Publications by authors named "Mark Fletcher"

Purpose: In the setting of an established childhood pneumococcal vaccination programme with immediate initiation and treatment of antiretroviral therapy (ART) for people living with HIV (PLWH), the risk of adult pneumococcal community-acquired pneumonia (CAP) is not recently described. We aimed to investigate CAP incidence, recurrence, mortality, risk factors and microbiology before and during the COVID-19 pandemic.

Participants: Adults aged ≥18 years were enrolled in three South African provinces from March 2019 to October 2021, with a brief halt during the initial COVID-19 lockdown.

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Article Synopsis
  • A study reviewed RSV (respiratory syncytial virus) data from 149 countries across WHO regions to assess pediatric burdens from 2012 to 2022.
  • A gap analysis revealed wide variations in hospitalization rates, mortality, and case definitions, with infants under 6 months at higher risk and needing longer hospital stays.
  • Findings indicate significant regional differences in RSV impact and highlight the need for standardized data to better understand and address this health issue globally.
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Infections attributable to respiratory syncytial virus (RSV) are a major cause of hospitalization among young children worldwide. Despite substantial clinical and economic burden, real-world data associated with RSV infections in the United Arab Emirates (UAE) are limited. This study aimed to assess among children (<18 years) diagnosed with RSV the epidemiology, seasonality, comorbidities, treatment patterns, length of hospital stay, healthcare resource utilization (HCRU), and costs associated with pediatric infection in Dubai, UAE.

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Background: Adults who are elderly or who have underlying health conditions are at particular risk of Streptococcus pneumoniae infections, and pneumococcal vaccines are available. Nonetheless, only national recommendations from countries of North America and Europe have been previously reviewed in the literature.

Methods: Consequently, we aimed to collate national guidelines for adult pneumococcal immunization across the 161 countries within the World Health Organization (WHO) regions-the Americas (except Canada and the United States of America), Africa, Eastern Mediterranean, South East Asia, and Western Pacific-from country-level official websites and documents, from the WHO portal, and from direct contact with public health officials, pertinent governmental sources, or local vaccination experts.

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Objectives: To describe the carriage rate, serotype distribution, and antimicrobial susceptibility patterns of () nasopharyngeal (NP) isolates among healthy children aged 30 days to <60 months in the cities of Beijing and Shenzhen during 2018-2021.

Methods: A NP swab sample was collected among four annual cohorts of healthy children at routine well-child visits. was identified by culture, optochin sensitivity and bile solubility, serotypes determined by latex agglutination and Quellung, and antimicrobial susceptibility testing performed using E-test strips.

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Introduction: There was no 13-valent pneumococcal conjugate vaccine (PCV13) adult antibody concentration threshold regulatory criterion for licensure - unlike the pediatric indication; consequently, for the adult indication, PCV13 serotype-specific opsonophagocytic activity (OPA) geometric mean titer (GMT) values were immunobridged to the 23-valent plain polysaccharide vaccine (PPV23) to infer efficacy against invasive pneumococcal disease (IPD). Subsequently, a double-blind, randomized, controlled PCV13 efficacy trial (CAPiTA) was performed in community-living, older adults to confirm efficacy against vaccine-serotype IPD (VT-IPD) and establish efficacy against vaccine-serotype pneumococcal community-acquired pneumonia (VT-CAP).

Areas Covered: This article summarizes 31 publications from the PCV13 adult indication clinical development trials and other PCV13 clinical studies, organized by formulation, reactogenicity and safety, immunogenicity, coadministration, and clinical efficacy.

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Audible very-high frequency sound (VHFS) and ultrasound (US) have been rated more unpleasant than lower frequency sounds when presented to listeners at similar sensation levels (SLs). In this study, 17 participants rated the sensory unpleasantness of 14-, 16-, and 18-kHz tones and a 1-kHz reference tone. Tones were presented at equal subjective loudness levels for each individual, corresponding to levels of 10, 20, and 30 dB SL measured at 1 kHz.

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Background: Most publications on invasive pneumococcal disease (IPD) serotype distribution are from about 20 countries (Australia, Canada, China, European Union members, Japan, New Zealand, South Korea, and USA). Here, we reviewed the literature among underrepresented countries in the Americas (AMRO), Africa (AFRO), Eastern Mediterranean (EMRO), South-East Asia (SEARO), and Western Pacific (WPRO) WHO regions.

Methods: We performed a systematic review of the most recent IPD serotype surveillance publications (from 01/01/2010 to 31/12/2021, Medline/Embase) in those WHO regions.

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Recent advances in haptic technology could allow haptic hearing aids, which convert audio to tactile stimulation, to become viable for supporting people with hearing loss. A tactile vocoder strategy for audio-to-tactile conversion, which exploits these advances, has recently shown significant promise. In this strategy, the amplitude envelope is extracted from several audio frequency bands and used to modulate the amplitude of a set of vibro-tactile tones.

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Many people with hearing loss struggle to understand speech in noisy environments, making noise robustness critical for hearing-assistive devices. Recently developed haptic hearing aids, which convert audio to vibration, can improve speech-in-noise performance for cochlear implant (CI) users and assist those unable to access hearing-assistive devices. They are typically body-worn rather than head-mounted, allowing additional space for batteries and microprocessors, and so can deploy more sophisticated noise-reduction techniques.

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Haptic hearing aids, which provide speech information through tactile stimulation, could substantially improve outcomes for both cochlear implant users and for those unable to access cochlear implants. Recent advances in wide-band haptic actuator technology have made new audio-to-tactile conversion strategies viable for wearable devices. One such strategy filters the audio into eight frequency bands, which are evenly distributed across the speech frequency range.

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Background: Clostridioides difficile (formerly Clostridium difficile) is well-documented in Europe and North America to be a common cause of healthcare-associated gastrointestinal tract infections. In contrast, C difficile infection (CDI) is infrequently reported in literature from Asia, which may reflect a lack of clinician awareness. We conducted a narrative review to better understand CDI burden in Asia.

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Background: Pneumococcal disease caused by Streptococcus pneumoniae is an important cause of morbidity and mortality across all ages, particularly in younger children and older adults. Here, we describe pneumococcal disease hospitalizations at Ministry of Health (MoH) facilities in Malaysia between 2013 and 2015.

Methods: This was a retrospective databases analysis.

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Cochlear implants (CIs) have revolutionised treatment of hearing loss, but large populations globally cannot access them either because of disorders that prevent implantation or because they are expensive and require specialist surgery. Recent technology developments mean that haptic aids, which transmit speech through vibration, could offer a viable low-cost, non-invasive alternative. One important development is that compact haptic actuators can now deliver intense stimulation across multiple frequencies.

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Article Synopsis
  • Higher valency pneumococcal conjugate vaccines (PCV15 and PCV20) have been developed to combat non-vaccine serotypes contributing to invasive pneumococcal disease (IPD).
  • A systematic review of studies from 2010 to 2020 identified serotype characteristics, revealing PCV20nonPCV13 serotypes accounted for 28% of IPD, with distinct serotypes prevalent in children versus adults.
  • The findings highlighted serotypes 15B/C and 8 as significant for severe cases of pneumonia and meningitis, prompting potential guidance for vaccine selection and usage.
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Objective: To describe the risk condition status and clinical outcomes among Thai children hospitalized with pneumococcal disease.

Methods: In this retrospective analysis, children with invasive pneumococcal disease (IPD) or x-ray-confirmed non-bacteraemic pneumococcal pneumonia (NBPP) were identified from nine hospitals in Thailand between 2010 and 2019. Data on risk factors and outcomes were extracted from medical records.

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  • Lyme borreliosis (LB) is the most prevalent tick-borne disease in Europe, but accurate data on its incidence is lacking, motivating a systematic review of studies from multiple databases covering 2005 to 2020.
  • The review identified 61 unique studies across 25 European countries, revealing significant differences in study design and case definitions, with only 21% adhering to the standardized definitions established by the EUCALB.
  • Findings showed the highest LB incidences in Belgium, Finland, the Netherlands, and Switzerland (over 100 cases per 100,000 population per year), while some areas displayed much higher localized rates, indicating substantial variability in disease burden across the continent.
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Article Synopsis
  • Lyme borreliosis (LB) is the most prevalent tick-borne disease in Europe, with a systematic review showing significant variation in incidence reporting across 25 countries from 2005 to 2020.
  • Most countries (84%) employed passive surveillance methods, while only a few (Bulgaria, France, Poland, Romania) used standardized case definitions as recommended by public health authorities, which hampered cross-country comparisons.
  • The highest LB incidences were recorded in Estonia, Lithuania, Slovenia, and Switzerland (over 100 cases/100,000 PPY), with an estimated 128,888 cases reported annually and 24% of Europeans living in high-incidence areas.
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Lyme borreliosis (LB), a tick bite-transmitted infection caused by () complex spirochetes, is the most common tickborne disease in Europe. Studies in European countries have reported LB seroprevalence (prevalence of antibodies to infection) and diagnostic strategies used for testing. We conducted a systematic literature review to summarize contemporary LB seroprevalence in Europe.

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Since its initial identification in 1986, Lyme disease has been clinically diagnosed in 29 provinces in China; however, national incidence data are lacking. To summarize Lyme disease seropositivity data among persons across China, we conducted a systematic literature review of Chinese- and English-language journal articles published during 2005‒2020. According to 72 estimates that measured IgG by using a diagnostic enzyme-linked assay (EIA) alone, the seropositivity point prevalence with a fixed-effects model was 9.

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Rapid analysis of surrendered or seized drug samples provides important intelligence for health (e.g. treatment or harm reduction), and custodial services.

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Exciting developments in hearing aid and cochlear implant technology for linking signal processing across the ears have improved spatial hearing outcomes. This has resulted in an increased emphasis on clinical assessment of the spatial hearing abilities of hearing-assistive device users. Effective assessment of spatial hearing currently requires a large and costly loudspeaker array system, housed in a heavily acoustically treated testing room.

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The Community-Acquired Pneumonia immunization Trial in Adults (CAPiTA) evaluated older adult pneumococcal vaccination and was one of the largest vaccine clinical trials ever conducted. Among older adults aged ≥65 years, the trial established 13-valent pneumococcal conjugate vaccine (PCV13) efficacy in preventing first episodes of bacteremic and nonbacteremic pneumococcal vaccine serotype (VT) community acquired pneumonia (CAP), and of vaccine serotype invasive pneumococcal disease (VT-IPD). Since the publication of the original trial results, 15 additional publications have extended the analyses.

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