Specific Preventive Measures Research Articles

Prevalence, Pattern, Mortality, and Morbidity of Traumatic Small Bowel Perforation at King Abdulaziz Medical City: A Retrospective Cohort Study.

Introduction Bowel perforation, whether from trauma or other causes, presents with diverse clinical scenarios. Small bowel perforation (SBP), a potentially fatal condition often linked to blunt trauma like motor vehicle accidents, necessitates prompt detection and intervention, crucial for improved outcomes. This study investigated the prevalence, predictors, presentation, diagnostic findings, morbidity, and mortality of traumatic SBP for comprehensive insights. Methodology This wasa retrospective cohort studyconducted at King Abdulaziz Medical City, Riyadh. A review of 838 cases, which represent all abdominal trauma patientsfrom January 2017 to March 2023, was done. Forty patients who developed SBP and have complete data were included in this study. One case was excluded due to incomplete medical records. Data were collected with the non-probability convenience sampling technique via the BestCare system using a data collection sheet. Data were analyzed with IBM SPSS 29 (IBM Corp., Armonk, NY). Results Out of all abdominal trauma cases (n=838), 40 patients developed SBP (n=40, 4.77%). Males constituted 87.5%, and the most common mechanism was motor vehicle accidents (57.5%). Complications included cardiac arrest, disseminated intravascular coagulation (DIC), and leak (7.5% each). In motor vehicle accidents, SBP primarily affected patients who were in the driver'sposition(78.3%). Clinical signs at presentation revealed abdominal tenderness (52.5%), abdominal distension (22.5%), and abnormal systolic blood pressure (mean 115.3 mmHg). Linear regression showed gender and age positively associated with morbidity (p=0.474, p=0.543)while BMI exhibited a negative relationship (p=0.314). Logistic regression revealed non-significant predictors of mortality, except for mean initial hematocrit (HCT) (p=0.721, aOR=0.098). Conclusion Our study provides crucial findings on the incidence, patterns, mortality, and morbidity of traumatic bowel perforation, contributing to the existing body of research. The identified prevalence of 4.77% and mortality at 17.5% from the studied populationunderline the serious impact of this condition, and the37.5% complication rateobserved demonstrates the potential risks involved. The average hospital stay is found to be 14 days, adding further to the disease burden. These findings underscore the importance of specific preventative measures, particularly related to motor vehicle accidents (MVAs), and highlight potential markers for predicting outcomes, such as age, gender, and mean initial HCT. This substantiates the need for further research involving larger cohorts and prospective designs to gain comprehensive insights and establish more robust preventative and treatment strategies.

A systematic overview of bovine brucellosis and its implications for public health

Comprehensive study reveals the complex nature of bovine brucellosis, with special emphasis on its potential for transmission to humans. By adopting a systemic methodology thorough literature search was done, including publications published during 1897 to 2022, form academic databases, research repositories, and scholarly credible literature sources. The criteria for being included in this study ensured an in-depth investigation of the previous and current facets of the disease. The methodological extraction and processing of data enabled for the categorising of pertinent findings into particular groups, which enhanced the comprehension of characteristics, transmission trends, clinical aspects, diagnostic tools, treatment options, prevention strategies, vaccination, and public health concerns. This study highlights the importance of this zoonotic threat indicating the compelling need of effective solutions of this problem by keeping in view the zoonotic variables and epidemiological views. Understanding disease origins and transmission patterns help design effective control strategies that are tailored to each mode of transmission. A detailed evaluation of symptoms shows that humans and animals need appropriate diagnosis. Comprehensive treatment and preventative measures are supported by the review. The study of vaccination as a preventive measure underlines its importance in eliminating bovine brucellosis. Public health issues require knowledge, surveillance, and economic concerns. In conclusion, this comprehensive study not only explores uncharted research grounds but also serves as a beacon for researchers and policy makers. Through an in-depth analysis of the interaction between bovine brucellosis and public health, findings in this study provide crucial information that is useful to a wide range of stakeholders. This systemic review provides a clear and comprehensive perspective of the public health implication of bovine brucellosis by emphasising the need of specific interventions and preventive measures.

Mortality trends and years of potential life lost due to suicide in adolescents.

To assess the trend in mortality rates and years of potential life lost (YPLL) due to suicide among adolescents in Northeast Brazil. This is an ecological time series study, with secondary data from 2011 to 2020 from the Mortality Information System for adolescents aged 10 to 19 years in the Northeast region of Brazil. Groups of causes from the 10th Revision of the International Classification of Diseases were included: X60-X84 (intentionally self-inflicted injuries), Y10-Y19 (poisoning of undetermined intent), and Y87 (sequelae of intentional self-harm). Mortality coefficients and frequency distribution by sociodemographic variables, place of occurrence, and method of suicide were estimates. YPLL were estimated by gender and age. Joinpoint regression analysis was used, and the annual percentage change (APC) was determined with 95% confidence intervals. A total of 2,410 deaths were recorded, with a predominance of adolescents aged between 15 and 19, males, of mixed-race, low schooling, and home was the main place of occurrence. The trend in the death rate was increasing in the Northeast (APC: 3.6%; p = 0.001), in girls aged 10 to 14 (APC: 8.7%; p = 0.003), in boys aged 15 to 19 (APC: 4.6%; p = 0.002) and in Bahia (APC: 8.1%; p = 0.012). Hanging/strangulation was the main method adopted by both sexes. The YPLL due to suicide were 11,110 in 2011 and 14,960 in 2020. The precociousness of suicide committed by girls and the increase in mortality among older adolescents are noteworthy, and specific preventive measures need to be adopted for these groups in order to reduce this preventable cause of death.

Infectious bovine rhinotracheitis: Epidemiology, control, and impacts on livestock production and genetic resources

The present review aims to determine the epidemiology of infectious bovine rhinotracheitis (IBR), control measures, and its impact on livestock production and genetic resources. The literature search was conducted to select and compile peer-reviewed journals, book chapters, and international organization proceedings on the epidemiology, control, and impacts of IBR. IBR is a highly contagious disease of cattle that causes substantial economic losses throughout the world, particularly in the dairy and beef industries. Bovine alphaherpesvirus-1 causes this infectious viral disease, affecting the respiratory, and reproductive systems. IBR causes severe inflammation and dysfunction of the respiratory system. Infection of the reproductive system is responsible for abortion, retained placenta, metritis, and balanoposthitis. The transmission is by inhalation, contact with nasal and genital secretions, and fomites. Epidemiologically, the disease is known for its distinct latency characteristics. The infectious agent establishes a lifelong latent infection in the peripheral nervous system. The introduction of latently infected cattle, high stocking densities, confined pens, concurrent diseases, and low ambient temperatures increase the transmission and severity of the disease. The disease has no specific drug treatments, so control and prevention measures have inevitable roles. IBR is a significant constraint on livestock production globally, particularly in developing countries. It causes poor reproductive performance and productivity, the loss of replacement herds, and the culling of mature, productive animals. The implementation of strict biosecurity measures, immunization, quarantine, herd screening, and proper herd management are the most important control and prevention strategies.

A community based seroprevalence of SARS-CoV-2 antibodies in Somali Region, Eastern Ethiopia.

Coronavirus disease 19 (COVID-19)is life-threatening infectious disease caused by SARS-CoV-2virus that caused a global pandemic. SARS-CoV-2has been widely transmitted throughout Ethiopia, with over 501,060 cases confirmed and 7574 deaths until November 2023. This study assessed for the first time the seroprevalence SARS-CoV-2in the general population of the Somali Region during the COVID-19 pandemic. A cross-sectional study design was conducted from May to June 2021 in 14 districts of Somali Region. Blood samples were collected in 820 participants in addition to administering a questionnaire that included sociodemographic characteristics and history of clinical symptoms of COVID-19.Blood samples were tested for the presence or absence of anti-SARS-CoV-2using a commercial Enzyme-Linked Immunosorbent Assay (ELISA)kit (Euroimmun). Overall, 477 (58.2%) were male and 343 (41.8%) were female. The majority of the participants (N = 581; 70.9%) were between 18 and 34 years old and not vaccinated against COVID-19 (N = 793; 96.7%). The overall seroprevalence of SARS-CoV-2 antibodies was 41.7% (95% CI: 33.3%-47.6%). The highest prevalence was found in Goljano district (70%) and the lowest in Gunagado district (22.5%). Only age was found to be associated with COVID-19 seropositivity. Prevalence of SARS-CoV-2 antibodies was the highest ever reported in Ethiopia, indicating that a large proportion of the population had been infected 14 months after the start of the outbreak in the country. Such studies are important to swiftly reassess and improve specific COVID-19 preventive and control measures to reduce transmissions within the community in a given setting.

Maternal Preconception Serum Alanine Aminotransferase Levels and Risk of Preterm Birth among Reproductive-Aged Women - China, 2013-2017.

The significance of maternal liver health concerning preterm birth (PTB) is well recognized; however, there is a gap in understanding the precise influence of preconception serum alanine aminotransferase (ALT) levels on the risk of PTB. In this retrospective cohort study, a J-shaped relationship between preconception serum ALT levels and risk of PTB was observed, indicating that both significantly elevated and decreased ALT levels may contribute to the risk. Maintaining optimal preconception serum ALT levels may reduce the risk of PTB, thereby informing specific preventive measures for women of reproductive age.

A positive correlation between mutated gene of sickle cell anemia and glucose-6-phosphate dehydrogenase among gond tribes of Chhattisgarh, India

BackgroundGlucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymopathy affecting millions of individuals worldwide. It is believed that the prevalence of G6PD deficiency in different ethnic populations increases its association with other pathological conditions especially sickle cell anemia (SCA), as they both are well-known adaptations against malaria. Thus, the present study aims to determine the frequency of G6PD deficiency among SCA patients and the association between them in the tribal community (Gond) of Chhattisgarh, India. MethodA total of 810 samples from three different age groups i.e., 10–20, 21–30, and 31–40 years were collected from the tribal community (Gond) of Kabirdham district of Chhattisgarh. The frequency of SCA was determined by a slide test followed by cellulose acetate paper electrophoresis and G6PD deficiency by methemoglobin reduction test. Glutathione-S-Transferase (GST) gene polymorphism in sickle celled individuals and variant analysis in G6PD deficient individuals were analyzed by RT-PCR. ResultsThe frequency of SCA and G6PD deficiency was reported at 9.75% and 17.16% respectively and a high degree of positive correlation between SCA and G6PD deficiency was also found (HbSS-G6PD deficient: r = 0.84, p = .356; HbAS-G6PD deficient: r = 0.89, p = .345). Results of the GST gene revealed that GSTM1 and GSTT1 genes are present in almost all sickled individuals while GSTP1 and GSTP1a exist in the mutated form in a maximum percentage of individuals. G6PD variant analysis also showed that 70% and 60% of individuals have mutated Mahidol and Union variants respectively, while none of the individuals have mutated Chinese variants. ConclusionA high degree of correlation between SCA and G6PD was reported among Gond tribes of Chhattisgarh, India with a high degree of mutated GSTP1, GSTP1a, Mahidol, and Union variants. The study makes it possible to take specific preventive measures concerning the medication of anti-oxidizing drugs.

The molecular characterisation of bacteria associated with neonatal necrotising enterocolitis and sepsis which were isolated from hospitals in Bogotá, Colombia

Background: The identification and molecular characterisation of bacteria associated with neonatal necrotising enterocolitis (NNE) and sepsis is very important in clarifying the role such bacteria play in the development of this disease. Methods: The present multicentre study was aimed at characterising bacteria isolated from haemocultures obtained from 20 neonates suffering NNE by using traditional and molecular methodologies (16 S rRNA subunit sequencing and multilocus sequence typing - MLST). Results: NNE incidence in hospitals in Bogotá was also estimated, finding rates similar to and higher than those reported in the literature (1 to 3 cases of NNE per 1,000 live-births). Staphylococcus epidermidis ST2, ST81, and ST126 sequence types were identified by using these two molecular techniques; the Escherichia coli ST394 sequence type was also identified. Species could not be identified for the Pantoea agglomerans isolate due to the high degree of intra-species identity. Interestingly, the bacterial isolates from the two neonates who died were classified in the same sequence type (i.e. S. epidermidis ST81), even though they came from different hospitals. Conclusion: Such molecular techniques allow characterising bacterial pathogen populations occurring in one or more hospitals in a particular city or determined geographical area and support taking more specific preventative measures directed against such particular clones.

Diagnosis of pulmonary edema of small pets

The respiratory system provides the body with oxygen, which is necessary for the vital activity of organs, tissues and cells of the animal. Respiratory diseases are widespread and therefore improving the methods of diagnosis and prevention of lung pathologies is important for veterinary medicine. Pulmonary edema is a life-threatening condition of the animal and requires immediate assistance. There are various types and causes of edema, however, knowing the symptoms, it is possible to carry out the necessary diagnostics, therefore, the study of the mechanism of development and types of pulmonary edema using radiological diagnostic methods is relevant. The research work was carried out on the basis of the veterinary clinic of LLC "Ringa", the object of the study were dogs and cats with clinical manifestations of respiratory failure, the main diagnostic method was digital radiography. Based on the conducted studies, cardiogenic and non–cardiogenic pulmonary edema was identified, the mechanism of development of which has differences: cardiogenic pulmonary edema manifests itself against the background of heart defects, cardiosclerosis, arterial hypertension; non-cardiogenic – due to impaired capillary permeability and the release of the liquid part of the blood into the interstitial tissue, and then into the alveoli. X-ray diagnostics allows you to differentiate the pathology of the lungs at the initial stages of its development, since a long process of diagnostic measures can have negative consequences on the animal, and the finished radiograph has high-quality detail of the picture in high resolution with specific changes in the lungs with edema, which ensures the exclusion of other pathologies that can also lead to respiratory failure (neoplasms, pulmonary fibrosis , etc.), and that contributes to the provision of rapid appropriate actions in emergency situations to eliminate this condition and the appointment of specific therapeutic and preventive measures, allowing you to reduce the time in diagnosis, to help the patient, increasing the chances of a favorable outcome.

Mfat-1 ameliorates cachexia after hypoxic-ischemic brain damage in mice by protecting the hypothalamus-pituitary-adrenal axis

AimsCachexia, a metabolic syndrome, affects 21 % of patients suffering from ischemic encephalopathy. However, the specific mechanism and prevention measures are still unclear. Omega-3 polyunsaturated fatty acids (n−3 PUFAs) have been proven to reduce inflammatory cytokine levels during ischemic events, but whether they have a protective effect against cachexia after hypoxic-ischemic brain damage (HIBD) remains unclear. Main methodsC57BL/6J wild-type and mfat-1 transgenic male mice were treated with and without HIBD. One day after HIBD, the epididymal white fat, gastrocnemius muscle and hypothalamus were weighed and analyzed the phenotypic changes. RNA sequencing was applied to gastrocnemius muscle to identify differential genes and pathways in HIBD groups. The effect of HPA axis on cachexia post-HIBD was examined via adrenalectomy, dexamethasone (0.1 mg/kg), and corticosterone injection (100 mg/kg). Key findingsThe results showed that the incidence of cachexia in mfat-1 mice, which produce high proportion of n−3 PUFAs, was significantly lower than that in wild-type mice post-HIBD. Cachexia-related factors, such as inflammation, muscle atrophy and lipid metabolism were significantly improved in mfat-1 HIBD. RNA sequencing revealed that catabolic and proteasome pathways were significantly downregulated. In hypothalamus, inflammatory cytokines, lipid peroxidation levels were reduced. Corticosterone, glucocorticoid receptor, and dexamethasone suppression test all showed that mfat-1 improved the dysfunction of the HPA axis post-HIBD. The present study elucidated for the first time that mfat-1 reduced HIBD-induced hyperactivation of the HPA axis in mice by reducing inflammation and oxidative stress and contributed to the reduction of metabolic imbalance in peripheral tissues. SignificanceOur study provides mechanistic information for the development of intervention strategies to prevent cachexia.

India's Fitness Industry Amid COVID-19

Since ancient times, fitness has been a part of the Indian culture. However, with increased western influence and changing lifestyle, the quest for fitness has also become modern and new trends are gaining importance. The entry of Giant techs like Google, Apple, etc has given a great impetus to fitness industry. According to Redseer Consulting, the market value of fitness industry in India was US $12 billion in 2018. According to Fitternity, there are around 24,000 gyms and studios in the country. To sustain themselves amid COVID-19, they are providing online training sessions over WhatsApp, Instagram and other channels of social media. The employees working in fitness industry have been laid off because of bankruptcy within gyms. During corona virus to enhance their immunity, many people took cycling to keep themselves fit. Under Unlock-3.0, Government decided to re-open gyms by following some generic and specific preventive measures. In the post COVID-19 world, the fitness industry worldover is set to witness a major change with prime focus on social distancing and hygiene measures. The gyms will have to accept new normal. When gyms do finally re-open, capacity is likely to be reduced by half to maintain the 6 feet distancing, while personal trainers will have to give advice from a distance, digital apps will be developed, social media will be utilized, etc. At-home workouts and online fitness training sessions will become more prominent. Hence, the gym industry will be moving more towards Digitalization of fitness products and services in near future.

Exploring hepatitis E virus seroprevalence and associated risk factors among the human population in Tandil, Buenos Aires, Argentina.

Hepatitis E virus (HEV) infection is a common cause of acute clinical hepatitis worldwide and is emerging as a disease in Argentina. It is primarily transmitted through contaminated water and food, following the fecal-oral route. Furthermore, is a zoonotic disease with swine as the primary reservoir. Prevalence of HEV infection in humans in several regions of Argentina remains unknown. (i) Determine the seroprevalence of HEV among the human population in Tandil, Buenos Aires, Argentina; (ii) Evaluate its association with demographic, socioeconomic and other risk exposures variables, and (iii) Describe and analyze spatial patterns related to HEV infection. From August 2020 to July 2021, serum samples were collected from 969 individuals aged 1-80 years. Seroprevalence and 95% Confidence Interval was determined. To assess the factors associated with the presence of anti-HEV antibodies, associations between the variables and seropositivity were evaluated through bivariate and multivariate analysis. Spatial scanning for clusters of positivity was carried out. Factors associated with these clusters were also assessed. Anti-HEV antibodies were detected in 4.64% (IC 95% 3.27-6.02) of samples. Dark urine was associated with seropositivity (p = 0.02). Seropositivity was linked with the presence of natural water courses near their households (p = 0.02); the age (p = 0.04); and previous travel to Europe (p = 0.04). A spatial cluster of low rates of HEV seropositivity was detected, with greater distance of the households to water courses associated to the cluster, and male sex inversely associated to it. This study is the first study to investigate the prevalence of HEV in the population from Tandil, Buenos Aires, Argentina. Considering HEV infection in the differential diagnosis in individuals presenting acute hepatitis is highlighted. The incorporation of HEV testing into blood screening policies should be mandatory. Factors related to the infection and spatial patterns of high and low risk were determined, and should be considered when implementing specific preventive measures.

COVID‑19 Pandemic: Effect of Specific and Non-Specific Prevention Measures on the Risk of SARS‑CoV‑2 Infection in Employees of Healthcare Organizations

From the very onset of SARS‑CoV‑2 spreading, active involvement in the COVID‑19 epidemic process made the healthcare professionals (HCPs) a vulnerable group with higher risks of contracting the disease, severe course and fatal outcome.The aim. We aimed at studying the impact of specific and non-specific preventive measures on the risk of SARS‑CoV‑2 infection among the HCPs in a large industrial region settings during the COVID‑19 pandemic.Materials and methods. We analyzed the data obtained using 1 905 questionnaires for the personnel of infectious hospitals for treatment of COVID‑19 patients and non-core healthcare facilities in a large industrial region during the COVID‑19 pandemic, 100 questionnaires on adherence of the employees to hand hygiene and antiseptics, the results of the tests for specific IgG to the SARS‑CoV‑2 nucleocapsid (2 200 samples), as well as the results of assessment of viral and bacterial contamination of the outer surface of the personal protective equipment for infectious hospital staff (108 specimens).Results and discussion. In the course of the study, an effect of failure in the implementation of some specific and non-specific preventive measures on an increase in the incidence of COVID‑19 in various healthcare professionals has been identified. The COVID‑19 pandemic once again emphasized the need to save lives and health of the HCPs as socially significant category of citizens under the spread of pathogens with high epidemic potential, applying a complex of specific and non-specific measures that are not mutually exclusive.

Predicting the Adoption of COVID-19 Public Health Preventive Measures in Ethiopia: Application of Health Belief Model

In the face of coronavirus disease pandemic, adherence to public health measures largely influences their effectiveness in containing the spread. Four specific objectives guided this study: (i) Assess whether individuals are adhering to the COVID-19 preventive measures promoted by Ethiopian government; (ii) Examine the heterogeneity in adoption of preventive measures in Ethiopia; (iii) Identify the factors affecting adherence to preventive measures-based health belief model; and (iv) Examine the moderating effects of socio-economic factors on the relationship between adherence to preventive measures and HBM factors. The study relied on a nationally representative cross-sectional survey commissioned by the World Health Organization in 2021 for Ethiopia. Data was collected from 895 individuals aged 18 years of age or older. Analysis applied several methods including the Multiple Correspondence Analysis, Univariate analysis, hierarchical cluster analysis, cluster analysis and multiple regression analysis. Using face masks and washing hands were the most frequently practiced preventive measures. The regression analysis indicated that perceived severity, perceived barriers, and cues to action showed a significant association with adherence at p >0.05. Furthermore, socio-economic factors have a moderating role on adherence to preventive measures and HBM factors. Effective promotion and adoption of preventive measures require addressing individuals' perceptions of severity and benefits while minimizing barriers and providing clear cues to action. Additionally, specific preventive measures that require ongoing effort and habit development may face challenges in adoption. Tailoring interventions can help overcome these challenges and encourage the widespread adoption of preventive measures to curtail the spread. Keywords: Coronavirus disease - 2019, Prevention, Health belief model.

ICU-Acquired Colonization and Infection Related to Multidrug-Resistant Bacteria in COVID-19 Patients: A Narrative Review.

A large proportion of ICU-acquired infections are related to multidrug-resistant bacteria (MDR). Infections caused by these bacteria are associated with increased mortality, and prolonged duration of mechanical ventilation and ICU stay. The aim of this narrative review is to report on the association between COVID-19 and ICU-acquired colonization or infection related to MDR bacteria. Although a huge amount of literature is available on COVID-19 and MDR bacteria, only a few clinical trials have properly evaluated the association between them using a non-COVID-19 control group and accurate design and statistical methods. The results of these studies suggest that COVID-19 patients are at a similar risk of ICU-acquired MDR colonization compared to non-COVID-19 controls. However, a higher risk of ICU-acquired infection related to MDR bacteria has been reported in several studies, mainly ventilator-associated pneumonia and bloodstream infection. Several potential explanations could be provided for the high incidence of ICU-acquired infections related to MDR. Immunomodulatory treatments, such as corticosteroids, JAK2 inhibitors, and IL-6 receptor antagonist, might play a role in the pathogenesis of these infections. Additionally, a longer stay in the ICU was reported in COVID-19 patients, resulting in higher exposure to well-known risk factors for ICU-acquired MDR infections, such as invasive procedures and antimicrobial treatment. Another possible explanation is the surge during successive COVID-19 waves, with excessive workload and low compliance with preventive measures. Further studies should evaluate the evolution of the incidence of ICU-acquired infections related to MDR bacteria, given the change in COVID-19 patient profiles. A better understanding of the immune status of critically ill COVID-19 patients is required to move to personalized treatment and reduce the risk of ICU-acquired infections. The role of specific preventive measures, such as targeted immunomodulation, should be investigated.

Burden of non-communicable diseases among adolescents and young adults aged 10-24 years in the South-East Asia and Western Pacific regions, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.

Although non-communicable diseases (NCDs) remain the leading causes of mortality and disability worldwide, little comprehensive or recent evidence of the burden of NCDs among adolescents and young adults in the South-East Asia and Western Pacific regions is available. We aimed to report population shifts in people aged 10-24 years and their NCD burden from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. We retrieved data from GBD 2019 for people aged 10-24 years in the South-East Asia and Western Pacific regions from 1990 to 2019. We presented population shifts and analysed deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) for NCDs. We also quantified the associations of deaths and DALYs with the Socio-demographic Index (SDI) and Universal Health Coverage (UHC) effective coverage index using Spearman correlation and linear regression analyses. Percentages are reported to 1 decimal place and rates are reported to 2 decimal places. In 2019, there were 559·2 million young people aged 10-24 years in the South-East Asia region and 335·0 million in the Western Pacific region; India and China remained the countries with greatest number of this age group. In 1990-2019, India had an absolute increase of 139·4 million adolescents, while China had a decrease of 134·3 million. In 2019, NCDs accounted for 27·3% (95% uncertainty interval 25·1 to 29·2) and 34·6% (33·5 to 36·1) of total deaths, and 49·8% (45·3 to 54·4) and 65·1% (60·6 to 69·3) of total DALYs in the South-East Asia and the Western Pacific regions, respectively. Neoplasms, cardiovascular diseases, and mental disorders were the leading causes of NCD burden in 42 countries. Kiribati had the highest rates of deaths (62·82 [50·77 to 76·11] per 100 000 population), YLLs (4364·73 [3545·04 to 5275·63] per 100 000 population), and DALYs (9368·73 [7713·65 to 11340·99] per 100 000 population) for NCDs, whereas Australia (6976·51 [5044·46 to 9190·01] per 100 000 population) and New Zealand (6716·81 [4827·25 to 8827·69] per 100 000 population) had the largest rates of YLDs due to NCDs. From 1990 to 2019 across both regions, the rate of death due to NCDs declined by over a third (-32·8% [-41·1 to -22·9] in the South-East Asia region and -40·0% [-48·6 to -30·4] in the Western Pacific region), and DALYs decreased by about 12% (-12·0% [-16·8 to -7·7] in the South-East Asia region and -12·8% [-17·7 to -8·7] in the Western Pacific region), whereas the proportion of NCD burden relative to all-cause burden increased (45·7% [32·9 to 61·7] for deaths and 41·2% [35·2 to 48·8] for DALYs in the South-East Asia region; 11·8% [7·1 to 21·5] for deaths and 18·2% [14·6 to 22·0] for DALYs in the Western Pacific region). The rate of deaths and DALYs due to NCDs decreased monotonically alongside increases in SDI (rs=-0·57 [95% CI -0·81 to -0·32] for deaths and rs=-0·30 [-0·61 to 0·03] for DALYs). The rate of deaths (rs=-0·89 [95% CI -0·97 to -0·80]) and DALYs (rs=-0·67 [-0·93 to -0·41]) due to NCDs also decreased alongside increases in the UHC effective coverage index. Specific preventive and health service measures are needed for adolescents and young adults in countries with different levels of socioeconomic development to reduce the burden from NCDs. National Natural Science Foundation of China. For the Chinese translation of the abstract see Supplementary Materials section.

Preventive Measures Against Monkeypox: A Scoping Review

Objectives: Monkeypox (MPX), a viral zoonotic disease, is causing current outbreaks with a rise in cases. This study aims to describe available monkeypox preventive measures and summarize their results. Methods: We conducted a scoping review on monkeypox prevention methods. A search strategy including keywords of (1) monkeypox and (2) prevention was performed on PubMed, Scopus, and Embase. Results: Out of 2198 retrieved articles, 1046 duplicates were removed. After title, abstract, and full-text examination, 8 eligible studies on specific preventive measures were included. The most common monkeypox prevention methods were vaccination and health communication. Smallpox vaccines are effective, but immunity may decline over time. Film-based educational activities were successful in enhancing understanding and promoting healthy behaviors, while media campaigns had little impact. Conclusions: Monkeypox has limited data on prevention methods for humans. Future research on the effectiveness of these vaccines in humans, the relationship between vaccine efficacy and time since immunization, and the requirement to more thoroughly evaluate the impact of media campaigns are essential. Keywords: Monkeypox, Prevention, Vaccination, Health communication

Awareness and Practices Regarding Leptospirosis in Andaman and Nicobar Islands, Union Territory of India.

Background Leptospirosis is a worldwide prevalent zoonotic infection and re-emerging disease caused by the bacterium of genus Leptospira transmitted by infected animals in the environment.Andaman and Nicobar Islands has one of the highest incidence rates of leptospirosis in India with a seroprevalence of 52.7%.This study examined the knowledge, attitudes, and practices (KAP) regarding leptospirosis among the urban and rural populations of the Union Territory (UT) of India. Aim and objective This study aims to assess the knowledge, attitude, and practices regarding leptospirosis in a rural and an urban community of Andaman and Nicobar Islands. Materials and methods This community-based cross-sectional study was conducted atrural and urban field practice areas under the aegis of the Department of Community Medicine, Andaman and Nicobar Islands Institute of Medical Sciences (ANIIMS), Port Blair, for a period of three months.A semi-structured interview schedule was administered to 450 participants in community settings selected from a list of households obtained from the municipal council using a systematic random sampling method. All interviews were conducted face-to-face by the investigators to collect data on the sociodemographic variables of the study participants and their knowledge, attitudes, and practices regarding the disease. The data was analyzed using Statistical Package for the Social Sciences (SPSS) version 27.0 (IBM SPSS Statistics, Armonk, NY, USA). Results The knowledge and attitude regarding leptospirosis and henceforth the likelihood of individuals using preventive practices were evaluated. The majority of respondents (97%) had previously heard about leptospirosis; however, specific knowledge regarding its risk factors, causative agent, and complications was limited among the participants. Although more than 90% of them had a favorable attitude towardseeking treatment for the disease and adopting specific preventive measures and general hygiene,they did not practice these hygiene habits nor used self-protective equipment in their day-to-day lives. Less than 50% of participants wore protective clothing, boots, and gloves while cleaning cattle sheds, and only 40% of them used rodenticides despite the presence of rodents in their houses. Most of the owners (60%) had not vaccinated their pets. We also found a significant association between the male gender and urban residence with a good knowledge score (p=0.05). Conclusion Despite having knowledge of and a positive attitude towardthe disease, the participants did not practice preventive measures. We recommend that health interventions in endemic communities should focus on the implementation of protective measures by raising awareness in the susceptible population on multiple dimensions of leptospirosis in order to attain and ensure better compliance.

Role of Epigenetics and Metabolomics in Predicting Endothelial Dysfunction in Type 2 Diabetes.

Type 2 diabetes (T2D) is a worldwide health problem and cardiovascular disease (CVD) is a leading cause of morbidity and mortality in T2D patients, making the prevention of CVD onset a major priority. It is therefore crucial to optimize diagnosis and treatment to reduce this burden. Endothelial dysfunction is one of the most important prognostic factors for CVD progression, thus novel approaches to identify the early phase of endothelial dysfunction may lead to specific preventive measures to reduce the occurrence of CVD. Nowadays, multiomics approaches have provided unprecedented opportunities to stratify T2D patients into endotypes, improve therapeutic treatment and outcome and amend the survival prediction. Among omics strategies, epigenetics and metabolomics are gaining increasing interest. Recently, a dynamic correlation between metabolic pathways and gene expression through chromatin remodeling, such as DNA methylation, has emerged, indicating new perspectives on the regulatory networks impacting cellular processes. Thus, a better understanding of epigenetic-metabolite relationships can provide insight into the physiological processes altered early in the endothelium that ultimately head to disease development. Here, recent studies on epigenetics and metabolomics related to CVD prevention potentially useful to identify disease biomarkers, as well as new therapies hopefully targeting the early phase of endothelial dysfunction are highlighted.

Epidemiological analysis of the incidence of urolithiasis among the adult population of the Republic of Tatarstan in 2012−2021

Introduction. Urolithiasis is one of the leading urological diseases in terms of prevalence and is among the top three in terms of the frequency of emergency hospital admissions to the urological hospital. The Republic of Tatarstan is endemic for the prevalence of urolithiasis. In this connection, it is important to study the trends of urolithiasis morbidity, which will allow further development of special preventive measures that will help to reduce the cases of recurrence of this pathology.The aim of this work was to evaluate the dynamics of urolithiasis morbidity in the Republic of Tatarstan and to identify the territories endemic for this pathology.Materials and methods. The material for the study was statistical data on the number of detected cases of urolithiasis in 2012−2021, provided by the Republican Medical Information Analytical Center of the Republic of Tatarstan.Results. A decrease in the prevalence and primary incidence of urolithiasis in the Republic of Tatarstan has been revealed; a significant variability of these indicators in individual municipalities has been noted. Discussion Over the past decade, the Russian Federation has seen a steady increase in the prevalence of urolithiasis. To reduce the prevalence and primary morbidity in municipalities with the highest rates, a comprehensive approach is required, including correction of territorial features of environmental exposure, alimentary, metabolic factors, adequate prophylaxis and metaphylaxis of urolithiasis.Conclusion. Analysis of urolithiasis morbidity over a ten-year period in the Republic of Tatarstan revealed a decrease in primary morbidity and prevalence rates; municipalities with consistently higher prevalence and/or primary morbidity rates were identified.