Intervention Measures Research Articles

Evaluation of the components in pre-conflict and post-conflict phases of peace-building

This work presents the evaluation of the components in pre-conflict and post conflict phases of peace-building. The paper identified some research problems which includes the difficulty in peace building agents in determining the right kind of intervention measures that addresses the various phases of peace-building. The study main objective is to determine the component of the various phases of peace-building measures. The methodology applied is the qualitative research design which includes the use of secondary sources such as journals and text books in data generation and qualitative analysis. Among the findings reached is that, the components of the pre-conflict phase of peace-building include peace advocacy and conflict prevention measures. Components of conflict phase include peace-keeping, peace-enforcement, and ceasefire measures, and the post-conflict phase include Demobilization, Disarmament and Rehabilitation (DDR) of ex-combatants and reconstructive recovery projects. Among the recommendation made is that, there should be increased peace advocacy, conflict prevention in the pre-conflict phase, quick use of peace-keeping, peace-enforcement, ceasefire, buffer zone, in the conflict phase, and high level of reconstructive recovery projects in the post conflict phase of any peace-building measure. Keywords: Conflict, Intervention, Peace, Components, Peace-Building, Evaluation.

The Prevalence and Related Factors of Hearing Loss Among Adults: A Systematic Review and Meta-Analyses

Objectives: We aimed to estimate the global prevalence of hearing loss among adults and to explore its associated factors. Methods: Our systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA). We retrieved corresponding documents published up to Sep 24, 2021 in PubMed and Web of Science. Random-effects models were used to calculate the pooled prevalence of hearing loss. Subgroup analyses were conducted to explore potential heterogeneity. Results: The pooled prevalence of any hearing loss across 100 studies was 31.0% (95% CI: 26.9-35.1, P < .001, I2 = 99.9%), and the pooled prevalence of disabling hearing loss across 34 studies was 15.9% (95% CI: 11.1-20.7, P < .001, I2 = 99.9%). The prevalence of hearing loss was higher in the year range of 2000 to 2009, among the elder (≥70) or males, in studies using either ear side of hearing loss definition or in the region of the Americas. Ear disease or surgery, job noise exposure, current smoking, off-work noise exposure, males, cardiovascular disease, past drinking, diabetes mellitus, hypertension, older age, and past smoking are risk factors of hearing loss while education level surpasses high school acts as a protect factor for hearing. Conclusion: Our results demonstrate high prevalence of hearing loss among adults worldwide and verify several related factors of the disease. Prevention and intervention measures should be implemented.

The role of gut microbiome and its metabolites in pancreatitis.

Gut microbiome plays a vital role in the intestinal ecosystem and has close association with metabolites. Due to the development of metabolomics and microbiomics, recent studies have observed that alteration of either the gut microbiome or metabolites may have effects on the progression of pancreatitis. Several new treatments based on the gut microbiome or metabolites have been studied extensively in recent years. Gut microbes, such as Bifidobacterium, Akkermansia, and Lactobacillus, and metabolites, such as short-chain fatty acids, bile acids, vitamin, hydrogen sulfide, and alcohol, have different effects on pancreatitis. Some preliminary studies about new intervention measures were based on the gut microbiome and metabolites such as diet, prebiotic, herbal medicine, and fecal microbiota transplantation. This review aims to summarize the recent advances about the gut microbiome, metabolites, and pancreatitis in order to determine the potential beneficial role of the gut microbiome and metabolites in pancreatitis.

The actor-partner interdependence model of fertility stress and marital quality among couples undergoing in vitro fertilization and embryo transfer: The mediating role of dyadic coping.

To explore the relationships among fertility stress, dyadic coping and marital quality in couples undergoing in vitro fertilization-embryo transfer (IVF-ET). Couples receiving IVF-ET treatment at the clinic of the reproductive medicine centre of a hospital in China from February 2023 to October 2023 were selected by convenience sampling. A general information questionnaire, the Infertility Fertility Stress Scale (COMP-FPSS-SF), the dyadic coping inventory, and the marital adjustment test were used to evaluate the results. AMOS24.0 software was used to construct an actor-partner interdependence model that extended to mediation to analyze the relationships among couples' fertility stress, dyadic coping, and marital quality. The fertility stress level of IVF-ET wives was significantly higher than that of their husbands (p<0.05). Wives' levels of dyadic coping and marital quality were significantly lower than those of husbands (p<0.05). Fertility stress, dyadic coping, and marital quality were positively correlated between IVF-ET couples (p<0.01). In terms of the actor effect, the fertility stress of IVF-ET couples had a significant impact on their marital quality through their dyadic coping (β=-0.188, p<0.05; β=-0.109, p<0.05). In terms of partner effects, wives' fertility stress significantly affected their husbands' marital quality through their own or their husbands' dyadic coping (β=-0.055, p<0.01; β=0.157, p<0.01). Dyadic coping mediates the relationship between fertility stress and marital quality in IVF-ET couples. Nurses can use husbands and wives as central individuals and dyadic coping as the starting point to formulate intervention measures to reduce fertility stress and improve marital quality.

In-person vs mobile app facilitated life skills education to improve the mental health of internally displaced persons in Nigeria: protocol for the RESETTLE-IDPs cluster randomized hybrid type 2 effectiveness-implementation trial

BackgroundInternally displaced persons (IDPs) in Nigeria face a high burden of mental health disorders, with limited access to evidence-based, culturally relevant interventions. Life skills education (LSE) is a promising approach to promote mental health and psychosocial well-being in humanitarian settings. This study aims to evaluate the effectiveness and implementation of a culturally adapted LSE program delivered through in-person and mobile platforms among IDPs in Northern Nigeria.MethodsThis cluster-randomized hybrid type 2 effectiveness-implementation trial will be conducted in 20 IDP camps or host communities in Maiduguri, Nigeria. Sites will be randomly assigned to receive a 12-week LSE program delivered either through in-person peer support groups or WhatsApp-facilitated mobile groups. The study will recruit 500 participants aged 13 years and older. Intervention effectiveness outcomes include the primary outcome of change in post-traumatic stress disorder (PTSD) symptoms assessed using the PCL-5 scale, and secondary outcomes of depression, anxiety, well-being, and life skills acquisition. Implementation outcomes will be assessed using the Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM). Both sets of outcomes will be compared between the in-person and mobile delivery groups. Quantitative data will be analyzed using mixed-effects linear regression models, while qualitative data will be examined through reflexive thematic analysis. The study will be guided by the Reach-Effectiveness-Adoption-Implementation-Maintenance (RE-AIM) framework.DiscussionThe RESETTLE-IDPs study addresses key gaps in the evidence base on mental health interventions for conflict-affected populations. It focuses on underserved IDP populations, evaluates the comparative effectiveness of in-person and mobile-delivered LSE, and incorporates implementation science frameworks to assess contextual factors influencing adoption, fidelity, and sustainability. The study employs a community-based participatory approach to enhance cultural relevance, acceptability, and ownership. Findings will inform the development and scale-up of evidence-based, sustainable mental health interventions for IDPs in Nigeria and other humanitarian contexts.Trial sponsorDalhousie University, 6299 South St, Halifax, NS B3H 4R2, Canada.Trial registrationClinicalTrials.gov, NCT06412679 Registered 15 May 2024.

Current status of schistosomiasis in school-aged children in Mwanga district, Tanzania: impact of two decades of annual Mass Drug Administration programme.

Schistosomiasis is a neglected tropical disease with significant health implications, particularly among children. A cross-sectional study was conducted among school-aged children (SAC) in Mwanga district, Tanzania, a region known to be co-endemic for S. haematobium and S. mansoni infection and where annual mass drug administration (MDA) has been conducted for 20 years. In total, 576 SAC from 5 schools provided a urine sample for the detection of Schistosoma circulating anodic antigen using the upconverting particle-based lateral flow (UCP-LF CAA) test. Additionally, the potential of the point-of-care circulating cathodic antigen (POC-CCA) and microhaematuria dipstick test as field-applicable diagnostic alternatives for schistosomiasis were assessed and the prevalence outcome compared to UCP-LF CAA. Risk factors associated with schistosomiasis was assessed based on UCP-LF CAA. The UCP-LF CAA test revealed an overall schistosomiasis prevalence of 20.3%, compared to 65.3% based on a combination of POC-CCA and microhaematuria dipstick. No agreement was observed between the combined POC tests and UCP-LF CAA. Factors associated with schistosomiasis included age (5–10 years), involvement in fishing, farming, swimming activities and attending 2 of the 5 primary schools. Our findings suggest a significant progress in infection control in Mwanga district due to annual MDA, although not enough to interrupt transmission. Accurate diagnostics play a crucial role in monitoring intervention measures to effectively combat schistosomiasis.

Exploring Implementation Processes of a Multicomponent Family Support Intervention in Intensive Care Units (FICUS) Study: A Mixed-Methods Process Evaluation.

To investigate the experience with and progress of the implementation of a Family Support Intervention (FSI) into adult intensive care units (ICUs) as part of the cluster-randomised FICUS trial. A mixed-methods process evaluation using a multiple case study approach guided by the normalisation process theory. This study took place between June 2022 and July 2023 in eight Swiss ICUs randomised to the intervention arm. A tailored implementation strategy was used to introduce the multicomponent FSI, consisting of a new family nursing role and a family care pathway, into interprofessional ICU teams. Participants were 40 ICU key clinical partners. Qualitative data were collected twice, early (3-6 months) and mid-implementation (9-12 months), using small group interviews. A questionnaire with psychometric measures (Acceptability of Intervention Measure, Feasibility of Intervention Measure, Intervention Appropriateness Measure, Normalisation Measure Development Questionnaire) was administered at mid-implementation. RITA pragmatic rapid thematic analysis and descriptive statistics were used to analyse the data. Qualitative and quantitative results were then compared across ICUs (cases). Findings indicated the desired progress of the FSI integration overall and across cases, with high acceptability and appropriateness ratings but only moderate to high feasibility scores. Study-related barriers were noted in all ICUs (i.e., FSI delivery as part of a clinical trial). Implementation barriers included family nurses' limited capacity and clinician's attitudes towards the FSI. Leadership support and interprofessional collaboration were identified as facilitators. Case-based, integrated findings yielded two implementation pathways, namely early and protracted adopters. Implementation barriers were related to the feasibility of FSI delivery within the study context that required a high degree of standardisation and protocol adherence. Implementation progress was shaped by an interprofessional culture of family care, sufficient staff and time resources, and leadership support. The study's findings will inform future implementation of complex health interventions in ICUs. Good reporting of a Mixed-Methods Study (GRAMMS). Within the FICUS trial, a patient and family advisory board with a patient expert, three family members and a patient with own lived experience of critical care collaborate with the research team.

An Integrated Approach for Development of a Decision Support System for Early Surveillance of Japanese Encephalitis: a Remote Sensing-based study in Conjunction with Epidemiological Scenario in Assam, India

Abstract. Japanese Encephalitis (JE) is one of the serious mosquito borne viral diseases mostly prevalent in India and many of the South Asian countries. A comprehensive study was conducted in Dibrugarh, a JE endemic district of Assam taking into the account of the environmental and social factors that determine the outbreak of the disease. Effect of environmental and climatic factors on mosquito vector densities was investigated using geospatial tools and techniques. Wetlands were found to be the most preferred habitat type for most of the JE-transmitting mosquitoes followed by paddy-growing areas and ponds. The villages abundant with these habitats or located nearby were found to be more vulnerable to JE risk. Based on the spatial distribution of habitat types, villages in the district were divided into three categories of vector abundance and hence the risk of JE. It is found that rainfall (intensity as well as duration) is the most significant determinant in the modulation of mosquito density followed by temperature. It is also observed that the derived models could explain about 61% to 73% variation in mosquito density due to change in weather variables as indicated by R2 values of the Models. Among socio-economic determinants, pig rearing habit of the villagers was found to be most significant. JE risk map was prepared by integrating vector abundance map with the map of host abundance in GIS domain. Attempts were also made to forecast the intensity of JE cases based on a time series analysis of historical morbidity pattern, whereas forecast for onset of the disease was based on the modulation of weather variables in the study area. A web-based decision support system (DSS) developed by integrating the forecasts of JE onset, intensity and JE prone villages has been provided to the concerned health authorities to take timely intervention measures. The JE early warning system developed for Dibrugarh district was extended to two more JE prone districts viz, Sibsagar and Tinsukia as validation sites and observed that the accuracy of forecast was within the range of 69% to 77%. DSS on JE has opened up new opportunities to study similar vector-borne diseases of the JE serogroup viz., West Nile.

Network meta-analysis evaluating the impact of diverse exercise regimens on quality of life in women post-breast cancer surgery.

This study used network meta-analysis to compare the effects of various exercise interventions, with the aim of identifying the most effective intervention measures. Data were extracted from 8 databases, comprising of PubMed, Web of Science, EBSCO, and Embase. The Cochrane risk of bias assessment tool was used to assess the quality of the research. Network meta-analysis and meta-analysis were performed using STATA15.0 and Review Manager 5.4, respectively. This analysis incorporated 58 research papers that had 4998 participants, of which 2480 were assigned to the test group and 2518 to the control group. As revealed by the data, the following is a descending order of the impact of various exercise regimens on the quality of life (QoL) of women who have undergone breast cancer surgery: For the MOS item short form health survey, the recommended sequence was as follows: aerobic + resistance exercise, football, baduanjin, walking, tai chi, yoga, resistance exercise, slow-moving qigong, aerobic exercise, and usual care; for functional assessment of cancer therapy for breast cancer, the sequence was as follows: aerobic + resistance exercise, resistance exercise, relaxation, baduanjin, square dance, aerobic exercise, tai chi, yoga, Pilates, mixer dance, aquatic sports, cycle ergometer, and usual care; and for European Organization for Research and Treatment of Cancer quality of life questionnaire, the sequence was aerobic + resistance exercise, aerobic + yoga, aerobic exercise, Pilates, yoga, muscle strengthening, resistance exercise, square dance, usual care, walking, and aerobic + edema massage. The majority of exercise interventions demonstrated a discernible impact on the QoL in women following breast cancer surgery. The effects of diverse exercise interventions on the 3 QoL outcome indicators in patients with breast cancer exhibited variability. However, irrespective of the QoL measurement technique used, aerobic and resistance exercise continue to be the most favorable choices.

Analysis of the outcomes in treatment of ulcerative colitis with acupuncture and moxibustion

To clarify the key outcomes of acupuncture-moxibustion treatment of ulcerative colitis. The clinical randomized controlled trials (RCTs) for ulcerative colitis treated with acupuncture and moxibustion were searched from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, and Web of Science, from the inception of each database to March 20th, 2023. The basic information of literature, intervention measures and outcome indexes were collected. The selection of primary and secondary outcomes, the use frequency of each index and the combination of them in utility were analyzed; and index domains of acupuncture and moxibustion for ulcerative colitis were summarized. A total of 215 RCTs were included and 54 outcomes were involved, classified into 6 categories, i.e. TCM syndromes, symptoms/physical signs, physical and chemical tests, quality of life, long-term prognosis and safety events. The top 3 outcomes with high use frequency were clinical effect evaluation, adverse reactions of acupuncture and moxibustion and the score of main symptoms. Only 3 articles clearly reported the primary outcome and the secondary ones, 180 articles used two types of outcomes simultaneously, 3 articles clearly described the time points of the observation indexes, and 126 articles determined the sources of the evaluation criteria of therapeutic effect, with 57 criteria involved. At present, the outcomes have not been standardized in RCTs of acupuncture and moxibustion for ulcerative colitis. It needs to clarify the primary one and the secondary ones. The criteria have not been unified for the evaluation of therapeutic effects and there is less consideration on the quality of life in patients, the follow-up visit and safety events. The attention should be paid to develop the outcome set, in which, the endoscopic score is taken as the objective, and the improvements in the symptoms/physical signs and the biochemical examination as the supplementary.

Primary and secondary prevention of postpartum depression

Pregnancy is one of the important life events in a woman's life, which in the face of pregnancy, childbirth and breastfeeding process, maternal psychology and physiology will have obvious changes, among which postpartum depression is more common. Postpartum depression (PPD) is a mental syndrome with obvious depressive symptoms or typical depressive episodes during the puerperal period. Its etiology is complex, with sleepiness, gloomy expression, crying and other symptoms in clinic, and even some patients will have suicidal tendencies, which seriously endangers maternal physical and mental health. In recent years, the adverse events caused by postpartum depression have attracted more and more social attention, and postpartum women's mental health has become a hot spot in clinical research. Clinical workers should improve the awareness of postpartum depression, and strengthen the maternal mental health screening, so as to detect psychological abnormalities as early as possible and give timely intervention measures. In view of the high incidence of postpartum depression, it is very important to establish a sound mental health service system for pregnant women. This paper will analyze the high risk factors of PPD summarized the targeted primary prevention and secondary prevention, and proposed prevention strategies before and after the onset of postpartum depression, respectively, to provide theoretical basis for effectively preventing the occurrence of postpartum depression or delaying the progression of postpartum depression.

Studi Kriminologi terhadap Kejahatan Prostitusi Online Melalui Aplikasi MiChat Ditinjau dari Perspektif Anomie Theory (Studi Kasus Aplikasi MiChat)

Online prostitution is the practice of prostitution conducted through digital platforms, such as messaging apps or social media, where sexual services are offered and transactions are managed online. Michat is an instant messaging app that allows users to communicate via text, voice, and video. In addition to basic features like private and group chats, Michat also provides options for media sharing and finding new friends. However, this app is sometimes misused for illegal activities such as online prostitution. This study uses a qualitative method with a case study approach to explore how Michat serves as a medium for this crime and how social, economic conditions, and changes in societal values contribute to the phenomenon. The findings of this research suggest that Anomie Theory explains how social disorder and the decline of norms can contribute to the emergence of deviant behavior, including online prostitution. Additionally, the study provides in-depth insights into the causes of online prostitution and offers recommendations for more effective prevention and intervention measures by the government.

External evaluation of Brain Injury Guideline (BIG) low risk criteria for traumatic brain injury

BackgroundFewer than 20 % of traumatic brain injury (TBI) cases with traumatic intracranial hemorrhage (ICH) result in clinical deterioration. The Brain Injury Guideline (BIG) criteria were published in 2014 and categorize patients with TBI into three risk groups (BIG 1, 2, and 3) based on CT scan findings, neurological examination, anti-coagulant/platelet medications, and intoxication. Early data is promising, suggesting no instances of neurosurgical intervention or death in the low-risk BIG1 category within 30 days. We sought to externally validate the BIG criteria and identify patients with TBI at low risk of clinical deterioration. We hypothesized that patients meeting the BIG1 low risk criteria have less than a 1 % risk of death or neurosurgical intervention. MethodsWe performed a retrospective cohort study of a level 1 trauma center's trauma registry records from 2011 to 2022 to identify patients with head trauma. We abstracted demographics, injury characteristics, clinical course, CT imaging results, and outcomes, and we categorized patients according to the BIG criteria. The Clopper-Pearson Exact method was used to estimate outcome frequency with confidence intervals. The primary outcome was death or neurosurgical intervention within 30 days. Secondary outcomes included progression on repeat head CT (RHCT), ICU admission with neurocritical care intervention, and TBI-related hospital readmission within 30 days. ResultsA total of 1714 patients with TBI with ICH were identified from the trauma registry. 325 patients were excluded due to missing data, pregnancy, incarceration, polytrauma, or GCS < 13, leaving 1389 for analysis. 193 patients (13.9 %) were classified as BIG1. No patients classified as BIG1 experienced the primary outcome measures of death or neurosurgical intervention (95 % confidence interval [CI]: 0 %–1.9 %). The number of patients who experienced the secondary outcome measures of progression on RHCT, ICU admission with neurocritical care intervention, or TBI-related hospital readmission within 30 days were 9 (4.7 %, 95 % CI: 2.2 %–8.7 %), 1 (0.5 %, 95 % CI: 0 %–2.9 %), and 4 (2.1 %, 95 % CI: 0.6 %–5.2 %), respectively. ConclusionBIG1 criteria identified a low-risk subset of patients with TBI with ICH. However, an upper 95 % CI of 1.9 % does not exclude the risk of neurologic deterioration being <1 %. Validation of these criteria in larger cohorts is warranted.

Microbiology, induction, and management practices to mitigate lameness caused by bacterial chondronecrosis with osteomyelitis in broiler chickens

Bacterial chondronecrosis with osteomyelitis (BCO) lameness is the most prevalent skeletal disorder in poultry, implicated by the inherent risk of the high growth rate of modern broilers. The non-synchronization of massive body mass accretion vs maturation of the structural bone induces vulnerability to bone microfracture and immunosuppression, leading to bacterial necrosis in the skeletal and thoracic vertebral bones, leg paralysis, and eventual death. BCO lameness also imposes animal welfare issues and confers food safety risks. A study in 20 broiler farms in Australia recorded 28% BCO lesions of the necropsied birds, while a study in commercial flocks in Europe reported 19% moderate-to-severe lameness symptoms. The high incidence of lameness in commercial broiler farms reduces production value and leads to a huge economic loss in the poultry industry. Managing BCO lameness in broiler poultry is more challenging than that of other species because the peak of lameness incidence emerges at the marketing age of broilers. Moreover, curative treatment of the affected broilers is arduous due to their larger populations but shorter production cycles. Thus, condemnation of clinically lame birds has been a common practice in broiler farms to prevent the transmission of highly contagious BCO throughout the broiler populations. This practice decreases the production value and increases the economic forfeits. Therefore, presenting intervention measures for managing and controlling BCO in broiler poultry is necessary. Knowledge of etiological agents, pathogenesis, detection, and experimental lameness models to evaluate the efficacy of the intervention measures is highly important in presenting approaches to mitigate BCO lameness. Thus, this review focuses on microbiology studies of BCO, models of creating experimental lameness, and intervention measures mitigating BCO lameness in broiler chickens.

Evaluations of Groundwater Quality using Principal Component Analysis and Associated Multivariate Techniques: A Case History in Ewekoro Communities, South-West Nigeria

The quest for quality water consumption is comprised of integration of numerous techniques from different professionals whose contributions go a long way in determining overall health status and wellness of any given society. The water quality status of boreholes in Ewekoro communities of Ewekoro Local Government Area, South-West Nigeria was investigated in this work. Water samples were collected from 25 boreholes at various sampling stations across the study area. Standard analytical water quality methods using Inductively Coupled Mass Spectrometry (ICP-MS)/Optical Emission Spectrometry (ICP-OES) and Pour Plate Techniques were respectively employed in the laboratory for the samples’ geochemical and bacteriological analyses. The raw data were processed and analyzed using Principal Component Analysis and other multivariate techniques with Excel and SPSS 20.0 statistical software packages with the corresponding outcomes systematically compared with water quality standards. For the PCA, the varimax rotation converged in 23 iterations with 6 components extracted which accounted for 92.76% of the total cumulative variance respectively observed for geochemical parameters. Na2+, K+, Ca2+, Cl-, SO42-, NH4+, PO43-, and HCO3-, Mg3+, Cu2+, Cd2+, Zn2+, Ni, S , Si, Fe3+, NO3− and Al3+ played a significant contribution with higher factor loading supported by the dominance of HCO3− among the water quality determinants. The rotation converged in 8 iterations with 3 extracted components that accounted for a total cumulative variance of 90.99% % with pH, TEMP, EC, BOD, TS, TURB, ALK, TH, TDS, THC, and DO in the Physico-chemical Parameters series. Most quality determinants in the sampled water are within allowable limits of the approved water quality standards including WHO except Alkalinity, HCO3−, MgCO3−, Cl−, BOD, Cd2+, Fe3+ and Zn2+. The overall ionic dominance pattern follows the same trend K+ &gt;Na2+ &gt; Fe3+ &gt;Mn2+ and Cl- &gt;NO3- &gt;NO2-. The results of the microbial analyses revealed the highest Total Coliform Count of 17 x 102 MPN/100 ml while that of THBC and FCC were reported as 7.8 ×102 cfu/ml and 1.2×102 cfu/ml respectively. The hygienic status of the water sources was found to be poor. High BOD, Coliform Count and BOD5:NO3- ratios of 248.23 recorded for the groundwater samples were suggestive of possible organic pollution due to faecal invasion with the lowest measured depth of 35m. Multivariate statistical approaches namely Correlation, Principal Component Analysis and Descriptive statistics simplified and identified the interrelationship among the analyzed physicochemical parameters and the pollution sources. This study has therefore revealed that boreholes in Ewekoro were polluted and posed potential risk to biomedical safety and overall human health. Intervention measures are therefore necessary to safeguard the inhabitants from water-related diseases and their consequences.

Global, regional, and national temporal trends in metabolism-related ischemic stroke mortality and disability from 1990 to 2021

BackgroundStroke ranks as the second leading cause of mortality and the third leading cause of disability worldwide. Nonetheless, the evolving burden of ischemic stroke attributable to various metabolic risk factors remains inadequately elucidated. A thorough grasp of these trends is crucial for a nuanced comprehension of stroke epidemiology and the formulation of effective preventive and interventional measures. MethodBased on the Global Burden of Disease, Injury, and Risk Factors Study 2021 (GBD), we analyzed national temporal trends in the burden of metabolism-associated ischemic stroke in 204 countries and territories globally from 1990-2021, as measured by the average annual percentage change (AAPC), using join-point regression models. The burden of disease was assessed using age-standardized (ASR) mortality rates and disability-adjusted life years (DALY) per 100 000 population. Cross-country inequalities in ischemic stroke burden were quantified using standard health equity methods and changes in ischemic stroke burden were projected to 2045. ResultsGlobally, the ASR for ischemic stroke mortality linked to overall dietary metabolic risk declined by an average of 1.6% annually, while the ASR for disability-adjusted life years saw an average annual decrease of 1.3%. High systolic blood pressure remained a primary contributor to metabolism-related ischemic stroke, accounting for 57.9% of deaths and 58.0% of disability in 2021. Disparities associated with the sociodemographic index (SDI) diminished, with the gap in DALYs between countries with the highest and lowest SDIs narrowing from 592.2 (95% CI: 440.2-744.4) to 480.4 (95% CI: 309.7-651.2) in 2021. Projections indicate a continued decline in overall metabolism-related ischemic stroke deaths, mortality rates, and ASRs through 2045, although an increase in DALYs and ASRs is anticipated within the male population. ConclusionThe global burden of metabolic risk-associated ischemic stroke has generally been decreasing from 2019 to 2021. This study highlights significant challenges in controlling and managing metabolic risk-associated ischemic stroke, including an increase in the number of cases in certain countries and regions, as well as an uneven distribution worldwide. These findings may provide valuable insights for the development of improved public health policies and the rational allocation of healthcare resources.

A two-strain COVID-19 co-infection model with strain 1 vaccination

COVID-19 has caused substantial morbidity and mortality worldwide. Previous models of strain 1 vaccination with re-infection when vaccinated, as well as infection with strain 2 did not consider co-infected classes. To fill this gap, a two co-circulating COVID-19 strains model with strain 1 vaccination, and co-infected is formulated and theoretically analyzed. Sufficient conditions for the stability of the disease-free equilibrium and single-strain 1 and -strain 2 endemic equilibria are obtained. Results show as expected that (1) co-infected classes play a role in the transmission dynamics of the disease (2) a high efficacy vaccine could effectively help mitigate the spread of co-infection with both strain 1 and 2 compared to the low-efficacy vaccine. Sensitivity analysis reveals that the main drivers of the effective reproduction number Re are primarily the effective contact rate for strain 2 (β2), the strain 2 recovery rate (τ2), and the vaccine efficacy or infection reduction due to the vaccine (η). Thus, implementing intervention measures to mitigate the spread of COVID-19 should not ignore the co-infected individuals who can potentially spread both strains of the disease.

The potential influence and intervention measures of gut microbiota on sperm: it is time to focus on testis-gut microbiota axis.

As the global male infertility rate continues to rise, there is an urgent imperative to investigate the underlying causes of sustained deterioration in sperm quality. The gut microbiota emerges as a pivotal factor in host health regulation, with mounting evidence highlighting its dual influence on semen. This review underscores the interplay between the Testis-Gut microbiota axis and its consequential effects on sperm. Potential mechanisms driving the dual impact of gut microbiota on sperm encompass immune modulation, inflammatory responses mediated by endotoxins, oxidative stress, antioxidant defenses, gut microbiota-derived metabolites, epigenetic modifications, regulatory sex hormone signaling. Interventions such as probiotics, prebiotics, synbiotics, fecal microbiota transplantation, and Traditional natural herbal extracts are hypothesized to rectify dysbiosis, offering avenues to modulate gut microbiota and enhance Spermatogenesis and motility. Future investigations should delve into elucidating the mechanisms and foundational principles governing the interaction between gut microbiota and sperm within the Testis-Gut microbiota Axis. Understanding and modulating the Testis-Gut microbiota Axis may yield novel therapeutic strategies to enhance male fertility and combat the global decline in sperm quality.

Prevalence and determinants of stunting and anaemia in children aged 6-23 months: A multilevel analysis from rural Ethiopia.

Low- and middle-income countries shoulder the greatest burden of stunting and anaemia in children. This calls for prompt and effective intervention measures, while the contributing factors are not fully understood. This study evaluates determinants spanning from individual-, household- and community levels including agroecology and antinutrients as unique sets of predictors. Primary data were collected from 660 rural households representing the midland (ML), highland, and upper highland (UHL) agroecological zones from northern Ethiopia. The study relates several predictors to stunting and anaemia in children aged 6-23 months. We found 49.1% and 49.7% of children were stunted and anaemic, respectively. Children living in the ML are approximately twice more likely to be stunted adjusted odds ratio (AOR: 1.869; 95% CI: 1.147-3.043) than in the UHL. The risk of stunting increases by 16.3% and 41.9% for every unit increase in phytate-to-zinc and phytate-to-iron molar ratios, respectively. A 10% increase in mean aggregated crop yield was observed to reduce the likelihood of stunting occurrence by 13.6%. Households lacking non-farm income-generating opportunities, travel longer time to access the marketplace and poor health service utilisation were associated with increased risk of stunting. Low diversity of child's diet, age of the child (18-23 months) and mothers at a younger age are significantly associated with stunting. Risk of anaemia in children is high amongst households with unimproved water, sanitation, and hygiene practices, younger age (6-11 months) and mostly occurs amongst boys. Children in the ML had a 55% reduced risk of being anaemic (AOR: 0.446; 95% CI: 0.273-0.728) as compared to the UHL. Therefore, the influence of these factors should be considered to tailor strategies for reducing undernutrition in children of 6-23 months in rural Ethiopia. Interventions should go beyond the administrative boundaries into targeting agroecological variation.

A Five-Year Malaria Prevalence/Frequency in Makenene in a Forest-Savannah Transition Ecozone of Central Cameroon: The Results of a Retrospective Study.

Understanding the epidemiological features of malaria is a key step to monitoring and quantifying the impact of the current control efforts to inform future ones. This study establishes the prevalence and frequency of malaria in a forest-savannah ecozone for 5 consecutive years in Cameroon. A retrospective study was conducted in 3 health centers of Makenene from 2016 to 2020, a period covering the second long-lasting insecticide net mass distribution campaign. Malaria infectious records were reviewed from laboratory registers. The difference in exposure to malaria was estimated using a regression logistic model. A total of 13525 patients underwent malaria diagnostic tests, with a general malaria prevalence of 65.3%. A greater prevalence of malaria was observed in males (68.39%) compared to females (63.14%). The frequency of consultations in health centers was dominated by females, with a gender ratio (M/F) of 0.66. Annual trends in malaria prevalence slightly varied from 2016 to 2020, exceeding 60%: 65.2% in 2016; 66.7% in 2017, 68.1% in 2018, 63.2% in 2019, and 65.3% in 2020, with a significant seasonal variation (p < 0.0001). The highest malaria prevalence was observed during the short rainy season, no matter the year. Among positive cases, the most represented age groups were 6-15 (p < 0.0001), followed by those under 5, while the age group >25 years was the least represented. Close monitoring and additional intervention measures for malaria control are needed, as are more studies on vector bionomics and transmission patterns.