Prophylaxis Research Articles

In vivo and Laboratory Studies of Tetracycline Prevention of Foulbrood disease of Apis cerana indica Fab. and its Effects on Honey

Laboratory and field studies were carried out to assess the efficacy of the antibiotic tetracycline in preventing and managing American foulbrood (AFB) and European foulbrood (EFB) diseases in honey bees. Experiments with immature worker bees in the laboratory demonstrated that honey bee larvae could endure a broad range of antibiotic doses in their diet. The recommended dose of tetracycline (100 μg/ml) effectively protected young larvae from infection. However, once the dose exceeded this recommended level, it reached a point where it became lethal.

Cardiovascular disease risk reduction for all-cause mortality benefit in low-risk individuals

Background: Current recommendations for the primary prevention of cardiovascular disease (CVD) are based solely on 10-year CVD risk assessment. However, CVD mortality is not compared with all-cause mortality, which could provide insights into the potential benefits of CVD risk interventions on overall mortality. Methods: CVD risk for average American white and black males and females is calculated using the 2013 American Heart Association equations. CVD death risk is determined by combining CVD risk with the death rate following a CVD diagnosis. This CVD death risk is then compared with all-cause mortality data from National Vital Statistics Reports. A larger ratio indicates that most deaths are attributed to CVD, suggesting that intervention may be more beneficial. Results: The CVD mortality ratio is highest for white men and lowest for black men, indicating that white male likely to benefit most from CVD risk modification, while black males will benefit the least. Additionally, the ratio, and the potential benefit, decreases with age for all groups, especially after the age of 70. Conclusion: For the average U.S. population without a CVD diagnosis, the potential mortality benefit from interventions targeting CVD risk factors varies significantly based on patient characteristics such as race, age, and gender. The potential benefit is greatest for white males and decreases with age for all groups.

A study of CPITN score in Periodontics Clinic Patients, RSGM Airlangga University, 2022

Background: Approximately 90% of the global population suffers from periodontal disesase, characterizes by bleeding gums, pain, and bad breath. The impact of this disease is diverse, ranging from tooth loss, disruption of aesthetics and confidence, to influencing individual nutritional status. The disease can be caused by damage of the periodontal tissues. Therefore, the Community Periodontal Index of Treatment Needs (CPITN) is highly essential for assessing the extend of issues in periodontal tissues, including evaluating oral and dental health problems in patients. This assessment can aid in the treatment and prevention of periodontal disease. Material and Methods: This research is a descriptive study. The population consists of all patients who visited the periodontology clinic at the Faculty of Dentistry, Airlangga University, in the year 2022. The sample was taken using a total sampling technique, involving secondary data obtained from the periodontal status cards of patients, specifically focusing on the examination data related to the condition of periodontal tissues based on the Community Periodontal Index of Treatment Needs (CPITN). Conclusion: The CPITN scores vary between gender and age groups of the patients. Therefore, bivariate research is needed to analyze the relationship of these parameters with the CPITN scores of periodontology patients.

First Report of Leaf Spot on Lonicera japonica Caused by Aspergillus niger in China.

Honeysuckle (Lonicera japonica Thunb, LJ) is a common medicinal and edible plant (He et al. 2022). It has been utilized in various industries such as biomedicine, animal husbandry, and food production (Li et al. 2014; Su et al. 2020). In June 2023, a significant leaf lesion was observed on approximately 20% of honeysuckle "Juhua No.1" leaves in a 3.33-ha field at the base of Julu County, Hebei province, China. Almost all leaves were infected. Leaf spot disease occurred in the field honeysuckle throughout the flowering period, especially after picking. The disease mainly infected the leaves of honeysuckle, forming irregular spots on the edge of the leaf surface with black-brown edges, the midrib and lateral veins were affected (Figure S1A). In advanced stages, the entire leaf would become necrotic. For pathogen isolation, small pieces (4×4 mm) of the infected tissue from diseased leaves were surface sterilized with 75% ethanol and 5% sodium hypochlorite, rinsed with the sterile water, incubated on PDA. Finally, six isolated pathogens were obtained. Hyphae were white. The mycelium was multicellular, had diaphragm. Conidiophores protruded from the stroma, started as spherical structures and gradually developed into radial, black-brown formations. Spore acrosome was subglobose, bilayered pedicels covering acrosome, 40-60 µm in diameter, yellowish brown (Figures S1B, S1C). Based on morphological and cultural characteristics, the leaf spot disease fungus was tentatively identified as Aspergillus spp. (Wei 1979). To test the pathogenicity of pathogen, leaves of three healthy potted honeysuckle "Juhua No.1" plants were inoculated by sprayed with conidial suspensions (106 spores/ml) (Figure S1D). Negative controls were established by inoculating leaf with sterile distilled water. All plants were incubated in a greenhouse at 28 ± 2℃. The experiment was replicated three times. After 10 days, typical leaf spot symptoms were observed on inoculated leaves, whereas no symptoms were found on the control groups. The re-isolated fungus from the inoculated leaves displayed the same morphological traits (Figures S1E-S1H), again identified as Aspergillus spp., confirming Koch's postulates, designated as H2. To confirm the pathogen's identity, genomic DNA was extracted from the pathogenicity isolate H2. The 18S rDNA and the ITS genes were amplified and sequenced using primer pairs S1/S2 (Zhang et al. 2018) and ITS1/ITS4 (Zhang et al. 2023), respectively. Results of BLAST searches showed that the 18s rDNA and ITS sequences of H2 were highly homologous (>99%) with Aspergillus niger. The close genetic relationship indicated that H2 belonged to the genus Aspergillus (Figure S2a). We further sequenced the whole genome of H2. The sequence data were available in the NCBI GenBank (Accession number: PRJNA1117256). We also analyzed the ANI (Yoon et al. 2017) and digital DNA-DNA blotting (dDDH) (Figures S2b, S2c). The ANI values of H2 compared to Aspergillus niger CBS 554.65 and Aspergillus niger KJC3 were higher than 95%. The dDDH values of H2 compared to Aspergillus niger CBS 554.65 and Aspergillus niger KJC3 were higher than 70%. Above all results, honeysuckle leaf spot disease was identified as Aspergillus niger. This is the first report of leaf spot on Lonicera japonica caused by Aspergillus niger in China. Our findings expand the geographical range of A.niger-infected plants, also provide reference for scientific prevention and control of honeysuckle leaf spot disease.

Plasma Brain-Derived Neurotrophic Factor (BDNF) Levels and BDNF Promoters’ DNA Methylation in Workers Exposed to Occupational Stress and Suffering from Psychiatric Disorders

Introduction: Decreased plasma BDNF (pBDNF) levels have been proposed as a biomarker in the illness phases of mood disorders. This cross-sectional study aimed to evaluate the pBDNF and BDNF promoters’ DNA methylation levels in workers exposed to occupational stress and suffering from work-related stress disorders. Methods: the pBDNF and BDNF exon I and IV promoters’ methylation levels were measured by specific immunoassays and methylation-sensitive high-resolution melting (MS-HRM) in 62 patients with adjustment disorders (AD), 79 patients with major depressive disorder (MDD) and 44 healthy controls. Occupational stress was evaluated in the patients and controls using the Job Content Questionnaire (JCQ). Results: the pBDNF levels were significantly higher in the MDD (p < 0.001) and AD (p < 0.0001) patients than in the controls. The MDD patients showed significantly lower pBDNF levels than the AD ones (p = 0.01). The BDNF exon I and IV promoters’ methylation levels were significantly higher in the MDD patients than in the AD ones (exon I promoter: p = 0.0001, exon IV promoter: p < 0.0001) and controls (exon I promoter: p = 0.0001, exon IV promoter: p < 0.0001). In the patients, but not in the controls, the BDNF promoters’ methylation levels showed significant negative correlations with occupational stress. Conclusions: BDNF could play a key role in the pathophysiology of stress-related disorders and the peripheral elevation of it observed in patients exposed to occupational stress could suggest a protective mechanism for neurons from stress-mediated damage. The elevation of the pBDNF levels, even in MDD, may characterize a “reactive” subtype of depressive episode, while the significant elevation of the BDNF promoters’ methylation levels in depressed patients could indicate a predisposition to more severe illness under stress. Further research is needed, focusing on biomarkers for stress-related disorders as a potential tool for the diagnosis and prevention of occupational diseases.

Adding traditional and emerging biomarkers for risk assessment in secondary prevention: A prospective cohort study of 20,656 patients with cardiovascular disease.

This study aims to explore whether conventional and emerging biomarkers could improve risk discrimination and calibration in secondary prevention of recurrent atherosclerotic cardiovascular disease (ASCVD), based on a model using predictors from SMART2. In a cohort of 20,658 UK Biobank participants with medical history of ASCVD, we analysed any improvement in C indices and net reclassification index (NRI) for future ASCVD events, following addition of LP-a, ApoB, cystatin C, HbA1c, GGT, AST, ALT, and ALP, to a model with predictors used in SMART2 for the outcome of recurrent major cardiovascular event. We also examined any improvement in C indices and NRIs replacing creatinine based estimated glomerular filtration rate (eGFR) with cystatin C based estimates. Calibration plots between different models were also compared. Compared with the baseline model (C index=0.663), modest increment in C indices were observed when adding HbA1c (ΔC=0.0064, p<0.001), cystatin C (ΔC=0.0037, p<0.001), GGT (ΔC=0.0023, p<0.001), AST (ΔC= 0.0007, p<0.005) or ALP (ΔC=0.0010, p<0.001) or replacing eGFRCr with eGFRCysC (ΔC=0.0036, p<0.001) or eGFRCr-CysC (ΔC=0.00336, p<0.001). Similarly, the strongest improvements in NRI were observed with the addition of HbA1c (NRI=0.014), or cystatin C (NRI= 0.006) or replacing eGFRCr with eGFRCr-CysC (NRI=0.001) or eGFRCysC (NRI=0.002). There was no evidence that adding biomarkers modify calibration. Adding several biomarkers, most notably cystatin C and HbA1c, but not LP-a, in a model using SMART2 predictors modestly improved discrimination.

Genomic revolution in parasitology: Unlocking the mysteries of parasites

Whole-genome sequencing has revolutionized parasitology, offering insights into parasites' biology, evolution, and potential interventions. This discussion explores the profound impact of genomics on parasitology, from democratizing research to understanding parasites' intricacies and their relationships with hosts. High-throughput sequencing has made genomics accessible globally, allowing labs worldwide to study parasitic organisms. Whole-genome sequencing provides a comprehensive view of parasite genes and regulatory elements, facilitating in-depth biological investigations. It helps identify drug targets and reveals the genetic basis of drug resistance, which is vital for new antiparasitic drug development. Comparative genomics is a powerful tool for understanding the evolutionary relationships among parasites. Researchers create robust phylogenetic trees that clarify parasite evolution by comparing genomic data. Case studies of malaria parasites, trypanosomes, schistosomes, and Leishmania species illustrate the insights gained. Genomics also sheds light on parasite life cycles, uncovering gene expression, regulatory networks, key proteins, and molecular markers. This informs our understanding of host-specific adaptations. Practical applications encompass drug target discovery, vaccine development, diagnostics, intervention strategies, understanding drug resistance, and disease eradication efforts. In conclusion, genomics is transforming parasitology, especially whole-genome sequencing and comparative genomics. It offers a holistic view of parasites and their evolution, paving the way for innovative antiparasitic strategies and contributing to the control and potential eradication of parasitic diseases.

Rheumatic diseases and metabolism: where centre and periphery meet.

Over the past few decades, the connection between metabolism and various inflammatory and rheumatic diseases has been an area of active investigation. Nonetheless, the precise mechanisms underlying these relationships remain a topic of ongoing debate, owing in part to conflicting data. This discrepancy can be attributed to the predominant focus on peripheral mechanisms in research into the metabolic consequences of rheumatic diseases. However, a wealth of evidence supports the notion that the central nervous system, specifically the hypothalamus, has an important influence on metabolic homeostasis. Notably, links have been established between crucial hypothalamic mechanisms responsible for regulating energy balance (including food intake, thermogenesis, and glucose and lipid metabolism), such as AMP-activated protein kinase, and the pathophysiology of rheumatoid arthritis. This Review aims to comprehensively examine the current understanding of central metabolic control in rheumatic diseases and explore potential therapeutic options that target this pathophysiological mechanism.

Evaluation of the Diversities in the Inflammatory Responses in Cats With Bacterial and Viral Infections.

Understanding the nature of inflammatory responses in cats with bacterial and viral infections is essential for accurately managing the infection. This study aimed to investigate the diversities of inflammatory responses between bacterial and viral infections in cats to figure out their role in the pathophysiology of these infections. Seventy-five owned cats were included in the study. The evaluations were performed based on three groups: healthy control, bacterial infection group (those with bronchopneumonia and gastrointestinal tract and urinary tract infections) and viral infection group (21 with feline coronavirus [FCoV], 3 with feline leukaemia virus [FeLV] and 1 with feline calicivirus), each containing 25 individuals. Total and differential leukocyte counts, C-reactive protein (CRP), transforming growth factor beta (TGF-β), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and interleukin-10 (IL-10) concentrations were assessed in the blood samples collected from sick and healthy animals. No statistically significant difference was noted in serum TNF-α, IL-1β and IL-10 concentrations of the infected cats (p=0.996, p=0.160 and p=0.930, respectively). Serum TGF-β concentration in the viral infection group was reduced compared to the healthy control (p=0.001). In contrast, WBC count and IL-6 and CRP concentrations were increased in the cats with bronchopneumonia, gastrointestinal tract infections and urinary tract infections compared to the healthy control and viral infection groups (p=0.001, p=0.001 and p=0.001, respectively). This study revealed significant differences between bacterial and viral infections regarding the fashion of inflammatory responses in cats, and the relevant data will undoubtedly contribute to the management and control of feline infectious diseases, rendering the development of novel therapeutic strategies.

Multifaceted implementation strategy to improve the evaluation of penicillin allergies in perioperative patients: a pre-post feasibility implementation study.

The U.S. Centers for Disease Control and Prevention encourages nurses to evaluate penicillin allergies as part of hospital-based antibiotic stewardship programs. We evaluated the feasibility of an implementation strategy to improve nurses' comprehensive documentation of penicillin allergies. We defined feasibility as the uptake and acceptability of documentation procedures. Six-month pre-post feasibility implementation study. Outpatient surgical areas of an academic medical center located in the U.S. The implementation strategy was guided by the Capability, Opportunity, Motivation Model for Behavior Change and included, building an interdisciplinary coalition to iteratively evaluate the implementation effort, educational meetings with surgical prescribers and perioperative nurses, the development and distribution of educational pocket cards, and structured communication messages in the electronic medical record. A total of 426 patients with 487 penicillin allergy records (216 records pre-implementation period, 271 records post-implementation period) were analyzed. Penicillin allergy documentation contained the following information in the pre- versus post-implementation period: symptoms of the reaction (87% vs 87%), timing/years since reaction (8% vs 26%), onset of reaction in relation to taking penicillin (0% vs 21%), how symptoms resolved (0% vs 21%), and penicillin re-exposure (3% vs 21%). Focus groups revealed nurses perceived documentation procedures as highly acceptable. Major drivers of acceptability included the perceived effectiveness of a detailed allergy history and self-efficacy in conducting a detailed allergy history. Nurses perceived the comprehensive documentation of penicillin allergy history intervention as acceptable, and uptake improved following a theory-informed implementation strategy. We offer implementation strategy components to facilitate nurses' engagement in penicillin allergy evaluation.

Antimicrobial Performance of Different Metals

Health care associated infections or nosocomial infections (NI) is the fourth leading cause of disease and the most common complication affecting hospitalised patients in addition to a minimum of 175,000 deaths every year in industrialised countries. The Center for Disease Control and Prevention (CDC) states that influenza is transmitted from person to person primarily via large virus-laden droplets or through direct or indirect contact with respiratory secretions when touching surfaces contaminated with influenza virus and approximately 80% of the infections are transmitted via touch surfaces. In the year 2020 the Coronavirus (Covid 19) spread has affected the global community and also caused a great concern for the people and health care workers with a global infected population of more than five million. With the ongoing population rise in the cities growing drug resistant bacteria, increasing infection rate in hospitals and communities, ageing world population strongly indicates the need to minimise the spread of infections via touch surfaces. Metals (and products manufactured from them) such as copper and silver are known to exhibit antimicrobial properties. These metals, or composites containing them, can be used as additives and incorporated into other materials such as paints, plastics and powder coatings to imbue these materials with antimicrobial properties. In this paper we present the inherent antimicrobial properties of a copper containing alloy, two alloys of hospital grade steel (304 and 316), extruded aluminium (606013), anodized aluminium (606013) and zinc clad aluminium (3003-7072). Additionally, these materials were coated in epoxy resin powder coating with and without silver based antimicrobial additive. The ability of these metal alloys to reduce the population of inoculated microorganism numbers was assessed via the international standard (ISO) 22196:2011 Measurement of antimicrobial activity on plastics and other non-porous surfaces.

The contribution of extracellular RNA and its derived biomaterials in disease management

AbstractThe RNA found in the circular system is known as extracellular RNA (exRNA). This kind of RNA has been found to play a biological role similar to that of a messenger. They can be used as indicators of disease status or the physiological health of an organism. A large number of RNA‐based biomaterials have been developed by simulating the biological function and structure of natural RNA molecules. The structural programmability of RNA‐based biomaterials provides the spur for scientists to pioneer new approaches in disease detection and prevention. Nevertheless, the link between exRNA function and the design of RNA‐based biomaterials has not been fully understood. Understanding the biological structure and function of exRNA will contribute to the clinical translation of this novel biotechnology. The present review discusses the research progress associated with exRNA and their derivatives to bridge the gap between natural exRNA and RNA‐based biomaterials.

Optimization of architectural design and construction with integrated BIM and PLM methodologies.

Digital transformation in the architecture industry encounters challenges such as data silos within design stages, between design and construction, and across the entire industry chain, including BIM and project management. This study introduces a pioneering approach for seamlessly integrating building information modeling (BIM) and product lifecycle management (PLM) within the management framework and collaborative workflows of architectural design and construction. The proposed methodology was implemented in two major projects, namely, the Wuhan Next-Generation Weather Radar Construction Project and the Hubei Center for Disease Control and Prevention Comprehensive Capacity Enhancement Project (Phase I), with the former being China's first end-to-end digitally integrated construction project. Compared with traditional projects, these implementations achieved improvements of 24.39% and 38.04%, respectively, in objective function values. The findings highlight the unique advantages of BIM-PLM integration in optimizing lifecycle management, enhancing cross-disciplinary, cross-enterprise, and cross-regional collaboration, improving project design efficiency and quality, and reducing costs and waste. This integration provides valuable insights into the digital advancement of the construction industry.

An evaluation of vilobelimab (anti-C5a) as a cost-effective option to treat severely ill mechanically ventilated patients with COVID-19.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. COVID-19 patients in intensive care units (ICUs) requiring invasive mechanical ventilation (IMV) have few available treatment options. PANAMO, a multicenter, double-blind, randomized, placebo-controlled phase 3 study of vilobelimab, which blocks the inflammatory process caused by complement component 5a, demonstrated a significant mortality benefit at 28 and 60 days in these patients. A cost-effectiveness analysis was conducted to assess the incremental cost per quality-adjusted life-year (QALY). A Markov model was used to estimate QALYs and the incremental cost-effectiveness ratio (ICER) of vilobelimab plus standard of care (SOC) versus SOC alone. The model simulated progression from severe COVID-19 to survival or death over a lifetime horizon. Outcomes data (COVID-19 all-cause mortality and renal replacement therapy) were incorporated from the PANAMO trial. COVID-19 mortality estimates were based on Centers for Disease Control and Prevention age-specific survival data. Utility values and hospital costs came from the literature. Vilobelimab cost was obtained from RED BOOK Online. For COVID-19 ICU patients, total costs of care were $103,414 (SOC) and $132,247 (SOC plus vilobelimab), respectively, resulting in an incremental cost of $28,833. SOC provided 6.70 QALYs versus 7.99 QALYs for vilobelimab, an additional 1.29 QALYs. The ICER for vilobelimab plus SOC versus SOC alone was $22,287/QALY. Probabilistic sensitivity analysis demonstrated the robustness of the cost-effectiveness result as vilobelimab plus SOC was favored at a willingness-to-pay threshold of $50,000 in over 81% of iterations. Vilobelimab provides a cost-effective option to treat ICU patients with severe COVID-19 receiving IMV compared to SOC, at well below the commonly accepted $50,000 US willingness-to-pay threshold.

Local Supports to Break the Cycle: A Description of Intersectional Interventions to Address Adverse Childhood Experiences and Drug Overdose.

Adverse childhood experiences (ACEs), substance use disorders (SUDs), and overdose are interconnected issues impacting individuals and communities at multiple levels of the social ecology and across generations. Few studies describe approaches that intentionally and simultaneously address these issues. This paper examines activities of 15 sites across the country that were designed to simultaneously prevent ACEs, SUD, and overdose. This paper describes the work at the intersection as well as gaps and opportunities. Describing ways to implement intersectional programming may assist other organizations in taking similar steps in their communities. From December 2020 through July 15, 2023, funded sites received technical assistance from the National Association of County and City Health Officials and the Centers for Disease Control and Prevention for 18months to support the implementation, adaptation, and/or expansion of evidence-based programs to address ACEs, SUD, and overdose. Activities were coded to identify intersectional interventions that addressed ACEs, SUD, and overdose. Most of the ACEs prevention strategies and overdose prevention priority areas/guiding principles from which communities could choose were represented. Most activities were implemented with caregivers and families and addressed ACEs through interventions to lessen harm or to promote social norms. Primary prevention and coordination of resources were the most used overdose prevention priority area/guiding principle. It is possible to address the intersection of ACEs, SUD, and overdose on a local level. Opportunities to further address the intersection include incorporating more secondary and tertiary prevention strategies, expanding economic supports, and increasing the work focused on equity.

Evaluation of a Question Prompt List About Cardiovascular Disease Risk and Prevention After Hypertensive Pregnancy: A Pilot Study.

The aim of this study was to pilot test a question prompt list (QPL) about cardiovascular disease (CVD) risk reduction after hypertensive pregnancy (HDP). In a prospective cohort study of adult women who had HDP given the QPL before and surveyed after a physician visit, we assessed perceived person-centred care, self-efficacy for self-management, perceived self-management and QPL feasibility. Twenty-three women participated: 57% of diverse ethno-cultural groups, 65% < 40 years of age and 48% immigrants. Most scored high for person-centred care (mean 4.1 ± 0.2/5); and moderately for self-efficacy (mean 7.4 ± 0.6/10) and self-management (mean 3.1 ± 0.3/5). Most appreciated QPL design and reported QPL benefits: helped them to prepare for the visit and know what to ask; increased confidence to ask questions, knowledge of the link between HDP and CVD and lifestyle behaviours to reduce CVD risk. Most reported that physicians were receptive to discussing QPL questions. Women appreciated the QPL and knowledge about self-management was high but self-efficacy for or perceived self-management was moderate. It appears feasible to share a QPL with ethno-culturally diverse women who can share it with physicians to facilitate discussions about post-pregnancy HDP-related CVD risk. This study involved women who experienced HDP and engaged ethno-culturally diverse women with lived experience of HDP as study advisors in all stages of the research.

Understanding Community-Specific Health Behaviors to Prevent Type 2 Diabetes and Depression in Rural Adolescents: A Qualitative Study.

Type 2 diabetes (T2D) and depression co-occur, and rates are on the rise in adolescents, disproportionately affecting teenagers in rural communities and those who identify as members of historically disadvantaged racial/ethnic groups. Addressing the promotion of health behaviors is important for prevention of these comorbid health concerns; however, disparities in their prevalence highlight that a healthy lifestyle is not equally accessible for all individuals. Thus, holistic and multi-level approaches that address structural inequities, leverage cultural and family assets, and are effectively integrated into the community are critically needed. This project is an initial phase of a broader community-academic collaboration that aims to address preventable chronic diseases and mental health in adolescents living in the rural Mountain West by tailoring an evidence-based health behavior and lifestyle intervention for these communities. Interviewers conducted semi-structured interviews with N = 19 individuals (n = 11 adolescents, 11-17years, n = 8 mothers) who lived in neighboring counties in the rural Mountain Western USA and had a family history of T2D. Interview schedules were developed by an interdisciplinary team, with community input, and covered topics such as food and staying active, stress, T2D risk, and community and culture. Using thematic analysis, data were reduced through coding, categorization, and development of themes. Data revealed three major themes: "Families Face Systemic Barriers to Health," "Family Routines Support Health," and "Connection is Crucial to Holistic Health." Findings reveal opportunities for addressing health inequities and developing effective, integrated T2D and depression prevention strategies within this specific community. They also potentially contain insights that may be applicable to others interested in adapting interventions for diverse groups.

මාතර හෙළ වෙදකම පිළිබඳ විමර්ශනාත්මක අධ්‍යයනයක්

Hela wedakama is Sri Lanka’s local helth insurance system. That has existed since time immemorial.This was not introduced from any other country, but was produced by the ancient inhabitants of ourcountry. Traditional Hela medicine treats the three categories of human, animal and non-humanTraditional medicine helps in the prevention of physical, mental, infectious and non-infectious diseases.The specialties of Hela medicine are unique to each region and they differ from each other. Matararegion has been known as the birth place of Hela medicine since time immemorial. Matara Helavedakama is at the forefront in providing treatment for human and non-human categories as well asphysical, mental, infectious and non-infectious diseases. Matara Hela medicine is special, because it isbased on the practices of the area for disease prevention. Accordingly, the content and practices ofMatara Hela medicine were studied in this research. Data was collected through library reference, fieldstudy and interviews. According to the facts revealed in the study, it was possible to identify thepeculiarities of Hela medicine, that is unique to the Matara area.

Isolation and identification of probiotic Bacillus subtilis AJQ03 from the intestinal tract of Anguilla japonica (Japanese eel)

In recent years, the use of fish-derived probiotics in aquaculture has become more widespread. However, research on Anguilla japonica-derived probiotics is still limited. To evaluate the potential of probiotics for disease control in eel aquaculture, isolates were obtained from the intestinal tract of healthy Anguilla japonica. These isolates were assessed for their adhesion properties, inhibition of pathogen adhesion, and hydrolytic enzyme production. Morphological characteristics and 16S rRNA sequence analysis were used for identification. Results showed that the AJQ03 strain adhered to the intestinal mucus and inhibited common pathogenic bacteria through adhesion inhibition, and further produced amylase, lipase, protease, and cellulase. Based on morphological characteristics and 16S rRNA sequencing, AJQ03 was identified as Bacillus subtilis. The strain demonstrated tolerance to various extreme conditions, as well as survival in simulated gastrointestinal fluids and superior growth in intestinal fluid compared to Luria-Bertani (LB) broth. In vitro safety tests showed that AJQ03 was not resistant to 32 antibiotics and exhibited γ hemolysis on blood plate. In vivo safety tests demonstrated a 100% survival rate for the fish, with stable organ indices, reduced bacterial loads in the liver and spleen, and complete bacterial clearance by day 7 without residue. Intestinal bacterial load results confirmed effective colonization by strain AJQ03. Analysis of the impact of AJQ03 on the gut microbiota of A. japonica revealed a significant increase in the relative abundance of Bacillus at the genus level, corroborating the colonization efficiency of AJQ03. Additionally, the relative abundances of Klebsiella, Pseudomonas, and Aeromonas were significantly lower compared to the controls, indicating that strain AJQ03 effectively reduced harmful bacteria and improved gut microbiota composition. This study confirms that B. subtilis AJQ03, isolated from the intestine of A. japonica, can serve as a probiotic candidate in A. japonica aquaculture.

Comparative Efficacy of Adagrasib and Sotorasib in KRAS G12C-Mutant NSCLC: Insights from Pivotal Trials

Background: The KRAS G12C mutation, prevalent in various malignancies, including non-small cell lung cancer (NSCLC), represents a unique therapeutic target. Adagrasib and sotorasib, two FDA-approved agents specifically targeting this mutation, have shown promise in clinical trials. This study aims to compare their efficacy in treating KRAS G12C-mutated NSCLC, drawing insights from pivotal clinical trials. Methods: We analyzed data from three key clinical trials: KRYSTAL-1, CodeBreak100, and CodeBreak200. Our methodology involved reconstructing individual patient data from published Kaplan–Meier curves using the IPDfromKM tool (Version 0.1.10). The primary endpoints were progression-free survival (PFS) and overall survival (OS), evaluated through hazard ratios (HRs) and the restricted mean survival time (RMST) method. Results: The HR for PFS favored adagrasib (HR: 0.90 [95% CI: 0.69, 1.19], p = 0.473), suggesting a non-significant trend toward better disease control compared to sotorasib. For OS, the HR was 0.99 [95% CI: 0.75, 1.33] (p = 0.969), indicating no significant difference between the two drugs. RMST analysis supported these findings, with adagrasib showing a consistently higher RMST in PFS at 6, 12, and 18 months. However, OS benefits converged over time, with adagrasib marginally surpassing sotorasib by the 18-month mark. Conclusions: This comprehensive analysis reveals that while adagrasib may offer a slight advantage in PFS, both drugs demonstrate comparable efficacy in OS for KRAS G12C-mutated NSCLC. The subtle differences observed, particularly in PFS, could inform clinical decision-making, emphasizing the need for personalized treatment strategies. Future research should focus on long-term effects and identifying patient subgroups that may benefit more from one drug over the other.