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Background: Medial knee osteoarthritis (OA) is a common health problem resulting in knee pain and limiting patients' physical activity. After failed conservative treatment, unicompartmental knee arthroplasty (UKA) and high tibial osteotomy (HTO) are possible surgical treatment options for this condition. There is a paucity of high-quality evidence in the literature comparing objective and subjective outcomes of these procedures. Also, there is no common agreement on whether these procedures provide comparable results in late-stage medial knee OA patients., Methods: We will perform a prospective randomized controlled trial comparing HTO and UKA in patients with late-stage medial knee OA. 100 patients with isolated medial knee OA (KL III-IV) are assigned to either UKA (n = 50) or HTO (n = 50) procedure in patients 45-65 years of age. Our primary outcome will be KOOS 5 at one year postoperatively. Secondary outcomes include OARSI physical assessment, length of stay, wearable activity watch, radiographs (OA progression according to Kellgren-Lawrence classification), patient-reported outcomes (KOOS subscales, pain visual analog scale [VAS], Lysholm, and Oxford knee scores), and adverse events (conversion to total knee arthroplasty, surgery-related complications, need for revision surgery) outcomes. Our hypothesis is that neither of the interventions is superior as measured with KOOS 5 at 12 months., Ethics and Dissemination: The institutional review board of the Helsinki and Uusimaa Hospital District has approved the protocol. We will disseminate the findings through peer-reviewed publications., Trial Registration: ClinicalTrials.gov/TooloH NCT05442242. Registered on 7/1/2022., (© 2023. The Author(s).)

Background: Most antidepressant treatment studies have included patients strictly based on the Diagnostic and Statistical Manual of Mental Disorders definition of Major Depressive Disorder (MDD). Given the heterogeneity of MDD, this approach may have obscured inter-patient differences and hampered the development of novel and targeted treatment strategies. An alternative strategy is ​​to use biomarkers to delineate endophenotypes of depression and test if these can be targeted via mechanism-based interventions. Several lines of evidence suggest that "inflammatory depression" is a clinically meaningful subtype of depression. Preliminary data indicate that omega-3 fatty acids, with their anti-inflammatory and neuroprotective properties, may be efficacious in this subtype of depression, and this study aims to test this hypothesis., Method: We conduct a match-mismatch-trial to test if add-on omega-3 fatty acid eicosapentaenoic acid (EPA) reduces depressive symptoms in patients with MDD and systemic low-grade inflammation. MDD patients on a stable antidepressant treatment are stratified at baseline on high sensitivity-C-reactive protein (hs-CRP) levels to a high-inflammation group (hs-CRP ≥ 3 mg/L) or a low-inflammation group (hs-CRP < 3 mg/L). Both groups receive add-on EPA (2 g per day) for 8 weeks with three study visits, all including blood draws. Patients and raters are blind to inflammation status. Primary outcome measure is change in Hamilton Depression Rating Scale score between baseline and week 8. We hypothesize that the inflammation group has a superior antidepressant response to EPA compared to the non-inflammation group. Secondary outcomes include a composite score of "inflammatory depressive symptoms", quality of life, anxiety, anhedonia, sleep disturbances, fatigue, cognitive performance and change in biomarkers relating to inflammation, oxidative stress, metabolomics and cellular aging., Discussion: In this study we will, for the first time using a match-mismatch trial design, test if omega-3 is an efficacious treatment for inflammatory depression. If our study is successful, it could add to the field of precision psychiatry., Trial Registration: This trial was registered May 8, 2017 on clinicaltrials.gov under the reference number NCT03143075., (© 2022. The Author(s).)

Background: Dengue is a mosquito-borne flavivirus present in many metropolitan cities of tropical countries., Methods: During and after the dengue season (September 2018 to January 2019), we conducted a case-control study in order to determine the risk factors for dengue fever in Hanoi city, Vietnam. 98 dengue patients and 99 patients with other acute infections, such as Hepatitis B virus infection, were recruited at Department of Infectious Disease of Bach Mai national hospital in Hanoi. Patients were interviewed using a structured questionnaire covering demographic, housing, environmental factors and knowledge, attitude, and practice on dengue prevention and control. Univariate analysis and multivariable logistic regression were used to determine the risk factors of dengue status., Results: The mean score of knowledge items and practice items was only 7.9 out of total 19 points and 3.9 out of total 17 points, respectively. While the mean score of attitude items was 4.8 out of total 6 points. Multivariable logistic regression indicated that older patients had lesser risk of getting dengue infection as compared to younger adults aged 16-30, and patients living in peri-urban districts were less likely to suffer of dengue fever than patients living in central urban districts (OR = 0.31; 95% CI 0.13-0.75). This study could not find any association with occupation, water storage habit, knowledge, attitude, or practice on dengue prevention., Conclusions: All patients had a relatively low level of knowledge and practice on dengue prevention and control. However, the attitude of the participants was good. We found that age group and living district were the risk factors correlated with the dengue status. Communication programs on raising dengue awareness should be repeated all year round and target particular groups of adolescents, younger adults, landlords and migrants from other provinces to improve their knowledge and encourage them to implement preventive measures against dengue fever.

Background: Livestock production, particularly the dairy sector, is important for food and nutritional wellbeing of communities in India, it supports livelihoods of many farmers, and contributes to the economy of the country. India is a high consumer of antibiotics and antimicrobial resistant (AMR) bacteria are a major public health concern., Objectives: Our objectives were to identify animal health and drug use practices that may contribute to emergence and spread of AMR in the country, review previous AMR- mitigation strategies, and discuss "theory of change" as an approach to informing the choice of interventions., Methods: We undertook a desk review of literature to identify practices with potential to contribute to emergence and spread of antimicrobial resistance in India. Searches were done in PubMed, Google scholar, and Google. Data were synthesized and discussed by themes., Results: Animal disease surveillance is less developed and infrastructure to support delivery of services is inadequate. Several groups are known to offer animal health services. The untrained "animal health workers" and para-veterinarians are more popular with farmers as they charge less for consultations (compared to veterinarians who are few and charge more). Over-the-counter access of antibiotics, without prescription, and direct marketing of drugs to farmers are common. Because of this, farmers are able to treat their animals and only consult when cases become non- responsive to treatment. Antibiotics are mostly used in management of mastitis cases. Drug withdrawal periods are rarely observed and occurrence of antibiotic- contaminated milk has been reported. Awareness on AMR is low and antimicrobial stewardship in livestock is yet to be developed. Initiatives such as the National programme for containment of AMR, National Action Plan on AMR, and the National Health policy point to government's commitment in addressing the problem of AMR in the country., Conclusion: Several animal health and drug use practices, with potential to cause AMR, have been described, and their contribution can be discussed further by engaging stakeholders in a "theory of change" exercise. Interventions that address AMR from the animal health perspective should be promoted, and incentives to increase their adoption explored.

Background: Rapid urbanization has led to expansion of peri-urban fringes, where intensive, industry-style livestock rearing has led to emerging vulnerabilities at the human-animal-environment interface. This study was undertaken to understand the health system and farm-level factors that influenced the risk of transmission of bovine Tuberculosis (bTB) in animals and humans in peri-urban smallholder dairy farms of India., Methods: Thematic guides were developing through literature review and expert consultation. In-depth interviews were conducted till attainment of saturation. Identification of core themes was followed by etiological enquiry and generation of a conceptual model., Results: Veterinarians were consulted as a last resort after home-remedies and quacks had failed. Damage control measures, especially with respect to- selling or abandoning sick animals, added to the risk of disease transmission. Although civic authorities believed in the adequacy of a functioning laboratory network, end users were aggrieved at the lack of services. Despite the presence of extension services, knowledge and awareness was limited, promoting risky behaviour. The absence of cogent policies in dealing with bTB was a significant barrier. Stakeholders did not consider bTB to be a major concern. It is possible that they underestimate the problem., Conclusion: The current study helps to identify gaps which need to be addressed through collaborative research, and OneHealth interventions to build community awareness.

Background: Antimicrobial resistance (AMR) has been identified as one of the major threats to global health, food security and development today. While there has been considerable attention about the use and misuse of antibiotics amongst human populations in both research and policy environments, there is no definitive estimate of the extent of misuse of antibiotics in the veterinary sector and its contribution to AMR in humans. In this study, we explored the drivers ofirrational usage of verterinary antibiotics in the dairy farming sector in peri-urban India., Methods and Materials: The study was conducted in the peri-urban belts of Ludhiana, Guwahati and Bangalore. A total of 54 interviews (formal and non-formal) were carried out across these three sites. Theme guides were developed to explore different drivers of veterinary antimicrobial use. Data was audio recorded and transcribed. Analysis of the coded data set was carried out using AtlasTi. Version 7. Themes emerged inductively from the set of codes., Results: Findings were presented based on concept of 'levels of analyses'. Emergent themes were categorised as individual, health systems, and policy level drivers. Low level of knowledge related to antibiotics among farmers, active informal service providers, direct marketing of drugs to the farmers and easily available antibiotics, dispensed without appropriate prescriptions contributed to easy access to antibiotics, and were identified to be the possible drivers contributing to the non-prescribed and self-administered use of antibiotics in the dairy farms., Conclusions: Smallholding dairy farmers operated within very small margins of profits. The paucity of formal veterinary services at the community level, coupled with easy availability of antibiotics and the need to ensure profits and minimise losses, promoted non-prescribed antibiotic consumption. It is essential that these local drivers of irrational antibiotic use are understood in order to develop interventions and policies that seek to reduce antibiotic misuse., Competing Interests: Signed consent was obtained from all participants prior to data collection and after explaining the nature of the study in detail as well as answering any questions that any of the participants had. The study received ethical approval from the ethics committee of the Public Health Foundation of India (TRC-IEC-219/14). Local field partners who were veterinary colleges obtained specific regulatory permissions from their colleges required for the conduct of the study in their site.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Background: Aflatoxin M 1 (AFM 1 ) is a hydroxylated metabolite formed after aflatoxin B 1 (AFB 1 ) is consumed by humans and animals; it can be detected in urine, milk and blood. It is well recognized that AFB 1 is toxic to humans and other animals. The International Agency for Research on Cancer (IARC) classifies aflatoxins as group 1 carcinogens and AFM 1 as group 2B carcinogen. The main objective of this study was to evaluate the exposure of pigs to aflatoxins as well as to assess the public awareness of aflatoxins among people in five provinces in Vietnam., Results: A total of 1920 urine samples were collected from slaughterhouses located in five provinces. Overall, the positive rate of AFM 1 was 53.90% (95% confidence interval 51.64-56.15) using a cut-off of 0.15 μg/kg (range: limit of detection to 13.66 μg/kg, median: 0.2 μg/kg and mean: 0.63 μg/kg). A total of 252 people from the general population were interviewed from 5 provinces, and overall 67.86% reported being aware of aflatoxins. We also found that men and more highly educated had significantly increased awareness of aflatoxins compared to the females and primary/secondary school group. The respective odds ratios (ORs) were as follows: "male" group (OR: 2.64), "high school educated" group (OR: 3.40) and "college/university or more educated" group (OR: 10.20)., Conclusions: We can conclude that pigs in Vietnam are exposed to aflatoxins to varying degrees, and there may be a risk that pork products could contain AFM 1 . Further investigation is needed into the possible health impacts as well as to aid in establishing regulations for animal feed to reduce the health impacts in humans and animals.

Background: West Nile fever virus is a zoonotic arboviral infection maintained in a sylvatic cycle involving mosquito vectors and birds. It is one the arboviruses whose geographical range is expanding because of climate and land use changes that enhance the densities of mosquitoes and promote mosquito-bird-human interactions. We carried out a survey to determine the reservoirs of WNV among wild birds in Tana River and Garissa counties, Kenya., Methods: Blood samples were obtained from 361 randomly trapped wild birds. Using real-time polymerase chain reaction (PCR), all samples were screened for WNV using gene specific primer sets amplifying a portion of the E region of the genome encoding the envelope protein., Results: Sixty five (65) out of 361 birds screened tested positive for WNV on real-time PCR assay. Sequencing of the selected positive samples reveals that the isolated WNV were most closely related to strains isolated from China (2011). A regression analysis indicated that sampling location influenced the occurrence of WNV while species, age, weight and sex of the birds did not have any effect., Conclusions: This study provides baseline information on the existing circulation of WNV in this region among wild bird reservoirs that could spill over to the human population and points to the need for implementation of surveillance programs to map the distribution of the virus among reservoirs. Awareness creation about West Nile fever in this region is important to improve its detection and management.

To augment capacity-building for microbiome and probiotic research in Africa, a workshop was held in Nairobi, Kenya, at which researchers discussed human, animal, insect, and agricultural microbiome and probiotics/prebiotics topics. Five recommendations were made to promote future basic and translational research that benefits Africans.

Background: One of the challenges faced by equine breeders is ensuring delivery of good quality semen doses for artificial insemination when the mare is due to ovulate. Single Layer Centrifugation (SLC) has been shown to select morphologically normal spermatozoa with intact chromatin and good progressive motility from the rest of the ejaculate, and to prolong the life of these selected spermatozoa in vitro. The objective of the present study was a proof of concept, to determine whether fertilizing ability was retained in SLC-selected spermatozoa during prolonged storage., Findings: Sixteen mares were inseminated with SLC-selected sperm doses that had been cooled and stored at 6°C for 48 h, 72 h or 96 h. Embryos were identified in 11 mares by ultrasound examination 16-18 days after presumed ovulation., Conclusion: SLC-selected stallion spermatozoa stored for up to 96 h are capable of fertilization.