Emerging Health Issues Research Articles

A Pilot Study of Transplanting Methods for Wilding American Beech (Fagus grandifolia)

American beech is facing pressure from a number of emergent health issues including beech bark disease, beech leaf disease, beech leaf mining weevil, and climate and habitat change. Interest has increased in the propagation of American beech in response to the demand for more disease-resistant American beech for use in restoration. This study describes the first steps towards publishing methods for transplanting beech in order to supplement commercially available beech seedlings in an area with multiple agencies depleting the existing stock of slow growing species. American beech seedlings were purchased from a nursery in northern Michigan and were excavated from natural stands in the Hiawatha National Forest. Survival rates for these cohorts were compared after a growing season and by the relative amounts of fine roots present on the trees. Generally, the wildling seedlings had a higher survivability than the purchased bare root seedlings. Future work is proposed that could clarify the conditions leading to the higher survival in these wildling seedlings, including the potential for handling the time or age of the seedlings to influence survival.

Utilizing Causal Loop Diagramming to Explore a Research and Evaluation Capacity Building Partnership.

The capacity to engage in research, evaluation and evidence-informed decision-making supports effective public health policy and practice. Little is known about partnership-based approaches that aim to build capacity across a system or how to evaluate them. This study examines the impacts of a research and evaluation capacity building partnership called the Western Australian Sexual Health and Blood-borne Virus Applied Research and Evaluation Network (hereafter, SiREN). SiREN aims to strengthen capacity across a system of clinical and medical services and government and non-government organizations. These organizations are connected through their shared aim of preventing and managing sexually transmissible infections and blood-borne viruses. To examine SiREN, systems concepts and methods were used. Data were collected from SiREN organizational documents (n = 42), a survey tool (n = 104), in-depth interviews (n = 17), a workshop and three meetings with SiREN stakeholders and used to develop two causal loop diagrams. Findings show engagement with SiREN was influenced by a complex interplay of contextual (e.g., organizational capacity) and process (e.g., presence of trusting relationships) factors. SiREN contributed to system level changes, including increased resources for research and evaluation, the development of networks and partnerships that led to more efficient responses to emerging health issues, evidence sharing, and sustainable research and evaluation practice. The use of causal loop diagrams enabled the identification of key leverage points that SiREN can use for continuous improvement or evaluation. The focus on how contextual factors influenced SiREN's ability to create change provides valuable information for researchers, policymakers or practitioners seeking to develop a similar partnership.

Hepatitis of Unknown Origin and Etiology (Acute Non HepA-E Hepatitis) among Children in 2021/2022: Review of the Current Findings

Several clusters and individual cases of acute hepatitis have been reported in the US, Europe and recently in Asia and Central America since October 2021. A laboratory investigation of the common viral hepatitis agents (HAV, HBV, HCV, HDV and HEV) yielded negative results prompting the use of the term “acute non HepA-E hepatitis” to describe this condition. The cases were characterized by the manifestations of acute hepatitis (abdominal pain, vomiting, diarrhea, jaundice and very high levels of liver enzymes) affecting children with a median age of 3–4 years. The exact underlying etiology has not been revealed yet; however, a leading hypothesis is that an infectious agent is the culprit, underlying cause or a risk factor for acute non HepA-E hepatitis occurrence. So far, laboratory testing has shown the presence of the group F human adenovirus serotype 41 (HAdV-F41) in about three-fourths of the investigated cases. As of 13 May 2022, more than 450 cases were reported worldwide, the majority of which were in the UK (n = 176), the US (n = 109), 13 European countries (at least 103 cases) and in Argentina, Brazil, Canada, Costa Rica, Indonesia, Israel, Japan, Palestine, Panama, Singapore and South Korea. Vigilant surveillance and epidemiologic investigations to identify further cases are warranted to delineate the features of this emergent public health issue. The possible role of environmental and toxic agents including foodborne toxins should also be considered. Specific guidelines for identification of further cases are necessary, particularly in low-income settings where testing for adenoviruses is not considered routinely. A genetic analysis of HAdV-F41 isolates is recommended to assess the potential changes in the virus genome with subsequent possible altered virus behavior. Immunopathogenesis is another possibility that should be evaluated considering the lack of viral structures in liver biopsies of the affected children in the US.

A comparative study between emergency department provisional diagnoses and final discharge diagnoses in tertiary and quaternary health centers of India

An Emergency Department (ED), or the Emergency Room (ER), is a specialized patient care facility in tertiary and quaternary health care centers dedicated to Emergency Medicine. The main function of which, is to take care of patients with immediate and emergent health issues. In view of limited literature on Emergency Medicine in India, a comparative study of the admission and discharge diagnoses was performed, as a baseline for future reference in continuous quality improvement. A scientific endeavor dedicated to undertake a comparative study between the emergency department provisional diagnosis and the final inpatient discharge diagnosis, thus determining the diagnostic accuracy of the emergency medicine department in large health care centers of India. A total of 3000 patients visiting the emergency department were considered and a comparative study was performed between the emergency department diagnoses and the final discharge diagnoses of these patients after admission to respective specialties. In 81% cases the emergency department diagnoses was found to be concordant with the discharge diagnoses of the patients under study, and the concordance was found to be statistically significant. According to our study, the initial diagnoses made by emergency department physicians were mostly consistent with the final diagnoses. The significance of a correct diagnosis in the emergency department is far reaching. A correct diagnosis of the disease in the emergency enables prompt implementation of desired management protocols facilitating better patient outcomes and favorable disease prognosis. However, our study also highlights the need for further improvement in the diagnostic protocols in the emergency department.

Secondary Metabolite Variation and Bioactivities of Two Marine Aspergillus Strains in Static Co-Culture Investigated by Molecular Network Analysis and Multiple Database Mining Based on LC-PDA-MS/MS.

Co-culture is known as an efficient way to explore the metabolic potential of fungal strains for new antibiotics and other therapeutic agents that could counter emerging health issues. To study the effect of co-culture on the secondary metabolites and bioactivities of two marine strains, Aspergillus terreus C23-3 and Aspergillus. unguis DLEP2008001, they were co-cultured in live or inactivated forms successively or simultaneously. The mycelial morphology and high-performance thin layer chromatography (HPTLC) including bioautography of the fermentation extracts were recorded. Furthermore, the agar cup-plate method was used to compare the antimicrobial activity of the extracts. Based on the above, liquid chromatography-photodiode array-tandem mass spectrometry (LC-PDA-MS/MS) together with Global Natural Products Social molecular networking (GNPS) and multiple natural products database mining were used to further analyze their secondary metabolite variations. The comprehensive results showed the following trends: (1) The strain first inoculated will strongly inhibit the growth and metabolism of the latter inoculated one; (2) Autoclaved A. unguis exerted a strong inducing effect on later inoculated A. terreus, while the autoclaved A. terreus showed high stability of its metabolites and still potently suppressed the growth and metabolism of A. unguis; (3) When the two strains are inoculated simultaneously, they both grow and produce metabolites; however, the A. terreus seemed to be more strongly induced by live A. unguis and this inducing effect surpassed that of the autoclaved A. unguis. Under some of the conditions, the extracts showed higher antimicrobial activity than the axenic cultures. Totally, A. unguis was negative in response but potent in stimulating its rival while A. terreus had the opposite effect. Fifteen MS detectable and/or UV active peaks showed different yields in co-cultures vs. the corresponding axenic culture. GNPS analysis assisted by multiple natural products databases mining (PubChem, Dictionary of Natural Products, NPASS, etc.) gave reasonable annotations for some of these peaks, including antimicrobial compounds such as unguisin A, lovastatin, and nidulin. However, some of the peaks were correlated with antagonistic properties and remain as possible novel compounds without mass or UV matching hits from any database. It is intriguing that the two strains both synthesize chemical ‘weapons’ for antagonism, and that these are upregulated when needed in competitive co-culture environment. At the same time, compounds not useful in this antagonistic setting are downregulated in their expression. Some of the natural products produced during antagonism are unknown chlorinated metabolites and deserve further study for their antimicrobial properties. In summary, this study disclosed the different responses of two Aspergillus strains in co-culture, revealed their metabolic variation, and displayed new opportunities for antibiotic discovery.

Increasing incidence of Enterococcus-associated diseases in poultry in France over the past 15 years

Enterococci are commensal intestinal bacteria and opportunistic pathogens in humans and animals. Enterococcus-associated diseases are an emerging health issue in poultry. The aim of this retrospective study was to assess the occurrence of enterococci in poultry in France with regard to the manifested diseases and the affected avian species. Our analysis is based on veterinary laboratory data collected by the French poultry epidemiological surveillance network (RNOEA) that monitors avian diseases in France based on the voluntary participation of its veterinarian members. Since the creation of the network in 1989, 12, 177 Enterococcus cases have been reported by veterinary laboratories (Enterococcus cecorum 53.1% and Enterococcus faecalis 24.3%), with emergence starting in 2006, year in which Enterococcus represented 0.4% of all reported pathogens, and incidence growing to 12.9% in 2020. The main diseases associated with these reports were locomotor disorders 35.2% (mainly involving E. cecorum 77.9%), septicaemia 34.9% (involving E. cecorum 53.4% and E. faecalis 23.8%), and omphalitis 14.4% (mainly involving E. faecalis 59.5%). Most of these Enterococcus-associated diseases (71.5%) were reported in broilers (particularly affected by the locomotor disorders and septicaemia involving E. cecorum), accounting for 9.1% of all the diseases reported in this production sector, with an increase from 1.4% in 2006 to 17.2% in 2020. This study highlights the emergence of enterococcal diseases in poultry in France over the past 15 years and the need to maintain a surveillance system.

Commentary on Weinberger et al.: Tobacco and cannabis policies as drivers of nicotine and cannabis co-use - research and measurement implications to move the field forward.

Commentary on Weinberger et al.: Tobacco and cannabis policies as drivers of nicotine and cannabis co-use - research and measurement implications to move the field forward.

The Antibiotic Resistance Profiling of Bacteria Isolated from Hospital Wastewater in Multan

Resistance against antibiotics mainly due to their misuse and overuse is an emerging health issue, worldwide. Antibiotics release active antibiotic residues in the environment during their production. Bacteria encounter these active antibiotic residues and the genes present in them; resultantly, they acquire resistance against antibiotics. The current study was conducted to determine the prevalence of multidrug-resistant (MDR) bacterial strains, isolated from hospital wastewater. Using standard procedures, bacterial resistance patterns against different classes of antibiotics were analysed and their species level identification was made. The disc diffusion method was used to determine the bacterial activity against antimicrobial agents. Clear zones were measured separately in millimeters around each disc. Five wastewater samples were collected from different drainage regions of hospitals situated in Multan. A total of 45 bacterial strains were isolated. Out of these 45 bacterial strains, 13 (29%) were found resistant against two or more than two classes of antibiotics. All the bacterial strains (100%) isolated from samples 2 and 3 were MDR. Twenty-five bacterial strains (55.5%) belonged to the Bacillus species and others belonged to Enterococcus species, Micrococcus species, Staphylococcus species, and Streptococcus species, respectively. The presence of resistant bacterial strains in hospital waste demands the availability of effectual treatment plants to treat the waste before it is disposed of into hospital waste lines.

Digital Therapeutics Care Utilizing Genetic and Gut Microbiome Signals for the Management of Functional Gastrointestinal Disorders: Results From a Preliminary Retrospective Study.

Diet and lifestyle-related illnesses including functional gastrointestinal disorders (FGIDs) and obesity are rapidly emerging health issues worldwide. Research has focused on addressing FGIDs via in-person cognitive-behavioral therapies, diet modulation and pharmaceutical intervention. Yet, there is paucity of research reporting on digital therapeutics care delivering weight loss and reduction of FGID symptom severity, and on modeling FGID status and symptom severity reduction including personalized genomic SNPs and gut microbiome signals. Our aim for this study was to assess how effective a digital therapeutics intervention personalized on genomic SNPs and gut microbiome signals was at reducing symptomatology of FGIDs on individuals that successfully lost body weight. We also aimed at modeling FGID status and FGID symptom severity reduction using demographics, genomic SNPs, and gut microbiome variables. This study sought to train a logistic regression model to differentiate the FGID status of subjects enrolled in a digital therapeutics care program using demographic, genetic, and baseline microbiome data. We also trained linear regression models to ascertain changes in FGID symptom severity of subjects at the time of achieving 5% or more of body weight loss compared to baseline. For this we utilized a cohort of 177 adults who reached 5% or more weight loss on the Digbi Health personalized digital care program, who were retrospectively surveyed about changes in symptom severity of their FGIDs and other comorbidities before and after the program. Gut microbiome taxa and demographics were the strongest predictors of FGID status. The digital therapeutics program implemented, reduced the summative severity of symptoms for 89.42% (93/104) of users who reported FGIDs. Reduction in summative FGID symptom severity and IBS symptom severity were best modeled by a mixture of genomic and microbiome predictors, whereas reduction in diarrhea and constipation symptom severity were best modeled by microbiome predictors only. This preliminary retrospective study generated diagnostic models for FGID status as well as therapeutic models for reduction of FGID symptom severity. Moreover, these therapeutic models generate testable hypotheses for associations of a number of biomarkers in the prognosis of FGIDs symptomatology.

Swimming Pool Regulations in the COVID-19 Era: Assessing Acceptability and Compliance in Greek Hotels in Two Consecutive Summer Touristic Periods

The COVID-19 pandemic has urged many countries to issue new regulations to assure safety in pool environments. Greece enforced stricter requirements in 2020 and 2021 for hotel pools. However, even though regulations are important, they can only be effective when accepted by the pool managers and users. The aim of this study was to (a) assess the acceptability of the regulations by hotel managers; (b) assess compliance during the summer touristic periods in 2020 and 2021; and (c) identify challenges during the implementation of the regulations that need to be addressed. Several non-compliances from the regulations were identified. Continuous chlorination with an automatic chlorinator was not a regular practice and suggested water circulation rates were poorly met. The microbiological and chemical testing frequency of the pool water and keeping the number of bathers allowed per surface area in the pool were reported as the most difficult requirements to meet. Most pool managers agreed that new measures contribute to the pool users’ safety; however, they reported increased cost as the main impediment for their implementation. The modernization of regulations governing swimming pools’ function, in terms of risk assessment orientation, will contribute to the adoption of an integrated compliance strategy on emerging health issues, such as COVID-19.

Nephroprotective Activity of the Hydro-alcoholic, Ethanolic Extract and its Fractions of Tukhme Soya (Anethum sowa Roxb.) against Gentamicin Induced Nephrotoxicity in Albino Rats

<p style="text-align: justify;"><strong>Background:</strong> Nephrotoxicity is an emerging health issue in many countries due to exogenous or endogenous toxicants. Many drugs are responsible for causing renal damage including antibiotics such as aminoglycoside, cisplatin, etc. Meanwhile some herbs are traditionally used to treat kidney disorders due to their nephroprotective properties. One of them is Tukhme- soya (Seed of Anethum sowa) from family Umbelliferae. This study aims to evaluate the Tukhm-e-soya in gentamicin induced nephrotoxic kidney models in Albino rats. <strong>Methods: </strong>The rats were divided in to eight groups and each group was comprised of six rats. Group I- VIII were control, toxic, hydro-alcoholic, ethanolic, petroleum ether, chloroform, acetone, aqueous groups respectively. 1% carboxy methyl cellulose was used as control and gentamicin was used as toxicant. Duration of the study was 8 days. Serum creatinine (S.Cr), Blood Urea Nitrogen (BUN), histopathological studies of kidneys, and lipid peroxidation (LPO), were evaluated. Results were analyzed using one-way analysis of variance followed by Dunnett&rsquo;s post hoc test.<strong> Results:</strong> BUN, S.Cr and LPO levels were significantly increased in toxicant group when compared with control. Groups III - VIII showed significantly lower values close to control group in these parameters. Study revealed that it has a potent antioxidant activity which may be responsible for its nephroprotective actions. <strong>Conclusion:</strong> Therefore, it is concluded that all the extracts and fractions of Tukhme soya were effective in nephroprotection but acetone fraction, hydroalcoholic and chloroform fractions were more effective than other groups. <p style="text-align: justify;"><strong>Key words: </strong>Nephroprotective, Tukhm-e-soya, Gentamicin, Histopathology, Lipid peroxidation.

A network of empirical ethics teams embedded in research programmes across multiple sites: opportunities and challenges in contributing to COVID-19 research and responses

Covid-19 continues to teach the global community important lessons about preparedness for research and effective action to respond to emerging health threats. We share the COVID-19 experiences of a pre-existing cross-site ethics network-the Global Health Bioethics Network-which brings together researchers and practitioners from Africa, Europe, and South east Asia. We describe the network and its members and activities, and the work-related opportunities and challenges we faced over a one-year period during the pandemic. We highlight the value of having strong and long-term empirical ethics networks embedded across diverse research institutions to be able to: 1) identify and share relevant ethics challenges and research questions and ways of ’doing research’; 2) work with key stakeholders to identify appropriate ways to contribute to the emerging health issue response – e.g. through ethics oversight, community engagement, and advisory roles at different levels; and 3) learn from each other and from diverse contexts to advocate for positive change at multiple levels. It is our view that being both embedded and long term offers particular opportunities in terms of deep institutional and contextual knowledge and relationships with and access to a wide range of stakeholders in place. Being networked offers opportunities to draw upon a wide range of expertise and perspectives operating at multiple levels, and to bring together internal and external perspectives (i.e. different positionalities). Long term funding means that the people and resources are in place and ready to respond in a timely way. However, many tensions and challenges remain, including difficulties in negotiating power and politics regarding roles that researchers and research institutions play in an emergency, and the position of empirical ethics activities in programmes of research more specifically. We discuss some of these tensions and challenges, and consider the implications for our own and similar networks in future.

Combined training improves the diagnostic measures of sarcopenia and decreases the inflammation in HIV-infected individuals.

BackgroundHIV‐related sarcopenia is an emerging health issue that often remains undiagnosed and can lead to reduced quality of life, independence, and premature death if untreated. This study investigated the effects of a 6 month combined training (resistance plus aerobic exercise) (CT) intervention on diagnostic measures of sarcopenia, including grip strength, appendicular lean mass index (ALMI), and gait speed.MethodsForty participants were randomized into either a CT group (n = 20; age = 38.3 ± 4.9 years) or a control group (CON; n = 20; age = 37.9 ± 5.1 years). Participants in the CT group performed three supervised sessions per week for 6 months, consisting of weekly reverse linear periodized resistance training followed by 20 min aerobic training. Participants in the CON group were instructed to continue with their current lifestyle habits. Assessments were completed at baseline and after 6 months. Statistical analyses were performed using a two‐way analysis of covariance (ANCOVA) adjusted for sex and preintervention values. Primary outcomes included grip strength, ALMI, and gait speed. Secondary outcomes were changes in levels of pro‐inflammatory cytokines (IL‐6 and TNF‐α), IGF‐1, and myostatin. Associations were explored between changes in inflammatory markers (IL‐6 and TNF‐α), gait speed, and ALMI with grip strength.ResultsA significant increase in ALMI was found for CT compared with CON (0.29 ± 0.13 kg/m2 vs. −0.11 ± 0.14 kg/m2, respectively; P < 0.001). Significant improvements in grip strength (7.86 ± 8.50 kg for CT vs. −1.58 ± 2.47 kg for CON) and gait speed (0.16 ± 0.07 m/s2 for CT vs. −0.06 ± 0.52 m/s2 for CON; both P < 0.001) were also observed in CT compared with CON. Reduction in inflammatory biomarkers was found in CT compared with CON (IL‐6; TNF‐α, both P < 0.001). An increase in IGF‐1 (74.36 ± 56.64 pg/mm3 for CT vs. 7.19 ± 99 pg/mm3 for CON; P < 0.001) and a decrease in myostatin (−158.90 ± 62.03 pg/mm3 for CT vs. −43.33 ± 146.60 pg/mm3 for CON; P < 0.001) was found following CT compared with the CON group. Change in grip strength was correlated with changes in IL‐6 (r = −0.65, P < 0.001), TNF‐α (r = −0.63, P < 0.001), gait speed (r = 0.63, P < 0.001), and ALMI (r = 0.54, P = 0.001), but not IGF‐1 and myostatin. No adverse events were recorded, and compliance with the CT exercise sessions was high (>85%).ConclusionsCombined training appears to be an effective means to counteract sarcopenia and improve various inflammatory markers and growth hormones in people living with HIV.

A cross-sectional study on extensive gaming in adolescents.

Background: Extensive gaming and the consequences thereof is frequently reported from child and adolescent psychiatry and school health care. The behavior is associated with compulsion, psychiatric and physical symptoms, impaired cognitive development, and poorer school performance. This phenomenon has been described as an emergent health issue for men and little is known about its potential gender-specific characteristics. The aim of this study was to explore extensive gaming among male and female adolescents and to investigate whether the frequency of often feeling low, often feeling anxious, self-reported ADHD, self-reported ASD, being satisfied with one’s own general health, poor sleep, loneliness, and having tried smoking, alcohol, and/or other substances differed among those with and without extensive gaming.Design and Methods: This study was based on data collected through a public health survey distributed in 2016 to pupils in 9th grade of primary school and in second grade of secondary school, including a total of 13498 participants. The association between extensive gaming and different factors was estimated among male and female respondents separately.Results: Roughly 30% of the male and 5% of the female respondents were categorized as extensive gamers. Extensive gaming was associated with a higher prevalence of poor sleep and a lower prevalence of being satisfied with one’s own health among boys and (to a higher degree) among girls.Conclusions: Altogether, our results contribute to the impression that extensive gaming is more heavily related to subjective health complaints among female than male adolescents. Significance for public health Extensive gaming is associated with compulsion, psychiatric and physical symptoms, impaired cognitive development and poorer school performance. This phenomenon has been described as an emergent health issue for men and little is known about its potential gender-specific characteristics. The aim of this study was to explore extensive gaming among Swedish male and female adolescent pupils and to investigate whether the frequency of often feeling low, often feeling anxious, self-reported ADHD, self-reported ASD, being satisfied with one’s own general health, poor sleep, loneliness, and having tried smoking, alcohol, and/or other substances differed among those with and without extensive gaming. The attention and interest of problems related to gaming in media, institutions such as schools, social services and other health institutions are huge. Our findings are clinically relevant in screening and treatment of both male and female adolescent problem gamers.

Lycopene: A Natural Arsenal in the War against Oxidative Stress and Cardiovascular Diseases.

Lycopene is a bioactive red pigment found in plants, especially in red fruits and vegetables, including tomato, pink guava, papaya, pink grapefruit, and watermelon. Several research reports have advocated its positive impact on human health and physiology. For humans, lycopene is an essential substance obtained from dietary sources to fulfil the body requirements. The production of reactive oxygen species (ROS) causing oxidative stress and downstream complications include one of the major health concerns worldwide. In recent years, oxidative stress and its counter strategies have attracted biomedical research in order to manage the emerging health issues. Lycopene has been reported to directly interact with ROS, which can help to prevent chronic diseases, including diabetes and neurodegenerative and cardiovascular diseases. In this context, the present review article was written to provide an accumulative account of protective and ameliorative effects of lycopene on coronary artery disease (CAD) and hypertension, which are the leading causes of death worldwide. Lycopene is a potent antioxidant that fights ROS and, subsequently, complications. It reduces blood pressure via inhibiting the angiotensin-converting enzyme and regulating nitrous oxide bioavailability. It plays an important role in lowering of LDL (low-density lipoproteins) and improving HDL (high-density lipoproteins) levels to minimize atherosclerosis, which protects the onset of coronary artery disease and hypertension. Various studies have advocated that lycopene exhibited a combating competence in the treatment of these diseases. Owing to all the antioxidant, anti-diabetic, and anti-hypertensive properties, lycopene provides a potential nutraceutical with a protective and curing ability against coronary artery disease and hypertension.

Description and comparative genomic analysis of a mcr-1-carrying Escherichia coli ST683/CC155 recovered from touristic coastal water in Northeastern Brazil.

Polymyxin resistance is an emerging health issue aggravated by mcr dissemination among Enterobacterales recovered from various sources. Commensal Escherichia coli plays a key role in the spread of antimicrobial resistance in community settings and is likely to spread silently. It may transfer resistance genes to pathogenic bacteria in the gastrointestinal tract and the environment, and may cause difficult-to-treat infections, especially in immunocompromised patients. Unraveling actors disseminating resistance to last-resort antimicrobials might support the future development of control measures. Here we report the occurrence of a commensal ST683/CC155 colistin-resistant mcr-1.1-harboring E. coli (JP24) obtained from touristic coastal water. JP24's genome was sequenced and comparatively analyzed with other genomes from ST683/CC155 isolated worldwide and with mcr-carrying isolates recovered from various sources in Brazil. Besides mcr-1, JP24 carried blaCTX-M-8, tet(A), tet(34), dfrA12, sul2, sul3, aph(3')-Ia, aph(3')-IIa, aadA1, aadA2, cmlA1, Inu(G), mef(B) and mdf(a). mcr-1 and blaCTX-M-8 were transferable by IncX4 and IncI1/Iγ plasmids, respectively. Tree-based phylogeny of the ST683/CC155 isolates core genome revealed two larger clades. E. coli JP24 was grouped into a subclade together with an isolate from Thailand (ERR4221036), both carrying mcr-1. The core genome-based tree of the isolates carrying mcr-1 from Brazil revealed proximity with E. coli ECEST9 recovered from a mangrove also located in Northeastern Brazil. Accessory genome-based tree clustered most environmental isolates apart from the clinical ones and remained JP24 closer to ECEST9. High sequence conservation was observed between mcr-1-harboring plasmids detected in different species and reservoirs in Brazil and other countries. In addition to recreational coastal waters being potential sources for community exposure to antimicrobial-resistant bacteria, our findings reinforce a more prominent role of horizontal gene transfer, other than clonal expansion, in mcr dissemination in the community.

Autophagy as a Therapeutic Target of Natural Products Enhancing Embryo Implantation.

Infertility is an emerging health issue worldwide, and female infertility is intimately associated with embryo implantation failure. Embryo implantation is an essential process during the initiation of prenatal development. Recent studies have strongly suggested that autophagy in the endometrium is the most important factor for successful embryo implantation. In addition, several studies have reported the effects of various natural products on infertility improvement via the regulation of embryo implantation, embryo quality, and endometrial receptivity. However, it is unclear whether natural products can improve embryo implantation ability by regulating endometrial autophagy. Therefore, we performed a literature review of studies on endometrial autophagy, embryo implantation, natural products, and female infertility. Based on the information from these studies, this review suggests a new treatment strategy for female infertility by proposing natural products that have been proven to be safe and effective as endometrial autophagy regulators; additionally, we provide a comprehensive understanding of the relationship between the regulation of endometrial autophagy by natural products and female infertility, with an emphasis on embryo implantation.

Total serum cholesterol and selected electrolytes during pregnancy among women residents in Yenagoa metropolis, Bayelsa state Nigeria

The incidence of high cholesterol, electrolytes imbalance and hypertension are emerging health issues prevalent among pregnant women globally. This study determines total serum cholesterol, selected electrolytes (Na+ and K+) and blood pressure of pregnant women subjects in Yenagoa metropolis. A total sample of two hundred pregnant women subjects aged 18-&gt;40years with 80, 70, and 50 in their first, second, and third trimesters were randomly recruited. While total serum cholesterol was measured using oxidative and hydrolysis method the blood pressure and electrolytes were recorded by standard methods using automated electrolytes analyser and Omron digital blood pressure machine. One way ANOVA was used to analysed the data obtained for comparison between groups. Result from the study shows a significant (&lt;0.05) increase in total serum cholesterol and percentage difference from the first, second, and third trimesters of pregnancy. Serum sodium concentration was slightly higher in the second trimester compared with the first and third trimesters while potassium concentration was slightly higher in the first trimester compared with other trimesters. The blood pressure of the participants were higher among subjects with high total serum cholesterol and age 34years and above during pregnancy. Findings from this study have shown slight decrease in serum potassium concentration among pregnant women with raised blood pressure compared to mean values of other subject groups.

Zinc-Coated Urea for Enhanced Zinc Biofortification, Nitrogen Use Efficiency and Yield of Basmati Rice under Typic Fluvents

Deficiency of Zn in human diet is an emerging health issue in many developing countries across the globe. Agronomic Zn biofortification using diverse Zn fertilization options is being advised for enhancing Zn concentration in the edible portion of rice.A field study was carried out to find out the Zn fertilization effects on biofortification of basmati rice and nutrient use efficiencies in the Himalayan foothills region. Amongst the Zn nutrition treatments, 4.0% Zn-coated urea (ZnCU) + 0.2% Zn foliar spray (FS) using ZnSO4·7H2O recorded the highest grain (3.46 t/ha) and straw (7.93 t/ha) yield of basmati rice. On average, the rice productivity increase due to ZnCU application was ~25.4% over Commercial Urea. Likewise, the same Zn fertilization treatment also resulted in the maximum Zn (35.93 and 81.64 mg/kg) and N (1.19 and 0.45%) concentration in grain and straw of rice, respectively. Moreover, N use efficiency (NUE) was also highest when ZnCU was applied at 4.0% (ZnSO4·7H2O) in comparison to soil application. From the grain quality viewpoint, Zn ferti-fortification had significant effect on elongation ratio and protein concentration of grain only and respective Zn fertilization treatment recorded highest quality parameters 1.90 and 7.44%, respectively. Therefore, ZnCU would be an important low-cost and useful strategy for enhancing yield, NUE and biofortification, and also in minimizing the Zn malnutrition related challenges in human diet in many developing economies.

Educating Medical Students for Practice in a Changing Landscape: An Analysis of Public Health Topics within Current Indonesian Medical Programs.

Medical curricula need to prepare doctors for emerging health issues and increased public health roles. With medical schools spread over a vast geographical region of Indonesia, ensuring that all schools meet appropriate standards in the quality of subjects, course delivery, and performance is challenging. This paper explores the inclusion of public health subjects in medical education across the country. A search of all subjects (n = 388) who were taught in 28 representative medical schools was undertaken and categorized by geographical region, accreditation grade, and according to the Indonesian National Standard of Medical Competency. Basic biomedicine subjects had the highest representation in the curricula (49.2 ± 8.7%) and public health was generally well represented (14.3 ± 5.0%). All medical schools complied with the minimum of 144 credits required for the bachelor stage. No statistically significant difference was found between school accreditation grades, or when an overall comparison of programs in Eastern and Western regions was undertaken. The Indonesian medical schools included have relatively good curriculum transparency, and public health is an important feature in their curricula. Further research is critical to identify the materials taught, the relevance and the applicability of the specific public health content, and the assessment of public health competency of graduates.