Seroprevalence of influenza A H1N1 and influenza D viruses in ruminants in Qatar

BackgroundInfluenza is among the most common viruses affecting humans and many animals worldwide. While influenza A (IAV) and D (IDV) viruses are associated with respiratory disease in humans and animals, respectively, their prevalence in the Middle East is unknown. MethodsHere, we assessed the seroprevalence of IDV and IAV/H1N1 in 331 ruminants (including camels, sheep, cattle, and goats) in Qatar. Sera samples were collected from ruminants in different farms and titrated by hemagglutination inhibition (HAI) assay. ResultsWe showed a high prevalence of IDV in all ruminants, ranging between 55 and 84 %, with the highest rates seen in sheep and cattle. The rates were much lower for IAV, ranging between 6 and 8 %, but were not detectable in goats. HAI titers of IDV-seropositive samples ranged between 20 and 2560, whereas IAV titers ranged between 20 and 640. ConclusionsOur study provides the first serological evidence of IDV and IAV/H1N1 in ruminants in Qatar. These results underscore the need for further investigation into the role of ruminants in influenza virus transmission.This work was funded by Qatar University, BRC Internal Funds 2020, and Qatar National Research Fund (QNRF), grant MME03-1128-210032

Linking pharmacy dispensing data to other administrative health datasets to measure the compliance and effectiveness of RSV immunoprophylaxis

Introduction Respiratory Syncytial Virus (RSV) causes considerable morbidity in children. RSV vaccines are in development, but the only current preventive measure is immunoprophylaxis with monoclonal antibody, palivizumab. Australia has no uniform palivizumab guidelines. In Western Australia palivizumab is licensed for use in high risk children but compliance and effectiveness is unknown. Objectives and Approach We conducted a retrospective cohort study using palivizumab data from multiple pharmacy dispensing datasets which had been linked with routine laboratory, hospital morbidity, emergency department presentations, deaths and perinatal data for a cohort of infants admitted to Level 3 Neonatal Intensive Care Units (NICU) between 2002 and 2013. We identified palivizumab eligible infants as those who were extremely premature (<28 weeks gestation) with bronchopulmonary dysplasia and/or who identified as Indigenous and were NICU inpatients during the annual winter RSV season (May-October). We describe the use of palivizumab in infants that did and did not fit the eligibility criteria. Results The NICU cohort included 24,367 infants, of which 1754 had at least 1 RSV-confirmed infection before age 5 years. A total of 686 (2.8%) cohort infants were eligible for palivizumab. Palivizumab dispensing data were amalgamated from 5 pharmacy datasets. Overall, 173 of the palivizumab eligible infants (25.2%) had at least 1 palivizumab dose (27% 1 dose, 34% 2 doses, 28% 3 doses and 11% 4 or more doses). From 2011 when palivizumab guidelines were formalised, 143 (75%) had at least 1 dose. Compliance with at least 1 palivizumab dose was highest in 2011 (84.9%). From 2002-2013, 98 infants were given palivizumab outside eligibility criteria (33% 1 dose, 33% 2 doses, 34% 3 or more doses) with annual use increasing since 2008. Conclusion/Implications This is the first time pharmacy dispensing data have been linked to other datasets to measure use and effectiveness. Compliance with palivizumab guidelines was high from 2011. These data will be used to measure the effectiveness of palivizumab against RSV-confirmed infections and respiratory infection-related hospitalisations up to age 5 years

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Survival of Pediatric Leukemia: The Role of Social Determinants

In most high-income countries, leukemia is the most common cancer in children. Currently, overall survival (OS) of children with acute leukemia is 90% in gratitude to advances in research and therapy. The goal of this structured review is to identify the association between ethnicity, social environment and survival-related outcomes of cancer treatments among children with leukemia. A search strategy was developed and applied in PubMed, EMBASE, ProQuest and Ovid (Medline) using relevant key terms related to survival related and socioeconomic factors. Electronic searches from inception to November 15th, 2017 were performed. Of the 175 publications screened for eligibility, 30 studies met the criteria for full review, and 9 studies met final inclusion criteria. The overall 5-year survival rates being reported in the studies ranged from 69.5% to 92%, with lower survival percentages coming from studies that indicate involvement of socio-demographic factors such as race and poverty. Other studies suggested no association between the survival rates as well as mortality rates and socio-demographic factors. Various studies have provided evidence and indicated that children with leukemia belonging to specific ethnic groups, and economic minority groups experience inferior survival outcomes as compared to their advantaged majority counterparts

Psychiatric disorders in childhood cancer survivors: A retrospective matched cohort study of inpatient hospitalisations and community-based mental health services utilisation in Western Australia

Objective: We examined the impact of long-term mental health outcomes on healthcare services utilisation among childhood cancer survivors in Western Australia using linked hospitalisations and community-based mental healthcare records from 1987 to 2019. Method: The study cohort included 2977 childhood cancer survivors diagnosed with cancer at age \u3c 18 years in Western Australia from 1982 to 2014 and a matched non-cancer control group of 24,994 individuals. Adjusted hazard ratios of recurrent events were estimated using the Andersen–Gill model. The cumulative burden of events over time was assessed using the method of mean cumulative count. The annual percentage change in events was estimated using the negative binomial regression model. Results: The results showed higher community-based service contacts (rate/100 person-years: 30.2, 95% confidence interval = [29.7–30.7] vs 22.8, 95% confidence interval = [22.6–22.9]) and hospitalisations (rate/1000 person-years: 14.8, 95% confidence interval = [13.6–16.0] vs 12.7, 95% confidence interval = [12.3–13.1]) in childhood cancer survivors compared to the control group. Childhood cancer survivors had a significantly higher risk of any event (adjusted hazard ratio = 1.5, 95% confidence interval = [1.1–2.0]). The cumulative burden of events increased with time since diagnosis and across age groups. The annual percentage change for hospitalisations and service contacts significantly increased over time (p \u3c 0.05). Substance abuse was the leading cause of hospitalisations, while mood/affective and anxiety disorders were common causes of service contacts. Risk factors associated with increased service events included cancer diagnosis at age \u3c 5 years, leukaemia diagnosis, high socioeconomic deprivation, and an attained age of \u3c 18 years. Conclusions: The elevated utilisation of healthcare services observed among childhood cancer survivors emphasises the need for periodic assessment of psychiatric disorders, particularly in high-risk survivors, to facilitate early management and optimise healthcare resources

Multiple Object Tracking in Robotic Applications: Trends and Challenges

The recent advancement in autonomous robotics is directed toward designing a reliable system that can detect and track multiple objects in the surrounding environment for navigation and guidance purposes. This paper aims to survey the recent development in this area and present the latest trends that tackle the challenges of multiple object tracking, such as heavy occlusion, dynamic background, and illumination changes. Our research includes Multiple Object Tracking (MOT) methods incorporating the multiple inputs that can be perceived from sensors such as cameras and Light Detection and Ranging (LIDAR). In addition, a summary of the tracking techniques, such as data association and occlusion handling, is detailed to define the general framework that the literature employs. We also provide an overview of the metrics and the most common benchmark datasets, including Karlsruhe Institute of Technology and Toyota Technological Institute (KITTI), MOTChallenges, and University at Albany DEtection and TRACking (UA-DETRAC), that are used to train and evaluate the performance of MOT. At the end of this paper, we discuss the results gathered from the articles that introduced the methods. Based on our analysis, deep learning has introduced significant value to the MOT techniques in recent research, resulting in high accuracy while maintaining real-time processing

Multiple Object Tracking in Robotic Applications: Trends and Challenges

The recent advancement in autonomous robotics is directed toward designing a reliable system that can detect and track multiple objects in the surrounding environment for navigation and guidance purposes. This paper aims to survey the recent development in this area and present the latest trends that tackle the challenges of multiple object tracking, such as heavy occlusion, dynamic background, and illumination changes. Our research includes Multiple Object Tracking (MOT) methods incorporating the multiple inputs that can be perceived from sensors such as cameras and Light Detection and Ranging (LIDAR). In addition, a summary of the tracking techniques, such as data association and occlusion handling, is detailed to define the general framework that the literature employs. We also provide an overview of the metrics and the most common benchmark datasets, including Karlsruhe Institute of Technology and Toyota Technological Institute (KITTI), MOTChallenges, and University at Albany DEtection and TRACking (UA-DETRAC), that are used to train and evaluate the performance of MOT. At the end of this paper, we discuss the results gathered from the articles that introduced the methods. Based on our analysis, deep learning has introduced significant value to the MOT techniques in recent research, resulting in high accuracy while maintaining real-time processing