Superficial Fungal Infections Research Articles

ЕНЕРГОСПОЖИВАННЯ ШКОЛИ В УМОВАХ НЕПОВНОЇ ЗАЙНЯТОСТІ ДЛЯ РІЗНИХ РЕЖИМІВ ОПАЛЕННЯ ПРИМІЩЕНЬ

The challenges facing the Ukrainian education system, particularly in light of demo-graphic changes and the impact of war, are examined in this research. It highlights the poten-tial for optimizing the operation modes of school buildings under conditions of partial occu-pancy to reduce energy consumption and ensure comfortable conditions for students. Energy modeling analysis using DesignBuilder software shows that the configuration of classrooms significantly impacts the energy efficiency of buildings. The best results for energy efficiency were achieved with rooms stacked on top of each other, outperforming the variant with three rooms on the middle floor by 22.3%, and mixed configurations by 8.5% and 16%. This efficiency is due to minimized contact with unheated premises and maximized solar heat gains. However, without appropriate building upgrades, the use of limited spaces may not provide adequate comfort conditions in colder periods. For the rooms studied (45-48m^2), the required heating device capacity to maintain comfortable conditions varies from 7.5 to 10.5 kW, depending on the level of insulation, which is 3-5 times more than the standard capacity for such spaces. Providing comfortable conditions without upgrading the heating system in cold periods is unfeasible, even with high levels of building insulation and a constant heating schedule. Therefore, implementing partial use of school buildings, despite their high potential for en-ergy savings, cannot satisfy student comfort needs without corresponding improvements. Future research could provide a foundation for developing comprehensive strategies for managing school spaces, considering variable building usage conditions and ensuring an optimal combination of energy efficiency, cost-effectiveness, and comfort for students and staff. The findings can be useful for school administrations, local educational authorities, and policymakers in education and energy efficiency. Further studies are suggested to explore the impact of internal wall insulation, increased heating device capacity, and heating uncondi-tioned rooms to a certain temperature level on energy efficiency and comfort conditions in occupied spaces.

Cassia alata L.: A Study of Antifungal Activity against Malassezia furfur, Identification of Major Compounds, and Molecular Docking to Lanosterol 14-Alpha Demethylase.

Empirically, in Indonesia, the leaves of Cassia alata L. (candle bush or ketepeng cina) have been used as a topical antifungal agent. Malassezia furfur is a natural microorganism found in the human body. It is among the factors contributing to conditions such as pityriasis versicolor, a common, benign, superficial fungal infection of the skin that is closely associated with seborrheic dermatitis and dandruff. This study aimed to explore C. alata leaves, starting from determining antifungal activity against M. furfur and the identification of major compounds in the ethyl acetate and n-hexane fractions, and then we carried out molecular docking of the major compounds in the n-hexane fraction to lanosterol 14-alpha demethylase. The method was the disc diffusion technique to test antifungal activity, LC-MS/MS for major compound identification, and homology modeling through Swiss Models for molecular docking. The fractions of ethyl acetate and n-hexane extract showed concentration-dependent antifungal activity against M. furfur. The LCMS/MS analysis revealed five major compounds in the ethyl acetate and n-hexane fractions. The molecular docking demonstrated the highest binding affinity with stearidonic acid at -7.2 kcal/mol. It can be concluded that the compounds in the n-hexane fraction have antifungal activity against M. furfur, as supported by both in vitro and in silico studies.

Effects of additional oral fosravuconazole l-lysine ethanolate therapy following inadequate response to initial treatment for onychomycosis: A multicenter, randomized controlled trial.

Onychomycosis, a superficial fungal infection, develops when dermatophytes infect nail plate and beds. Fosravuconazole l-lysine ethanolate (F-RVCZ), a fourth-generation azole antifungal agent with potent antifungal activity and few drug interactions, was highly effective in a clinical trial, with a complete cure rate of 59.4% at 48 weeks after treatment initiation. However, some patients were not completely cured. To achieve a higher complete cure rate, additional therapy needs to be examined. We aimed to examine (i) the criteria for additional F-RVCZ therapy in patients with an inadequate response to initial F-RVCZ treatment for onychomycosis; (ii) the timing of additional therapy; and (iii) the effects of additional treatment. This was a multicenter, open-label, three-arm randomized clinical trial. Patients with onychomycosis were orally administered an approved dose of F-RVCZ for 12 weeks, and its efficacy was assessed at week 24. Patients who demonstrated ≥55% reduction in nail involvement ratio at week 24 were included in Group X and followed up. Patients with <55% reduction were randomly assigned to follow-up (Group A) or additional treatment (Group B) groups. The complete cure rate at week 72 in Group X was 73.3%. In Groups A and B, the complete cure rates were 29.6% and 46.7%, respectively, and were significantly different (P = 0.0414, odds ratio 2.08). During the study, 63 adverse drug reactions were recorded in 59 of the 318 patients (18.6%), for which a causal relationship with F-RVCZ could not be ruled out. In Group B, three of 75 patients (4.0%) experienced three adverse drug reactions, all observed during additional treatment; none were serious. A high complete cure rate is possible without additional F-RVCZ treatment when nail involvement decreases by ≥55% at week 24; however, when the reduction is <55% at week 24, additional F-RVCZ treatment should be considered to improve the cure rate.

Age and Sex Characteristics of Dermatophytosis in Gianyar, Indonesia

Highlights:1. Although dermatophytes may typically cause mild infections, it is crucial to conduct continuous research due to their potential to cause severe diseases in individuals who are highly susceptible to infection.2. This study offers insight into the increased risk of developing dermatophytosis for female and adult individuals compared to male and younger individuals. Abstract Dermatophytosis is a superficial fungal infection caused by a filamentous fungus that attacks keratinized tissues on the skin, nails, and hair. The clinical manifestation of dermatophytosis is determined by the source. In addition, it can be influenced by host-related factors, such as age, sex, and race. These are significant epidemiological factors, although the association between these factors and susceptibility to infection has not been clarified. Therefore, this study aimed to determine the association between the incidence of dermatophytosis and host-related factors (i.e., age and sex) in Gianyar Regency, Indonesia. This observational study used a cross-sectional design and total sampling. A total of 100 samples were collected from the medical records of patients diagnosed with dermatophytosis. The Chi-square test was employed to determine the correlation between the independent and dependent variables with a p-value of &lt;0.05. The data were analyzed using IBM SPSS Statistics for Windows, version 22.0 (IBM Corp., Armonk, N.Y., USA). The majority of patients with dermatophytes infection were adults over the age of 19 (74%) and females (57%). The most prevalent type of dermatophytosis was tinea corporis (36%). The Chi-square test revealed a significant association between the type of dermatophytosis and the variables being examined, namely age (p = 0.025; OR = 1.978; 95% CI = 1.087-3.599) and sex (p = 0.003; OR = 2.357; 95% CI = 1.334-4.162). In conclusion, the manifestation of certain types of dermatophytosis is associated with age and sex. The findings of this study recommend enhancing the detection of dermatophytosis infection, especially in adults (&gt;19 years old) and women.

Impact of cotton dust, endotoxin exposure, and other occupational health risk due to indoor pollutants on textile industry workers in low and middle- income countries

The textile industry consists of several units that engage different processes namely ginning, spinning, weaving, dyeing, printing, and several other processes which required for converting raw cotton fiber into finished fabrics. Exposure to cotton dust, endotoxin, chemicals, noise, and musculoskeletal disorders causes several health-related hazards to textile workers. This review article aims to study the health issues due to various risk factors associated with the working environment in detail and its impacts on workers' health. This review article also reports dust and endotoxin concentrations in indoor environments of textile industries, as well as discusses the association between workplace exposure to cotton dust, endotoxin, and the prevalence of respiratory disorders. In this review, the focus is also given to the prevalence of indoor pollutants like Particulate Matter (PM), Carbon dioxide (CO2), Carbon monoxide (CO), and Volatile Organic Compounds (VOCs), Formaldehyde (HCHO) in the workplace and its effects on human health. The study expands to other aspects that influence human comfort and health during working hours like occupational noise, musculoskeletal disorders, and eyesight problems. In addition, the advanced technologies for monitoring indoor air quality for control and reduction of pollutants indoor environment the current regulatory limits of cotton dust and indoor pollutants, and suggestions to enhance the occupational safety and health conditions in textile sectors are also pointed out. In conclusion, the current study stresses the need to regulate and apply international standards in the textile sector to prevent short- and long-term occupational illness.

Occupational challenges: burnout syndrome and brazilian legislation

The article addresses the intersection between Burnout Syndrome and changes in Brazilian legislation, offering a holistic view of the clinical, psychological and legal implications of this phenomenon in the workplace. By exploring the trajectory of Burnout Syndrome as a new occupational condition, the analysis highlights the evolution of legal perspectives in Brazil. Using a desk research approach, the study reviews Brazilian legislation and analyzes related studies, revealing increasing attention to mental health and specific changes in legislation to protect workers. Furthermore, the ethical discussion and employers' responsibilities are addressed, expanding the scope of the analysis. The research contributes to an ongoing dialogue about mental health, legislation and work practices, promoting a deeper understanding and prevention of Burnout in Brazilian professional environments.

Investigation of Vibration Characteristics during Various Building Construction Stages under Train Operations

In response to land use challenges, major urban centers have started implementing over-track building constructions above metro lines as a means of accommodating residents and workers. However, the continuous operation of trains can generate excessive vibrations that may negatively impact the overall living conditions for occupants residing in these structures. In this paper, vibration measurements were conducted on the soil and within a three-story frame structure building. Additionally, a three-dimensional finite element model of the track–soil–building was established. The wheel–rail contact force was incorporated as a dynamic load that varies with time to accurately simulate the vibration response induced by trains. According to the construction process of the over-track building, four construction stages were set up using the finite element model to study the impact of the construction stages on the vibration propagation from the soil to building structure. The results indicate that the presence of existing structures exerts a mitigating influence on soil vibrations. Pile foundation construction can effectively mitigate soil vibration to a significant extent. The findings provide references for the future development and design of over-track buildings.

The problem of treating acne and rosacea in women of reproductive age

Often enough, women of reproductive age make medical appointments for problems such as acne and rosacea. Treatment of these diseases in this group of patients has unique features. For example, isotretinoin can only be administered for some indications and in combination with most effective contraceptive methods due to its teratogenicity. Also worth noting is that acne prevalence rates among pregnant women are quite high – up to 43% according to various studies. In fact, symptoms of the disease develop during the second and third trimesters. The choice of therapy for these patients is limited and mainly includes topical drugs. The acne management strategies in women planning pregnancy are similar to that in pregnant women. Foreign studies show the relationship between rosacea and hormonal and reproductive factors. Thus, the disease often develops in premenopause; the risk of developing rosacea is also increased in nulliparous women and women delivering their first and last child at an older age. In our practice, we often prescribe a 1% clindamycin solution as a topical antibiotic. The drug is easy to apply and is not visible on the skin after its use. Absence of drug-induced photosensitivity is a significant advantage of the solution over drugs from other groups, which allows using the drug during periods of high solar activity (in particular, in spring and summer). This is also important for patients with rosacea, as exposure to ultraviolet light is one of the factors known to aggravate the disease. A number of management strategies and treatment algorithm for patients of reproductive age suffering from acne and rosacea that are provided in this work will help physicians to select the optimal and safe treatment with due account for reproductive life plans.

Occupational and Return-To-Work Characteristics of Covid-19 Patients After Treated in Udayana University Hospital

Corona virus disease 2019 (COVID-19) is a new disease caused by severe acute respiratory syndrome corona virus 2 (SARS-COV-2). The COVID-19’s symptoms are fatigue, muscle pain, and psychological disorders. The purpose of this study was to describe the occupational characteristics and health conditions of COVID-19 patients who had recovered after being treated at Udayana University Hospital. This study is a descriptive study with a quantitative method and cross-sectional design. The research samples were 110 COVID-19 patients treated at Udayana University Hospital from June to August 2020 and taken using random sampling. The results showed that the highest proportion of respondents were aged between 24-44 years (44.5%), with almost equal proportions of women (50.1%) and men (49.09%). Most of them lived in Denpasar (46.36%). Most respondents work as private sector employees (24.55%), and 70% of them were using personal protective equipment (PPE) while working. Most respondents needed less than seven days to return to work after being declared “in recovery state” (60%), with the remaining 55.5% having a decreased work duration to be less than 8 hours per day. The proportion of respondents with comorbidities was 30.91%. As many as 27.27% were experiencing previously similar symptoms (fever, fatigue, cough) 4 to 5 months after being declared “cured.” COVID-19 patients who have recovered should be monitored for a longer period of time to evaluate the symptom reoccurrence and its impact on their occupational and health conditions.

Ketoconazole: A Review of It's Therapeutic Effectiveness in Superficial and Systemic Fungal Infections

Ketoconazole: A Review of It's Therapeutic Effectiveness in Superficial and Systemic Fungal Infections

In vitro antifungal susceptibility of the dermatophytes: a single center study from Eastern Black Sea Region of Turkey.

A large number of patients applying to the dermatology clinics are affected by fungal diseases, and a significant portion of which are superficial fungal infections. Dermatophyte infections are a notable public health concern and frequently encountered in clinical practice. Dermatophytosis not only compromises the quality of life but also predisposes individuals to various comorbidities due to its role as a gateway for secondary bacterial agents. This study aims to determine the species distribution of dermatophytes prevalent and assess their susceptibility to antifungal drugs. Skin, nail, and hair samples were obtained from patients with a clinical diagnosis of dermatophytosis. Samples were all cultured to isolate and identify the species. In vitro liquid microdilution tests were conducted to assess the susceptibility of the isolated strains against terbinafine, fluconazole, griseofulvin, and butenafine. A total of 353 samples were obtained from the hair, skin, and nail lesions of 326 patients. Dermatophyte was isolated in 71 of the samples (20.1%). The cultured dermatophyte subtypes included Trichophyton rubrum (13.8% in 49 samples), Microsporum audouini (5.7% in 20 samples), and Trichophyton mentagrophytes (0.6% in 2 samples). Antifungal susceptibility testing revealed that terbinafine was the most effective antifungal drug against all dermatophyte species, while fluconazole exhibited the highest resistance. The most common dermatophytosis agent in our region is T. rubrum. The least antifungal resistance was found against terbinafine. Conducting antifungal susceptibility tests is crucial for selecting effective treatment regimens and early detection of resistance development.

“I feel a bit more of a conduit now”: Sign language interpreters coping and adapting during the COVID-19 pandemic and beyond

This article examines the impact of the COVID-19 pandemic on the sign language interpreting profession drawing on data from a fourth and final survey conducted in June 2021 as part of a series of online “living surveys” during the pandemic. The survey, featuring 331 respondents, highlights significant changes in the occupational conditions and practices of sign language interpreters due to the sudden shift towards remote video-mediated interpreting. The findings reveal a range of challenges faced by interpreters, including the complexities of audience design, lack of backchanneling from deaf consumers, the need for heightened self-monitoring, nuanced conversation management, and team work. Moreover, the study highlights the physical and mental health concerns that have emerged among interpreters as a result of the shift in working conditions, and a need for interpreters to acquire new skills such as coping with the multimodal nature of online interpreting. While the blend of remote, hybrid, and on-site work has introduced certain advantages, it also poses new challenges encompassing workload management, online etiquette, and occupational health concerns. The survey’s findings underscore the resilience and adaptability of SLIs in navigating the shift to remote interpreting, suggesting a lasting transformation in the profession with implications for future practice, training, and research in the post-pandemic era.

Responses of keratinocytes to Trichophyton mentagrophyte infection based on whole transcriptome analysis.

Dermatophytosis is an intractable superficial mycosis in humans and animals mainly caused by Trichophyton mentagrophytes (T. mentagrophytes), with a global prevalence of about 20%. Keratinocytes are the most abundant participants in skin immunity, and they also play a role in the first-line defence against T. mentagrophytes. However, no studies of keratinocyte responses against T. mentagrophytes infection based on the whole transcriptome have been reported. Here, we systematically analysed changes in keratinocytes infected with T. mentagrophytes using whole transcriptome sequencing technology. The phenotypic changes in keratinocytes after infection with 1 × 105 conidia/mL T. mentagrophytes were observed by light microscopy, scanning electron microscopy, transmission electron microscopy and terminal deoxynucleotidyl transferase dUTP nick end labeling. RNA-sequencing (RNA-seq), small RNA-seq technology and related bioinformatics methods were used to systematically analyse the whole transcriptome changes in keratinocytes upon T. mentagrophytes stimulation. We found that T. mentagrophytes infection caused morphological changes, membrane damage, the formation of irregular organelles and keratinocyte apoptosis. A total of 204 differentially expressed (DE) circular RNAs (circRNAs), 868 DE long noncoding RNAs (lncRNAs), 2973 DE mRNAs and 209 DE micro RNAs (miRNAs) were identified between noninfected and T. mentagrophytes-infected keratinocytes. The expression level of selected RNAs was validated by quantitative real-time polymerase chain reaction (qRT-PCR). Functional enrichment analysis revealed that the parental genes of DE circRNAs were related to cell response, cell death and establishment of the skin barrier. Genes targeted by miRNA were involved in regulating the initiation of the immune response. Based on the expression level of circRNAs, lncRNAs, mRNAs and miRNAs, circRNA-miRNA-mRNA competing endogenous (ceRNA) networks comprised of 159 DE miRNAs, 141 DE circRNAs and 2307 DE mRNAs, and lncRNA-miRNA-mRNA ceRNA networks comprised of 790 DE lncRNAs, 190 DE miRNAs and 2663 DE mRNAs were constructed. The reliability of two selected ceRNA networks was verified using qRT-PCR. Further functional enrichment analysis revealed that the DE mRNAs interacting with circRNAs and lncRNAs in the ceRNA network mainly participated in fungal recognition, inflammation, the innate immune response and the death of keratinocytes. Our findings might provide new evidence on the pathogenesis of T. mentagrophytes-induced dermatophytosis, which is essential for identifying new therapeutic targets for dermatophytosis treatment.

The Relationship Between Type and Position of Fungal Infection with Age and Gender

Dermatophytosis is a superficial fungal infection caused by filamentous fungi that attack the keratinized tissue. Aimed to: the find out relationship between type and position of fungal infection with age and gender. Material and Methods: This cross-sectional survey study was carried out at the dermatology department, from August 2021 to July 2023. Results: The ages most affected by fungi were between 17 and 32 years old at 60%, followed by the oldest age over 35 years old. The females were the most infected with fungi, 93 out of 155. As for the type of infection, yeast was the highest, especially in 60 women. hyphae 28 and spores 8 where males were less infectious, the relationship between gender and fungal position, because p-value &lt; 0.05, As for the type of fungus and its existence, it has nothing to do with gender because p-value &gt; 0.05, it has nothing to do with gender because p-value &gt; 0.05, and the relationship between age and presence of fungal infection, because p-value &lt; 0.05, the type of fungus and position of fungal infection, it has nothing to do with age because p-value &gt; 0.05. Conclusion: females are more likely to be infected with fungi, whether they are by infection type or location, and the most infected ages are between 17 and 32 years old. The study also showed that the place of infection in nails was found in males and there was no infection in females.

Borneol serves as an adjuvant agent to promote the cellular uptake of curcumin for enhancing its photodynamic fungicidal efficacy against Candida albicans

Candida albicans (C. albicans), a major opportunistic pathogenic fungus, is known to cause superficial skin infections. Unfortunately, the misuse of antibiotics has led to the emergence of drug resistance in fungi. Antimicrobial photodynamic therapy (aPDT), a non-antibiotic alternative, has shown potential in treating drug-resistant fungal infections. Curcumin is a photodynamically active phytochemical whose photodynamic fungicidal efficacy is largely dependent on its intracellular accumulation. However, curcumin faces challenges in penetrating the cytoplasm due to its poor water solubility and the fungal cell wall. Borneol, another monoterpenoid phytochemical, is known for its ability to enhance drug absorption. In this study, we showed that borneol improved the cellular uptake of curcumin, thereby enhancing its photodynamic fungicidal efficacy against C. albicans. This effect was attributed to borneol's ability to increase cell permeability. Transcriptomic analysis further confirmed that borneol disrupted the normal structure and function of the C. albicans cell wall and membrane, resulting in dysregulated mRNA expression of related genes and ultimately increased cell permeability. As a result, the excessive accumulation of curcumin in C. albicans triggered the overproduction of intracellular ROS upon exposure to blue light. These excessive intracellular ROS disrupted various cellular structures, interfered with essential cellular processes, inhibited biofilm formation and reduced virulence. Remarkably, borneol was also found to enhance curcumin uptake by C. albicans within biofilms, further enhancing the anti-biofilm efficacy of curcumin-mediated aPDT (Cur-aPDT). In conclusion, the results of this study strongly support the potential of borneol as an adjuvant agent to Cur-aPDT in treating superficial cutaneous fungal infections.

Analysis of Fungal Infections and Public Community Literature in Iran: A Systematic Review

Context: Today, the emergence of fungal infections in public places has become a focus, especially in developing countries. Objectives: The present study aimed to study the literature on fungal infections in public places in Iran to find a variety of fungal infections. Study Selection: A search was performed to identify relevant studies in PubMed, Web of Science, Scopus, Scientific Information Database (SID), and Magiran databases from 2010 to 2022 using special keywords and equivalents. Overall, 25 studies met the inclusion criteria. Finally, the required information was extracted and discussed. Results: The research findings indicate that the research design of most of the papers was cross-sectional. Most of the studies in the field of fungal infections in public environments in Iran have been carried out in places such as swimming pools, schools, some health-related environments, cultivation environments, and soil. Different species of Aspergillus, Penicillium, Mucor, and Mucormycosis were identified in the environments. Conclusions: Examination of different species showed a combination of superficial, skin, mucosal, and visceral fungal infections observed in public places. Prevention and environmental analysis should be given more attention by health policy-makers in order to reinforce public health.

Occupational conditionality of integral hematological indices in metallurgical production workers

The health of the working population is one of the main guarantors of the sustainable and planned development of the state's economy, while working conditions and factors of the production environment play an important role in its formation. Studies of indicators of endogenous intoxication make it possible to identify the formation of adaptive and compensatory changes in the hemogram depending on the conditions of the production environment and the labor &#x0D; process.&#x0D; The study aims to explore the degree of professional conditionality of integral hematological indices for early diagnosis of the harmful effects of production factors on the body of workers employed in metallurgy.&#x0D; The authors have analyzed the results of some integral hematological indices and carried out the assessment of occupational risk in accordance with the "Temporary methodological recommendations for the calculation of occupational risk indicators" (2005) and the methodological recommendations "Methodology for the detection of occupational diseases and diseases related to working conditions" based on the calculation of relative risk (RR, units) and etiological proportion (EF, %).&#x0D; The calculation of the leukocyte intoxication index showed high values in all occupational groups from 50.00% for electricians and gas welders to 88.16% for potash workers. Scientists diagnosed a significantly increased number of eosinophilic granulocytes (more than 5%) in 26.09% of draggers, in 34.52% of rope-winding machinists, in 38.16% of potters compared with the control group (p&lt;0.001). Scientists determined the most pronounced changes in the indicators of endogenous intoxication in the first five years of contact with harmful factors of production. We found high LII values in 62.16% of draggers, 75.00% of compressor unit drivers, 73.53% of rope winding drivers and 45.00% of electricians. The content of eosinophils in peripheral blood, as well as the calculated allergization index, demonstrate almost complete industrial conditionality in all occupational groups of the examined (RR&gt;5, EF=81–100%). In the group of electricians, these indicators have a very high degree of production conditionality.&#x0D; Timely identification of workers with violations of integral hematological indices in the dynamics of professional activity allows them to be identified as a risk group for further monitoring and preventive measures.&#x0D; Limitations. The conducted study took into account the influence of only harmful production factors on deviations of integral hematological indices in workers of metallurgical production.&#x0D; Ethics. The material of the article was approved by the Bioethical Commission at the Ufa Research Institute of Occupational Medicine and Human Ecology (Protocol No. 01-11 dated 11/22/2023).

Community based integrated wound care: Results of a pilot formative research conducted in Benin and Côte d’Ivoire, West Africa

Appropriate treatment of chronic wounds is priority in the management of Neglected Tropical Skin Diseases (NTSDs) and non-communicable diseases. We describe an integrated, community-based wound care pilot project carried out in Benin and Cote d’Ivoire that entailed both outreach education and evidence based wound care training for nurses staffing rural clinics. This research was carried out by a transdisciplinary research. Following the collection of baseline data on wound care at home and in clinics, an innovative pilot project was developed based on a critical assessment of baseline data in three parts: a pragmatic nurse training program; mass community cultural sensitive outreach programs and a mobile consultation. It came out from our investigation that several dangerous homecare and inappropriate wound treatment practices in clinics, gaps in knowledge about Neglected Tropical Skin Diseases (NTSDs), and little health staff communication with patients about appropriate wound care. Nurse training covered 11 modules including general principles of wound management and advice specific to endemic NTSDs. Nurse pre-post training knowledge scores increased substantially. Eight mass community outreach programs were conducted, followed by mobile clinics at which 850 people with skin conditions were screened. Three hundred and three (35.65%) of these people presented with wounds of which 64% were simple, 20% moderate, and 16% severe cases. Patients were followed for ten weeks to assess adherence with wound hygiene messages presented in outreach programs and repeated by nurses during screening. Over 90% of simple and moderate cases were managed appropriately at home and 98% of wounds were healed. Of the 47 cases referred to the health center, 87% came for and adhered to wound care advice. In 90% of cases, wounds healed. This pilot study provides a model for introducing integrated community based wound care in Africa.

Teledermatology to Improve Access to and Quality of Skin Care in Eastern Indonesia.

Skin diseases are a major public health concern in Indonesia, although access to specialized care in remote areas is limited. We initiated a low-cost teledermatology service in Sumba, a remote island in eastern Indonesia. Eighteen healthcare workers (HCWs) at five primary healthcare centers received training to manage common skin diseases and submit clinical cases beyond their expertise to an online platform. Submitted cases were reviewed by at least one dermatologist. Diagnostic agreement between HCWs and dermatologists was calculated. The HCWs participated in a satisfaction survey 2 years after project initiation. Since October 2020, of 10,384 patients presenting with skin complaints in a 24-month period, 307 (3%) were submitted for a teledermatology consultation. The most frequent skin diseases were infections and infestations (n = 162, 52.8%) and eczematous (85, 27.7%) and inflammatory (17, 5.5%) conditions. Fifty-three patients (17.3%) were diagnosed with a neglected tropical skin disease, including leprosy and scabies. Dermatologist advice was provided within a median of 50 minutes (interquartile range, 18-255 minutes), with 91.9% of consultations occurring within 24 hours. The diagnostic agreement level between HCWs and dermatologists significantly improved over time, from 46.9% in the first 6-month period (κ = 0.45; 95% CI, 0.37-0.54) to 77.2% in the last 6-month period (κ = 0.76; 95% CI, 0.67-0.86; global P < 0.001). The HCWs reported that the teledermatology service was extremely/very useful in supporting daily practice (100%) and improved their knowledge of skin diseases tremendously/a lot (92%). Teledermatology can improve accessibility and quality of skin services in medically underserved areas, providing opportunities for scalability and knowledge transfer to frontline HCWs.

Service Life Prediction and Life Cycle Costs of Light Weight Partitions

This study investigates the life expectancy (LE) and life cycle costs (LCC) of three alternatives of interior partitions in residential units: gypsum board, autoclaved concrete block, and hollow concrete block partitions. The aim is to examine the sustainability and cost-effectiveness of these partitions in various service and occupancy conditions. Three different service conditions were analyzed: Standard (constructed without faults), Inherent Defect Conditions (with initial, non-progressing defects), and Failure Conditions (developing defects over time). To analyze the impact of occupancy conditions, six ‘negative occupancy factors’ were identified that accelerate partition deterioration, including non-ownership, poor maintenance, high residential density, the presence of young children, the presence of domestic animals, and the density of furniture. These factors define four occupancy condition categories: light, moderate, standard, and intensive. The research found that hollow concrete block partitions are the most durable, exceeding 100 years in light or moderate conditions. Gypsum board partitions, while cost-effective, have a lower life expectancy, needing replacement in 11–27 years in intensive conditions. Autoclaved concrete blocks offer moderate durability, with similar costs to hollow blocks in normal conditions. Overall, the study highlights the influence of service and occupancy on the lifespan of interior building components, and provides recommendations for partition type selection that are based on specific conditions. These recommendations are a pivotal outcome, highlighting the study’s significant contribution to the understanding of the long-term performance and sustainability of building materials in residential construction.