To identify and present the pathogens and sources of contamination linked to outbreaks within hematopoietic stem cell transplant (HSCT) units.

Systematic review.

Inpatient HSCT units.

The PubMed/Medline databases were systematically searched as per the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, employing the search terms “stem cell”, “bone marrow”, “transplant”, “transplantation”, “outbreak” and “pseudo-outbreak” from inception until July 31, 2024. Data on the type of event, pathogen involved, and source of contamination were extracted from eligible publications.

In total, 39 studies including 387 patients were included in this review. The overall mortality rate was 23%. Pathogens identified included adenovirus, RSV, Pseudomonas aeruginosa, Aspergillus spp., and non-tuberculous mycobacteria (NTM). P. aeruginosa outbreaks were associated with contaminated sanitary fixtures (P = .007) and water (P = .039), outbreaks caused by NTM were associated with water (P = .009), while Aspergillus spp. outbreaks were associated with construction (P < .001). An index case was identified in 36.8% of viral outbreaks (P = .016). Other sources included inadequate disinfection and transmission from visitors.

Our study highlights several associations between pathogens involved in HSCT unit outbreaks and their respective sources. Establishing standardized guidelines for unit construction – particularly for ventilation and water safety – could further reduce the risk of pathogen transmission and enhance infection prevention in these high-risk settings.

The aim of this study was to provide insights learned from disaster research response (DR2) efforts following Hurricane Harvey in 2017 to launch DR2 activities following the Intercontinental Terminals Company (ITC) fire in Deer Park, Texas, in 2019.

A multidisciplinary group of academic, community, and government partners launched a myriad of DR2 activities.

The DR2 response to Hurricane Harvey focused on enhancing environmental health literacy around clean-up efforts, measuring environmental contaminants in soil and water in impacted neighborhoods, and launching studies to evaluate the health impact of the disaster. The lessons learned after Harvey enabled rapid DR2 activities following the ITC fire, including air monitoring and administering surveys and in-depth interviews with affected residents.

Embedding DR2 activities at academic institutions can enable rapid deployment of lessons learned from one disaster to enhance the response to subsequent disasters, even when those disasters are different. Our experience demonstrates the importance of academic institutions working with governmental and community partners to support timely disaster response efforts. Efforts enabled by such experience include providing health and safety training and consistent and reliable messaging, collecting time-sensitive and critical data in the wake of the event, and launching research to understand health impacts and improve resiliency.

Identify risk factors that could increase progression to severe disease and mortality in hospitalized SARS-CoV-2 patients in the Southeast region of the United States.

Multicenter, retrospective cohort including 502 adults hospitalized with laboratory-confirmed COVID-19 between March 1, 2020, and May 8, 2020 within 1 of 15 participating hospitals in 5 health systems across 5 states in the Southeast United States.

The study objectives were to identify risk factors that could increase progression to hospital mortality and severe disease (defined as a composite of intensive care unit admission or requirement of mechanical ventilation) in hospitalized SARS-CoV-2 patients in the Southeast United States.

In total, 502 patients were included, and 476 of 502 (95%) had clinically evaluable outcomes. The hospital mortality rate was 16% (76 of 476); 35% (177 of 502) required ICU admission and 18% (91 of 502) required mechanical ventilation. By both univariate and adjusted multivariate analyses, hospital mortality was independently associated with age (adjusted odds ratio [aOR], 2.03 for each decade increase; 95% confidence interval [CI], 1.56-–2.69), male sex (aOR, 2.44; 95% CI, 1.34–4.59), and cardiovascular disease (aOR, 2.16; 95% CI, 1.15–4.09). As with mortality, risk of severe disease was independently associated with age (aOR, 1.17 for each decade increase; 95% CI, 1.00–1.37), male sex (aOR, 2.34; 95% CI, 1.54–3.60), and cardiovascular disease (aOR, 1.77; 95% CI, 1.09–2.85).

In an adjusted multivariate analysis, advanced age, male sex, and cardiovascular disease increased risk of severe disease and mortality in patients with COVID-19 in the Southeast United States. In-hospital mortality risk doubled with each subsequent decade of life.

The objective of this study is to examine an association between apathy and caregiver burden in amnestic mild cognitive impairment.

This was a retrospective cross sectional study. We selected 92 consecutive patients diagnosed with Amnestic Mild Cognitive Impairment who had a comprehensive battery of neuropsychological tests and a behaviour rating scale of interest for this study recorded in the database. Correlation analysis was done to look into association between apathy and caregiver burden.

Apathy score was significantly related to caregiver burden in amnestic mild cognitive impairment.

Our study has shown high association of apathy with caregiver burden in aMCI.

The primary aim of this study is to examine an association between apathy and frontal lobe dysfunction in patients with memory problems. We also aimed to look into the association between apathy severity and caregiver burden along with the relationship between apathy and praxis.

This was a retrospective cross sectional study. We selected 160 consecutive patients diagnosed with Alzheimer's dementia and Amnestic Mild Cognitive Impairment who had a comprehensive battery of neuropsychological tests and a behaviour rating scale of interest for this study recorded in the database. Correlation between apathy with and without depression were tested against frontal lobe test including Trail making A, Trial making B, Letter Fluency, Ideational Fluency, Category Fluency, Abstract Thinking and Executive functioning subtest of CAMGOG-R. Similarly correlation analysis was also done to look into association between apathy and caregiver burden as well as praxis.

Statistically significant relationship were found between apathy and executive function scores, ideational fluency scores, abstract thinking and category fluency scores. Relationship between apathy and caregiver burden were highly significant. Further sub analysis, found apathy to be significantly associated with caregiver burden in both AD and aMCI patients.

Apathy is associated with frontal lobe dysfunction especially impaired executive function and ideational fluency even when controlled for depression. It is highly associated with caregiver burden both in AD & aMCI .Hence early recognition and management of apathy is important in improving the prognosis of patients with AD & aMCI as well as their caregiver.

Patients with Mild Cognitive Impairment (MCI) do not have significant deficits in their activities of daily living (ADL) and therefore questions exist as to whether carers of patients with MCI experience burden. Caregiver burden (CB) is defined as the adverse consequences of providing care. Studies report 20–30% of caregivers of MCI patient experience a significant degree of burden. CB is associated with poor outcomes for both patients and carers of people with dementia.

The main objective of this study is to look into the association of apathy and caregiver burden in patients with amnestic Mild Cognitive Impairment (aMCI) and also identify other significant predictors of caregiver burden.

This was a retrospective cross sectional study. We selected 92 consecutive patients diagnosed with aMCI who had a comprehensive battery of neuropsychological tests and a behaviour rating scale of interest for this study recorded. Nonparametric correlational analyses examined relationships between apathy, behavioural pathology, executive function, anxiety scores, depression scores, instrumental activities of daily living (IADL), cognitive scores and caregiver burden scores. Linear regressions identified predictors of CB.

There was significant relationship between apathy, impairments in IADL, behavioural pathology and CB in aMCI patients. However linear regression analysis showed that apathy was the only significant predictor of CB.

Apathy is highly prevalent and a significant contributor to caregiver burden in amnestic MCI. Improved identification and early interventions to improve apathy symptom is likely alleviate CB and thereby improving the prognosis and QoL of both the patients and caregiver.