Introduction: The recovery of other pathogens in patients with SARS-CoV-2 infection has been reported, either at the time of a SARS-CoV-2 infection diagnosis (co-infection) or subsequently (superinfection). However, data on the prevalence, microbiology, and outcomes of co-infection and superinfection are limited. The purpose of this study was to examine the occurrence of co-infections and superinfections and their outcomes among patients with SARS-CoV-2 infection. Patients and methods: We searched literature databases for studies published from October 1, 2019, through February 8, 2021. We included studies that reported clinical features and outcomes of co-infection or superinfection of SARS-CoV-2 and other pathogens in hospitalized and non-hospitalized patients. We followed PRISMA guidelines, and we registered the protocol with PROSPERO as: CRD42020189763. Results: Of 6639 articles screened, 118 were included in the random effects meta-analysis. The pooled prevalence of co-infection was 19% (95% confidence interval [CI]: 14%-25%, I² = 98%) and that of superinfection was 24% (95% CI: 19%-30%). Pooled prevalence of pathogen type stratified by co- or superinfection were: viral co-infections, 10% (95% CI: 6%-14%); viral superinfections, 4% (95% CI: 0%-10%); bacterial co-infections, 8% (95% CI: 5%-11%); bacterial superinfections, 20% (95% CI: 13%-28%); fungal co-infections, 4% (95% CI: 2%-7%); and fungal superinfections, 8% (95% CI: 4%-13%). Patients with a co-infection or superinfection had higher odds of dying than those who only had SARS-CoV-2 infection (odds ratio = 3.31, 95% CI: 1.82–5.99). Compared to those with co-infections, patients with superinfections had a higher prevalence of mechanical ventilation (45% [95% CI: 33%-58%] vs. 10% [95% CI: 5%-16%]), but patients with co-infections had a greater average length of hospital stay than those with superinfections (mean = 29.0 days, standard deviation [SD] = 6.7 vs. mean = 16 days, SD = 6.2, respectively). Conclusions: Our study showed that as many as 19% of patients with COVID-19 have co-infections and 24% have superinfections. The presence of either co-infection or superinfection was associated with poor outcomes, including increased mortality. Our findings support the need for diagnostic testing to identify and treat co-occurring respiratory infections among patients with SARS-CoV-2 infection.

MRI has high sensitivity but low specificity for the detection of esophageal cancer, which shows promise for determining neoadjuvant therapy response and for detecting locally advanced disease for ... Background Although CT, endoscopic US, and PET are critical in determining the appropriate management of esophageal carcinoma (squamous cell carcinoma and adenocarcinoma), previous reports show tha...

Introduction: Ultrasonic vocalization (USV) can indicate affective states—including psychosocial stress—in mice and rats. However, stress-induced USV changes could be confounded by laboratory experimental variables such as the type of behavioral stress paradigm, the elicitation method, rodent strain, etc. We sought to provide a review of the current literature to delineate how psychosocial stress-altered rodent USVs may be affected by factors of age, sex, strain, species, elicitation paradigm, and stressor. Methods: We used PubMed, Scopus (Elsevier), PsycINFO (EBSCO), and the following Web of Science (Clarivate) databases: Biological Abstracts, CAB Abstracts, Science Citation Index-Expanded, and Emerging Sources Citation Index. The studies identified by our search strategy were independently screened by two authors with the following inclusion criteria: peer-reviewed, in English, reported original data, and described USV in response to stress in rats or mice. The data extracted included USV acoustic parameters (mean peak frequency and mean amplitude (loudness)), details of the stress and USV elicitation paradigms, rodent species, age, and sex variables. Results: The following screening of 5309 titles/abstracts and 687 full-text articles revealed 148 articles. Footshock (20%), cold exposure (14%), and maternal separation (23.5%) were the most commonly used stress paradigms (duration and type of stressor varied across studies), with the total number of USV calls being the most commonly reported acoustic outcome. In rats, 121 articles described stress-altered USVs, while 25 studies reported the same in mice, and two reported multiple rodent species (rats and mice, alongside other rodent species such as gerbils). With respect to stress-altered USV changes with age, mice and rats increase USV rates after birth, with a peak around 6 to 10 days, and decrease USVs until weanling age. Of the five studies that reported sex-related differences in stress-induced USVs, females had an increased number of calls and lower average peak frequency in response to stress when compared to males. Only two to four studies reported strain-related differences in stress-induced vocalizations in rats and mice, respectively. Conclusions: The data from this review lay the groundwork for better understanding rodent USVs in response to psychosocial stress with effects of elicitation paradigm, stressor, age, and sex.

Cancer incidence is increasing globally. Although Pakistan does not have a unified national cancer registry, several institutional and regional cancer registries can provide vital information for cancer planning. Following the Joanna Briggs Institute and PRISMA-ScR guidelines, we conducted a comprehensive search across multiple databases and grey literature. Data were extracted regarding registry characteristics, data collection methods, and study details, and findings were summarised narratively to highlight key attributes and data gaps. Of 3714 unique abstracts screened, 102 studies met inclusion criteria, including 92 reporting registry data and 10 describing registry characteristics without patient-level data. Seventeen cancer registries were identified, with varying scope and geographical coverage. Only 19 of Pakistan's 129 cities contribute data to at least one registry. Data collection methods ranged from paper-based forms to advanced software systems. The Karachi Cancer Registry was noted for its high research output. Funding sources were limited, and several registries faced operational challenges. This Review highlights Pakistan's fragmented cancer registry landscape. While important policy-level data can be obtained from existing registries, there is an urgent need for strategic efforts and stakeholder collaboration to establish a national cancer registry system. Such a system could enhance cancer surveillance, inform public health efforts, and serve as a model for similar initiatives in south and southeast Asia.

Purpose: The purpose of this scoping review was to (a) summarize methodological characteristics of studies examining vocal characteristics of infants at high risk for neurological speech motor involvement and (b) report the state of the high-quality evidence on vocal characteristic trends of infants diagnosed or at high risk for cerebral palsy (CP). Method: The PRISMA (Preferred Reporting Items of Systematic Reviews and Meta-Analyses) extension for scoping reviews was followed for reporting our review. Studies measured prelinguistic vocal characteristics of infants under 24 months with birth risk or genetic conditions known to commonly present with speech motor involvement. Fifty-five studies met criteria for Part 1. Eleven studies met criteria for synthesis in Part 2. Results: A smaller percentage of studies examined infants with or at risk for CP compared to studies examining genetic conditions such as Down syndrome. The median year of publication was 1999, with a median sample size of nine participants. Most studies were conducted in laboratory settings and used human coding of vocalizations produced during caregiver–child interactions. Substantial methodological differences were noted across all studies. A small number of high-quality studies of infants with or at risk for CP revealed high rates of marginal babbling, low rates of canonical babbling, and limited consonant diversity under 24 months. Mixed findings were noted across studies of general birth risk factors. Conclusions: There is limited evidence available to support the early detection of speech motor involvement. Large methodological differences currently impact the ability to synthesize findings across studies. There is a critical need to conduct longitudinal research with larger sample sizes and advanced, modern technologies to detect vocal precursors of speech impairment to support the accurate diagnosis and prognosis of speech development in infants with CP and other clinical populations.