World Health Organization Reports Research Articles

Screening Tests for the Interaction of Rubus idaeus and Rubus occidentalis Extracts with Antibiotics against Gram-Positive and Gram-Negative Human Pathogens

WHO (World Health Organization) reports from recent years warn about the growing number of antibiotic-resistant bacterial strains. Therefore, there is an urgent need to constantly search for new substances effective in the fight against microorganisms. Plants are a rich source of chemical compounds with antibacterial properties. These compounds, classified as secondary metabolites, may act independently or support the action of currently used antibiotics. Due to the large number of metabolites isolated from the plant kingdom and new plant species being studied, there is a need to develop new strategies/techniques or modifications of currently applied methods that can be used to select plant extracts or chemical compounds isolated from them that enter into positive, synergistic interactions with currently used antibiotics. One such method is the dual-disk synergy test (DDST). It involves the diffusion of active compounds in the agar environment and influencing the growth of microorganisms grown on it. The method was used to assess the interaction of extracts from the fruit and shoots of some cultivated varieties of Rubus idaeus and Rubus occidentalis with selected antibiotics. The research was conducted on strains of bacteria pathogenic to humans, including Staphylococcus aureus, Corynebacterium diphtheriae, Escherichia coli, Pseudomonas aeruginosa, Helicobacter pylori, and Candida albicans, showing synergy, antagonism, or lack of interaction of the tested substances—plant extract and antibiotic. As a result, it was found that the diffusion method is useful in screening tests to assess the impact of antibiotic–herbal substance interactions on Gram-positive and Gram-negative microorganisms.

Exploring the competency and confidence levels of physiotherapists in the management of patients diagnosed with life-limiting illnesses

Background Globally, palliative care services do not meet demand. The World Health Organisation reports that 14% of people who need palliative care currently receive it. Moreover, the increase in chronic disease prevalence will result in the need for services to continue to grow. In Ireland, to help manage this demand, it is recommended that all physiotherapists should be able to deliver basic palliative care to patients diagnosed with life-limiting illnesses. Objective To explore the competency and confidence levels of physiotherapists in the management of patients with life-limiting conditions. Methods An anonymous, cross-sectional online questionnaire was designed and administered to physiotherapists working across various settings in Ireland. Results There were 90 respondents (response rate = 4.2%). A significant majority (93%, n = 84) agreed that most patients with life-limiting conditions can participate in physiotherapy. Just over half (56%, n = 50) felt confident in their ability to prescribe exercise for this cohort. Less than one-third (29%, n = 26) felt that the role of physiotherapy in palliative care was understood by the multi-disciplinary team. The majority (76%, n = 68) did not agree that their undergraduate training prepared them for work in this area. The ability to access mentorship from specialist palliative care physiotherapists was deemed as a facilitator in providing patient care. Conclusion This study highlights the demand for greater palliative care education, the need for a better understanding among the wider multi-disciplinary team so that patients receive timely access to physiotherapy, and the importance of establishing strong links between specialist physiotherapists and their generalist counterparts.

OPTIMIZING AN EXPERT SYSTEM FOR DIAGNOSING A DEPRESSION DISORDER USING A CASE BASED REASONING METHOD

According to data from the World Health Organization (WHO), 3.7% of the population in Indonesia experiences depression. Depression can impact both the mental and physical conditions of an individual. WHO reports that every year, approximately 800,000 people die by suicide, with depression being one of the causes. Depression treatment is handled by a professional, and in the field, the process of diagnosing depression disorders is still generally done manually by them. This creates many opportunities for errors, despite the fact that each level of depression disorder requires different handling. Inadequate treatment can hinder the patient's recovery and may potentially worsen their condition. A precise and efficient method is needed to diagnose depression disorders. An expert system can reduce the risk of errors that occur with manual calculations. The implemented case-based reasoning method can classify depression disorders. Testing was conducted using 30 datasets as initial knowledge, with 20 sample data points for testing, randomly selected from the population through questionnaires. The classification accuracy for depression disorders reached up to 90%.

Bedaquiline: An Insight Into its Clinical Use in Multidrug-Resistant Pulmonary Tuberculosis.

Every year, the World Health Organization reports 500,000 new cases of drug-resistant tuberculosis (TB), which poses a serious global danger. The increased number of XDR-TB and MDR-TB cases reported worldwide necessitates the use of new therapeutic approaches. The main issues with the antitubercular medications now in use for the treatment of multidrug-resistant tuberculosis are their poor side effect profile, reduced efficacy, and antimicrobial resistance. One possible remedy for these problems is bedaquiline. The need for better treatment strategies is highlighted by the strong minimum inhibitory concentrations that bedaquiline (BDQ), a novel anti-TB medicine, exhibits against both drug-resistant and drug-susceptible TB. Bedaquiline may be able to help with these problems. Bedaquiline is a medication that is first in its class and has a distinct and particular mode of action. Bedaquiline is an ATP synthase inhibitor that is specifically directed against Mycobacterium tuberculosis and some nontuberculous mycobacteria. It is metabolized by CYP3A4. Bedaquiline preclinical investigations revealed intralesional drug biodistribution. The precise intralesional and multi-compartment pharmacokinetics of bedaquiline were obtained using PET bioimaging and high-resolution autoradiography investigations. Reduced CFU counts were observed in another investigation after a 12-week course of therapy. Meta-analyses and systematic reviews of phase II trials on bedaquiline's efficacy in treating drug-resistant tuberculosis in patients reported higher rates of cure, better culture conversion, and lower death rates when taken in conjunction with a background regimen. Here is a thorough medication profile for bedaquiline to aid medical professionals in treating individuals with tuberculosis.

Metabolic Management of Cancer Disease – A Review

The US National Cancer Institute (NCI) define cancer as a disease in which some of the body’s cells are growing uncontrollably and are also spreading to other parts of the body. Cancer disease is a major cause of deaths worldwide and from the World Health Organization (WHO) report, in year 2020 alone, cancer caused about 10 million deaths globally. Also from a WHO report, cancer disease is responsible for 1 out of every 4 to 5 deaths worldwide. Conventionally, the treatment of cancer is based on three major approaches, viz; chemical therapy, surgery and radiation therapy. But, the outcome and prognosis of the conventional treatment of cancer disease is limited in its effectiveness, so there is an urgent need for more research based therapies that can effectively treat and manage cancer disease. With that, the treatment outcome and the survival rate of cancer will likely increase. Meanwhile, the term tumour was originally applied to the swelling caused by inflammation and there are two types of tumours; benign tumours and malignant tumours. Cancer is the common term for malignant tumours and the normal progression of most malignant tumours can be divided into four phases, which are; malignant change in the target cells, growth of the changed cells, local invasion of the surrounding tissues and organs by the changed cells, and distant metastases of the changed cells to other organs. In the clinical diagnosis of cancer disease, systems have been developed to express the level of differentiation of cancer within a patient (grade) and also the extent of spread of cancer within a patient (stage). The staging of cancers is based on the; size of the primary lesion, its extent of spread to regional lymph nodes, and the presence or absence of blood-borne metastases. Two major staging systems are quite common and the first was developed by the America Joint Committee (AJC) on Cancer Staging, while the second was by the Union Internationale Contre Cancer (UICC). The UICC employs a classification called the TNM system. Normal cells use the sophisticated process of respiration for their cellular energy production, but cancer cells use the primitive process of fermentation. However, no cell in its right conditions would ever use fermentation when there is enough oxygen, especially considering that fermentation does not produce as much energy as respiration, and it also creates toxic by-products. So, fermentation is primitive and wasteful. But, surprisingly, cancer cells use fermentation even when there is plenty of oxygen around. That very observation is the basis of the explanation for the Warburg effect, which is considered to be the metabolic signature of most cancer cells. From the meta-analysis research done on cancer at the University of Cambridge, UK, it was concluded that cancer is a mitochondrial disease and one of the effective ways of managing it is through diets. So, it was concluded from the meta-analysis that cancer growth and progression can be managed through a whole body transition from fermentable metabolites made up of basically glutamine and glucose, to respiratory metabolites made up of majorly ketone bodies.

A Study For: Socio-cultural Environment and the Microinsurance

The poor are much more exposed to the dangers from their surroundings. They live in unhealthy environment where even proper sanitation is not available. Natural calamities like floods, drought, earth quake etc. hit them the hardest. An unfortunate event like Illness or death in the family can change the living standard of the poor for the worse. Cost of medical care being prohibitive, s/he consumes lots of (already diminished) resources from the family. Since they do not have adequate savings, such an episode drives them to either sell their assets or borrow money from local money lenders at high interest rates. According to World Health Organization report (2006), out of total health expenditure in India, 73% happens through out-of pocket spending. This is a very precarious situation as it exposes the poor household to sudden spurt in unplanned and unexpected medical expenses. So, how do we ensure that the poor, or the ‘excluded’ face this ever-threatening risk to their lives and livelihood? Insurance as a concept was introduced in 19th century to do exactly that - protect the poor! But over a period of time, it became a financial tool for the rich. Affordability being one of the prime reasons but exposure and access being other important reason for low penetration in this segment.

Effects of Gluteal Muscle Strengthening Exercise-Based Core Stabilization Training on Pain and Quality of Life in Patients with Chronic Low Back Pain.

Background: The World Health Organization reports that back pain is a major cause of disorder worldwide. It is the most common musculoskeletal disorder with limited pain, muscle tension, and stiffness, and 70-80% of all individuals experience it once in their lifetime, with higher prevalence in women than in men. This study aimed to investigate the effects of gluteal muscle strengthening exercise- based core stabilization training (GSE-based CST) on pain, function, fear-avoidance patterns, and quality of life in patients with chronic back pain. Methods: This study included 34 patients with non-specific chronic low back pain. Seventeen individuals each were included in GSE-based CST and control groups. The GSE-based CST group performed GSE and CST for 15 min, three times a week for four weeks, and the control group performed CST for 30 min a day, three times a week for four weeks. The numeric pain rating scale was used to evaluate pain before and after treatment, Roland-Morris disability questionnaire was used to evaluate function, fear-avoidance beliefs questionnaire was used to evaluate fear-avoidance patterns, and quality of life was measured using the short form-36. Results: In this study, pain, function, and fear-avoidance pattern decreased significantly in both groups (All p < 0.05). During the evaluation of quality of life, both groups showed significant increase in physical and mental factors (p < 0.05). There were significant differences in pain and quality of life (p < 0.05) between the GSE-based CST and control groups. Conclusions: Therefore, GSE-based CST can be used as a basis for effective intervention to enhance pain, function, fear-avoidance patterns, and quality of life, emphasizing the need for gluteal muscle strengthening exercises in patients with non-specific chronic back pain in the future.

Assessment of three antibiotic combination regimens against Gram-negative bacteria causing neonatal sepsis in low- and middle-income countries

Gram-negative bacteria (GNB) are a major cause of neonatal sepsis in low- and middle-income countries (LMICs). Although the World Health Organization (WHO) reports that over 80% of these sepsis deaths could be prevented through improved treatment, the efficacy of the currently recommended first- and second-line treatment regimens for this condition is increasingly affected by high rates of drug resistance. Here we assess three well known antibiotics, fosfomycin, flomoxef and amikacin, in combination as potential antibiotic treatment regimens by investigating the drug resistance and genetic profiles of commonly isolated GNB causing neonatal sepsis in LMICs. The five most prevalent bacterial isolates in the NeoOBS study (NCT03721302) are Klebsiella pneumoniae, Acinetobacter baumannii, E. coli, Serratia marcescens and Enterobacter cloacae complex. Among these isolates, high levels of ESBL and carbapenemase encoding genes are detected along with resistance to ampicillin, gentamicin and cefotaxime, the current WHO recommended empiric regimens. The three new combinations show excellent in vitro activity against ESBL-producing K. pneumoniae and E. coli isolates. Our data should further inform and support the clinical evaluation of these three antibiotic combinations for the treatment of neonatal sepsis in areas with high rates of multidrug-resistant Gram-negative bacteria.

Development in the Inhibition of Dengue Proteases as Drug Targets.

Viral infections continue to increase morbidity and mortality severely. The flavivirus genus has fifty different species, including the dengue, Zika, and West Nile viruses that can infect 40% of individuals globally, who reside in at least a hundred different countries. Dengue, one of the oldest and most dangerous human infections, was initially documented by the Chinese Medical Encyclopedia in the Jin period. It was referred to as "water poison," connected to flying insects, i.e., Aedes aegypti and Aedes albopictus. DENV causes some medical expressions like dengue hemorrhagic fever, acute febrile illness, and dengue shock syndrome. According to the World Health Organization report of 2012, 2500 million people are in danger of contracting dengue fever worldwide. According to a recent study, 96 million of the 390 million dengue infections yearly show some clinical or subclinical severity. There is no antiviral drug or vaccine to treat this severe infection. It can be controlled by getting enough rest, drinking plenty of water, and using painkillers. The first dengue vaccine created by Sanofi, called Dengvaxia, was previously approved by the USFDA in 2019. All four serotypes of the DENV1-4 have shown re-infection in vaccine recipients. However, the usage of Dengvaxia has been constrained by its adverse effects. Different classes of compounds have been reported against DENV, such as nitrogen-containing heterocycles (i.e., imidazole, pyridine, triazoles quinazolines, quinoline, and indole), oxygen-containing heterocycles (i.e., coumarins), and some are mixed heterocyclic compounds of S, N (thiazole, benzothiazine, and thiazolidinediones), and N, O (i.e., oxadiazole). There have been reports of computationally designed compounds to impede the molecular functions of specific structural and non-structural proteins as potential therapeutic targets. This review summarized the current progress in developing dengue protease inhibitors.

Abdominal Injuries Detection

Abstract: Abdominal trauma refers to physical injuries or damage to the abdominal region, which includes the area between the casket and pelvis. This can involve colorful structures within the tummy, similar as the organs (e.g., liver, spleen, bowel, kidney, and extravasation). Traumatic injury affects individualities across all age groups and stands as one of the primary causes of mortality encyclopedically. The World Health Organization reports that nearly 5 million individualities succumb to traumatic injuries annually. The main ideal of an abdominal injuries’ discovery design is to ameliorate the early and accurate identification of abdominal injuries performing from trauma. This design generally involves the development and perpetration of colorful tools, ways, and protocols to achieve the objects like perfecting the delicacy of CT for detecting abdominal trauma and prognosticate the probability of specific traumatic injuries to abdominal organs. Diagnosing abdominal trauma clinically through physical examination, patient symptoms, or laboratory tests can frequently be grueling. thus, timely opinion using medical imaging plays a pivotal part in patient care. Our design will identify whether the case is suffering from abdominal trauma or not and help the cases by informing when immediate surgery is needed. Abdominal trauma discovery generally involves analysis of CT images to prognosticate the probability of specific traumatic injuries to abdominal organs, similar as the bowel, extravasation (generally refers to bleeding from blood vessel), liver.

Influence of metal ions (Me: Fe, Cu, Co, Ni, Mn, Cr) on direct Z-scheme photocatalysts CN/Me-BTC on the degradation efficiency of tetracycline in water environment

BackgroundThe World Health Organization (WHO) reports that antibiotic resistance contributes to approximately 700,000 deaths yearly, with estimate suggesting a rise to 10 million deaths over the next 35 years. MethodsIn this study, direct Z-scheme heterojunction photocatalysts CN/Me-BTC (CN: graphite carbon nitride, Me: metal ions, BTC: benzene-1,3,5-tricarboxylic acid) were successfully synthesized using a hydrothermal combined microwave method, eliminating the need for toxic solvents and featuring a short crystallization time and low reaction temperature. Significant findingsThe study also explores the influence of various metal ions (Fe, Ni, Co, Mn, Cr, and Cu) on the morphological, physicochemical properties, and photocatalytic efficiency of tetracycline (TC) degradation. The CN/Me-BTC photocatalysts exhibit remarkable characteristics, including high visible light absorption, high surface area, low recombination rate between electrons and holes, and fast charge transfer ability.Among the synthesized photocatalysts, CN/FeBTC stands out with the highest efficiency in TC degradation (97.18 %) and degradation rate (decay constant k = 0.0197 min−1), surpassing CN by four times. The study comprehensively investigates factors influencing the TC degradation process, including catalyst mass, pH, antibiotic concentration, participating radicals, anions, and water sources. The mechanism of the photocatalytic process is elucidated based on radical quenching experiments and electrochemical properties.

Modeling spillover dynamics: understanding emerging pathogens of public health concern

The emergence of infectious diseases with pandemic potential is a major public health threat worldwide. The World Health Organization reports that about 60% of emerging infectious diseases are zoonoses, originating from spillover events. Although the mechanisms behind spillover events remain unclear, mathematical modeling offers a way to understand the intricate interactions among pathogens, wildlife, humans, and their shared environment. Aiming at gaining insights into the dynamics of spillover events and the outcome of an eventual disease outbreak in a population, we propose a continuous time stochastic modeling framework. This framework links the dynamics of animal reservoirs and human hosts to simulate cross-species disease transmission. We conduct a thorough analysis of the model followed by numerical experiments that explore various spillover scenarios. The results suggest that although most epidemic outbreaks caused by novel zoonotic pathogens do not persist in the human population, the rising number of spillover events can avoid long-lasting extinction and lead to unexpected large outbreaks. Hence, global efforts to reduce the impacts of emerging diseases should not only address post-emergence outbreak control but also need to prevent pandemics before they are established.

Analyzing the Capacity of the Healthcare System in Gaza to Address Gaza Residents Needs

The present humanitarian crisis in Gaza has resulted in the devastation of medical facilities and health infrastructure. As of January 2024, the World Health Organization reports that 78% of primary care clinics funded by the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA, 2024) have ceased operations, and hospitals’ bed capacity throughout Gaza has decreased by more than 59% (World Health Organization, 2024). Direct military attacks on medical facilities as well as the blockade of medical supplies and humanitarian aid pose the largest obstacles to greater healthcare attainment in Gaza (IRC, 2024). Over the course of the conflict, there has been a surge in the number of people suffering from war injuries, which now totals 71,377 (Shurafa, 2024). The rise in the number of patients who require access to medical services in combination with the limited hospital functionality in the Gaza Strip is putting a massive strain on their already limited healthcare system; before the over 6 month long duration of direct military attacks by the Israeli Defence Forces (IDF) on hospitals in Gaza, data indicated a maximum ratio of 1.55 hospital beds per 1000 individuals across the entire region of the Gaza Strip, while the ratio in the US is around 2.35 hospital beds per 1000 individuals (Taylor, 2024). The already poor living conditions of the demographic–most of whom are housed in temporary structures in severe weather conditions with a lack of access to food and water for sustenance or hygiene–signify a need for a more robust healthcare system. However, triage conditions prioritize treatment of the most severe war injuries, which has forced hospitals to abandon previously established vaccination projects and disease surveillance programs, leaving the remaining population to suffer from preventable diseases such as chickenpox, upper respiratory infections, scabies, and Hepatitis A (Soni, 2024). Individuals who do receive medical care face higher levels of infection due to a lack of adequate sanitation, waste management measures, and basic hygiene supplies (The Economist, 2024).

Impacts of gait freeze on quality of life in Parkinson's disease, from the perspectives of patients and their carers.

The World Health Organisation (WHO) reports that morbidity and mortality due to Parkinson's disease (PD) are increasing faster than for other neurodegenerative conditions. People with Parkinson's (PwP) present with a variety of motor symptoms, such as tremor, bradykinesia, and rigidity. Freezing of gait (FoG) is a significant motor symptom that manifests as temporary episodes of inability to move one's feet, despite the intention to walk. This study examined the impact of FoG on quality of life (QoL) within an Irish cohort of PwP, from the perspectives of both PwP and their carers, using validated questionnaires that had been adapted for online use. PwP and their carers were recruited by outreach to the Irish Parkinson's Community. Anonymous online questionnaires were distributed, which combined a demographic survey with several clinically validated surveys, including Freezing of Gait Questionnaire (FoG-Q), Parkinson's Disease Questionnaire 8 (PDQ-8), and Parkinson's Disease Carer Questionnaire (PDQ-C). There was a strong correlation (p < 0.001) between severity of FoG and lower QoL among PwP. Significant correlation was also found between FoG severity and several motor symptoms, such as postural instability and difficulty with balance, and non-motor symptoms, such as cognitive changes and pain/discomfort. FoG severity correlated with disease progression. Significant correlation was also found between FoG and symptoms, as assessed from the perspective of the patients' carers. This study shows that FoG is a significant detriment to the QoL of PwP, from the perspectives of patients and carers. This method of assessing FoG and QoL using online questionnaires has potential to enhance the reach and flexibility of this type of research. These findings will inform future studies on larger cohorts and highlight unmet clinical needs in PwP.

WHO’s end of TB targets: unachievable by 2035 without addressing under nutrition, forced displacement, and homelessness: trend analysis from 2015 to 2022

Tuberculosis (TB) remains a significant global health challenge, despite the World Health Organization (WHO) actively working towards its eradication through various initiatives and programs. Undernutrition, forced displacement, and homelessness worsen TB’s burden and challenge control efforts; however, there is still no adequate research that shows the trend of these underlying factors to attain the WHO’s ambitious TB targets. So, this study aims to analyze the trend analysis of these underlying factors worldwide from 2015 to 2022 and their impact on the feasibility and implications of reaching the End TB targets by 2035. We utilized international databases, including UNHCR, FAO, and WHO reports, as secondary data sources. Data were extracted chronologically from 2015 to 2022 to illustrate trends in undernutrition, forced displacement, and homelessness on a global level.This trend analysis reveals that undernutrition, forced displacement, and homelessness have worsened over time. Undernutrition rose from 8.4 to 9.8% globally between 2015 and 2021, affecting 22.7 million additional individuals each year. In 2022, undernutrition affected 735 million people globally. Africa (21.9%) and Asia (10.6%) had the highest rates, while Western Europe and North America had lower rates than the global average: 3.4% and 2.5%, respectively.Similarly, the global rate of forced displacement increased from 65.1 million people in 2015 to 108.4 million in 2022, a 21% increase from 2021. This means that an extra 19 million people were displaced in 2021. Globally, homelessness, affecting 1.6 billion people, has worsened over time. Despite being a highly vulnerable group to TB, homeless individuals are often neglected in TB control efforts. Our findings underscore the critical importance of addressing undernutrition, forced displacement, and homelessness in achieving the World Health Organization’s ambitious End TB targets by 2035, as highlighted through trend analysis from 2015 to 2022. Implementing policies focusing on nutrition, stable housing, and the challenges faced by displaced populations is imperative for progress toward a TB-free world.

"I Can’t Exercise Because My Foot Hurts Me Too Much." Does BMI Change after Common Foot and Ankle Surgeries? A Retrospective Review

Introduction/Purpose: The World Health Organization reports that 1.9 billion people worldwide have a body mass index (BMI) that classifies them as being either overweight (BMI &gt; 25) or obese (BMI &gt; 30). Patients often claim, prior to orthopaedic surgery, that their physical activity and exercise is negatively impacted by their orthopaedic condition. Hip and Knee arthroplasty literature has established that patients with high preoperative BMI continue to have high BMI post-operatively, despite also reporting improvements in their joint pain. No such studies exist in foot and ankle surgery. The purpose of this study was to analyze changes in BMI after many common foot and ankle surgeries. Methods: A retrospective review of all patients undergoing bunion correction, flatfoot correction, 1st MTP arthrodesis, and midfoot arthrodesis procedures between November 2018 and December 2022 was conducted in this IRB approved, single center study. BMI data was collected from the electronic medical record for preoperative and 12 months postoperative time points. Descriptive statistics were reported for age, gender, diabetes, A1c for diabetic patients, smoking status, and overall follow up time. Repeated measures of analysis of variation were conducted with one between-groups factor being type of surgery. Results: 196 patients were included in the study. The average age was 62.1 years, 151(76.6%) patients were female. Average BMI amongst all patients preoperatively was 29.58 +/- 5.21, and postoperatively 29.79 +/- 5.33, with an overall average increase in BMI of 0.2182 +/- 2.21. Upon subgroup analysis, all surgical cohorts yielded an increase in postoperative BMI (bunion +0.2489 +/- 2.06, double arthrodesis +0.4767 +/- 1.37, 1st MTP fusion +0.2293 +/- 2.07, midfoot arthrodesis +0.0251 +/- 3.10) although these changes did not reach significance (p value 0.425). There was no significant difference observed in changes in BMI between surgical groups (p value 0.958). BMI outcomes were normally distributed with acceptable equality of error variances (Levene’s test p- values &gt; 0.270). Conclusion: The current statistics surrounding the prevalence of overweight and obesity are staggering. The results of this study demonstrate that elective orthopaedic surgery of common foot and ankle procedures do not facilitate a change in BMI one year postoperatively, despite the goal of reducing chronic pain and increasing physical function, which is often cited as the primary restriction to exercise amongst patient populations. Additional studies are warranted to further elucidate changes in BMI to adequately council patients regarding postoperative expectations. Study Data Summary

An examination of non-wearable methods for fall detection

Amidst the emergence of an aging global population, elderly healthcare has evolved into a pressing societal concern. The World Health Organization reports that approximately 646,000 individuals across the globe succumb to fatal falls annually. Notably, those aged over 60 experience the highest mortality rate, representing the most significant portion of these deaths. Given these stark statistics, there has been a surge of interest in researching fall detection methodologies. This article delves into non-wearable fall detection techniques, emphasizing their various classifications and applications. Initially, we provide an overview of distinct categories within the non-wearable fall detection landscape. Following this, each method is elaborated upon, elucidating its mechanisms and practical applications. To complement this, a brief discourse on prevalent machine learning algorithms employed in fall detection is presented. In culmination, a comparative analysis of each technique is provided, highlighting their respective merits and limitations. The objective is to furnish readers with a holistic perspective on the current state of non-wearable fall detection. As we gaze towards the horizon, it becomes evident that advancing this domain is paramount to safeguarding our elderly and reducing preventable fatalities.

AN OVERVIEW OF CURRENT VACCCINES FOR THE PROPHYLAXIS OF BACTERICAL INFECTIONS

Antibacterial vaccines play a central role in modern medicine by providing an effective approach to combating infectious diseases caused by bacteria. The importance of these vaccines lies in their ability to stimulate the immune system to recognise and neutralise bacterial pathogens, or exotoxins produced by them, thereby preventing, or mitigating the severity of bacterial infections. The development and widespread use of antibacterial vaccines have contributed significantly to reducing the global burden of diseases such as pneumonia, meningitis, and sepsis. Today, the global increase in vaccine-preventable diseases is a worrying trend that is closely linked to the emergence and advocacy of anti-vaccination policies. According to the latest World Health Organisation report, vaccination coverage in Serbia has declined over the past decade, jeopardising the collective immunity and led to recent outbreaks of vaccine-preventable diseases such as whooping cough and measles. Understanding the significance of antibacterial vaccines underscores their importance in promoting individual and community immunity, which ultimately leads to a healthier population and the prevention of antibiotic resistance. This paper summarises the main characteristics of the different types of antibacterial vaccines, such as whole cell vaccines, subunit vaccines and toxoid vaccines, and provides an overview of the types of bacterial antigens contained in vaccines available for mandatory immunisation (vaccines against tuberculosis, diphtheria, tetanus, pertussis, Haemophilus influenzae and pneumoccus) or for non-mandatory immunisation (meningococcal vaccine, typhoid vaccine, cholera vaccine).

Biofilm Production and Porin Permeability Activity in Clinical Isolates of Ciprofloxacin-Resistant Klebsiella pneumoniae in the Tertiary Hospital in Purwokerto, Indonesia

World Health Organization reports that the current use of ciprofloxacin as a broad-spectrum antibiotic shows a pattern of high bacterial resistance in many countries. Klebsiella pneumoniae is known as a Gram-negative bacterium that most often causes infection and is resistant to antibiotics. This study aimed to find patterns of resistance mechanisms based on biofilm production and porin permeability activity in K. pneumoniae clinical specimens from patients at RSUD Prof. Dr Margono Soekardjo Purwokerto, Indonesia. Several isolates of ciprofloxacin-resistant K. pneumoniae were isolated from clinical specimens of blood, sputum, urine, pus, stool and pleural fluid from August to October 2022. Identification and sensitivity testing of K. pneumoniae to ciprofloxacin were performed using Vitek® 2 Compact. A test for biofilm production is carried out by measuring optical density (OD) with a microplate at a wavelength of 630 nm. The porin permeability activity was determined using the value of the minimum inhibitory concentration (MIC) by the LC-MS spectrophotometry method at a wavelength of 630 nm. The results showed that 72 (47 %) isolates were resistant to ciprofloxacin. Among them, 41.3 % (24/58) of ciprofloxacin-resistant K. pneumoniae were able to produce strong biofilm. Porin permeability is indicated by MIC values of 1, 2 and 4 mg/L with bacterial cell counts of 32×106, 19×106 and 34×106 CFU/mL, respectively. This number decreased from the initial control with a bacterial cell count of 10.15×107 CFU/mL. Analysis of the correlation between the significance of biofilm production and the number of bacterial cells indicated that biofilm formation was related to the number of bacterial cells (R = 0.628, p ≤ 0.05). In conclusion, the resistance mechanism of ciprofloxacin-resistant K. pneumoniae involves biofilm production and decreased porin permeability activity. HIGHLIGHTS Major resistance mechanisms in pneumoniae decreased cell permeability from porin activity and biofilm formation Bacterial outer membrane permeability to antimicrobial substances influences inherent resistance. Bacteria produce biofilm to increase their resistance to antibiotics. Porins are non-specific diffusion transport proteins that play a part in the antibiotic resistance process The evolutionary development in the case of antibiotic resistance has an impact on the emergence of understanding in new perspective patterns on how to overcome health problems related to antibiotic resistance GRAPHICAL ABSTRACT

Environmental and health impacts of air pollution: A mini-review

Air pollution is one of the leading risk factors for death but also a significant contributor to the global disease burden, affecting quality of life. According to a World Health Organisation (WHO) report, seven million people die from air pollution every year, and 9 out of 10 people worldwide breathe polluted air. Any person can be affected by exposure to polluted air, especially the elderly, children, pregnant women, and people with comorbidities. Some studies indicate that the diseases most affected by air pollution are respiratory infections, chronic obstructive pulmonary disease (COPD), lung cancer, and cardiovascular diseases. The degree of effect on the body depends on the pollutant composition, source and dose, level and duration of exposure to polluted air. Particulate matter (PM10 and PM2.5), carbon monoxide (CO), ozone (O3), nitrogen dioxide (NO2), and sulphur dioxide (SO2) could lead to air pollution. Long-term exposure to air pollution can affect every organ in the body and worsen existing health conditions. Short-term exposure to contaminants can include unpleasant sensations such as coughing, wheezing, shortness of breath, eye, nose, and throat irritation, headache, dizziness, and fatigue. Community and individual solutions such as using clean fuel, wearing personal masks, filtering indoor air, and ventilating need to be taken to reduce the impact of air pollution.