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Global Health

Mpox outbreak in South Africa: A wake-up call for strengthening preparedness and response
Al-Tawfiq JA, Pan Q and Schlagenhauf P
Long-term Kidney Transplant Survival Across the Globe: An Important Clarification!
Hariharan S and Mahillo B
GATA4 downregulation enhances CCL20-mediated immunosuppression in hepatocellular carcinoma
Nasir NJM, Chuah S, Shuen T, Prawira A, Ba R, Lim MC, Chua J, Nguyen PHD, Lim CJ, Wasser M, Hazirah SN, Lim TKH, Leow WQ, Loh TJ, Wan WK, Pang YH, Soon G, Cheow PC, Kam JH, Iyer S, Kow A, Dan YY, Bonney GK, Chung A, Goh BKP, Chow PKH, Albani S, Zhai W, Ouyang JF, Toh HC and Chew V
Hepatocellular carcinoma (HCC) is a deadly cancer with a high global mortality rate, and the downregulation of GATA binding protein 4 (GATA4) has been implicated in HCC progression. In this study, we investigated the role of GATA4 in shaping the immune landscape of HCC.
One-year outcome of robotical vs. manual percutaneous coronary intervention
von Zur Mühlen C, Jeuck M, Heidt T, Maulhardt T, Hartikainen T, Supady A, Hilgendorf I, Wolf D, Kaier K, Westermann D and Rilinger J
Robotic-assisted percutaneous coronary intervention (R-PCI) is a promising technology for optimizing the treatment of patients with coronary heart disease. For a better understanding of the potential of R-PCI in clinical routine compared to conventional manual PCI (M-PCI) both initial treatment success of the index procedure and long-term outcome have to be analysed.
Purification, Structural Characterization, and Anticandidal Activity of a Chitin-Binding Peptide with High Similarity to Hevein and Endochitinase Isolated from Pepper Seeds
Gonçalves GR, de Azevedo Dos Santos L, da Silva MS, Taveira GB, da Silva TM, Almeida FA, Ferreira SR, Oliveira AEA, Silveira V, de Oliveira Carvalho A, Rodrigues R and Gomes VM
With the emergence of multidrug-resistant microorganisms, microbial agents have become a serious global threat, affecting human health and various plants. Therefore, new therapeutic alternatives, such as chitin-binding proteins, are necessary. Chitin is an essential component of the fungal cell wall, and chitin-binding proteins exhibit antifungal activity. In the present study, chitin-binding peptides isolated from Capsicum chinense seeds were characterized and evaluated for their in vitro antimicrobial effect against the growth of Candida and Fusarium fungi. Proteins were extracted from the seeds and subsequently the chitin-binding proteins were separated by chitin affinity chromatography. After chromatography, two fractions, Cc-F1 (not retained on the column) and Cc-F2 (retained on the column), were obtained. Electrophoresis revealed major protein bands between 6.5 and 26.6 kDa for Cc-F1 and only a ~ 6.5 kDa protein band for Cc-F2, which was subsequently subjected to mass spectrometry. The protein showed similarity with hevein-like and endochitinase and was then named Cc-Hev. Data are available via ProteomeXchange with identifier PXD054607. Next, we predicted the three-dimensional structure of the peptides and performed a peptide docking with (NAG). Subsequently, growth inhibition assays were performed to evaluate the ability of the peptides to inhibit microorganism growth. Cc-Hev inhibited the growth of C. albicans (up to 75% inhibition) and C. tropicalis (100% inhibition) and induced a 65% decrease in cell viability for C. albicans and 100% for C. tropicalis. Based on these results, new techniques to combat fungal diseases could be developed through biotechnological applications; therefore, further studies are needed.
Methicillin-resistant Staphylococcus pseudintermedius: epidemiological changes, antibiotic resistance, and alternative therapeutic strategies
Nocera FP and De Martino L
Staphylococcus pseudintermedius is a major opportunistic bacterial pathogen that belongs to the skin and mucosal microbiota of the dog. Since its global emergence around 2006, multidrug - methicillin-resistant S. pseudintermedius (MRSP) clones have become endemic worldwide. MRSP strains pose a significant threat to animal health and make antimicrobial therapy difficult due to their typical multidrug resistance phenotypes. The difficulty to treat MRSP infections using the current antimicrobials licensed for veterinary use has intensified research efforts to develop new treatment strategies and alternative anti-infective approaches to conventional antimicrobial therapy. The present narrative review outlines the latest changes in the epidemiology of MRSP with focus on the geographical distribution variability and antimicrobial resistance profiles in the main MRSP lineages. It also provides an overview of the effectiveness of currently available antimicrobials and the status of anti-infective alternatives to conventional antimicrobials.Recent studies have reported notable changes in the population structure of MRSP, with the emergence of new epidemic lineages, such as ST258, ST123, ST496, and ST551 in European countries and ST45, ST181, ST258, ST496 in non-European countries, which partly or totally replaced those that were initially prevalent, such as ST71 in Europe and ST68 in the US. Due to methicillin resistance often associated with the resistance to a broader number of antimicrobials, treating canine MRSP skin infection is challenging. Several alternative or supplementary treatment options to conventional antibiotics, especially for topical treatment, such as a novel water-soluble hydroxypyridinone-containing iron-chelating 9 kDa polymer (DIBI), antimicrobial peptides (AMPs), nanoparticles, and bacteriophages seem to be particularly interesting from a clinical perspective.
Antibiotic residue contamination in the aquatic environment, sources and associated potential health risks
Akhter S, Bhat MA, Ahmed S and Siddiqui WA
Antibiotic residues are widely recognized as major pollutants in the aquatic environment on a global scale. As a significant class of pharmaceutically active compounds (PhACs), antibiotics are extensively consumed worldwide. The primary sources of these residues include hospitals, municipal sewage, household disposal, and manures from animal husbandry. These residues are frequently detected in surface and drinking waters, sewage effluents, soils, sediments, and various plant species in countries such as China, Japan, South Korea, Europe, the USA, Canada, and India. Antibiotics are used medicinally in both humans and animals, with a substantial portion excreted into the environment as metabolites in feces and urine. With the advancement of sensitive and quantitative analytical techniques, antibiotics are consistently reported in environmental matrices at concentrations ranging from nanograms per liter (ng/L) to milligrams per liter (mg/L). Agricultural soils, in particular, serve as a significant reservoir for antibiotic residues due to their strong particle adsorption capacities. Plants grown in soils irrigated with PhAC-contaminated water can uptake and accumulate these pharmaceuticals in various tissues, such as roots, leaves, and fruits, raising serious concerns regarding their consumption by humans and animals. There is an increasing need for research to understand the potential human health risks associated with the accumulation of antibiotics in the food chain. The present reviews aims to shed light on the rising environmental pharmaceutical contamination concerns, their sources in the environment, and the potential health risks as well as remediation effort. To discuss the main knowledge gaps and the future research that should be prioritized to achieve the risk assessment. We examined and summarized the available data and information on the antibiotic resistance associated with antibiotic residues in the environment. As studies have indicated that vegetables can absorb, transport, and accumulate antibiotics in edible parts when irrigated with wastewater that is either inadequately treated or untreated. These residues and their metabolites can enter the food chain, with their persistence, bioaccumulation, and toxicity contributing to drug resistance and adverse health effects in living organisms.
Managing the Historic Burden of Kernicterus Mortality in India
Vidavalur R and Bhutani VK
Prevention of neonatal bilirubin injury exemplifies success of systems approach to avert adverse neonatal and childhood outcomes that rely on strategies including prenatal identification of Rhesus sensitization, universal maternal blood typing, risk assessment for neonatal extreme hyperbilirubinemia (EHB), unfettered access to safe, effective phototherapy, and application of patient safety principles. India's diverse landscape suggests varied real-time experiences of neonatal hyperbilirubinemia and consequent infant mortality rates (IMR). Utilizing Global Burden of Disease (GBD) database, the authors examined national and subnational trends, infant mortality timing, and the disease burden from hemolytic and perinatal jaundice over 30 y (1999 to 2019). They also assessed the correlation of EHB-IMR with socio-demographic index and health expenditure per capita, estimating economic losses from EHB-related infant mortality to guide policy decisions at national and state domains. From 1990 to 2019, India delivered 811,078,415 livebirths of which, 1,189,856 infant deaths were due to EHB. EHB-related deaths decreased from 57,773 in 1990 to 19,664 in 2019, a 60% reduction vs. 40% in overall IMR. Early (0-6 d), late (7-27 d), and post-neonatal (28-364 d) deaths accounted for 61%, 34%, and 5% of mortality, respectively. Uttar Pradesh and Bihar contributed to 38% of all EHB deaths. Economic analysis estimate losses between US $7.2 and 11.7 billion for the year 2019 secondary to EHB-related mortality. The present analysis reveals consistent declines across all states to reach current EHB-IMR of 0.8 per 1,000 live-births in India by 2019. Significant economic impact of lost human productivity highlight ongoing need for targeted life-saving public health strategies.
Disparities in 36 cancers across 185 countries: secondary analysis of global cancer statistics
Li Q, Xia C, Li H, Yan X, Yang F, Cao M, Zhang S, Teng Y, He S, Cao M and Chen W
Cancer is a major public health problem and represents substantial disparities worldwide. This study reported estimates for 36 cancers across 185 countries by incidence, mortality, 5-year prevalence, mortality-to-prevalence ratio (MPR), and mortality-to-incidence ratio (MIR) to examine its association with human development index (HDI) and gross national income (GNI). Data were collected from the GLOBOCAN 2020. MPR and MIR were calculated by sex, age group, country, and cancer type and then summarized into totals. Segi's population and global cancer spectrum were used to calculate age- and type-standardized ratios. Correlation analyses were conducted to assess associations. Results showed that breast cancer was the most diagnosed cancer globally. Low- and middle-income countries had high MPR and MIR. Cancers of esophagus, pancreas, and liver had the highest ratios. Males and the older population had the highest ratios. HDI and GNI were positively correlated with incidence and mortality but negatively correlated with MPR/MIR. Substantial disparities in cancer burden were observed among 36 cancer types across 185 countries. Socioeconomic development may contribute to narrowing these disparities, and tailored strategies are crucial for regional- and country-specific cancer control.
A narrative review of lifestyle management guidelines for metabolic dysfunction-associated steatotic liver disease
Ivancovsky Wajcman D, Byrne CJ, Dillon JF, Brennan PN, Villota-Rivas M, Younossi ZM, Allen AM, Crespo J, Gerber LH and Lazarus JV
Metabolic dysfunction-associated steatotic liver disease (MASLD) management guidelines have been published worldwide; we aimed to summarize, categorize and compare their lifestyle intervention recommendations.
Snakebite incidence and healthcare-seeking behaviors in Eastern Province, Rwanda: A cross-sectional study
Hakizimana D, MacDonald LE, Kampire HT, Bonaventure M, Tadesse M, Murara E, Dusabe L, Ishema L and Schurer JM
Snakebite envenoming (SBE) is a potentially life-threatening event that can lead to severe physical, mental, and economic hardships, particularly in under-resourced regions like sub-Saharan Africa. In Rwanda, there have been no epidemiological assessments of SBE to guide the Ministry of Health in its efforts to reduce the burden. This study had two main objectives: first, to estimate the incidence of snakebites across districts, and second, to describe formal versus informal healthcare seeking behaviors among snakebite victims in Eastern Province, Rwanda in 2020.
Essential and multifunctional mpox virus E5 helicase-primase in double and single hexamer
Xu Y, Wu Y, Zhang Y, Gao K, Wu X, Yang Y, Li D, Yang B, Zhang Z and Dong C
An outbreak of mpox virus in May 2022 has spread over 110 nonpandemic regions in the world, posing a great threat to global health. Mpox virus E5, a helicase-primase, plays an essential role in DNA replication, but the molecular mechanisms are elusive. Here, we report seven structures of mpox virus E5 in a double hexamer (DH) and six in single hexamer in different conformations, indicating a rotation mechanism for helicase and a coupling action for primase. The DH is formed through the interface of zinc-binding domains, and the central channel density indicates potential double-stranded DNA (dsDNA), which helps to identify dsDNA binding residues Arg, Lys, Lys, and Lys. Our work is important not only for understanding poxviral DNA replication but also for the development of novel therapeutics for serious poxviral infections including smallpox virus and mpox virus.
Presentation and outcomes of Lassa fever in children in Nigeria: a prospective cohort study (LASCOPE)
Duvignaud A, Etafo IC, Jaspard M, Salau Q, Serra B, Kareem AJ, Juchet S, Jegede TO, Gabillard D, Abidoye AT, Le Gal C, Abejegah C, Owhin S, Okwaraeke K, Doutchi M, Vihundira JK, Besong-Lache RM, Seri B, Bérerd-Camara M, Salam APA, Olayinka A, Horby P, Ogbaini-Emovon E, Duraffour S, Ahmed LA, Günther S, Adedosu AN, Anglaret X, Malvy D, Lang HJ and Ayodeji OO
Data on the presentation, management and outcomes of Lassa fever (LF) in children are limited.
More With Less: Diffusing Innovations in Cardiovascular Service Delivery
Longenecker CT, Brant L, Okello E and Beaton A
A Comprehensive Analysis of COVID-19 Misinformation, Public Health Impacts, and Communication Strategies: Scoping Review
Kisa S and Kisa A
The COVID-19 pandemic was marked by an infodemic, characterized by the rapid spread of both accurate and false information, which significantly affected public health. This infodemic led to confusion, mistrust in health authorities, noncompliance with health guidelines, and engagement in risky health behaviors. Understanding the dynamics of misinformation during the pandemic is crucial for developing effective public health communication strategies.
Correction: Current Use and Discrepancies in the Adoption of Health-Related Internet of Things and Apps Among Working Women in Japan: Large-Scale, Internet-Based, Cross-Sectional Survey
Sasayama K, Nishimura E, Yamaji N, Ota E, Tachimori H, Igarashi A, Arata N, Yoneoka D and Saito E
[This corrects the article DOI: 10.2196/51537.].
IUSTI Europe position statement on use of DoxyPEP: June 2024
Sherrard J, Gokengin D, Winter A, Marks M, Unemo M, Jensen JS, Cusini M, Mårdh O and
This position statement is aimed at front-line clinical practitioners and public health authorities in WHO European Region providing services for people wishing to reduce their risk of acquiring sexually transmitted infections (STIs), including HIV.
Vitiligo - a disease: A position paper on stigmatization, life quality impairment and psychosocial comorbidity
Böhm M, Sommer R, Gieler U, Staubach P, Zink A, Apfelbacher C and Peters EMJ
Vitiligo is a common disorder characterized by the visible loss of skin pigmentation. Non-segmental vitiligo (NSV) is the major subtype. The disease is caused by autoimmune-mediated destruction of melanocytes. Vitiligo leads to stigmatization and a significant reduction in quality of life. Disregarding the psychosocial burden, vitiligo is sometimes viewed solely as a cosmetic problem and, according to a global survey, is diagnosed on average only after 2.4 years. This delay contributes to a considerable burden of disease, including suicidal ideation. Stigmatization promotes the development of psychological comorbidities such as anxiety and depressive disorders, with prevalence rates varying by country and study (0.1%-67.9%). Data for Germany are heterogeneous and largely based on estimates. Due to psychosocial factors, the inflammatory component, and a higher incidence of somatic comorbidities, NSV may be regarded as an inflammatory systemic disease. We recommend optimizing care by incorporating the assessment of quality of life as a standard in routine care, in addition to monitoring disease activity. Moreover, early screening for psychological comorbidities is crucial to initiate appropriate treatment before the condition becomes chronic and cumulative (irreversible) impairments occur. The goal is a personalized and patient-centered integrated care approach that sustainably improves the health status of those affected.
Association of Victimization by Sex among Public Facing Bus and Subway Transit Workers, New York City
Vlahov D, Hagen D, Cziner M, Merdjanoff A, Sherman MF and Gershon RR
Federal data indicate that assaults on transit workers resulting in fatalities or hospitalizations tripled between 2008 and 2022. The data indicated a peri-pandemic surge of assault-related fatalities and hospitalizations, but assaults with less dire outcomes were not recorded. In collaboration with the Transport Workers Union, Local 100, we conducted an online survey in late 2023 through early 2024 of New York City public-facing bus and subway workers that focused on their work experiences during the 2020-2023 period of the COVID-19 pandemic. Items for this analysis on victimization included measures of physical and sexual assault/harassment, verbal harassment/intimidation, theft, and demographic characteristics (e.g., sex, race, work division). We estimated separate modified Poisson models for each of the four outcomes, yielding prevalence ratios (PRs) and 95% confidence intervals (CIs). Potential interactions between variables with strong main effects in the adjusted model were further examined using product terms. Among 1297 respondents, 89.0% reported any victimization; respondents also reported physical assault (48.6%), sexual assault/harassment (6.3%), verbal harassment/intimidation (48.7%), and theft on the transit system (20.6%). Physical assault was significantly more common among women in the bus division compared to female subway workers, male bus workers, and male subway workers (adjusted PR (aPR) = 3.54; reference = male subway workers; Wald test p < .001). With the same reference group, sexual assault/harassment was more frequently reported among female subway workers (aPR = 5.15; Wald test, p < .001), but verbal assault/intimidation and experiencing theft were least common among women in the bus division (aPR = 0.22 and 0.13, respectively; Wald tests, p < .001). These data point to the need for greater attention to record and report on victimization against workers in both buses and subway.
The Growing Influence of the Financial Sector in Serious Illness Care in the United States
Hunt LJ and Morrison RS
Facile construction of efficient WO/VO coupled g-CN ternary composite photocatalyst for environmental emergent aqueous pollutant degradation: Stability, degradation reaction pathway and effect of pH evaluation
Shanthini K, Manivannan V, Govindan R, Praburaman L, Al-Humaid LA, Oh TH and Vignesh S
Currently, one of the primary challenges that human society must overcome is the task of decreasing the amount of energy used and the adverse effects that it has on the environment. The daily increase in liquid waste (comprising organic pollutants) is a direct result of the creation and expansion of new companies, causing significant environmental disruption. Water contamination is attributed to several industries such as textile, chemical, poultry, dairy, and pharmaceutical. In this study, we present the successful degradation of methylene blue dye using g-CN (GCN) mixed with WO and VO composites (GCN/WO/VO ternary composite) as a photocatalyst, prepared by a simple mechanochemistry method. The GCN/WO/VO ternary composite revealed a notable enhancement in photocatalytic performance, achieving around 97% degradation of aqueous methylene blue (MB). This performance surpasses that of the individual photocatalysts, namely pure GCN, GCN/WO, and GCN/VO composites. Furthermore, the GCN/WO/VO ternary composite exhibited exceptional stability even after undergoing five consecutive cycles. The exceptional photocatalytic activity of the GCN/WO/VO ternary composite can be ascribed to the synergistic effect of metal-free GCN and metal oxides, resulting in the alteration of the band gap and suppression of charge recombination in the ternary photocatalyst. This study offers a better platform for understanding the characteristics of materials and their photocatalytic performance under visible light conditions.
Delayed global standardization and prefectural disparities in systematic lupus erythematosus treatment in Japan: a nationwide study using the National Database of Health Insurance Claims and Specific Health Checkups of Japan
Yokogawa N, Sakai R, Matsushita M, Shimizu M, Inoue Y, Inoue E, Yamaji K, Mori M and Miyamae T
To evaluate the status of the global standardization of, and prefectural differences in, systematic lupus erythematosus (SLE) treatments in Japan.
Coordinated analysis of groundwater spatiotemporal chemical characteristics, water quality, and potential human health risks with sustainable development in semi-arid regions
Wang Z, Wang Y, Shi M, Ji W, Li R and Wang X
The emergence of large-scale time-series data and advancements in computational power have opened new avenues for analyzing the spatiotemporal evolution of groundwater chemistry, water quality, and human health risks. This paper utilizes hydrogeochemical methods to elucidate the controlling factors of water chemical components based on the test results of 124 groundwater samples collected from 31 monitoring wells in Fuxin City, Liaoning Province, China, from 2018 to 2021. By integrating the Random Forest and Enhanced Water Quality Index methods for water quality assessment and employing the Human Health Risk Assessment (HHRA) model to analyze human health risks, our findings indicate that the groundwater is mildly alkaline, with SO·Cl-Ca·Mg and HCO-Ca·Mg as the dominant hydrochemical types, primarily derived from the dissolution of carbonate and silicate minerals such as dolomite, limestone, and andesite, and cation exchange reactions. The EI_RF water quality evaluation model reveals that the overall water quality in the study area is poor, with Class I and II water quality zones mainly located in the northeastern and central parts of the study area, showing a gradual transition from Class I and II in the northeast to Classes IV and V in the southwest, significantly influenced by NO, TH, TDS, and SO. The HHRA model results indicate that the potential non-carcinogenic risk of groundwater nitrates has a severe impact on infants, with the spatial distribution being low in the northeast and high in the southwest. Due to industrial activities, agricultural practices, and population growth, certain areas in developing countries such as China and India exhibit nitrate concentrations significantly higher than those in most international regions, highlighting global environmental and public health challenges. This underscores the importance of enhancing groundwater monitoring and implementing measures to mitigate pollution. These research outcomes hold significant implications for the government in formulating rational protection and management measures to ensure the sustainable utilization of groundwater resources.
Singlestick purchases: a comparative cross-country analysis in 10 African countries, Global Adult Tobacco Survey, 2012-21
Mbulo L, Blutcher-Nelson G, Chowdhury PP, Egbe CO, Bouhabib A and Palipudi K
We utilized Global Adult Tobacco Survey data to examine singlestick purchases and related demographic characteristics in 10 African countries (Botswana, Cameroon, Ethiopia, Kenya, Nigeria, Mauritania, Senegal, South Africa, Uganda and Tanzania). Results show the weighted percentages and prevalence ratios with predicted marginal means to evaluate significant differences between groups (P < 0.05). The prevalence of singlestick purchases among the 10 African countries ranged from 48.4% in South Africa to 92.0% in Tanzania. Across countries, the incidence of singlestick purchases was higher in urban areas than rural areas in Kenya; among those aged 15-24 years versus those aged 45 years and older in Botswana, Ethiopia, Mauritania, Nigeria and South Africa; and among those aged 25-44 years versus those aged 45 years and older in Botswana, South Africa and Tanzania. The incidence in Botswana was higher among adults with no formal or primary education than among those with secondary or higher education. In South Africa, the incidence was higher among adults in the middle or lower wealth index than among those in the high or highest wealth index. The findings suggest opportunities for strengthening efforts to prevent singlestick purchases through effective legislation and enforcement in line with Article 16 of the World Health Organization Framework Convention on Tobacco Control.
A review of groundwater iodine mobilization, and application of isotopes in high iodine groundwater
Zheng Y, Li H, Li M, Zhang C, Su S and Xiao H
Excessive intake of iodine will do harm to human health. In recent years, high iodine groundwater has become a global concern after high arsenic and high fluorine groundwater. A deep understanding of the environmental factors affecting iodine accumulation in groundwater and the mechanism of migration and transformation is the scientific prerequisite for effective prevention and control of iodine pollution in groundwater. The paper comprehensively investigated the relevant literature on iodine pollution of groundwater and summarized the present spatial distribution and hydrochemical characteristics of iodine-enriched groundwater. Environmental factors and hydrogeological conditions affecting iodine enrichment in aquifers are systematically summarized. An in-depth analysis of the hydrologic geochemistry, physical chemistry, biogeochemistry and human impacts of iodine transport and transformation in the surface environment was conducted, the results and conclusions in the field of high iodine groundwater research are summarized comprehensively and systematically. Stable isotope can be used as a powerful tool to track the sources of hydrochemical components, biogeochemistry processes, recharge sources and flow paths of groundwater in hydrogeological systems, to provide effective research methods and means for the study of high iodine groundwater system, and deepen the understanding of the formation mechanism of high iodine groundwater, the application of isotopic technique in high iodine groundwater is also systematically summarized, which enriches the method and theory of high iodine groundwater research. This paper provides more scientific basis for the prevention and control of groundwater iodine pollution and the management of groundwater resources in water-scarce areas.
Evaluation of YouTube as a Health Education Resource for Skin Graft Procedures
Torres GB, Brondeel KC, Sledge TR, Nus BM, Kamma SA, Wu K and Branski LK
Recent studies indicate that YouTube has become a primary source of healthcare information for patients. Videos about skin graft procedures on YouTube have accumulated millions of views, yet there lacks a publication investigating the educational quality of this content. With current literature revealing misleading healthcare information found on YouTube, this study aims to evaluate the educational quality of videos related to skin graft procedures. YouTube was searched for various terms such as "Skin Graft Procedures" and "Skin Graft Surgery." 105 videos were assessed, with 21 excluded. Four independent reviewers rated the material with the Global Quality Scale (5 = highest quality, 1 = lowest quality) to judge educational value. Viewership, source, modality, and date of upload were also collected from each video and compiled for further analysis. The average Global Quality Scale was 2.60 amongst all videos, with videos led by physicians recording significantly higher scores than those not led by physicians (p<0.01). In comparing educational modalities, physician-led presentations provided the highest educational value, whereas live surgeries and consumer-friendly content contained low educational quality (p<0.01). Assessing videos split into cohorts based on viewership noted a significantly higher Global Quality Scale in videos with lower view counts (p<0.05). Skin graft videos on YouTube largely provide low quality information. Videos performed by physicians, particularly physician-led presentations, significantly improved the educational quality of skin graft content. Physicians must involve themselves in enhancing the quality of online content to better guide patients in navigating treatment options and making healthcare decisions.
Global pandemic preparedness: learning from the COVID-19 vaccine development and distribution
Agampodi S, Mogeni OD, Chandler R, Pansuriya M, Kim JH and Excler JL
The COVID-19 pandemic catalyzed unprecedented vaccine innovation, revealing critical shortcomings in achieving equitable vaccine access and underscoring the need for a focused review of the lessons learned to inform future pandemic preparedness, with emphasis on vaccine delivery, equity, and challenges in LMICs.
Health Information Seeking on the Internet Among Patients With and Without Cancer in a Region Affected by the 2011 Fukushima Triple Disaster: Cross-Sectional Study
Kaneda Y, Ozaki A, Murakami M, Sawano T, Nomura S, Bhandari D, Saito H, Tsubokura M, Yamaoka K, Nakata Y, Tsukada M and Ohira H
Health information seeking via the internet among patients with cancer in disaster-affected areas is underresearched.
Hepatoprotective effects of diosmin: a narrative review
Hassanein EHM, Althagafy HS, Baraka MA and Amin H
Liver diseases represent a formidable global health threat. Hesperidin, a flavonoid found in citrus fruits, is the source of diosmin (DS). The in vivo and in vitro investigations of the pharmacological effects of DS reveal that it exhibits tremendous beneficial effects, such as fighting against inflammation, oxidative stress, and fibrosis. These effects have been noticed in various disease models, emphasizing the potential therapeutic value of DS in tackling diverse pathological conditions. Interestingly, DS has promising liver-defense capabilities against a range of hepatic illnesses, such as radiation-induced hepatic injury, liver ischemia/reperfusion injury, alcoholic hepatic disease, nonalcoholic fatty liver disease (NAFLD), and hepatocellular carcinoma (HCC). Furthermore, DS demonstrates potential hepatoprotective effects against environmental toxins, such as heavy metals. DS activates PPAR-γ and Nrf2, leading to antioxidant effects that reduce oxidative stress. Moreover, DS suppresses NF-κB, NLRP3, MAPK activities, and cytokine production (TNF-α and IL-1β), resulting in inflammation suppression. These anti-inflammatory effects are attributed to the activation of PPAR-γ and Nrf2, which are NF-κB inhibitors. This review aims to comprehensively discuss the hepatoprotective capacity of DS, elucidating the underlying mechanisms and identifying several research avenues that warrant further exploration to ascertain the prospective clinical advantages of DS intake as a viable strategy for the treatment of hepatic illnesses.
Chitin synthase genes of Aedes albopictus and their effects on development of pupae
Ruiling Z, Sha A and Zhong Z
The invasive species Aedes albopictus is a major vector of several arboviruses. The global spread of this species seriously threatens human health. Insecticide resistance is an increasing problem worldwide that limits the efficacy of mosquito control. As the major structural component of cuticles, chitin is indispensable to insects. Chitin synthase (CHS) is the enzyme that catalyzes the biosynthesis of chitin at the final step. In this study, two CHS genes of Aedes albopictus (AaCHS1 and AaCHS2) were identified and their basic characteristics were evaluated via bioinformatics analysis. The highest abundance of AaCHS1 transcripts was detected in pupae, whereas that of AaCHS2 transcripts was detected in females; the highest expression levels of AaCHS1 and AaCHS2 were found in the epidermis and the midgut of pupae, respectively. The survival and emergence rates of pupae were significantly reduced after the injection of double-stranded RNA of AaCHS1 or AaCHS2, indicating that both AaCHS1 and AaCHS2 play crucial roles in the pupal development. In addition, the chitin content of pupae was obviously decreased after the suppression of AaCHS1 expression by RNA interference (RNAi) treatment. This influence of the RNAi treatment was further supported by the reduced chitin thickness and weakened chitin fluorescence signal in the new cuticle. The midgut of pupae presented a reduced intensity of the chitin fluorescence signal along with RNAi treatment specific to AaCHS2 expression. The results of this study indicate that CHS genes may be suitable as molecular targets used for controlling mosquitoes.
Exploring healthcare workers' perceptions of child health research at Kamuzu Central Hospital, Malawi: an interpretative phenomenological analysis
Ndambo MK, Ndambo TB and Manda-Taylor L
Children's health is a global public health priority and a determinant of development and sustainability. Its effective delivery and further improvements require constant and dedicated research on children, especially by child healthcare workers (HCWs). Studies have shown a high involvement of child HCWs from developed countries in child health research, with an under-representation from the global south in authorship and leadership in international collaborations. To our knowledge, there is very little literature on challenges faced by child HCWs in Malawi in conducting child health research. We sought to explore the lived experiences of child HCWs at Kamuzu Central Hospital (KCH) in Malawi by examining their perceptions of child health research and assessing the availability of child health research opportunities.
sp. nov., isolated from human upper respiratory samples collected in Botswana
Popowitch EB, Boiditswe SC, Patel MZ, Aquino JN, Sozat AK, Caiazzo AJ, Maldonado-Barragán A, Hurst JH, Steenhoff AP and Kelly MS
Four strains (MSK211, MSK294, MSK312, MSK433) of a novel species were cultured from nasopharyngeal swabs collected from mother-infant dyads in southern Botswana. These strains grew optimally on tryptic soy agar with 5% sheep blood solid medium and in fastidious bacteria broth. Colonies on tryptic soy agar with 5% sheep blood agar appeared grey or white with a flat, smooth surface and variable alpha haemolysis. Cells were Gram-positive, non-spore-forming, non-motile cocci that lacked catalase or oxidase activity. Major fatty acids were C (palmitic acid), Cω9 (oleic acid), and C (stearic acid). Analyses of 16S rRNA gene sequences identified these strains as belonging to the genus (family ), which currently contains only a single validly published species (). Whole-genome sequencing revealed that the genomes of these strains are 1.98-2.07 Mbp in size and have a G+C content of 39.6-39.9 mol%. Comparisons of these genomes to publicly available genomes of yielded average nucleotide identities and DNA-DNA hybridization values of 92.3-92.9% and 49.1-51.4%, respectively. These results indicate that these strains represent a novel species of , for which we propose the name sp. nov., with the type strain MSK294 (=DSM 117171=JCM 36673).
Design, Synthesis, and Evaluation of the Antitubercular Activity of 5-Phenyl Substituted-5, 6-dihydropyrido[2, 3-]pyrimidine-4, 7(, )-dione Compounds
Sun L, Kou S, Wang B, Wang Y, Meng J, Liu T, Ma Y, Zhao J, Yi H, Cen S, Lu Y and Li Z
Tuberculosis (TB) remains a major public health challenge, with research on new anti-TB drugs crucial for global TB elimination efforts. Here, we report a novel class of anti-TB agents. Especially, compounds and exhibited the highest activity [minimum inhibitory concentration (MIC) H37Rv: 0.16 and 0.12 μg/mL]. Chiral resolution was performed on compounds and ; the isomers were evaluated for their activity and safety, confirming that the -isomer and displayed significant anti-TB activity (MIC H37Rv: 0.03-0.06 μg/mL; MDR-: 0.125-0.06 μg/mL) and low hERG toxicity. Further evaluations on and demonstrated good metabolic stability, favorable kinetic parameters and oral bioavailability (F: 56.7 and 63.8%, respectively). The results of activity assessment indicate that and exhibit protective and therapeutic effects on zebrafish larvae and adult zebrafish infected with . Based on these results, compounds and are considered promising candidates for further in-depth studies.
[Not Available]
Riis ÅG, Jensenius M, Greve OJ, Lier T, Nylenna Ø and Yaqub S
Cystic echinococcosis is a zoonosis caused by the parasite Echinococcus granulosus. The disease rarely occurs in Norway, but constitutes a significant global health issue.
Blood metal concentrations and cardiac structure and function in total joint arthroplasty patients
Brennan PC, Peterson SM, O'Byrne TJ, Laporta ML, Wyles CC, Jannetto PJ, Kane GC, Vassilaki M and Maradit Kremers H
There is concern regarding potential long-term cardiotoxicity with systemic distribution of metals in total joint arthroplasty (TJA) patients.
Why Was the Azithromycin "for Life" Trial Necessary?
Maitland K and Walker AS
The identification of heterogeneous reactive oxygen subtypes in esophageal squamous cell carcinoma to aid patient prognosis and immunotherapy
Lu Q, Yang Q, Zhao J, Li G, Zhang J, Jia C, Wan Y and Chen Y
Esophageal cancer is increasingly recognized as a significant global malignancy. The main pathological subtype of this cancer is esophageal squamous cell carcinoma (ESCC), which displays a higher degree of malignancy and a poorer prognosis. Reactive oxygen species (ROS) play a critical role in modulating the immune response to tumors, and understanding the regulation of ROS in ESCC could lead to novel and improved therapeutic strategies for ESCC patients.
Azithromycin to Reduce Mortality - An Adaptive Cluster-Randomized Trial
O'Brien KS, Arzika AM, Amza A, Maliki R, Aichatou B, Bello IM, Beidi D, Galo N, Harouna N, Karamba AM, Mahamadou S, Abarchi M, Ibrahim A, Lebas E, Peterson B, Liu Z, Le V, Colby E, Doan T, Keenan JD, Oldenburg CE, Porco TC, Arnold BF, Lietman TM and
Twice-yearly mass distribution of azithromycin to children is a promising intervention to reduce childhood mortality in sub-Saharan Africa. The World Health Organization recommended restricting distribution to infants 1 to 11 months of age to mitigate antimicrobial resistance, although this more limited treatment had not yet been tested.
Mega-analysis of the brain-age gap in substance use disorder: An ENIGMA Addiction working group study
Scheffler F, Ipser J, Pancholi D, Murphy A, Cao Z, Ottino-González J, , Thompson PM, Shoptaw S, Conrod P, Mackey S, Garavan H and Stein DJ
The brain age gap (BAG), calculated as the difference between a machine learning model-based predicted brain age and chronological age, has been increasingly investigated in psychiatric disorders. Tobacco and alcohol use are associated with increased BAG; however, no studies have compared global and regional BAG across substances other than alcohol and tobacco. This study aimed to compare global and regional estimates of brain age in individuals with substance use disorders and healthy controls.
Global years lived with disability for musculoskeletal disorders in adults 70 Years and older from 1990 to 2019, and projections to 2040
Chen C, Du Y, Cao K, You Y, Pi L, Jiang D, Yang M, Wu X, Chen M, Zhou W, Qi J, Chen D, Yan R, Zhu C and Yang S
In this article, we provided a comprehensive overview and in-depth analysis of global patterns and temporal trends in years lived with disability (YLDs) for musculoskeletal (MSK) disorders in individuals aged ≥70. Data on YLDs for MSK disorders in individuals aged ≥70 were obtained from the Global Burden of Disease 2019. The average annual percentage change (AAPC) was calculated to assess the temporal trends in the YLDs rate of MSK disorders. A Bayesian Age-Period-Cohort model was used to predict the YLDs rate up to the year 2040. In 2019, the global rate of YLDs for MSK disorders in individuals aged ≥70 were 4819.81 (95 % UI: 3402.91 - 6550.77) per 100,000 persons. The YLDs rate of MSK disorders in female was 1.36 times higher than that in male, and was highest in high SDI regions. From 1990 to 2019, the global YLDs rate showed a slightly downward trend (AAPC = -0.04 %, 95 % CI: -0.06 % to -0.03 %), while it significantly increased in high, low-middle, low SDI regions. Tobacco and high body mass index were the primary risk factors worldwide, while in low SDI regions, occupational risks emerged as the predominant factors. Up to 2040, the global YLDs rate of MSK disorders are expected to increase by 1.78 %, with 36.39 %, 20.66 %, 18.96 % and 5.32 % growth in other MSK disorders, rheumatoid arthritis, neck pain and osteoarthritis. MSK disorders are a significant and continuously growing public health concern among older adults. Tailored interventions should be developed for older adults, taking into account the variations across distributions, trends, and risk factors in terms of sex and SDI levels.
Investigation of non-communicable diseases prevalence, patterns, and patient outcomes in hospitalized populations: a prospective observational study in three tertiary hospitals
Belayneh A, Chelkeba L, Amare F, Fisseha H, Abdissa SG, Kaba M, Patel SA and Ali MK
Non-communicable diseases (NCDs) pose a significant global health challenge, constituting over 80% of mortality and morbidity. This burden is particularly pronounced in low- and middle-income countries (LMICs), including Ethiopia. Despite this, there's limited research on this issue in Africa. This study aims to investigate the prevalence, patterns, and outcomes of NCDs in hospitalized populations across three tertiary hospitals in Ethiopia.
How to decouple tourism growth from carbon emission? A panel data from China and tourist nations
Gan H, Zhu D and Waqas M
A pervasive threat regarding human health, ecological balance, progress, and sustainability marks the current era. Many nations are grappling with the consequences of the overabundance of carbon emissions from a wide range of destructive human activities, which is the primary driver of air pollution, global warming, and warming. Thus, while some countries are squandering their riches, others are making great strides to keep the environment clean and green so that future generations may thrive. National governments and policymakers are now focusing a lot of energy on addressing the dangers posed by environmental concerns and the threat of climate change. A very contentious issue in recent years has been the link between environmental change and tourism and its vulnerability. This study focuses on the impact of fluctuating visitor numbers on greenhouse gas emissions, the primary gas responsible for the acceleration of global warming and other environmental changes. Therefore, we look at how the most visited countries' carbon emissions have changed due to increased tourism. The ecological effects of tourism on a regional scale are investigated using a panel data analysis spanning the years 2001-2018 in China, including the top 80 countries. The best-modified assessment methodologies determine the overall, direct, and indirect impact of tourist spending on carbon emissions. The findings demonstrate that CO2 emissions might be reduced by environmental regulation, urbanization, and tourist revenue and that they could be increased through economic expansion, population, and tourism. Due to this distinction, tourists' overall impact is much more harmful than their direct impact. In addition, a U-shape is formed by the direct effects of carbon emissions and a growing economy, and vice versa. Several factors impact environmental regulation, including population density, population growth, pollution, and GDP growth. Spending on infrastructure development and economic expansion also considerably mitigates the impacts of tourism and environmental alteration. The results reveal that a nation's emissions often rise with the expansion of its tourism industry. Still, they begin to decline after certain levels and show that the link between the two has important policy implications.
Comment on "Usability of the ROBOVID mobile app for health education about COVID-19"
Daungsupawong H and Wiwanitkit V
Building Clinical Care Capacity for Patients With Special Pathogens in Advance of the Next Outbreak
Wiesner L, Flinn J, Brewer B, Resnick A, Carrasco SV, Garibaldi BT, Wohl DA, Little B, Schnell NA, Wortmann G, DeAtley C, Kappler SB and Fischer WA
In response to the growing number of outbreaks of emerging infectious diseases, the US Administration for Strategic Preparedness and Response (ASPR) has embarked on a plan to improve and expand special pathogen patient care capabilities. To achieve this, ASPR is developing a coordinated network of Regional Emerging Special Pathogen Treatment Centers (RESPTCs) to serve as state-of-the-art facilities staffed by a highly trained workforce to care for and manage special pathogen patients across the lifespan. The RESPTC network represents the operational arm of a broader US National Special Pathogen System of care to prevent and prepare for the next infectious disease outbreak. RESPTCs are strategically located in every region across the country and form a network linking local and regional healthcare partners to enhance national preparedness through training in best practices for detection, isolation, and treatment of individuals suspected of or known to be infected with a special pathogen. This local, regional, and national network is also designed to lead a coordinated response that includes the dissemination of accurate and trustworthy information to responders and the public. The overarching goal of the RESPTCs is to serve as a valuable resource for clinical care, training, and material support to meet current and future major infectious diseases challenges. In this case study, 2 new RESPTCs, MedStar Washington Hospital Center and the University of North Carolina, describe their experiences related to designing a biocontainment unit, creating clinical teams, building staff resiliency, receiving mentoring from regional RESPTC partners, and developing opportunities for innovation.
Albumin-Mediated Drug Uptake by Organic Anion Transporter 1/3 Is Real: Implications for the Prediction of Active Renal Secretion Clearance
Tan SPF, Tillmann A, Murby SJ, Rostami-Hodjegan A, Scotcher D and Galetin A
Modulation of the transport-mediated active uptake by human serum albumin (HSA) for highly protein-bound substrates has been reported and improved the -to- extrapolation (IVIVE) of hepatic clearance. However, evidence for the relevance of such a phenomenon in the case of renal transporters is sparse. In this study, transport of renal organic anion transporter 1 or 3 (OAT1/3) substrates into conditionally immortalized proximal tubular epithelial cells transduced with OAT1/3 was measured in the presence and absence of 1 and 4% HSA while keeping the unbound substrate concentration constant (based on measured fraction unbound, ). In the presence of 4% HSA, the unbound intrinsic active uptake clearance (CL) of six highly protein-bound substrates increased substantially relative to the HSA-free control (3.5- to 122-fold for the OAT1 CL, and up to 28-fold for the OAT3 CL). The albumin-mediated uptake effect (fold increase in CL) was more pronounced with highly bound substrates compared to no effect seen for weakly protein-bound substrates adefovir (OAT1-specific) and oseltamivir carboxylate (OAT3-specific). The relationship between OAT1/3 CL and agreed with the facilitated-dissociation model; a relationship was established between the albumin-mediated fold change in CL, and for both the OAT1 and OAT3, with implications for IVIVE modeling. The relative activity factor and the relative expression factor based on global proteomic quantification of OAT1/3 expression were applied for IVIVE of renal clearance. The inclusion of HSA improved the bottom-up prediction of the level of OAT1/3-mediated secretion and renal clearance (CL and CL), in contrast to the underprediction observed with the control (HSA-free) scenario. For the first time, this study confirmed the presence of the albumin-mediated uptake effect with renal OAT1/3 transporters; the extent of the effect was more pronounced for highly protein-bound substrates. We recommend the inclusion of HSA in routine OAT1/3 assays due to considerable improvements in the IVIVE of CL and CL.
Single-cell RNA sequencing reveals the effects of high-fat diet on oocyte and early embryo development in female mice
Zhu Q, Li F, Wang H, Wang X, Xiang Y, Ding H, Wu H, Xu C, Weng L, Cai J, Xu T, Liang N, Hong X, Xue M and Ge H
Obesity is a global health issue with detrimental effects on various human organs, including the reproductive system. Observational human data and several lines of animal experimental data suggest that maternal obesity impairs ovarian function and early embryo development, but the precise pathogenesis remains unclear.
Shifts in Serum Bile Acid Profiles Associated with Barrett's Esophagus and Stages of Progression to Esophageal Adenocarcinoma
Kumar A, Gwalani P, Iyer PG, Wang KK, Falk GW, Ginsberg GG, Lightdale CJ, Del Portillo A, Lagana SM, Li Y, Li H, Genkinger J, Jin Z, Rustgi AK, Wang TC, Wang HH, Quante M and Abrams JA
Reflux bile acids are thought to promote EAC, but the role of systemic bile acids is unknown. This study aimed to assess associations between systemic bile acids and stages of Barrett's esophagus (BE) progression.
CT1812 biomarker signature from a meta-analysis of CSF proteomic findings from two Phase 2 clinical trials in Alzheimer's disease
Lizama BN, Williams C, North HA, Pandey K, Duong D, Di Caro V, Mecca AP, Blennow K, Zetterberg H, Levey AI, Grundman M, van Dyck CH, Caggiano AO, Seyfried NT and Hamby ME
CT1812 is in clinical development for the treatment of Alzheimer's disease (AD). Cerebrospinal fluid (CSF) exploratory proteomics was employed to identify pharmacodynamic biomarkers of CT1812 in mild to moderate AD from two independent clinical trials.
Gut phageome in Mexican Americans: a population at high risk for metabolic dysfunction-associated steatotic liver disease and diabetes
Kwan S-Y, Sabotta CM, Cruz LR, Wong MC, Ajami NJ, McCormick JB, Fisher-Hoch SP and Beretta L
Mexican Americans are disproportionally affected by metabolic dysfunction-associated steatotic liver disease (MASLD), which often co-occurs with diabetes. Despite extensive evidence on the causative role of the gut microbiome in MASLD, studies determining the involvement of the gut phageome are scarce. In this cross-sectional study, we characterized the gut phageome in Mexican Americans of South Texas by stool shotgun metagenomic sequencing of 340 subjects, concurrently screened for liver steatosis by transient elastography. Inter-individual variations in the phageome were associated with gender, country of birth, diabetes, and liver steatosis. The phage signatures for diabetes and liver steatosis were subsequently determined. Enrichment of was associated with both diabetes and liver steatosis. Diabetes was further associated with the enrichment of predominantly temperate phages, some of which possessed virulence factors. Liver steatosis was associated with the depletion of phages r1t and BK5-T, and enrichment of the globally prevalent phages, including members of genus cluster IX (, ) and VI (). The phages showed strong correlations and co-occurrence with , while the phages, , , and UAG-readthrough crAss clade correlated and co-occurred with . In conclusion, we identified the gut phageome signatures for two closely linked metabolic diseases with significant global burden. These phage signatures may have utility in risk modeling and disease prevention in this high-risk population, and identification of potential bacterial targets for phage therapy.IMPORTANCEPhages influence human health and disease by shaping the gut bacterial community. Using stool samples from a high-risk Mexican American population, we provide insights into the gut phageome changes associated with diabetes and liver steatosis, two closely linked metabolic diseases with significant global burden. Common to both diseases was an enrichment of , a group of phages that infect bacterial hosts chronically without lysis, allowing them to significantly influence bacterial growth, virulence, motility, biofilm formation, and horizontal gene transfer. Diabetes was additionally associated with the enrichment of -infecting phages, some of which contained virulence factors. Liver steatosis was additionally associated with the depletion of -infecting phages, and enrichment of phages, a group of virulent phages with high global prevalence and persistence across generations. These phageome signatures may have utility in risk modeling, as well as identify potential bacterial targets for phage therapy.
Multidisciplinary care meeting practices across diverse international settings
Pershad AR, Graetz D, Le MA, Forrest H, Gonzalez-Guzman M and Friedrich P
Multidisciplinary care (MDC) meetings improve the quality of cancer care by providing a space for interdisciplinary communication. The Pediatric Oncology Facility Integrated Local Evaluation (PrOFILE) tool assesses MDC meetings as part of the Service Integration module. We aimed to evaluate the characteristics of MDC meetings at institutions that completed PrOFILE.
The Mediating Role of Human Mobility in Temporal-Lagged Relationships Between Risk Perception and COVID-19 Dynamics in Taiwan: Statistical Modeling for Comparing the Pre-Omicron and Omicron Eras
Chang MC and Wen TH
The COVID-19 pandemic has profoundly impacted all aspects of human life for over 3 years. Understanding the evolution of public risk perception during these periods is crucial. Few studies explore the mechanisms for reducing disease transmission due to risk perception. Thus, we hypothesize that changes in human mobility play a mediating role between risk perception and the progression of the pandemic.
Determining the Disinfectants Resistance Genes and the Susceptibility to Common Disinfectants of Extensively Drug-Resistant Carbapenem-Resistant Strains at a Tertiary Hospital in China
Zhao K, Wang L, Deng J, Zuo Q, Adila M, Wang X, Dai Z and Tian P
Carbapenem-resistant (CRKP) infection has become a significant threat to global health. The application of chemical disinfectants is an effective infection control strategy to prevent the spread of CRKP in hospital environments. However, bacteria have shown reduced sensitivity to clinical disinfectants in recent years. Furthermore, bacteria can acquire antibiotic resistance due to the induction of disinfectants, posing a considerable challenge to hospital infection prevention and control. This study collected 68 CRKP strains from the Fifth Affiliated Hospital of Xinjiang Medical University in China from 2023 to 2024. These strains were isolated from the sputum, urine, and whole blood samples of patients diagnosed with CRKP infection. Antibiotic susceptibility tests were performed on CRKP strains. Concurrently, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of disinfectants (benzalkonium bromide, 1% iodophor disinfectant, alcohol, and chlorine-containing disinfectant) against the test isolates were determined by the broth microdilution method. The efflux pump genes (cepA, qacE, qacEΔ1, qacEΔ1-SUL1, oqxA, and oqxB) were detected using polymerase chain reaction. The results showed that 21 out of the 68 CRKP strains exhibited extensive drug resistance, whereas 47 were nonextensively drug-resistant. The MIC value for benzalkonium bromide disinfectants displayed statistically significant differences ( < 0.05) between extensively drug-resistant (XDR) and non-XDR strains. Additionally, the MBC values for benzalkonium bromide disinfectants and 1% iodophor disinfectants displayed statistically significant differences ( < 0.05) between XDR and non-XDR strains. The detection rates for the efflux pump genes were as follows: cepA 52.9%, qacE 39.7%, qacEΔ1 35.2%, qacEΔ1-SUL1 52.9%, oqxA 30.8%, and oqxB 32.3%. The detection rate of the qacEΔ1-SUL1 gene in XDR CRKP strains was significantly higher than in non-XDR CRKP strains ( < 0.05). This indicates a potential link between CRKP bacterial disinfectant efflux pump genes and CRKP bacterial resistance patterns. Ongoing monitoring of the declining sensitivity of XDR strains against disinfectants is essential for the effective control and prevention of superbug.
Effect of COVID-19 lockdowns on quality-of-life and health services access by socio-economic status in Australia
Feng YR, Li I, Kristoffersen I, Armstrong BK and Preen DB
This study examined changes in physical and mental health quality-of-life and health services access before and after the onset of the COVID-19 pandemic among individuals of lower and higher socio-economic status (SES) in Australia. Difference-in-differences and logistic regression models were undertaken using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey and government data on COVID-19 lockdowns between January 2020 and February 2021. Individuals from higher SES reported larger decreases in mental health quality-of-life scores than those from lower SES after the onset of the pandemic. Those from lower SES reported less disruption with any health services (24.2% vs 30.4%; OR = 0.68; p < 0.001), specifically dental services (8.2% vs 15.4%; OR = 0.51; p < 0.001) and allied health services (5.9% vs 8.5%; OR = 0.60; p < 0.001), compared with those from higher SES. Additional days under lockdown were associated with reduced access to all health services (OR = 1.19). Furthermore, long-term health conditions (higher SES: OR = 1.54) and scores indicative of poorer physical (lower SES: OR = 1.17; higher SES: OR = 1.07) and mental health (lower SES: OR = 1.16; higher SES: OR = 1.12) were associated with increased health services disruption. While individuals from higher SES were more likely than those from lower SES to experience greater relative declines in mental health and increased disruption with health services access, individuals with a greater apparent need for health services, regardless of SES, may have faced inequalities in accessing these services during the COVID-19 pandemic.
Strengthening International Collaboration for Global Health Security: The Role of the Infectious Disease Emergency Specialist Training Program and NETEC Partnership
Hibino H, Herstein JJ, Stern KL, Matsuzawa Y, Moroika S, Sugihara J, Takei T, Omagari N, Tewell A, Hunt RC, Mukherjee V and Lowe JJ
Myocardial mechanics in anorexia nervosa: a systematic review and meta-analysis of speckle tracking echocardiographic studies
Gherbesi E, Faggiano A, Sala C, Carugo S, Grassi G, Cuspidi C and Tadic M
Clinical complications of anorexia nervosa (AN) include cardiac structural and functional alterations. Available evidence on impaired myocardial deformation in AN patients without overt systolic dysfunction as assessed by left ventricular ejection fraction (LVEF) is scanty and based on a few studies. The aim of the present meta-analysis was to provide comprehensive and updated information on this issue.
Biallelic loss-of-function variant causes intellectual disability, developmental delay, and dysmorphic features
Al Mutairi F, Joueidi F, Alshalan M, Aloyouni E, Ballow M, Aldrees M, Al Abdulrahman A, Al Tuwaijri A, Abbas S, Umair M and Alfadhel M
HMGXB4 (additionally known as HMG2L1) is a non-histone DNA-binding protein that contains a single HMG-box domain. HMGXB4 was originally described in Xenopus where it was seen to negatively regulate the Wnt/β-catenin signaling pathway.
The Relationships among communication competence, professional autonomy and clinical reasoning competence in oncology nurses
Noh S and Kang Y
To investigate the relationships among communication competence, professional autonomy and clinical reasoning and to identify the factors that influence clinical reasoning competence in oncology nurses.
Decoding the connection between lncRNA and obesity: Perspective from humans and
Dayal Aggarwal D, Mishra P, Yadav G, Mitra S, Patel Y, Singh M, Sahu RK and Sharma V
Obesity is a burgeoning global health problem with an escalating prevalence and severe implications for public health. New evidence indicates that long non-coding RNAs (lncRNAs) may play a pivotal role in regulating adipose tissue function and energy homeostasis across various species. However, the molecular mechanisms underlying obesity remain elusive.
A qualitative exploration to inform an oral health training for disability care workers in Burkina Faso
Põld A, Kientega DF, Garé JV and Lorenz M
To explore enablers and barriers to the creation of an oral health training for care workers at specialized centres for children with disabilities in Ouagadougou.
Use of smartphone sensor data in detecting and predicting depression and anxiety in young people (12-25 years): A scoping review
Beames JR, Han J, Shvetcov A, Zheng WY, Slade A, Dabash O, Rosenberg J, O'Dea B, Kasturi S, Hoon L, Whitton AE, Christensen H and Newby JM
Digital phenotyping is a promising method for advancing scalable detection and prediction methods in mental health research and practice. However, little is known about how digital phenotyping data are used to make inferences about youth mental health. We conducted a scoping review of 35 studies to better understand how passive sensing (e.g., Global Positioning System, microphone etc) and electronic usage data (e.g., social media use, device activity etc) collected via smartphones are used in detecting and predicting depression and/or anxiety in young people between 12 and 25 years-of-age. GPS and/or Wifi association logs and accelerometers were the most used sensors, although a wide variety of low-level features were extracted and computed (e.g., transition frequency, time spent in specific locations, uniformity of movement). Mobility and sociability patterns were explored in more studies compared to other behaviours such as sleep, phone use, and circadian movement. Studies used machine learning, statistical regression, and correlation analyses to examine relationships between variables. Results were mixed, but machine learning indicated that models using feature combinations (e.g., mobility, sociability, and sleep features) were better able to predict and detect symptoms of youth anxiety and/or depression when compared to models using single features (e.g., transition frequency). There was inconsistent reporting of age, gender, attrition, and phone characteristics (e.g., operating system, models), and all studies were assessed to have moderate to high risk of bias. To increase translation potential for clinical practice, we recommend the development of a standardised reporting framework to improve transparency and replicability of methodology.
Evaluation of dupilumab on the disease burden in children and adolescents with atopic dermatitis: A population-based cohort study
Tsai SY, Gaffin JM, Hawryluk EB, Ruran HB, Bartnikas LM, Oyoshi MK, Schneider LC, Phipatanakul W and Ma KS
Dupilumab is the first and only biologic agent approved for the treatment of atopic dermatitis (AD) in pediatric patients aged from 6 months to 17 years. The study aimed to evaluate the impact of dupilumab on the occurrence of comorbidities in pediatric patients with AD.
The impact of vaccine type and booster dose on the magnitude and breadth of SARS-CoV-2-specific systemic and mucosal antibodies among COVID-19 vaccine recipients
Tsoi HW, Ng MK, Cai JP, Poon RW, Chan BP, Chan KH, Tam AR, Chu WM, Hung IF and To KK
The COVID-19 pandemic has had a major impact on global health and economy, which was significantly mitigated by the availability of COVID-19 vaccines. The levels of systemic and mucosal antibodies against SARS-CoV-2 correlated with protection. However, there is limited data on how vaccine type and booster doses affect mucosal antibody response, and how the breadth of mucosal and systemic antibodies compares. In this cross-sectional study, we compared the magnitude and breadth of mucosal and systemic antibodies in 108 individuals who received either the BNT162b2 (Pfizer) or CoronaVac (SinoVac) vaccine. We found that BNT162b2 (vs CoronaVac) or booster doses (vs two doses) were significantly associated with higher serum IgG levels, but were not significantly associated with salivary IgA levels, regardless of prior infection status. Among non-infected individuals, serum IgG, serum IgA and salivary IgG levels were significantly higher against the ancestral strain than the Omicron BA.2 sublineage, but salivary IgA levels did not differ between the strains. Salivary IgA had the weakest correlation with serum IgG (r = 0.34) compared with salivary IgG (r = 0.63) and serum IgA (r = 0.60). Our findings suggest that intramuscular COVID-19 vaccines elicit a distinct mucosal IgA response that differs from the systemic IgG response. As mucosal IgA independently correlates with protection, vaccine trials should include mucosal IgA as an outcome measure.
Water, sanitation and hygiene (WASH) index for primary healthcare facilities: Towards achieving WASH security
Odjegba EE, Bankole AO, Sadiq A, Layi-Adigun BO, Adebimpe AM, Kosemani MO, Ojo EB and Adewuyi MA
This study focused on designing a WASH Index for assessing the status of WASH in Primary Healthcare Facilities (PHCs) especially for low- and middle-income countries. To assess the effectiveness of the WASH Index in evaluating the WASH in PHCs, PHCs were selected from 70 Local Government Areas (LGA) across 3 Southwestern States in Nigeria. The WASH index comprises of the five Joint Monitoring Programme service ladders as outlined in the World Health Organization Global Baseline Report for monitoring basic WASH services in health care facilities: water, sanitation, hygiene, waste management and environmental cleaning. The 5 service elements (termed as components) assessed were based on 10 indicators and 30 sub-indicators. The results of the WASH Index of the PHCs were compared statistically on LGA and State basis with emphasis on the status of WASH facilities. The study concludes that the result would further provide baseline information on the status of WASH in PHCs in the selected States in the quest to achieve the Sustainable Development Goals (SDGs). This study recommends that the WASH Index could be adopted an assessment tool for evaluating WASH in PHCs in other to ensure communication of results to policy makers and other relevant stakeholders, for effective monitoring healthcare facilities.
Insights into the global genomic features of Salmonella enterica serovar Gallinarum biovars Gallinarum and Pullorum
Campos IC, Vilela FP, de Mesquita Souza Saraiva M, Junior AB and Falcão JP
Characterize global genomic features of 86 genomes of Salmonella Gallinarum (SG) and Pullorum (SP), which are important pathogens causing systemic infections in poultry.
Comorbidities and confusion: addressing COVID-19 vaccine access and information challenges
Attwell K, Roberts L and Blyth CC
Early in the coronavirus disease 2019 (COVID-19) pandemic, evidence emerged that individuals with chronic and immunocompromising conditions faced increased risk of severe infection, including death. The Australian Government and public health authorities prioritised these citizens' access to vaccines, including them in phase 1b of the rollout from 22 March 2021. Given the rapidly evolving knowledge and advice, we sought to understand what people with comorbidities understood about their eligibility, where they obtained information, and their experiences interfacing with the program.
Differential COVID-19 case ascertainment by age and vaccination status in Victoria, Australia: a serosurveillance and record linkage study
Szanyi J, Price DJ, Carville KS, Batty M, Yallop S, Nicholson S, Karapanagiotidis T, Rowe S, Sullivan S, Menon V, West D, Manoharan L, Copsey E, Majumdar SS, Sutton B, Williamson DA and McVernon J
To compare serological evidence of prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with linked coronavirus disease 2019 (COVID-19) case notification data in Victoria, Australia, and to determine SARS-CoV-2 neutralisation activity based on prior infection and vaccination history.
Regional molecular epidemiology of dengue and the potential optimization of its control through the use of vaccines. Report of the arbovirus committee of the latin american society of pediatric infectious diseases, SLIPE
Torres JR, Brea-Del Castillo J, Sáez-Llorens X, Ávila-Agüero ML, Coronell R W, Martinez-De Cuellar C and Debbag R
Dengue disease represents a large and growing global threat to public health, accounting for a significant burden to health systems of endemic countries. The World Health Organization's (WHO) Strategic Advisory Group of Experts (SAGE) and the European Medicines Agency (EMA) currently recommend the use of TAK-003 dengue vaccine in high dengue burden and transmission settings for countries considering vaccination as part of their integrated management strategy for prevention and control of Dengue.
The effect of curcumin-piperine supplementation on lipid profile, glycemic index, inflammation, and blood pressure in patients with type 2 diabetes mellitus and hypertriglyceridemia
Hosseini H, Bagherniya M, Sahebkar A, Iraj B, Majeed M and Askari G
Type 2 diabetes mellitus (T2DM) is a metabolic disorder associated with insulin resistance and ensuing dysglycemia, dyslipidemia, and inflammation. Owing to the putative metabolic benefits of curcumin-piperine combination, we explored the efficacy of this combination in improving cardiometabolic indices of patients with T2DM and hypertriglyceridemia. In this double-blind clinical trial, 72 patients with T2DM and hypertriglyceridemia were randomized to receive either a tablet containing 500 mg of curcuminoids plus 5 mg of piperine, or a matched placebo for 12 weeks. Anthropometric indices, blood pressure, glycemic indices, lipid profile, C-reactive protein (CRP), quality of life, and mood were evaluated at baseline and end of the study. After 12 weeks of intervention, the levels of triglycerides (p-value = 0.001) and fasting blood glucose (p-value = 0.004) were significantly reduced in the curcumin-piperine compared with the placebo group. CRP levels were marginally reduced in the curcumin-piperine compared with the placebo group (p-value = 0.081). In addition, energy/fatigue significantly increased in the curcumin-piperine group compared to the control group (p-value = 0.024). However, between-group comparisons showed no significant change in other parameters, including anthropometric indices (waist circumference and body mass index (BMI)), biochemical parameters (low-density lipoprotein (LDL-c), high-density lipoprotein (HDL-c), and insulin), HOMA-IR, blood pressure, quality of life, and DASS-21 items between the studied groups (p-value >0.05). The current study showed that curcumin-piperine supplementation can improve serum CRP, triglycerides, and glucose concentrations in patients with T2DM and hypertriglyceridemia.
Global research trends and hotspots in overweight/obese comorbid with depression among children and adolescents: A bibliometric analysis
Wang YQ, Wu TT, Li Y, Cui SE and Li YS
Overweight/obesity combined with depression among children and adolescents (ODCA) is a global concern. The bidirectional relationship between depression and overweight/obesity often leads to their comorbidity. Childhood and adolescence represent critical periods for physical and psychological development, during which the comorbidity of overweight/obesity and depression may increase the risk of adverse health outcomes.
Modeling of HIV-1 prophylactic efficacy and toxicity with islatravir shows non-superiority for oral dosing, but promise as a subcutaneous implant
Kim HY, Zhang L, Hendrix CW, Haberer JE and von Kleist M
HIV prevention with pre-exposure prophylaxis (PrEP) constitutes a major pillar in fighting the ongoing epidemic. While daily oral PrEP adherence may be challenging, long-acting (LA-)PrEP in oral or implant formulations could overcome frequent dosing with convenient administration. The novel drug islatravir (ISL) may be suitable for LA-PrEP, but dose-dependent reductions in T cell and lymphocyte counts were observed at high doses. We developed a mathematical model to predict ISL pro-drug levels in plasma and active intracellular ISL-triphosphate concentrations after oral vs. subcutaneous implant dosing. Using phase II trial data, we simulated antiviral effects and estimated HIV risk reduction for multiple dosages and dosing frequencies. We then established exposure thresholds where no adverse effects on immune cells were observed. Our findings suggest that implants with 56-62 mg ISL offer effective HIV risk reduction without reducing lymphocyte counts. Oral 0.1 mg daily, 3-5 mg weekly, and 10 mg biweekly ISL provide comparable efficacy, but weekly and biweekly doses may affect lymphocyte counts, while daily dosing regimen offered no advantage over existing oral PrEP. Oral 0.5-1 mg on demand provided protection, while not being suitable for post-exposure prophylaxis. These findings suggest ISL could be considered for further development as a promising and safe agent for implantable PrEP.
Inhibitors of the mTOR signaling pathway can play an important role in breast cancer immunopathogenesis
Al-Hawary SIS, Altalbawy FMA, Jasim SA, Jyothi S R, Jamal A, Naiyer MM, Mahajan S, Kalra H, Jawad MA and Zwamel AH
This study explores the critical role of inhibitors targeting the mammalian target of rapamycin (mTOR) signaling pathway in breast cancer research and treatment. The mTOR pathway, a central regulator of cellular processes, has been identified as a crucial factor in the development and progression of breast cancer. The essay explains the complex molecular mechanisms through which mTOR inhibitors, such as rapamycin and its analogs, exert their anticancer effects. These inhibitors can stop cell growth, proliferation, and survival in breast cancer cells by blocking critical signaling pathways within the mTOR pathway. Furthermore, the essay discusses the implications of using mTOR inhibitors as a comprehensive therapeutic strategy. It emphasizes the potential benefits of combining mTOR inhibitors with other treatment approaches to enhance the effectiveness of breast cancer treatment. The evolving landscape of breast cancer research underscores the significance of mTOR as a therapeutic target and highlights ongoing efforts to improve and optimize mTOR inhibitors for clinical use. In conclusion, the essay asserts that inhibitors of the mTOR signaling pathway offer a promising approach in the fight against breast cancer. These inhibitors provide a focused and effective intervention targeting specific dysregulations within the mTOR pathway. As research advances, the integration of mTOR inhibitors into customized combination therapies holds excellent potential for shaping a more effective and personalized approach to breast cancer treatment, ultimately leading to improved outcomes for individuals affected by this complex and diverse disease.
The activity-regulated cytoskeleton-associated protein (Arc) functions in a cell type- and sex-specific manner in the adult nucleus accumbens to regulate non-contingent cocaine behaviors
Wood DJ, Huebschman JL, Martinez D, Tsvetkov E, Snyder K, Tjhia R, Kumar J, Hughes BW, Taniguchi M, Smith LN, Cowan CW and Penrod RD
Repeated cocaine use produces adaptations in brain function that contribute to long-lasting behaviors associated with cocaine use disorder (CUD). In rodents, the activity-regulated cytoskeleton-associated protein (Arc) can regulate glutamatergic synaptic transmission, and cocaine regulates Arc expression and subcellular localization in multiple brain regions, including the nucleus accumbens (NAc)-a brain region linked to CUD-related behavior. We show here that repeated, non-contingent cocaine administration in global Arc KO male mice produced a dramatic hypersensitization of cocaine locomotor responses and drug experience-dependent sensitization of conditioned place preference (CPP). In contrast to the global Arc KO mice, viral-mediated reduction of Arc in the adult male, but not female, NAc (shArc) reduced both CPP and cocaine-induced locomotor activity, but without altering basal miniature or evoked glutamatergic synaptic transmission. Interestingly, cell type-specific knockdown of Arc in D1 dopamine receptor-expressing NAc neurons reduced cocaine-induced locomotor sensitization, but not cocaine CPP; whereas, Arc knockdown in D2 dopamine receptor-expressing NAc neurons reduced cocaine CPP, but not cocaine-induced locomotion. Taken together, our findings reveal that global, developmental loss of Arc produces hypersensitized cocaine responses; however, these effects cannot be explained by Arc's function in the adult mouse NAc since Arc is required in a cell type- and sex-specific manner to support cocaine-context associations and locomotor responses.
Risk and protective factors for revictimization from intimate partner violence: A systematic review
Ortega Pacheco YJ, Gallo-Barrera YD and Pozo Muñoz C
Intimate partner violence is a global public health problem that mainly affects women rather than men. It has been associated with negative physical and mental health outcomes, including experiences of revictimization. This systematic review describes the risk and protective factors associated with revictimization in female victims of intimate partner violence.
Antibacterial effect of phage cocktails and phage-antibiotic synergy against pathogenic
Zhao M, Li H, Gan D, Wang M, Deng H and Yang QE
The global rise of antibiotic resistance has renewed interest in phage therapy, as an alternative to antibiotics to eliminate multidrug-resistant (MDR) bacterial pathogens. However, optimizing the broad-spectrum efficacy of phage therapy remains a challenge. In this study, we addressed this issue by employing strategies to improve antimicrobial efficacy of phage therapy against MDR strains, which are notorious for their resistance to conventional antibiotics. This includes the selection of broad host range phages, optimization of phage formulation, and combinations with last-resort antibiotics. Our findings unveil that having a broad host range was a dominant trait of isolated phages, and increasing phage numbers in combination with antibiotics significantly enhanced the suppression of bacterial growth. The decreased incidence of bacterial infection was explained by a reduction in pathogen density and emergence of bacterial resistance. Furthermore, phage-antibiotic synergy (PAS) demonstrated considerable broad-spectrum antibacterial potential against different clades of clinical MDR pathogens. The improved treatment outcomes of optimized PAS were also evident in a murine model, where mice receiving optimized PAS therapy demonstrated a reduced bacterial burden in mouse tissues. Taken together, these findings offer an important development in optimizing PAS therapy and its efficacy in the elimination of MDR pathogens.
The costs, health and economic impact of air pollution control strategies: a systematic review
Wang S, Song R, Xu Z, Chen M, Di Tanna GL, Downey L, Jan S and Si L
Air pollution poses a significant threat to global public health. While broad mitigation policies exist, an understanding of the economic consequences, both in terms of health benefits and mitigation costs, remains lacking. This study systematically reviewed the existing economic implications of air pollution control strategies worldwide.
A Brief Alcohol Intervention (BAI) to reduce alcohol use and improve PrEP outcomes among men who have sex with men in Vietnam: study protocol for a randomized controlled trial
Bui HTM, Giang LM, Chen JS, Sripaipan T, Nong HTT, Nguyen NTK, Bartels SM, Rossi SL, Hutton H, Chander G, Sohn H, Ferguson O, Tran HV, Nguyen MX, Nguyen KD, Rutstein SE, Levintow S, Hoffman IF, Powell BJ, Pence BW, Go VF and Miller WC
In Vietnam and other global settings, men who have sex with men (MSM) have become the population at greatest risk of HIV infection. Although HIV pre-exposure prophylaxis (PrEP) has been implemented as a prevention strategy, PrEP outcomes may be affected by low persistence and adherence among MSM with unhealthy alcohol use. MSM have a high prevalence of unhealthy alcohol use in Vietnam, which may affect PrEP outcomes.
Prevalence of carbapenem-resistant Enterobacterales with predominance in hospitals from 2018 to 2021 in Nara, Japan
Kishi R, Nakano R, Nakano A, Harimoto T, Taniguchi R, Ando S, Suzuki Y, Yamaguchi K, Kitagawa D, Horiuchi S, Tsubaki K, Morita R, Kawabe T and Yano H
Despite the global health risk of carbapenem-resistant Enterobacterales (CRE), especially carbapenemase-producing Enterobacterales (CPE), Japan reports a significantly low frequency of CRE with a predominance of IMP-type carbapenemases. This study aimed to investigate the prevalence and characteristics of CRE isolated from hospitals in the city of Nara, Japan.
Driving improvement of diagnosis and awareness of heavy menstrual bleeding in women among physicians
Kadir RA, Tarawah A, Shridhar N and Kulkarni R
A number of barriers in care exist for women/girls with bleeding disorders. Little progress has been made to overcome them, particularly regarding levels of awareness of healthcare professionals (HCPs) and women/girls.
Functioning in chronic pain: a call for a global definition
Freynhagen R, Fullen BM, Reneman MF and Treede RD
Synthesis of Silver Nanoparticles Using Azadirachta indica and Syzygium aromaticum Extract and Its Antibacterial Action Against Enterococcus faecalis: An In Vitro Study
Chandran N, Ramesh S and Shanmugam R
Introduction Nanotechnology is the study of manipulating matter at the atomic scale involving particles smaller than 100 nm. Silver nanoparticles (AgNPs) are gaining popularity across diverse sectors including medical, food, healthcare, consumer goods, and industrial fields due to their distinctive physical and chemical characteristics. The eco-friendly synthesis of AgNPs offers a straightforward, cost-effective, and environmentally benign method devoid of hazardous chemicals. Methodology Eighty milliliters (mL) of silver nitrate mixed with 20 mL of and plant extract underwent two days of magnetic stirring for AgNP synthesis. Characterization was done via ultraviolet-visible (UV-vis)-spectroscopy (300-700 nm), and antimicrobial properties, which were checked with , were assessed using the agar-well diffusion method. Results The change in color and peak observed in the UV-vis spectrum confirmed the successful synthesis of AgNPs. Both neem and clove extract-mediated synthesis of AgNPs exhibited antibacterial activity against . However, neem extract synthesized AgNPs displayed a larger inhibitory zone diameter and lower minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values compared to those synthesized using clove extract. Conclusion Incorporating neem and clove extracts in AgNP synthesis offers a practical, eco-friendly, and cost-efficient method with notable efficacy. These AgNPs exhibit antibacterial activity against , suggesting their viability as potent antibacterial agents for addressing oral pathogens. Their sustainable synthesis underscores a promising avenue for developing effective antimicrobial solutions in oral healthcare.
Safety of Atypical Antipsychotics in a Child and Adolescent Inpatient Setting: A Naturalistic Study
Burak Baykara H, Alşen Güney S, Avcil S, Buran BŞ, Ogulcan Cıray R, Ermis C and Inal N
This study's objective was to investigate the adverse effects of atypical antipsychotics (AAPs) on the metabolic, hematological, and endocrinological systems in the inpatient environment for children and adolescents with diverse psychiatric disorders.
"OpenWHO" SEARO NCD PEN-HEARTS Courses: Training 10000 Health Care Providers in 100 Countries in 100 Days
Varghese C, Nongkynrih B, Kumar S, Krakauer EL, Paleri A, Viswanathan V, Khongsit A, Chandra A, Gunawardena N, Dancante AM, Allègre AS, Piroux C, Utunen H and Mikkelsen B
Enhancing health-care workforce capacity in primary care settings is critical for delivering quality care to individuals with noncommunicable diseases (NCDs). Despite significant resources allocated to traditional face-to-face training methods, challenges persist in terms of scale, coverage, training material standards, and availability of trainers across different domains. Self-paced learning through an accessible platform with evaluation is a feasible option to overcome these challenges. Taking advantage of the technology and reach of the OpenWHO platform, the WHO South-East Asia Region developed four SEARO NCD PEN-HEARTS courses. Content was adapted from WHO guidance to low- or middle-income countries context. These courses cover NCD service planning, primary health-care interventions, diabetic foot care, and palliative care. The courses target primary health-care managers tasked with planning, training, implementing, and monitoring NCD health services. This is the first set of OpenWHO courses on NCD services for primary health-care launched on October 26, 2023. Courses were rolled out through WHO country offices in SEAR. WHO staff in HQ and regions were also informed. SEAnetNCD network which includes 10 institutions from eight countries of Southeast Asia, with more than 100 members were appraised of the courses through a web-based meeting. In addition, social media platforms such as Facebook, Twitter, LinkedIn, and WhatsApp groups were used extensively. We observed a high level of interest and uptake for the courses. Within 100 days, the four courses had 18,250 enrolments with 12,090 unique users. More than 75% of users were in the 20-39 age group and covered diverse areas of work, ranging from health professionals, students, public health experts, national health ministries, and United Nations staff. Over 7,000 certificates have been awarded through graded assessments with average scores of 75%. Such courses of short duration focusing on specific skills and built with WHO guidance can be a solution to addressing gaps in capacity building.
Microbial communities living inside plant leaves or on the leaf surface are differently shaped by environmental cues
Mahmoudi M, Almario J, Lutap K, Nieselt K and Kemen E
Leaf-associated microbial communities can promote plant health and resistance to biotic and abiotic stresses. However, the importance of environmental cues in the assembly of the leaf endo- and epi-microbiota remains elusive. Here, we aimed to investigate the impact of seasonal environmental variations, on the establishment of the leaf microbiome, focusing on long-term changes (five years) in bacterial, fungal, and nonfungal eukaryotic communities colonizing the surface and endosphere of six wild populations. While leaf-microbial communities were found to be highly stochastic, the leaf niche had a predominant importance with endophytic microbial communities consistently exhibiting a lower diversity and variability. Among environmental factors, radiation- and humidity-related factors are the most important drivers of diversity patterns in the leaf, with stronger effects on epiphytic communities. Using linear models, we identified 30 important genera whose relative abundance in leaf compartments could be modeled from environmental variables, suggesting specific niche preferences for these taxa. With the hypothesis that environmental factors could impact interactions within microbial communities, we analyzed the seasonal patterns of microbial interaction networks across leaf compartments. We showed that epiphytic networks are more complex than endophytic and that the complexity and connectivity of these networks are partially correlated with the mentioned environmental cues. Our results indicate that humidity and solar radiation function as major environmental cues shaping the phyllosphere microbiome at both micro (leaf compartment) and macro (site) scales. These findings could have practical implications for predicting and developing field-adapted microbes in the face of global change.
Prevalence of Current Areca Nut Use and Its Associated Factors among Bhutanese Aged 15-69 Years: Analysis of the Nationally Representative STEPS Survey 2019
Penjor T, Gurung MS, Robson MG and Siriwong W
Areca nut (AN) use receives less global attention than tobacco use. Studies have linked AN consumption to a range of adverse health effects, including oral cavity and pharyngeal cancers, periodontal diseases, cardiovascular diseases, diabetes, hypertension, and addiction. The masticatory use of AN is rampant in Bhutan. There is a paucity of local evidence and limited empirical studies to understand the factors associated with current AN use in Bhutan.
Systematic review of bovine and zoonotic tuberculosis in the Western Pacific and the Southeast Asia regions of the World Health Organization
Singh BB, Dhand NK, Cadmus S, Dean AS and Merle CS
Tuberculosis (TB) remains a leading cause of mortality worldwide. We conducted this systematic review to understand the distribution of bovine and zoonotic tuberculosis in the World Health Organization (WHO)'s Southeast Asia Region (SEAR) and Western Pacific Region (WPR) to inform our understanding of the risk posed by this disease.
Understanding inequalities in the coverage of adolescent sexual and reproductive health services: a qualitative case study of the selected regions of Zambia
Munakampe MN, Ngoma-Hazemba A, Sampa M and Jacobs CN
Despite substantial investment in improving healthcare among adolescents in low- and middle-income countries, barriers to access and utilization of services persist, especially to sexual and reproductive health (SRH) services. In response to adolescents' health service needs due to their vulnerability, interventions aimed at improving access and utilization of sexual and reproductive health services have been implemented in specific regions of Zambia. To highlight progress in the access and the overall delivery of services in Zambia, in the wake of a system-level funding mechanism, this paper aims to understand the accessibility, availability, acceptability and quality (AAAQ) of health services provided to young people.
The South-South Dimension in International Research Collaboration
McManus C, Neves AAB, Finan TJ, Pimentel F, Pimentel D and Schleicher RT
In this paper, we looked at the collaboration publishing patterns for groups of Global South countries (Latin America, Africa, ASEAN, Asian, BRICS), as well as publishing parameters. We looked at financing and the relationships between these groups and the Global North. Data from 2002 to 2021 was collected from InCites ® (Web of Science, Clarivate Analytics) and SciVal® (Scopus Elsevier). The impact was lower for BRICS, while Latin America and Asean countries tended to have a higher Field Weighted Citation Impact. Good Health and well-being (SDG 3) dominates South-South Collaborations. Asian countries showed a higher percentage of Affordable and Clean Energy (SDG7), while Africa and Latin America had a higher rate of Zero Hunger (SDG1). Each region shows different production profiles, but collaboration with the Global North is necessary for all regions. Intra-regional shows a lower impact than inter-regional financing, calling attention to the increasing influence of China in all regions, except for Latin America. The data analysed can be used for orienting South-South scientific Collaboration programs, focusing on pre-existent synergies and on where policy changes and results can be maximised.
Bridging disciplines-key to success when implementing planetary health in medical training curricula
Malmqvist E and Oudin A
Planetary health is being or should be added to medical training curricula in accordance with association consensus. Several articles published in recent years have addressed concern on the implementation, and the challenges that can occur if not addressed properly. This scoping narrative literature review focuses on planetary health as a concept, as well as challenges and suggested solutions to address these challenges. Planetary health is an important concept and needs to be addressed in all medical training. We found that one main challenge is implementation without ensuring the right competences and resources. Medically trained teachers set out to understand and teach complex natural and social systems. At some institutions the time allocated to teach planetary health is limited or non-existent. Case studies and student led teaching are solutions suggested, while other argue that true interdisciplinarity by inviting experts are more in line with what we expect from other subjects. In conclusion, the roots of planetary health, the enormous health risks at stake and nature of the subject requires medical training to adopt a true inter/trans-disciplinary approach to succeed. It might not be expected for all students to become planetary health experts, but all need a general understanding of the most important aspects and values.
The Egyptian journey from having the highest prevalence of hepatitis C virus to being the first to achieve "gold tier" in conquering the disease
Abosheaishaa H, Abdelghany A, Abdelhalim O, Mohamed I, Morsi S, Youssef M, Salem A, Bahbah AA, Shady A, Naguib MS, Nassar M and El-Kassas M
Hepatitis C virus (HCV) is a major global health concern, particularly in Egypt, due to historic schistosomiasis control efforts that inadvertently led to widespread HCV transmission. This study aimed to evaluate the efficacy of Egypt's national strategies in controlling and reducing the prevalence of HCV, including introducing sofosbuvir and implementing the "100 Million Healthy Lives" campaign. The approach includes a review of epidemiological data, an analysis of the national HCV control strategies implemented, and an assessment of their outcomes, focusing on the period from 2006 to 2022. Significant milestones were achieved, including a drastic reduction in new HCV infections from 300 per 100,000 in 2014 to 9 per 100,000 in 2022 and successful treatment of over 4 million people. Egypt has become the first country in the world to achieve the "gold tier" status based on World Health Organization criteria on the path to eradication of HCV. Egypt's comprehensive approach can serve as a model for similar endemic regions. Other nations with high HCV prevalence might benefit from adopting similar multidimensional strategies, emphasizing prevention and treatment.
The effect of Ba Duan Jin exercise intervention on cardiovascular disease: a meta-analysis of randomized controlled trials
Chen J, Zhang M, Wang Y, Zhang Z, Gao S and Zhang Y
There is a growing interest in the use of complementary therapies for the prevention of disease and the maintenance of health. Furthermore, complementary therapies that incorporate exercise are becoming increasingly prevalent among the older adult, and thus may represent a crucial strategy for the primary and secondary prevention of cardiovascular disease (CVD). Exercise therapy, as a means to prevent and treat cardiovascular diseases, has been gradually applied in clinical practice. It has the advantages of reducing mortality, improving clinical symptoms, restoring physical function and improving quality of life. In recent years, traditional Chinese sports such as Ba Duan Jin and Qigong have developed rapidly. Therefore, a comprehensive systematic review is required to examine interventions involving Ba Duan Jin exercise in healthy adults or those at increased risk of CVD in order to determine the effectiveness of Ba Duan Jin exercise for the primary prevention of CVD.
Prevalence of pre-eclampsia in women in the Middle East: a scoping review
Hegazy A, Eid FA, Ennab F, Sverrisdóttir YB, Atiomo W and Azar AJ
Hypertensive disorders of pregnancy are the second most common cause of maternal deaths worldwide. Metabolic syndrome is recognized as one of the risk factors for pre-eclampsia. A recent study revealed a high prevalence of metabolic syndrome in the United Arab Emirates (UAE), particularly amongst Emirati women compared with global estimates. This finding raises the possibility that the prevalence of pre-eclampsia in the region may also be higher as research is increasingly demonstrating an association between pre-eclampsia and metabolic syndrome. We therefore conducted this scoping review of the literature to investigate the nature and extent of studies evaluating the prevalence of pre-eclampsia within the Middle East region to enable subsequent comparison of these findings with the global burden of pre-eclampsia, objectively identify gaps in the literature and inform the design of future studies to address these gaps. PubMed and Scopus were used to extract studies published over the last 20 years (2003-2023). The search terms used included ("Pre-eclampsia" AND "Prevalence") OR ("Hypertension in pregnancy" AND "Prevalence") OR ("Pregnancy" AND "Pre-eclampsia") OR ("Pre-eclampsia" AND "Epidemiology"). We limited our studies to those from the Middle East (ME). A total of 556 relevant articles were identified following which 11 were shortlisted for review. There were four studies from Iran, two from Saudi Arabia, two from Qatar, one from Jordan, and one from Bahrain. The remaining study included 29 countries from Africa, Asia, Latin America, and the Middle East of which data from Jordan, Lebanon, the Occupied Palestinian Territory, and Qatar were included. There were four retrospective, two cross-sectional, and two cohort studies, one prospective study, one meta-analysis, and one descriptive-analytical study. The prevalence of pre-eclampsia in the studies ranged from 0.17 to 5%. We did not find any study investigating the prevalence of pre-eclampsia in the United Arab Emirates. Based on our findings, we conclude that there is a significant scarcity of research in this area, especially within the Middle East, and notably an absence of studies specifically pertaining to the UAE. Consequently, we assert that there is a pressing requirement for additional research to evaluate the prevalence of pre-eclampsia in the region.
Forkhead Box O (FOXO) signaling in NSCLC: pathways to targeted therapies
Thangavelu L, Andreoli Pinto TJ, Pathak S, Tiwari A, Tiwari V, Gupta G, Pant K, Gupta S and Shahwan M
Understanding evidence ecosystems: What influences the production, translation, and use of modeled evidence in Burkina Faso, Nigeria, India, and Kenya?
Sié A, Fofana H, Kagoné M, Ouédraogo M, Onwujekwe OE, Mbachu CO, Chokshi M, Chilgod L, Mokashi T, Nair AB, Muriuki P, Taddese A, Ewald L and Handigol A
This study sought to document and understand facilitators and barriers to producing, translating, and using modeled evidence in decision-making in Burkina Faso, Nigeria, India, and Kenya. We explored researcher-decision-maker engagement mechanisms as key facilitators of evidence use, with a focus on knowledge brokers and boundary organizations.
Promoter Methylation Leads to Hepatocyte Nuclear Factor 4A Loss and Pancreatic Cancer Aggressiveness
Hatziapostolou M, Koutsioumpa M, Zaitoun AM, Polytarchou C, Edderkaoui M, Mahurkar-Joshi S, Vadakekolathu J, D'Andrea D, Lay AR, Christodoulou N, Pham T, Yau TO, Vorvis C, Chatterji S, Pandol SJ, Poultsides GA, Dawson DW, Lobo DN and Iliopoulos D
Decoding pancreatic ductal adenocarcinoma heterogeneity and the consequent therapeutic selection remains a challenge. We aimed to characterize epigenetically regulated pathways involved in pancreatic ductal adenocarcinoma progression.
Editorial: Impact and control of food- and waterborne protozoan parasites
Matos O, Karanis P and Razakandrainibe R
Advances in microbial based bio-inoculum for amelioration of soil health and sustainable crop production
Samantaray A, Chattaraj S, Mitra D, Ganguly A, Kumar R, Gaur A, Mohapatra PKD, Santos-Villalobos SL, Rani A and Thatoi H
The adoption of sustainable agricultural practices is increasingly imperative in addressing global food security and environmental concerns, with microbial based bio-inoculums emerging as a promising approach for nurturing soil health and fostering sustainable crop production.This review article explores the potential of microbial based bio-inoculumsor biofertilizers as a transformative approach toenhance plant disease resistance and growth. It explores the commercial prospects of biofertilizers, highlighting their role in addressing environmental concerns associated with conventional fertilizers while meeting the growing demand for eco-friendly agricultural practices. Additionally, this review discusses the future prospects of biofertilizers, emphasizing the ongoing advancements in biotechnology and formulation techniques that are expected to enhance their efficacy and applicability. Furthermore, this article provides insights into strategies for the successful acceptance of biofertilizers among farmers, including the importance of quality control, assurance, and education initiatives to raise awareness about their benefits and overcome barriers to adoption. By synthesizing the current research findings and industrial developments, this review offers valuable guidance for stakeholders seeking to exploit the potential of biofertilizers or beneficial microbes to promote soil health, ensure sustainable crop production, and addressing the challenges of modern agriculture.
Development and validation of a hypoxia- and mitochondrial dysfunction- related prognostic model based on integrated single-cell and bulk RNA sequencing analyses in gastric cancer
Li Y, Cui Y, Wang Z, Wang L, Yu Y and Xiong Y
Gastric cancer (GC) remains a major global health threat ranking as the fifth most prevalent cancer. Hypoxia, a characteristic feature of solid tumors, significantly contributes to the malignant progression of GC. Mitochondria are the major target of hypoxic injury that promotes mitochondrial dysfunction during the development of cancers including GC. However, the gene signature and prognostic model based on hypoxia- and mitochondrial dysfunction-related genes (HMDRGs) in the prediction of GC prognosis have not yet been established.
Hidradenitis suppurativa patient requiring cardiac procedure with inguinal access: Case management with ertapenem
Mainville L, MacHaalany J and Veillette H
Hidradenitis suppurativa is a chronic inflammatory skin disease that usually presents in young adults with painful abscesses in intertriginous areas. We present a case of severe hidradenitis suppurativa (Hidradenitis Suppurativa Investigator Global Assessment (HS-IGA) = 5; Hurley stage III) investigated by cardiology and respirology specialists for dyspnea. The patient's symptoms required right-sided cardiac catheterization via the right femoral vein in the inguinal area. The patient was able to undergo this invasive cardiac procedure without infectious complications using multidisciplinary management (dermatology, cardiology, respirology, internal medicine, and infectious diseases specialists), intravenous ertapenem 1 g/day for 6 weeks perioperatively, biologic therapy, and treatment of diabetes with semaglutide. The administration of ertapenem preoperatively and postoperatively of an invasive procedure can be beneficial, particularly when the upcoming intervention requires access to skin areas severely affected by hidradenitis suppurativa. Comorbidities such as obesity and diabetes should be addressed as their treatment might contribute to improve hidradenitis suppurativa.
Artificial Intelligence, the Digital Surgeon: Unravelling Its Emerging Footprint in Healthcare - The Narrative Review
Shang Z, Chauhan V, Devi K and Patil S
Artificial Intelligence (AI) holds transformative potential for the healthcare industry, offering innovative solutions for diagnosis, treatment planning, and improving patient outcomes. As AI continues to be integrated into healthcare systems, it promises advancements across various domains. This review explores the diverse applications of AI in healthcare, along with the challenges and limitations that need to be addressed. The aim is to provide a comprehensive overview of AI's impact on healthcare and to identify areas for further development and focus.
Perinatal intimate partner violence among teen mothers and children's attachment disorders in Rwanda: potential mediating factors
Nshimyumukiza M, Niyonsenga J, Kanazayire C, Sebatukura SG and Mutabaruka J
The alarming prevalence of teen mothers' exposure to perinatal intimate partner violence (IPV, 8.3-67%) and attachment disorders (ADs) among their children is a global concern, especially in sub-Saharan Africa with high teenage pregnancy rates. This study, therefore, aimed to examine the link between teen IPV and AD in their offspring. We sought also to explore the mediating roles of postpartum depression symptoms, maternal sensitivity, parenting stress, and perceived social support in the relationship between perinatal IPV and children's ADs. This cross-sectional study selected a random sample of 309 teen mothers from Nyanza district. This sample size was determined using Yamane's formula, with random sampling. Various instruments were used for data collection, including questionnaires on intimate partner violence, social support, maternal sensitivity, postpartum depression symptoms and parenting stress and early trauma-related disorders. The data was analysed using SPSS, with mediation analyses performed using the PROCESS macro (version 4.1). IPV was found to be significantly associated with attachment disorders. Simple mediation models showed that parenting stress completely mediated these relationships, while postpartum depression, perceived social support, and maternal sensitivity partially mediated the relationship between IPV and children's ADs. In parallel mediation model, the combined roles of all mediators fully mediated the associations between IPV and ADs. These findings offer valuable insights in designing or strengthening the appropriate interventions to prevent and mitigate the perinatal intimate partner violence and its detrimental impact on children's attachment disorders. Combating intimate partner violence in post-conflict situations is challenging in teen mothers, however, our results suggest that efforts to address maternal mental health and parenting practices may protect children from attachment disorders.
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