Public Health Hazard Research Articles

Tobacco smoking and substance use among medical undergraduates in Najaf, Iraq: prevalence and associated factors

ABSTRACT Background Tobacco smoking and substance use is a public health hazard. The investigations studying tobacco smoking, substance use, and their associated factors among Iraqi undergraduates are limited. Our study aimed to examine tobacco smoking, and substance use among medical undergraduates in Najaf, Iraq, and report associated characteristics. Methods A piloted questionnaire was utilized to conduct a descriptive cross-sectional web-based survey. The snowball technique was used for sampling. The subjects’ features, perceived risk of harm, location, motivations, and effects of cigarette smoking and substance misuse were used to conduct association testing. Results Tobacco smoking was reported in 17.3% of the students (at least once in the previous month), and substance use in 3%. Mostly, the age of initiation was <15 years, and psychological stress (50.9%) was the reason for tobacco smoking and substance use. However, the presence of a smoker or user friend or family member was significantly associated (p-value <.05) with tobacco smoking and substance use. Conclusion The prevalence of tobacco smoking and substance use and several risk factors were identified. In addition to promoting awareness about tobacco smoking and substance use and its potential consequences, the associated characteristics reported in this study are useful when developing effective counteracting policy initiatives.

The Role of Quorum Sensing in the Development of Microcystis aeruginosa Blooms: Gene Expression.

Microcystis aeruginosa (M. aeruginosa) is the dominant cyanobacterial species causing harmful algal blooms in water bodies worldwide. The blooms release potent toxins and pose severe public health hazards to water bodies, animals, and humans who are in contact with or consume this water. The interaction between M. aeruginosa and heterotrophic bacteria is thought to contribute to the development of the blooms. This study strives to provide a specific answer to whether quorum sensing is also a potential mechanism mediating the interaction of different strains/species and the expression by gene luxS or gene mcyB in M. aeruginosa growth. The luxS gene in M. aeruginosa PCC7806 is associated with quorum sensing and was tested by q-PCR throughout a 30-day growth period. The same was performed for the mcyB gene. Heterotrophic bacteria were collected from local water bodies: Cibolo Creek and Leon Creek in San Antonio, Texas. Results revealed that in algal bloom scenarios, there is a similar concentration of gene luxS that is expressed by the cyanobacteria. Gene mcyB, however, is not directly associated with algal blooms, but it is related to cyanotoxin production. Toxicity levels increased in experiments with multiple algal strains, and the HSL treatment was not effective at reducing microcystin levels.

β-Lactamase Producing Escherichia coli Encoding blaCTX-M and blaCMY Genes in Chicken Carcasses from Egypt.

Escherichia coli with multidrug resistance and β-lactamase genes may constitute a great public health hazard due to the potential for their transmission to humans through the food chain. This study determined the prevalence, antibiotic resistance profiles, phylogroups, and β-lactamase genes of E. coli isolates from chicken carcasses marketed in Mansoura, Egypt. Interestingly, E. coli was detected in 98% (98/100) of the chicken carcasses examined, which seemed among the highest contamination rates by E. coli worldwide. From the 425 genetically verified uidA gene-positive E. coli, 85 isolates were further studied for antimicrobial resistance profiles, phylogroups, and β-lactamase genes. Interestingly, 89.41% of E. coli (76/85) strains tested against 24 different antibiotics were multidrug-resistant. Of the examined 85 E. coli isolates, 22 (25.88%) isolates harbored blaCTX-M and were resistant to ampicillin, cefazoline, and ceftriaxone, while three of them were resistant to ceftazidime besides. Nine (10.59%) E. coli strains harbored AmpC- β-lactamase blaCMY and were resistant to ampicillin. One isolate co-carried blaCMY and blaCTX-M genes, though it was negative for the blaTEM gene. Of the 35 isolates that harbored either extended-spectrum β-lactamase (ESBL) and/or AmpC β-lactamase genes, six strains (17.14%) were assigned to pathogenic phylogroup F and one to phylogroup E, whereas 28 (80%) isolates belonged to commensal phylogenetic groups.

Seroprevalence of Bovine Brucellosis in Selected Sites of Central Highland of Ethiopia.

Brucellosis is a contagious, economically significant bacterial disease that affects animals worldwide and is one of the most neglected zoonotic diseases in the world. The disease poses a barrier to the trade of animals and animal products, represents a public health hazard, and is an impediment to free animal movement. A cross-sectional study was carried out from December 2019 to May 2020 in order to determine seroprevalence and identify potential risk factors for brucellosis in dairy cows in the Central Highlands of Ethiopia with recent cases of abortion. Purposive sampling was carried out on the farms and kebeles in question to screen for recent cases of abortion in dairy cows. For the purpose of performing serological testing, 352 blood samples from dairy cattle were obtained. The Rose Bengal Plate test was used to initially screen the serum samples, and the Complement Fixation test was utilized as a confirmatory test. Using combined RBPT and CFT tests, the overall seroprevalence of bovine brucellosis was 0.6% (95% CI: 0.16-2.09). Retained fetal membrane (OR = 32.74, p = 0.006), market-based stock replacement (OR = 16.55, p = 0.002), breeding method (OR = 7.58, p = 0.027), and late stage of abortion (OR = 14.74, p = 0.0002) are all significantly associated risk factors. The present seroprevalence study revealed that brucellosis is prevalent at a lower rate among dairy cattle in the study areas. However, there is a possible risk of brucellosis transmission in dairy cattle and the exposed human population in research locations because no control measures were put in place there. Implementing a test and slaughter method with compensation for farmers is advised due to the low prevalence of bovine brucellosis in government-owned and small-holder farms.

A Blockchain-Driven Food Supply Chain Management Using QR Code and XAI-Faster RCNN Architecture

The availability of food in a country and the capacity of its citizens to access, acquire, and receive enough food are both referred to as having food security. A crucial component of food security is ensuring and maintaining safe and high-quality goods, which the supply chain process should take into due deliberation. To enhance the food supply chain, organic and wholesome food items should be encouraged. Although packaged goods are evaluated and approved by legal authorities, there is no mechanism in place for testing and assessing the market’s available supply on a regular basis. As a result, food manufacturers are compelled to provide nutritious and healthy products. In this research, we propose an explainable artificial intelligence-based faster regions with convolutional neural networks (XAI-based Faster RCNN) model to evaluate the contents of the food items through user-friendly web-based front-end design and QR code. To validate each communication token in the network, an elliptic curve integrated encrypted scheme (ECIES) based on blockchain technology is utilized. Additionally, artificial rabbit optimization (ARO) is used to register each user and assign him a key. The user will gain a deeper understanding of machine learning (ML) and AI applications using the XAI technique. An EAI-based Faster RCNN model is proposed to help digitize information about food products, rapidly retrieve the information, and discover any hidden information in the quick response (QR) code that could have impacted the safety and quality of the food. The results of the experiments indicated that the proposed method requires less response time than other existing methods with the increase of payload and users. The Shapley additive explanation is used to obtain a legal plea for the laboratory test based on the nutritional information present in the QR code. The benefits provided by ECIES-based blockchain technology assist policymakers, manufacturers, and merchants in efficient decision-making, minimizing public health hazards, and improving welfare. This paper also shows that the accuracy achieved by the proposed method reached 99.53%, with the lowest processing time.

Distinguishing Exposure to Secondhand and Thirdhand Tobacco Smoke among U.S. Children Using Machine Learning: NHANES 2013-2016.

While the thirdhand smoke (THS) residue from tobacco smoke has been recognized as a distinct public health hazard, there are currently no gold standard biomarkers to differentiate THS from secondhand smoke (SHS) exposure. This study used machine learning algorithms to assess which combinations of biomarkers and reported tobacco smoke exposure measures best differentiate children into three groups: no/minimal tobacco smoke exposure (NEG); predominant THS exposure (TEG); and mixed SHS and THS exposure (MEG). Participants were 4485 nonsmoking 3-17-year-olds from the National Health and Nutrition Examination Survey 2013-2016. We fitted and tested random forest models, and the majority (76%) of children were classified in NEG, 16% were classified in TEG, and 8% were classified in MEG. The final classification model based on reported exposure, biomarker, and biomarker ratio variables had a prediction accuracy of 95%. This final model had prediction accuracies of 100% for NEG, 88% for TEG, followed by 71% for MEG. The most important predictors were the reported number of household smokers, serum cotinine, serum hydroxycotinine, and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL). In the absence of validated biomarkers specific to THS, comprehensive biomarker and questionnaire data for tobacco smoke exposure can distinguish children exposed to SHS and THS with high accuracy.

Longitudinal Study of Dynamic Epidemiology of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Pigs and Humans Living and/or Working on Pig Farms.

Extended-spectrum beta-lactamase (ESBL)-producing Enterobacterales have been increasingly isolated from pigs, highlighting their potential for transmission to humans living and/or working within pig farms. As longitudinal data on the prevalence and the molecular characteristics of such isolates from the high-risk farming population remain scarce, we performed a long-term study on 39 Dutch pig farms. Fecal samples from pigs, farmers, family members, and employees were collected during four sampling occasions with a 6-month period. The presence of ESBL-producing Enterobacterales and their molecular characteristics (ESBL gene, plasmid, and sequence types) were determined by standard methods. Data on personal and farm characteristics were collected using questionnaires. ESBL-producing Escherichia coli was present in pigs at least once for 18 of 39 farms and in 17 of 146 farmers, family members, and/or employees. Among these 417 E. coli isolates, blaCTX-M-1 was the most frequently observed ESBL gene in pigs (n = 261) and humans (n = 25). Despite the great variety in plasmid (sub)types and E. coli sequence types (STs), we observed genetic similarity between human- and pig-derived isolates in (i) ESBL gene, plasmid (sub)type, and ST, suggesting potential clonal transmission in seven farms, and (ii) only ESBL gene and plasmid (sub)type, highlighting the possibility of horizontal transfer in four farms. Five pig farmers carried ESBL producers repeatedly, of whom two carried an identical combination of gene, plasmid (sub)type, and ST over time. Human ESBL carriage was associated with both presence of ESBL producers in pigs and average number of hours working on the pig farm per week, while prolonged human carriage was observed only incidentally. IMPORTANCE Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli represents a public health hazard due to reduced therapeutic options for the treatment of infections. Although direct contact with pigs is considered a risk factor for human ESBL-producing E. coli carriage through occupational exposure, nationwide data regarding the occurrence of such isolates among pigs and humans living and/or working on farms remain scarce. Therefore, we determined (i) the longitudinal dynamics in prevalence and molecular characteristics of ESBL-producing E. coli in Dutch pig farmers and their pigs over time and (ii) the potential transmission events between these reservoirs based on genetic relatedness and epidemiological associations in longitudinal data. Our data suggesting the possibility of clonal and horizontal dissemination of ESBL-producing Escherichia coli between pigs and pig farmers can be used to inform targeted intervention strategies to decrease the within-farm human exposure to ESBL-producing E. coli.

Urine Metabolome Dynamics Discriminate Influenza Vaccination Response.

Influenza represents a major and ongoing public health hazard. Current collaborative efforts are aimed toward creating a universal flu vaccine with the goals of both improving responses to vaccination and increasing the breadth of protection against multiple strains and clades from a single vaccine. As an intermediate step toward these goals, the current work is focused on evaluating the systemic host response to vaccination in both normal and high-risk populations, such as the obese and geriatric populations, which have been linked to poor responses to vaccination. We therefore employed a metabolomics approach using a time-course (n = 5 time points) of the response to human vaccination against influenza from the time before vaccination (pre) to 90 days following vaccination. We analyzed the urinary profiles of a cohort of subjects (n = 179) designed to evenly sample across age, sex, BMI, and other demographic factors, stratifying their responses to vaccination as “High”, “Low”, or “None” based on the seroconversion measured by hemagglutination inhibition assay (HAI) from plasma samples at day 28 post-vaccination. Overall, we putatively identified 15,903 distinct, named, small-molecule structures (4473 at 10% FDR) among the 895 samples analyzed, with the aim of identifying metabolite correlates of the vaccine response, as well as prognostic and diagnostic markers from the periods before and after vaccination, respectively. Notably, we found that the metabolic profiles could unbiasedly separate the high-risk High-responders from the high-risk None-responders (obese/geriatric) within 3 days post-vaccination. The purine metabolites Guanine and Hypoxanthine were negatively associated with high seroconversion (p = 0.0032, p < 0.0001, respectively), while Acetyl-Leucine and 5-Aminovaleric acid were positively associated. Further changes in Cystine, Glutamic acid, Kynurenine and other metabolites implicated early oxidative stress (3 days) after vaccination as a hallmark of the High-responders. Ongoing efforts are aimed toward validating these putative markers using a ferret model of influenza infection, as well as an independent cohort of human seasonal vaccination and human challenge studies with live virus.

Analysis of sildenafil citrate in herbal aphrodisiac preparations marketed in Sokoto metropolis and its public health implications

Aphrodisiacs are among the most widely marketed and consumed herbal products in North-Western Nigeria. There are speculations that these products are being adulterated with orthodox medicines in order to boost their effects and sales. The objective of current research was to analyse the presence of adulterated sildenafil citrate in some herbal aphrodisiacs commonly sold and consumed in Sokoto metropolis. Ten different liquid herbal aphrodisiac preparations marketed in Sokoto metropolis were collected from different areas of the city. Each of the preparation was analysed for adulteration with sildenafil citrate using thin layer chromatography and UV spectroscopy. Five of the preparations were found to contain sildenafil citrate in the range of 34 – 291 mg per daily dose. The findings from this study indicate that some of the herbal aphrodisiac preparations marketed in Sokoto metropolis are being adulterated with substantial amount of undeclared sildenafil citrate, a practice that poses serious public health hazard to its consumers. Consequences of which ranges from nausea, dyspepsia, pain, dizziness, abnormal vision, and headache and potentially heart attack especially among adults with underlying chronic diseases such as hypertension among others.

A mathematical model of Zika virus transmission with saturated incidence and optimal control: A case study of 2016 zika outbreak in Puerto Rico

ABSTRACT Zika virus outbreak is creating a global public health hazard due to its increasing prevalence rate and neurological complication in affected individuals. In this work we have developed and studied an ODE compartmental Zika model with non-linear saturated incidence function and three control measures including prevention control from vector bite, treatment control of infected host and vector killing control. Our theoretical analysis shows that the disease free equilibrium is locally as well as globally asymptotically stable when the basic reproduction number is less than unity. The virus is uniformly persistent when the basic reproduction number is greater than unity. An endemic equilibrium point exists and locally stable when the basic reproduction number is greater than unity. The model is validated by fitting the model to real reported data of 2016 Zika outbreak in Puerto Rico and estimated the model parameters. We also have studied the basic reproduction number and effective reproduction number of the outbreak. Sensitivity analysis has been carried out to find most sensitive parameters. The optimal control and efficiency analysis has been done to find the policy of control variables. Lastly, the manuscript is ended by some conclusions.

Probable nexus between Methane and Air Pollution in Bangladesh using Machine Learning and Geographically Weighted Regression Modeling

This paper investigates the probable nexus between methane (CH4) and air pollutants, a public health hazard in Bangladesh. The hypothesis considers that the concentration of CH4 is dependent on the ten air pollutants found in the five districts in Dhaka Division, a major urban and industrial area in Bangladesh. These pollutants are: Particular matters (PM2.5), Nitrogen dioxide (NO2), Nitrogen oxide (NOx), Aerosol optical thickness (AOT), Sulfur dioxide (SO2), Carbon monoxide (CO), Ozone (O3), Black carbon (BC), Formaldehyde (HCHO) and Dust. The study applies Machine Learning (ML) technique and Geographically Weighted Regression (GWR) Modeling. Temporal CH4 datasets from the Sentinel-5P sensor are classified to estimate the annual CH4 concentration during 2019-2021.Seven supervised classifiers of ML coupled with the GWR model are used to predict the statistical and spatial relationships. CH4 increases gradually during 2018-2021 in Dhaka, Gazipur, and Munshiganj Districts. It relates differently with various air pollutants, e.g., positively with BC, Dust, NO2, PM2.5, O3, and AOT, and negatively with NOx, CO, HCHO, and SO2.This study results that Rational quadratic (RMSE-0.001, MAE-0.001, R2-0.96), Random Forest (RMSE-0.004, MAE-0.003, R2-0.91), and Stepwise regression (RMSE-0.002, MAE-0.002, R2-0.87) are the suitable method in ML. The highest goodness-of-fit (R2) of 82%-96% is found in Dhaka and Narshingdi Districts. The key findings may help formulate the appropriate action plan to mitigate ongoing and future air pollution in Bangladesh. In addition, the methodology of the research may be applicable elsewhere nationally and internationally for air pollution research.

Real-Time Identification and Positioning of Sewer Blockage Based on Liquid Level Analysis in Rural Area

Sewer blockages delay sewage discharge or cause it to overflow, which pollutes the environment and is a public health hazard. This necessitates the quick and accurate identification and positioning of sewer blockages. Following a sewer blockage, the sewage is intercepted and the liquid level at the upstream and downstream of the blocking point changes. This study established a method for identifying sewer blockages by analyzing the range and rate of the liquid level change at the upstream and downstream of the blocking point. Through pilot-scale and full-scale experiments, this study summarized the threshold values of the liquid level change rate and the liquid level fluctuation range of the drainage pipeline in normal operation, as well as the threshold values of the liquid level change rate and the liquid level fluctuation range of the upstream and downstream of the sewer blocking point. Moreover, the sewer blockage identification matrix was completed. Sewer blockage in rural areas can be identified and positioned using mathematical tools such as the data-driven model. This research method allows for real-time monitoring and timely warning of the sewer status, thereby reducing the labor and material consumption and unnecessary earthwork excavation to ensure the stable operation of the drainage pipeline.

Phenotypic and Genotypic Identification of Typical and Atypical Staphylococcus aureus Isolated From Bovine Milk Samples

This study aimed to determine the phenotypic and genotypic identification and differentiation of typical coagulase positive Staphylococcus aureus (CPSA) and atypical coagulase negative Staphylococcus aureus (CNSA) from other Staphylococci isolated form bovine milk. Out of 111 milk samples, 67 Staphylococcus strains were isolated, phenotypically, based on resistance to Acriflavine; Staphylococcus aureus (S. aureus) was detected in 44 isolates of them (30 CPSA strains and 14 CNSA strains). Twenty five from CPSA and 5 from CNSA isolates were positive for slime production on Congo red agar plates. Genotypically, the all five tested typical Staphylococcus aureus (CPSA) as well as three atypical Staphylococcus aureus (CNSA) strains encoded all investigated genes (nuc, spa-x and clfA), while the other two atypical CNSA strains, one encoded only nuc gene and the other encoded both nuc and clfA genes. Acriflavine sensitivity test must be included in the routine of phenotypic identification S. aureus as the gold method together with tube coagulase test. PCR analysis is most important confirmation method by detection of nuc gene. Genotypically both typical and atypical S. aureus isolates are virulent. Typical and atypical S. aureus isolated from isolated from bovine milk samples sold in dairy shops were with higher percentage than subclinical mastitic milk samples threating public health hazard. Attention must be paid toward detection and identification of atypical tube coagulase negative S. aureus strains.

Transforming Agriculture: Innovations in Sustainable Wastewater Reuse – A review

This scientific review delves into the crucial role of wastewater reuse in agriculture for sustainable water resource management, especially in the context of water scarcity. The paper examines innovative wastewater treatment methods like biofiltration, membrane bioreactors, and electrocoagulation, exploring their effectiveness and limitations. It emphasizes the significance of proper wastewater treatment in mitigating risks and maximizing benefits. Key considerations such as economic viability and social acceptance are highlighted, urging comprehensive cost-benefit analyses and active engagement with stakeholders. Drawing from case studies in Tshwane, Egypt, Valencia, and Sde Warburg, successful wastewater reuse practices underscore the importance of stringent water quality standards, public education, regulatory frameworks, and stakeholder involvement in achieving sustainable wastewater management. Despite global advancements, challenges persist in the adoption of these technologies in many African countries, necessitating collaborative efforts and targeted capacity-building for widespread implementation. Historical insights reveal the evolution of wastewater irrigation from European and American cities to its current global prevalence, impacting around 10% of the world’s irrigated land with untreated or partially treated wastewater. Technological advancements, such as biofiltration relying on microbial activities, membrane bioreactors integrating biological treatment with filtration, and electrocoagulation as an electrochemical process, offer sustainable solutions. Case studies highlight the economic, environmental, and social benefits of successful wastewater reuse programs. However, the review acknowledges the risks associated with wastewater reuse, including environmental contamination and public health hazards. To strike a balance between risks and benefits, the paper advocates for proper wastewater treatment, robust regulatory frameworks, and responsible farming practices. It concludes by stressing the need for collaborative efforts, international partnerships, and targeted capacity-building initiatives to overcome barriers to the adoption of advanced wastewater treatment technologies in African countries, fostering water management, ensuring food security, and contributing to social and economic development amid global challenges.

Monitoring antimicrobial residues in table eggs in Aswan governorate markets and their impact on egg quality and public health.

Organic egg is among the most common organic foods offered for sale in Egyptian markets in recent years, and consumers buy them at a higher price because they believe organic eggs are safer and have superior nutritional value than conventional eggs. The present work aimed to monitor antimicrobial residues in brown table eggs, whether conventional or organic type, in Aswan governorate markets and assessed their physical and chemical quality and their public health hazards. Brown table egg samples (n = 400 total) were randomly selected in the present study, in which they represented two equal groups (n = 200 each) including conventional eggs and organic eggs. Eggs were collected from different retail stores in the Aswan governorate, Egypt. Egg samples were subjected to thorough physical and chemical quality evaluation as well as an assessment of antimicrobial residues. The results reported that organic eggs were cleaner and had a better odor, less blood, and meat spots, but smaller with more shell cracks than conventional eggs. Chemical analysis of some nutrient contents in the egg yolk revealed significantly higher nutritive values of organic eggs than that of conventional ones as the organic eggs contain significantly higher levels of vitamin A and vitamin D/D3 and significantly lower values of cholesterol, calcium, magnesium, and zinc than those in conventional eggs. Disc diffusion assay has been used for monitoring antimicrobial residues in egg samples. The results have shown that all examined organic eggs were free from antimicrobial residues, while 12% and 8% of conventional egg yolk and white were positive for antimicrobial residues, respectively. The study concludes the higher nutritive value of organic eggs compared with the conventional type because of their significantly higher contents of vitamins A and D and their significantly lower contents of cholesterol. Moreover, organic eggs were free from antimicrobial residues which maximizes their public health benefits..

Environmental fungal spore aerosolization: a review

Bioaerosol containing fungal spores became public health hazards. The aerosols contain the fungal spores of different species of Aspergillus, Cladosporium, Chaetomium, Penicillium, Wallemia, Stachybotrys etc. and caused various life-threatening respiratory diseases such as hypersensitivity, pneumonia, Aspergillosis, Candidiasis, Mucormycosis, Cancer, etc. They are easily transmitted from one individual to another. They also cause extreme damage to crops and create problems in food security by producing mycotoxins. The transmissions of fungal spores depend upon the environmental factor, seasonal variation, growth surface, type of fungal spore, etc. There are various biophysical, biochemical and molecular techniques that are present to detect fungal spores in aerosol. There are numerous physical and chemical agents that can kill fungi. Good public health and food security can be achieved through the detection and management of fungal spores in aerosols.

Bacterial Urinary Tract Infection as Public Health Hazard among children in Basrah, Iraq

Bacterial Urinary Tract Infection as Public Health Hazard among children in Basrah, Iraq

Study on optimizing the built environment of universities guided by disaster resilience theory

The threats and challenges of climate change and public health and safety hazards have made the optimal construction of habitat a hot topic, and the resilience of habitat has gradually become a hot topic of concern for academics and the public. The study investigated the current situation of resilience construction in some university campuses in the Central Plains region. The preliminary evaluation index system model of the resilience of university built environment was compiled. The study provides research inspiration for the resilience enhancement of the built environment of universities in a universal way.

The COVID-19 Pandemic and Landspitali's Operating Room and Intensive Care Unit

The COVID-19 pandemic, one of the most serious public health hazards of recent times, led to a high number of hospitalisations. The pressure on intensive care units has been significant. In many countries, including Iceland, there was a need to increase the capacity of these units to meet the growing demand for intensive care spaces, especially at the start of the pandemic. At Landspitali, the National University Hospital of Iceland (hereafter referred to as Landspitali), increasing unit capacity was a large-scale and extensive project where project management methodologies were utilised to assess risks and develop response plans. Using information gathered from interviews, this study explores the experience of managers in Landspitali’s surgical and intensive care unit in preparing for the pandemic and their evaluations of the project\'s success. The interviews were conducted in the autumn of 2020 after the first wave of the pandemic had passed in Iceland. The study utilised a qualitative methodology. Eight managers from Landspitali’s surgical and intensive care unit participated in semi-structured interviews. The study employs thematic analysis to analyse the findings. The data analysis reveals four themes. The first theme, ‘dealing with the unknown’, illustrates the uncertainty that was prevalent at the beginning of the pandemic. The second, ‘one step ahead’, reveals how the managers utilised resources both within and outside the hospital to prepare the intensive care unit for COVID-19 patients. The third theme, ‘fighting the virus’, highlights the challenges the managers encountered throughout the process. Lastly, the ‘in this together’ theme focuses on how the staff came together to accomplish the project. The initial uncertainty during the preparation phase posed difficulties for the managers. Working in accordance with existing response plans and utilising the findings of the situation analysis made it possible for managers to organise how space, personnel, and supplies would be utilised and thus increase the surge capacity of the units. The respondents\' main challenges were facility adaptation and ensuring adequate staffing. Cooperation and solidarity among the staff, along with well-timed preventive measures implemented by the authorities, proved crucial to the success of Landspitali’s intensive care unit in dealing with the pandemic.

Evidence-based identification and characterization of methicillin-resistant Staphylococcusaureus isolated from subclinical mastitis in dairy buffaloes of Pakistan.

Methicillin-resistant Staphylococcus aureus (MRSA), affecting livestock and human beings, has become a global public health hazard with economic consequences. The current study was designed to investigate the prevailing MRSA-associated subclinical mastitis and associated risk factors in dairy buffaloes. The study also highlighted the genetic variations and in silico-based proteomic differences among MRSA isolates. Out of 516 milk samples, 45.93% (237/516) were found positive for subclinical mastitis, while the prevalence of S. aureus was recorded 56.12%. The methicillin resistance in S. aureus isolates was evaluated by oxacillin disc diffusion test and molecular identification of the mecA gene. The results revealed a phenotypic and molecular prevalence of MRSA at 45.11% and 18.79%, respectively. The risk factor analysis revealed that among various assumed risk factors, parity, milking hygiene, milker care during milking, milk yield, housing system, and floor type were significantly associated with subclinical mastitis in buffaloes. The sequencing and phylogenetic analysis showed no significant genetic variations among study isolates and depicted a high similarity with isolates from Africa, USA, India, Italy, Turkey, and Iran. The in-silico protein analysis showed that all sequences had the same protein motifs resembling penicillin protein 2a except Buff-13, whose protein structure resembles alpha-catenin-like protein hmp-1. The current study was the first report of the genotypic characterization and in silico protein analysis of MRSA from dairy buffaloes in Pakistan. The result highlighted the importance of antimicrobial resistance (AMR) and development of control strategies against MRSA infections.