Sociocultural and behavioural features of anticipated COVID-19 vaccine acceptance in Papua New Guinea: a mixed methods study proposal

BACKGROUND: Coronavirus disease 2019 (COVID-19) was characterised by the World Health Organisation (WHO) as a pandemic in 2020. Papua New Guinea (PNG) has remained on high alert ever since its National Control Centre continues to coordinate national preparedness and response measures guided by its Emergency Preparedness and Response Plan for COVID-19. As part of the WHO, Gavi and other global partners' COVAX program, PNG received several COVID-19 vaccine doses. A national-wide vaccine roll-out for COVID-19 was initiated in PNG in May 2021. Despite the availability of vaccines and the capacity of health systems to vaccinate frontline workers and community members, including high-risk groups, questions on vaccine safety, confidence, and acceptance remain critical for the effectiveness of the COVID-19 vaccination campaign. Evidence from studies on COVID-19 vaccine acceptance and demand in low- and middle-income countries (LMICs) suggests that sociocultural factors of the community and behaviours of different vaccine stakeholders, including vaccine recipients, vaccine providers and policymakers, determine the effectiveness of vaccination interventions or strategies. OBJECTIVE: This study will examine sociocultural determinants of anticipated acceptance of the COVID-19 vaccine in the population of urban and rural areas of different regions in PNG, and healthcare providers' views on vaccine acceptance. METHODS: The study design includes a mixed methods approach to implement in PNG's coastal and highlands regions. The first research activity will use a qualitative methodology in which the epistemological foundation is based on constructivism. This design elicits and listens to community members' accounts of ways culture as a rich source provides meaning to the COVID-19 pandemic, adherence to 'niupela pasin' (New normal) and vaccination acceptance. The second activity will be a cross-sectional survey to assess the distribution of features of vaccine acceptance, priorities and practices. The third activity will be in-depth interviews of healthcare providers actively involved in either COVID-19 clinical management or public health-related pandemic control activities. RESULTS: The project proposal has been reviewed and approved by the Medical Research Advisory Committee of Papua New Guinea. The qualitative data collection started in December 2022 and the survey will begin in May 2023. The findings will be disseminated to the participated communities later this year followed by the publications. CONCLUSIONS: Proposed research on community views and experience concerning sociocultural and behavioural features of anticipated acceptance of the vaccine will provide a better understanding of communication and education needs for vaccine action for COVID-19 control in PNG and other LMICs. The research also considers the influence of healthcare providers' and policymakers' roles in the awareness and use of the COVID-19 vaccine. INTERNATIONAL REGISTERED REPORT: PRR1-10.2196/44664

Genomic characterization of coxsackievirus A22 from a regional university hospital in the Netherlands

Background: Enteroviruses are highly diverse with a wide spectrum of genotypes and clinical manifestations. Coxsackievirus A22 (CVA22) has been detected globally from sewage surveillance; however, currently there is limited information on its prevalence in patients, as well as available genomic data. Objective: We aimed to provide genomic and relative frequency data on CVA22 from a regional hospital perspective between 2013-2020. Study design: Sanger sequencing was performed on all samples with a positive enterovirus RT-qPCR result ( 3 weeks). Furthermore, we report the first two near-complete CVA22 sequences from Europe, which grouped with a strain previously isolated from Bangladesh in 1999. Conclusions: We show a highly diverse enterovirus genotype which causes infections annually, typically in autumn and winter, and is capable of recurrent infection in an immunocompromised patient. Furthermore, we highlight the use of NGS to complement conventional targeted Sanger sequencing

Memory Performance is Related to Language Dominance as Determined by the intracarotid amobarbital procedure

Objective The goal of this study was to explore the relationship between language and memory lateralization in patients with epilepsy undergoing the intracarotid amobarbital procedure. Methods In 386 patients, language lateralization and memory lateralization as determined by laterality index (LI) were correlated with each other. Results Language lateralization and memory lateralization were positively correlated (r = 0.34, P \u3c 0.01). Correlations differed depending on the presence and type of lesion (χ2 = 7.98, P \u3c 0.05). LIs correlated significantly higher (z = 2.82, P \u3c 0.05) in patients with cortical dysplasia (n = 41, r = 0.61, P \u3c 0.01) compared with the group without lesions (n = 90, r = 0.16, P \u3e 0.05), with patients with hippocampal sclerosis falling between these two groups. Both memory (P \u3c 0.01) and language (P \u3c 0.01) LIs were higher in right- compared with left-sided lesions. Conclusion Correlation of language and memory is more pronounced in patients with structural lesions as compared with patients without lesions on MRI

Visual Naming Performance after ATL Resection: Impact of Atypical Language Dominance.

Purpose- To characterize the interaction between language dominance and lateralization of the epileptic focus for pre- and postoperative Boston Naming Test (BNT) performance in patients undergoing anterior temporal lobectomy (ATL). Methods- Analysis of pre- and postoperative BNT scores depending on lateralization of language as measured by the intracarotid amobarbital procedure (IAP) versus lateralization of the temporal lobe epileptic focus. Results- Changes between pre- and postoperative BNT performance depended on epilepsy lateralization (effect size = 0.189) with significant decrease in patients undergoing left ATL. Subgroup analysis in these showed that postoperative decline in BNT scores was significant in patients with atypical (n = 14; p \u3c 0.05), but did not reach statistical significance in patients with left language dominance (n = 36; p = 0.09). Chi-square test revealed a trend of higher proportions of patients experiencing significant postsurgical deterioration in naming performance in atypical (57.1%) as compared to left language dominance (30.6%; p = 0.082). Surgical failure was also associated with greater decline of BNT scores and was more common in atypical than in left language dominant patients (χ2 (1, n = 98) = 4.62, p = 0.032). Age of onset, duration of epilepsy, and seizure frequency had no impact on changes in BNT performance. Conclusion- Atypical language dominance is a predictor of change in visual naming performance after left ATL and may also impact postsurgical seizure control. This should be considered when counseling surgical candidates

Assessment of Viral Targeted Sequence Capture Using Nanopore Sequencing Directly from Clinical Samples

Shotgun metagenomic sequencing (SMg) enables the simultaneous detection and characterization of viruses in human, animal and environmental samples. However, lack of sensitivity still poses a challenge and may lead to poor detection and data acquisition for detailed analysis. To improve sensitivity, we assessed a broad scope targeted sequence capture (TSC) panel (ViroCap) in both human and animal samples. Moreover, we adjusted TSC for the Oxford Nanopore MinION and compared the performance to an SMg approach. TSC on the Illumina NextSeq served as the gold standard. Overall, TSC increased the viral read count significantly in challenging human samples, with the highest genome coverage achieved using the TSC on the MinION. TSC also improved the genome coverage and sequencing depth in clinically relevant viruses in the animal samples, such as influenza A virus. However, SMg was shown to be adequate for characterizing a highly diverse animal virome. TSC on the MinION was comparable to the NextSeq and can provide a valuable alternative, offering longer reads, portability and lower initial cost. Developing new viral enrichment approaches to detect and characterize significant human and animal viruses is essential for the One Health Initiative

Comparative efficacy of two fipronil spot-on formulations against experimental tick infestations (Ixodes ricinus) in dogs

A parallel-group-design, randomized, unicentre and blinded controlled study was undertaken to assess the efficacy of a new fipronil-based spot-on formulation applied once to dogs against experimental Ixodes ricinus infestations. Six dogs served as negative controls (group 1), six dogs served as positive controls (group 2) receiving the original fipronil spot-on (Frontline® spot-on Dog, Merial) at a dosage of 0.67 mL for a dog weighing from 2 to 10 kg and 1.34 mL for a dog weighing from 10.1 to 20 kg and six dogs were treated with a 10% w/v fipronil-based spot-on solution (Effipro® Spot-on, Virbac SA) at an identical dosage (group 3, 0.67 mL for a dog weighing from 2 to 10 kg and 1.34 mL for a dog weighing from 10.1 to 20 kg). Each dog was sedated and subsequently infested with 50 unfed adult I. ricinus on days −7, −2, 7, 14, 21, 28 and 35. Forty-eight hours after the treatment and 48 h after each challenge (days −5, 2, 9, 16, 23, 30 and 37), the population of the remaining ticks was assessed for each animal. Geometric mean tick counts obtained were reduced by 99% and 94% on day 2 in groups 2 and 3, respectively, compared to the negative control group. Dogs were protected from re-infestations with an efficacy of >90% for 3 weeks in group 2 and for 5 weeks in group 3. Both 10% w/v fipronil-based spot-on solutions, despite different vehicles, were equally able to eradicate tick infestation, to prevent new infestations and were equally well tolerated

Ictal asystole secondary to suspected herpes simplex encephalitis: a case report

Herpes simplex virus is a leading cause of sporadic encephalitis. While seizures are a common feature of Herpes simplex virus encephalitis, and periods of asystole have been reported in Herpes simplex virus patients, there have been no prior reports of ictal asystole secondary to such an infection

Automated Analysis of Risk Factors for Postictal Generalized EEG Suppression

Rationale: Currently, there is some ambiguity over the role of postictal generalized electro-encephalographic suppression (PGES) as a biomarker in sudden unexpected death in epilepsy (SUDEP). Visual analysis of PGES, known to be subjective, may account for this. In this study, we set out to perform an analysis of PGES presence and duration using a validated signal processing tool, specifically to examine the association between PGES and seizure features previously reported to be associated with visually analyzed PGES. Methods: This is a prospective, multicenter epilepsy monitoring study of autonomic and breathing biomarkers of SUDEP in adult patients with intractable epilepsy. We studied videoelectroencephalogram (vEEG) recordings of generalized convulsive seizures (GCS) in a cohort of patients in whom respiratory and vEEG recording were carried out during the evaluation in the epilepsy monitoring unit. A validated automated EEG suppression detection tool was used to determine presence and duration of PGES. Results: We studied 148 GCS in 87 patients. PGES occurred in 106/148 (71.6%) seizures in 70/87 (80.5%) of patients. PGES mean duration was 38.7 ± 23.7 (37; 1–169) seconds. Presence of tonic phase during GCS, including decerebration, decortication and hemi-decerebration, were 8.29 (CI 2.6–26.39, p = 0.0003), 7.17 (CI 1.29–39.76, p = 0.02), and 4.77 (CI 1.25–18.20, p = 0.02) times more likely to have PGES, respectively. In addition, presence of decerebration (p = 0.004) and decortication (p = 0.02), older age (p = 0.009), and hypoxemia duration (p = 0.03) were associated with longer PGES durations. Conclusions: In this study, we confirmed observations made with visual analysis, that presence of tonic phase during GCS, longer hypoxemia, and older age are reliably associated with PGES. We found that of the different types of tonic phase posturing, decerebration has the strongest association with PGES, followed by decortication, followed by hemi-decerebration. This suggests that these factors are likely indicative of seizure severity and may or may not be associated with SUDEP. An automated signal processing tool enables objective metrics, and may resolve apparent ambiguities in the role of PGES in SUDEP and seizure severity studies