Since 2020, the "marketing authorization updates" section of Bulletin du Cancer has provided a monthly educational summary of new marketing authorizations (MAs) granted by the European Medicines Agency (EMA) in the fields of oncology and hematology. A survey was conducted five years after its creation to assess the functioning of the format, its informative and educational value, and potential areas for improvement. An online questionnaire comprising 16 items was distributed in May 2025 to the 245 authors who had contributed to at least one article in the AMM section. A total of 78 responses were collected, including 52 residents and 26 senior physicians. The results were positive regarding the organization and the quality of interactions within the author pairs, with writing guidelines rated as "clear" or "perfectly clear" in over 80% of responses. The perceived educational value was high for both trainees and seniors (median self-reported educational benefit of 9/10 for residents and 7.5/10 for senior physicians). Overall satisfaction with the format was also high, with a median rating of 9/10 in both groups. This survey highlights the value of the "marketing authorization updates" section, which successfully fulfils a dual mission of education and information, while fostering intergenerational collaboration.
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In 2023, a significant increase in the number of pertussis cases was recorded in Poland, which is consistent with the trend of a resurgence of respiratory diseases observed across Europe following the COVID-19 pandemic. This increase is related to factors such as declining population immunity, delays in vaccinations, and diagnostic difficulties, particularly in adults and adolescents. The aim of the study was to assess the epidemiological situation of pertussis in Poland in 2023 compared to the situation in previous years, with particular emphasis on assessing the impact of the COVID-19 pandemic and assessing the vaccination status of children against pertussis. The assessment of the epidemiological situation of pertussis in Poland was made based on the results of the analysis of individual reports on pertussis cases registered at the National Institute of Public Health NIH - National Research Institute in the EpiBaza system and data from the annual bulletins "Infectious diseases and poisonings in Poland" and the bulletin "Vaccinations in Poland in 2023". In 2023, 922 cases of pertussis were recorded. The incidence was 2.45/100,000, which was 150% higher than in 2022. The highest incidence of pertussis occurred in children aged 0-4 years (17.3/100,000), and high in children aged 5-9 years (7.6/100,000). Approximately 45% of cases occurred in people over 15 years of age. In 2023, the number of pertussis cases in Poland increased more than 2.5-fold compared to the previous year, which is due, among other things, to the complete lifting of pandemic restrictions and an increase in social contacts. Pertussis remains a significant public health threat, and waning post-vaccination immunity promotes transmission, especially among adolescents and adults, who can infect infants. W 2023 roku w Polsce odnotowano istotny wzrost liczby zachorowań na krztusiec, co wpisuje się w obserwowany w całej Europie trend nawrotu chorób układu oddechowego po pandemii COVID-19. Wzrost ten jest związany m.in. ze spadkiem odporności populacyjnej, opóźnieniami w szczepieniach oraz trudnościami w diagnostyce, zwłaszcza u dorosłych i młodzieży. Celem pracy była ocena sytuacji epidemiologicznej krztuśca w Polsce w 2023 r. w porównaniu z sytuacją w ubiegłych latach, ze szczególnym uwzględnieniem oceny wpływu pandemii COVID-19 oraz oceny stanu zaszczepienia dzieci przeciw krztuścowi. Ocena sytuacji epidemiologicznej krztuśca w Polsce została wykonana na podstawie wyników analizy raportów jednostkowych o zachorowaniach na krztusiec zarejestrowanych w NIZP PZH – PIB w systemie EpiBaza oraz danych z biuletynów rocznych „Choroby zakaźne i zatrucia w Polsce” oraz biuletynu „Szczepienia ochronne w Polsce w 2023 r.”. W 2023 r. zarejestrowano 922 zachorowań na krztusiec. Zapadalność wynosiła 2,45 /100 tys. i była wyższa o 150% w porównaniu z zapadalnością w roku 2022. Najwyższa zapadalność na krztusiec wystąpiła u dzieci w grupie wieku 0-4 lata (17,3/100 tys.), a wysoka u dzieci w wieku 5-9 lat (7,6/100 tys.). Około 45% zachorowań dotyczyło osób powyżej 15 r.ż. W 2023 roku w Polsce liczba zachorowań na krztusiec wzrosła ponad 2,5-krotnie w porównaniu z rokiem poprzednim, co wiąże się m.in. z całkowitym zniesieniem ograniczeń pandemicznych i wzrostem liczby kontaktów społecznych. Krztusiec pozostaje istotnym zagrożeniem zdrowia publicznego, a wygasająca odporność poszczepienna sprzyja transmisji, zwłaszcza wśród młodzieży i dorosłych, którzy mogą zakażać niemowlęta. Najwyższą zapadalność odnotowano wśród dzieci w wieku 0-4 lat. Najbardziej narażone na ciężki przebieg i zgon są niemowlęta poniżej 6 miesiąca życia.
The proteome is defined as the total protein complement of a genome-whether that genome is associated with an individual cell, tissue, or organism (Wasinger et al., Electrophoresis 16:1090-1094, 1995). Proteomics refers to the application of technologies to characterize the proteome. The term "proteome" was coined by researchers at the University of Sydney, Australia, in a paper published in 1995 (Wasinger et al., Electrophoresis 16:1090-1094, 1995). But did proteomics really begin in 1995 or were researchers doing proteomic research long before? As a PhD student, I would tell people that my field of expertise was protein science, as I was involved in determining the three-dimensional structures of proteins using nuclear magnetic resonance (NMR) spectroscopy. As my career evolved to using mass spectrometry (MS) to analyze complex mixtures of proteins, my field of expertise was proteomics. While still studying proteins, what had changed was the number of proteins I was analyzing per experiment. In a nutshell, proteomics is simply the large-scale study of proteins. While protein scientists have been studying proteins for almost 200 years (Mulder, Bulletin des Sciences Physiques et Naturelles en Néerlande 104, 1838), proteomics has increased the throughput and the ability to characterize proteins in the context of other proteins within their environment. While well-known for its high-throughput ability to identify and quantitate proteins, proteomics encompasses several different facets of protein characterization including such things as structure, function, protein-protein interactions, posttranslational modifications, and protein quantitation. Data acquired under any of these broad categories can be applied to greater understand something part of the cell system.
Professional organizations' syphilis screening guidelines are updated to align with evidence and need. Guideline awareness, current guideline dissemination sources, and future preferred sources were investigated among prenatal providers (n = 225). Some providers lacked awareness of screening guidelines, and primary sources of guideline information were practice bulletins, professional organizations, and continuing education courses.
The Stroop interference effect - slower color naming on incongruent trials (e.g., GREEN printed in red) compared to neutral trials (e.g., PRESS printed in red) - is widely regarded as a hallmark of selective attention failure. We (Curtis et al., Psychonomic Bulletin & Review, 32, 1328-1336, 2025) have previously argued that the integrated nature of the Stroop stimulus is a main factor contributing towards the robustness of this interference, which shows a characteristic positively sloped delta plot pattern. Here, we tested this claim by directly comparing the standard, integrated Stroop task with the primed Stroop task, in which the word and color are separated temporally (e.g., GREEN in monochrome followed by XXXX in red). Participants completed randomly intermixed standard (integrated) and primed Stroop trials: In Experiment 1, the prime-target stimulus-onset asynchrony (SOA) was 550 ms; and in Experiment 2, it was 250 ms. In the standard task, interference was large and increased across quantiles, replicating the classic delta plot pattern. In contrast, interference in the primed Stroop task was smaller and remained constant across the RT distribution - producing a flat delta slope, with both long and short SOAs. We take these results as support for our claim that the robustness of Stroop interference stems from the perceptual integration of word and color into a single visual object, and when this integration is broken as in the primed Stroop task, the resulting interference effect reflects a qualitatively different mechanism; thus, the effect in the primed Stroop task is not a "Stroop effect."
In 2023 there was a significant increase in the number of syphilis cases in Poland, more than 50% new cases were reported compare to previous year. There is still a problem with the clinical differentiation of reported cases, i.e. new infections, reinfections, and residual positive serological tests confirming the presence of antibodies against Treponema pallidum in previously successfully treated individuals. The aim of the study was to assess the epidemiological situation of syphilis cases in Poland in 2023 in comparison to previous years. Analysis of the epidemiological situation was based on case-based data from reports of newly detected syphilis cases received from doctors and laboratories and registered in 2023 year. Additionally aggregated data from MZ-56 reports on infectious diseases, infections and poisoning from 2017 to 2019 sent from Sanitary Inspections to NIPH NIH - NRI was used. Also, data about treatment patients in dermatology/venereology clinics in 2020-2023 reported on MZ-14 forms and published in the NIPH NIH - NRI bulletins were used. In 2023, in Poland, 2,968 syphilis cases were reported (diagnosis rate was 7.89 per 100,000 population), including 130 cases among non-Polish citizens. The most often syphilis cases were detected among people below 30 years old (37.1%) and among men (88.1%). In 2023, early syphilis (ICD-10 code: A51) consisted 36.0% of all cases reported to surveillance (1,068 cases) and other syphilis and undetermined (ICD-10 code: A53) consisted 60.6% (1,799 cases). In 2023, the number of reported syphilis cases increased more than by half compared to the previous year. The percentage of cases of early syphilis (the most infectious), which probably occurred in a short period of time, also remains high, what can influence on transmission this infection in population and lead to increase in the number of new cases. W 2023 roku nastąpił znaczny wzrost liczby przypadków kiły w Polsce, zgłoszono o ponad 50% więcej przypadków niż w roku poprzednim. Nadal pozostaje problemem rozróżnienie kliniczne zgłaszanych przypadków tj. nowych zakażeń, reinfekcji, oraz pozostałości dodatnich testów serologicznych potwierdzających obecność przeciwciał w kierunku Treponema pallidum u osób wcześniej skutecznie leczonych. Celem pracy była ocena sytuacji epidemiologicznej kiły w Polsce w roku 2023 w porównaniu z poprzednimi latami. Ocenę sytuacji epidemiologicznej przeprowadzono na podstawie zgłoszeń przypadków kiły zarejestrowanych w roku 2023 pochodzących od lekarzy i z laboratoriów. Wykorzystano również zagregowane dane ze sprawozdań o zachorowaniach na choroby zakaźne, zakażeniach i zatruciach MZ-56 (meldunki dwutygodniowe, kwartalne, roczne) za lata 2017-2019 przekazane przez Państwową Inspekcję Sanitarną do NIZP PZH – PIB oraz dane ze sprawozdań MZ-14 o leczonych w poradniach skórno-wenerologicznych, publikowane w biuletynach NIZP PZH – PIB za lata 2020-2023. W 2023 roku w Polsce zgłoszono 2 968 przypadków kiły (wskaźnik rozpoznań 7,89 na 100 000 mieszkańców), w tym 130 u obcokrajowców. Najwięcej przypadków stwierdzono u osób poniżej 30 r.ż. (37,1%) oraz mężczyzn (88,1%). W 2023 roku kiła wczesna (ICD-10: A51) stanowiła 36,0% wszystkich rozpoznań kiły zgłoszonych do nadzoru (1 068 przypadków), a kiła inna i nieokreślona (ICD-10: A53) 60,6% (1 799 przypadków). W 2023 roku liczba zgłoszeń przypadków kiły zwiększyła się o ponad połowę w porównaniu z poprzednim rokiem. Na wysokim poziomie pozostawał również odsetek przypadków kiły wczesnej (najbardziej zakaźnej), co może mieć wpływ na rozprzestrzenianie się zakażeń w populacji i wzrost liczby nowych przypadków.
The objective is to determine the prevalence and types of drug-related problems (DRPs), identify associated factors, and evaluate the impact of a structured pharmacist-led intervention on prescribing quality in pediatric outpatient care in a resource-limited health system with limited advanced prescribing decision-support. A pre-post intervention study was conducted from July 2023 to June 2024 at a secondary-level hospital in a lower-middle-income country setting (Vietnam). Two independent cross-sectional prescription samples were obtained using systematic random sampling (323 prescriptions preintervention and 323 postintervention). DRPs were identified using national prescribing frameworks and mapped to the Pharmaceutical Care Network Europe DRP Classification (v9.1). The intervention comprised pharmacist-led educational sessions and the dissemination of drug information bulletins, with ongoing reminders, targeting the most frequent baseline DRPs. Factors associated with DRP occurrence (≥1 DRP per prescription) were examined using logistic regression; pre-post comparisons used Chi-square tests. At baseline, 57.9% of prescriptions contained at least one DRP, predominantly dosage regimen-related problems, with incorrect timing of administration being the most frequent (32.20%). In multivariable analysis, prescriptions issued by male prescribers had higher odds of DRPs (odds ratio 2.51, 95% confidence interval 1.51-4.18), whereas prescriptions for children aged 2-6 years and 6-12 years had lower odds than those for children aged ≤2 years. Following the intervention, DRP prevalence decreased significantly to 40.2% (P < 0.001), with marked reductions in timing- and dosing-related DRPs. A structured, low-cost pharmacist-led intervention integrated into routine outpatient practice was associated with a clinically meaningful reduction in DRPs. Strengthening clinical pharmacy services is a feasible and scalable strategy to improve pediatric prescribing safety in resource-limited settings where systematic medication review and electronic decision support are constrained.
This study investigated interword spacing effects on eye movement during Arabic reading, focusing on the distinctive orthographic system of Arabic text. Research on Roman-script languages (e.g., English) concluded that interword spacing facilitates word identification and sentence comprehension (Rayner et al. in Vision Research 38:1129–1144, 1998, https://doi.org/10.1016/s0042-6989(97)00274-5 ; Slattery et al. in Journal of Experimental Psychology: Applied 22:406–422, 2016, https://doi.org/10.1037/xap0000104 ), whereas studies on other languages could not replicate these results (Bai et al. in Journal of Experimental Psychology: Human Perception and Performance 34:1277–1287, 2008, https://doi.org/10.1037/0096-1523.34.5.1277 ). While written Arabic uses interword spaces between words, we showed that manipulating interword spaces did not inhibit reading-related eye movements. However, we found a significant influence of interword spacing on saccadic programming. Overall, the lack of an ‘interword spacing effect’ in Arabic led us to postulate that Arabic orthography might have an important role in guiding saccades despite the absence of interword spacing. Our conclusions are also in line with the proposal that there is an independent level of abstract letter representation of Arabic which encodes allographs and letter positions (e.g., Carreiras et al. Psychonomic Bulletin & Review 19:685–690, 2012, https://doi.org/10.3758/s13423-012-0260-8 ).
The endemic channel is a surveillance method that presents statistical indicators and visual representations of a disease's historical dynamics. Its epidemic curve defines the central tendency of cases and their expected variation, providing 3 levels (ie, "safety," "warning," and "epidemic") to assess the epidemiological status of a region. Parameters include the central tendency used as the epidemiological warning threshold (EWT), the size of the retrospective window, and the handling of previous outbreaks and zero values in data. The absence of clear guidelines for the selection of these parameters may compromise reproducibility and hinder outbreak definitions and responses for endemic diseases such as dengue. This study aimed to review the parameters of the endemic channel used for the definition and monitoring of dengue outbreaks in Colombia while quantitatively assessing the performance of the method. We reviewed institutional epidemiological bulletins in Colombia and quantitatively assessed the endemic channel in two main aspects: (1) the impact on the EWT of parameter selection regarding the retrospective data window, previous epidemic years handling, and zero-value handling, using a statistical framework; and (2) the endemic channel's performance based on the windows of opportunity, outbreak detection capacity, and the ratio of warnings that correspond to actual outbreaks. The endemic channel's performance is higher as transmission increases due to more robust data that facilitate a timely detection of outliers, while lower-transmission areas show a sharper rise in cases when outbreaks are missed, indicating limited detection capacity. Reducing the retrospective data window improved metrics across all transmission profiles by 6.34% on average, while extending it decreased performance due to changes in detection capacity. There was no significant difference (P value >.01) in performance when data from epidemic years were included or excluded for municipalities with high or very high transmission levels. Instead of adding an entire unit, shifting the data by 0.001 prevents the estimation of null values for the EWT and thresholds and significantly improves performance across all transmission levels (P value <.01) by 23.07% on average. The endemic channel's performance varies with the outbreak definition and the municipality's transmission level. Encouraging an optimal retrospective window is challenging, as data are computed over the years. Nevertheless, the improved performance with shorter retrospective windows is likely due to reduced overlap in seasonal outbreaks. Shifting data by a limiting-to-zero value, instead of adding a complete unit, improves performance and can be easily integrated into existing surveillance templates. Windows of opportunity should be considered when selecting the parameter combination. Finally, reassessing outbreak definitions and method parameters underpinning surveillance tools is essential to ensure their validity and effectiveness, especially when used to inform early warning systems and public policies.
Lyme disease is a vector-borne disease transmitted by ticks of the Ixodes genus, caused by a heterogeneous group of Borrelia burgdorferi sensu lato. Human infection occurs through a tick bite and its feeding on the skin. Due to the diverse symptoms, diagnosing Lyme disease is challenging and usually involves a two-step serological approach. Currently, there is still no vaccine against Lyme disease, but in 2024, data on the immunogenicity and safety of the VLA15-221 vaccine, which is in the second phase of clinical trials, was announced. The aim of the study is to discuss the epidemiological situation of Lyme disease in Poland in 2023 compared to previous years. To assess the epidemiological situation of Lyme disease in Poland, data sent to NIPH NIH - NRI by the district Sanitary-Epidemiological Stations and published in the annual bulletin: "Infectious diseases and poisonings in Poland in 2023" were used. In 2023, there were 25 285 reported cases of Lyme disease and 1 155 hospitalizations. This represents a significant increase in cases by 45.58% compared to the previous year. Seasonal variations in case occurrences are evident in distinct quarters, with the number rising from 2 466 in Q1 to 11 626 in Q3, and then declining in Q4 to 5 945. The highest incidence was recorded in the Małopolskie voivodeship (122.9 per 100,000), Podlaskie voivodeship (96 per 100,000), and Warmińsko-Mazurskie voivodeship (95.2 per 100,000). The number of borreliosis cases returned to pre-pandemic levels but also increased by 22.57% compared to 2019 (20 630 cases), and doubled (95.49%) compared to 2020 (12 934 cases). Seasonality has remained unchanged for years. Usually, eastern Poland (most often the Podlaskie voivodeship) is characterised by the highest incidence, however, in 2023, the highest incidence was recorded in the Małopolskie voivodeship at 122.9 per 100,000. Borelioza to choroba wektorowa przenoszona przez kleszcze rodzaju Ixodes, wywoływana przez niejednorodną grupę Borrelia burgdorferi sensu lato. Zakażenie człowieka odbywa się poprzez ukłucie i żerowaniu kleszcza na skórze. Z uwagi na zróżnicowane objawy, rozpoznanie choroby z Lyme jest trudne i zwykle obejmuje dwuetapowe podejście serologiczne. Obecnie, nie ma jeszcze szczepionki przeciwko boreliozie, ale w 2024 roku zostały ogłoszone dane dotyczące immunogenności i bezpieczeństwa szczepionki VLA15-221 będącej w drugiej fazie badań klinicznych. Celem pracy jest omówienie sytuacji epidemiologicznej boreliozy w Polsce w 2023 r. w porównaniu do ubiegłych lat. Do przeprowadzenia oceny sytuacji epidemiologicznej boreliozy w Polsce wykorzystano dane nadsyłane do NIZP PZH – PIB przez Wojewódzkie Stacje Sanitarno-Epidemiologiczne i publikowane w biuletynie rocznym: „Choroby zakaźne i zatrucia w Polsce w 2023 r.”. W 2023 r. zarejestrowano 25 285 zachorowań na boreliozę oraz 1 155 hospitalizacji z powodu tej choroby. Jest to znaczny wzrost zachorowań o 45,58% w stosunku do poprzedniego roku. W poszczególnych kwartałach widać sezonowość występowania przypadków tzn. wzrost ich liczby z 2 466 w Q1 do 11 626 w Q3 oraz spadek w Q4 do 5 945. Największą zapadalność odnotowano w województwie małopolskim (122,9 na 100 tys.) podlaskim (96 na 100 tys.), oraz warmińsko-mazurskim (95.2 na 100 tys.). Liczba przypadków boreliozy zgłaszanych przez lekarzy do powiatowych stacji sanitarno-epidemiologicznych nie tylko wróciła do wartości sprzed pandemii, ale uzyskała wzrost o 22,57% w porównaniu do roku 2019 (20 630 przypadków), oraz prawie dwukrotny wzrost (95,49%) w porównaniu do roku 2020 (12 934 przypadków). Sezonowość pozostaje niezmienna od lat – szczyt zachorowań jest rejestrowany w Q3, a najmniej zachorowań występuje w Q1. Zazwyczaj największą zapadalnością charakteryzuje się wschodnia część Polski (najczęściej województwo podlaskie), jednak w 2023 r. najwyższa zapadalność została odnotowana w województwie małopolskim 122,9 na 100 tys.
Snow avalanches pose a serious hazard in snow-covered, mountainous areas. In order to protect inhabited areas and infrastructure such as roads and railway lines, avalanche protection measures need to be taken. In addition to permanent, technical protection measures, temporary, organizational measures, which are based on risk assessments by local avalanche warning commissions, are utilized. These avalanche risk assessments rely on regional avalanche bulletins, weather forecasts, local expertise, and information on current snowpack conditions. Our research seeks to enhance knowledge of current snowpack and avalanche conditions by providing in situ monitoring of potential avalanche slopes. Therefore, we developed a novel sensor box array, peakr, consisting of multiple sensor units deployed by hand or by drone at key avalanche slope locations throughout the winter season. The sensors continuously measure temperature, humidity, position, and snowpack movement. Data are transmitted via LoRaWAN and GSM, stored locally, and accessed through a web platform. Automated analysis using a decision tree and event-detection algorithm triggers immediate alerts to responsible personnel via SMS and email. This paper presents an overview of the peakr sensor array and web platform, focusing on data analysis and avalanche events from the Arlberg ski resort in winter 2023/2024, supported by webcam time-lapse validation.
Jacoby et al. (Psychonomic Bulletin & Review, 10, 638-644, 2003) reported that, in Stroop tasks, stimuli that more frequently involve targets combined with a congruent distractor (e.g., the word RED in the color red) produce larger Stroop effects than stimuli that more frequently involve targets combined with an incongruent distractor (e.g., RED in green). This pattern suggests that adaptive control can be item-specific in addition to item-nonspecific, and reactive in addition to proactive (although this conclusion has been challenged). This adaptive-control process has often been assumed to be driven by the conflict associated with incongruent stimuli; however, the typical experimental manipulations investigating this issue allow the facilitation associated with congruent stimuli to also play a role. Here, we modified those manipulations in order to focus exclusively on conflict, removing any impact of congruency facilitation, by contrasting targets presented with either neutral (letter strings) or incongruent distractors. Neutral stimuli were presented more frequently than incongruent ones in the Mostly-Neutral (MN) condition and vice versa in the Mostly-Incongruent (MI) condition. Paralleling the original pattern, Stroop interference was larger in the MN condition, suggesting that item-specific conflict frequency can be used to adapt attention accordingly. Importantly, this effect was replicated after experimentally controlling for stimulus frequency, a confound that was found to explain part, but not all, of the general pattern. These results support Jacoby et al.'s claims that (a) control can be adapted in an item-specific fashion and (b) conflict plays a key role in that process.
Food and waterborne diseases are a significant Public Health problem. In recent years, their epidemiology has been influenced by the COVID-19 pandemic and the increasing burden of Clostridioides difficile infections (CDI). Assessment of epidemiological situation of foodborne infections and intoxications in Poland in 2021-2023. Routine surveillance data collected by the District Sanitary and Epidemiological Stations (PSSE) through the Registry of Epidemic Outbreaks and data from the bulletins "Infectious Diseases and Poisonings in Poland" (2021-2023) were analyzed. Incidence, etiology, outbreak settings and hospitalization rates were assessed. In 2021-2023, an increase in the number of cases of bacterial infections and intoxications was registered (over 90,000 cases, incidence 80.2/100,000) related to an increase in Clostridioides difficile infections (56.4/100,000 in 2023 vs. median 29.5/100,000 in 2015-2019). Also, there was an increase in listeriosis incidence. Among viral infections most prevalent were rotaviral infections, with an increase in 2022 and a decrease in 2023 and incidence between 15.7-20.1/100,000. Between 2021 and 2023, 2,722 foodborne outbreaks were reported, in which 20,102 cases occurred (compared to 2,767 outbreaks and 22,681 cases between 2017 and 2019). Majority of outbreaks were of bacterial etiology (53%), among which the most prevalent were salmonellosis outbreaks, and in this category 80% were S. Enteritidis outbreaks. Proportion of Clostridioides difficile outbreaks was 21.5% (16.5% of all outbreak cases), in medical facilities, outbreaks of this aetiology accounted for 78% of outbreaks. Overall, 27.9% of outbreak cases were hospitalized, most frequently in CDI and hepatitis A outbreaks. Outbreaks occurred mainly in household settings; however, most cases occurred in food-serving facilities and medical facilities. In 2021-2023, the number of foodborne infections and intoxications outbreaks was comparable with the pre-pandemic period, but its aetiology-related structure changed (increases in CDI and viral etiology outbreaks. Those results may confirm the need of ongoing surveillance enhancement and laboratory diagnostic capacity development. Choroby przenoszone drogą pokarmową stanowią istotny problem zdrowia publicznego na świecie. W ostatnich latach na sytuację epidemiologiczną tych chorób w Europie wpływały zarówno zmiany związane z pandemią COVID-19, jak i rosnące znaczenie zakażeń Clostridioides difficile (CDI). Ocena sytuacji epidemiologicznej zatruć i zakażeń pokarmowych w Polsce w latach 2021-2023. Wykorzystano dane z rutynowego nadzoru epidemiologicznego gromadzone przez PSSE w systemie Rejestr Ognisk Epidemicznych (ROE) oraz dane z biuletynów „Choroby zakaźne i zatrucia w Polsce” z lat 2021-2023. Analizowano zapadalność, etiologię i miejsca występowania ognisk zakażeń i zatruć pokarmowych oraz odsetek hospitalizacji. W latach 2021–2023 odnotowano wzrost liczby przypadków bakteryjnych zakażeń i zatruć pokarmowych (łącznie ponad 90 tys., zapadalność 80,2/100 tys.). Wzrost zachorowań był związany ze zwiększeniem liczby zakażeń Clostridioides difficile: w 2023 r. zapadalność wyniosła 56,4/100 tys. (mediana 2015-2019: 29,5/100 tys.). Odnotowano także wzrost zapadalności na listeriozę. Wśród zakażeń wirusowych dominowały rotawirusy, ze wzrostem w 2022 r. i spadkiem w 2023 r., zapadalność norowirusów utrzymywała się w przedziale 15,7-20,1/100 tys. W 2021-2023 zarejestrowano 2 722 ogniska obejmujące 20 102 zachorowania, wobec 2 767 ognisk i 22 681 zachorowań w 2017-2019. Dominowały ogniska o etiologii bakteryjnej (53,3% ognisk), przede wszystkim salmonelozowe, głównie S. Enteritidis (80% ognisk salmonelozowych). Udział ognisk wywołanych przez Clostridioides difficile wyniósł 21,5% oraz 16,5% liczby zachorowań, w placówkach medycznych ogniska o tej etiologii stanowiły 78% ognisk. Hospitalizowano 5 609 (27,9%) chorych w ogniskach, najczęściej w przebiegu CDI (78,4%) oraz WZW A (69,4%). Ogniska najczęściej występowały w gospodarstwach domowych, natomiast najwięcej zachorowań było w podmiotach gastronomicznych i placówkach medycznych. W latach 2021-2023 liczba ognisk chorób przenoszonych drogą pokarmową była porównywalna z okresem przedpandemicznym, natomiast istotnym zmianom uległa ich struktura etiologiczna, w tym wzrost udziału CDI i spadek ognisk wirusowych. Wyniki te podkreślają potrzebę dalszego wzmacniania rutynowego nadzoru epidemiologicznego oraz rozszerzania diagnostyki laboratoryjnej.
This study aimed to identify predictors for maternal morbidity among individuals categorized as low-risk for postpartum hemorrhage (PPH) according to American College of Obstetrics and Gynecology (ACOG) Practice Bulletin (no.: 183). A retrospective cohort study of all singleton births between March 2020 and February 2022 at a Level IV maternity center. Individuals deemed at medium- or high-risk for PPH according to the ACOG risk stratification and those with missing data were excluded from the main analysis. Individuals with the composite maternal hemorrhagic outcome (CMHO) were compared with those without. Variables previously associated with maternal morbidity yet absent from the ACOG stratification were examined as potential predictors of the CMHO. Possible predictors were identified using a multivariable logistic regression and further assessed with a receiver operating characteristic curve (ROC). Out of 8,623 deliveries, 3,472 (40.3%) met the inclusion criteria. Among them, 175 (5.0%) had a CMHO. Individuals with the composite outcome were older, had a higher body mass index, and had higher rates of Hispanic race/ethnicity, diabetes, postterm pregnancy, scheduled cesarean delivery, and neonatal birth weight ≥ 4,000 g. The combination of ≥ 2 risk factors among low-risk patients, present in 16%, was associated with a similar CMHO rate compared with those at medium PPH risk by the ACOG criteria. The combined presence of ≥ 4 factors was associated with a CMHO rate of 36% and yielded a 10.47 positive likelihood ratio (95% confidence interval [CI]: 3.55-30.90). The area under the curve for the ROC curve of the final model was 0.63 (95% CI: 0.62-0.65). Among low-risk PPH patients, several risk factors with low predictive value flagged roughly one out of six with morbidity similar to medium risk. · Five percent of individuals categorized as low-risk for PPH have hemorrhagic morbidity.. · Several predictors of morbidity were identified.. · Low-risk patients with ≥ 2 predictors had similar morbidity to patients with a moderate PPH risk..
BACKGROUND: In Bangladesh, sub-district hospitals (SDHs) are the first referral point for inpatient primary healthcare (PHC) services of the public providers in both rural and municipal corporation areas. These facilities also provide both outpatient and emergency healthcare services to the population at a minimum user fee. The efficient use of resources in primary-level healthcare facilities is essential for delivering quality healthcare services. Therefore, our aim was to estimate the technical efficiency (TE) of the SDHs in Bangladesh. METHODS: We used an output-oriented data envelopment analysis (DEA) method to estimate the variable returns to scale (VRS) and constant returns to scale (CRS) TE of a total of 423 SDHs using data from the Local Health Bulletin -2017. To measure TE, we used workforce and inpatient beds as inputs and the number of inpatients and outpatients served by the hospitals in a month as output. We applied the Simar and Wilson model to find how the other internal and external characteristics of these hospitals influenced estimated TE score. We compared our DEA results with stochastic frontier analysis (SFA) and performed sensitivity analysis. RESULTS: The average VRS and CRS TE of the SDHs were estimated to be 58.9% and 53.4%, respectively. Of the 423 SDHs, 15 were fully efficient in CRS, 30 were in VRS and 60 were scale efficient, while the rest operated below the efficiency frontier. The population density per bed, ratios of bed occupancy, ratios of beds to physicians, ratios of physicians to nurses, and administrative division had a significant positive influence, while lengths of stay and ratios of beds to nurses had a significant negative influence on the SDHs efficiency scores. The mean TE demonstrated that the SDHs, on an average, could improve their output by 42% using the existing level of input mix. The results were consistent in the sensitivity analysis. CONCLUSIONS: The average TE of the SDHs was half of the best score, suggesting there is scope for overall improvement among the inefficient SDHs by learning from the efficient SDHs. The Ministry of Health and Family Welfare (MOHFW) of Bangladesh allocates resources to SDHs based on the number of beds rather than based on an assessment of needs. The MOHFW could improve its monitoring system to investigate why some facilities are performing well using similar resources while others do not and adjust the allocation system to take into account the quantity and quality of care.
In a highly influential study across a wide breadth of literature, Kornell and Bjork (Psychological Science, 19[6], 585-592, 2008) showed that learning is enhanced by presenting exemplars (paintings) of to-be-learned categories (artists) in an interleaved sequence (e.g., A1, B1, C1 … A2, B2,, C2 …) rather than a blocked sequence (e.g., A1, A2, A3 … B1, B2, B3 …). However, this study, and nearly all direct replications, used an identification procedure that confounds memory abilities with response biases (i.e., one's criteria for using certain response choices); any interleaving effect assessed through an identification task may be an overestimate or, indeed, an underestimate of the effect (Hautus et al., Detection Theory, 2021). To address this, we conducted a direct replication: online, N = 288; t(287) = 8.08, p < 0.001, dz = 0.48, 96% CI [0.36, 0.59]-for the first time to our knowledge-accompanied by measures of differential learning and response biases across learned categories (which were substantial, with participants using some response categories at a rate several times higher than others). We then conducted a critical conceptual replication, changing the task from identification ("Which artist painted this?") to n-alternative forced-choice ("Which of these was painted by [e.g.] Seurat?"), the gold standard of memory tests (Brady et al., Psychonomic Bulletin & Review, 30, 2023). Reassuringly, the 2AFC experiment showed an interleaving effect comparable to our direct replication: online, N = 276; t(275) = 7.19, p < .001, dz = 0.43, 95% CI [0.32, 0.55]. Put together, this study showcases the challenges of interpretation facing any identification paradigm, illustrates a straightforward method to address them, and puts the interleaving effect on firmer footing.