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Abstract Background Abdominal pain in adults represents a wide range of illnesses, often warranting immediate intervention. This study is to fill the gap in the knowledge about incidence, presentation, causes and mortality from abdominal pain in an established emergency department of a tertiary hospital in Tanzania. Methods This was a prospective cohort study of adult (age ≥ 18 years) patients presenting to the Emergency Medicine Department of Muhimbili National Hospital (EMD-MNH) in Dar Es Salaam, Tanzania with non-traumatic abdominal pain from September 2017 to October 2017. A case report form was used to record data on demographics, clinical presentation, management, diagnosis, outcomes and patient follow-up. The primary outcome of mortality was summarized using descriptive statistics; secondary outcome was, risks for mortality. Results Among 3381 adult patients present during the study period, 288 (8.5%) presented with abdominal pain, and of these 199 (69%) patients were enrolled in our study. Median age was 47 years (IQR 35–60 years), 126 (63%) were female, and 118 (59%) were referred from another hospital. Most common final diagnoses were malignancies 71 (36%), intestinal obstruction 11 (6%) and peptic ulcer disease 9 (5%). Most common EMD interventions given were intravenous fluids 57 (21%), analgesia 49 (25%) and antibiotics 40 (20%). 160 (80%) were admitted of which 15 (8%) underwent surgery directly from EMD. 24-h and 7-day mortality were 4 (2%) and 7 (4%) respectively, while overall in hospital-mortality was 16 (8%). Among the risk factors for mortality were male sex Relative Risk (RR) 2.88 (p = 0.03), hypoglycemia (RR) 5.7 (p = 0.004), ICU admission (RR) 14 (p

Abstract Background Non-traumatic chest pain (NTCP) is a common reason for emergency department (ED) attendance in high-income countries, with the primary concern focused on life threatening cardiovascular diseases. There is general lack of data on aetiologies, diagnosis and management of NTPC in Sub Sahara African (SSA) countries. We aimed to describe evaluation, diagnosis and outcomes of adult patients presenting with NTCP to an urban ED in Tanzania. Method This was a prospective observational cohort study of consecutive adult (≥18 years) patients presenting with non-traumatic chest pain to the Emergency Medicine Department (EMD) of Muhimbili National Hospital (MNH) in Dar es salaam from September 2017 to April 2018. Structured case report form was used to collected demographics, clinical presentation, investigations, diagnosis, and EMD disposition and in hospital mortality. We determined frequency of NTCP among our patients, aetiologies, 24-h and 7-day in-hospital mortality, and predictors for mortality. Results We screened 29,495 adults attending EMD-MNH during the study and 389 (1.3%) presented with NTCP of these, 349 (90%) were enrolled. The median age was 45 (IQR 29–60) years and 177 (50.7%) were female. Overall, 69.1% patients received electrocardiography (ECG) in the EMD and 34.1% had a troponin test. Heart failure and pulmonary tuberculosis (PTB) were the leading hospital diagnoses (12.6% each), followed by chronic kidney disease (10%) and acute coronary syndrome (ACS) (9.6%). Total of 167 (48%) patients were admitted, and the 24-h and 7-day in-hospital mortality were 5 (3%) and 16 (9.6%) respectively. Univariate risk factors for mortality were a Glasgow Coma Scale of 0.04 ng/ml [RR 2.9 (95%CI 1.2–7.3)]. Features distinguishing cardiovascular from other causes were: bradycardia [RR = 2.6 (95%CI 2.1–3.2)], heart beat awareness [RR = 2.3 (95%CI 1.7–3.2)] and history of diabetic mellitus [RR = 2.2 (95% CI 1.6–3.0)]. Conclusion In this ED of SSA country, heart failure and pulmonary tuberculosis were the leading causes of NCTP, and ACS was present in 9.6%. NTCP in this setting carries high mortality, and ACS was the leading risk factor for death. ED providers in SSA must increasingly consider cardiovascular causes of NTCP.

BACKGROUND:Non-traumatic chest pain (NTCP) is a common reason for emergency department (ED) attendance in high-income countries, with the primary concern focused on life threatening cardiovascular diseases. There is general lack of data on aetiologies, diagnosis and management of NTPC in Sub Sahara African (SSA) countries. We aimed to describe evaluation, diagnosis and outcomes of adult patients presenting with NTCP to an urban ED in Tanzania. METHOD:This was a prospective observational cohort study of consecutive adult (≥18 years) patients presenting with non-traumatic chest pain to the Emergency Medicine Department (EMD) of Muhimbili National Hospital (MNH) in Dar es salaam from September 2017 to April 2018. Structured case report form was used to collected demographics, clinical presentation, investigations, diagnosis, and EMD disposition and in hospital mortality. We determined frequency of NTCP among our patients, aetiologies, 24-h and 7-day in-hospital mortality, and predictors for mortality. RESULTS:We screened 29,495 adults attending EMD-MNH during the study and 389 (1.3%) presented with NTCP of these, 349 (90%) were enrolled. The median age was 45 (IQR 29-60) years and 177 (50.7%) were female. Overall, 69.1% patients received electrocardiography (ECG) in the EMD and 34.1% had a troponin test. Heart failure and pulmonary tuberculosis (PTB) were the leading hospital diagnoses (12.6% each), followed by chronic kidney disease (10%) and acute coronary syndrome (ACS) (9.6%). Total of 167 (48%) patients were admitted, and the 24-h and 7-day in-hospital mortality were 5 (3%) and 16 (9.6%) respectively. Univariate risk factors for mortality were a Glasgow Coma Scale of  0.04 ng/ml [RR 2.9 (95%CI 1.2-7.3)]. Features distinguishing cardiovascular from other causes were: bradycardia [RR = 2.6 (95%CI 2.1-3.2)], heart beat awareness [RR = 2.3 (95%CI 1.7-3.2)] and history of diabetic mellitus [RR = 2.2 (95% CI 1.6-3.0)]. CONCLUSION:In this ED of SSA country, heart failure and pulmonary tuberculosis were the leading causes of NCTP, and ACS was present in 9.6%. NTCP in this setting carries high mortality, and ACS was the leading risk factor for death. ED providers in SSA must increasingly consider cardiovascular causes of NTCP.

Abstract Background Marburg virus disease (MVD) is a deadly illness caused by the zoonotic Marburg virus, which has led to outbreaks with fatality rates up to 100% in some African countries. On March 21, 2023, Tanzania had its first MVD outbreak, resulting in nine cases and six deaths, leading to a fatality rate of 66.7%. Following that, the Risk Communication and Community Engagement (RCCE) approach was promptly initiated to create community awareness regarding the MVD. A descriptive cross-sectional assessment was conducted in May 2023 in Bukoba District Council and Bukoba Municipal Council in the Kagera region to document the community awareness and sources of information regarding MVD during the outbreak. Data were collected using a structured questionnaire developed using the WHO COVID-19 RCCE Rapid Quantitative Assessment Tool. Descriptive analysis was conducted using Microsoft Excel 2021. Results There were a total of 714 community respondents, of whom 456 (63.9%) were from Bukoba District Council. The majority 628 (88%) were aged 18 years and above. There were 393 (55%) females, and 407 (57%) of respondents had completed primary education. All respondents reported being informed about MVD through different channels, with 588 (82.4%) receiving information from Community Health Workers. Most of them 573 (80.3%) were satisfied with implemented RCCE interventions, 651 (91.2%) perceived MVD to be an extremely severe disease, and 698 (97.76%) mentioned hand washing as one of the recommended preventive measures. Conclusions During the Marburg virus disease outbreak response, where risk communication and community engagement interventions were implemented, the community was aware of the Marburg virus disease and community health workers emerged as the most frequently mentioned channel of communication during the outbreak.

Abstract Background Increased global trade, while beneficial economically, can also increase the spread of vector-borne diseases, particularly those transmitted by Aedes mosquitoes spreading via trade routes. Given the heightened trade-induced activity at ports of entry, it is particularly crucial to assess the risk of mosquito-borne diseases in these settings. This study compared the risks of Aedes-borne disease in and around the eastern Tanzanian seaport of Tanga. Methods A 200 m × 200 m grid-based system was used to sample mosquitoes within the port area, and in surrounding areas at 2 km, 2.5 km, and 5 km away, between June and December 2023. We characterized mosquito breeding habitats, collected mosquito larvae using standard dippers and tested susceptibility of raised adult Aedes aegypti populations to different insecticides. Adult mosquitoes were collected using BG sentinel traps (daytime) and Centers for Disease Control (CDC) light traps (night-time). Additionally, more than 200 port users and neighboring residents were surveyed to assess their experiences with and perceptions of mosquito biting and disease risks. Results There were 2931 breeding sites, with (60.8%, n = 1782) positive for Aedes larvae. The percentage of water-holding containers infested with Aedes immatures, i.e., the container index (CI), was highest in the port area (66.2%), and lowest 5 km away (44.6%). The port area also had a greater proportion of temporary breeding sites (64.9%) than did the surrounding areas. The adult mosquito surveys revealed 20,449 mosquito species including: Culex quinquefasciatus (56.2%), Mansonia uniformis (38.6%), Ae. aegypti (5.1%), Anopheles gambiae (0.1%), and Anopheles funestus. Ae. aegypti were more abundant in the port area than in the surrounding areas (P

Health risks associated with poor sanitation behaviours continue to be reported mostly from low-income countries (LICs). Reports show that various factors limit many people from accessing and using improved latrines, forcing some to opt for sharing latrines with neighbours, others practicing open defecation. Meanwhile, debate prevails on whether shared latrines should be categorised as unimproved according to WHO/UNICEF-JMP criteria. We contribute to this debate based on results from a study undertaken in three regions, Tanzania.Data were collected through observations in 1,751 households with latrines, coupled with collection of opinions from heads of such households regarding the latrine-sharing practices. Bivariate and multivariate logistic regression analyses were performed to assess associations between the outcome and possible predictor variables.Of all 1,751 latrines, 14.6% were shared. Among the shared latrines, 74.2% were found being generally clean as compared to 69.2% of the non-shared ones. Comparing the shared and non-shared latrines, the non-shared latrines were significantly less likely to be found with floors built with permanent materials (OR = 0.73, 95% CI: 0.55, 0.98); washable floors (OR = 0.69; 95% CI: 0.51, 0.93); and lockable doors (OR = 0.73; 95% CI: 0.56, 0.95). Shared latrines were less likely to have floors with faecal matter, functional handwashing facilities (HWFs), HWFs with running water, and roofs; albeit the differences in all these scenarios were not statistically significant. Respondents expressed desire for improved latrines, but also did not find it wrong to share latrines if cleanliness was maintained.Having an 'improved' latrine remains important as JMP recommends, but based on our study findings, we argue that possessing a non-shared latrine neither guarantees safety to its users nor its categorisation as 'improved'. Instead, the state of the latrine, the construction technology used and the behaviours of the users may be more important.

Type 2 diabetes (T2D) is a chronic disorder affecting 462 million worldwide, often managed with metformin as first-line treatment. However, metformin's response varies among individuals, including up to 30% experiencing serious adverse drug reactions (ADRs) and 20-50% inefficacy. These differences may be due to various factors, including pharmacogenetic (PGx) variants. The PGx variants documented so far could affect both the safety and efficacy of metformin, but due to a lack of replication studies, none reached the clinical evidence-level needed to be used as a predictive marker for treatment response. Therefore, this study aims to evaluate the association between the presence of candidate PGx variants and metformin response in T2D subjects. We conducted an association study involving 108 T2D participants currently or previously treated with metformin. A characterization of their therapeutic response was carried out through questionnaires and pharmacological profile reviews. DNA samples were collected during their single visit to perform genotyping of 24 selected candidate PGx variants. Association analyses between candidate PGx variants and metformin response were performed. Among the subjects included in the analyses (n =  84), 25% were non-responders, and 58% experienced ADRs. At the time of study enrollment, 93.9% of non-responders continued to use metformin. The odds of being a non-responder to metformin are 5.6 times higher for homozygous carriers of the alternative allele of a variant within the PCK1 gene (rs4810083) compared to the other genotypes (95% interval confidence [1.9-16.6]). Two variants in perfect linkage disequilibrium within the SLC22A2 gene (rs316019 and rs316009) were associated with increase odds of having ADRs, where homozygous genotype carriers are 7.3 times more likely to have ADRs presentation (95% interval confidence [1.85-29.01]). This study identified associations between PCK1 and SLC22A2 candidate PGx variants and metformin response in T2D treatment. Additional genetic and functional studies are necessary to elucidate the variants' impact in metformin's pharmacological mechanisms., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2025 St-Amour et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Influenza can be associated with nonrespiratory disease presentation, but these are less well documented due to the lack of routine testing for influenza in the healthcare system, especially if patients do not present with influenza-like illness (ILI). We aimed to measure the proportion of influenza cases seeking care at emergency department (ED) for a nontraumatic cause, to describe their clinical presentation and their ED-discharge diagnosis., Methods: The study was conducted at seven hospitals in France, Spain, Italy and Germany during the 2019-20 influenza season, for a period of 10 weeks. Patients (≥ 18 years) consulting for nontraumatic causes at the ED were invited to participate. Consenting patients provided upper respiratory swab samples for influenza testing by reverse transcription polymerase chain reaction. Clinical and demographic data were collected., Results: There were 8678 patients included, 50.7% were female and the median age was 57 years. Among them, 494 (5.7%) were laboratory-confirmed influenza (LCI) cases. Nonetheless, only 24.3% of LCI cases had an ED-discharge of influenza. Of all cases confirmed as influenza, 47.6% had a nonrespiratory discharge diagnosis, which frequency increased with age. ILI case definition from the European Centre for Disease Prevention and Control was the most frequently met among influenza cases (68.6%). Older patients (≥ 65 years) were less frequently identified based on any ILI signs/symptoms., Conclusion: Our findings indicate that the impact of influenza among patients seeking care at the ED cannot be easily assessed based on clinical presentation and medical records alone. Preventing influenza among adult population may reduce healthcare utilization., (© 2024 The Author(s). Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd.)

Background: Physical exercise is an evidence-based treatment to reduce symptoms and negative affect in several psychiatric disorders, including depressive, anxiety, and psychotic disorders. However, the effect of physical exercise on negative affect in patients with borderline personality disorder (BPD) has not yet been investigated. In this pilot study, we tested the safety, acceptability, and potential acute effects on negative affect of a single session of aerobic physical exercise in adults with BPD., Method: After completing a negative mood induction procedure, 28 adults with BPD were randomly assigned to a 20-minute single session of stationary bicycle or a control condition (emotionally neutral video)., Results: No adverse effects attributed to the physical exercise were reported and it was considered acceptable to patients. Following the negative mood induction, both conditions decreased the level of negative affect with a medium effect size but there was no significant difference between them., Conclusion: The results suggest that a single 20-minute session of physical exercise does not produce a reduction of negative affect in BPD. Future research should consider the duration and intensities of physical exercise with the greatest potential to reduce negative affect both acutely and in a more prolonged manner in this patient group., Competing Interests: The authors have declared that no competing interests exist.

The superior longitudinal fasciculus (SLF) is part of the longitudinal association fiber system, which lays connections between the frontal lobe and other areas of the ipsilateral hemisphere. As a dominant association fiber bundle, it should correspond to a well-defined structure with a clear anatomical definition. However, this is not the case, and a lot of confusion and overlap surrounds this entity. In this review/opinion study, we survey relevant current literature on the topic and try to clarify the definition of SLF in each hemisphere. After a comparison of postmortem dissections and data obtained from diffusion MRI studies, we discuss the specifics of this bundle regarding its anatomical landmarks, differences in lateralization, as well as individual variability. We also discuss the confusion regarding the arcuate fasciculus in relation to the SLF. Finally, we recommend a nomenclature based on the findings exposed in this review and finalize with a discussion on relevant functional correlates of the structure., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Janelle, Iorio-Morin, D'amour and Fortin.)

Inaccurate perceptions, such as under- or over-estimation of body size are often found in clinical eating disorder populations but have recently been shown also in healthy people. However, it is not yet clear how body size perception may be affected when the internal body representation is manipulated. In this study, visual adaptation was used to investigate whether exposure to distorted visual feedback alters the representation of body size and how long any such effects might last. Participants were exposed for five minutes to a distorted life-size image of themselves that was either 20% wider or 20% narrower than their normal size. Accuracy was measured using our novel psychophysical method that taps into the implicit body representation. The accuracy of the representation was assessed at 6, 12 and 18 min following exposure to adaptation. Altered visual feedback caused changes in participants' judgements of their body size: adapting to a wider body resulted in size overestimation whereas underestimations occurred after adapting to a narrower body. These distortions lasted throughout testing and did not fully return back to normal within 18 min. The results are discussed in terms of the emerging literature indicating that the internal representation of the body is dynamic and flexible., Competing Interests: We declare we have no competing interests., (© 2022 The Authors.)

Inhaled corticosteroids (ICS) have been associated with increased risk of pneumonia. Their impact on respiratory virus infections is unclear. We performed a post-hoc analysis of the FLUVAC cohort, a multicenter prospective cohort study of adults hospitalized with influenza-like illness (ILI) during six consecutive influenza seasons (2012-2018). All patients were tested for respiratory virus infection by multiplex PCR on nasopharyngeal swabs and/or bronchoalveolar lavage. Risk factors were identified by logistic regression analysis. Among the 2658 patients included, 537 (20.2%) were treated with ICS before admission, of whom 282 (52.5%, 282/537) tested positive for at least one respiratory virus. Patients on ICS were more likely to test positive for non-influenza respiratory viruses (25.1% vs. 19.5%, P = 0.004), especially for adenovirus (aOR 2.36, 95% CI 1.18-4.58), and respiratory syncytial virus (aOR 2.08, 95% CI 1.39-3.09). Complications were reported in 55.9% of patients on ICS (300/537), primarily pneumonia (171/535, 32%). Among patients on chronic ICS who tested positive for respiratory virus, 14.2% (40/282) were admitted to intensive care unit, and in-hospital mortality rate was 2.8% (8/282). Chronic use of ICS is associated with an increased risk of adenovirus or RSV infections in patients admitted for ILI., (© 2022. The Author(s).)

Objectives: The purpose of this study was to describe the clinical characteristics and in-hospital and post-discharge outcomes of respiratory syncytial virus (RSV) infection among adults hospitalised with influenza-like illness (ILI) and compared against patients admitted for influenza., Methods: Adults hospitalised with ILI were prospectively included from five French university hospitals over two consecutive winter seasons (2017/2018 and 2018/2019). RSV and influenza virus were detected by multiplex reverse transcription PCR on nasopharyngeal swabs. RSV-positive patients were compared to RSV-negative and influenza-positive hospitalised patients. Poisson regression models were used to estimate the adjusted prevalence ratio (aPR) associated with in-hospital and post-discharge outcomes between RSV and influenza infections. The in-hospital outcome was a composite of the occurrence of at least one complication, length of stay ≥7 days, intensive care unit admission, use of mechanical ventilation and in-hospital death. Post-discharge outcome included 30- and 90-day all-cause mortality and 90-day readmission rates., Results: Overall, 1428 hospitalised adults with ILI were included. RSV was detected in 8% (114 of 1428) and influenza virus in 31% (437 of 1428). Patients hospitalised with RSV were older than those with influenza (mean age 73.0 versus 68.8 years, p=0.015) with a higher frequency of chronic respiratory or cardiac disease (52% versus 39%, p=0.012, and 52% versus 41%, p=0.039, respectively) and longer hospitalisation duration (median stay 8 versus 6 days, p<0.001). Anti-influenza therapies were less prescribed among RSV patients than influenza patients (20% versus 66%, p<0.001). In-hospital composite outcome was poorer in RSV patients (aPR 1.5, 95% CI 1.1-2.1) than in those hospitalised with influenza. No difference was observed for the post-discharge composite outcome (aPR 1.1, 95% CI 0.8-1.6)., Conclusion: RSV infection results in serious respiratory illness, with worse in-hospital outcomes than influenza and with similar midterm post-discharge outcomes., Competing Interests: Conflict of interest: N. Lenzi has nothing to disclose. Conflict of interest: F. Galtier has nothing to disclose. Conflict of interest: F. Lainé has nothing to disclose. Conflict of interest: Z. Lesieur has nothing to disclose. Conflict of interest: P. Vanhems reports grants from Pfizer, Sanofi, Anios, MSD and Astellas, outside the submitted work. Conflict of interest: S. Amour has nothing to disclose. Conflict of interest: A-S. L'Honneur has nothing to disclose. Conflict of interest: N. Fidouh has nothing to disclose. Conflict of interest: V. Foulongne has nothing to disclose. Conflict of interest: G. Lagathu has nothing to disclose. Conflict of interest: X. Duval has nothing to disclose. Conflict of interest: C. Merle has nothing to disclose. Conflict of interest: B. Lina has nothing to disclose. Conflict of interest: F. Carrat has nothing to disclose. Conflict of interest: O. Launay is principal investigator for clinical trials sponsored by Janssen, GSK, Pfizer, Sanofi Pasteur and MSD, outside the submitted work. Conflict of interest: P. Loubet reports personal fees from Pfizer and non-financial support from Sanofi Pasteur, outside the submitted work. Conflict of interest: A. Descamps has nothing to disclose., (Copyright ©The authors 2022. For reproduction rights and permissions contact permissions@ersnet.org.)

Introduction: Delay between symptom onset and access to care is essential to prevent clinical worsening for different infectious diseases. For COVID-19, this delay might be associated with the clinical prognosis, but also with the different characteristics of patients. The objective was to describe characteristics and symptoms of community-acquired (CA) COVID-19 patients at hospital admission according to the delay between symptom onset and hospital admission, and to identify determinants associated with delay of admission., Methods: The present work was based on prospective NOSO-COR cohort data, and restricted to patients with laboratory confirmed CA SARS-CoV-2 infection admitted to Lyon hospitals between February 8 and June 30, 2020. Long delay of hospital admission was defined as ≥6 days between symptom onset and hospital admission. Determinants of the delay between symptom onset and hospital admission were identified by univariate and multiple logistic regression analysis., Results: Data from 827 patients were analysed. Patients with a long delay between symptom onset and hospital admission were younger (p<0.01), had higher body mass index (p<0.01), and were more frequently admitted to intensive care unit (p<0.01). Their plasma levels of C-reactive protein were also significantly higher (p<0.01). The crude in-hospital fatality rate was lower in this group (13.3% versus 27.6%), p<0.01. Multiple analysis with correction for multiple testing showed that age ≥75 years was associated with a short delay between symptom onset and hospital admission (≤5 days) (aOR: 0.47 95% CI (0.34-0.66)) and CRP>100 mg/L at admission was associated with a long delay (aOR: 1.84 95% CI (1.32-2.55))., Discussion: Delay between symptom onset and hospital admission is a major issue regarding prognosis of COVID-19 but can be related to multiple factors such as individual characteristics, organization of care and severe pathogenic processes. Age seems to play a key role in the delay of access to care and the disease prognosis., Competing Interests: The authors have read the journal’s policy and have the following competing interests: PV received grants and fees from Anios, Pfizer, Astellas, MSD, Gilead and Sanofi. These grants and fees were not related to this present manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare. All other authors have no competing interest to declare.

Introduction: A new respiratory virus, SARS-CoV-2, has emerged and spread worldwide since late 2019. This study aims at analysing clinical presentation on admission and the determinants associated with admission in intensive care units (ICUs) in hospitalized COVID-19 patients., Patients and Methods: In this prospective hospital-based study, socio-demographic, clinical and biological characteristics, on admission, of adult COVID-19 hospitalized patients presenting from the community for their first admission were prospectively collected and analysed. Characteristics of patients hospitalized in medical ward to those admitted in ICU were compared using Mann-Whitney and Chi-square or Fisher exact test when appropriate. Univariate logistic regression was first used to identify variables on admission that were associated with the outcome i.e. admission to an ICU versus total hospital stay in a medical ward. Forward selection was then applied beginning with sex, age and temperature in the multivariable logistic regression model., Results: Of the 412 patients included, 325 were discharged and 87 died in hospital. Multivariable regression showed increasing odds of ICU hospitalization with temperature (OR, 1.56 [95% CI, 1.06-2.28] per degree Celsius increase), oxygen saturation <90% (OR, 12.45 [95% CI, 5.27-29.4]), abnormal lung auscultation on admission (OR, 3.58 [95% CI, 1.58-8.11]), elevated level of CRP (OR, 2.7 [95% CI, 1.29-5.66for CRP>100mg/L vs CRP<10mg/L). and monocytopenia (OR, 3.28 [95% CI, 1.4-7.68]) were also associated with increasing odds of ICU hospitalization. Older patients were less likely to be hospitalized in ICU (OR, 0.17 [95%CI, 0.05-0.51]., Conclusions: Age and delay between onset of symptoms and hospital admission were associated with the risk of hospitalisation in ICU. Age being a fixed variable, interventions that shorten this delay would improve the prognosis of Covid-19 patients., Competing Interests: The authors have read the journal’s policy and have the following competing interests: PV received grants and fees from Anios, Pfizer, Astellas, MSD, Gilead and Sanofi. These grants and fees were not related to this present manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare. All other authors have no competing interest to declare.

Surgical site infection (SSI) surveillance methods are not standardised and are often time-consuming. We compared an active method, based on orthopaedic department staff reporting suspected SSI, with a semi-automated method, based on computerised extraction of surgical revisions, after total hip and knee arthroplasty. Both methods allowed finding the same SSI cases. We found the same sensitivity but higher specificity with a straightforward time gain using the passive method. This represents an added value for the organisation of an effective SSI surveillance, based on existing hospital databases., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)

The perception of the body and its parts has traditionally been studied using the conscious body image. Here, we determine the implicit representation of the hand. Participants were sequentially shown two life-size images of either the dorsal or palmar surface of their hand. In one interval either the horizontal or vertical dimension of the image was varied using an adaptive staircase, while the other interval contained the full-size, undistorted image. Participants reported which image most closely matched their hand. The staircase honed in on the distorted image that was equally likely to be judged as matching their own hand as the accurate image. The implicit representation was taken as midway between these two images. The experiment was repeated with different hand orientations. Perceived width depended on the orientation, with differences found between the upright and right orientations. Interestingly, the perceived length of the dorsum and palm were different from each other-length of the dorsum was overestimated whereas palm length was perceived accurately. This study reveals distortions of the implicit representation of the hands in healthy individuals., Competing Interests: The authors have declared that no competing interests exist.

Perceived body size is a fundamental construct that reflects our knowledge of self and is important for all aspects of perception, yet how we perceive our bodies and how the body is represented in the brain is not yet fully understood. In order to understand how the brain perceives and represents the body, we need an objective method that is not vulnerable to affective or cognitive influences. Here, we achieve this by assessing the accuracy of full-body size perception using a novel psychophysical method that taps into the implicit body representation for determining perceived size. Participants were tested with life-size images of their body as seen from different viewpoints with the expectation that greater distortions would occur for unfamiliar views. The Body Shape Questionnaire was also administered. Using a two-alternative forced choice design, participants were sequentially shown two life-size images of their whole body dressed in a standardized tight-fitting outfit seen from the front, side, or back. In one image, the aspect ratio (with the horizontal or vertical dimension fixed) was varied using an adaptive staircase, while the other was undistorted. Participants reported which image most closely matched their own body size. The staircase honed in on the distorted image that was equally likely as the undistorted photo to be judged as matching their perception of themselves. From this, the perceived size of their internal body representation could be calculated. Underestimation of body width was found when the body was viewed from the front or back in both sexes. However, females, but not males, overestimated their width when the body was viewed from the side. Height was perceived accurately in all views. These findings reveal distortions in perceived size for healthy populations and show that both viewpoint and sex matter for the implicit body representation. Though the back view of one's body is rarely-if ever-seen, perceptual distortions were the same as for the front view. This provides insight into how the brain might construct its representation of three-dimensional body shape., (Copyright © 2019 D’Amour and Harris.)

Self-motion information can be used to update spatial memory of location through an estimate of a change in position. Viewing optic flow alone can create Illusory self-motion or "vection." Early studies suggested that peripheral vision is more effective than central vision in evoking vection, but controlling for retinal area and perceived distance suggests that all retinal areas may be equally effective. However, the contributions of the far periphery, beyond 90°, have been largely neglected. Using a large-field Edgeless Graphics Geometry display (EGG, Christie, Canada, field of view ±112°) and systematically blocking central (±20° to ±90°) or peripheral (viewing through tunnels ±20° to ±40°) parts of the field, we compared the effectiveness of different retinal regions at evoking forwards linear vection. Fifteen participants indicated when they had reached the position of a previously presented target after visually simulating motion down a simulated corridor. The amount of simulated travel needed to match a given target distance was modelled with a leaky spatial integrator model to estimate gains (perceived/actual distance) and a spatial decay factor. When optic flow was presented only in the far periphery (beyond 90°) gains were significantly higher than for the same motion presented full field or in only the central field, resulting in accurate performance in the range of speeds associated with normal walking. The increased effectiveness of optic flow in the peripheral field alone compared to full-field motion is discussed in terms of emerging neurophysiological studies that suggest brain areas dedicated to processing information from the far peripheral field.

Perceptual body size distortions have traditionally been studied using subjective, qualitative measures that assess only one type of body representation-the conscious body image. Previous research on perceived body size has typically focused on measuring distortions of the entire body and has tended to overlook the face. Here, we present a novel psychophysical method for determining perceived body size that taps into implicit body representation. Using a two-alternative forced choice (2AFC), participants were sequentially shown two life-size images of their own face, viewed upright, upside down, or tilted 90°. In one interval, the width or length dimension was varied, while the other interval contained an undistorted image. Participants reported which image most closely matched their own face. An adaptive staircase adjusted the distorted image to hone in on the image that was equally likely to be judged as matching their perceived face as the accurate image. When viewed upright or upside down, face width was overestimated and length underestimated, whereas perception was accurate for the on-side views. These results provide the first psychophysically robust measurements of how accurately healthy participants perceive the size of their face, revealing distortions of the implicit body representation independent of the conscious body image.

Incorporating the fact that the senses are embodied is necessary for an organism to interpret sensory information. Before a unified perception of the world can be formed, sensory signals must be processed with reference to body representation. The various attributes of the body such as shape, proportion, posture, and movement can be both derived from the various sensory systems and can affect perception of the world (including the body itself). In this review we examine the relationships between sensory and motor information, body representations, and perceptions of the world and the body. We provide several examples of how the body affects perception (including but not limited to body perception). First we show that body orientation effects visual distance perception and object orientation. Also, visual-auditory crossmodal-correspondences depend on the orientation of the body: audio "high" frequencies correspond to a visual "up" defined by both gravity and body coordinates. Next, we show that perceived locations of touch is affected by the orientation of the head and eyes on the body, suggesting a visual component to coding body locations. Additionally, the reference-frame used for coding touch locations seems to depend on whether gaze is static or moved relative to the body during the tactile task. The perceived attributes of the body such as body size, affect tactile perception even at the level of detection thresholds and two-point discrimination. Next, long-range tactile masking provides clues to the posture of the body in a canonical body schema. Finally, ownership of seen body parts depends on the orientation and perspective of the body part in view. Together, all of these findings demonstrate how sensory and motor information, body representations, and perceptions (of the body and the world) are interdependent.

We assessed the perception and attitudes of university staff, including medical school and other science specialties, toward the 2009 A/H1N1 influenza pandemic and influenza vaccination program. A cross-sectional online survey was conducted among 4,529 university personnel on October 19-20, 2009. Seven hundred (15%) employees participated in the study. Only 18% were willing to be vaccinated, men more than women (29% versus 9%, P < 0.001), and professors/researchers more than administrative/technical staff (30% vs. 6%, P < 0.001). Intention to be vaccinated was insufficient. Additional efforts are needed to improve information dissemination among university staff. Medical university personnel should receive more information to increase vaccine coverage and protect them as well as patients.