WHO Director-General Research Articles

Physical Activity in Mild Vascular Cognitive Impairment: Results of the AFIVASC Randomized Controlled Trial at 6 Months.

Vascular cognitive impairment is frequent, in mild (mVCI) or severe forms (vascular dementia). To do a randomized controlled-trial to evaluate the impact of physical activity on cognition (primary outcome), neurocognitive measures, quality of life, functional status, and physical function (secondary outcomes), in patients with mVCI. A hundred and four patients with mVCI (mean age 71.2 years; 53 women) were randomized for a six-month intervention of moderate physical activity (60-minute sessions, 3 times/week) (n = 53) or best-practice "usual care" (n = 51). Comprehensive evaluations of primary and secondary outcomes included an objective measure of physical activity through accelerometry at baseline and after intervention. Mean session attendance was 58%. Adverse events were negligible. After 6 months, no significant primary outcome change was observed, either in the intervention or 'usual care' group. The intervention group improved significantly in some secondary outcomes in physical function - aerobic capacity (U = 403; p = 0.000) and agility (U = 453; p = 0.005) after 6 months. Regardless of randomization arm, a post-hoc analysis based on fulfilling at least 21.5 minutes/day of moderate or 10.7 minutes/day of vigorous physical activity (World Health Organization-WHO standards) revealed improvements. These were not only in motor capacity but also on the global measure of cognition, executive functions and memory. Physical activity was safe and beneficial regarding domains of physical function. No significant cognitive decline was registered over 6-months, regardless of intervention allocation. Larger samples, longer follow-ups and focus on intervention adherence are needed to fully analyze the impact of WHO recommendations for physical activity in mVCI populations.

Mesenchymal Non-Meningothelial Tumors of the CNS: Evolving Molecular Landscape and Implications for Neuroradiologists.

The World Health Organization Classification of Tumors of the Central Nervous System (WHO CNS5) significantly revised the terminology and diagnostic criteria of "mesenchymal non-meningothelial" tumors of CNS to better align with the classification of these soft tissue tumors outside the CNS. The CNS chapter only covers the entities with distinct histological or molecular characteristics that occur exclusively or primarily in the CNS. These tumors usually arise from the meninges and are rarely intraparenchymal in origin, mainly in the supratentorial compartment. These tumors are grouped into three main categories: soft tissue, chondro-osseous, and notochordal. Soft tissue tumors, the largest group, are further divided into fibroblastic, vascular, and skeletal muscle subtypes. Notably, a new subcategory for "tumors of uncertain differentiation" has been introduced, encompassing three new histomolecular entities: FET::CREB fusion-positive, CIC-rearranged sarcoma, and primary intracranial sarcoma, DICER1-mutant. Emerging entities like dural angioleiomyomas and spindle cell neoplasms with NTRK-rearrangements have been reviewed, although not introduced in WHO CNS5. Given the often non-specific histology and immunophenotype of mesenchymal nonmeningothelial tumors of uncertain differentiation, molecular techniques have become indispensable for accurate diagnosis. This review provides a comprehensive overview of primary mesenchymal non-meningothelial CNS tumors, including their clinical, radiological, histopathological, and molecular characteristics and treatment strategies.ABBREVIATIONS: ALK: Anaplastic lymphoma kinase; ATF1: activating transcriptase factor-1; CREB: cAMP response element-binding protein; CREM: cAMP response element modulator; CIC: Capicua transcriptional receptor; EWSR1: Ewing sarcoma RNA binding protein; FUS: fused in sarcoma; NAB2: nerve growth factor-inducible protein A binding protein 2; STAT6: signal transducer and activator of transcription 6; WHO: World Health Organization WHO CNS5: World Health Organization Classification of Tumors of the Central Nervous System, fifth edition.

Sub-grid Variability and its Impact on Exposure in Regional Scale Air Quality and Integrated Assessment Models: Application of the uEMEP Downscaling Model

Regional scale air quality and integrated assessment models are necessarily limited in their spatial resolution, particularly when applied to larger regions such as Europe or for global applications. The EMEP MSC-W chemical transport model and the GAINS integrated assessment model, which makes use of source receptor information precalculated by the EMEP MSC-W model, use resolutions of 0.1°×0.1° and 0.3°×0.2°. These resolutions cannot account for variability at finer scales. Variability within grids, both concentration and population distributions, can be significant. To improve exposure calculations that take into account the sub-grid variability, the uEMEP model has been applied in this study to provide suitable parameterisations of the sub-grid variability within an EMEP MSC-W grid. The uEMEP model is applied on a European domain at 250 × 250 m2. This provides roughly 7000 sub-grids within each EMEP MSC-W 0.3°×0.2° grid to analyse the sub-grid variability in exposure. The analysis derives an exposure correction factor (ECF) for each source sector in each EMEP MSC-W grid. This factor provides information on the impact of sub-grid resolution on the population weighted concentrations within each grid. The population weighted standard deviation is also calculated, providing information on sub-grid variability to derive frequency distributions and parameterised forms of the sub-grid variability suitable for health risk assessments. The impact of sub-grid variability is assessed for the pollutants PM2.5, NOX and NO2. For NO2, additional chemistry calculations are carried out on the NOX frequency distributions. We show that the parameterised form of the sub-grid variability provides close to equivalent results as the original uEMEP calculations. Exposure to PM2.5 increases by around 13% when the sub-grid variability is taken into account for a 2030 emission scenario. For NO2, this increase is around 31% for the same scenario. A similar increase is found in the health risk indicator ’population attributable fraction’ when no lower concentration threshold is used in the concentration–response function. When applying the World Health Organizations recommended threshold value we find that including the sub-grid variability increases the calculated population attributable fraction by 32% and 46% for PM2.5 and NO2 respectively. We conclude that sub-grid variability should be taken into account in future exposure calculations for regional scale modelling and impact assessments.

Association of Urinary Mycotoxins with Sperm Quality: A Case-Control Study in Southern Nigeria.

The objective of this study was to determine the association between mycotoxins and the quality of spermatozoa in Nigeria. We designed a prospective case-control study involving 136 men diagnosed with reduced sperm count and quality in five infertility clinics in southwest Nigeria and 154 normal fertile controls. Sperm analysis was conducted in accordance with the recommendations of the World Health OrganizationWHO, while Liquid Chromatography-Mass Spectrometry was used to assay three metabolites of mycotoxins (zearalenone, ochratoxin A, and deoxyvinelol) in the urine samples of cases and controls. The data were analysed with descriptive statistics and non-parametric linear regression. The results showed no overall significant difference in levels of these metabolites between the cases and control groups. In contrast, higher levels of zearalenone and ochratoxin A significantly decreased sperm motility in the cases. Similarly, an increase in the level of ochratoxin A decreased sperm morphology in the unadjusted model in the cases. We conclude that exposure to mycotoxins reduces the quality of spermatozoa (motility and morphology) in Nigerian men but may have no effect on sperm count. Efforts to reduce the exposure of men to mycotoxins are important interventions to improve sperm quality and reduce the prevalence of male infertility in the country.

Cardiovascular disease mortality and air pollution in countries with different socioeconomic status.

Cardiovascular diseases (CVDs) account for 17.9 million deaths annually. Behavioral risk factors increase the risk of dying fromCVD. Air pollution is not included in this risk calculation since the appreciation of air pollution as a modifiable risk factor is still limited. The purpose of this study was to analyze CVD mortality attributed to air pollution in all World Health OrganizationWHO member states and demonstrate the association of CVD mortality with air pollution depending on countries'income level. The CVD death rate was calculated by dividing the number of deaths by the total population. The proportion of the population with primary reliance on clean fuels and technologies for cooking was calculated as an indicator of household air pollution. The annual mean concentration of fine particulate matter ≤2.5 µg/m3and ≤10.0 µg/m3to which the population is exposed was used as an indicator of ambient air pollution. There is a gradual increase in CVD mortality attributed to air pollution from high-income countries (HICs) to low-income countries (LICs). Household air pollution is the major cause of CVD mortality in LICs. Ischemic heart disease mortality attributed to ambient air pollution in all countries is higher than stroke mortality attributed to ambient air pollution. In LIC, mortality from stroke is attributed to household air pollution of 39.27 ± 14.47, which is more than twice the stroke mortality attributed to ambient air pollution at 18.60 ± 5.64, t = 7.17, p < 0.01. Air pollution control should be an essential component of the CVD preventive strategy, along with lifestyle modifications and effective disease management.

Importance of World AIDS Day

HIVAIDS is not just a pandemic disease but a prosodemic disease. HIVAIDS had rapidly spread reaching every village of the world neither wind nor water has a role in spreading the disease. The first World Health Assembly WHA met in 1948 at Geneva. Members of the assembly agreed that people all over the world suffered due to World War. Members discussed global health issues and felt the need for medical facility to serve everyone when in need. Hence WHA stressed the importance of awareness of good health and wellbeing. To achieve this awareness about global health all the members of World Health Organization WHO should devote one day to talk about good health and wellbeing and also should provide necessary medical help. Government organizations and non-governmental organizations of all the nations joined hands with WHO. WHO decided to observe ldquoWorld Health Day WHDrdquo every year all over the world. The first WHD was observed on April 7 1950. Mahatma Gandhi Father of our Nation deeply sympathized towards leprosy patients in India. On 30th January 1948 Mahatma Gandhi was assassinated. Government of India decided to observe ldquoMartyrs day 30th January 1948rdquo as ldquoAnti-Leprosy Day in Indiardquo. Every year in India January 30th is observed as anti-leprosy day and during the entire January month survey of all villages is conducted to detect leprosy cases school health programs and leprosy awareness programs for common man are also conducted. In 1954 French journalist Raoul Follereau noticed the success of anti-leprosy awareness activities in India and wanted WHA to observe last Sunday of January as World Leprosy Day WLD. Since 1954 every year Last Sunday of January is observed as lsquoWorld Leprosy Dayrsquo. In 1982 24th March was observed as ldquoWorld Tuberculosis Day WTDrdquo. Dr. Jonathan Mann in 1988 made WHA to devote one day in a year to remember the increasing menace of HIVAIDS. WHA decided to observe 1st of December as ldquoWorld AIDS Day WADrdquo. In 1991 ldquoWorld Diabetes Day WDDrdquo was observed on November 14th. In 1992 December 3rd was observed as ldquoWorld Disability Day WDDrdquo. In 2007 April 25th was observed as ldquoWorld Malaria Day WMDrdquo.

Knowledge and Awareness of Needle Stick Injuries among Dental Healthcare Providers

Background and Aims Needle stick injuries NSI or accidental needle cuts are very common among healthcare providers. These occupational accidents could be a gateway to serious and potentially lethal infectious diseases. According to World Health Organization WHO healthcare workers HCW experience an average of 1-9 needle cuts per year. However in many instances these incidents go unreported or overlooked by healthcare providers leading to serious health hazard. Hence the present study was conducted to quantify the approach and assess the knowledge and awareness of accidental needle cuts among the dental healthcare providers of our institution.Methodology A cross-sectional observational study was conducted amongst healthcare providers at a dental college. A predesigned three segment questionnaire which assessed knowledge and awareness about accidental needle cuts and its management was the tool for data collection. The data collected were tabulated analyzed statistically and results were calculated based on frequency and percentages using SPSS.Results Among the total 160 participants overall knowledge scores revealed high knowledge of which dental faculties and postgraduate students demonstrated the highest knowledge scores mean score 14.9. The knowledge regarding accidental needle cuts 87.7 was more compared to post exposure protocol 86.2 and disposal of sharps 79.8.Conclusion Our study revealed that dental healthcare providers in the institution were more knowledgeable about the accidental needle cuts and use of preventive measures compared to the disposal of sharps.

Eudemonia of People Living with HIV at an Anti-Retroviral Therapy Center, Ron, Gadag District - A Mixed Method Feasibility Study

Background In the realm of health and wellbeing the cursed part is the illness. Times elapsed health problems and challenges evolved constantly. In 1980s the first case of HIV Human Immunodeficiency Virus was reported and according to World Health Organization WHO 36.9 million people worldwide are living with HIVAIDS Acquired Immunodeficiency Syndrome.Aim This study aimed to explore the meaning of lived experiences of people living with HIV PLHIV and evaluate the effectiveness of health interventions on the state of health of PLHIV at an Anti-retroviral therapy ART center Ron Gadag District.Methods A sequential exploratory mixed-method study was conducted from August 2022 to September 2022. The qualitative strand with five samples explored lived experiences of PLHIV to develop health related counselling programme and quantitative strand with 14 samples tested the health-related counselling programme developed based on the data extracted from qualitative strand leading to first level integration in addition to administration of oral zinc 20 mgday for one month. Qualitative data analysis was done using QDA Miner lite version 3.0 and quantitative data analysis was done using IBM SPSS version 29.0 followed by mixing of data by integrated analysis.Results After qualitative analysis six themes and twenty-one sub-themes were derived in development of phenomenology. After quantitative analysis H1 amp H2 were accepted as P value obtained was 0.001 for df - 01 at 5 level of significance. The integrated analysis showed that findings from both the strands complemented supported and synergized the state of eudemonia among PLHIV.Conclusion The study concluded that administration of oral zinc supplementation and regular health related counselling sessions are effective strategies in maintaining eudemonia of people living with HIV amp AIDS.

The interpretation of COVID-19 in cause-of-death statistics: a matter of causality.

Mortality is an important indicator for estimating the impact of the COVID-19 pandemic. However, different registrations provide different figures and the question is how to interpret the number of COVID-19 deaths reported. To study the role of COVID-19 in dying in order to explain the representation of COVID-19 in cause-of-death statistics. Analysis of all death certificates mentioning COVID-19 in the Dutch cause-of-death registry during the pandemic (n=51,181). The role of COVID-19 as cause of death was studied by the way it was reported on death certificates. A calculation of odds ratios was performed for studying associations between COVID-19 and other reported causes of death. In 24% of the cases COVID-19 was the only cause of death mentioned on a death certificate. In 76% of the cases, one or more other diseases played a role in dying. Three patterns emerged: COVID-19 associated with 1. neurodegenerative disorders, 2. chronic respiratory disorders, and 3. metabolic disorders. Of all death certificates mentioning the diseases, COVID-19 was the start of the causal chain leading to death in 45.2% of the cases, while COVID-19 was selected for cause-of-death statistics by special World Health Organization WHO instructions in 93.9% of the cases. Cause-of-death statistics overestimate the role of COVID-19 as underlying cause of death. In a majority of the deceased cases, there is an association of COVID-19 with other diseases not captured by cause-of-death statistics reporting (only) one cause of death per deceased. A multi-causal approach is needed to evaluate the pandemic and inform health policy.

Comparison of efficacy between levonorgestrel intrauterine system and dienogest in adenomyosis: a randomized clinical trial.

Medical management of adenomyosis is an emerging perspective in modern gynecology. Though levonorgestrel intrauterine system (LNG-IUS) and dienogest (DNG) effectively relieve symptoms in adenomyosis, neither has been approved for the same indication. Our study aims to compare the efficacy and safety of these progestins in treating adenomyosis. To study the efficacy and safety of LNG-IUS versus DNG in patients with symptomatic adenomyosis. Open-labeled, parallel, single-centered, randomized clinical trial. Patients with adenomyosis-associated pain with or without abnormal uterine bleeding were randomly allocated to either LNG-IUS group or DNG group. The primary outcome was a reduction in painful symptoms after 12 weeks of treatment measured by visual analog scale (VAS) score. Changes in menstrual blood loss (MBL), improvement in quality of life (QoL), and adverse drug reactions were also analyzed. The VAS score significantly decreased from baseline in both groups. The baseline and post-treatment VAS scores in the LNG-IUS group were 6.41 ± 1.07 and 3.41 ± 1.04 (p = <0.001) and in the DNG group, were 6.41 ± 0.95 and 3.12 ± 1.40 (p = <0.001), respectively. A significantly greater proportion of patients in the LNG-IUS group experienced lighter MBL as compared to the DNG group [27/30 (90%) in the LNG-IUS group versus 17/22 (77.2%) in the DNG group (p = 0.006)]. Both the groups had improvement in QOL scores calculated by the World Heath Organisation QOL scale (WHOQOL BREF) questionnaire; however, it was more pronounced in the DNG group [(28.76 ± 30.47 in the LNG-IUS group versus 48.26 ± 44.91 in the DNG group (p = 0.04)]. Both the agents were safe as there were no reported major adverse drug reactions. DNG can be an effective and safe alternative to LNG-IUS for the medical management of adenomyosis. The trial was prospectively registered at the clinical trial registry - India (CTRI) vide CTRI number CTRI/2020/05/025186.

Levels of physical activity and sedentary behaviors in different universities of Bogotá

Abstract The global recommendations for physical activity (PA) advised by the World Health Organization WHO (2012) are 150 minutes of moderate intensity (at least 600 MET-min/week) or 75 minutes of vigorous intensity per week (at least 3000 MET-min/week). The objective were determine the levels of PA and sedentary behaviors (SB) in people at different universities in Bogotá (students, administrative personal). The dimensions IPAQ was applied (PA in the transportation PAT, PA in Leisure Time PALT and auto evaluation of sedentary behaviors ASB). Study was descriptive, correlational, with simple random sampling. The project had ethics considerations aproved by Ethic Comitee of Libre University. The data were analyzed with Rversion 4.2.3. Results were n = 717 distributed in 442 (61.6%) women and 275 (38.4%) men. 100 men (36.4%) with 120.9 ± 185.9 MET-min/week and 161 women (36.4%) with 313.9 ± 198.8 MET-min/week did not fulfill PAT recommendations. 109 men (36.5%) with 193.6 ± 217.0 MET-min/week and 141 women (31.9%) with 186.4 ± 194.5 MET-min/week did not fulfill PALT recommendations. 75 men (27.3%) report sedentary time (ASB) greater than 2 hour/day (2311.2 min/week ± 1487.7) and 104 women (23.5%) report 2255.1 min/week (±1316.4). Instead, people fewer than 2 hours were 200 men (72.7%) with 323.6 min/week (±320.7) and 338 women (76.5%) with 312.4 min/week (±308.8). Statistical tests for association were applied for the variables PAT and PALT which did not have significant statistical differences but between PALT and ASB were found significant statistical differences (p-value &amp;lt; 2.2e–16, CI 1032.740–1608.664), so they were related. Universities must promote and maintain recommended PA levels through strengthening programs and infrastructure oriented to PA in population, especially promoting forms of transportation such as bicycles and different forms of active leisure time differentiated between genders. However, sedentary times are a threat to health, due to its great increase in this population. Key messages • The global recommendations for physical activity (PAG) recommended by the WHO (2012) is 150 minutes of moderate intensity or 75 minutes of vigorous intensity per week.

Genomic, phenotypic and demographic characterization of Mycobacterium tuberculosis in Israel in 2021.

According to World Health Organization WHO, Tuberculosis (TB) is the second cause of death from infectious disease worldwide. During 2021, 10.6 million people were infected with TB, and 1.6 million people died. TB is caused by pathogens belonging to the Mycobacterium tuberculosis complex (MTBC), mainly by Mycobacterium tuberculosis (M.tb). Members of this complex are acid-fast bacilli, which can cause intrapulmonary and extra pulmonary TB, and can be divided into various lineages, based on genomic markers. The main public health threat comes from drug resistant M.tb strains, which are responsible for about 25% of TB death and treatment failure worldwide. Treating drug resistant TB patients significantly raises the costs of TB treatment. This study provides an overview of the demographic and drug susceptibility characteristics of newly diagnosed TB patients in Israel in 2021. The State of Israel has a very low level of TB endemicity and is at a pre-elimination phase. Notably, only 11.7% of the newly diagnosed TB patients were born in Israel. In this report, of the 154 new laboratory-confirmed TB patients, 66.7% had pulmonary TB, while 16% had extrapulmonary TB. Males accounted for 52% of the patients, with the most prevalent age group being 21-40. Most patients were citizens of Israel (53.9%), while 37.7% had no Israeli citizenship. Among non-citizens, there was a predominance of males and patients aged 21-40. The susceptibility profile showed a high resistance rate to streptomycin (18.2%) and to a lower extent to isoniazid (13.6%), pyrazinamide (8.4%), rifampicin (7.8%), and ethambutol (3.2%). Only 2 cases of XDR-TB and 10 MDR-TB strains were detected in Israel in 2021, with both XDR strains and 5 out of 10 MDR strains belonging to the Beijing lineage. Most of Beijing isolates were resistant to at least one tested drug. Genomic sequencing of 134 out of 156 strains and bioinformatics analysis using the MTBseq program and WHO mutation catalogue shows a good match with only 9 discrepancies between phenotypic and genotypic susceptibility profiles in first line drugs. The most common lineage is Delhi-Cas (23%) followed by the Beijing lineage (17%). Most patients from the Delhi-Cas lineage were born in Africa, while patients with Beijing isolates were born in different countries. Minimum spanning tree analysis identified 15 clusters. The study highlights the need for ongoing surveillance of TB using molecular and phenotypic tools to further decreasing the spreading level of the disease and develop effective treatment strategies.

Multimodel habitats constructed by perfusion and/or diffusion MRI predict isocitrate dehydrogenase mutation status and prognosis in high-grade gliomas

To determine whether tumour vascular and cellular heterogeneity of high-grade glioma (HGG) is predictive of isocitrate dehydrogenase (IDH) mutation status and overall survival (OS) by using tumour habitat-based analysis constructed by perfusion and/or diffusion magnetic resonance imaging (MRI). Seventy-eight HGG patients that met the 2021 World Health Organization WHO Classification of Tumors of the Central Nervous System, 5th edition (WHO CNS5), were enrolled to predict IDH mutation status, of which 32 grade 4 patients with unmethylated O6-methylguanine-DNA methyltransferase (MGMT) promoter were enrolled for prognostic analysis. The deep-learning-based model nnU-Net and K-means clustering algorithm were applied to construct the Traditional Habitat, Vascular Habitat (VH), Cellular Density Habitat (DH), and their Combined Habitat (CH). Quantitative parameters were extracted and compared between IDH-mutant and IDH-wild-type patients, respectively, and the prediction potential was evaluated by receiver operating characteristic (ROC) curve analysis. OS was analysed using Kaplan-Meier survival analysis and the log-rank test. Compared with IDH-mutants, median relative cerebral blood volume (rCBVmedian) values in the whole enhancing tumour (WET), VH1, VH3, CH1-4 habitats were significantly increased in IDH-wild-type HGGs (all p<0.05). Additionally, the accuracy of rCBVmedian values in CH1 outperformed other habitats in identifying IDH mutation status (p<0.001) at a cut-off value of 4.83 with AUC of 0.815. Kaplan-Meier survival analysis highlighted significant differences in OS between the populations dichotomised by the median of rCBVmedian in WET, VH1, CH1-3 habitats (all p<0.05). The habitat imaging technique may improve the accuracy of predicting IDH mutation status and prognosis, and even provide a new direction for subsequent personalised precision treatment.

EVALUATION OF THE EFFECTS OF HEAVY METALS ON WATER FROM ILLEGAL CRUDE OIL REFINERIES: A CASE STUDY OF THREE SELECTED COMMUNITIES IN THE NIGER DELTA REGION, NIGERIA

In order to assess the levels of heavy metals and health concerns associated with the operations of illicit refineries in water, 15 surface water samples were taken from Okerenkoko, Peterou-Gbene, and Bille in the Niger Delta region of Nigeria. A number of heavy metal indices, including the Contamination Factor (Cf), Pollution Load Index (PLI), Modified Degree of Contamination (mCd), Ecological Risk Factor (Erf), and Geo Accumulation Index (Igeo), were successfully applied in the evaluation of heavy metal contamination in surface water using World Health Organization WHO (2011) and Nigerian Standard for Water Quality NSDWQ (2007) standards. Additional research from WHO and NSDWQ comparisons revealed that the majority of the investigated heavy metals were higher than permissble limits in comparison to the control site. Although the concentration of heavy metals in the aquatic habitats varies amongst the various communities in the area, according to the CV. Additionally, CV contends that there is a connection between the illicit refiners’ actions at the study site and the water chemistry changes that result in surface water contamination. According to data from the WHO and the NSDWQ, the majority of heavy metal concentration readings in the study sites exceeded the acceptable limits when compared to those in the control site. According to the results of heavy metals indices such as Cf and PLI, the surface water in the analyzed site ranges from very slightly contaminated to extremely contaminated. However, Erf and Igeo findings showed that human activities through illegal refiners increase heavy metal concentration, which results in a very high potential ecological risk associated with surface water. Additional mCd results demonstrated that in the studied sites, the surface water has a high degree of contamination. The findings suggest that surface water assessment is required to warn against a decline in water quality in the area.

A Retrospective Genomic Landscape of 661 Young Adult Glioblastomas Diagnosed Using 2016 WHO Guidelines for Central Nervous System Tumors.

The authors present a cohort of 661 young adult glioblastomas diagnosed using 2016 WHO World Health Organization Classification of Tumors of the Central Nervous System, utilizing comprehensive genomic profiling (CGP) to explore their genomic landscape and assess their relationship to currently defined disease entities. This analysis explored variants with evidence of pathogenic function, common copy number variants (CNVs), and several novel fusion events not described in literature. Tumor mutational burden (TMB) mutational signatures, anatomic location, and tumor recurrence are further explored. Using data collected from CGP, unsupervised machine-learning techniques were leveraged to identify 10 genomic classes in previously assigned young adult glioblastomas. The authors relate these molecular classes to current World Health Organization guidelines and reference current literature to give therapeutic and prognostic descriptions where possible.

Why are surgical never events still occurring: A Delphi study research sample across NHS England operating theatres

This paper examines the application of the Surgical Safety Checklist (SSC) within NHS hospital operating theatres England. The aim of the study, through a combination of open-ended questions, was to solicit specific information including views and opinions from operating theatre experts to establish from how the World Health Organisations (WHO) SSC is being applied, and therefore and why intraoperative ‘Never Events’ continue to occur more than a decade after the SSC was introduced. Participants were from the seven regions identified by NHS England.The intention of this paper is not to establish definitively whether the quantitatively identified themes; including a lack of training and engagement with human factors explains the increased presence of intraoperative ‘Never Events’. However, these themes, when subjected to methodological triangulation with the current literature, do appear consistent, and therefore provide an exploratory approach to inform research intended to improve safety in the operating theatre by informing policy and its application to safe practice ultimately towards quality improvements.

Expert meeting on noncommunicable disease prevention and control: learning from the arts. World Health Organization (Who). Regional Office for Europe

Muchos factores que afectan nuestra salud y bienestar son sociales, culturales, políticos, psicológicos o económicos. En las últimas dos décadas, ha habido un gran aumento en la investigación sobre el efecto de las artes en la salud y el bienestar. La evidencia indica que las intervenciones artísticas desempeñan un papel importante en la prevención, la promoción de la salud y el tratamiento de las enfermedades no transmisibles a lo largo de la vida. Estas evidencias fueron recogidas por la Organización Mundial de la Salud, en su informe, What is the evidence on the role of the arts in improving health and well-being? A scoping review, publicado en diciembre del 2019, y que sin duda representó un avance y respaldo para todos aquellos que venimos trabajando desde años en este ámbito del arte y la salud. Tres años después de la publicación de este informe, de nuevo la Organización Mundial de la Salud, en concreto la WHO European Office for Prevention and Control of NCDs y el programa europeo de la WHO, Behavioural and cultural insights convocan esta reunión de expertos, entendiendo este encuentro como una plataforma multidisciplinar para compartir experiencias a nivel regional y nacional, estudios de casos concretos, buenas prácticas y políticas cros-sectoriales que tienen un especial potencial para el desarrollo de las artes como estrategia y herramienta válida para la salud.

Countering antibiotic resistance: a new course of action is needed.

Antibiotic resistance does not seem to be stopping despite international policies that have been aiming to combat this phenomenon for more than 10 years. The World health organization (Who) seeing the relentless growth of the issue has reiterated its recommendations that have been implemented at the national level. In fact, in Italy the new National plan against antibiotic-resistance 2022-2025 (Pncar 2022-2025) is in full operation. At Asl Napoli 3 Sud, which boasts a population of more than 1 million people, an analysis was carried out regarding antibiotic consumption in the first six months of 2022. The results showed consumption deviating from the regional and national average, thus suggesting that swift actions are needed to curb overprescription by physicians as much as possible. This work also aims to raise awareness among physicians and health care professionals of compliance with the requirements of regulatory agencies and scientific societies, so that a virtuous path toward a decisive change of pace can be taken.

Design, Synthesis and In Vitro Studies of 3-Amidocoumarins as Novel Antibiofilm Agents

Pseudomonas aeruginosa, a life-threatening bacteria listed as a priority pathogen by World Health Organization WHO, is known to cause severe nosocomial infections and fatality in immunocompromised individuals through its quorum sensing (QS) mediated biofilm formation. P. aeruginosa’s antibiotic-resistant biofilms are highly challenging to the existing antibiotic treatment options. There is an urgent clinical need to develop novel alternative therapeutic molecules such as antibiofilm and antiquorum sensing agents to counter the emergence of an unprecedented pace of antibiotic resistance of pathogens. In this context, a library of seventy 3-amidocoumarin derivatives was designed, and docking studies were performed against the P. aeruginosa LasR receptor using AutoDock 4.0. Based on docking results, a final series of sixteen 3-amidocoumarin derivatives (4a–p) were synthesized and evaluated for antibiofilm activity in vitro. Eight compounds significantly inhibited the formation of P. aeruginosa PAO1 biofilm. Compounds 4f, 4l and 4o showed maximum % inhibition in antibiotic-resistant P. aeruginosa PAO1 biofilm formation in the range of 80% to 86%. Further, the structure–activity relationship (SAR) studies revealed that the presence of electron-donating and bromo substituents at benzamido and coumarin moieties, respectively, effectively enhances the antibiofilm activity. In addition, the binding interactions between the synthesized compounds and active sites of the LasR QS receptor (Protein Data Bank Code: 2uv0) in P. aeruginosa were also investigated by molecular docking. The high binding affinities indicate that these compounds might be suitable for development into potent inhibitors of QS and biofilm disruptors.

A thermostable, dry formulation inactivated Hikojima whole cell/cholera toxin B subunit oral cholera vaccine

The feared diarrheal disease cholera remains an important global health problem. Use of oral cholera vaccine (OCV) from a global stockpile against both epidemic and endemic cholera is a cornerstone in the World Health Organisations (WHOs) global program for “Ending cholera by 2030”. Three liquid inactivated whole-cell OCVs (Dukoral®, ShancholTM, and Euvichol-Plus®) are WHO prequalified and have proved to be safe and effective. However, their multicomponent composition and cold-chain requirement increase manufacturing, storage and transport costs. ShancholTM and Euvichol-Plus® OCVs used in WHOs global vaccine stockpile also lack the protective cholera toxin B-subunit (CTB) antigen present in Dukoral®, which results in suboptimal efficacy.WHOs Global Task Force on Cholera Control (GTFCC) has identified a thermostable, dry formulation vaccine as a priority for further OCV development. We describe here the development of such a vaccine, based on a lyophilized mixture of a single strain of formalin-killed Hikojima bacteria together with a low-cost, recombinantly produced CTB. The new vaccine, which is easy and inexpensive to manufacture, could be stored for at least 26 months at 25 °C and for at least 8 months at 40 °C with preservation of cell morphology and with no loss of protective Ogawa and Inaba lipopolysaccharides or CTB. It also proved to be well tolerated and to have equivalent oral immunogenicity in mice as ShancholTM and Dukoral® OCVs with regard to both serum and intestinal-mucosal antibody responses.