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MRI features are presented in a multicenter retrospective series of five patients with a unilateral masslike lesion seen in the genitourinary diaphragm at MRI performed for known or suspected prostate cancer. In all cases, the lesion appeared as an encapsulated 1.3 to 3.0 cm mass of heterogeneous low or intermediate T2 signal intensity in the genitourinary diaphragm, and targeted biopsy demonstrated benign Cowper's gland tissue. This entity is a potential imaging pitfall that could result in a diagnosis of an exophytic nodule of benign prostatic hyperplasia or local spread of prostate cancer. We present these cases to facilitate correct identification of Cowper's gland hyperplasia as an occasional finding at MRI of the prostate.

The aim of this study was to investigate the spatiotemporal association between socioeconomic deprivation and the incidence of COVID-19 and how this association changes through the seasons due to the existence of restrictive public health measures. A retrospective observational study was conducted among COVID-19 cases that occurred in the Apulia region from 29 February 2020 to 31 December 2021, dividing the period into four phases with different levels of restrictions. A generalized estimating equation (GEE) model was applied to test the independent effect of deprivation on the incidence of COVID-19, taking into account age, sex, and regional incidence as possible confounding effects and covariates, such as season and levels of restrictions, as possible modifying effects. The highest incidence was in areas with a very high deprivation index (DI) in winter. During total lockdown, no rate ratio between areas with different levels of DI was significant, while during soft lockdown, areas with very high DI were more at risk than all other areas. The effects of social inequalities on the incidence of COVID-19 changed in association with the seasons and restrictions on public health. Disadvantaged areas showed a higher incidence of COVID-19 in the cold seasons and in the phases of soft lockdown.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is the world's largest public health concern in 2021. This study evaluated the associations of the prevalence of airway symptoms among the tested individuals and data regarding the natural environmental factors with the weekly number of newly diagnosed COVID-19 patients in Sendai City (N

Coronavirus is a common type of virus that usually infects humans and results in a high breathing infection. This virus transmits through the air by coughing and sneezing, near physical contacts, and touching virus-contaminated substances or surfaces. Symptoms include runny nose, sore throat, feeling unwell, cough, and fever. The coronavirus outbreak (officially known as COVID-19), which started in China, has so far taken lives of over 190,656 people and affected 2,718,797 people across the world. The infection has spread to 185 countries. According to the official report released by the Ministry of Health and Family Welfare of the Union (MoHFW), 23,077 confirmed cases and 718 deaths have been registered so far in India. The transmission of COVID-19 was successfully controlled by India until now. The Department of Indian Health Science is well organized to control the corona epidemic. The Indian Health Sciences Department and the Regulatory Team (CDSCO) are advancing bio-war against the pandemic by providing effective and constructive updates to the pharmaceutical industry and making it easier for the citizens to prevent transmission in India. The most critical factor in preventing the local spread of the virus is to motivate the public to obtain the right information and take precautions in compliance with the health ministry's warnings.

The COVID-19 pandemic has spread globally; however, the risk of contracting COVID-19 on public transportation and its role in local spread remains unclear. Essential workers who are transit-dependent tend to be from low-income and minority populations and are faced with the risk of contracting COVID-19 each time they take a bus. We investigate bus ridership from April to September of 2020 and the risk of contracting COVID-19 on the bus by combining a transportation data analysis and an epidemiological model of COVID-19 risk. Our results show that 4% of county cases were contracted on the bus or from a bus-rider (first degree), disproportionately (52%) from trips that were over their mandated capacity. The risk of contracting COVID-19 on the bus was low, but socially worth mitigating. A cost-benefit analysis reveals that dispatching autonomous vehicles or deploying longer buses for passed-by passengers rather than allowing crowding have the lowest societal costs.

BackgroundThe patterns of spread of influenza A viruses in local populations in tropical and sub-tropical regions are unclear due to sparsity of representative spatiotemporal sequence data.MethodsWe sequenced and analyzed 58 influenza A(H3N2) virus genomes sampled between December 2015 and December 2016 from nine health facilities within the Kilifi Health and Demographic Surveillance System (KHDSS), a predominantly rural region, covering approximately 891 km2along the Kenyan coastline. The genomes were compared with 1,571 contemporaneous global sequences from 75 countries.ResultsWe observed at least five independent introductions of A(H3N2) viruses into the region during the one-year period, with the importations originating from Africa, Europe, and North America. We also inferred 23 virus location transition events between the nine facilities included in the study. International virus imports into the study area were captured at the facilities of Chasimba, Matsangoni, Mtondia, and Mavueni, while all four exports from the region were captured from the Chasimba facility, all occurring to Africa destinations. A strong spatial clustering of virus strains at all locations was observed associated with local evolution.ConclusionOur study shows that influenza A(H3N2) virus epidemics in local populations appear to be characterized by limited introductions followed by significant local spread and evolution.

International audience; Zoonotic tick-borne diseases threat human and animal health. Understanding the role of hosts in the production of infected ticks in an epidemiological system is essential to be able to design effective measures to reduce the exposure of humans and animals to infectious tick bites. The reservoir host potential, i.e. number of infected ticks produced by a host species, depends on three components: tick production, realized reservoir competence and host density. The parameters and factors that determine the reservoir host potential need to be characterized to achieve a robust understanding of the dynamics of pathogen-tick-host systems, and thus to mitigate the acarological risk of emerging infections. Few studies have investigated the role of birds in the local spread of Lyme borreliosis Borrelia. Knowledge of the research effort on the reservoir host potential of birds in Lyme borreliosis Borrelia circulation is necessary to prioritize future research on this topic. We provide a systematic review of the research effort on components of the reservoir host potential of wild birds for Lyme borreliosis Borrelia circulation, and factors that modulate these components in the European epidemiological system. Our review of 242 selected publications showed that tick production has been 1.4 and 21 times more studied than realized reservoir competence and bird density respectively. Only one study achieved to characterize the global host reservoir potential of birds in a given epidemiological system. Investigated factors were mostly related to bird species identity, individual characteristics of birds and tick characteristics, whereas the influence of bird life-history traits have been largely under-investigated. Because simultaneous characterization of all parameters is notoriously complex, interdisciplinary research is needed to combine and accumulate independent field and laboratory investigations targeting each parameter on specific epidemiological system or host species. This can help gain an integrated appraisal of the functioning of the studied system at a local scale.

ispartof: CLINICAL LUNG CANCER vol:22 issue:4 pages:E552-E554 ispartof: location:United States status: published

A thymoma belongs to rather rare tumors, although it holds the first place among primary mediastinal tumors in adults. The biological characteristics of thymomas are considerably divergent. The tumors are usually asymptomatic at the begining, later due to a local spread, symptoms from the infiltration or compression of adjacent structures arise, they metastasize rarely. Thymomas are often associated with various autoimmune or endocrinologic diseases. The authors present case of the patient with less common paraneoplasia - autoimmune hemolytic anemia (AIHA). Main strategy of treatment thymom with AIHA isn´t clear. The most important seems to be the early started corticotherapy. Achieving remission of secondary AIHA has importace in following therapy of thymoma - surgical resection or chemotherapy. Thymectomy has positive effect on the course of associated paraneoplastic syndromes and prognosis in general.

Despite the global efforts to mitigate the ongoing COVID-19 pandemic, the disease transmission and the effective controls still remain uncertain as the outcome of the epidemic varies from place to place. In this regard, the province-wise data from Nepal provides a unique opportunity to study the effective control strategies. This is because (a) some provinces of Nepal share an open-border with India, resulting in a significantly high inflow of COVID-19 cases from India; (b) despite the inflow of a considerable number of cases, the local spread was quite controlled until mid-June of 2020, presumably due to control policies implemented; and (c) the relaxation of policies caused a rapid surge of the COVID-19 cases, providing a multi-phasic trend of disease dynamics. In this study, we used this unique data set to explore the inter-provincial disparities of the important indicators, such as epidemic trend, epidemic growth rate, and reproduction numbers. Furthermore, we extended our analysis to identify prevention and control policies that are effective in altering these indicators. Our analysis identified a noticeable inter-province variation in the epidemic trend (3 per day to 104 per day linear increase during third surge period), the median daily growth rate (1 to 4% per day exponential growth), the basic reproduction number (0.71 to 1.21), and the effective reproduction number (maximum values ranging from 1.20 to 2.86). Importantly, results from our modeling show that the type and number of control strategies that are effective in altering the indicators vary among provinces, underscoring the need for province-focused strategies along with the national-level strategy in order to ensure the control of a local spread.

We investigate the interplay between the local spread of COVID-19 and patterns of individual mobility within and across self-contained geographical areas. Conceptually, we connect the debate on regional development in the presence of shocks with the literature on spatial labour markets and address some research questions about the role of individual mobility in affecting the spread of the disease. By looking at granular flows of Facebook users moving within and across Italian labour market areas (LMAs), we analyse whether their heterogeneous internal and external mobility has had a significant impact on excess mortality. We also explore how individual mobility plays different roles in LMAs hosting industrial districts – characterised by a thicker local labour market and denser business and social interactions – and with a high presence of “essential sectors” - activities not affected by the COVID-19 containment measures taken by the Italian government at the onset of the crisis.

We develop a novel temporal complex network approach to quantify the US county level spread dynamics of COVID-19. We use both conventional econometric and Machine Learning (ML) models that incorporate the local spread dynamics, COVID-19 cases and death, and Google search activities to assess if incorporating information about local spreads improves the predictive accuracy of models for the US stock market. The results suggest that COVID-19 cases and deaths, its local spread, and Google searches have impacts on abnormal stock prices between January 2020 to May 2020. Furthermore, incorporating information about local spread significantly improves the performance of forecasting models of the abnormal stock prices at longer forecasting horizons.

To study the jitter parameters in the distant (DM) and the adjacent muscle (AM) after botulinum neurotoxin type A (BoNT/A) injection in 78 patients, jitter was measured by voluntary activation in DM (n = 43), and in AM (n = 35). Patients were receiving BoNT/A injections as a treatment for movement disorders. Mean age 65.1 years (DM) and 61.9 years (AM). The mean jitter was abnormal in 13.9% (maximum 41.4 &micro, s) of DM, and 40% (maximum 43.7 &micro, s) of AM. Impulse blocking was sparse. We found no correlation of the mean jitter to age, BoNT/A most recent injection (days/units), number of muscles injected, total BoNT/A units summated, number of total BoNT/A sessions, beta-blockers/calcium channel blockers use, and cases with local spread symptoms such as eyelid drop/difficulty swallowing. Maximum mean jitter (41.4/43.7 &micro, s) for DM/AM occurred 61 and 131 days since the most recent BoNT/A, respectively. The far abnormal mean jitter (32.6/36.9 &micro, s) occurred 229 and 313 days since the most recent BoNT/A. We suggested that jitter measurement can be done after BoNT/A in a given muscle other than the injected one, after 8 (DM) and 11 (AM) months, with reference &gt, 33 &micro, s and &gt, 37 &micro, s, respectively.

Using microdata from the Current Employment Statistics survey and the Current Population Survey, I illustrate how the local spread of coronavirus disease 2019 (COVID-19) has differentially affected industry employment Industries that are not very telework friendly are more likely to have job loss related to its spread In addition, COVID-19's spread appears to be most correlated with temporary job loss, which could partially explain employment numbers improving slightly in May and June 2020

Background: The focus of the study is to assess the role of different transport means in the importation and diffusion of 1918-19 influenza and a novel 2019 corona virus designated as COVID-19 in Nigeria. Methods: The study provides a review of the means by which the two pandemics were imported into the country and the roles the transport means of each period played in the local spread of the epidemics. Results: The study notes that seaports and railways, being the emerging transportation modes in the country were significant to the importation and local diffusion of 1918-19 influenza, respectively, while air transport is significant to the importation of the current COVID-19 pandemic. Conclusions: The study concludes that increasing preference for the transport at a given epoch is significant to the diffusion of prevailing epidemic in the epoch.

Candida auris, draws attention as a new emerging antifungal resistant pathogen, leading to healthcare-associated infections and outbreaks. This is the first report of C. auris fungemia in a 81-year-old patient, confirmed by sequential analysis, from Turkey. Although the source of the isolate could not be identified, its spread in the hospital has been taken under control by effective infection control measures.

We announce the genome sequences of two strains of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolated in Israel, one imported by a traveler who returned from Japan and the second strain collected from a patient infected by a traveler returning from Italy. The sequences obtained are valuable as early manifestations for future follow-up of the local spread of the virus in Israel.

Neurologic complications of lymphoid cancer can be challenging to recognize and treat. The nervous system can be affected directly by hematogenous or local spread of lymphoma. Indirect neurologic effects of lymphoma include paraneoplastic syndromes and vascular complications. Lymphoma treatments can also cause neurologic complications. Early identification and treatment are crucial to stabilize or reverse neurologic deficits, prevent further nervous system injury, and optimize overall oncologic therapy. This article provides an overview of the different neurologic complications of lymphoma and its treatments, in addition to presenting case studies that emphasize commonly encountered clinical scenarios.

Candida parapsilosis osteomyelitis is a rare diagnosis. Candidal infection can occur via hematogenous or local spread. A localized swelling around a bony structure should raise clinical suspicion. Diagnosis is made by a combination of imaging modalities and biopsy. Anecdotal case reports have been reported in medical literature and treatment guidelines are very limited. Treatment modality includes a combination of surgical debridement and antifungal therapy.

Plasmodesmata (PD) allow membrane and cytoplasmic continuity between plant cells, and they are essential for intercellular communication and signaling in addition to metabolite partitioning. Plant pathogens have evolved a variety of mechanisms to subvert PD to facilitate their infection of plant hosts. PD are implicated not only in local spread around infection sites but also in the systemic spread of pathogens and pathogen-derived molecules. In turn, plants have developed strategies to limit pathogen spread via PD, and there is increasing evidence that PD may also be active players in plant defense responses. The last few years have seen important advances in understanding the roles of PD in plant-pathogen infection. Nonetheless, several critical areas remain to be addressed. Here we highlight some of these, focusing on the need to consider the effects of pathogen-PD interaction on the trafficking of endogenous molecules, and the involvement of chloroplasts in regulating PD during pathogen defense. By their very nature, PD are recalcitrant to most currently used investigative techniques, therefore answering these questions will require creative imaging and novel quantification approaches.

A simple model of local spread of COVID-19 is needed to assist local governments and health care providers prepare for surges of clinical cases in their communities. National and state based models are inadequate because the virus is introduced and spreads at different rates in local areas. In the U.S. as of July 3, 2020, 73 percent of cases and 84 percent of deaths occurred in the 200 counties with the most cases and deaths. Each county has its own function of cases in time that can be used to predict increases in reported cases two weeks in advance for each of 988 counties in the U.S. with populations of 50,000 or more inhabitants. A logarithmic model based on growth in cases during the past 30 days is substantially predictive of increase in cases during the subsequent 14 days. Predicted increase in cases for the 988 U.S. counties will be published online daily.

Tau and amyloid β (Aβ), 2 key pathogenic proteins in Alzheimer’s disease (AD), reportedly spread throughout the brain as the disease progresses. Models of how these pathogenic proteins spread from affected to unaffected areas had been proposed based on the observation that these proteins could transmit to other regions either through neural fibers (transneuronal spread model) or through extracellular space (local spread model). In this study, we modeled the spread of tau and Aβ using a graph theoretical approach based on resting-state functional magnetic resonance imaging. We tested whether these models predict the distribution of tau and Aβ in the brains of AD spectrum patients. To assess the models’ performance, we calculated spatial correlation between the model-predicted map and the actual map from tau and amyloid positron emission tomography. The transneuronal spread model predicted the distribution of tau and Aβ deposition with significantly higher accuracy than the local spread model. Compared with tau, the local spread model also predicted a comparable portion of Aβ deposition. These findings provide evidence of transneuronal spread of AD pathogenic proteins in a large-scale brain network and furthermore suggest different contributions of spread models for tau and Aβ in AD.

Key Clinical Message Polyarticular septic arthritis is a rare but life‐threatening condition and should not be underestimated. Clinicians should look for potential source of infection, either local spread or hematogenous distribution. However, this should not delay the main treatment for septic arthritis.

Bejel, an endemic treponematosis caused by infection with Treponema pallidum subspecies endemicum, has not been reported in eastern Asia and the Pacific region. We report local spread of bejel among men who have sex with men in Japan. Spread was complicated by venereal syphilis.

Background: Breast cancer is the most common cause of cancer death for women worldwide. The accurate clinical staging of patients with breast cancer is important in determining the most appropriate treatment. The present study investigated the value of staging CECT in detecting asymptomatic distant (lung, liver and bone) metastases in patients with primary breast cancer. Material And Method: 30 patients with Breast Imaging Reporting and Data System category (BI-RADS) 4, 5 and 6 lesions underwent unenhanced breast CTand contrast material enhanced CTbefore histopathological correlation. Result And Discussion: In present study, 5(16.6%) cases shows metastasis into the lungs, 3(10%) cases shows metastasis into the liver, 3(10%) cases shows metastasis into the bones, 1(3.3%)case show metastasis into multiple site(lung and liver), 18(60%) cases shows no any evidence of metastasis. By contrast, 12 of 30 patients (40%) with stage III were upstaged to stage IV and 13 patients (43.3%) of those were originally stage IIIB or IIIC. Conclusion:CECTappears as an essential imaging modality to detect presence, extent and localisation of metastasis.

Introduction Klebsiella pneumoniae carbapenemase (KPC)-producing bacteria are amongst the most important causative agents of nosocomial infections worldwide. Isolates of this bacterium have been identified in Venezuela but little is known about their local spread. The aim of this study was to perform the molecular characterization of KPC-producing strains isolated from 2012 to 2013 in a public hospital in Caracas, Venezuela. Methods Twenty-two K. pneumoniae clinical isolates phenotypically classified as KPC producing were subjected to PCR screening for the presence of blaKPC genes and their location within transposon Tn4401. The blaKPC PCR product was sequenced to identify the KPC alleles. Genotypic analysis was performed by means of repetitive extragenic palindromic PCR (rep-PCR) and Multi Locus Sequence Typing (MLST). Finally, conjugation and electroporation assays were used to determine whether the blaKPC genes were found in plasmids. Results All isolates contained the blaKPC-2 variant, and 21 of the 22 were associated with the Tn4401b isoform. The strains were distributed in 8 sequence types (ST), three of which were new. Conjugation and electroporation assays indicated that 95.5% (n = 21/22) of the isolates contained the blaKPC gene in plasmids. Conclusions This study on circulating bacterial strains and the identification of KPC alleles may help to understand the routes of dissemination and control their spread within this hospital.

The purpose of the study was to evaluate the value of contrast-enhanced ultrasound in detecting local spread, regional and distant metastases from cervical cancer. Materials and methods. The findings of contrast-enhanced ultrasound examination of 4 cervical cancer patients (IB1–IVB) treated at N.N. Blokhin Russian Cancer Research Center from September to October 2016 were evaluated. The HI VISION Ascendus device was used. Ultrasound patterns in different phases of contrast-enhanced accumulation and excretion were analyzed. Results. Our first experience in using contrast-enhanced ultrasound in the detection of local spread, regional and distant metastases from cervical cancer allowed us to study the structure of the tumor and its spread in greater detail. Conclusion. A small number of observations do not yet allow us to draw serious conclusions about the capabilities of this modern technology.

Cutaneous angiosarcoma is a rare and aggressive malignant tumor of vascular origin. Multimodality treatment including surgery, radiotherapy and chemotherapy should be used according to age and local spread. Prognosis is poor with a 5-year survival of 10-15%. We report the case of an angiosarcoma of the scalp and face treated with sequential contact radiotherapy and chemotherapy. After local response, the patient progressed in non-irradiated zone then had liver metastasis.

Background Radiographs are the most valuable modality for diagnosis of bone tumors, however MRI is emerging as the modality of choice for assessing local spread of tumor. Objective To assess role of MRI in local spread of tumor and comparison to surgical & histo-pathological results. Results 47 patients ( age 10-73 years with mean age of 38 years) were studied from May 2018 to November 2019. There were 26 males and 21 females, 9 patients were excluded as no operative results were available. Out of the 38 total cases, 11 were osteosarcoma, 7 were Ewing’s sarcoma, 7 were GCT, 6 were Chondrosarcoma, 2 Osteochondroma, 1 PNET, 1 ABC, 1 Hemangioma, 1 Chordoma and 1 Multiple myeloma. Cortical break was detected in 29 patients on MRI with 2 false positive cases showing 93% accuracy. Medulla involvement was detected in 34/35 patients (97%). Neuro-vascular involvement was detected in 9 patients on MRI with 1 false positive cases showing 88.9% accuracy. Joint involvement was detected in 13 patients on MRI with 2 false positive cases showing 84.6% accuracy. All 4 cases of skip lesion (100%) were detected on MRI. Conclusion MRI is the modality of choice to assess for local spread of bone tumors.

BackgroundOn February 27, 2020, the first patient with COVID-19 was reported in the Netherlands. During the following weeks, nine healthcare workers (HCWs) were diagnosed with COVID-19 in two Dutch teaching hospitals, eight of whom had no history of travel to China or Northern-Italy. A low-threshold screening regimen was implemented to determine the prevalence and clinical presentation of COVID-19 among HCWs in these two hospitals.MethodsHCWs who suffered from fever or respiratory symptoms were voluntarily tested for SARS-CoV-2 by real-time reverse-transcriptase PCR on oropharyngeal samples. Structured interviews were conducted to document symptoms for all HCWs with confirmed COVID-19.FindingsThirteen-hundred fifty-three (14%) of 9,705 HCWs employed were tested, 86 (6%) of whom were infected with SARS-CoV-2. Most HCWs suffered from relatively mild disease and only 46 (53%) reported fever. Eighty (93%) HCWs met a case definition of fever and/or coughing and/or shortness of breath. None of the HCWs identified through the screening reported a travel history to China or Northern Italy, and 3 (3%) reported to have been exposed to an inpatient known with COVID-19 prior to the onset of symptoms.InterpretationWithin two weeks after the first Dutch case was detected, a substantial proportion of HCWs with fever or respiratory symptoms were infected with SARS-CoV-2, probably caused by acquisition of the virus in the community during the early phase of local spread. The high prevalence of mild clinical presentations, frequently not including fever, asks for less stringent use of the currently recommended case-definition for suspected COVID-19.RESEARCH IN PERSPECTIVEEvidence before this studyThis study was conducted in response to the global spread of SARS-CoV-2, and the detection of eight healthcare workers (HCWs) in two Dutch teaching hospitals within two weeks after the first patient with COVID-19 was detected in the Netherlands who had no history of travel to China or Northern-Italy, raising the question of whether undetected community circulation was occurring.Added value of this studyTo the best of our knowledge, this report is the first to describe the prevalence, the clinical presentation and early outcomes of COVID-19 in HCWs, which may be helpful for others seeking to identify HCWs suspected for COVID-19 in an outbreak situation.Implications of all the available evidenceWe describe that within two weeks after the first Dutch case was detected, a substantial proportion of HCWs with fever or (mild) respiratory symptoms were infected with SARS-CoV-2, probably caused by acquisition of the virus in the community during the early phase of local spread. The high prevalence of mild clinical presentations, frequently not including fever, asks for less stringent use of the currently recommended case-definition for suspected COVID-19.