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By 2020, the World Health Organization and the Ghana Neglected Tropical Diseases programme intended to treat 75% and 100% of school-age children, respectively, during preventative chemotherapy (PCT), to control soil-transmitted helminths. The performance of PCT was assessed, and the factors associated with albendazole uptake in 2019 were determined. This study comprised secondary data (2019 PCT) and a community-based cross-sectional study conducted among 352 children aged from 7 to 14 years and enrolled with their caregivers. Logistic regression was used to determine the factors hindering or favouring the PCT uptake. According to surveillance data (2019 PCT), Krachi East Municipal reported coverage of 83% in schools and 40.9% for all children between 5 and 14 years. The cross-sectional data showed that the median child age was 11 years (IQR: 9–12). There was no gap in the estimates for coverage and uptake, which were both 90.9% (95%CI: 87.4–93.5%). Christians made up the majority of the caregivers (87.5%), and 48.0% had completed secondary or higher education. After controlling for potential confounders, caregiver religion (aOR = 0.07 95%CI: 0.01–0.36) and the perception of a child’s PCT risk (aOR = 0.33 95%CI: 0.13–0.84) were the significant barriers of PCT uptake, whereas the child’s age (aOR = 1.49 95%CI: 1.19–1.88) and the perception of a child’s PCT’s benefit (aOR = 10.26 95%CI: 2.57–40.95) were the significant facilitators among children 7–14 years old. Although the performance of PCT was high, the national treatment target was not attained. Intensive and focused health education is therefore needed to improve positive perceptions towards PCT for school-age children.

Background Fever and hypothermia have been observed in septic patients. Their influence on prognosis is subject to ongoing debates. Methods We did a secondary analysis of a large clinical dataset from a quality improvement trial. A binary logistic regression model was calculated to assess the association of the thermal response with outcome and a multinomial regression model to assess factors associated with fever or hypothermia. Results With 6542 analyzable cases we observed a bimodal temperature response characterized by fever or hypothermia, normothermia was rare. Hypothermia and high fever were both associated with higher lactate values. Hypothermia was associated with higher mortality, but this association was reduced after adjustment for other risk factors. Age, community-acquired sepsis, lower BMI and lower outside temperatures were associated with hypothermia while bacteremia and higher procalcitonin values were associated with high fever. Conclusions Septic patients show either a hypothermic or a fever response. Whether hypothermia is a maladaptive response, as indicated by the higher mortality in hypothermic patients, or an adaptive response in patients with limited metabolic reserves under colder environmental conditions, remains an open question. Trial registration The original trial whose dataset was analyzed was registered at ClinicalTrials.gov (NCT01187134) on August 23, 2010, the first patient was included on July 1, 2011.

To evaluate the clinical utility of PCT, CRP, IL-6, NLR, and TyG index in improving the early diagnosis and severity assessment of acute pancreatitis (AP). This retrospective study included 137 AP patients and 30 healthy controls from Hunan Provincial People’s Hospital (January 2021–September 2023). Univariate and multivariate logistic regression analyses assessed the associations between biomarkers and severe acute pancreatitis (SAP). Receiver operating characteristic (ROC) curves, DeLong test, and Bonferroni correction were used to evaluate predictive performance. Model robustness was validated via 5-fold cross-validation. PCT, CRP, IL-6, NLR, and TyG index levels were significantly elevated in AP patients compared to controls ( P  < 0.001) and correlated with disease severity ( P  < 0.05). CRP and NLR levels differed significantly among mild, moderate, and severe AP ( P  < 0.01). Alcohol consumption and hyperlipidemia were significantly linked to AP severity (P for trend < 0.0001). Multivariate analysis identified hyperlipidemia (OR = 3.030, P  = 0.040), CRP (OR = 1.011, P  < 0.001), and NLR (OR = 1.078, P  = 0.020) as independent SAP predictors. The combined model of CRP + NLR + TyG achieved the highest AUC (0.882, sensitivity = 77.2%, specificity = 88.5%), though it was not significantly better than CRP + NLR or CRP + TyG models ( P  > 0.05). 5-fold cross-validation confirmed consistent performance (mean AUC = 0.817 ± 0.118). PCT, CRP, IL-6, NLR, and TyG index are valuable in diagnosing and assessing AP prognosis. Hyperlipidemia, CRP, and NLR are reliable independent predictors of SAP. Combining multiple biomarkers enhances diagnostic precision and provides guidance for personalized treatment strategies in AP.

Background. The use of C-reactive protein (CRP) and procalcitonin (PCT) as guiding biomarkers in treating severe infections could improve the use of antibiotics. Biomarker dynamics are more reliable than single values in predicting sepsis when making the diagnosis and evaluating the response to antibiotic therapy. Both CRP and PCT used protocols have to be consistent with the clinical context and patient populations.Objectives: reviewing the use of PCT and CRP in various clinical contexts and the patient populationSources. We analyzed the most recent studies of these biomarkers for antimicrobial stewardship, including meta-analyses and original trials.Content. According to several studies, critically ill patients who get antibiotic treatment under the guidance of CRP and PCT see a decrease in antibiotic exposure and related adverse effects. When patients are hospitalized in intensive care units (ICUs), CRP and PCT can be used to distinguish between viral and non-infectious causes of systemic inflammation. In septic patients, CRP levels are reliable to show a high negative predictive value (NPV), especially on day 1 of ICU admission. Consequently, CRP levels decrease during therapy with appropriate antibiotics in the next 3 days.Implication. In addition to other clinical and laboratory parameters, CRP and PCT provide information about the risk of the bacterial infection worsening or improving under appropriate treatment. These improve antibiotic treatment decisions, allowing individualized treatment regimens with reduced overall antibiotic exposure.

Bacterial and viral infections often present with similar symptoms. Etiologic misdiagnosis can alter the trajectory of patient care, including antibiotic overuse. A host-protein signature comprising tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), interferon gamma-induced protein-10 (IP-10), and C-reactive protein (CRP) was validated recently for differentiating bacterial from viral disease. However, a focused head-to-head comparison of its diagnostic performance against other biomarker candidates for this indication was lacking in patients with respiratory infection and fever without source. We compared the signature to other biomarkers and prediction rules using specimens collected prospectively at two secondary medical centers from children and adults. Inclusion criteria included fever > 37.5 °C, symptom duration ≤ 12 days, and presentation with respiratory infection or fever without source. Comparator method was based on expert panel adjudication. Signature and biomarker cutoffs and prediction rules were predefined. Of 493 potentially eligible patients, 314 were assigned unanimous expert panel diagnosis and also had sufficient specimen volume. The resulting cohort comprised 175 (56%) viral and 139 (44%) bacterial infections. Signature sensitivity 93.5% (95% CI 89.1–97.9%), specificity 94.3% (95% CI 90.7–98.0%), or both were significantly higher (all p values < 0.01) than for CRP, procalcitonin, interleukin-6, human neutrophil lipocalin, white blood cell count, absolute neutrophil count, and prediction rules. Signature identified as viral 50/57 viral patients prescribed antibiotics, suggesting potential to reduce antibiotic overuse by 88%. The host-protein signature demonstrated superior diagnostic performance in differentiating viral from bacterial respiratory infections and fever without source. Future utility studies are warranted to validate potential to reduce antibiotic overuse.

Procalcitonin (PCT) is a current, frequently-used marker for severe bacterial infection. The aim of this study was to develop a cost-effective detection kit for rapid quantitative and on-site detection of PCT. To develop the new PCT quantitative detecting kit, a double-antibody sandwich immunofluorescent assay was employed based on time-resolved immunofluorescent assay (TRFIA) combined with lateral flow immunoassay (LFIA). The performance of the new developed kit was evaluated in the aspects of linearity, precision, accuracy, and specificity. Two-hundred thirty-four serum samples were enrolled to carry out the comparison test. The new PCT quantitative detecting kit exhibited a higher sensitivity (0.08 ng/mL). The inter-assay coefficient of variation (CV) and the intra-assay CV were 5.4%–7.7% and 5.7%–13.4%, respectively. The recovery rates ranged from 93% to 105%. Furthermore, a high correlation (n = 234, r = 0.977, p < 0.0001) and consistency (Kappa = 0.875) were obtained when compared with the PCT kit from Roche Elecsys BRAHMS. Thus, the new quantitative method for detecting PCT has been successfully established. The results indicated that the newly-developed system based on TRFIA combined with LFIA was suitable for rapid and on-site detection for PCT, which might be a useful platform for other biomarkers in point-of-care tests.

PurposeThe purpose of this research is to propose and empirically validate a theoretical framework to investigate the willingness of the elderly to disclose personal health information (PHI) to improve the operational efficiency of AI-integrated caregiver robots.Design/methodology/approachDrawing upon Privacy Calculus Theory (PCT) and the Technology Acceptance Model (TAM), 274 usable responses were collected through an online survey.FindingsEmpirical results reveal that trust, privacy concerns, and social isolation have a direct impact on the willingness to disclose PHI. Perceived ease of use (PEOU), perceived usefulness (PU), social isolation, and recognized benefits significantly influence user trust. Conversely, elderly individuals with pronounced privacy concerns are less inclined to disclose PHI when using AI-enabled caregiver robots.Practical implicationsGiven the pressing need for AI-enabled caregiver robots due to the aging population and a decrease in professional human caregivers, understanding factors that influence the elderly's disclosure of PHI can guide design considerations and policymaking.Originality/valueConsidering the increased demand for accurate and comprehensive elder services, this is the first time that information disclosure and AI-enabled caregiver robot technologies have been combined in the field of healthcare management. This study bridges the gap between the necessity for technological improvement in caregiver robots and the importance of transparent operational information by disclosing the elderly's willingness to share PHI.

Background and Objectives: Sepsis is a life-threatening condition characterized by organ dysfunction due to a dysregulated host response to infection. Blood cultures (BCs) remain the gold standard for diagnosing bloodstream infections, yet their positivity rate is limited and culture-negative sepsis remains poorly characterized. This study aimed to identify clinical and laboratory predictors of BC positivity in patients with suspected sepsis and to evaluate the prognostic implications of BC results on 28-, 90-, and 365-day survival. Materials and Methods: We retrospectively analyzed adult patients admitted to the Emergency Department of Policlinico di Bari (March 2023–December 2025) with sepsis or septic shock (Sepsis-3 criteria). After excluding contaminated cultures, 912 patients were included (602 culture-positive; 310 culture-negative) with a 1-year follow up. Predictors of BC positivity were assessed using logistic regression and ROC analysis; survival was evaluated with Kaplan–Meier curves and Cox models adjusted for age and Sequential Organ Failure Assessment (SOFA) score. We also evaluated time-to-positivity (TTP) for all blood culture isolates. Results: Culture-positive patients presented with greater initial severity, including higher rates of septic shock, elevated procalcitonin, CRP, lactate, and SOFA scores, and more frequent thrombocytopenia. Procalcitonin showed good discriminatory ability (AUC (area under the ROC curve) 0.785; cutoff 0.85 ng/mL; sensitivity 59.8%; specificity 83.8%). Key laboratory thresholds included a procalcitonin cutoff of 0.85 ng/mL, while CRP and platelet count did not show meaningful discriminatory cutoffs beyond their significant differences between culture-positive and culture-negative patients. Survival was consistently lower in culture-positive patients at 28 days (72.9% vs. 85.9%), 90 days (57.5% vs. 71.8%), and 365 days (44.3% vs. 61.2%). However, in adjusted Cox regression, BC positivity was not independently associated with 1-year mortality (HR 1.46; p = 0.092), whereas age and SOFA score remained significant predictors. Conclusions: Blood culture positivity identifies patients with greater initial severity, explaining their poorer unadjusted survival. However, culture positivity itself is not an independent predictor of long-term mortality, as age and organ dysfunction remain the main determinants of outcome. Procalcitonin showed solid discriminatory ability for true bacteremia.

Background There is a lack of studies comparing PCT, CRP and WBC levels in the differential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections. It is necessary to explore the correlation between above markers and different types of ARTI. Methods 108 children with confirmed bacterial infection were regarded as group A, 116 children with virus infection were regarded as group B, and 122 children with mycoplasmal infection were regarded as group C. The levels of PCT, CRP and WBC of the three groups were detected and compared. Results The levels of PCT, CRP and WBC in group A were significantly higher than those in groups B and C ( p  < 0.05). The positive rate of combined detection of PCT, CRP and WBC was significant higher than that of single detection. There was no significant difference in PCT, CRP and WBC levels between the group of G + bacterial infection and G − bacterial infection ( p  > 0.05). ROC curve results showed that the AUC of PCT, CRP and WBC for the diagnosis of bacterial respiratory infections were 0.65, 0.55, and 0.58, respectively. Conclusions PCT, CRP and WBC can be combined as effective indicators for the identification of acute bacterial or no-bacterial infections in children. The levels of PCT and CRP have higher differential diagnostic value than that of WBC in infection, and the combined examination of the three is more valuable in clinic.

Pre-commercial thinning (PCT) is a common measure in Norway spruce (Picea abies L. Karst.) stands but the profitability of doing PCT and timing of PCT has not been fully investigated over a full rotation. Further, limited knowledge is available for mixed forest management compared to monocultures. In this study, different PCT strategies were tested to investigate the effect of PCT and timing of PCT on the production and profitability of Norway spruce monocultures and mixed Norway spruce–birch stands. A forest decision support system was used to simulate stand development during the whole rotation. Our study findings show that there is a positive effect of PCT on Norway spruce plantations’ long-term profitability but that the timing of PCT has little effect on profitability. However, site variation might influence the effect of PCT timing on the profitability of Norway spruce stands. Moreover, we also found that retaining 1000 Norway spruce ha−1 and 1000 birch ha−1 after PCT supports a mixture of Norway spruce and birch over a full rotation, with little or no economic loss compared to pure Norway spruce stands. Therefore, such a mixture can lead to profitable production while still providing other ecosystem services.