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1

Madzgarashvili, Lali, Jamine Weiss, Marina Baidauri, Marika Geleishvili, Meghan Lyman e Amy Kolwaite. "Development of National Infection Control and Prevention Guidelines in Georgia, 2017–2019". Infection Control & Hospital Epidemiology 41, S1 (ottobre 2020): s189. http://dx.doi.org/10.1017/ice.2020.729.

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Background: In 2015, the Ministry of Internally Displaced Persons from the Occupied Territories, Labor, Health and Social Affairs (MoLHSA) of Georgia identified infection prevention and control (IPC) as a top priority. Infection control legislation was adopted and compliance was made mandatory for licensure. Participation in the universal healthcare system requires facilities to have an IPC program and infrastructure. To support facilities to improve IPC, MoLHSA and the National Center for Disease Control and Public Health (NCDC) requested assistance from the US CDC to revise the 2009 National IPC guidelines, which were translated versions of international guidelines and not adapted to the Georgian context. Methods: An IPC guideline technical working group (TWG), comprising clinical epidemiologists, IPC nurses, head nurses, and infectious diseases doctors from the NCDC, academic and healthcare organizations and the CDC was formed to lead the development of the national IPC guidelines. Additionally, an IPC steering committee was established to review and verify the guidelines’ compliance with applicable decrees and regulations. The TWG began work in April 2017 and was divided into 4 subgroups, each responsible for developing specific guideline topics. A general IPC guideline template for low- and middle-income countries was used to develop 7 of the guidelines. Additional reference materials and international guidelines were used to develop all the guidelines. Drafts were shared with the subgroups and the steering committee during 2 workshops to discuss unresolved technical issues and to validate the guidelines. Results: The revised guidelines consist of 18 topics. In addition to standard precautions (eg, hand hygiene, personal protective equipment, injection safety, etc) and transmission-based precautions, the guideline topics include laundry, environmental cleaning and disinfection, decontamination and sterilization, occupational health and safety, biosafety in clinical laboratory, blood bank and transfusion services, intensive care unit, emergency room, and mortuary. They do not include healthcare-associated infection surveillance or organism-specific guidance. To supplement the guidelines, a separate implementation manual was developed. The guidelines were approved by MoLHSA in October 2019. The TWG continues to be engaged in IPC activities, assisting with guideline rollout, training, and monitoring, and drafting the National IPC strategy and action plans. Conclusions: The Georgian Ministry of Health developed national IPC guidelines using local experts. This model can be replicated in other low- and middle-income countries that lack country-specific IPC guidelines. It can also be adapted to develop facility-level guidelines and standard operating procedures.Funding: NoneDisclosures: None
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Tsinamdzgvrishvili, Bezhan, Amiran Gamkrelidze, Dali Trapaidze, Lela Sturua, Nino Grdzelidze, Tamar Abesadze, Nana Mebonia et al. "May Measurement Month 2019: blood pressure screening results in Georgia, Europe". European Heart Journal Supplements 23, Supplement_B (1 maggio 2021): B59—B61. http://dx.doi.org/10.1093/eurheartj/suab022.

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Abstract May Measurement Month is a global campaign aimed at raising public awareness of hypertension and to improve the management of hypertension—the main risk factor for cardiovascular diseases in the population. Screening was carried out at 400 sites on a national scale. More than 500 volunteers, including physicians (80%) and students of medical universities (20%) participated in the screening. To familiarize them with the research tools and standard blood pressure (BP) measurement method, they were trained by the members of the Georgian Society of Hypertension and the National Center for Disease Control and Public Health’s staff. Medical societies, health-care professionals, public health workers, social mass media, and other stakeholders were actively involved in the recruitment process. A total of 13 267 (38.5% males and 61.5% females) individuals were screened. The mean age of participants was 54.7 years (SD 15.9). All participants were Caucasian. After imputation of missing BP readings, 8510 (64.1%) were found to have hypertension, out of whom 7269 (85.4%) were aware of their condition, 7232 (85.0%) were on medication, and 1278 (15.0%) were not taking any medication. Of those taking antihypertensive medication, 34.8% had their BP controlled (<140/90 mmHg). May Measurement Month detected a high proportion of participants with hypertension, with results indicating low rates of control in Georgia.
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WALLACE, DAVID J., THOMAS VAN GILDER, SUE SHALLOW, TERRY FIORENTINO, SUZANNE D. SEGLER, KIRK E. SMITH, BELETSHACHEW SHIFERAW, RUTH ETZEL, WALLACE E. GARTHRIGHT e FREDERICK J. ANGULO. "Incidence of Foodborne Illnesses Reported by the Foodborne Diseases Active Surveillance Network (FoodNet)—1997". Journal of Food Protection 63, n. 6 (1 giugno 2000): 807–9. http://dx.doi.org/10.4315/0362-028x-63.6.807.

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In 1997, the Foodborne Diseases Active Surveillance Program (FoodNet) conducted active surveillance for culture-confirmed cases of Campylobacter, Escherichia coli O157, Listeria, Salmonella, Shigella, Vibrio, Yersinia, Cyclospora, and Cryptosporidium in five Emerging Infections Program sites. FoodNet is a collaborative effort of the Centers for Disease Control and Prevention's National Center for Infectious Diseases, the United States Department of Agriculture's Food Safety and Inspection Service, the Food and Drug Administration's Center for Food Safety and Applied Nutrition, and state health departments in California, Connecticut, Georgia, Minnesota, and Oregon. The population under active surveillance for food-borne infections was approximately 16.1 million persons or roughly 6% of the United States Population. Through weekly or monthly contact with all clinical laboratories in these sites, 8,576 total isolations were recorded: 2,205 cases of salmonellosis, 1,273 cases of shigellosis, 468 cases of cryptosporidiosis, 340 of E. coli O157:H7 infections, 139 of yersiniosis, 77 of listeriosis, 51 of Vibrio infections, and 49 of cyclosporiasis. Results from 1997 demonstrate that while there are regional and seasonal differences in reported incidence rates of certain bacterial and parasitic diseases, and that some pathogens showed a change in incidence from 1996, the overall incidence of illness caused by pathogens under surveillance was stable. More data over more years are needed to assess if observed variations in incidence reflect yearly fluctuations or true changes in the burden of foodborne illness.
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Paulukonis, Susan, Todd Griffin, Mei Zhou, James R. Eckman, Robert Hagar, Angela Bauer Snyder, Lisa Feuchtbaum, Althea M. Grant e Mary Hulihan. "Sickle Cell Disease Mortality in California and Georgia 2004-2008". Blood 124, n. 21 (6 dicembre 2014): 439. http://dx.doi.org/10.1182/blood.v124.21.439.439.

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Abstract On-going public health surveillance efforts in sickle cell disease (SCD) are critical for understanding the course and outcomes of this disease over time. Once nearly universally fatal by adolescence, many patients are living well into adulthood and sometimes into retirement years. Previous SCD mortality estimates have relied on data from death certificates alone or from deaths of patients receiving care in high volume hematology clinics, resulting in gaps in reporting and potentially biased conclusions. The Registry and Surveillance System for Hemoglobinopathies (RuSH) project collected and linked population-based surveillance data on SCD in California and Georgia from a variety of sources for years 2004-2008. These data sources included administrative records, newborn screening reports and health insurance claims as well as case reports of adult and pediatric patients receiving care in the following large specialty treatment centers: Georgia Comprehensive Sickle Cell Center, Georgia Regents University, Georgia Comprehensive Sickle Cell Center at Grady Health Systems and Children's Healthcare of Atlanta in Georgia, and Children's Hospital Los Angeles and UCSF Benioff Children's Hospital Oakland in California. Cases identified from these combined data sources were linked to death certificates in CA and GA for the same years. Among 12,143 identified SCD cases, 640 were linked to death certificates. Combined SCD mortality rates by age group at time of death are compared to combined mortality rates for all African Americans living in CA and GA. (Figure 1). SCD death rates among children up to age 14 and among adults 65 and older were very similar to those of the overall African American population. In contrast, death rates from young adulthood to midlife were substantially higher in the SCD population. Overall, only 55% of death certificates linked to the SCD cases had SCD listed in any of the cause of death fields. Thirty-four percent (CA) and 37% (GA) had SCD as the underlying cause of death. An additional 22% and 20% (CA and GA, respectively) had underlying causes of death that were not unexpected for SCD patients, including related infections such as septicemia, pulmonary/cardiac causes of death, renal failure and stroke. The remaining 44% (CA) and 43% (GA) had underlying causes of death that were either not related to SCD (e.g., malignancies, trauma) or too vague to be associated with SCD (e.g., generalized pulmonary or cardiac causes of death. Figure 2 shows the number of deaths by state, age group at death and whether the underlying cause of death was SCD specific, potentially related to SCD or not clearly related to SCD. While the number of deaths was too small to use for life expectancy calculations, there were more deaths over age 40 than under age 40 during this five year period. This effort represents a novel, population-based approach to examine mortality in SCD patients. These data suggest that the use of death certificates alone to identify deceased cases may not capture all-cause mortality among all SCD patients. Additional years of surveillance are needed to provide better estimates of current life expectancy and the ability to track and monitor changes in mortality over time. On-going surveillance of the SCD population is required to monitor changes in mortality and other outcomes in response to changes in treatments, standards of care and healthcare policy and inform advocacy efforts. This work was supported by the US Centers for Disease Control and Prevention and the National Heart, Lung and Blood Institute, cooperative agreement numbers U50DD000568 and U50DD001008. Figure 1: SCD-Specific & Overall African American Mortality Rates in CA and GA, 2004 – 2008. Figure 1:. SCD-Specific & Overall African American Mortality Rates in CA and GA, 2004 – 2008. Figure 2: Deaths (Count) Among Individuals with SCD in CA and GA, by Age Group and Underlying Cause of Death, 2004-2008 (N=615) Figure 2:. Deaths (Count) Among Individuals with SCD in CA and GA, by Age Group and Underlying Cause of Death, 2004-2008 (N=615) Disclosures No relevant conflicts of interest to declare.
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Tsertsvadze, Tengiz, Amiran Gamkrelidze, Nikoloz Chkhartishvili, Akaki Abutidze, Lali Sharvadze, Vakhtang Kerashvili, Maia Butsashvili et al. "Three Years of Progress Toward Achieving Hepatitis C Elimination in the Country of Georgia, April 2015–March 2018". Clinical Infectious Diseases 71, n. 5 (29 settembre 2019): 1263–68. http://dx.doi.org/10.1093/cid/ciz956.

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Abstract Background In April 2015, in collaboration with the US Centers for Disease Control and Prevention and Gilead Sciences, the country of Georgia embarked on the world’s first hepatitis C elimination program. We aimed to assess progress toward elimination targets 3 years after the start of the elimination program. Methods We constructed a hepatitis C virus (HCV) care cascade for adults in Georgia, based on the estimated 150 000 persons aged ≥18 years with active HCV infection. All patients who were screened or entered the treatment program during April 2015–March 2018 were included in the analysis. Data on the number of persons screened for HCV were extracted from the national HCV screening database. For the treatment component, we utilized data from the Georgia National HCV treatment program database. Available treatment options included sofosbuvir and ledipasvir/sofosbuvir–based regimens. Results Since April 2015, a cumulative 974 817 adults were screened for HCV antibodies; 86 624 persons tested positive, of whom 61 925 underwent HCV confirmatory testing. Among the estimated 150 000 adults living with chronic hepatitis C in Georgia, 52 856 (35.1%) were diagnosed, 45 334 (30.2%) initiated treatment with direct-acting antivirals, and 29 090 (19.4%) achieved a sustained virologic response (SVR). Overall, 37 256 persons were eligible for SVR assessment; of these, only 29 620 (79.5%) returned for evaluation. The SVR rate was 98.2% (29 090/29 620) in the per-protocol analysis and 78.1% (29 090/37 256) in the intent-to-treat analysis. Conclusions Georgia has made substantial progress in the path toward eliminating hepatitis C. Scaling up of testing and diagnosis, along with effective linkage to treatment services, is needed to achieve the goal of elimination.
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Stone, Rebecca, Yunmi Chung e Benjamin Ansa. "Syphilis Trends in the Central Savannah River Area (CSRA) of Georgia and South Carolina, USA". Journal of Clinical Medicine 7, n. 8 (31 luglio 2018): 190. http://dx.doi.org/10.3390/jcm7080190.

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There has been an alarming resurgence of early syphilis since 2000, especially in the southeast region, which has one of the highest rates of primary and secondary syphilis in the United States of America (USA). Although the Central Savannah River Area (CSRA) is the second most populous area in Georgia with a large presence of health care facilities, its counties have one of the lowest overall rankings in health outcomes. This study examined the syphilis rates and trends in the CSRA. Data from the Centers for Disease Control and Prevention (CDC) National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention’s AtlasPlus was used. Cases of primary and secondary syphilis diagnosed during 2010–2015 were analyzed to describe reported syphilis among CSRA residents. In the CSRA, between 2010 and 2015, the incidence rate of primary and secondary syphilis increased from 5.9 to 9.4 cases per 100,000 population. The lowest rate of syphilis was observed in 2011 (2.7 cases per 100,000) and the highest rate in 2015. In 2015, the highest syphilis rates were observed among males (15.9 per 100,000), non-Hispanic blacks (16.9 per 100,000), and persons between the ages 20–24 years (34.5 per 100,000). The relevance of preventive measures has been widely communicated, yet it is clear that risk-taking sexual behavior is on the rise. Greater effort is warranted to reduce risky behaviors that promote the transmission of syphilis, including areas outside of major metropolitan areas.
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Rascoe, Lisa N., Cynthia Santamaria, Sukwan Handali, Sriveny Dangoudoubiyam, Kevin R. Kazacos, Patricia P. Wilkins e Momar Ndao. "Interlaboratory Optimization and Evaluation of a Serological Assay for Diagnosis of Human Baylisascariasis". Clinical and Vaccine Immunology 20, n. 11 (18 settembre 2013): 1758–63. http://dx.doi.org/10.1128/cvi.00387-13.

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ABSTRACTA Western blot assay using a recombinant protein, recombinantBaylisascaris procyonisRAG1 protein (rBpRAG1), was developed for the diagnosis of human baylisascariasis concurrently by the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, and the National Reference Centre for Parasitology (NRCP) in Montreal, Canada. Assay performance was assessed by testing 275 specimens at the CDC and 405 specimens at the NRCP. Twenty specimens from 16 cases of baylisascariasis were evaluated. Eighteen were positive, with the assay correctly identifying 14 of 16 patients. The rBpRAG1 Western blot assay showed no cross-reactivity withToxocara-positive serum and had an overall sensitivity of 88% and a specificity of 98%.
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Knudsen, Richard C. "Risk Assessment for Biological Agents in the Laboratory". Journal of the American Biological Safety Association 3, n. 3 (settembre 1998): 99–104. http://dx.doi.org/10.1177/109135059800300305.

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Risk assessments for using biological agents in the laboratory are qualitative rather than quantitative. A number of risk factors for performing the assessment are identified and discussed in terms of information needed and assessment. A process for performing a qualitative risk assessment for biological agents in the laboratory is presented with an example. This article was presented at the 5th National Symposium on Biosafety held in Atlanta, Georgia on January 17–20, 1998. The Symposium was sponsored by the Centers for Disease Control and Prevention (CDC) and the American Biological Safety Association (ABSA). Reprinted from Rational Basis for Biocontainment Proceedings, ABSA, pp. 56–65.
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Graffunder, Corinne M., Stephen W. Wyatt, Barbara Bewerse, Irene Hall, Barbara Reilley e Rebeca Lee-Pethel. "Skin Cancer Prevention: The Problem, Responses, and Lessons Learned". Health Education & Behavior 26, n. 3 (giugno 1999): 308–16. http://dx.doi.org/10.1177/109019819902600303.

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Skin cancer is one of the most common forms of cancer and has rapidly increased during the past three decades in the United States. More than 1 million new cases of skin cancer are estimated to be diagnosed in the United States each year. The National Skin Cancer Prevention Education Program (NSCPEP) was launched by the Centers for Disease Control and Prevention (CDC) in 1994 as a national effort to address the Healthy People 2000 objectives for skin cancer prevention. The NSCPEP is a comprehensive, multidimensional public health approach that includes (1) primary prevention interventions; (2) coalition and partnership development; (3) health communications and education; and (4) surveillance, research, and evaluation. In 1994, through support from the CDC, state health departments in Arizona, California, Georgia, Hawaii, and Massachusetts initiated primary prevention intervention projects to conduct and evaluate skin cancer prevention education. This article discusses the comprehensive, multidimensional public health approach highlighting examples from the state demonstration projects.
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Jiles, Ruth B., Danni Daniels, Hussain R. Yusuf, Mary M. McCauley e Susan Y. Chu. "Undervaccination with hepatitis B vaccine22Address reprint requests to: Centers for Disease Control and Prevention, National Immunization Program Resource Center, 1600 Clifton Road NE, Mailstop E-34, Atlanta, Georgia 30333. Fax: (404) 639-8828." American Journal of Preventive Medicine 20, n. 4 (maggio 2001): 75–83. http://dx.doi.org/10.1016/s0749-3797(01)00276-8.

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SUKNIDZE, Mariam, Nato PITSKHELAURI e Nino CHIKHLADZE. "Study of injuries epidemiological charasteristics in Georgia on the example of Adjara region". One Health & Risk Management 4, n. 2 (11 marzo 2023): 12–17. http://dx.doi.org/10.38045/ohrm.2023.2.02.

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Introduction. Injury is a significant public health concern that is a leading cause of mortality and disability worldwide. Injuries have a significant financial and quality-of-life impact on persons and communities. The absence of fundamental epidemiological data on the prevalence of injuries prevents developing countries from creating effective prevention programs. The goal of this study was to characterise the epidemiological features of injury in the Adjara region. Material and methods. The database and source of the data that we used in this article were provided from the Georgian National Center for Disease Control and Public Health’s 2019 database, which contains all hospitalizations in the Adjara area and was utilized to find trauma cases that were treated at medical facilities. Based on the ICD-10 diagnosis codes S and T, as well as V-Y, cases were chosen. Version 23.0 of SPSS was used to analyze the data. Results. Between the ages of 0 and 103, there were a total number of 2,239 patients, inclusive 1,321 (59%) – males, and 918 (41%) – women, who were hospitalized for treatment of an injury. The incidence was highest among those aged 65 and over (n=510; 23%), followed by those aged 20-34 (n= 488; 20%). The most prevalent cause of injury was falling (n=1,324; 59%), followed by exposure to inanimate mechanical forces (n=244; 11%). The range of hospital stays was from 1 to 3,652 days, with a median and mode of 3 and 2 days. Conclusions. This study provides information for public health decision-making. In order to enhance the standard of treatment and focus efforts on avoiding more injuries, intervention strategies may be devised using our data to understand better the extent of the injuries and outcomes linked to traumatic injury hospitalizations.
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El Rassi, Fuad, Eldrida Randall, Sidney F. Stein, H. Jean Khoury, James R. Eckman e Morgan L. McLemore. "Acute Chest Syndrome Rate at the Emory University Georgia Comprehensive Sickle Cell Center at Grady Health System". Blood 126, n. 23 (3 dicembre 2015): 3420. http://dx.doi.org/10.1182/blood.v126.23.3420.3420.

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Abstract Background: Acute chest syndrome (ACS) is one of the most feared complications of sickle cell disease. This syndrome is defined by a clinical constellation of symptoms including fever, infiltrate on lung imaging and hypoxia. ACS is a well-known complication to occur early in the hospitalization of patients for sickle cell vaso-occlusive pain crises (VOP). It is hard to differentiate from pneumonia and its rate of occurrence has not been well characterized. Management of ACS includes exchange or simple transfusion, depending on the severity of its presentation, along with critical care support and pain control. Early recognition of this clinical syndrome can lead to better management and outcomes for patients with sickle cell disease. Methods: The Emory University Georgia Comprehensive Sickle Cell Center at Grady Health System has 1073 sickle cell patients and provides a 24/7 acute care unit (ACU) for the evaluation of patients presenting with pain crises. We conducted a retrospective review of all the ACS cases reported at the Center for the last 5 years. Results: The number of sickle cell patient-visits in the ACC was 4409. 30 cases of ACS were confirmed on retrospective review. The rate of ACS was 6.8 per 1000 patient visits. The median age was 39, and the patients' phenotypes 89% SS and 11% SC. Of the patients evaluated, 18% were smokers, 43% were taking hydroxyurea and 89% were taking folic acid. Seventy five percent of the patients were successfully managed with supportive care only, while the remaining 25% required red cell exchanges. On admission, the median white cell count (WBC), platelet count, LDH and reticulocyte count were increased above their upper limits of normal. Eighteen percent of the patients had a d-dimer checked and the median was well above the range of normal (6097). Table 1 shows the patient characteristics and data. Discussion: The rate of ACS over the last 5 years at our sickle cell center is well below historic reports of ACS. We believe that several factors explain our observation. Because our 24/7 ACU is staffed with providers who know their patients' histories and treatment plans and are experienced in the management of VOP, we postulate that our comprehensive management approach involving the rapid and appropriate initiation of intravenous fluids, the administration of pain medications along with antibiotics, and the use of anti-inflammatory medications contribute to the truncation of the sickle cell-related inflammatory state and the prevention of serious complications such as ACS. The fact that inflammatory markers (WBC, Platelet count, LDH) were initially elevated is to be expected in the setting of VOP. What is remarkable is the high percentage of good patient outcomes associated with our comprehensive management approach. This retrospective report should be validated in a prospective study that compares the results of the management of all acute care VOP visits delivered in a 24/7 ACU with the management of acute care VOP delivered in a general emergency room. Such a study should include the collection of laboratory and clinical data that is typically abnormal in patients with VOP. If a significantly decreased rate of ACS rate is observed when 24/7 ACU care is provided, then the institution of 24/7 acute care units would be warranted on a national level to improve the survival of patients with sickle cell disease. Table 1. Characteristics of patients studied Age median (range) 39 (19-58) Gender Females 14/ males 14 Genotype n (%) SC 3 (11%)/ SS 25 (89%) Smoking (%) 18 % Hydrea use (%) 43% Folic acid use (%) 89% Management n (%) Exchanged 7 (25%)/ supportive 21 (75%) Hemoglobin median (range) 10.4 (4.9-11.1) White count median (range) 18.6 (6.1-47) Platelet median (range) 492 (79-646) Reticuolcyte count median (range) 300.6 (151-597) LDH median (range) 677 (238-2287) D-dimer % patients/ median (range) 18%/ 6097 (609-33370) Ferritin % patients/ median (range) 11%/ 2844 (335.2-6060) Total/direct bilirubin median (range) 3.7/1.3 (1-19/0.2-4.9) Creatinine median (range) 1.3 (0.5-3.5) AST/ALT median (range) 59/49 (21-110/12-118) Disclosures No relevant conflicts of interest to declare.
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Armstrong-Mensah, Elizabeth, Ato Kwamena Tetteh e Gifty Rhodalyn Tetteh. "COVID-19 Pandemic: Face Mask Mandates, Hospitalization, and Infection Rates in the United States". International Journal of Translational Medical Research and Public Health 5, n. 2 (25 giugno 2021): 113–24. http://dx.doi.org/10.21106/ijtmrph.365.

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Face masks have been identified as one of the preventive methods for the control of the 2019 coronavirus disease (COVID-19). Although the World Health Organization (WHO) and the United States Centers for Disease Control and Prevention (CDC) recommend the universal use of face masks, there are controversies in the implementation of a national face mask mandate in the US. This commentary discusses the relationship between facemask mandates and key COVID-19 indicators such as infection rates and hospitalization rates in the US. It also summarizes some of the political issues surrounding the implementation of the national face mask mandate. We conducted an ecological study on the relationship between face mask mandates and key COVID-19 indicators. We searched PubMed and Google Scholar and reviewed 150 English articles related to face mask challenges in the US published from 2005 to 2021. We identified seven challenges associated with face mask wearing - conflicting messaging, individualism, denial, health consequences, lack of a national masking standard, concerns of African American males, and environmental issues. We found that North Dakota, a state without a face mask mandate had the highest COVID-19 prevalence of 13.3%. The mean prevalence for the highest top 10 ranked states without and with a face mask mandate was 11.1% and 10.5%, respectively. We also found that Florida, Arizona and Georgia, states without a face mask mandates, had the highest cumulative hospitalizations of 83,381, 58,670, and 57,911 hospitalizations, respectively. Alabama, Indiana, and Minnesota, which have face mask mandates, had the lowest hospitalization rates of 47,090, 47,787, and 26,651, respectively.
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Klevens, R. Monina, e Elizabeth T. Luman. "U.S. children living in and near poverty22Address reprint requests to: Centers for Disease Control and Prevention, National Immunization Program Resource Center, 1600 Clifton Road NE, Mailstop E-34, Atlanta, Georgia 30333. Fax: (404) 639-8828." American Journal of Preventive Medicine 20, n. 4 (maggio 2001): 41–46. http://dx.doi.org/10.1016/s0749-3797(01)00281-1.

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Reed, Paul. "A Personal Journal Account of the Monrovia Medical Unit in Liberia". Disaster Medicine and Public Health Preparedness 9, n. 5 (17 aprile 2015): 581–85. http://dx.doi.org/10.1017/dmp.2015.45.

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AbstractOn September 16, 2014, President Obama, speaking from the Centers for Disease Control and Prevention in Atlanta, Georgia, declared the Ebola epidemic in West Africa a national security priority and laid out the US government’s plan for contributing to and helping to lead the international response. There were, and remain, several facets to the US government’s efforts to help control the epidemic, including the commitment to provide a facility and staffing in Liberia that would ensure access to a high level of quality care for any Liberian or international health care workers who may, themselves, become infected and ill with Ebola. That facility came to be known as the Monrovia Medical Unit and is staffed by officers of the US Public Health Service. The following pages are excerpts from the journal I kept during my time at the Monrovia Medical Unit, which I hope will relate some elements of the concerted effort that took place that led to this arm of the US government response being established. (Disaster Med Public Health Preparedness. 2015;9:581–585)
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Cheishvili, Jilda, Irene Zarnadze e Shalva Zarnadze. "Management of Change Delivery Decision Making Through the Force Field Analysis in Georgia". IRA-International Journal of Management & Social Sciences (ISSN 2455-2267) 6, n. 3 (27 marzo 2017): 411. http://dx.doi.org/10.21013/jmss.v6.n3.p7.

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<div><p><em>Children’s generation of Georgia recovers parent’s generations only for 70-80%. According to same data, there are only 14 countries with the similar low indicators. The increase of C-section can cause the decrease of birthdates.</em></p><p><em>WHO recommended The Partnership for Maternal, Newborn, and Child Health - </em><em>through the creation of an <strong>Advocacy Team.</strong></em><em> (WHO, 2005).</em><em> This model ensures the relaxed environment where the mothers can receive information delivered by qualified health workers, who teach pregnant women and family members about health and well-being. </em><em>Advocacy Team comprises - nurses, medical students, and volunteer.</em><em></em></p><p><em>Project benefit will be </em><em>increased antenatal and postnatal care services through the country, in the lead the better attitude and knowledge about health and well-being across all Social levels . Further families will save money because they couldn't pay for C-section </em><em></em></p><p><em>Evaluation of the project –</em><em>annual statistical analysis by </em><em>NCDC (National Center for Disease Control and Public Health) </em><em>decrease C-section rate for mother request.</em><em></em></p><p><em>Project outcome</em><em> will be increased maternal and Child health and well-being,</em><em> </em><em>Increase right participation from the community, Support of pregnant women and her family economically.</em><em></em></p></div>
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Herrera, Guillermo A., Zhen Zhao e R. Monina Klevens. "Variation in vaccination coverage among children of Hispanic ancestry22Address reprint requests to: Centers for Disease Control and Prevention, National Immunization Program Resource Center, 1600 Clifton Road NE, Mailstop E-34, Atlanta, Georgia 30333. Fax: (404) 639-8828." American Journal of Preventive Medicine 20, n. 4 (maggio 2001): 69–74. http://dx.doi.org/10.1016/s0749-3797(01)00277-x.

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Bartlett, Diana L., Trena M. Ezzati-Rice, Shannon Stokley e Zhen Zhao. "Comparison of NIS and NHIS/NIPRCS vaccination coverage estimates11Address reprint requests to: Centers for Disease Control and Prevention, National Immunization Program Resource Center, 1600 Clifton Road NE, Mailstop E-34, Atlanta, Georgia 30333. Fax: (404) 639-8828." American Journal of Preventive Medicine 20, n. 4 (maggio 2001): 25–27. http://dx.doi.org/10.1016/s0749-3797(01)00284-7.

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Ezzati-Rice, Trena M., e Lester R. Curtin. "Population-based surveys and their role in public health11Address reprint requests to: Centers for Disease Control and Prevention, National Immunization Program Resource Center, 1600 Clifton Road NE, Mailstop E-34, Atlanta, Georgia 30333. Fax: (404) 639-8828." American Journal of Preventive Medicine 20, n. 4 (maggio 2001): 15–16. http://dx.doi.org/10.1016/s0749-3797(01)00287-2.

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Szilagyi, Peter G. "Measuring the success of the U.S. childhood immunization system11Address reprint requests to: Centers for Disease Control and Prevention, National Immunization Program Resource Center, 1600 Clifton Road NE, Mailstop E-34, Atlanta, Georgia 30333. Fax: (404) 639-8828." American Journal of Preventive Medicine 20, n. 4 (maggio 2001): 3–5. http://dx.doi.org/10.1016/s0749-3797(01)00288-4.

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Shilton, Sonjelle, Ketevan Stvilia, Maia Japaridze, Nino Tsereteli, Dali Usharidze, Shota Phevadze, Miranda Jghenti et al. "Home-based hepatitis C self-testing in people who inject drugs and men who have sex with men in Georgia: a protocol for a randomised controlled trial". BMJ Open 12, n. 9 (settembre 2022): e056243. http://dx.doi.org/10.1136/bmjopen-2021-056243.

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Abstract (sommario):
IntroductionGlobally, it is estimated that more than three-quarters of people with chronic hepatitis C virus (HCV) are unaware of their HCV status. HCV self-testing (HCVST) may improve access and uptake of HCV testing particularly among key populations such as people who inject drugs (PWID) and men who have sex with men (MSM) where HCV prevalence and incidence are high and barriers to accessing health services due to stigma and discrimination are common.Methods and analysisThis randomised controlled trial compares an online programme offering oral fluid-based HCVST delivered to the home with referral to standard-of-care HCV testing at HCV testing sites. Eligible participants are adults self-identifying as either MSM or PWID who live in Tbilisi or Batumi, Georgia, and whose current HCV status is unknown. Participants will be recruited through an online platform and randomised to one of three arms for MSM (courier delivery, peer delivery and standard-of-care HCV testing (control)) and two for PWID (peer delivery and standard-of-care HCV testing (control)). Participants in the postal delivery group will receive an HCVST kit delivered by an anonymised courier. Participants in the peer delivery groups will schedule delivery of the HCVST by a peer. Control groups will receive information on how to access standard-of-care testing at a testing site. The primary outcome is the number and proportion of participants who report completion of testing. Secondary outcomes include the number and proportion of participants who (a) receive a positive result and are made aware of their status, (b) are referred to and complete HCV RNA confirmatory testing, and (c) start treatment. Acceptability, feasibility, and attitudes around HCV testing and cost will also be evaluated. The target sample size is 1250 participants (250 per arm).Ethics and disseminationEthical approval has been obtained from the National Centers for Disease Control and Public Health Georgia Institutional Review Board (IRB) (IRB# 2021-049). Study results will be disseminated by presentations at conferences and via peer-reviewed journals. Protocol version 1.1; 14 July 2021.Trial registration numberClinicalTrials.gov Registry (NCT04961723).
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Bragg-Gresham, Jennifer, JS Thakur, Gursimer Jeet, Sanjay Jain, Arnab Pal, Rajendra Prasad, Subramaniam Pennathur e Rajiv Saran. "Population-based comparison of chronic kidney disease prevalence and risk factors among adults living in the Punjab, Northern India and the USA (2013–2015)". BMJ Open 10, n. 12 (dicembre 2020): e040444. http://dx.doi.org/10.1136/bmjopen-2020-040444.

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ObjectivesIndia is witnessing a disturbing growth in non-communicable diseases (NCDs), including chronic kidney disease (CKD). Recently, a WHO STEPS survey was conducted in the state of Punjab, India to collect data from the adult population on NCD risk factors. We sought to compare the prevalence of CKD and its risk factors between this large state in northern India and the USA.SettingSamples were drawn from both locations, Punjab, India and the USA, using multistage stratified sampling designs to collect data representative of the general population.ParticipantsData from 2002 participants in the Punjab survey (2014–2015) and 5057 in the USA (National Health and Nutrition Examination Survey (NHANES; 2013–2014), between the ages of 18–69 years were examined.Primary and secondary outcome measuresModified Poisson regression was employed to compare prevalence between the two samples for markers of CKD and its risk factors. All analyses used sampling weights.ResultsThe average age in the Punjab sample was significantly lower than the USA (38.3 vs 42.5 years, p<0.0001). While smoking and obesity were higher in the USA, hypertension was much more common in Punjab (48.2% vs 33.4%, p<0.0001). Significant differences were seen in the prevalence of CKD, with lower prevalence of eGFR <60 mL/min/1.73 m2 (2.0% vs 3.8%, p<0.0001), but markedly higher prevalence of albuminuria (46.7% vs 8.9%, p<0.0001) in Punjab. These differences could not be explained by traditional risk factors such as diabetes and hypertension.ConclusionsWe report a strikingly high prevalence of albuminuria in Punjab, India, compared with the USA. This requires further study and may have enormous public health implications for future burden of progressive CKD, end-stage kidney disease, morbidity, mortality and specifically for elevated risk or presence of cardiovascular disease in the northern state of Punjab, India.Funding came from the National Health Mission, Punjab, India, JST and the Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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Shefer, Abigail M., Elizabeth T. Luman, Bridget H. Lyons, Victor G. Coronado, Philip J. Smith, John M. Stevenson e Lance E. Rodewald. "Vaccination status of children in the Women, Infants, and Children (WIC) Program22Address reprint requests to: Centers for Disease Control and Prevention, National Immunization Program Resource Center, 1600 Clifton Road NE, Mailstop E-34, Atlanta, Georgia 30333. Fax: (404) 639-8828." American Journal of Preventive Medicine 20, n. 4 (maggio 2001): 47–54. http://dx.doi.org/10.1016/s0749-3797(01)00279-3.

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Stokley, Shannon, Philip J. Smith, R. Monina Klevens e Michael P. Battaglia. "Vaccination status of children living in rural areas in the United States22Address reprint requests to: Centers for Disease Control and Prevention, National Immunization Program Resource Center, 1600 Clifton Road NE, Mailstop E-34, Atlanta, Georgia 30333. Fax: (404) 639-8828." American Journal of Preventive Medicine 20, n. 4 (maggio 2001): 55–60. http://dx.doi.org/10.1016/s0749-3797(01)00280-x.

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Cedzyńska, M., M. Marta, P. Koczkodaj e I. Przepiorka. "Smoking Cessation Among Cancer Patients in Central and Eastern Europe: Call for Action". Journal of Global Oncology 4, Supplement 2 (1 ottobre 2018): 84s. http://dx.doi.org/10.1200/jgo.18.50900.

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Abstract (sommario):
Background: Despite the fact that smoking has been linked not only to the development of cancer, but also to prognosis upon diagnosis and risk of death during treatment, many cancer patients continue to smoke. Quitting smoking can be beneficial also after cancer diagnosis, regardless of stage and prognosis. Those benefits are: improved survival outcomes, reduced risk of recurrence and second primary formation, increase treatment response to chemo and radiotherapy, reduced treatment-related complications, better self-reported quality of life related to disease and treatment than among smokers and less pain. The evidence is strong enough to incorporate tobacco dependence treatment into routine cancer care, but in majority of countries in central and eastern Europe (CEE) there are no actions taken to help cancer patients to quit smoking. Aim: To identify main barriers in providing smoking cessation to cancer patients in central and eastern Europe. Methods: Data were collected from participants of Workshop on Tobacco Control and Cessation organized by Cancer Center and Institute of Oncology, Poland and the National Cancer Institute, US. Following countries provided detailed data: Armenia, Georgia, Hungary, Kazakhstan, Kirgizstan, Lithuania, Poland, Macedonia, Serbia. The areas that were investigated: guidelines on smoking cessation dedicated to cancer patients, quit smoking programs for cancer patients, existing literature on barriers for delivery smoking cessation advice and personal opinion of tobacco control experts regarding those barriers. Results: I. Guidelines for smoking cessation among cancer patients have been published only in one country (Serbia) out of nine analyzed countries of the region. II. Programs on smoking cessation dedicated to cancer patients were implemented only in two countries: 1: Poland. Pilot program within National Health Program in 2015 (3 months in cancer centers in two cities). 2: Hungary. In 2012 pilot project. In 2017 National Institute for Pulmonology run 3 workshops on smoking cessation for cancer nurses. III. There is no literature on barriers in incorporating smoking cessation into cancer care in the CEE region. IV. Experts opinions are consistent with worldwide literature findings-the main barriers are lack of knowledge, lack of training, overloading with work focused on diagnosis and cancer treatment, difficulties in implementing systemic changes. Conclusion: There is a strong need to take action in central and eastern Europe to engage oncologists and other cancer healthcare providers into smoking cessation. It is crucial to increase the knowledge on benefits of quitting smoking for cancer patients' health and results of cancer treatment. Sustainable change can be achieved by publishing guidelines and implementing training programs that address the attitudes and beliefs. Implementing systemic changes within cancer centers might be required to improve survival and quality of life of cancer patients in central and eastern European region.
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Shvelidze, Ekaterine, Tinatiin Beruchashvili, Tamari Lobzhanidze e Vasili Tkeshelashvili. "Breast Cancer Burden in Tbilisi". Caucasus Journal of Social Sciences 7, n. 1 (3 novembre 2023): 189–227. http://dx.doi.org/10.62343/cjss.2014.140.

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According to GLOBOCAN/IARC (2013), in 2008, 1 384 000 new cases of breast cancer incidence and 458 000 cancer related deaths were registered worldwide. Epidemiolo-gical research has been conducted at the University of Georgia to specify the number of breast cancer incidence in Tbilisi. There is data on 12 913 cases of breast cancer in Tbilisi in 1998-2010 provided by the National Center for Disease Control and Public Health (NCDC). Tbilisi Population Cancer Registry provided information about 16 705 cases of death in the Tbilisi’s female population in 2002-2004.Based on a descriptive analysis, it has been determined that in the Tbilisi’s female population, the number and frequency of breast cancer is an important medical and social problem. The frequency of incidence of breast cancer in Tbilisi (ASR=123% ; AAR=158%) and the frequency of cancer related deaths (ASR=33% ; AAR=43%) correspond to the index of the average level of the developed countries of the world. Besides, according to both indicators in dynamics, there was an increase in breast cancer incidence. Compared to 1988-1992, in 2008-2010, according to SRR, the frequency of breast cancer rose 3.5 times, and according to SIR – by 253%.In Tbilisi, in 2002-2004, the cases of deaths caused by cancer ranked second after those caused by the circulatory system and its share in the structure of death comprised 18%. In the structure of cancer mortality in women over 25, breast cancer ranks first. At the same time, at a later period, 35-59, breast cancer again ranks first in the structure of different causes of death. As a result of the research, recommendations have been worked out.
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Somi, Geofrey R., Tabitha Kibuka, Karidja Diallo, Tulli Tuhuma, Diane E. Bennett, Chunfu Yang, Charles Kagoma, Eligius F. Lyamuya, Roland O. Swai e Sidibe Kassim. "Surveillance of transmitted HIV drug resistance among women attending antenatal clinics in Dar es Salaam, Tanzania". Antiviral Therapy 13, n. 2_suppl (febbraio 2008): 77–82. http://dx.doi.org/10.1177/135965350801302s08.

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Background In resource-limited settings where antiretroviral treatment (ART) access is being scaled-up, the World Health Organization (WHO) recommends surveillance of transmitted HIV drug resistance (HIVDR). We used the WHO HIVDR threshold survey method to assess transmitted HIVDR in Dar es Salaam where ART was introduced in 1995 and where ∼11,000 people are currently on ART. Methods From November 2005 to February 2006, dried blood spot (DBS) specimens were made from remnant specimens collected during the national HIV serosurvey from 60 primagravidas <25 years old attending six antenatal clinics for routine syphilis testing. Genotyping was performed at the Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Protease and reverse transcriptase drug resistance mutations were identified using the Stanford University HIV drug resistance database. We used the National Institutes of Health genotyping tool for HIV-1 subtyping. HIVDR prevalence categorization was based on the WHO threshold survey binomial sequential sampling method. Results Among the 60 eligible specimens collected, 50 DBS were successfully amplified using RT-PCR. Sequencing was performed on the first 39 specimens: 13 (33.3%) were subtype A1, 13 (33.3%) subtype C, and 4 (10.3%) subtype D, the remainder differed in the closest subtype based on protease versus reverse transcriptase. No resistance mutations were seen; HIVDR to all drug classes was categorized as <5%. Conclusions Our survey indicates that prevalence of transmitted HIVDR among recently infected pregnant women in Dar es Salaam is low (<5%). The survey should be repeated during the next HIV sentinel survey in Dar es Salaam and extended to other regions where ART is being scaled up.
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Barker, Lawrence E., e Elizabeth T. Luman. "Changes in vaccination coverage estimates among children aged 19–35 months in the United States, 1996–199911Address reprint requests to: Centers for Disease Control and Prevention, National Immunization Program Resource Center, 1600 Clifton Road NE, Mailstop E-34, Atlanta, Georgia 30333. Fax: (404) 639-8828." American Journal of Preventive Medicine 20, n. 4 (maggio 2001): 28–31. http://dx.doi.org/10.1016/s0749-3797(01)00283-5.

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Ayala, Andrea J., Ketty Kabengele, Salvador Almagro-Moreno e C. Brandon Ogbunugafor. "Meteorological associations of Vibrio vulnificus clinical infections in tropical settings: Correlations with air pressure, wind speed, and temperature". PLOS Neglected Tropical Diseases 17, n. 7 (6 luglio 2023): e0011461. http://dx.doi.org/10.1371/journal.pntd.0011461.

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V. vulnificus is one of the deadliest waterborne pathogens, yet little is known of the ecological and environmental forces that drive outbreaks. As a nationally notifiable disease, all cases of V. vulnificus diagnosed in the United States are reported to the state in which they occurred, as well as to the Centers for Disease Control (CDC) in Atlanta, Georgia. Given that the state of Florida is a ‘hotspot’ for V. vulnificus in the United States, we examined the prevalence and incidence of cases reported to the Florida Department of Health (2008–2020). Using a dataset comprised of 448 cases of disease caused by V. vulnificus infection, we identified meteorological variables that were associated with clinical cases and deaths. Combined with data from the National Oceanic and Atmospheric Administration (NOAA), we first utilized correlation analysis to examine the linear relationships between satellite meteorological measurements such as wind speed, air temperature, water temperature, and sea-level pressure. We then measured the correlation of those meteorological variables with coastal cases of V. vulnificus, including the outcome, survival, or death. We also constructed a series of logistic regression models to analyze the relationship between temporal and meteorological variables during months that V. vulnificus cases were reported versus months when V. vulnificus cases were not reported. We report that between 2008 and 2020, V. vulnificus cases generally increased over time, peaking in 2017. As water temperature and air temperature increased, so too did the likelihood that infection with V. vulnificus would lead to patient death. We also found that as mean wind speed and sea-level pressure decreased, the probability that a V. vulnificus case would be reported increased. In summary, we discuss the potential factors that may contribute to the observed correlations and speculate that meteorological variables may increase in their public health relevance in light of rising global temperatures.
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Luman, Elizabeth T., Shannon Stokley, Danni Daniels e R. Monina Klevens. "Vaccination visits in early childhood32Address reprint requests to: Centers for Disease Control and Prevention, National Immunization Program Resource Center, 1600 Clifton Road NE, Mailstop E-34, Atlanta, Georgia 30333. Fax: (404) 639-8828.33The full text of this article is available via AJPM Online at www.elsevier.com/locate/ajpmonline." American Journal of Preventive Medicine 20, n. 4 (maggio 2001): 32–40. http://dx.doi.org/10.1016/s0749-3797(01)00282-3.

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Balmaseda, Ángel, Saira Saborío Galo, Karla González, Yolanda Téllez, Nadezna García, Leonel Pérez, Lionel Gresh e Eva Harris. "Development of in-house serological methods for diagnosis and surveillance of chikungunya". Revista Panamericana de Salud Pública 41 (29 giugno 2017): 1. http://dx.doi.org/10.26633/rpsp.2017.56.

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Objective.To develop and evaluate serological methods for chikungunya diagnosis and research in Nicaragua.Methods.Two IgM ELISA capture systems (MAC-ELISA) for diagnosis of acute chikungunya virus (CHIKV) infections, and two Inhibition ELISA Methods (IEM) to measure total antibodies against CHIKV were developed using monoclonal antibodies (mAbs) and hyperimmune serum at the National Virology Laboratory of Nicaragua in 2014–2015. The sensitivity, specificity, predictive values, and agreement of the MAC-ELISAs were obtained by comparing the results of 198 samples (116 positive; 82 negative) with the Centers for Disease Control and Prevention’s IgM ELISA (Atlanta, Georgia, United States; CDC-MAC-ELISA). For clinical evaluation of the four serological techniques, 260 paired acute and convalescent phase serum samples of suspected chikungunya cases were used.Results.All four assays were standardized by determining the optimal concentrations of the different reagents. Processing times were substantially reduced compared to the CDC-MAC-ELISA. For the MAC-ELISA systems, a sensitivity of 96.6% and 97.4%, and a specificity of 98.8% and 91.5% were obtained using mAb and hyperimmune serum, respectively, compared with the CDC method. Clinical evaluation of the four serological techniques versus the CDC real-time RT-PCR assay resulted in a sensitivity of 95.7% and a specificity of 88.8%–95.9%.Conclusion.Two MAC-ELISA and two IEM systems were standardized, demonstrating very good quality for chikungunya diagnosis and research demands. This will achieve more efficient epidemiological surveillance in Nicaragua, the first country in Central America to produce its own reagents for serological diagnosis of CHIKV. The methods evaluated here can be applied in other countries and will contribute to sustainable diagnostic systems to combat the disease.
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Barkley, W. Emmett. "Predicting Biocontainment Requirements for the Future". Journal of the American Biological Safety Association 3, n. 2 (giugno 1998): 59–64. http://dx.doi.org/10.1177/109135059800300204.

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This paper was first presented as one of four keynote addresses at the 5th National Symposium on Biosafety held in Atlanta, Georgia on January 17–20, 1998 (Richmond, 1998). The Symposium was sponsored by the Centers for Disease Control and Prevention (CDC) and the American Biological Safety Association (ABSA). The original title of the address “Where are we going?” was selected by the Symposium's planning committee. While contemplation of the future can be an enjoyable intellectual exercise, predictions about the course of science and the corresponding future requirements of biocontainment will yield only uncertain results. Contemporary science has demonstrated that revolutions in science occur with spontaneity. The best recent example is the revolution in the biomedical sciences brought about by recombinant DNA in the 1970s. Scientists cannot predict the next revolution, but they are keenly vigilant to discern its occurrence. Biological safety professionals must be equally prepared to recognize major scientific advancements since the future may require swift changes in the practice of biocontainment as was evident in the recombination DNA revolution. To be prepared, biological safety professionals must establish a continuing and meaningful dialogue with scientists. For this to happen, the biological safety professional must become better informed of current knowledge and strive to gain the trust and respect of the scientific community. Biological safety professionals, as partners in science, can ensure that biocontainment keeps pace with new requirements that will most certainly occur in the future.
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Laurent, Sherry L., Shirley J. Thompson, Cheryl Addy, Carol Z. Garrison e Edward E. Moore. "An epidemiologic study of smoking and primary infertility in women**Data were provided by the Centers for Disease Control, Atlanta, Georgia.††Funding for the original data base was made possible by interagency agreement 3-401-HD-8-1037 between Centers for Disease Control and the National Institute of Child Health and Human Development, with additional support from the National Cancer Institute, Bethesda, Maryland." Fertility and Sterility 57, n. 3 (marzo 1992): 565–72. http://dx.doi.org/10.1016/s0015-0282(16)54901-2.

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Bagwell, Mary Ann, Shirley J. Thompson, Cheryl L. Addy, Ann L. Coker e Elizabeth R. Baker. "Primary infertility and oral contraceptive steroid use**Data were provided by the Centers for Disease Control and Prevention, Atlanta, Georgia. Funding for the original data base was made possible by interagency agreement 3–Y01-HD-8–1037 between the Centers for Disease Control and the National Institute of Child Health and Human Development, with additional support from the National Cancer Institute, Bethesda, Maryland." Fertility and Sterility 63, n. 6 (giugno 1995): 1161–66. http://dx.doi.org/10.1016/s0015-0282(16)57590-6.

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Smith, Philip J., Michael P. Battaglia, Vicki J. Huggins, David C. Hoaglin, Ann-Sofi Rodén, Meena Khare, Trena M. Ezzati-Rice e Robert A. Wright. "Overview of the sampling design and statistical methods used in the National Immunization Survey21Address reprint requests to: Centers for Disease Control and Prevention, National Immunization Program Resource Center, 1600 Clifton Road NE, Mailstop E-34, Atlanta, Georgia 30333. Fax: (404) 639-8828.22The full text of this article is available via AJPM Online at www.elsevier.com/locate/ajpmonline." American Journal of Preventive Medicine 20, n. 4 (maggio 2001): 17–24. http://dx.doi.org/10.1016/s0749-3797(01)00285-9.

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Tao, Guoyu, Ping Zhang e Qian Li. "Services provided to nonpregnant women during general medical and gynecologic examinations in the United States1 1At the time this study was conducted, Ping Zhang and Qian Li were affiliated with the Department of Agricultural Economics at Kansas State University. Ping Zhang is currently affiliated with the Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia." American Journal of Preventive Medicine 21, n. 4 (novembre 2001): 291–97. http://dx.doi.org/10.1016/s0749-3797(01)00366-x.

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Wilcox, Lynne S., Susan Y. Chu, Elaine D. Eaker, Scott L. Zeger e Herbert B. Peterson. "Risk factors for regret after tubal sterilization: 5years of follow-up in a prospective study**The Collaborative Review of Sterilization was supported in part by an interagency agreement between the Centers for Disease Control, Atlanta, Georgia, and by grant Y01-HD-41075 from the National Institute of Child Health and Human Development, Bethesda, Maryland; and by grant AI25529 to S.L.Z. from the National Institutes of Health." Fertility and Sterility 55, n. 5 (maggio 1991): 927–33. http://dx.doi.org/10.1016/s0015-0282(16)54301-5.

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A. Gabaidze, Gulnara, Lali Khurtsia, Mishiko Gabaidze e Salome Abashidze. "Assessment of the spread of the COVID-19 pandemic in Georgia - the specifics of his manage in 2019-2022". International Journal Of Community Medicine And Public Health 10, n. 12 (30 novembre 2023): 4931–36. http://dx.doi.org/10.18203/2394-6040.ijcmph20233802.

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Abstract (sommario):
This research paper aims to assess the spread of the COVID-19 pandemic in Georgia from 2019 to 2022 and evaluate the management methods used in different regions. The research methodology involved analyzing reports and statistics published by the Ministry of Health of Georgia and the Center for Disease Control. The study is based on data from 2019 to the present. Research methodology is a mixed method that combines both qualitative and quantitative methods-meta-analysis. The findings indicate that the spread of COVID-19 in Georgia was not uniform across different regions. Tbilisi had the highest cases, followed by West Georgia and East Georgia. The government of Georgia implemented a range of measures to manage the pandemic, including social distancing, the use of face masks, and restrictions on movement. A combination of factors, including public health measures and regional differences, influenced the spread of COVID-19 in Georgia. The research paper provides insights into managing the COVID-19 pandemic in Georgia and highlights the importance of evidence-based strategies for controlling the spread of infectious diseases.
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Avetisyan, Karine O. "National Medical Research Center for Children’s Health". Russian Pediatric Journal 1, n. 4 (15 gennaio 2021): 5–10. http://dx.doi.org/10.15690/rpj.v1i4.2188.

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Background. The clinical course of bronchial asthma (BA) in children is often mild. However, in real-world clinical practice it may not always be possible to attain complete control of BA symptoms. In the majority of cases cessation of basic therapy with inhaled corticosteroids (ICS) leads to a poorer BA control in spite of satisfactory general health status in patients. As a result of incomplete BA control, children demonstrate impaired activities of daily living, decreased daily physical activity and gradual reduction or withdrawal of sports participation and other activities. Under the conditions of restricted everyday activities children with mild BA and in the absence of continuous anti-inflammatory basic therapy may feel comfortable without any complaints. This may result in faulty evaluation of asthma as well controlled, which can cause disease progression.Case report. All the above mentioned situations are exemplified by the case report of a youngster suffering from mild bronchial asthma. Also, this article clearly demonstrates the significance of use of asthma control test (ACT) in real-world clinical practice in order to work out a strategy for asthma management. Besides, the role of taking a detailed medical history for correct assessment of mild BA symptom control is demonstrated. In a given clinical example we managed to evaluate, in a short space of time, everyday life changes of a youngster with mild BA (an increase in daily activities and improved quality of life) following administration of basic therapy with ICS.Conclusion. This case report demonstrates the significance of correct assessment of BA control regardless of severity of disease, in our case mild asthma, and shows its role in conducting proper basic therapy and achieving improvement of child’s quality of life.
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Babiker, Ahmed, Chris W. Bower, Sarah W. Satola, Jesse T. Jacob e Michael H. Woodworth. "787. Clinical and Genomic Epidemiology of mcr-9 Containing Carbapenem-resistant Enterobacterales Isolates in Metropolitan Atlanta, 2012-2017". Open Forum Infectious Diseases 8, Supplement_1 (1 novembre 2021): S490. http://dx.doi.org/10.1093/ofid/ofab466.984.

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Abstract Background Colistin is a last-resort antibiotic for multidrug resistant gram-negative infections. Recently, a new allele of the mobile colistin resistance (mcr) gene family designated mcr-9, has been reported. However, its clinical and phenotypic significance remains unclear. Methods The Centers for Diseases Control and Prevention-funded Georgia Emerging Infections Program (EIP) performs population- and laboratory- based surveillance for CRE isolated from sterile sites or urine in metropolitan Atlanta, GA including standardized chart abstraction. We queried genomes of carbapenem-resistant Enterobacterales (CRE) for mcr-9 from a convenience sample of Georgia EIP clinical isolates between 2012-2017. Isolates underwent phenotypic characterization by broth microdilution and population analysis profiling. Nine available E. cloacae (two mcr-9 positive, seven mcr-9 negative) genomes from the National Institutes of Health were included in downstream genomic analysis. Fastq files underwent de novo assembly, annotation and AMR and virulence gene prediction, pan-genome association analysis, pairwise comparisons of average nucleotide identity and phylogenetic tree construction based on core genes. We compared characteristics and outcomes of mcr-9 positive and negative CRE cases. Results Among 449 sequenced CRE genomes, thirteen (2.9%) were found to harbor mcr-9, all of which were E. cloacae. Fourteen mcr-9 negative E. cloacae (n=14) were included as a comparative group. E. cloacae was most commonly isolated from the urine (22/24, 86%), and none were community associated. The median colistin MIC, rates of heteroresistance and inducible resistance were similar between mcr-9 positive and negative isolates (Table 1). 90-day mortality was high in both mcr-9 positive (31%) and negative (7% cases (p=0.28, Table 1). Phylogenetic analysis revealed no geo-temporal clustering (Figure 1). Plasmid-associated genes were significantly associated with the presence of mcr-9 (p&lt; 0.001). Phylogeny and average nucleotide identity heatmap of mcr-9 positive and mcr-9 negative E. cloacae. Figure Legend 1: Phylogeny and average nucleotide identity heatmap of mcr-9 positive (n=13) and mcr-9 negative (n=14) E. cloacae from Georgia Emerging Infection program in addition to 9 available E. cloacae (two mcr-9 positive, seven mcr-9 negative) from the National Institutes of Health. A phylogenetic tree based on a core gene alignment containing 1,904 genes defined using Roary v3.13.0. was generated using IQtree v2.0.3. A maximum likelihood tree was generated by running 1,000 bootstrap replicates under the generalized time-reversible model of evolution. The tree was visualized and annotated using Interactive Tree of Life (iTOL) v4. Pairwise comparisons of average nucleotide identity on the assembled genomes were performed with the Mashmap method using fastANI v1.32. Abbreviations: GA EIP: Georgia Emerging Infection Program, NIH: National Institutes of Health, Table 1: Carbapenem-resistant E. cloacae clinical and microbiological characteristics Conclusion The presence of mcr-9 was not associated with significant changes in colistin resistance or clinical outcomes. Disclosures All Authors: No reported disclosures
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Krewer, Gerard, Danny Stanaland, Oscar Liburd, Jerry Larson, Roosevelt McWilliams, D. Scott NeSmith, Ruperto Hepp e Ben Mullinix. "ORGANIC BLUEBERRY PRODUCTION AND OBSERVATIONS IN GEORGIA". HortScience 40, n. 3 (giugno 2005): 891a—891. http://dx.doi.org/10.21273/hortsci.40.3.891a.

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Georgia has an excellent window for organic blueberry production since much of the crop ripens ahead of production in the northern U.S. Major challenges facing Georgia organic blueberry growers are weed control, organic fertilization, insect control and disease control. A team of Georgia growers, extension agents and scientists are working together to solve these production problems. Since 2002 a series of experiments have been conducted on blueberry establishment and maintenance. Various mulch materials were tested. On young plants, pine straw produced the highest yields, but pine bark and landscape fabric were also successful. With the pine straw treatment, a respectable yield of 0.97 kg/plant occurred 24 months after planting. In addition, a bed shaper–plastic mulch layer was modified by developing a removable center. Using this system, beds are formed, plants are mechanically transplanted, plants are pruned to 75 mm, and plastic is then pulled over the stem. This produces a fairly tight fit around the stem and a nearly weed free system except for weeds growing from the edges. On mature plants, pine bark and wheat straw were tested. Wheat straw produced excellent weed control and improved blueberry growth in year one and two. However, pine bark mulch provided the best weed control in year three. Various organic burn down compounds such as vinegar, Xpress, Alldown, and Matran 2 were tested for winter weed control efficacy. In these trials Matran 2 was the most effective, and the product also performed well on woody weeds that were winter pruned, allowed to resprout and then treated. A propane torch was also tested, but discarded because of the fire hazard. Entrust insecticide was tested for thrips control and gibberellic acid for fruit set. Thrips populations were low, so no effect on fruit set was noted from Entrust. Gibberellic acid significantly improved fruit set.
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El Rassi, Fuad, Martha Arellano, Leonard T. Heffner, Edmund K. Waller, Elliott F. Winton, Kevin Ward e H. Jean Khoury. "Incidence and Geographic Distribution of Adult Acute Lymphoblastic Leukemia in the State of Georgia". Blood 120, n. 21 (16 novembre 2012): 4309. http://dx.doi.org/10.1182/blood.v120.21.4309.4309.

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Abstract Abstract 4309 We investigated an apparent increase in acute lymphoblastic leukemia (ALL) referral from north Georgia to Emory University Hospital, a tertiary care center located in Atlanta, Georgia. Cases reported between 1999 and 2008 to the Georgia Comprehensive Cancer Registry (GCCR) and the national Surveillance Epidemiology and End Results (SEER) cancer registry were analyzed. Age-adjusted incidence rates were calculated for all counties and public health regions within the state of Georgia and compared to national rates calculated using SEER 17 data for those ages 20 and above. Cases of adult acute myeloid leukemia (AML) served as control for health referral patterns, completeness of data collection and healthcare availability. The associations between geographic residence and acute leukemia were analyzed using Poisson regression analysis, and additional models were created to control for the effects of race and ethnicity. The age-adjusted incidence rate of adult ALL (0.8/100,000) and AML (4.6/100,000) for the state of Georgia were comparable to the national rates (0.9/100,000 and 5.2/100,000 respectively). Overall, the rate of ALL observed in parts of the North Georgia region (1.1 (95% CI 0.8, 1.5) were similar when compared to the rest of the state; and not affected after adjusting for race. We conclude that the higher number of cases of ALL cases referred from North Georgia is likely related to a physician-related referral pattern rather than an increased incidence. Age-adjusted incidence rate of ALL by state and public health region and rate ratios comparing the rate of ALL within each region to the pooled rates demonstrated in all other Georgia public health regions. Region of Georgia (GA) Rate SE Lower CI Upper CI Count Pop GA: Clayton (Jonesboro) 1.1 0.3 0.6 1.8 17 1,715,865 GA: DeKalb 0.8 0.1 0.5 1.1 37 5,111,685 GA: Fulton 0.6 0.1 0.4 0.8 37 6,565,834 GA: Northwest (Rome) 0.9 0.1 0.6 1.2 35 3,962,399 GA: North Georgia (Dalton) 0.9 0.2 0.6 1.4 23 2,632,276 GA: North (Gainesville) 1.1 0.2 0.8 1.5 41 3,723,276 GA: Cobb-Douglas 0.8 0.1 0.5 1.1 38 5,357,377 GA: Gwinnett 0.7 0.1 0.5 1 38 5,712,772 GA: LaGrange 0.8 0.1 0.5 1.1 37 4,818,090 GA: South Central (Dublin) 0.3 0.2 0.1 0.9 4 1,009,356 GA: North Central (Macon) 0.7 0.1 0.4 1 24 3,476,472 GA: East Central (Augusta) 0.7 0.2 0.4 1.1 20 3,017,677 GA: West Central (Columbus) 0.6 0.2 0.3 1 14 2,492,172 GA: South (Valdosta) 0.3 0.1 0.1 0.8 5 1,638,741 GA: Southwest (Albany) 0.9 0.2 0.5 1.3 22 2,500,405 GA: Coastal (Savannah) 0.8 0.2 0.6 1.2 29 3,568,163 GA: Northeast (Athens) 0.9 0.2 0.6 1.3 26 2,903,745 GA: All Georgia 0.8 0 0.7 0.8 463 62,540,286 Rates are per 100,000 and age-adjusted to the 2000 US Std Population (19 age groups - Census P25–1130) standard; Confidence intervals (Tiwari mod) are 95% for rates. Disclosures: Waller: Outsuka: Research Funding.
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43

Murusidze, Lela, Irine Zarnadze, Shalva Zarnadze, Tamar Bakradze e Jilda Cheishvili. "The Peculiarities of Family Doctors Retraining in Georgia". IRA-International Journal of Management & Social Sciences (ISSN 2455-2267) 8, n. 2 (10 settembre 2017): 221. http://dx.doi.org/10.21013/jmss.v8.n2.p10.

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<p>Working out of the human resources development policy and long-term plan, funding of critical specialties and employment of sought-after experts in coastal and mountainous regions, coordination and standardization of continuing and medical education are necessary. Geographical and financial availability of the first healthcare services, create the adequate conditions of the first healthcare team which one consists: appropriate equipment and physical infrastructure, medical documents, to acknowledge the necessity of team working in healthcare system and define the proper contract obligations for doctors, for the reason of medical service improvement quality in providing the Disease Control national recommendations and standards availability for regional doctors, encourage the audit systemspread information about the reform of Georgian healthcare in populations and healthcare professionals, encourage patient’s education, check the teaching programs of doctors retraining on which foundation will be able to create better conditions for practical skills. </p><p>Our country must encourage to hold some priority scientific researches as in the field of state as in international grant program. Above-mentioned can be implemented by the active collaboration with USA and European disease control leading medical schools or universities, scientific funds and other international partner organizations.</p>
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Pokhrel, Kabi, e Julie Caine. "Technical Assistance and Tobacco Control". Health Promotion Practice 12, n. 6_suppl_2 (novembre 2011): 114S—117S. http://dx.doi.org/10.1177/1524839911414706.

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Ursula Bauer, PhD, MPH, currently directs the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention. She has also worked in the New York Department of Health as Director of the Division of Chronic Disease and Injury Prevention and as Director of the Tobacco Control Program. In this interview, she shares her perspectives on the importance of technical assistance in tobacco control.
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45

Berg, Carla J., Ana Dekanosidze, Arevik Torosyan, Lilit Grigoryan, Zhanna Sargsyan, Varduhi Hayrumyan, Marina Topuridze et al. "Examining smoke-free coalitions in Armenia and Georgia: baseline community capacity". Health Education Research 34, n. 5 (26 agosto 2019): 495–504. http://dx.doi.org/10.1093/her/cyz024.

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Abstract Local coalitions can advance public health initiative but have not been widely used or well-studied in low- and middle-income countries. This paper provides (i) an overview of an ongoing matched-pairs community-randomized controlled trial in 28 communities in Armenia and Georgia (N = 14/country) testing local coalitions to promote smoke-free policies/enforcement and (ii) characteristics of the communities involved. In July–August 2018, key informants (e.g. local public health center directors) were surveyed to compare their non-communicable disease (NCD) and tobacco-related activities across countries and across condition (intervention/control). More than half of the informants (50.0–57.1%) reported their communities had programs addressing hypertension, diabetes, cancer and human papilloma virus, with 85.7% involving community education and 32.1% patient education programs. Eleven communities (39.3%) addressed tobacco control, all of which were in Georgia. Of those, all included public/community education and the majority (72.7–81.8%) provided cessation counseling/classes, school/youth prevention programs, healthcare provider training or activities addressing smoke-free environments. Informants in Georgia versus Armenia perceived greater support for tobacco control from various sectors (e.g. government, community). No differences were found by condition assignment. This paper provides a foundation for presenting subsequent analyses of this ongoing trial. These analyses indicate wide variability regarding NCD-related activities and support across communities and countries.
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Simpson, Eric, Christian Fenske, Alvin Li, Zach Dawson, Yolanda Muñoz Maldonado, Kaylee Ho, Kayla Callahan et al. "Patients with Atopic Dermatitis Not on Systemic Therapy have High Rates of Severe, Uncontrolled Disease, and Considerable Impact on Quality of Life". SKIN The Journal of Cutaneous Medicine 8, n. 1 (16 gennaio 2024): s330. http://dx.doi.org/10.25251/skin.8.supp.330.

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Patients with atopic dermatitis not on systemic therapy have high rates of severe, uncontrolled disease and considerable impact on quality of life Eric Simpson1, Christian Fenske2, Alvin Li3, Zach Dawson2, Yolanda Muñoz Maldonado3, Kaylee Ho3, Kayla Callahan3, Linda Stein Gold4, Seemal Desai5, Alexandra Golant6, Douglas DiRuggiero7, Jonathan I Silverberg8 1Oregon Health & Science University, Portland, Oregon, USA; 2Eli Lilly and Company, Indianapolis, USA; 3CorEvitas LLC, Waltham, Massachusetts, USA; 4Henry Ford Health System, Michigan, USA; 5Innovative Dermatology, PA, Texas, USA; 5The University of Texas Southwestern Medical, Dallas, Texas, USA; 6Icahn School of Medicine at Mount Sinai, New York, USA; 7Skin Cancer and Cosmetic Dermatology Center, Rome, Georgia, USA; 8George Washington University School of Medicine and Health Sciences, Washington, DC, USA Background: Decision to initiate a new systemic therapy (ST) among patients with atopic dermatitis (AD) is complex. This cross-sectional study explored overall disease burden, sociodemographic and clinical characteristics, and disease activity among patients with moderate-to-severe AD. Methods: Adult patients with AD who had a vIGA-ADTM score ≥3 and Eczema Area Severity Index (EASI) score ≥12 at enrollment were identified from the prospective, longitudinal CorEvitas AD Registry between 07/21/2020 and 12/31/2022. Included patients were newly prescribed an eligible ST (ST group) or not prescribed an eligible ST (non-ST group) at enrollment. Patients on ST before enrollment were excluded. Sociodemographic characteristics, disease features, severity measures (vIGA-ADTM [0–4]; body surface area (BSA) [0–100%]; EASI [0–72]), and patient-reported outcomes (PROs) were assessed. PROs included Dermatology Life Quality Index (DLQI) [0-30], Itch/Pruritus Numeric Rating Scale [0-10], Patient-Oriented Eczema Measure (POEM) [0-26], and AD Control Tool (ADCT) [<7 controlled, >7 not controlled]. Differences in means or proportions of characteristics among ST and non-ST groups were summarized using effect sizes (ES). Results: The study included 673 (mean age=50.7 years, 55.6% female) patients who were newly prescribed ST and 229 (47.8 years, 51.3%) who were not prescribed ST. The overall distribution of race (Whites 70.4% vs. 60.5%, Asians 8.6% vs. 17.5%, Black 13.7% vs. 8.3%, Other 7.3% vs. 13.6%; ES=0.17) and geographic region (West 8.5% vs. 28.4%, South 32.1% vs. 15.7%; ES=0.27) had small differences between the ST and non-ST groups. More patients (n=402 [59.7%]) in the ST group had severe AD (vIGA-ADTM=4), whereas moderate AD (vIGA-ADTM=3) was more common (n=137 [59.8%]) in the non-ST group. Higher disease severity was reported in the ST group versus non-ST group: BSA (mean [SD]: 41.6% [17.1] vs. 31.5% [16.0]; ES=0.61) and EASI (24.3 [10.1] vs. 19.8 [8.6]; ES=0.47). Mean [SD] PRO measures were also higher in the ST group compared to non-ST group: DLQI (11.7 [7.5] vs. 10.4 [7.9]; ES=0.17), mean peak pruritus in the past 24 hours (6.8 [2.9] vs. 6.1 [3.1]; ES=0.25), POEM (17.8 [7.1] vs. 16.6 [7.5]; ES=0.17), and ADCT (14.4 [6.1] vs. 13.0 [6.7]; ES=0.21). Conclusion: Patients not initiating ST have high rates of severe, uncontrolled AD, and considerable burden from their disease, indicating potential delayed or undertreatment. Understanding the factors that influence the decision to escalate therapy in systemic-eligible patients is important for improving care of AD. Disclosures Eric Simpson: Dr. Simpson reports personal fees from Advances in Cosmetic Medical Derm Hawaii LLC, AbbVie, Amgen, AOBiome LLC, Arcutis Biotherapeutics, Arena Pharmaceuticals, Aslan Pharma, Boehringer-Ingelheim USA, Inc., Boston Consulting Group, Bristol Myers Squibb – BMS, Collective Acumen LLC (CA), CorEvitas, Dermira, Eli Lilly, Evelo Biosciences, Evidera, ExcerptaMedica, FIDE, Forte Bio RX, Galderma, GlaxoSmithKline, Incyte, Janssen, Johnson & Johnson, Kyowa Kirin Pharmaceutical Development, Leo Pharma, Medscape LLC, Merck, MauiDerm, MLG Operating, MJH holding, Pfizer, Physicians World LLC, PRImE, Regeneron, Revolutionizing Atopic Dermatitis Inc., Roivant, Sanofi-Genzyme, Trevi therapeutics, Valeant, Vindico Medical education, WebMD. Dr. Simpson reports grants (or serves as Principal investigator role) from AbbVie, Acrotech Biopharma Inc., Amgen, Arcutis, Aslan, Castle Biosciences, CorEvitas, Dermavant, Dermira, Eli Lilly, Incyte, Kymab, Kyowa Kirin, National Jewish Health, Leo, Pfizer, Regeneron, Sanofi, and Target RWE. These potential conflicts of interest have been reviewed and managed by OHSU. Christian Fenske: Employment and stockholder, Eli Lilly and Company. Alvin Li: Employee of CorEvitas, LLC and stockholder, Eli Lilly and Company. Zach Dawson: Employment and stockholder, Eli Lilly and Company. Yolanda Muñoz Maldonado: Employee of CorEvitas, LLC. Kaylee Ho: Employee of CorEvitas, LLC. Kayla Callahan: Employee of CorEvitas, LLC and stockholder, Eli Lilly and Company. Linda Stein Gold: Investigator, advisor and/or speaker for Lilly, BMS, UCB, Pfizer, Sanofi, Regeneron, Dermavant, Arcutis, Sun, Incyte, Leo, Aslan. Seemal Desai: Dr. Desai is currently performing paid consulting services. He has previously been an advisor for Lilly and also performed consulting and/or clinical for multiple organizations. Alexandra Golant: Dr. Golant has received consulting or speaker fees from: Regeneron, Sanofi, AbbVie, Incyte, Dermavant, Lilly, Leo Pharma, Arcutis, Janssen, Amgen, Pfizer. Douglas DiRuggiero: Industry speaker bureau and advisory boards: AbbVie, Amgen, Arcutis, BMS, Incyte, Janssen, Lilly, Novartis, Sanofi/Regeneron, UCB. Jonathan I. Silverberg: Jonathan Silverberg has received honoraria as a consultant and/or advisory board member for AbbVie, AOBiome, Arcutis, Alamar, Amgen, Arena, Asana, Aslan, BioMX, Biosion, Bodewell, Boehringer-Ingelheim, Cara, Castle Biosciences, Celgene, Connect Biopharma, Dermavant, Dermira, Dermtech, Eli Lilly, Galderma, GlaxoSmithKline, Incyte, Kiniksa, Leo Pharma, Menlo, Novartis, Optum, Pfizer, RAPT, Regeneron, Sanofi-Genzyme, Shaperon, Union; speaker for AbbVie, Eli Lilly, Leo Pharma, Pfizer, Regeneron, Sanofi-Genzyme; institution received grants from Galderma, Pfizer.
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Kiladze, Ivane, Elene Mariamidze e Branislav Jeremic. "Real-World Treatment Patterns of Lung Cancer in a Resource-Restricted Country: the Experience of Georgia". Health Services Insights 14 (gennaio 2021): 117863292110552. http://dx.doi.org/10.1177/11786329211055296.

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Lung cancer (LC) is the most common malignancy responsible for 1.8 million of deaths worldwide. Lung and bronchus cancer represents 13% (n = 1217) of all new cancer cases in Georgia. In 2018, in Georgian males lung cancer age-standardized incidence rate was 35.7/per 100 000, less compared to regional countries as Turkey (70.6), Russia (48.2), Ukraine (41.7), and Armenia (58.5), but higher than in neighbor Azerbaijan (25.5). Incidence is higher compared to central and eastern Europe (27.3) and near similar to North America (34.5). Georgia is an Eastern European, middleincome country with 3.7 million residents and one of the highest numbers of active smokers in the European Region. The Georgian health care system is divided into a public and a private sector, with coverage of nearly 100% of the population. There is a national healthcare system as well as private insurance and all patients, irrespective of insurance (private or governmental) can choose the hospital for treatment by themselves all over the country. The Basic Package of the Universal Health Care Program includes the treatment of oncologic patients, specifically surgery, chemotherapy, hormone therapy and radiotherapy and investigations and medications related to these procedures. The program covers all types of laboratory and instrumental investigations related to planned treatment. Georgia lacks an LC screening program for smokers and partially because of this, the majority of patients with lung cancer present at an advanced stage. The National Centre for the Disease Control (NCDC) showed that almost 90% of LC patients in the country present with advanced stages (III-IV) with 60% of patients having stage IV disease at diagnosis . Lung cancer is generally diagnosed at an advanced stage. For non-small cell lung cancer (NSCLC), the proportion with metastatic disease (TNM stage IV) ranged from 46.8% to 61.2% in developed countries. In recent years, there have been several publications addressing specifics of LC worldwide, but none concerning Georgia. In light of the rapidly changing landscape in the diagnosis, staging, and treatment of LC, we thought to define the state of practice in Georgia by convening specialists who treat LC across 13 institutions in our country with the goal to describe differences in access and approaches to LC.
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Evsyutina, Yulia V. "National Medical Research Center for Preventive Medicine, Moscow, Russia". CardioSomatics 10, n. 4 (15 dicembre 2019): 55–58. http://dx.doi.org/10.26442/22217185.2019.4.190597.

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Arterial hypertension is the leading cause of cardiovascular morbidity and mortality. According to Russian and international studies, prevalence of hypertension is approximately 40%. In the next years an increase in the number of patients can be expected. Hypertension is the main independent risk factor for coronary heart disease for all age groups. Modern antihypertensive drugs can provide good control of blood pressure and reduce the incidence of complications and mortality. By prescribing antihypertensive therapy, it is necessary to achieve the target level of blood pressure, for most patients ≤130/80 mm Hg. When prescribing combination therapy, preference should be given to fixed combinations. Approximately 10% of patients with hypertension have resistance to therapy. Such patients often need an extended diagnostic search to exclude pseudoresistance and secondary hypertension. One of the main causes of pseudoresistance is poor adherence to therapy. Patients with resistant hypertension have a higher risk of adverse outcomes compared with patients without this type of disease.
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49

Pransky, Joanne. "The Pransky interview: Professor Robin R. Murphy, Co-founder of the Field of Disaster Robotics and Founder of Roboticists Without Borders". Industrial Robot: An International Journal 45, n. 5 (20 agosto 2018): 591–96. http://dx.doi.org/10.1108/ir-07-2018-0136.

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Purpose This paper is a “Q&A interview” conducted by Joanne Pransky of Industrial Robot Journal as a method to impart the combined technological, business and personal experience of a prominent, robotic industry engineer-turned successful innovator and leader regarding the challenges of bringing technological discoveries to fruition. This paper aims to discuss these issues. Design/methodology/approach The interviewee is Dr Robin R. Murphy, Raytheon Professor of Computer Science and Engineering, Texas A&M University; Co-lead, Emergency Informatics EDGE Innovation Network Center, Texas A&M, Director of the Humanitarian Robotics and AI Laboratory and Vice President of the Center for Robot-Assisted Search and Rescue (CRASAR) http://crasar.org. In this interview, Dr Murphy provides answers to questions regarding her pioneering experiences in rescue robotics. Findings As a child, Dr Murphy knew she wanted to be a mechanical engineer and obtained her BME degree from Georgia Institute of Technology (Georgia Tech). While working in industry after her BME, she fell in love with computer science and received an MS and PhD in Computer Science at Georgia Tech where she was a Rockwell International Doctoral Fellow. In the mid-1990s, while teaching at the Colorado School of Mines, she pioneered rescue robots after one of her graduate students returned from the Oklahoma City bombing and suggested that small rescue robots should be developed for future disasters. The National Science Foundation awarded Murphy and her students the first grant for search-and-rescue robots. She has since assisted in responses at more than 20 worldwide disasters, including Hurricane Katrina, the Crandall Canyon Mine collapse, the Tohoku Tsunami and the Fukushima Daiichi nuclear accident. Originality/value The response to the World Trade Center attacks after September 11, 2001 by Dr Murphy’s team from the University of South Florida (the only academic institution), along with four other teams brought together by CRASAR, marked the first recorded use of a rescue robot at a disaster site. In addition to being a founder in the field of rescue robots, she is also a founder in the field of human–robot interaction and the Roboticists Without Borders. She has written over 100 publications and three books: the best-selling textbook, Introduction to AI Robotics, Disaster Robotics and Robotics-Through-Science-Fiction: Artificial Intelligence Explained Six Classic Robot Short Stories. Dr Murphy has received approximately 20 national awards and honors including: the AUVSI’s Al Aube Outstanding Contributor Award, the Eugene L. Lawler Award for Humanitarian Contributions within Computer Science and Informatics, CMU Field Robotics Institute “Pioneer in Field Robotics” and TIME Magazine, Innovators in Artificial Intelligence. She is an IEEE Fellow.
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Marchal, Bruno, Ariadna Nebot Giralt, Lela Sulaberidze, Ivdity Chikovani e Ibukun-Oluwa Omolade Abejirinde. "Designing and evaluating provider results-based financing for tuberculosis care in Georgia: a realist evaluation protocol". BMJ Open 9, n. 4 (aprile 2019): e030257. http://dx.doi.org/10.1136/bmjopen-2019-030257.

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IntroductionIn 2016, Georgian researchers and policymakers were developing a policy to improve the performance of the national tuberculosis (TB) control programme. The research programme ‘Designing and Evaluating Provider Results-Based Financing for Tuberculosis Care in Georgia: Understanding Costs, Mechanisms of Effect and Impact (Results4TB)’ was initiated to inform the policy formulation phase, document the policy implementation and assess the effectiveness, cost-effectiveness and the processes of change. To achieve this, the research team intends to combine an impact evaluation, a cost-effectiveness study and a realist evaluation (RE) within an overarching theory-informed design. This protocol is the RE component of the programme.MethodsA realist methodological approach will be adopted to guide the research design and evaluation. RE answers the question of ‘what works in which conditions for whom?’ and starts with the development of an initial programme theory (IPT). The IPT will feed into other phases of the realist research cycle (study design, data collection, data analysis and synthesis and theory refinement). Data will be collected in a multiple embedded case study design (five intervention and three control sites) through document reviews, in-depth interviews, non-participant observations and context mapping at facility and national levels. Additional data from other research components (cost-effectiveness and impact evaluation) will aid data triangulation.Ethics and disseminationThe Institutional Review Boards of the National Centre for Disease Control and Public Health in Georgia (ref. IRB # 2018–019) and the Institute of Tropical Medicine, Antwerp (ref. IRB #- 1240/18) have granted ethical approval to the study.Trial registration numberISRCTN14667607
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