 2013, in which NTDs were suggested as tracers of equity in the assessment of progress towards the Sustainable Development Goals. Nationwide surveys were undertaken in all 18 states of Sudan to identify the geographical distribution and to estimate the prevalence and intensity of schistosomiasis and other intestinal helminthiases from December 2016 to March 2017. Methods We used two-stage random sampling. Each district was subdivided into one to three different ecological zones (EZs) based on proximity to water bodies. Probability-proportional-to-size sampling was used to select schools from each EZ. We estimated schistosomiasis and intestinal helminthiasis prevalence by the centrifugation method and Kato-Katz smears. Multi-level mixed-effect models were used to investigate the relationship between the prevalence of infections and risk factors, including improved water or latrine status at the household or school level. We estimated the cost-effectiveness of a one-time mass drug administration (MDA) intervention with 75% coverage at the district and EZ levels. Results A total of 105,167 students from 1772 schools were surveyed. The overall egg-positive rates were: Schistosoma haematobium, 5.2%; S. mansoni, 0.06%; and intestinal helminths, 5.47%. Severe endemic areas were concentrated in East and South Darfur States. Children living in a house or attending schools with an improved latrine were less likely to be infected with schistosomiasis than those without a latrine (adjusted odds ratio, aOR: 0.45, 95% confidence interval, CI: 0.41–0.51 and aOR: 0.75, 95% CI: 0.70–0.81 at the household or the school levels, respectively). Open defecation was strongly associated with schistosomiasis (aOR: 1.50, 95% CI: 1.35–1.66). In community-wide mass treatment at the district level with an 8% threshold for schistosomiasis, 2.2 million people would not benefit from MDA interventions with 75% coverage despite high endemicity, whilst 1.7 million people would receive the MDA intervention unnecessarily. EZ-level MDA was estimated to be more cost-effective than district-level administration under all circumstances. Conclusions Our findings provide updated prevalence figures to guide preventive chemotherapy programmes for schistosomiasis and intestinal helminthiasis in Sudan. Schistosomiasis was found to be common among the inhabitants of fragile and conflict-affected areas. In addition, we found that MDA interventions would be more cost-effective at the sub-district level than at the district level, and there was a strong association between schistosomiasis prevalence and latrine status, at both the household and school levels. This study will help the Sudanese government and its neighbouring countries develop adequate control and elimination strategies.This study was funded by the Korea International Cooperation Agency (KOICA). The views, opinions, assumptions, or any other information set out in this article should not be attributed to KOICA or any person connected with them

Clinical Impact of Prophylactic Antibiotic Treatment for Self-Expandable Metallic Stent Insertion in Patients with Malignant Colorectal Obstruction

Purpose. The aim of this study was to determine the efficacy of prophylactic antibiotics (PA) for reducing the infectious complications and the potential risk factors responsible for the infectious complications after stent insertion for malignant colorectal obstruction. Methods. We performed a retrospective review of 224 patients who underwent self-expandable metallic stent (SEMS) insertion for malignant colorectal obstruction from May 2004 to December 2012. Results. There were 145 patients in the PA group and 79 in non-PA group. The CRP level in PA group was significantly higher than that in non-PA. Abdominal tenderness and mechanical ileus were significantly more frequent in PA group than those in non-PA. The frequency of post-SEMS insertion fever, systemic inflammatory response syndrome (SIRS), and bacteremia was not significantly different between PA and non-PA groups. In multivariate analysis, the CRP level was risk factor related to post-SEMS insertion SIRS. However, in propensity score matching analysis, there was no independent risk factor related to post-SEMS insertion fever, SIRS, and bacteremia. Conclusion. The use of PA in patients with malignant colorectal obstruction may be not effective to prevent the development of infectious complications after SEMS insertion

Chronic Idiopathic Myelofibrosis Presenting as Cauda Equina Compression due to Extramedullary Hematopoiesis: A Case Report

Extramedullary hematopoiesis (EMH) is occasionally reported in idiopathic myelofibrosis and is generally found in the liver, spleen, and lymph nodes several years after diagnosis. Myelofibrosis presenting as spinal cord compression, resulting from EMH tissue is very rare. A 39-yr-old man presented with back pain, subjective weakness and numbness in both legs. Sagittal magnetic resonance imaging showed multiple anterior epidural mass extending from L4 to S1 with compression of cauda equina and nerve root. The patient underwent gross total removal of the mass via L4, 5, and S1 laminectomy. Histological analysis showed islands of myelopoietic cells surrounded by fatty tissue, consistent with EMH, and bone marrow biopsy performed after surgery revealed hypercellular marrow and megakaryocytic hyperplasia and focal fibrosis. The final diagnosis was chronic idiopathic myelofibrosis leading to EMH in the lumbar spinal canal. Since there were no abnormal hematological findings except mild myelofibrosis, additional treatment such as radiothepary was not administered postoperatively for fear of radiotoxicity. On 6 month follow-up examination, the patient remained clinically stable without recurrence. This is the first case of chronic idiopathic myelofibrosis due to EMH tissue in the lumbar spinal canal in Korea