Recent History Research Articles

The recent history and near future of digital health in the field of behavioral medicine: an update on progress from 2019 to 2024.

The field of behavioral medicine has a long and successful history of leveraging digital health tools to promote health behavior change. Our 2019 summary of the history and future of digital health in behavioral medicine (Arigo in J Behav Med 8: 67-83, 2019) was one of the most highly cited articles in the Journal of Behavioral Medicine from 2010 to 2020; here, we provide an update on the opportunities and challenges we identified in 2019. We address the impact of the COVID-19 pandemic on behavioral medicine research and practice and highlight some of the digital health advances it prompted. We also describe emerging challenges and opportunities in the evolving ecosystem of digital health in the field of behavioral medicine, including the emergence of new evidence, research methods, and tools to promote health and health behaviors. Specifically, we offer updates on advanced research methods, the science of digital engagement, dissemination and implementation science, and artificial intelligence technologies, including examples of uses in healthcare and behavioral medicine. We also provide recommendations for next steps in these areas with attention to ethics, training, and accessibility considerations. The field of behavioral medicine has made meaningful advances since 2019 and continues to evolve with impressive pace and innovation.

The Test of Sports and Folk Narratives with the Notion of Haram: Citing the Example of the Branch of Wrestling

Culture consists of material and spiritual values and tools that a nation has accumulated in the historical process. In addition to the most basic contexts such as language and religion, contexts such as sporting activities, art, public medicine, and the public calendar are also important environments that reveal their own cultural elements. Among these contexts, religion is very effective in shaping the daily life of the individual and, thus, society through the rules it enjoins. Religion does not dominate only the world of belief of the individual. Through the world of belief, it also directs their relations with the social institutions they are involved in. Sport is one of the most important activities and social institutions that stand out with various functions in daily life, with wrestling being one of the branches of sports that have emerged as a result of the imitation of the struggle of human beings with nature and other creatures with which they share nature. In particular, those involved in the nomadic way of life had to hunt in order not to starve and fight in order to survive. Wrestling, which emerged as a result of these obligations, held an important place among all Turks in the world for a period of time, especially in the transition periods of life, such as birth, marriage, and death. One of the conditions set forth by women as a condition of marriage was that their suitor defeated them in wrestling. Examples of this condition are also observed in literary texts belonging to different periods when Turks were not yet acquainted with Islam and the concepts of halal and haram, which entered their lives together with Islam. According to the provisions of the Holy Qur’an, right/unprohibited thoughts and actions are associated with the words good and halal, while wrong/prohibited thoughts and actions are associated with the words sin and haram. In this study, the social and cultural phases of wrestling as a sports branch among Turks in the historical process will be evaluated on the basis of the history of religions and religious references, in addition to the literary texts belonging to historical periods when Turks were members of different religions, in the context of two events that have been experienced and reported in the news. The study was carried out using the method of document analysis, a method of qualitative research, and the data obtained by this method were evaluated using content analysis. The narratives of Alıp Manaş, Alpamış, Alpamıs, Alıpmenşen, and Bamsı Beyrek, which are evaluated in this context, belong to the periods when the Turks had not been introduced to Islam or had only recently been introduced to it. Alıp Manaş was collated from different Turkic tribes such as the Altais, Alpamış from the Uzbeks, Alpamıs the Kazakhs/Karakalpaks, Alıpmenşen the Bashkirs/Tatars, and Bamsı Beyrek the Oghuz Turks. The narratives of Kirmanshah, Köse Kenan-Dânâ Hanım, Bey Böyrek, Shah Ismail, and Yaralı Mahmut, which are evaluated in the study, belong to the periods when the Turks became Muslim en masse, and are related only among the Oghuz Turks. These narratives are included in the study because they are similar to Alıp Manaş, Alpamış, Alpamıs, Alıpmenşen, and Bamsı Beyrek and they belong to the period when Islam was largely established among the Turkish masses in Anatolia. The effect of the new religion on wrestling, which is a branch of sport, will be revealed through these narratives belonging to different tribes and religious periods. Once more, an event that occurred in recent history, and was the subject of the news, was subjected to document analysis, and content analysis was carried out through the text of the news and evaluated in the context of the study. This study aims to explain the effect of religious rules on sports branches with theological, folkloric, and sociological references based on ancient literary texts belonging to the Turks and two incidents which were experienced.

Historical archaeology in the Indian Ocean world

This edited volume by Mark Hauser and Julia Jong Haines aims to bring together local narratives within the context of the Indian Ocean in modern times, from c. AD 1500, and establish how these narratives can inform historical archaeology. As the editors highlight in the introductory chapter, historical archaeology has been greatly informed and inspired by the Atlantic world and its colonial histories. Here, they seek instead to foreground the Indian Ocean as a setting for historical archaeology in its own right. The authors use the long and deep history of interconnectedness and trade in this ocean as a basis for understanding more recent history, not just in light of colonial impact but through bottom-up approaches that focus on the local in the global. The case studies in this book and its overall theme are also part of the ongoing process to decentralise Europe in archaeological discourse. The book consists of 11 chapters, including an introductory chapter by Haines and Hauser and two commentaries. The majority of the case studies are from island East Africa or South India, which naturally limits the scope somewhat.

The Australian Identity: Through the Othering of China

This article deconstructs the Australian national identity through the “othering” of China amidst the coronavirus pandemic. During this time, Australia–China relations reached one of their lowest points in recent history. It examines the diplomatic fallout and the media frames used to portray China in the image of mistrust, fear, threat, and a place of disease and sickness. Through this process of “othering,” the Australian media reassigned and redefined its national identity and what it meant to be an Australian in the global order. The article engages with public discourse, highlighting the media's influence in narrating, shaping, and reinforcing the values of the national identity. It argues that these negative perceptions of China, place China in the seat of the “other” and serve to juxtapose and strengthen the Australian identity that is democratic, liberal, free, and just.

Genetic Characterization and Breeding Habitats of Black Fly (Diptera, Simuliidae) Vector Species in Laos

Genetic diversity and ecology are two important aspects of vector species crucial to a full understanding of disease epidemiology. In this study, we examined genetic diversity, genetic structure and the physiochemical parameters of the breeding habitats of the two significant black fly vector species, Simulium chumpornense Takaoka and Kuvangkadilok and S. nodosum Puri, from Laos. Genetic diversity of S. chumpornense in Laos was relatively high with maximum genetic divergence of 3.05% but no significant genetic differentiation between populations. Comparisons with conspecific populations from Thailand also found no genetic differentiation between the two countries. This possibly related to the recent history of this species, as a very recent (31,000 years ago) historical population expansion was detected. Physicochemical parameters of the breeding habitats suggest the ability to utilize diverse stream sizes from small flows (1 m wide) to huge rivers (290 m or more wide). Populations of S. nodosum from Laos had low genetic diversity with maximum genetic divergence of 2.56% and no genetic structuring among populations. Comparisons with those reported from other countries revealed five genetically divergent lineages (I–V) with minimum genetic divergence of 1.36%. The majority (42 of 52) of specimens from Laos belonged to lineage I and the remaining (10) comprised lineage II. Lineage I is the largest and representative of specimens from Thailand, Myanmar, Vietnam, Taiwan and Laos. Population history analysis revealed that lineage I had undergone recent demographic expansion dating back to 7000 years ago. This very recent population expansion resembles others reported from Thailand and possibly indicates a response to increasing human and domestic animals following the agricultural revolution. Breeding sites of S. nodosum are diverse in respect to elevation, velocity, water conductivity and streambed particle size. The ability to utilize a wide variety of breeding sites could promote the production of a large adult population, which can be a pest for humans and other animals.

IgG4-Related Disease Involving the Ear: A Case Report.

IgG4-related disease is a chronic inflammatory disease with widespread clinical presentation. It mimics various malignant, infectious, and inflammatory conditions, leading to confusion in diagnosis and management. Otological manifestations, though relatively rare, can lead to significant complications. A 45-year-old male with a recent history of ventilation tube placement in the right ear presented with a sensation of imbalance associated with profound hearing loss. He was managed in line of acute otitis media with labyrinthitis with steroids and antibiotics and removal of the ventilation tube. He returned in one week and presented with right-sided lower motor neuron-type facial paresis. Computed tomography images of the temporal bone showed a soft tissue density lesion in the right middle ear cavity extending to the mastoid antrum. He underwent a right cortical mastoidectomy with decompression of the facial nerve. Histopathology and immunohistochemistry of granulation tissues from the middle ear and the mastoid revealed evidence suggestive of probable IgG4 disease. IgG4-related disease is a relatively new entity, and its pathogenesis has not been properly understood. IgG4 subclass has been involved in this disease resulting in fibro-inflammatory conditions leading to tumor-like masses or fibrosis of the affected organs. Treatment includes glucocorticoids and immunosuppressant medications.

Risk factors and disease trajectories of recurrent immune thrombocytopenia in children.

This retrospective study aimed to analyse the course and outcome of recurrent immune thrombocytopenia (ITP) in children and to identify factors associated with recurrence. A total of 497 newly diagnosed ITP children with platelet <30 × 109/L between January 1988 and December 2019 were included. Recurrent ITP was defined as a new event of thrombocytopenia after at least 3 months of remission without treatment. Twenty-nine (5.8%) children experienced 48 recurrent episodes. The median time from diagnosis to recurrence was 22 months. Most recurrences occurred in children aged 1.5-10 years with a recent infection history. Compared to non-recurrent ITP, children with recurrent ITP had delayed remission with lower platelets at 1 month and 3 months postdiagnosis. Multivariate analysis identified aged 1.5-10 years (hazard ratio [HR] 3.65, 95% confidence interval [CI]: 1.35-9.82) and delayed remission at 7-12 months (HR 4.04, 95% CI: 1.37-11.95) as predictors for recurrence. Most recurrent ITP patients had minor or mild symptoms, higher platelet counts, did not require treatment, and achieved remission within 12 months. The similar remission trajectories among the first and recurrent ITP, but different from the courses in the non-recurrent ITP, suggest that recurrent ITP might have a unique biological basis.

The covert and overt role of art in landscape partnership

Although in recent history the arts have received substantial attention as a conduit for memorable artworks to draw attention to issues that may be coincidental to the artists original intention, this does not acknowledge the arts as equal partner in a shared enterprise but more to facilitate the accessibility of difficult concepts. This essay explores the capability for the visual arts to increase understanding of issues as disparate as the loss of rural landscape to urban development and the incremental effects of sea level rise upon coastal communities. With increased specialisation of disciplinary practice there is an incapacity to address the multi-dimensional character of practical challenges, particularly in the matter of the societal impacts of environmental change. This demands greater flexibility in approach to policy and an understanding that the increasing frequency of unforeseen events beg the question of our cultural preparedness to evolve a new paradigm for knowledge sharing.

Соціальна політика як чинник забезпечення життєстійкості держави

In the conditions when Ukrainian statehood is facing the most serious challenge in its recent history, issues regarding state policy priorities in the social and economic sphere are becoming relevant. The goal of the article is to study the place and role of social policy in the process of ensuring the sustainability of the state. General scientific methods of analysis and synthesis, generalization, classification, system analysis, as well as a graphic method for visualization of the obtained results were used to form the main theses of the study. The work analyzes the modern scientific and theoretical platform and basic definitions of the concept of «sustainability», investigates the specifics and permanent context of the use of terms related to it — viability, stability and resilience, offers a systemic view of the state’s viability and identifies its components. Social policy is considered as an element of the management system of social processes, which directly affects the sustainability of Ukrainian society. At the current stage of development of the global economy, human is the main source of economic growth, and the quality of human potential is the key to the state’s competitiveness. Taking this into account, the importance of social and humanitarian policy is growing many times over. In economic policy, making a profit does not become a self-sufficient activity, instead the policy should be aimed at the person, unlocking the potential of the individual and forming the quality human potential of the state. Therefore, when assessing social policy, one should remember the value of a person, in particular the economic one, and the need for appropriate investments — in safety, health care system, and improving working conditions for the development of this resource. The work highlights the main elements of the state’s sustainability, shows the connection between its higher-level elements, such as the sustainability of the economy and the sustainability of society. It is in society — in the family, community, at the place of study — that the personality is formed and acquires a certain physical condition, education, professional skills and qualifications, and social connections. In this way, human and social capital is formed as a resource for the development of the economy and, accordingly, its stability and sustainability. At the same time, the economy generates material and financial resources that are necessary for both physical existence and development of an individual, as well as for the existence of society as a whole, in particular, social and engineering infrastructure facilities. The conducted analysis clearly demonstrates the importance of social policy as a social institution of sustainability in the state.

Assessment of Urban Resilience to Floods: A Spatial Planning Framework for Cities

Urbanization-led economic growth drives infrastructure investments and population accumulation in cities, hence exploiting natural resources at an extreme rate. In this context, coastal cities have become vulnerable to climate change-induced extreme weather events and human-made disasters in recent history, where effective measures to improve the resilience of cities are pivotal for developing sustainable living environments. This study proposes a framework for assessing urban resilience to natural disasters (floods) using bottom-up spatial interactions among natural, physical, and social systems within cities and regions. It is noted that seminal studies focus on either the mitigation or adaptation strategies within urban environments to assess disaster resilience, where limited multidisciplinary and operational models hinder evaluations at the city scale. Therefore, urban system interactions and quantifiable parameters proposed in this framework are essential for policymakers and disaster management agencies in the timely allocation of resources to optimize the recovery process. Moreover, spatial planning agencies can adopt resilience mapping to identify the potential risk zones and orient sustainable land use management. Urban resilience can be embodied in spatial strategies with the operational framework proposed here, and future urban growth scenarios can be tested in multiple disaster conditions.

Exogenous Methicillin-Resistant Staphylococcus aureus Endophthalmitis is Caused by Multidrug-Resistant Lineages that are Associated with Poor Outcomes

ABSTRACT Purpose To investigate the genomic epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis and correlate it with the presenting clinical features and outcomes. Methods Nine patients presenting with MRSA endophthalmitis from 2014 to 2022 were included. Phenotypic and genomic tests were used for strain characterization. Demographics, clinical presentation, treatment and outcomes were reviewed. Results The MRSA population was dominated by multidrug-resistant (MDR) strains within the clonal complex 5 (CC5) carrying an SCCmec type II genetic element (USA100-like strains). These strains carried genes that confer resistance to five antibiotic classes, in addition to mutations in topoisomerase genes (gyrA and parC) that resulted in resistance to all fluoroquinolones tested. Patients were mostly male (56%), with a median age of 82.7 years, and most had no recent history of extensive healthcare exposure. All cases were exogenous following ocular surgery (67%) or intravitreal injection (33%). The main exam findings were visual acuity ≤ hand motion, hypopyon (89%), and vitreous opacity (89%). Five patients (56%) showed improvement in visual acuity at 1 month following presentation, three (33%) at 3 months, and two (22%) at 6 months. Complications included evisceration (n = 1) and phthisis (n = 1). Patients who had pars plana vitrectomy within 48 hours of presentation had better clinical outcomes compared to those who did not. Conclusion Exogenous MRSA endophthalmitis is caused by MDR strains that resemble the hospital-acquired lineage USA100. These strains cause severe endophthalmitis in patients with no recent hospital/healthcare exposure.

Albuminuria and Rapid Kidney Function Decline as Selection Criteria for Kidney Clinical Trials in Type 1 Diabetes Mellitus.

The optimal criteria to select individuals with type 1 diabetes mellitus (T1D) and albuminuric or normoalbuminuric diabetic kidney disease (DKD), who are at risk of rapid kidney function decline, for clinical trials are unclear. This study analyzed data from the Preventing Early Renal Loss in Diabetes (PERL) clinical trial, which investigated whether allopurinol slowed kidney function decline in persons with T1D and early-to-moderate DKD. Rates of iohexol GFR (iGFR) and estimated GFR (eGFR) decline during the three-year study were compared by linear mixed effect regression between participants enrolled based on a history of moderately or severely increased albuminuria (N=394) and those enrolled based on a recent history of rapid kidney function decline (≥3 ml/min/1.73 m2/year) in the absence of a history of albuminuria (N=124). The association between baseline albuminuria and iGFR/eGFR decline during the trial was also evaluated. Rates of eGFR decline during the trial were higher in participants with a history of albuminuria than in those with a history of rapid kidney function decline (-3.56 [95% confidence intervals {CI} -3.17, -3.95] versus -2.35 [95% CI: -1.86, -2.84] ml/min/1.73 m2/year, p=0.001). Results were similar for iGFR decline, although the difference was not significant (p=0.07). Within the history of albuminuria group, the rate of eGFR decline was -5.30 (95% CI -4.52, -6.08) ml/min/1.73m2/year in participants with severely increased albuminuria as compared to -2.97 (95% CI 2.44, -3.50) and -2.32 (95% CI -1.61, -3.03) ml/min/1.73m2/year in those with moderately increased or normal/mildly increased albuminuria at baseline (p<0.001). Severely increased albuminuria at screening is a powerful criterion for selecting persons with T1D at high risk of kidney function decline. A history of rapid eGFR decline without a history of albuminuria is less effective for this purpose but it can still identify individuals with T1D who will lose kidney function more rapidly than expected from physiological aging. ClinicalTrials.gov, NCT02017171.

Systemic Innate Immune System Restoration as a Therapeutic Approach for Neurodegenerative Disease: Effects of NP001 on Amyotrophic Lateral Sclerosis (ALS) Progression.

Amyotrophic lateral sclerosis (ALS) is a diagnosis that incorporates a heterogeneous set of neurodegenerative processes into a single progressive and uniformly fatal disease making the development of a uniformly applicable therapeutic difficult. Recent multinational ALS natural history incidence studies have identified systemic chronic activation of the innate immune system as a major risk factor for developing ALS. Persistent immune activation in patients with ALS leads to loss of muscle and lowering of serum creatinine. The goal of the current study was to test whether the slowing of nerve and muscle destruction in NP001-treated ALS patients compared with controls in phase 2 studies would lead to extension of survival. Phase 2 clinical studies with NP001, an intravenously administered form of the innate immune system regulator NaClO2, are now reporting long-term survival benefits for drug recipients vs. placebo controls after only six months of intermittent treatment. As a prodrug, NP001 is converted by macrophages to taurine chloramine, a long-lived regulator of inflammation. We performed a pooled analysis of all patients who had completed the studies in two six-month NP001 phase 2 trials. Changes in respiratory vital capacity and the muscle mass product, creatinine, defined treated patients who, compared to placebo, had up to a year of extended survival. The observed longer survival in ALS patients with the greatest inflammation-associated muscle loss provides further evidence that ALS is a disease of ongoing innate immune dysfunction and that NP001 is a disease-modifying drug with sustained clinical activity.

Cellular and humoral immunity and IgG subclass distribution after omicron XBB.1.5 monovalent vaccination in Japan

BackgroundUp to seven doses of coronavirus disease 2019 (COVID-19) mRNA vaccines (BNT162b2) were administered to Japanese healthcare workers, until February 2024. The monovalent Omicron XBB.1.5 vaccine (hereafter called XBB.1.5 vaccine) was used for dose 7. ObjectiveAlthough the XBB.1.5 vaccine has been reported to induce a robust increase in neutralizing antibodies against the currently circulating Omicron variant BA.2.86, little is known about its serological effects in Japan, where the BNT162b2 mRNA vaccine is the most frequently administered in the world. Study designTwenty-five recipients of the XBB.1.5 vaccine, categorized as seronegative (n = 18) or seropositive (n = 7) based on their recent history of COVID-19, were analyzed. Neutralizing antibody titers against Omicron subvariants, receptor binding domain (RBD) IgG levels, IgG subclass distribution, and T-cell responses were assessed. ResultsWe found a significant increase in neutralizing antibody titers against XBB.1.5 and BA.2.86 variants following XBB.1.5 vaccination, particularly in seropositive individuals. No significant change in total RBD IgG levels was observed, indicating efficient induction of antibodies targeting regions outside the RBD by XBB.1.5 vaccination. IgG subclass analysis demonstrated no significant subclass switching after vaccination. T-cell responses against the virus were comparable between seropositive and seronegative groups. ConclusionsThe study suggests that XBB.1.5 vaccination enhances humoral immunity against Omicron variants without significant IgG subclass switching. However, some individuals with low pre-vaccination IgG titers did not exhibit increased antibody levels post-vaccination, raising concerns about potential immune tolerance.

Abnormal spirometric patterns and respiratory symptoms in HIV patients with no recent pulmonary infection in a periurban hospital in Ghana.

Human immunodeficiency virus (HIV) infection is associated with chronic airway obstruction, even in patients who have achieved viral suppression from combination antiretroviral treatment (cART). Spirometry is a supplementary test that aids in diagnosing pulmonary dysfunction in people living with HIV. To compare the prevalence of spirometric abnormalities among cART-treated HIV patients and cART-naïve HIV patients with non-HIV controls with no recent history of pulmonary infection in a peri-urban hospital in Ghana. In a case-control design, spirometry was performed in 158 cART-treated HIV patients, 150 cART-naïve HIV patients and 156 non-HIV controls. Clinical, sociodemographic data and respiratory symptoms were collected using a structured questionnaire. Spirometric abnormalities were categorised as obstructive (OSP) or restrictive (RSP) spirometric patterns based on the Cameroonian reference equation. The prevalence of OSP was higher in the cART-treated and cART-naïve HIV patients compared to non-HIV controls (13.9% vs 10.7% vs 5.1% respectively, p = 0.026), whereas that of RSP was similar among the study groups. Respiratory symptoms were common among cART-treated and cART-naïve HIV patients compared to non-HIV controls (48.1% vs 40% vs 19.2% respectively, p < 0.001). The major factors associated with OSP were female gender [OR (95% CI) = 2.46 (1.09-5.13), p = 0.031], former cigarette smoking [1.92 (1.04-3.89), p < 0.001], exposure to medium-to-high levels of biomass [3.07 (1.16-8.73), p = 0.019], presence of a respiratory symptom [1.89 (1.11-5.08), p = 0.029] and unemployment [3.26 (1.19-8.95), p = 0.042]. The major determinants of RSP were age, female gender [1.74 (1.05-4.29), p = 0.041], former cigarette smoking [2.31 (1.27-6.77), p < 0.001] and medium-to-high biomass exposure [1.58 (1.06-5.37), p = 0.043]. In HIV patients without any recent pulmonary infection in a peri-urban area of Ghana, there was a higher prevalence of OSP among cART-treated and cART naïve HIV patients compared to the non-HIV control. However, the prevalence of RSP was similar among HIV patients and non-HIV controls.

Permissioned blockchain network for proactive access control to electronic health records

BackgroundAs digital healthcare services handle increasingly more sensitive health data, robust access control methods are required. Especially in emergency conditions, where the patient’s health situation is in peril, different healthcare providers associated with critical cases may need to be granted permission to acquire access to Electronic Health Records (EHRs) of patients. The research objective of this work is to develop a proactive access control method that can grant emergency clinicians access to sensitive health data, guaranteeing the integrity and security of the data, and generating trust without the need for a trusted third party.MethodsA contextual and blockchain-based mechanism is proposed that allows access to sensitive EHRs by applying prognostic procedures where information based on context, is utilized to identify critical situations and grant access to medical data. Specifically, to enable proactivity, Long Short Term Memory (LSTM) Neural Networks (NNs) are applied that utilize patient’s recent health history to prognose the next two-hour health metrics values. Fuzzy logic is used to evaluate the severity of the patient’s health state. These techniques are incorporated in a private and permissioned Hyperledger-Fabric blockchain network, capable of securing patient’s sensitive information in the blockchain network.ResultsThe developed access control method provides secure access for emergency clinicians to sensitive information and simultaneously safeguards the patient’s well-being. Integrating this predictive mechanism within the blockchain network proved to be a robust tool to enhance the performance of the access control mechanism. Furthermore, the blockchain network of this work can record the history of who and when had access to a specific patient’s sensitive EHRs, guaranteeing the integrity and security of the data, as well as recording the latency of this mechanism, where three different access control cases are evaluated. This access control mechanism is to be enforced in a real-life scenario in hospitals.ConclusionsThe proposed mechanism informs proactively the emergency team of professional clinicians about patients’ critical situations by combining fuzzy and predictive machine learning techniques incorporated in the private and permissioned blockchain network, and it exploits the distributed data of the blockchain architecture, guaranteeing the integrity and security of the data, and thus, enhancing the users’ trust to the access control mechanism.

A recent history of disease outbreaks in Kenya, 2007–2022: Findings from routine surveillance data

BackgroundAfrica reports the highest number of outbreaks globally, accounting for 39% of all outbreaks in 2022. The Integrated Disease Surveillance and Response strategy in Kenya ensures the reporting of outbreaks up to the national level. We present a summary of the burden of reported disease outbreaks in Kenya, 2007–2022.MethodsWe reviewed historical surveillance data, 2007–2022, summarized the annual caseload and deaths of reported outbreaks, and classified the outbreaks into 3 categories, that is high, moderate, and low burden. A nested Poisson regression model was fit to determine whether there was a significant increase in the number of diseases and counties reporting outbreaks over time.ResultsTwenty-three diseases were reported. COVID-19, cholera, epidemic malaria, kala-azar, and measles were associated with a high disease burden. The highest number of diseases reported in a single year was 10. We observed an increase in the number of outbreaks over time (IRR = 1.26, 95% CI [1.22–1.29], p < 0.001), and an increase in the number of counties reporting outbreaks over time (r = 0.97, p < 0.001).ConclusionThere was an increase in the frequency and geographic occurrence of outbreaks. The differences in outbreak occurrence between counties necessitate targeted and enhanced preventive, preparedness, and response interventions at the sub-national level to reduce the burden of outbreaks.

Long-term safety profile of sutimlimab in adult Japanese patients with cold agglutinin disease.

Sutimlimab, a complement inhibitor, has recently been approved in Japan for treating cold agglutinin disease (CAD). We report the safety and efficacy of sutimlimab in Japanese patients with CAD who completed a global phase 3 clinical trial (CARDINAL/CADENZA: 26-week treatment with 1-2years of open-label extension [OLE] periods) and subsequently participated in the Japanese OLE study. Patients with a recent history of blood transfusion (CARDINAL, n = 3) and those without (CADENZA, n = 4) were analyzed (71.4% female; median [range] baseline age: 70 [46-83] years). For CARDINAL/CADENZA, the treatment duration (median [range]) was 140.9 (104.9-157.3) weeks, and the cessation period was 70 (61-133) weeks. For the Japanese OLE study, the treatment duration was 47.1 (15.1-49.1) weeks. Three (42.9%) patients experienced treatment-related and treatment-emergent adverse events (TEAEs): injection site erythema, cystitis bacterial, viral infection, and blood pressure increased during CARDINAL/CADENZA. One (14.3%) patient experienced one treatment-related TEAE (urinary tract infection) during the Japanese OLE study. One patient died of renal failure, considered unrelated to sutimlimab, that was exacerbated by hepatorenal syndrome due to liver cirrhosis and bacterial peritonitis, in addition to CKD. Hemoglobin and bilirubin levels improved during treatment but deteriorated after withdrawal and recovered on retreatment. Sutimlimab was well tolerated over a median of 3.8years, with no new safety concerns identified during retreatment.

Rivers and spatial distance are drivers of genetic diversity in the south American dwarf caiman (Paleosuchus palpebrosus)

AbstractThe distribution of species and the way that lineages are structured are the result of intrinsic historical processes of the species and their relationships with landscape features. Paleosuchus palpebrosus is one of the smallest crocodilians in the world and has a wide geographic distribution in South America, occurring in different habitats. Here, we analyzed mitochondrial cytochrome b sequences of 227 individuals, investigated how elements of landscape heterogeneity impact genetic differentiation, and evaluated the evolutionary and phylogeographic history of the species. Thus, we hypothesized that landscape structures, such as aridity and slope, should act as resistance surfaces to population connectivity, while rivers could mediate the dispersion of the species as a conductor of the gene flow. The analyses recovered three main lineages of P. palpebrosus. While most of the observed genetic variation was explained by geographic resistance distance, river connectivity had a smaller contribution for the observed variation. We also found a recent history with limited genetic divergence throughout the wide distribution of the species. Our findings highlight the main drivers for the evolutionary history of the species and how landscape features can shape the diversification, especially if we consider rivers as a facilitator of gene flow.

The carbon crater: Comparing anthropogenic greenhouse gas emissions to historical planetary events

Equilibrium climate sensitivity modeling relies heavily on paleoclimate records that were affected by meteorite impacts and volcanic explosions. This paper conducts a thought experiment by re-assembling known data and theories to shed new light on anthropogenic carbon waste. Anthropogenic activity, meteorite impacts and volcanic explosions all extract material from the Earth’s crust and deposit it in the atmosphere. This thought experiment tests if the mass of anthropogenic greenhouse gas emissions from 1851 to 2021 is comparable to the mass of atmospheric emissions from historical planetary events. Approximately 3.60 trillion tons of anthropogenic carbon dioxide equivalents are converted into volume and then transformed into the shape of a meteorite impact structure named the “Carbon Crater.” The 35 km crater (bounded by 34%–68% confidence intervals of 25–45 km) would rank 23rd on the list of known impact structures. The 2.6 km projectile required to create the Crater would be a 10 on the 1–10 Torino hazard scale described as “. . .capable of causing global climatic catastrophe. . .” The estimated re-occurrence interval for a projectile of this size is 5.3 million years. An interval of this time in Earth’s recent history predates homo sapiens. The Crater’s volume is exponentially larger than the 1883 eruption of Krakatoa and ranks as an 8 (“mega-colossal”) on the 0–8 Volcanic Explosivity Index. The thought experiment indicates that the Carbon Crater’s scale is comparable with large historical biospheric events. These results likely confer few direct implications for the study of the paleoclimate in climate modeling but might change conceptual understandings of atmospheric human waste. Additional empirical research is required to understand the potential impact of the Carbon Crater on conceptual change.