Interest In Health Research Articles

A Cohort Study of Lt. Col. Luke J. Weathers VA Medical Center Patients with Positive FIT and Incomplete GI Evaluation during the COVID-19 Pandemic.

The reasons for and incidence of delay in screening colonoscopies during the coronavirus disease 2019 (COVID-19) pandemic are of major public health interest. The risks and reasons for delay likely vary between public and private institutions. This research sought to analyze data regarding the completion of screening colonoscopies after a positive fecal immunochemical test (FIT) before and during the COVID-19 pandemic and the reasons for a delay in obtaining these results at the Lt. Col. Luke Weathers, Jr. Veterans Affairs Medical Center. The goals were to evaluate the institutional resilience and analyze the problems associated with this major healthcare crisis. This closed cohort study included all positive FITs from our local Veterans Affairs (VA) medical center from October 2019 to January 2020 and July 2020 to May 2021. A total of 115 VA patients with a positive FIT prepandemic and 157 VA patients with a positive FIT during the pandemic were included. Completion rates within 180 days were measured, and charts were reviewed to identify the reasons for lack of completion. Both community and local VA procedures for veterans were included. Univariate and multivariable analyses were applied to calculate odds ratios (ORs). The Pearson χ2 test was applied to calculate P values. VA patients' percentage of timely completion was lower pre-COVID-19 than it was during the pandemic, and the percentage of delayed completion was higher pre-COVID-19 than it was during the pandemic. Comparing patients who completed a colonoscopy with those who did not, increasing age had an OR of 0.947 (95% CI 0.920-0.975), and White race had an OR of 0.504 (95% CI 0.291-0.873). Evaluating delays in colonoscopy completion, VA colonoscopies versus referral to the community had an OR of 4.472 (95% CI 1.602-12.483), and pre-COVID-19 completion versus during COVID-19 had an OR of 4.663 (95% CI 1.727-12.594) with multivariable logistic regression. There was a statistically significant increase in timely colonoscopy completion during the study period when compared with the pre-COVID-19 period. The completion rate was higher at the Lt. Col. Luke Weathers, Jr. VA Medical Center than a large population average in 2020, possibly related to community colonoscopies and an aggressive case management system. In addition, increasing age and White race were associated with decreased colonoscopy completion. Predictors of an increased delay in colonoscopy completion included a pre-COVID-19 positive FIT and colonoscopies performed within the VA rather than being referred to providers in the community. A common reason for delay in all of the groups was patients declining intervention and delay/lack of referral.

Desempeño cognitivo y académico en escolares con antecedentes perinatales y vulnerabilidad social en un hospital público de la provincia de Buenos Aires

Cognitive Development (CD) and Academic Performance (AP) of children who presented perinatal and social vulnerability risk factors are a topic of interest in health and education. Therefore, the aim of this research is to characterize CD and AP of a population with these characteristics, which was accompanied by professional interventions from the transdisciplinary follow-up team.Information was collected from pediatric and psychopedagogical medical records of thirty patients. The WISC IV Intelligence test was used; school reports were requested, and a socio-economic level survey was administered, which included information regarding stimulating learning at home.Most of the children showed average levels in CD and good AP. Socio-environmental factors and received interventions associated with them were identified. Early transdisciplinary interventions (ETI), contextualized and long-term, are favorable for DC and DA. Consequently, they should be considered in follow-up programs for similar populations.

Methodological challenges and actionable recommendations in studying the health effects of high-concentration THC products.

In conducting a scoping review on the health effects of high-concentration cannabis products, we have uncovered pervasive methodological shortcomings within the cannabis literature. This paper begins by defining the 'causal effect' of interest for public health and delineating the desirable features of study design that can address crucial questions pertaining to public health and policy. We further delve into the methodological complexities inherent in studying the health effects of high-concentration cannabis products, describing challenges associated with the measurement of exposures and outcomes, confounding, selection bias, and the generalizability of findings. We introduce causal inference methods to mitigate potential biases in observational cannabis use studies. We identify specific areas that necessitate further development and investigation to deepen our understanding of this topic. Finally, this paper extends actionable recommendations, serving as a roadmap for upcoming research initiatives in this domain.

Towards Sustainable Mental Health Using the Finnish Mood Scale

The interest in mental health in a sports context has increased in recent years. However, there is no scientifically sound measurement tool for assessing sport-related mental health symptoms in the Finnish language. One of the most frequently used measurement tools for such symptoms in English is the Brunel Mood Scale (BRUMS). The purpose of the present study was to adapt and validate a Finnish version of the BRUMS, referred to as the Finnish Mood Scale (FIMS). The 24-item, 6-factor FIMS was administered to 445 Finnish participants concurrently with Finnish versions of the Depression, Anxiety, and Stress Scale (DASS-21) and the Psychobiosocial States Scale (PBS-S). The sample consisted of 259 females (58.2%), 177 males (39.8%), and 9 who did not disclose their gender (2%), aged 16 to 75 years (M = 35.65, SD = 13.70). Sixty-two participants (13.9%) reported being a competitive athlete, 273 (61.3%) were regular exercisers, and 109 (24.5%) did not exercise regularly. A six-factor modified CFA model indicated an adequate fit to the data (CFI = 0.944, TLI = 0.934, RMSEA = 0.060). Concurrent measures correlated with FIMS in line with theoretical predictions, supporting convergent and divergent validity. Males reported significantly more positive mood scores than females. Physically active participants reported significantly more positive mood scores than inactive individuals, endorsing the mental health benefits of physical exercise. Findings indicate that the FIMS is a suitable measurement tool to screen mood modalities in Finnish populations aged 16 years and older. FIMS may be useful for the early detection of mental ill-health, thus, promoting sustainable mental health.

Predictors of infectious disease-related behaviors among adolescents in Armenia

Abstract Background We explored the behaviors related to infectious diseases (ID) and its predictors among 15-17 years old adolescents in Armenia. Methods We surveyed adolescents from public and private high schools in Yerevan and one province in 2023. The instrument explored ID-related behaviors, health literacy (HL), interest in health, and socio-demographics. ID-related behaviors were measured with five Yes/No questions about sharing a toothbrush, covering their mouth when coughing or sneezing, and washing hands with soap and water - before eating, after using the bathroom, and when coming home. HL was assessed with ten questions on a scale from ‘Strongly disagree’ to ‘Strongly agree’. Summative scores were calculated for ID-related behaviors and HL. Multivariable regression analysis explored factors associated with ID-related behaviors. Results Overall, 366 students completed the survey, most of them being females (64.4%). The majority were interested in health issues (80.7%). Almost all respondents reported not sharing a toothbrush with other persons (97.9%) and usually covering their mouth when coughing or sneezing in public places (94.1%). Somewhat lower percentages reported washing hands with soap and water before eating (82.0%), after using the bathroom (89.2%), and when coming home (86.6%). The mean behavior score was 4.52 out of 5 (SD = 0.92) and the percent score was 90.4%. The average HL score was 17.41 out of 30 (SD = 4.47). In the regression analysis, being female vs. male, being interested in health vs. not, studying in private vs. public schools, and having higher HL were independent significant predictors for higher score of ID-related behaviors. Conclusions Armenian adolescents reported high levels of compliance with ID-related behaviors. Improving health literacy and fostering interest in health can help further enhance the performance of preventive behaviors. Interventions targeting public schools and male adolescents are particularly pertinent. Key messages • Being female, studying in private schools, having higher interest in health issues, and better health literacy independently positively influence infectious disease-related behaviors. • Promoting health literacy and fostering interest in health in high schools have the potential to further enhance infectious disease prevention behaviors among adolescents.

Cross-sectional survey of health literacy among high school students in Armenia

Abstract Background We assessed the level of health literacy (HL) and explored its predictors among 15-17 years old adolescents in Armenia. Methods We conducted a survey among adolescents in public and private schools in the capital Yerevan and an adjacent province in 2023. The instrument included items on HL, general interest in health and socio-demographics. Ten questions measuring HL with four answer options were summed into the HL score (0-30). Multivariable regression model explored the independent associations of socio-demographic factors and interest in health issues with the HL. Results Overall, 366 students completed the survey. About 64% were females. The majority were interested in health issues (80.7%). Most participants felt they, in general, received sufficient health information (75.1%), could follow physician’s instructions (80.1%), were confident in advising family or friends on health improvements (70.5%), could easily give examples of health-promoting actions (76.8%), and explain their choices for health (77.6%). Additionally, 82.2% could judge the environmental impact of their actions, 82.0% could find understandable health information when needed, and 85.3% could assess how their behavior affects their health. Fewer respondents were confident in figuring out if the health information is correct (68.2%) or identifying correct health information when faced with conflicting data (67.1%). The average HL score was 17.41 (SD = 4.47), with a 58.0% percent score. In the regression analysis, being from private school vs. public and being interested in health vs. not were significant predictors of higher HL. Conclusions Despite having moderate HL level, a significant portion of Armenian adolescents lacked confidence in discerning correct health information. Interventions should prioritize enhancing HL, emphasizing critical evaluation skills and providing accessible and reliable health information resources tailored to adolescents, particularly in public schools. Key messages • The health literacy among Armenian adolescents was moderate with many lacking confidence in identifying correct health information and differentiating when faced with conflicting data. • Attending a private school and having an interest in health were significant predictors for higher health literacy, emphasizing the need for targeted health and policy interventions.

Honors Track in Global and Occupational Health: a students’ perspective from Humanitas University

Abstract Background To meet an increasing interest in global health, more opportunities for medical students should be created. Humanitas University (Milan, Italy) has debuted a new extracurricular activity called “Honors Track in Global and Occupational Health” (HT-GOH), to allow students critical insights into the field at the beginning of their career. Objectives HT-GOH is a two-year programme, led by expert professors in the field. The main aim is to circumvent limitations of global health education at individual institutions, achieved through a combined presence and online approach that allows for international collaboration with experts and attendance of online lectures and travel abroad for practical experiences. Complemented by monthly meetings, participation to workshops, seminars, conferences, and the discussion and literature review of crucial global health topics. Results The six participating students are actively promoting discussions, exchange of ideas, and literature findings on many global health issues. They audited courses in other universities and are building connections within the field. The active involvement of the students and their increasing interest in the global health debate can be seen by their participation in this abstract and the conference. The effectiveness of the programme is being evaluated through monthly feedback by students. Conclusions The programme allows for an initiation to research work, promoting collaboration between students and exploration of a variety of topics under the guidance of experts. The nature of a specific programme allows for a more individualized approach and greater development of skills unique to each student. This HT represent a valid approach to global health education, especially in settings in which this field is only taught in the context of a public health course. Key messages • A new programme at Humanitas University offering an innovative approach to the field of global health to interested students. • The students’ perspective towards an integrated approach to global health in medical schools.

Sanofi to sell interest in consumer health

Sanofi to sell interest in consumer health

Integrating AI in cause-of-death regular statistical production with human and expert system codings

Abstract Background Cause-of-death (CoD) statistics are key indicators in epidemiology and public health. These statistics are derived from death certificates completed by physicians and are usually coded by official statistics authorities according to the standards of the WHO ICD-10 classification to construct time- and cross-country-comparable statistics. For coding causes of death in free-text format in France according to ICD-10, predictions by deep neural networks (DNNs) are employed in addition to fully automatic batch coding by a rule-based expert system and to interactive coding by the coding team. Methods Seq-to-seq DNNs are trained from scratch on previously coded data to ICD-10 code multiple causes and underlying causes of death. Human coding is focused on certificates with a special public health interest or with low confidence in AI prediction quality to maximize the quality of the overall statistics disseminated when human resources are limited. DNNs also directly predict multiple causes and underlying causes of death for part of the certificates. Hence, the coding campaign aims to optimally allocate a coding mode to a given certificate. Results For deaths in 2021, 63% of the certificates are automatically batch coded by the expert system, 14% by the coding team, and 23% by DNNs. Compared to a traditional campaign that would have relied on automatic batch coding and manual coding, the present campaign reaches an accuracy of 95.7% for ICD-10 coding of the underlying cause (97.3% at the European shortlist level). Conclusions The 3-coding mode approach enables timeliness of dissemination of CoD statistics and may lead in the future to more responsive surveillance. Key messages • Deep neural networks trained on already coded data can be integrated into the regular statistical production of the CoD database in a fully controlled way. • The allocation between the different modes of coding can be optimized to achieve best quality and timeliness under the constraint of limited human resources.

Antimicrobial Efficiency of Commercial Products for Drinking Water Based on Organic and/or Inorganic Acids Against Bacteria of Interest in Animal and Human Health

Objective: This study aims to evaluate the effects of acidity regulators based on organic and inorganic acids for drinking water on pathogens of importance in swine and poultry farming using the Minimum Inhibitory Concentration (MIC) test. Theoretical Framework: The presence of intestinal pathogens in livestock production systems is a major global concern due to their impact on both animal and public health. Pathogens like Salmonella spp. and Escherichia coli are among the main microorganisms that adversely affect these systems, resulting in significant economic losses. Limitations on the use of antimicrobials, due to microbial resistance, require adopting alternative solutions for pathogen control. Method: The statistical analysis of the MIC of acidity regulators against the microorganisms was performed using the Kruskal-Wallis test, followed by the Student-Newman-Keuls post-test (p<0.05) with GraphPad Prism software, version 8.0.1. Results and Discussion: It was observed that the sensitization profile of the microorganisms differed depending on the species. Among the Salmonella serovars, there was a difference in the resistance profile between typhoidal and non-typhoidal Salmonella concerning the evaluated products. The results showed that among the commercially available acidifiers evaluated, only five were effective against all the microorganisms tested.

Pharmaceutical Advertising and Public Perceptions in Saudi Arabia

Introduction: As the pharmaceutical advertising landscape evolves with digital advancements, this study examines public awareness and perceptions of medication advertisements in Saudi Arabia. It focuses on the effects of regulatory frameworks and evaluates how they influence public understanding and attitudes toward these advertisements. Method: A cross-sectional study was conducted using an electronic survey in Saudi Arabia in December 2023. The survey was distributed on social media platforms and reached a diverse sample of 440 participants. It covered public perception and attitudes toward drug advertisements, knowledge of regulatory laws, and preferences regarding advertising mediums. Results: Out of the 440 participants in the study, who were primarily employees with bachelor’s degrees, there was a clear awareness of drug advertisements. The average age of the group was 33 years, and a significant portion (71.1%) held a bachelor’s degree, with 51.1% being employed. The findings revealed that 25.5% of participants frequently noticed drug ads, while 22.7% saw them very often. Although many found the ads informative, there were significant concerns about unrealistic expectations and the risk of overmedication; 89.8% believed the ads set unrealistic expectations about the effectiveness of medications. Additionally, 60.7% thought that celebrity endorsements might mislead the audience, and 91.1% felt that ads should provide more detailed information about potential risks and side effects. Regarding preferred advertising platforms, mobile apps and websites were favored (47%), followed closely by social media (46.4%). A striking 93.2% of participants believed that drug ads on social media should be subject to stricter regulations, and 96.4% wanted more proactive monitoring of online advertising. Many also reported using other sources, such as medical review sites, to verify medication information. Conclusions: Pharmaceutical advertising in Saudi Arabia must balance ethical transparency with educational value. The influence of digital platforms underscores the necessity for stricter regulation and accurate information dissemination. A collaborative approach is essential to align advertising practices with public health interests and regulatory standards.

Examination of public perceptions of microbes and microbiomes in the United States reveals insights for science communication.

Within a changing research and media landscape, misconceptions and misinformation about microorganisms and microbiomes can arise, necessitating improvements in science communication practices through insights in public perceptions of the microbial world. Yet, little is known about public perceptions of microorganisms and microbiomes, making it difficult to develop tailored messaging. Here we perform an inductive thematic analysis with interviews and surveys from thirty adults across the United States to identify key factors to enhance microbial science communication efforts. Together, our results underscore the importance of 1) recognizing the existing and desired future knowledge of an audience, 2) aligning with broader socio-scientific issues that resonate with people in relevant channels using social networks, 3) fostering collaboration between microbiologists, social scientists, and communicators to improve messaging, and 4) appealing to people's values and emotions to establish meaningful connections. This study concludes that non-microbial interests, such as an interest in health and wellness, may lead to acquisition of microbial knowledge and that people want scientists to share microbial messages preferably on platforms like social media. Additionally, we identified confusion about microbial terms and a desire to understand human-centric benefits of microorganisms and microbiomes. We suggest that microbiologists partner with science communicators to develop microbial messaging, capitalizing on connections to non-microbial interests and appealing to people's microbial worldview.

Nutrition in the prevention and treatment of skeletal muscle ageing and sarcopenia: a single nutrient, a whole food, and a whole diet approach.

Loss of skeletal muscle strength and mass (sarcopenia) is common in older adults and associated with an increased risk of disability, frailty, and premature death. Finding cost-effective prevention and treatment strategies for sarcopenia for the growing ageing population is therefore of great public health interest. Although nutrition is considered an important factor in the aetiology of sarcopenia, its potential for sarcopenia prevention and/or treatment is still being evaluated. Nutrition research for sarcopenia utilises three main approaches to understand muscle-nutrition relationships, evaluating: single nutrients, whole foods, and whole diet effects-both alone or combined with exercise. Applying these approaches, we summarise recent evidence from qualitative and quantitative syntheses of findings from observational and intervention studies of healthy older adults, and those with sarcopenia. We consider protein supplements, whole foods (fruits and vegetables), and the Mediterranean diet as exemplars. There is some evidence of beneficial effects of protein supplementation ≥0.8g/kg body weight/day on muscle mass when combined with exercise training in intervention studies of healthy and sarcopenic older adults. In contrast, evidence for effects on muscle function (strength and physical performance) is inconclusive. There is reasonably consistent epidemiological evidence suggesting benefits of higher fruits and vegetables consumption for better physical performance. Similarly, higher adherence to the Mediterranean diet is associated with beneficial effects on muscle function in observational studies. However, intervention studies are lacking. This review discusses how current evidence may inform the development of preventive and intervention strategies for optimal muscle ageing and nutritional public policy aimed at combatting sarcopenia.

Global health training opportunities during pediatric hematology/oncology fellowship: Results from a survey of program leaders.

There is growing interest in global health (GH) among medical trainees in the United States. However, providing GH training opportunities at the fellowship level presents several challenges. Understanding of barriers and facilitators to implementing GH training is essential for addressing these challenges. We developed a comprehensive survey of 65 Likert-scale multiple-choice and open-ended questions to assess perspectives of pediatric hematology/oncology fellowships leaders on GH training. The survey was electronically distributed to program leaders at all ACGME-accredited pediatric hematology/oncology fellowships programs, and data were summarized using descriptive analysis. Of 73 eligible programs, we had a 45.2% response rate with 27 complete and 6 partial responses. Respondents represented programs across the United States, including 19 (57.6%) affiliated with NCI-Designated Cancer Centers. Fourteen programs (43.8%) currently offer GH training opportunities, whereas 18 programs expressed interest in future opportunities (15, 83.3%) or plan to offer them soon (3, 16.7%). Major barriers identified include competing training priorities (23, 82.1%), lack of faculty mentors in the division (23, 82.1%), and lack of dedicated institutional funding (20, 71.4%). Key facilitators include the interest and initiative of current fellows (27, 96.4%), dedicated institutional funding (26, 92.8%), and having established international partnerships (26, 92.8%). The study reveals strong interest in GH training in pediatric hematology/oncology fellowships. Despite challenges such as competing priorities and a lack of mentors, significant facilitators include current fellows' initiatives, dedicated funding, and established international partnerships. These insights can help shape future initiatives to incorporate GH into pediatric oncology/hematology fellowship training.

Why hospitals hire tobacco lobbyists: conflicts of interest among lobbyists’ clients

Abstract Lobbyists sometimes represent clients with seemingly adversarial policy interests. We seek to explain the occurrence of such ostensible conflicts of interest. In hiring lobbyists, interests encounter a tradeoff between access and agency. Although some lobbyists promise access to lawmakers, they may not lobby as contracted. Interests hire seemingly conflicted lobbyists more often when access is costlier and reputational risks are smaller. We examine the hiring of tobacco lobbyists by health interests, given the possibilities for shirking and reputational damage. We find that institutions such as hospitals hire tobacco lobbyists regularly and more often than membership-based health groups. Intergroup competition for access and lobby laws, especially anti-conflict laws, affect the use of tobacco lobbyists independent of rates of multi-client lobbying. Conflicts are more common today than ever but interests can protect themselves somewhat from opportunistic agents. Our findings also suggest that reforms can improve the representation of client interests.

Understanding the Politics of Food Regulation and Public Health: An Analysis of Codex Standard-Setting Processes on Food Labelling

Background: The importance of the international food regulatory system to global health, is often overlooked. There are calls to reform this system to promote healthy and sustainable food systems centred on the Codex Alimentarius Commission (Codex), the United Nation’s (UN’s) standard-setting body. Yet this presents a significant political challenge, given Codex has historically prioritized food safety risks over wider harms to public health, and is dominated by powerful food exporting nations and industry groups with a primary interest in trade expansion. To better understand this challenge, we examine who participates and contests Codex standards, using the development of the new Guidelines on Front-of-pack Nutrition Labelling (FOPNL) as a case study. Methods: The study involved: (i) collecting Codex Committee on Food Labelling (CCFL) documents (2016-2023); (ii) identification, categorization, and enumeration of actors involved in the development of the Guidelines; and (iii) guided by a constructivist framework, analysis of how actors framed and contested key provisions of the Guidelines. Results: Country representation was skewed towards high-income (47.9%). Member state delegations were dominated by non-health ministries (59.8%) and industry actors (16.1%). Industry actors comprised the large majority of observers (84.2%) and civil society actors representing public health interests the least (12.2%). Commercial actors used frames supporting positive FOPNL messages (eg, low in salt) opposing negative ones (eg, "high-in" sugar warnings) and called for product exemptions (eg, sports foods and baby foods). Public health actors used frames supporting simplified FOPNL to reduce consumer confusion, that hold up public health goals, and prevent inappropriate marketing. Conclusion: Participation in the Guidelines development process suggests stronger preferences for trade facilitation and commerce over public health. Ambitions to reform the international food regulatory system may require an examination of who participates and how to address this asymmetrical representation of interests. These results suggest the need to greatly strengthen public health representation at Codex.

Evaluating cytotoxicity and genotoxicity of oil extracted from visceral fat of Caiman yacare (Daudin, 1802) in Chinese hamster lung fibroblast in vitro

In previous studies, the oil extracted from the visceral fat of Caiman yacare (Daudin, 1802) demonstrated a wound-healing effect on the skin of Wistar rats. To enhance knowledge our about the mechanism underlying this effect, we analysed the oil’s toxicological potential in vitro. Cytotoxicity, genotoxicity, pro-oxidant, and antioxidant activities were evaluated in a V79-4 cell line. The oil was obtained using the Soxhlet method, and the proportions of the fatty acid profile was previously identified 43.74 % saturated and 34.65 % unsaturated fatty acids. Protocol 487 of the Organisation for Economic Co-operation and Development (OECD) was employed for cell line selection and concentrations. Cytotoxicity was determined using the MTT assay and clonogenic survival. Pro-oxidant and antioxidant activities were analysed using flow cytometry. Genotoxicity was evaluated using comet and micronucleus assays. The oil did not demonstrate cytotoxicity up to a concentration of 500 µg/mL. At concentrations of 250 and 500 µg/mL, the oil exerted a protective effect against oxidative stress and showed genotoxic effects only at the highest concentration (2000 µg/mL). Like other oils of interest for human health, the oil extracted from the visceral fat of C. yacare demonstrated low toxicological potential in vitro.

Ambulance Transports from NCAA Division 1 Football Games.

There is significant public health interest towards providing medical care at mass-gathering events. Furthermore, mass gatherings have the potential to have a detrimental impact on the availability of already-limited municipal Emergency Medical Services (EMS) resources. This study presents a cross-sectional descriptive analysis to report broad trends regarding patients who were transported from National Collegiate Athletic Association (NCAA) Division 1 collegiate football games at a major public university in order to better inform emergency preparedness and resource planning for mass gatherings. Patient care reports (PCRs) from ambulance transports originating from varsity collegiate football games at the University of Minnesota across six years were examined. Pertinent information was abstracted from each PCR. Across the six years of data, there were a total of 73 patient transports originating from NCAA collegiate football games: 45.2% (n = 33) were male, and the median age was 22 years. Alcohol-related chief complaints were involved in 50.7% (n = 37) of transports. In total, 31.5% of patients had an initial Glasgow Coma Scale (GCS) of less than 15. The majority (65.8%; n = 48; 0.11 per 10,000 attendees) were transported by Basic Life Support (BLS) ambulances. The remaining patients (34.2%; n = 25; 0.06 per 10,000 attendees) were transported by Advanced Life Support (ALS) ambulances and were more likely to be older, have abnormal vital signs, and have a lower GCS. This analysis of ambulance transports from NCAA Division 1 collegiate football games emphasizes the prevalence of alcohol-related chief complaints, but also underscores the likelihood of more life-threatening conditions at mass gatherings. These results and additional research will help inform emergency preparedness at mass-gathering events.

Structure-Based Engineering of Monoclonal Antibodies for Improved Binding to Counteract the Effects of Fentanyl and Carfentanil.

The opioid overdose epidemic is a growing and evolving public health crisis fueled by the widespread presence of fentanyl and fentanyl analogues (F/FAs) in both street mixtures and counterfeit pills. To expand current treatment options, drug-targeting monoclonal antibodies (mAbs) offer a viable therapeutic for both pre- and postexposure clinical scenarios. This study reports the isolation, in vitro characterization, and in vivo efficacy of two murine mAb families targeting fentanyl, carfentanil, or both. Because humanization of the mAbs by CDR grafting negatively impacted affinity for both fentanyl and carfentanil, crystal structures of mAbs in complex with fentanyl or carfentanil were analyzed to identify key residues involved in ligand binding in murine versus humanized structures, and site-directed mutagenesis was used to verify their functional importance. The structural analysis identified a framework residue, Tyr36, present in the murine germline sequence of two mAbs, which was critical for binding to fentanyl and carfentanil. These studies emphasize the importance of structural considerations in mAb engineering to optimize mAbs targeting small molecules including opioids and other drugs of public health interest.

Barriers and facilitators to dissemination of non-communicable diseases research: a mixed studies systematic review.

There is a large number of research studies about the prevention of non-communicable diseases (NCD), with findings taking several years to be translated into practice. One reason for this lack of translation is a limited understanding of how to best disseminate NCD research findings to user-groups in a way that is salient and useful. An understanding of barriers and facilitators to dissemination is key to informing the development of strategies to increase dissemination. Therefore, this review aims to identify and synthesise the barriers and facilitators to dissemination of NCD research findings. A mixed studies systematic review was performed following JBI (formerly known as Joanna Briggs Institute) methodology. The search included articles from January 2000 until May 2021. We conducted a comprehensive search of bibliographic and grey literature of five databases to identify eligible studies. Studies were included if they involved end-users of public health research that were decision-makers in their setting and examined barriers/facilitators to disseminating research findings. Two pairs of reviewers mapped data from included studies against the Framework of Knowledge Translation (FKT) and used a convergent approach to synthesise the data. The database search yielded 27,192 reports. Following screening and full text review, 15 studies (ten qualitative, one quantitative and four mixed methods) were included. Studies were conducted in 12 mostly high-income countries, with a total of 871 participants. We identified 12 barriers and 14 facilitators mapped to five elements of the FKT. Barriers related to: (i) the user-group (n = 3) such as not perceiving health as important and (ii) the dissemination strategies (n = 3) such as lack of understanding of content of guidelines. Several facilitators related to dissemination strategies (n = 5) such as using different channels of communication. Facilitators also related to the user-group (n = 4) such as the user-groups' interest in health and research. Researchers and government organisations should consider these factors when identifying ways to disseminate research findings to decision-maker audiences. Future research should aim to build the evidence base on different strategies to overcome these barriers. The protocol of this review was deposited in Open Science Framework (https://doi.org/10.17605/OSF.IO/5QSGD).