Greater Mortality Research Articles

Myocarditis and pericarditis risk with mRNA COVID-19 vaccination compared to unvaccinated individuals: A retrospective cohort study in a Spanish Tertiary Hospital

ObjectiveThis study compared the incidence of pericarditis and myocarditis in patients exposed to mRNA COVID-19 vaccines to the incidence in those who were not vaccinated, considering the incidence of these conditions resulting from COVID-19 infection. MethodsThis was a retrospective cohort study of individuals assigned to health area of La Paz University Hospital in Spain. The exposure factor was vaccination with mRNA COVID-19 vaccines between December 27th, 2020 and January 9th, 2022 with a minimum follow-up of one month. The outcome was the incidence of pericarditis or myocarditis in these individuals. ResultsThe incidence of pericarditis and myocarditis in the total population exposed to at least one dose of mRNA COVID-19 vaccines was 5/100,000 (CI95%:3 to 8 per 100,000), compared to 70/100,000 (CI95%: 66 to 92 per 100,000) in those who were not vaccinated. In the adolescent population (aged 12–17), the incidence was 10/100,000 in vaccinated population (CI95%: 5 to 45 per 100,000) compared to 20/100,000 in unvaccinated (CI95%: 6 to 79 per 100,000). The incidence of pericarditis or myocarditis in patients with COVID-19 infection was 200/100,000 people (CI95%: 114 to 306 per 100,000). The most common cause of pericarditis and myocarditis in the cohort was idiopathic/infectious (74 cases). Cases of myocarditis attributed to COVID-19 infection were more severe and had higher mortality rates compared to cases with other causes. ConclusionThe incidence of pericarditis and myocarditis in patients exposed to mRNA COVID-19 vaccines was lower than in those who were not vaccinated, especially in adults.The most common cause of pericarditis and myocarditis was idiopathic/infectious, but the most frequent cause in adolescent patients was mRNA COVID-19 vaccination. Cases of myocarditis due to COVID-19 infection were more severe and had greater mortality.

Genetic history of Cambridgeshire before and after the Black Death.

The extent of the devastation of the Black Death pandemic (1346-1353) on European populations is known from documentary sources and its bacterial source illuminated by studies of ancient pathogen DNA. What has remained less understood is the effect of the pandemic on human mobility and genetic diversity at the local scale. Here, we report 275 ancient genomes, including 109 with coverage >0.1×, from later medieval and postmedieval Cambridgeshire of individuals buried before and after the Black Death. Consistent with the function of the institutions, we found a lack of close relatives among the friars and the inmates of the hospital in contrast to their abundance in general urban and rural parish communities. While we detect long-term shifts in local genetic ancestry in Cambridgeshire, we find no evidence of major changes in genetic ancestry nor higher differentiation of immune loci between cohorts living before and after the Black Death.

Correlation between Neutrophil-to-Lymphocyte Ratio, Platelets-to-Lymphocyte Ratio, C-Reactive Protein-to-Albumin Ratio and Clinical Picture of Elderly Chronic Heart Failure Patients.

Neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocyte ratio (PLR) and C-reactive protein-to-albumin ratio (CAR) are believed to be potential inflammatory markers that are closely related to the prognosis and course of cardiovascular diseases. The main goal of this study was the evaluation of NLR, PLR and CAR as factors reflecting the clinical picture and the prognosis of elderly chronic heart failure (CHF) patients. In 150 elderly patients with newly diagnosed CHF, the NLR, PLR and CAR were correlated with cardiac, laboratory and nutritional parameters. Systemic inflammatory ratios were correlated with selected patient's parameters. CAR was associated with an unfavorable clinical picture of CHF-a reduced EF (p = 0.007), an elevated PASP (p = 0.014), an increased LVESD in both males and females (p = 0.032 and 0.024, respectively) and a decreased TAPSE (p = 0.023). CAR allowed us to distinguish between NYHA I-III and NYHA IV classes with AUC of 0.830. By analyzing the five-year mortality rate in patients with different CAR values, the greater death rate was recorded for patients with high CAR values-one-year death rate (40.3% vs. 17.2%) and five-year death rate (80% vs. 58.3%) (p = 0.002). Both NLR and PLR correlated only with selected parameters. An analysis of inflammatory markers, mainly CAR, allows the management of CHF, because its value can reflect the cardiac and nutritional status of patients with a prognostic value. NLR and PLR can serve as supplementary examinations for CAR evaluation.

From historical pandemics to the COVID-19 crisis: lessons learned, challenges faced, and future directions in global health

This study aims to assess the coping strategies employed during major historical pandemics and their implications for mental health. An integrative literature review was conducted, encompassing the following databases: SciELO, PubMed, Lilacs, and Google Scholar. Scientific studies were identified using relevant Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH) combined with Boolean operators AND and OR. Seventeen publications that met the eligibility criteria and were published between 2003 and January 2023 were selected for analysis. The findings revealed that 9 articles (52.94%) focused on COVID-19, 2 articles (11.76%) discussed the Black Death, 3 articles (17.64%) explored the Spanish flu, 4 articles (23.52%) addressed H1N1, 1 article (5.88%) examined Perinthus cough, and 6 articles (35.29%) investigated mental health in pandemic scenarios. The study demonstrates that coping strategies have significantly improved with advancements in scientific and technological knowledge, leading to a better understanding of the transmission and prevention of pandemics, as well as the promotion of mental well-being.

Prognostic value of systemic immune-inflammation index and monocyte-to-HDL-cholesterol ratio in early cardio-cerebral complications in elderly patients with acute severe carbon monoxide poisoning

To investigate how effectively systemic immune-inflammation index (SII) and Monocyte-to-HDL-cholesterol ratio (MHR) predict the development of early cardio-cerebral complications in elderly patients who have experienced acute severe carbon monoxide poisoning (ASCMP). A retrospective analysis was conducted on 77 elderly patients with ASCMP admitted to the emergency department of Harrison International Peace Hospital from November 2020 to March 2022. The prevalence of early-onset complications among the 77 individuals was 38.96%. Binary Logistics regression analysis showed that SII and MHR were independent influencing factors of early cardio-cerebral complications in elderly patients with ASCMP. The complication group had a longer length of stay, a greater mortality rate, and a higher incidence of delayed encephalopathy after acute carbon monoxide poisoning (p < .05) than the non-complication group. The area under the curve (AUC) of SII and MHR in predicting early cardio-cerebral complications in elderly patients with ASCMP were 0.724 and 0.796, respectively, with 80.0% and 63.3% sensitivity, and 61.7% and 87.2% specificity. The incidence of early cardio-cerebral complications in elderly patients who had ASCMP is high and the prognosis is poor. SII and MHR can be utilized as independent predictors of early cardio-cerebral complications in elderly patients with ASCMP, allowing doctors to diagnose and treat cardio-cerebral complications earlier and improve prognosis.

Contrasted life trajectories: reconstituting the main population exposomes in French Guiana.

In French Guiana, life expectancy is between 2 and 3 years below that of France, reflecting differences in mortality rates that are largely sensitive to primary healthcare and thus preventable. However, because poverty affects half of the population in French Guiana, global measurements of life expectancy presumably conflate at least two distinct situations: persons who have similar life expectancies as in mainland France and persons living in precariousness who have far greater mortality rates than their wealthier counterparts. We thus aimed to synthesize what is known about statistical regularities regarding exposures and sketch typical French Guiana exposomes in relation to health outcomes. We conducted a narrative review on common exposures in French Guiana and made comparisons between French Guiana and mainland France, between rich and poor in French Guiana, and between urban and rural areas within French Guiana. The most striking fact this panorama shows is that being a fetus or a young child in French Guiana is fraught with multiple threats. In French Guiana, poverty and poor pregnancy follow-up; renouncing healthcare; wide variety of infectious diseases; very high prevalence of food insecurity; psychosocial stress; micronutrient deficiencies; obesity and metabolic problems; and frequent exposure to lead and mercury in rural areas constitute a stunningly challenging exposome for a new human being to develop into. A substantial part of the population's health is hence affected by poverty and its sources of nutrition.

First-Year Mortality of Four Early-Successional Species on Severely Degraded Sites in Eastern Canada as Influenced by a Factorial of Site Preparation Treatments

Barren, severely disturbed sites lacking soil, such as mine sites and waste deposit sites, present severe challenges to ecological service restoration because of high temperatures, solar radiation, and wind speeds; extreme temperature changes; and low soil moisture and nutrient availability. An ecological restoration experiment using three site preparation treatments was conducted. Straw (S), Meri-Crusher (MC), and coarse woody debris (CWD) were assessed in a site, no site preparation 2 × 2 × 2 factorial, including a control treatment, on sites barren for 25 years. In addition, four early-successional species: white birch (WB, Betula papyrifera Marsh), gray birch (GB, Betula populifolia Marsh), green alder (GA, Alnus viridis Vill. ssp. crispa Ait) and speckled alder (SA, Alnus incana L. ssp. rugosa Du Roi), were examined for mortality. Mortality was measured after three time periods, summer-related 2021, winter-related, and frost heave mortality (spring 2022). Summer-related mortality was predominantly influenced by S treatments (reduced mortality) and their interactions. Straw’s ability to retain moisture strongly suggests it mitigated summer-related drought mortality. S interactions were not rank changes but magnitude effects. The species × straw interaction showed that SA had the greatest magnitude difference, with 25% and 3.6% summer-related mortality for NS and S treatments, respectively. SA, a hydrophilic species, accounted for nearly half the total summer-related mortality, and there were strong species effects and species interactions. The full combination of site preparation treatments had the lowest summer-related mortality, at 1%. Winter-related mortality only affected 1.9% of the total sample size, and there were no species effects or interactions, but contrary to other results, S was the leading cause of mortality due to fungal presence found on expired seedlings. For frost heave mortality, it was clear that the S treatment was effective, with 1.2% and 20.7% overall mortality for S and NS, respectively. MC alone had the greatest negative effect, with 46.9% frost heave mortality; however, when interacting with S or CWD, the mortality decreased substantially. Frost heave had no species interactions and only a species effect, with SA having the greatest mortality. Over the first full year, MC alone and control had the greatest mortality, with 60% and 38%, respectively, after one year. Overall, one-year mortality showed S reduced mortality by 27% and CWD by 19%, while MC increased mortality by approximately 4%. When treatments were combined in any way, mortality dropped significantly, showing an additive effect, with the three-combination treatment resulting in the lowest one-year mortality, of only 3.1%. Straw provided the strongest effect, both as an effective barrier to moisture evaporation, providing up to 10% more soil moisture under dry conditions and provided an effective thermal barrier that substantially reduced the frost heave mortality. Even early-successional species such as WB, GB, GA, and SA need site preparation treatments to establish and survive the first year on long-term barren lands.

Impact of a Crisis on Waste Management Policy Adherence And Practices - A Narrative Review of Bio-Medical Waste Management During the Covid-19 Pandemic

As the greatest threat to humanity since the Black Death of 1929, the COVID-19 pandemic is believed to be the worst and most terrible world-wide health catastrophe of the century. This pandemic has significantly altered the demographics, and ordinary economic activity ceased to save human lives. Although the limited economy has helped to create an environmentally friendly atmosphere, it additionally brought about a significant problem with biomedical waste. This review paper covers the various steps, initiatives, methods, and techniques to degrade biomedical waste(BMW) from hospitals, clinics, production units, workplaces, homes, and laboratories due to the COVID-19 pandemic. The aim of the narrative review was to identify how the crisis impacted existing practices of biomedical waste management and adherence to overarching policy frameworks, along with the changes that were initiated in the same. We have reviewed a range of statutory norms, techniques, and methods used to dispose of biomedical waste appropriately during the pandemic. A big challenge to the world today is to dispose of them properly, without promulgating the infection in the immediate and larger environment. The results of the review show that there were definitive changes in the way BMW management practices were followed before and after the pandemic, along with overarching changes in statutory regulations and policy frameworks around these practices. The study also puts forth reasoning behind these changes and recommends a direction and context for the same in order to help prepare for another crisis while reducing the environmental impact of BMW.

Pandemics and cities: Evidence from the Black Death and the long-run

The Black Death killed 40% of Europe’s population between 1347 and 1352, making it one of the largest shocks in the history of mankind. Using a novel dataset that provides information on spatial variation in plague mortality at the city level, as well as various identification strategies, we explore the short-run and long-run impacts of Black Death mortality on city growth. On average, cities recovered their pre-plague populations within two centuries. However, aggregate convergence masked heterogeneity in urban recovery. Both of these facts are consistent with populations returning disproportionally to locations endowed with more rural and urban fixed factors of production. Land suitability and natural and historical trade networks played a vital role in recovery. Our study highlights the role played by the Black Death and physical and economic geography in determining the relative size of European cities.

Prevalence, molecular characterization, and antimicrobial resistance among Escherichia coli, Salmonella spp., and Staphylococcus aureus strains isolated from Egyptian broiler chicken flocks with omphalitis.

Bacterial Omphalitis has been reported as a significant cause of mortalities in newly hatched broiler chicks. This study aimed to assess the occurrence of omphalitis among broiler chickens in Gharbia governorate in Egypt. In addition, the bacteria associated with the occurrence of omphalitis in broiler chickens were also investigated and characterized. For this purpose, 43 farms in that area were surveyed. The comparative levels of omphalitis caused by Escherichia coli (E. coli), Salmonella spp., and Staphylococcus aureus (S. aureus) were screened in 129 chicks. The drug resistance to eight commonly used antimicrobials in Egyptian poultry farms was screened using the disk diffusion method. The overall incidence rate of omphalitis was 37.21%. In birds with omphalitis, the co-prevalence of S. aureus, Salmonella spp., and E. coli was 87.5%. When compared to healthy flocks, broiler chicks with omphalitis caused by Salmonella spp., E. coli, and S. aureus had a greater mortality rate in the first week of life. However, there were no significant differences in the mortality cases caused by these pathogens. Eighty-seven percent of the cases of omphalitis were linked to E. coli and 75% to Salmonella spp. and S. aureus. From the yolk sac of broiler chicks with omphalitis, E. coli, Salmonella spp., and S. aureus were isolated at rates of 87.5%, 62.5%, and 45.8%, respectively. The isolates of E. coli and Salmonella spp. exhibited great sensitivity to gentamycin and Tetracycline; however, the strongest drug resistance was observed toward cefpodoxime, sulphamethoxazole and trimethoprim, ampicillin, and amoxycillin and clavulanic acid. The recovered isolates of S. aureus showed susceptibility to chloramphenicol (72.37%), oxytetracycline (81.82%), and erythromycin (81.82%). However, every S. aureus isolate that was found resistant to amoxycillin and clavulanic acid, penicillin G and oxacillin. of blaTEM, blaSHV, and blaCTX-M genes has been proposed as the genetic cause of β-lactam antibiotic resistance in Salmonella spp. and E. coli. MecA and blaZ; however, were found in every strain of S. aureus. The frequency of omphalitis and its associated mortalities was comparatively high in Gharbia governorate. More efforts should be made to adopt strict hygienic standards for controlling and preventing such disease and this will consequently lead to minimizing the use of antimicrobials in poultry farms.

Emergency management of traumatic spinal cord injury: a systematic review

Globally, trauma is a prominent factor contributing to mortality and impairment. Hemorrhage accounts for up to 40% of fatalities resulting from traumatic injuries. Current approaches to improve mortality rates have prioritized the implementation of effective techniques for the early management of bleeding and the treatment of coagulation disorders. This is an updated systematic review of studies that examined the emergency care of traumatic spinal cord injury (SCI) from 2017 to 2023. A literature search was conducted using Google Scholar, Web of Science, Cochrane, and PubMed databases to find relevant research on our issue. The search terms used were &amp;quot;SCI, Spine trauma, Emergency, management, Traumatic cervical SCI&amp;quot; and were employed in different combinations. Furthermore, an assessment was conducted on original research that examines the emergency care of severe SCI. The inclusion criteria were based on full-text publications. Out of the 85 research that were collected, only nine satisfied the inclusion requirements. Out of the total number of studies, seven were conducted retrospectively, one was a case report, and another was a cross-sectional research. The research population consisted of around 159,982 individuals diagnosed with SCI. Respiratory ssues, septicemia, and cardiovascular complications were the leading causes of in-hospital mortality in those with complete acute SCI. Elderly people, physical injuries, paralysis of all four limbs, and reliance on mechanical breathing were all associated with greater death rates. The American Spinal Injury Association grade upon admission was the greatest predictor of morbidity and death. Road traffic accidents were the major cause of CI among Saudi men. Bomb blasts quickly followed falls, gaining second place. Road traffic accidents are the second most common cause of SCI among females, behind falls. Younger people who suffer spinal cord injuries frequently were found to have a better prognosis for recovery than older people.

QSPR analysis of distance-based structural indices for drug compounds in tuberculosis treatment

Tuberculosis (TB) is one of the most contagious diseases that has a greater mortality rate than HIV/AIDS and the cases of TB are feared to rise as a repercussion of the COVID-19 pandemic. The pharmaceutical industry is constantly looking for ways to improve drug design processes in order to combat the growth of infections and cure newly identified syndromes or genetically based dysfunctions with the help of QSPR models. QSPR models are mathematical tools that establish relationships between a molecular structure and its physicochemical attributes using structural properties. Topological indices are such properties that are generated from the molecular graph without any empirically derived measurements. This work focuses on developing a QSPR model using distance-based topological indices for anti-tuberculosis medications and their diverse physicochemical features.

Outcome of individuals with alcoholic cirrhosis hospitalized with first decompensation and their predictors.

Alcohol is one of most common aetiologies of cirrhosis and decompensated cirrhosis is linked to higher morbidity and death rates. This study looked at the outcomes and mortality associated risk variables of individuals with alcoholic cirrhosis who had hospitalization with their first episode of decompensation. Individuals with alcoholic cirrhosis who were hospitalized with the first episode of decompensation [acute decompensation (AD) or acute-on-chronic liver failure (ACLF)] were included in the study and were prospectively followed up until death or 90 days, whichever was earlier. Of the 227 study participants analyzed, 167 (73.56%) and 60 (26.43%) participants presented as AD and ACLF, respectively. In the ACLF group, the mortality rate at 90 days was higher than in the AD group (48.3 vs 32.3%, P=0.02). In the AD group, participants who initially presented with ascites as opposed to variceal haemorrhage had a greater mortality rate at 90 days (36.4 vs 17.1%, P=0.041). The chronic liver failure-consortium AD score and the lactate-free Asian Pacific Association for the study of the Liver-ACLF research consortium score best-predicted mortality in individuals with AD and ACLF. There is significant heterogeneity in the type of decompensation in individuals with alcoholic cirrhosis. We observed significantly high mortality rate among alcoholic participants hospitalized with initial decompensation; deaths occurring in more than one-third of study participants within 90 days.

No Centralization Without Population: The Black Death and State Formation in Europe

No Centralization Without Population: The Black Death and State Formation in Europe

Isolamento e caracterização molecular de Cordyceps sp. de Bemisia tabaci e patogênico para Glycaspis brimblecombei (Hemiptera: Aphalaridae)

The Brazilian forestry sector stands out for its technology, forestry management practices, social and environmental responsibility and, mainly, for its high productivity and exotic pests can reduce it. The red gum lerp psyllid Glycaspis brimblecombei (Moore, 1964) (Hemiptera: Aphalaridae) is an important pest in Eucalyptus plantations. The parasitoid Psyllaephagus bliteus (Riek, 1962) (Hymenoptera: Encyrtidae), predatory bugs and entomopathogenic fungi such as Beauveria bassiana and Metarhizium anisopliae are the natural enemies and used in the biological control of the red gum lerp psyllid. The use of entomopathogenic fungi against exotic pests is increasing in the forestry sector and the prospecting and identification of fungus isolates is important for integrated pest management. The objective of this work was the isolation and molecular identification of Cordyceps spp. And to evaluate the pathogenicity of isolates, obtained from Bemisia tabaci (Gennadius, 1889) (Hemiptera: Aleyrodidae) adults, against to the red gum lerp psyllid G. brimblecombei. The fungi were isolated from B. tabaci adults found in soybean and tomato crops and molecularly identified. The conidia obtained were suspended in solution with Tween 80 (0.1%) at a concentration of 1.0 × 108 conidia/mL and sprayed on ten G. brimblecombei nymphs per Eucalyptus leaf cut and placed on a hydroretentive gel inside per Petri dishes as a replication. The number of dead insects was quantified, daily, for seven days, and transferred to humid chambers. Cordyceps javanica (LCBPF 11) and C. fumosorosea (LCBPF 12 and LCBPF 63) were identified with a molecular analysis and all isolates were pathogenic to the insects and indicates that they could be used to manage G. brimblecombei and adds to reports that, normally, fungi cause greater mortality on insects of the same order as that from which they were isolated.

Citrulline and ADI-PEG20 reduce inflammation in a juvenile porcine model of acute endotoxemia.

Arginine is a conditionally essential amino acid that is depleted in critically ill or surgical patients. In pediatric and adult patients, sepsis results in an arginine-deficient state, and the depletion of plasma arginine is associated with greater mortality. However, direct supplementation of arginine can result in the excessive production of nitric oxide (NO), which can contribute to the hypotension and macrovascular hypo-reactivity observed in septic shock. Pegylated arginine deiminase (ADI-PEG20, pegargiminase) reduces plasma arginine and generates citrulline that can be transported intracellularly to generate local arginine and NO, without resulting in hypotension, while maintaining microvascular patency. The objective of this study was to assess the efficacy of ADI-PEG20 with and without supplemental intravenous citrulline in mitigating hypovolemic shock, maintaining tissue levels of arginine, and reducing systemic inflammation in an endotoxemic pediatric pig model. Twenty 3-week-old crossbred piglets were implanted with jugular and carotid catheters as well as telemetry devices in the femoral artery to measure blood pressure, body temperature, heart rate, and respiration rate. The piglets were assigned to one of three treatments before undergoing a 5h lipopolysaccharide (LPS) infusion protocol. Twenty-four hours before LPS infusion, control pigs (LPS; n=6) received saline, ADI-PEG20 pigs (n=7) received an injection of ADI-PEG20, and seven pigs (ADI-PEG20 + CIT pigs [n=7]) received ADI-PEG20 and 250 mg/kg citrulline intravenously. Pigs were monitored throughout LPS infusion and tissue was harvested at the end of the protocol. Plasma arginine levels decreased and remained low in ADI-PEG20 + CIT and ADI-PEG20 pigs compared with LPS pigs but tissue arginine levels in the liver and kidney were similar across all treatments. Mean arterial pressure in all groups decreased from 90 mmHg to 60 mmHg within 1h of LPS infusion but there were no significant differences between treatment groups. ADI-PEG20 and ADI-PEG20 + CIT pigs had less CD45+ infiltrate in the liver and lung and lower levels of pro-inflammatory cytokines in the plasma. ADI-PEG20 and citrulline supplementation failed to ameliorate the hypotension associated with acute endotoxic sepsis in pigs but reduced systemic and local inflammation in the lung and liver.

Studia and Monastic Itinerancy. The Case of S. Giusto in Volterra after the Black Plague

Studia and Monastic Itinerancy. The Case of S. Giusto in Volterra after the Black Plague

Severe Traumatic Brain Injury Induced Coagulopathy in Pediatric: An Important Lesson with Literature Review

Children with coagulopathy had a greater mortality rate after moderate to severe traumatic brain injury (TBI). The purpose of the current study was to examine the most recent relevant literature in relation to the therapy of TIC in pediatric isolated severe TBI patients. A 5 years old boy presented to emergency department with decrease of consciousness after hit by a motorcycle. He was referred from the district hospital without proper stabilization within 3 hours after the injury. From the blood examination, hemoglobin level was 8.1 g/dl, base deficit -9.9mEq/L with PTT and aPTT no coagulation suggesting coagulopathy. Emergency non-contrast head computed tomography was performed and showed anterior skull base fracture with discontinuity in left squamous suture suggesting a diastases fracture with an air hypodensity lesion in left frontal area suggesting a pneumocephalus. There was also a hyperdense lesion with crescent shape in frontal and interhemispheric region suggesting subdural hematoma. Delayed operation for almost 6 hours was advocated due to transfusion of whole blood and fresh frozen plasma to correct coagulopathy. The operation was successful, the patient was survived but upon 2 years follow up, the patient still wasn’t able to perform normal daily activity. Localized injury at the brain manifesting in systemic coagulopathy requires special care. Several steps need to be evaluated before surgery but it should not delay the attempt of controlling the source of coagulopathy by it means lesion in the brain. Our case demonstrates the important of recognizing and managing coagulopathy in severe traumatic brain injury.

«Черная смерть» в Золотой Орде: поле для исследований по истории и археологии Казахстана в XIII–XIV веках

The Black Death (the pandemic of bubonic plague caused by the bacterium Yersinia pestis) is critical for understanding the collapse of the Golden Horde and its aftermath in the 14th century. Recent historical and aDNA research argues that the Qinghai-Tibetan plateau is the point of origin for the rise of new highly virulent strains of the bacterium. It has been argued recently that this disease was present in the region during the lifetime of Chinggis Khan. The pandemic spread through Kyrgyzstan and the cities of Central Asia to Khorezm. The disease reached Kaffa simultaneously via the northern route in 1346 and spread to the rest of the Mediterranean world and beyond in 1347. Recent research has identified the southern course of the disease via Iran to Azerbaijan as well. aDNA research has shown that the same bacterium was responsible for the mass burials in Burana (near Issıq Köl, Kyrgyzstan) and Volga Bulgaria as in medieval Europe. This has implications for the study of the history of the entire territory of Kazakhstan. This study concludes that archeologists should be looking for evidence of mass burials in depopulated urban centers dating from the late 1330s-1340s to corroborate this research and to find ancient samples of the bacterium Yersinia pestis

HISTORY OF MAJOR PANDEMICS: FROM ANTIQUITY TO THE COVID-19 PANDEMIC, GLOBALIZATION, AND LOCKDOWN

Pandemics have played a significant role in human history, presenting profound challenges to societies and Public Health. From plagues in ancient civilizations to the 21st-century COVID-19 pandemic that swept the globe, these health crises have reshaped lives and the functioning of society. Over the centuries, we have witnessed devastating pandemics such as the Justinian Plague, the Black Death, the Spanish Flu, and more recently, the HIV/AIDS pandemic, each leaving a lasting impact on humanity, resulting in extensive loss of life and altering the approach to public health challenges. The COVID-19 pandemic, which began in early 2020, has not only posed medical and scientific challenges but has also highlighted the intricate interplay between health, politics, economics, and society. Measures like lockdowns, social distancing, and mask-wearing have become integral parts of daily life in an effort to contain the virus's spread but have also impacted the economy, education, and people's mental well-being. Furthermore, it has become evident that pandemics disproportionately affect various segments of the population, with the most vulnerable being the hardest hit by the consequences. As we confront the COVID-19 pandemic and its aftermath, it is imperative to learn from the lessons gleaned from past pandemics. History teaches us that pandemics are complex phenomena that extend beyond medical aspects, having profound social, economic, and political implications. Ultimately, it is crucial for societies to come together based on science and solidarity to address the challenges posed by pandemics. It is also essential to recognize the importance of equitable resource distribution and caring for vulnerable populations. The COVID-19 pandemic underscores the need to strengthen public healthcare systems and invest in scientific research to be prepared for future health threats. History reminds us that pandemics are part of the human journey, and we must learn from them to build a more resilient world prepared to face the challenges the future may bring.