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The objective of this study was to conduct a systematic analysis of the reporting quality of the Ebola Virus Disease (EVD) outbreak in West Africa from 2014-2018 using the Modified STROBE statement. We included studies on the 2014 EVD outbreak alone, limited to those on human patients in Africa. We searched the following databases (MEDLINE, EMBASE, and Web of Science) for outbreak reports published between 2014-2018. We assessed factors potentially associated with the quality of reporting. A total of 69 of 131 (53%) articles within the full-text review fulfilled our eligibility criteria and underwent the Modified STROBE assessment for analyzing the quality of reporting. The Modified STROBE scores of the included studies ranged from 11-26 points and the mean was found to be 19.54 out of 30 with a standard deviation (SD) of ± 4.30. The top three reported Modified STROBE components were descriptive characteristics of study participants, scientific background and evidence rational, and clinical significance of observations. More than 75% of the studies met a majority of the criteria in the Modified STROBE assessment tool. Information that was commonly missing included addressing potential source of bias, sensitivity analysis, further results/analysis such as risk estimates and odds ratios, presence of a flowchart, and addressing missing data. In multivariable analysis, peer-reviewed publication was the only predictor that remained significantly associated with a higher Modified STROBE score. In conclusion, the large range of Modified STROBE scores observed indicates variability in the quality of outbreak reports for EVD. The review identified strong reporting in some areas, whereas other areas are in need of improvement, in particular providing an important description of the outbreak setting and identifying any external elements (potential biases and confounding factors) that could hinder the credibility of the findings.

Non-target screening (NTS) has gained interest in recent years for environmental monitoring purposes because it enables the analysis of a large number of pollutants without predefined lists of molecules. However, sample preparation methods are diverse, and few have been systematically compared in terms of the amount and relevance of the information obtained by subsequent NTS analysis. The goal of this work was to compare a large number of sample extraction methods for the unknown screening of urban waters. Various phases were tested for the solid-phase extraction of micropollutants from these waters. The evaluation of the different phases was assessed by statistical analysis based on the number of detected molecules, their range, and physicochemical properties (molecular weight, standard recoveries, polarity, and optical properties). Though each cartridge provided its own advantages, a multilayer cartridge combining several phases gathered more information in one single extraction by benefiting from the specificity of each one of its layers.

Background: Mortality from multidrug-resistant (MDR) pathogens is an urgent healthcare crisis worldwide. At present we do not have any simplified screening tools to predict the risk of mortality associated with MDR infections. The aim of this study was to develop a screening tool to predict mortality in patients with multidrug-resistant organisms. Methods: A retrospective cohort study to evaluate mortality risks in patients with MDR infections was conducted at Phrae Hospital. Univariable and multivariable analyses were used to classify possible risk factors. The model performance was internally validated utilizing the mean of three measures of discrimination corrected by the optimism using a 1000-bootstrap procedure. The coefficients were transformed into item scores by dividing each coefficient with the lowest coefficient and then rounding to the most adjacent number. The area under the receiver operating characteristic curve (AuROC) was used to determine the performance of the model. Results: Between 1 October 2018 and 30 September 2020, a total of 504 patients with MDR infections were enrolled. The ICU-SEPSA score composed of eight clinical risk factors: 1) immunocompromised host, 2) chronic obstructive pulmonary disease, 3) urinary tract infection, 4) sepsis, 5) placement of endotracheal tube, 6) pneumonia, 7) septic shock, and 8) use of antibiotics within the past 3 months. The model showed good calibration (Hosmer-Lemeshow χ2 = 19.27; p- value = 0.50) and good discrimination after optimism correction (AuROC 84.6%, 95% confidence interval [Cl]: 81.0%–88.0%). The positive likelihood ratio of low risk (score ≤ 5) and high risk (score ≥ 8) were 2.07 (95% CI: 1.74–2.46) and 12.35 (95% CI: 4.90–31.13), respectively. Conclusion: A simplified predictive scoring tool wad developed to predict mortality in patients with MDR infections. Due to a single-study design of this study, external validation of the results before applying in other clinical practice settings is warranted.

Although runoff from trafficked urban areas is recognized as a potentially significant pathway of micropollutants, runoff pollution remains poorly documented, except for relatively few historical pollutants such as some metals and hydrocarbons. Therefore, in this work, road and parking lot runoff from four sites with contrasting traffic levels were analyzed for a very broad spectrum of molecules and elements. A total of 128 pollutants and micropollutants were monitored, including inorganic (n = 41) and organic (n = 87) pollutants. Both the dissolved and particulate phases were considered. For a reduced number of samples, non-targeted screening by high-resolution mass spectrometry (HRMS) was carried out. For targeted screening, the contamination profiles were quite homogeneous, but the concentrations significantly differed between the different sites. Sites with the highest traffic density exhibited the highest concentrations for polycyclic aromatic hydrocarbons (PAHs), some traffic-related metals, alkylphenols and phthalates. Overall, for most micropollutants, the parking lot runoff exhibited the lowest concentrations, and the specificity of this site was confirmed by its HRMS fingerprint. Non-target screening allowed the sites to be discriminated based on the occurrence of specific compounds. Unlike the results of targeted screening, the HRMS intra-site variability was lower than its inter-site variability. Unknown substances were tentatively identified, either characteristic of each site or ubiquitous of all samples.

Our study aimed to evaluate the effectiveness of the nursing care program on the incidence and rate of 28-day hospital readmissions among pulmonary tuberculosis (TB) patients. We conducted a quasi-experimental study using a historical control (usual care) group. Patients diagnosed with pulmonary TB who received nursing interventions between January 28, 2021, and May 31, 2021, were categorized as an intervention group, whereas historical controls were selected from January 1, 2020, to December 31, 2020. The primary outcomes were the incidence and rates of hospital readmissions within 28 days due to TB-related complications. The secondary outcome was the change in knowledge and self-care behavior scores at discharge and 28 days postdischarge. Cox models were used to assess the intervention's impact on the incidence of hospital readmission. Rates of readmission were compared by the Poisson model. Both Cox and Poisson models were adjusted for age, sex, sputum smears at diagnosis, serum albumin level, and diabetes mellitus at baseline. Among 104 pulmonary TB patients included in the analysis (68 were in a historical control group and 36 were in an intervention group), 20 patients were readmitted due to TB-related complications. We found that our nursing care program resulted in a significant reduction in the incidence (adjusted hazard ratio was 0.16 [95% CI 0.03, 0.87]) and the rate of hospital readmissions (adjusted incidence rate ratio was 0.22 [95% CI 0.06, 0.85]). Furthermore, nursing interventions significantly improved knowledge and self-care behavior scores with significant score retention at 28 days postdischarge. The nursing care program can significantly decrease the incidence and rate of 28-day hospital readmission and improve knowledge and self-care behavior scores in pulmonary TB patients.

Background Globally the burden of Obstructive Lung Diseases (OLD) is growing, however its effect on urban poor populations with the high prevalence of tobacco dependence is virtually unknown. The purpose of this project is to estimate the prevalence and burden of OLD in the urban, low-income populations of Ottawa, Canada. Methods The study presented in this paper was part of the PROMPT (Management and Point-of-Care for Tobacco Dependence) project; a prospective cohort study in a community-based setting ( n  = 80) with meaningful Patient Engagement from design to dissemination. Spirometry data, standardized questionnaires and semi-structured interviews from PROMPT were interpreted to understand the lung function, disease burden and social determinants (respectively) in this population. Results The prevalence of OLD among those who completed spirometry ( N  = 64) was 45–59%. Generic and disease-specific quality of life was generally poor in all PROMPT participants, even those without OLD, highlighting the higher disease burden this vulnerable population faces. Quality of life was impacted by two major themes, including i) socioeconomic status and stress and ii) social networks and related experiences of trauma. Conclusion The prevalence and disease burden of OLD is significantly higher in Ottawa’s urban poor population than what is observed in the general Canadian population who smoke, suggesting an etiological role of the social determinants of health. This urges the need for comprehensive care programs addressing up-stream factors leading to OLDs, including poor access and utilization of preventive healthcare addressing the social determinants of health. Trial registration ClinicalTrails.gov - NCT03626064 , Retrospective registered: August 2018.

Road runoff (RR) is an important vector of micropollutants towards groundwater and soils, threatening the environment and ecosystems. Through combined chemical and biological approaches, the purpose of this study was to get insights on specific toxicants present in RR from two sites differing by their traffic intensity and their toxicological risk assessment. Non-target screening was performed by HRMS on RR dissolved phase. Ecotoxicological risk was evaluated in a zebrafish embryos model and on rat liver mitochondrial respiratory chain. Specific HRMS fingerprints were obtained for each site, reflecting their respective traffic intensities. Several micropollutants, including 1,3-diphenylguanidine (DPG) and benzotriazole (BZT) were identified in greater concentrations at the high-traffic site. The origin of DPG was confirmed by analyzing HRMS fingerprints from shredded tires. RR samples from each site, DPG and BZT were of relatively low toxicity (no mortality) to zebrafish embryos, but all generated distinct and marked stress responses in the light–dark transition test, while DPG/BZT mixes abolished this effect. The moderate-traffic RR and DPG inhibited mitochondrial complex I. Our study highlights (i) the unpredictability of pollutants cocktail effect and (ii) the importance of a multi-approaches strategy to characterize environmental matrices, essential for their management at the source and optimization of depollution devices.

Rationale Oscillometry is an emerging technique that offers some advantages over spirometry as it does not require forced exhalation and may detect early changes in respiratory pathology. Obstructive lung disease disproportionately impacts people experiencing homelessness with a high symptoms burden, yet oscillometry is not studied in this population. Objectives To assess lung disease and symptom burden using oscillometry in people experiencing homelessness or at-risk of homelessness using a community-based participatory action research approach (The Bridge Model™). Methods Of 80 recruited, 55 completed baseline oscillometry, 64 completed spirometry, and all completed patient-reported outcomes with demographics, health, and respiratory symptom related questionnaires in the Participatory Research in Ottawa: Management and Point-of-Care for Tobacco Dependence project. Using a two-tail t-test, we compared mean oscillometry values for airway resistance (R 5–20 ), reactance area under the curve (A x ) and reactance at 5 Hz ( X 5 ) amongst individuals with fixed-ratio method (FEV 1 /FVC ratio < 0.70) and LLN (FEV 1 /FVC ratio ≤ LLN) spirometry diagnosed chronic obstructive pulmonary disease (COPD). We compared mean oscillometry parameters based on participants’ COPD assessment test (CAT) scores using ANOVA test. Results There was no significant difference between the pre- and post- bronchodilator values of R 5–20 and A x for the fixed ratio method ( p  = 0.63 and 0.43) and the LLN method ( p  = 0.45 and 0.36). There was a significant difference in all three of the oscillometry parameters, R 5–20 , A x and X 5 , based on CAT score ( p  = 0.009, 0.007 and 0.05, respectively). There was a significant difference in R 5–20 and A x based on the presence of phlegm ( p  = 0.03 and 0.02, respectively) and the presence of wheeze ( p  = 0.05 and 0.01, respectively). Oscillometry data did not correlate with spirometry data, but it was associated with CAT scores and correlated with the presence of self-reported symptoms of phlegm and wheeze in this population. Conclusions Oscillometry is associated with respiratory symptom burden and highlights the need for future studies to generate more robust data regarding the use of oscillometry in systematically disadvantaged populations where disease burden is disproportionately higher than the general population. Trial Registration : ClinicalTrails.gov —NCT03626064, Retrospective registered: August 2018, https://clinicaltrials.gov/ct2/show/NCT03626064

In the original publication [...]