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Wheezing at preschool age (i.e., before the age of six) is common, occurring in about 30% of children before the age of three. In terms of health care burden, preschool children with wheeze show double the rate of access to the emergency department and five times the rate of hospital admissions compared with school-age asthmatics. The consensus document aims to analyse the underlying mechanisms involved in the pathogenesis of preschool wheezing and define the risk factors (i.e., allergy, atopy, infection, bronchiolitis, genetics, indoor and outdoor pollution, tobacco smoke exposure, obesity, prematurity) and the protective factors (i.e., probiotics, breastfeeding, vitamin D, influenza vaccination, non-specific immunomodulators) associated with the development of the disease in the young child. A multidisciplinary panel of experts from the Emilia-Romagna Region, Italy, addressed twelve key questions regarding managing preschool wheezing. Clinical questions have been formulated by the expert panel using the PICO format (Patients, Intervention, Comparison, Outcomes). Systematic reviews have been conducted on PubMed to answer these specific questions and formulate recommendations. The GRADE approach has been used for each selected paper to assess the quality of the evidence and the degree of recommendations. Based on a panel of experts and extensive updated literature, this consensus document provides insight into the pathogenesis, risk and protective factors associated with the development and persistence of preschool wheezing. Undoubtedly, more research is needed to improve our understanding of the disease and confirm the associations between certain factors and the risk of wheezing in early life. In addition, preventive strategies must be promoted to avoid children's exposure to risk factors that may permanently affect respiratory health. [ABSTRACT FROM AUTHOR]

Background: Pulmonary hypertension (PH) is a serious complication of chronic obstructive pulmonary disease (COPD). While clinical guidelines recommend specific drug therapies for pulmonary arterial hypertension (PAH), these drug therapies are not recommended for PH due to lung disease.Methods: This was a retrospective cohort study using the Optum® Clinformatics® Data Mart from January 2009-September 2019. An algorithm was designed to identify adults with ≥ 2 ICD-9-CM or ICD-10-CM diagnosis codes for PH and with ≥ 2 diagnosis codes for COPD. Sensitivity analyses were conducted among subgroups of patients with evidence of a right heart catheterization (RHC) or pulmonary function test (PFT). Patient characteristics, medications used, and durations of use of PAH and COPD medications were analyzed.Results: A total of 25,975 patients met the study inclusion criteria. Their mean age was 73.5 (SD 10.0) years and 63.8% were female. Medications targeting PAH were prescribed to 643 (2.5%) patients, most frequently a phosphodiesterase-5 inhibitor (2.1%) or an endothelin receptor antagonist (0.75%). Medications for COPD were prescribed to 17,765 (68.4%) patients, most frequently an inhaled corticosteroid (57.4%) or short-acting beta agonist (50.4%). The median durations of use ranged from 4.9 to 12.8 months for PAH medications, and from 0.4 to 5.9 months for COPD medications. Of the subgroup of patients with RHC (N = 2325), 257 (11.1%) were prescribed a PAH medication and 1670 (71.8%) used a COPD medication. Of the subgroup with a PFT (N = 2995), 58 (1.9%) were prescribed a PAH medication and 2100 (70.1%) a COPD medication.Conclusions: Patients with PH associated with COPD were identified in a US administrative claims database. Very few of these patients received any of the medications recommended for PAH, and only about two thirds received medications for COPD. [ABSTRACT FROM AUTHOR]

The current population-based study examines the association between county-level ambient air pollution and childhood asthma. Data from the nationally representative 2010–2015 National Health Interview Survey were linked to nationwide fine particulate matter (PM2.5) air pollution data at the county-level from the National Environmental Public Health Tracking Network which utilizes air quality monitoring stations and modeled PM2.5 measurements (Downscaler model data) and adjusted by county-level socioeconomic characteristics data from the 2010–2015 American Community Survey. Multilevel modeling techniques were used to assess the association between PM2.5 annual concentrations (quartiles < 8.11, 8.11–9.50, 9.51–10.59, ≥ 10.60 µg/m3) and current childhood asthma along with two asthma outcomes (episode in the past year, emergency room (ER) visit due to asthma). From 2010 to 2015, there were significant declines in PM2.5 concentrations and asthma outcomes. In unadjusted models, children living in areas with higher PM2.5 concentrations were more likely to have current asthma, ≥1 asthma episode in the past year, and ≥1 ER visit due to asthma compared with children living in areas with the lowest quartile (< 8.11 µg/m3). After adjusting for characteristics at the county, geographic, and child and family-level, significant associations remained for asthma episode, and ER visit among children living in areas with PM2.5 annual concentrations between 9.51 and 10.59 µg/m3 (3rd quartile) compared with children living in areas with the lowest quartile. This study adds to the limited literature by incorporating nationally representative county-, child-, and family-level data to provide a multi-level analysis of the associations between air pollution and childhood asthma in the U.S. [ABSTRACT FROM AUTHOR]

Campylobacteriosis, a foodborne illness, is one of the world′s leading causes of gastrointestinal illness. This study investigates the link between human campylobacteriosis and the consumption of potentially contaminated food with Campylobacter jejuni. Three hundred sixty samples were collected from humans, chicken cloaca, raw chicken meat, unpasteurized milk, and vegetables. The chickens were obtained from licensed and non-licensed slaughterhouses, and only the necks and wings were studied. Samples were enriched under microaerobic conditions then cultured on the modified charcoal cefoperazone deoxycholate agar. Bacteria was identified by staining, biochemical testing, and molecular identification by the polymerase chain reaction for the virulence genes; hipO, asp, dnaJ, cadF, cdtA, cdtB, and cdtC. The genomic homogeneity of C. jejuni between human and chicken isolates was assessed by the serological Penner test and the pulse field gel electrophoresis (PFGE). Campylobacter was not detected in the vegetables and pasteurized milk, though, only twenty isolates from chickens and clinical samples were presumed to be Campylobacter based on their morphology. The biochemical tests confirmed that five isolates were C. coli, and fifteen isolates were C. jejuni including two isolates from humans, and the remaining were from chickens. The colonization of C. jejuni in chickens was significantly lower in necks (6.66%) obtained from licensed slaughterhouses compared to those obtained from non-licensed slaughterhouses (33.3%). The antimicrobial susceptibility test showed that all identified C. jejuni isolates were resistant to antibiotics, and the majority of isolates (53.5%) showed resistance against six antibiotics, though, all isolates were resistant to ciprofloxacin, tetracycline, and aztreonam. The Penner test showed P:21 as the dominant serotype in isolates from humans, necks, and cloaca. The serohomology of C. jejuni from human isolates and chicken necks, wings, and cloaca was 71%, 36%, 78%, respectively. The PFGE analysis of the pattern for DNA fragmentation by the restriction enzyme Smal showed a complete genotypic homology of C. jejuni human isolates and chicken necks compared to partial homology with cloacal isolates. The study brings attention to the need for effective interventions to ensure best practices for safe poultry production for commercial food chain supply to limit infection with foodborne pathogens, including Campylobacter. [ABSTRACT FROM AUTHOR]

Background: Currently, reported COVID-19 deaths are inadequate to assess the impact of the pandemic on global excess mortality. All-cause excess mortality is a WHO-recommended index for assessing the death burden of COVID-19. However, the global excess mortality assessed by this index remains unclear. We aimed to assess the global excess mortality during the COVID-19 pandemic. Methods: We searched PubMed, EMBASE, and Web of Science for studies published in English between 1 January 2020, and 21 May 2022. Cross-sectional and cohort studies that reported data about excess mortality during the pandemic were included. Two researchers independently searched the published studies, extracted data, and assessed quality. The Mantel–Haenszel random-effects method was adopted to estimate pooled risk difference (RD) and their 95% confidence intervals (CIs). Results: A total of 79 countries from twenty studies were included. During the COVID-19 pandemic, of 2,228,109,318 individuals, 17,974,051 all-cause deaths were reported, and 15,498,145 deaths were expected. The pooled global excess mortality was 104.84 (95% CI 85.56–124.13) per 100,000. South America had the highest pooled excess mortality [134.02 (95% CI: 68.24–199.80) per 100,000], while Oceania had the lowest [−32.15 (95% CI: −60.53–−3.77) per 100,000]. Developing countries had higher excess mortality [135.80 (95% CI: 107.83–163.76) per 100,000] than developed countries [68.08 (95% CI: 42.61–93.55) per 100,000]. Lower middle-income countries [133.45 (95% CI: 75.10–191.81) per 100,000] and upper-middle-income countries [149.88 (110.35–189.38) per 100,000] had higher excess mortality than high-income countries [75.54 (95% CI: 53.44–97.64) per 100,000]. Males had higher excess mortality [130.10 (95% CI: 94.15–166.05) per 100,000] than females [102.16 (95% CI: 85.76–118.56) per 100,000]. The population aged ≥ 60 years had the highest excess mortality [781.74 (95% CI: 626.24–937.24) per 100,000]. Conclusions: The pooled global excess mortality was 104.84 deaths per 100,000, and the number of reported all-cause deaths was higher than expected deaths during the global COVID-19 pandemic. In South America, developing and middle-income countries, male populations, and individuals aged ≥ 60 years had a heavier excess mortality burden. [ABSTRACT FROM AUTHOR]

Rationale: Alcohol use disorder (AUD) is shown to have an overall heritability of around 50%. One of the genes associated with AUD is SLC6A4 (solute carrier family 6 member A4) which codes for the serotonin transporter (SERT). The study looked at serotonin dysfunction on ethanol consumption in adolescents and the subsequent intergenerational effects of drinking by using a rat model: SERT+/+ (regular functioning), SERT+/− (50% transporter reduction) and SERT−/− (complete reduction). Objectives: We investigated sex and genotype differences in ethanol consumption in SERT knock-out Wistar rats (F0) followed by studying behaviour in the offspring (F1) of the male drinkers to assess effects of paternal alcohol consumption. Methods: An intermittent access two-bottle choice paradigm (IA2BC) was used to yield ethanol drinking behaviour in F0 adolescent Wistar rats. The highest drinking males were mated to alcohol-naive females and their offspring were compared with controls. Drinking behaviour (IA2BC) and ethanol-induced motor coordination effects (via rotarod) were measured in the F1s. Results: F0 drinking saw no SERT genotype differences in males. However, females consumed higher volumes of ethanol compared to males, with SERT−/− females showing the highest intake. A clearer genotype effect was seen in the F1 animals, with reduction in SERT activity leading to enhanced ethanol intake in both sexes. Importantly, paternal exposure to ethanol significantly reduced the ethanol induced motor side effects in offspring, independent of sex and genotype. Conclusions: These indicate a difference in the way genetic factors may act across sexes and suggest the involvement of epigenetic mechanisms in the intergenerational effects of alcohol. [ABSTRACT FROM AUTHOR]

Background: The serotonin transporter (SERT) mRNA was previously reported to be a quantitative and pathophysiology‐based biomarker of heavy drinking in 5HTTLPR:LL genotype‐carriers treated with ondansetron. Here, we validated the potential use of SERT mRNA for quantitative prediction of recent alcohol consumption (in the absence of treatment) and compared it with the known biomarkers ethyl glucuronide (EtG) and ethyl sulfate (EtS). Methods: Binge drinking men and women of European ancestry aged 21 to 65 years were enrolled in a 12‐day, in‐patient, randomized, double‐blind, crossover study, where they were administered three beverage doses (placebo, 0.5 g/kg [0.4 g/kg] ethanol, and 1 g/kg [0.9 g/kg] ethanol for men [women]) individually in three 4‐day periods (experiments), separated by minimum 7‐day washout period. Diet, sleep, and physical activity were controlled throughout the inpatient experiments. Twenty‐nine participants were randomized to receive beverage doses counterbalancing the sequence of treatment and gender within subgroups stratified by SERT genotypes 5HTTLPR:LL+rs25531:AA (LALA) versus 5HTTLPR:LS/SS. Peripheral venous blood was collected daily for (1) quantification of SERT mRNA (the primary outcome measure) using qRT‐PCR and (2) plasma EtG and EtS levels using tandem mass‐spectrometry. Results: The association between administered beverage dose and SERT mRNA from completers of at least one 4‐day experiment (N = 18) assessed by a linear mixed model was not statistically significant. Significant positive associations were found with beverage dose and plasma EtG, EtS and EtG/EtS ratio (β = 5.8, SE = 1.2, p < 0.0001; β = 1.3, SE = 0.6, p = 0.023; and β = 3.0, SE = 0.7, p < 0.0001, respectively; the C‐statistics for discriminating outcomes were 0.97, 0.8, and 0.92, respectively). Additionally, we observed a sequence effect with a greater placebo effect on SERT mRNA when it was administered during the first experiment (p = 0.0009), but not on EtG/EtS measures. Conclusion: The findings do not validate the use of SERT as a biomarker of heavy drinking. Larger and more innovative studies addressing the effects of placebo, race, gender, and response to treatment with serotonergic agents are needed to fully assess the utility of SERT as a biomarker of heavy and binge drinking. [ABSTRACT FROM AUTHOR]

The human body can withstand high temperatures to some extent, but exposure to temperatures exceeding human heat tolerance leads to sickness and, at very high temperatures, to death. In this study, using the analyzed data on the maximum temperature at 2 m above the surface in a 73-year period from 1948 to 2020, the seasonal, annual, decadal and centennial frequency of lethal temperatures above 50 °C (TU50c) in the Northern Hemisphere (NH) was analyzed. The aim of this research was to extract the frequency and trend in TU50c in the NH. In this study, regression analysis, trend component analysis and wavelet analysis were used. Examination of the frequency of TU50c occurrence in the NH showed that the trend of annual changes in the frequency of TU50c in the NH is upward and significant. Inter-decadal changes indicate that in the fifth decade (1980–1989) and sixth decade (1990–1999), there was an unprecedented increase in the frequency of TU50c. Inter-century changes also show that the incidence of TU50c has increased gradually from the twentieth to the twenty-first century. The highest incidence of twentieth-century TU50c extreme temperatures occurred between 1986 and 1988. Spatially, the region with the highest frequency and strongest TU50c is in Africa, especially Sudan, West Asia (between Iraq, southwestern Iran, Kuwait and Saudi Arabia) and India in the Indian subcontinent. These temperatures are not uncommon in the United States, but TU50c has not been reported in Europe and East Asia. The results of statistical analysis show that the frequency of occurrence of TU50c in the NH is related to the annual frequency of sunspots and also, to a much lesser extent, to the concentration of carbon dioxide. [ABSTRACT FROM AUTHOR]

Air pollution near schools is particularly problematic. Pollution emissions from vehicle idling at or around schools may have significant effects on children's health including increased rates of asthma and childhood leukemia. Outdoor pollution emissions from idling vehicles can also infiltrate into the schools resulting in health hazards both in school drop-off zones as well as inside nearby buildings. An Idle-Free Campaign was enacted at an elementary school to reduce idling among parents dropping off and picking up students. The campaign involved a focus group, surveys, informational events and materials, and vehicle counting efforts before and after the campaign. The surveys found that regardless of gender or level of education, parents were very concerned about air pollution concerns associated with idling and were willing to take steps to reduce their children's exposure. Furthermore, the vehicle counting efforts showed a 17% reduction in idling vehicles and a 37% reduction in idling time following the anti-idling campaign. These findings show that a multi-pronged approach involving parents, teachers, staff, bus drivers, and delivery truck drivers, may be an effective tool to reduce idling at schools thus reducing children's exposure. [ABSTRACT FROM AUTHOR]

Vehicle exhaust has been acknowledged as an essential factor affecting human health due to the extensive use of cars. Its main components include volatile organic compounds (VOCs) and nitrogen oxides (NOx), which can cause acute irritation and chronic diseases, and significant research on the treatment of vehicle exhaust has received increasing attention in recent decades. Recently, photocatalytic technology has been considered a practical approach for eliminating vehicle emissions. This review highlights the crucial role of photocatalytic technology in eliminating vehicle emissions using semiconductor catalysts. A particular emphasis has been placed on various photocatalytic materials, such as TiO2-based materials, Bi-based materials, and Metal–Organic Frameworks (MOFs), and their recent advances in the performance of VOC and NOx photodegradation. In addition, the applications of photocatalytic technology for the elimination of vehicle exhaust are presented (including photocatalysts combined with pavement surfaces, making photocatalysts into architectural coatings and photoreactors), which will offer a promising strategy for photocatalytic technology to remove vehicle exhaust. [ABSTRACT FROM AUTHOR]

BACKGROUND: Transnational immigration has increased since the 1950s. In countries such as the United States, immigrants now account for >15% of the population. Although differences in health between immigrants and nonimmigrants are well documented, it is unclear how environmental exposures contribute to these disparities. OBJECTIVES: We summarized current knowledge comparing immigrants’ and nonimmigrants’ exposure to and health effects of environmental exposures. METHODS: We conducted a title and abstract review on articles identified through PubMed and selected those that assessed environmental exposures or health effects separately for immigrants and nonimmigrants. After a full text review, we extracted the main findings from eligible studies and categorized each article as exposure-focused, health-focused, or both. We also noted each study’s exposure of interest, study location, exposure and statistical methods, immigrant and comparison groups, and the intersecting socioeconomic characteristics controlled for. RESULTS: We conducted a title and abstract review on 3,705 articles, a full text review on 84, and extracted findings from 50 studies. There were 43 studies that investigated exposure (e.g., metals, organic compounds, fine particulate matter, hazardous air pollutants) disparities, but only 12 studies that assessed health disparities (e.g., mortality, select morbidities). Multiple studies reported higher exposures in immigrants compared with nonimmigrants. Among immigrants, studies sometimes observed exposure disparities by country of origin and time since immigration. Of the 50 studies, 43 were conducted in North America. DISCUSSION: The environmental health of immigrants remains an understudied area, especially outside of North America. Although most identified studies explored potential exposure disparities, few investigated subsequent differences in health effects. Future research should investigate environmental health disparities of immigrants, especially outside North America. Additional research gaps include the role of immigrants’ country of origin and time since immigration, as well as the combined effects of immigrant status with intersecting socioeconomic characteristics, such as race/ethnicity, income, and education attainment. [ABSTRACT FROM AUTHOR]

This study aims to explore the perceptions of the Venezuelan immigrant population in Medellín, Colombia, regarding their employment, working and health conditions (physical, mental and psychosocial). A qualitative study was conducted (focused ethnography perspective). Semi‐structured interviews were carried out with 31 Venezuelans and 12 key informants from different social organisations that work with the immigrant population. A narrative content analysis was carried out (Atlas.Ti 8.0 software). The migratory process for Venezuelans is caused for political, economical and social aspects in Venezuela and Colombia is offered as the first destination for labour establishing. Access to the labour market is limited to certain occupations, in many cases in the informal economy. Participants referring low salaries, working long hours and reduced social benefits. Occupational risks are evidenced by low experience in the labour market. Some health problems are perceived, and a good part of the interviewed population referred to signs and symptoms related to mental health problems. Barriers to access health and social protection services were found. Finally, future expectations depend on their adaptation to Colombia, the improvement of social conditions in Venezuela or having chances of improving their social and living conditions in another country. A high labour and social vulnerability were found in Venezuelan participants that impact on physical and mental health. Political and strategies from a public health perspective are required and the implementation of systems for monitoring and evaluating the labour and health situation in the working immigrant population. [ABSTRACT FROM AUTHOR]

This study is about the use of naturally occurring filtering materials for rainwater treatment for drinking water proposal. Crushed gravel, ceramic spheres from natural clays, silica sand and natural zeolite were used as filtering materials. The mineralogical composition of filtering materials was determined, being the illite and mordenite the major components of ceramic spheres and natural zeolite, respectively. Naturally occurring materials were simultaneous evaluated on two configuration of pilot plant systems (biofilters) for rainwater treatment. Three columns were arranged in series with unstratified flooded beds. The first stage was packed using crushed gravel. The second stage was packed using ceramic spheres. The third stage was packed with silica sand for the first plant and a natural zeolite was used for the second pilot plant system. Finally, a last stage of ultraviolet disinfection was incorporated. The trial period was 90 days, and it was evaluated the removal of Fe+2 and Mn+2, total coliforms, faecal coliforms and Escherichia col (E. coli). The rainwater treatment system using natural zeolite provided better results than the one using silica sand at third stage. The concentration of Fe+2 and Mn+2 was below the maximum permissible limits within 45 days. The efficiency of the treatment systems was optimal within 45 days, after the efficiency decreased progressively. Then, it is an attractive proposal for rural areas in developing countries for single-family water treatment systems. [ABSTRACT FROM AUTHOR]

Urban air contamination is one of the ten most dangerous parameters for human health, which causes cardiovascular disease, respiratory, metabolic diseases, and decreased lung function. Air Q is a reliable software for studying the impacts of atmospheric contaminants on human health, and today, it is widely used in the environment. The purpose of this research was to quantify the mortality and morbidity rates that corresponded to ambient particulate matter (PM) in Rigan City. To perform this, the Air Q software was used. The findings reflected that the yearly mean values of PM10 and PM2.5 are 264.83 and 50.45 μg/m3. The findings indicated that the PM10 and PM2.5 content in Rigan was above standard levels described by WHO. The total number of deaths, cardiovascular deaths, and respiratory deaths due to PM in Rigan were estimated as 70.3, 45.8, and 10.7 persons, respectively. Hospital admissions for cardiovascular and respiratory diseases correlated to PM10 were estimated at 154.2 and 59 persons, respectively. Acute myocardial infarction associated with PM2.5 was 2.7 persons. Overall, the data in this study may be helpful to national and regional policymakers who are responsible for managing and preventing atmospheric contamination and assessing the costs of health risks. [ABSTRACT FROM AUTHOR]

As the 2022 human monkeypox (HMPX) multi-country outbreak is spreading, the response of healthcare workers (HCWs) is central to mitigation efforts. The current study aimed to evaluate HMPX knowledge and confidence in diagnosis and management among HCWs in Kuwait. We used a self-administered questionnaire distributed in July–August 2022 through a snowball sampling approach. The survey items evaluated HMPX knowledge, confidence in diagnosis and management of the disease, and the belief in conspiracies regarding emerging virus infections (EVIs). The sample size was 896 HCWs: nurses (n = 485, 54.1%), pharmacists (n = 154, 17.2%), physicians (n = 108, 12.1%), medical technicians/allied health professionals (MT/AHP, n = 96, 10.7%), and dentists (n = 53, 5.9%). An overall low level of HMPX knowledge was noticed for items assessing virus transmission and non-cutaneous symptoms of the disease, with higher knowledge among physicians. Approximately one-fifth of the study sample agreed with the false notion that HMPX is exclusive to male homosexuals (n = 183, 20.4%), which was associated with lower knowledge with higher frequency among MT/AHP compared to nurses, physicians, and pharmacists. Confidence levels were low: confidence in diagnosis based on diagnostic tests (n = 449, 50.1%), confidence in the ability to manage the HMPX (n = 426, 47.5%), and confidence in the ability to diagnose HMPX clinically (n = 289, 32.3%). Higher confidence levels were found among nurses and participants with postgraduate degrees. Higher embrace of conspiracy beliefs regarding EVIs was noticed among participants with lower knowledge, and among those who agreed or were neutral/had no opinion regarding the false idea of HMPX exclusive occurrence among male homosexuals, while lower levels of belief in conspiracies were noticed among physicians, dentists, and pharmacists compared to MT/AHP. Variable levels of HMPX knowledge were observed in this study per item, with low level of knowledge regarding virus transmission. Differences in knowledge and confidence levels in diagnosis and management of HMPX should be considered in education and training aiming to prepare for outbreak response. The relatively high prevalence of embracing conspiratorial beliefs regarding EVIs is worrisome and needs proper interventions. The attitude towards male homosexuals' role in monkeypox spread should be evaluated in future studies considering the possibility of stigma and discrimination in this most-at-risk group. [ABSTRACT FROM AUTHOR]

To examine the association between cytomegalovirus (CMV) seropositivity and all-cause mortality in a nationwide cohort of US adults. We obtained data from the National Health and Nutrition Examination Survey III (1988-1994), including 16,547 participants aged 18-90 years old with CMV serology assessments. Mortality status was ascertained until December 2019 using the National Death Index linkage data. The Cox proportional hazard model was applied to estimate the association between CMV seropositivity and mortality. During a median follow-up of 26.3 years, 6,930 deaths were recorded. CMV seropositivity was associated with a higher hazard of all-cause mortality after adjusting for attained age, sex, and ethnicity (HR: 1.22, 95% CI: 1.10, 1.36, p < 0.001). The magnitude of the association attenuated slightly after adjusting further for body mass index, family income, smoking status, diabetes, and self-reported cancer history (HR = 1.11, 95% CI: 1.00, 1.23, p = 0.04). While the association was observed for both men and women, it was only statistically significant among non-Hispanic white people (HR: 1.16, 95% CI: 1.06, 1.26, p = 0.001) but not among other ethnic populations. CMV seropositivity might be an independent risk factor for all-cause mortality among US adults. If the findings are validated in an independent population, further research is needed to unveil the biological mechanisms driving the increased mortality with CMV seropositivity., (© 2024 The Authors. Journal of Medical Virology published by Wiley Periodicals LLC.)

Probiotics should be administered in adequate amounts to confer health benefits. Probiotic dose-response studies are still missing. Saccharomyces cerevisiae UFMG A-905 prevented asthma development; however, the ideal dose has not been investigated. We evaluated the optimal dose and administration regimen of S. cerevisiae UFMG A-905 in the prevention of asthma. Male Balb/c mice were sensitized intraperitoneally with ovalbumin (OVA) and challenged with OVA intranasally. Mice received, via gavage, daily or alternate-day S. cerevisiae UFMG A-905. In daily regimen, different concentrations (10 7 , 10 8 , or 10 9  CFU/mL) were given 10 days before OVA sensitization and during challenges. In alternate-day regimen, a concentration of 10 9  CFU/mL was administered three times per week for 5 weeks, starting 2 weeks prior to the first sensitization. After the last challenge, in vivo bronchial hyperresponsiveness and airway and lung inflammation were assessed. OVA-challenged mice, when compared to saline-challenged mice, presented a significant increase in bronchial hyperresponsiveness and airway and lung inflammation. Daily and alternate-day administration of 10 9  CFU/mL of S. cerevisiae UFMG A-905 significantly reduced bronchial hyperresponsiveness; lower concentrations of S. cerevisiae UFMG A-905 did not significantly reduce bronchial hyperresponsiveness. Daily regimen with the highest concentration significantly reduced total cell number, eosinophil count in the BAL, and the levels of IL-4, IL-5, and IL-13. Daily administration of S. cerevisiae UFMG A-905 at 10 7 and 10 8  CFU/mL and alternate-day regimen did not significantly decrease airway and lung inflammation. S. cerevisiae UFMG A-905 led to a significant attenuation of bronchial hyperresponsiveness and lung inflammation in a dose-dependent manner., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Various communicable and infectious diseases could be contained by proper hand washing leading to a reduction in mortality and morbidity of children. Objective: To assess predictors of hand-washing practices at critical times among mothers of under 5 years old children in rural setting of Gedeo zone, Southern Ethiopia. Method: An institutional-based cross-sectional survey was conducted among 422 women with children under the age of 5 attended the Dilla Zuria health facility and were chosen using a systematic sampling method. Data was gathered using pre-tested interview-administered structured questionnaires. Data was entered into EPI info version 17 and analyzed using SPSS version 25. Binary logistic regression was employed to identify the association between dependent and independent variables. Finally, for variables with a P <.05 in multivariable analysis, adjusted odds ratio (AOR) with a 95% confidence interval (CI) was determined and interpreted. Results: The hand washing practice of mothers at critical times was 44.9% [95% CI: 40.1, 49.7%]. The pertinent predictors were favorable attitude [AOR = 7.77, 95% CI: 4.56, 10.37], availability of water source near the household [AOR = 5.31, 95% CI: 3.56, 10.37], and constant availability of soaps at household [AOR = 2.32, 95% CI: 1.33, 6.70]. Conclusion: In our study, hand-washing practices at critical times was low. The pertinent predictors were attitude, the presence of a water source near the household, and the presence of soap. Therefore, it is advised to encourage domestic hygiene education to improve mothers' attitudes and to increase the availability of water and soap close to the household to promote handwashing with soap and water at critical times. [ABSTRACT FROM AUTHOR]

Background: In 2016 Rwanda adopted "treat all" where all patients with HIV are immediately eligible for ART regardless of disease progression. Despite widespread availability of treatment, it is unknown whether presentation with advanced HIV persists.Methods: We conducted a retrospective cohort among patients aged ≥ 15 who enrolled in care between July 2016 and July 2018 in three rural Rwandan districts. We estimated the prevalence of advanced HIV, defined as presenting with CD4 count < 200 cells/mm3 or WHO stage 3 or 4, and compared baseline characteristics of patients with and without advanced HIV. We compared cumulative incidences and time to events using Chi squared tests and Cox proportional hazards models, respectively, for (a) viral load tests; (b) viral suppression; (c) death; and (d) treatment failure (a composite of death, lost to follow up, or virologic failure).Results: Among 957 patients, 105 (11.0%) presented with advanced HIV. These patients were significantly more likely to have low body mass index, come from Burera district, be older, and be identified through inpatient settings rather than through voluntary or prenatal testing. Patients with advanced HIV had significantly higher risks of death at 12-months (9.5% vs 1.5%, p < 0.001) and 18-months (10.5% vs 1.9%, p < 0.001) and significantly higher risk of treatment failure at 12-months (21.9% vs. 14.2%, p = 0.037). After adjusting for confounders, patients with advanced HIV had still higher rates of death (adjusted Hazard ratio [aHR] = 4.4, 95% CI: 1.9, 10.2, p < 0.001) and treatment failure (aHR = 1.7, 95% CI: 1.1, 2.5, p = 0.017), but no difference in viral load testing (aHR = 1.1, 95% CI: 0.8, 1.5, p = 0.442) or viral suppression (aHR = 1.0, 95% CI: 0.8, 1.4, p = 0.949). When allowing for the hazard ratio to vary over time, patients with advanced HIV experienced elevated rates of treatment failure in the first six of enrollment, but not after nine months.Conclusion: Presenting with advanced HIV remains common and is still associated with poor patient outcomes. Sensitization of the community to the benefits of early ART initiation, identification of patients with advanced HIV, and holistic support programs for the first 6 months of treatment may be needed to improve outcomes. [ABSTRACT FROM AUTHOR]

This study determines the impacts of gross domestic product, domestic bank credits given to private sector, and military expenditures on carbon emissions based on 1990–2019 time period. The panel quantile regression approach is applied for the Visegrád group countries. Our empirical results reveal that domestic bank credit given to private sector has a positive and meaningful impact on carbon emissions at medium and high quantile levels. On the other hand, it has been determined that gross domestic product has a reducing impact on carbon emissions, but military expenditures have an increasing impact on carbon emissions. Besides, as consequences of such tests, the difference between the quantiles, that is, the heterogeneous structure was revealed. A separate model was created with a different panel quantile approach for robustness control, and the results were compared by giving different values to penalty term. These results provide strong evidence for decision-makers and implementers. [ABSTRACT FROM AUTHOR]

Background: Within the past two decades, Ethiopia has achieved one of the fastest reductions of open defecation worldwide. This change can be attributed to the implementation of a national sanitation strategy that focused on facilitating community demand for latrine adoption and use of basic self-constructed latrines but less on other preconditions of hygienic sanitation. Recognition of sanitation by policymakers also catalyzed primary research in this area. As such, the synthesis of the available evidence is both warranted and possible. In this article, we thus decided to assess available primary evidence on the household-level sanitation in Ethiopia and its influencing factors.Methods: We searched primary studies that present findings on the role of factors influencing household-level sanitation outcomes in Ethiopia. We typologically classified sanitation outcomes analyzed in identified literature and computed pooled estimates for the most prevalent ones (measures of latrine availability and use). We characterized thematic types (themes and sub-themes) of influential sanitation drivers and used network analysis to examine the relational patterns between sanitation outcomes and their influencing factors.Findings: We identified 37 studies that met our inclusion criteria-all but one published after 2009. The general latrine coverage pooled across 23 studies was 70% (95% CI: 62-77%), the share of improved latrines pooled across 15 studies was 55% (95% CI: 41-68%), and latrine use pooled across 22 studies was 72% (95% CI: 64-79%). Between-study heterogeneity was high, and no time trends were identified. The identified sanitation outcomes were classified into eight types and factors reported to influence these outcomes were classified into 11 broader themes and 43 more specific sub-themes. Factors around the quality of latrines represented the most frequent sub-theme of consequential drivers. We found that the available research focused predominantly on outcomes concerning the initial adoption and use of basic latrines, emulating the main focus of national sanitation strategy. By contrast, research on drivers of the sustainability of sanitation change and, in particular, on the upgrading of latrines, has been rare despite its urgency. There is a high need to redirect the focus of sanitation research in Ethiopia towards understanding these factors on both the demand and supply side. [ABSTRACT FROM AUTHOR]

Background: Nine migrant agricultural workers died in Ontario, Canada, between January 2020 and June 2021. Methods: To better understand the factors that contributed to the deaths of these migrant agricultural workers, we used a modified qualitative descriptive approach. A research team of clinical and academic experts reviewed coroner files of the nine deceased workers and undertook an accompanying media scan. A minimum of two reviewers read each file using a standardized data extraction tool. Results: We identified four domains of risk, each of which encompassed various factors that likely exacerbated the risk of poor health outcomes: (1) recruitment and travel risks; (2) missed steps and substandard conditions of healthcare monitoring, quarantine, and isolation; (3) barriers to accessing healthcare; and (4) missing information and broader issues of concern. Conclusion: Migrant agricultural workers have been disproportionately harmed by the COVID-19 pandemic. Greater attention to the unique needs of this population is required to avoid further preventable deaths. [ABSTRACT FROM AUTHOR]

Background: Despite global interventions to prevent and control diarrhea, it still remains a public health problem leading to childhood morbidity and mortality majorly in developing countries. In Uganda, diarrhea is amongst the five leading causes of under-five mortality, contributing to more than 140,000 deaths every year and this accounts for 7.1% of all under-five mortalities in Uganda. Efforts to prevent and lower diarrheal diseases need to be informed by data on determinants of diarrhea. The study assessed factors associated with diarrheal diseases among children below five years in selected slum settlements in Entebbe municipality, Wakiso District, Uganda.Methods: The study employed a cross-sectional study design covering 384 randomly selected households having children < 5 years old in the study area using quantitative research methods. Data was collected using close-ended questionnaires and diarrhea disease history was captured for the last month before the survey. Bivariate and multivariate logistic regression analyses were used to identify the risk factors associated with childhood diarrhea considering a 95% confidence level.Results: The prevalence of Diarrhea disease in children among the selected slum settlements in Entebbe municipality was found to be at 62.4%. Access to water from a protected water source (deep well and borehole), presence of a vent in toilets, age, and child birth weight were found to be significantly associated with diarrheal diseases among children below five years in the selected slum settlements in Entebbe municipality.Conclusion: The prevalence of childhood diarrhea among children < 5 years of age in selected slums of Entebbe municipality was found high. Use of water from a protected source, presence of a vent in toilets, age, child birth and weight were identified as predictors of diarrhea occurrence. These findings imply that community health education is urgently needed for fighting childhood diarrhea in the study area to eliminate the predisposing factors to diarrhea. [ABSTRACT FROM AUTHOR]

The intestinal microbiota is known to influence local immune homeostasis in the gut and to shape the developing immune system towards elimination of pathogens and tolerance towards self-antigens. Even though the lung was considered sterile for a long time, recent evidence using next-generation sequencing techniques confirmed that the lower airways possess their own local microbiota. Since then, there has been growing evidence that the local respiratory and intestinal microbiota play a role in acute and chronic pediatric lung diseases. The concept of the so-called gut–lung axis describing the mutual influence of local microbiota on distal immune mechanisms was established. The mechanisms by which the intestinal microbiota modulates the systemic immune response include the production of short-chain fatty acids (SCFA) and signaling through pattern recognition receptors (PRR) and segmented filamentous bacteria. Those factors influence the secretion of pro- and anti-inflammatory cytokines by immune cells and further modulate differentiation and recruitment of T cells to the lung. This article does not only aim at reviewing recent mechanistic evidence from animal studies regarding the gut–lung axis, but also summarizes current knowledge from observational studies and human trials investigating the role of the respiratory and intestinal microbiota and their modulation by pre-, pro-, and synbiotics in pediatric lung diseases. [ABSTRACT FROM AUTHOR]

The policy of the national smart city (NSC) pilots, a new type of urbanization for future development, has been implemented in China in batches. This paper investigates the mechanism and effects of the NSC pilots on the environment. Using the prefecture-level panel data during 2004–2018 period, our multi-period difference-in-differences (DID) estimation shows that the NSC pilots causally mitigate SO2 (wastewater) pollution by 13.76% (14.36%), which is supported by a series of robustness tests. The mediating effect model indicates that green total factor productivity (GTFP) plays a partial mediating role in mitigating both SO2 and wastewater emissions, while technological innovation plays a partial mediating role in mitigating wastewater emissions. After introducing the two mediating channels into the multi-period DID model, the reduction effect for SO2 and wastewater emissions drops to 11.04% (1-e− 0.117) and 12.1% (1-e− 0.129), respectively. Comparatively, the NSC pilots contribute to the improvement of GTFP and GTFP takes the major mediating role in reducing SO2 and wastewater pollution. The heterogeneous effects of the NSC pilots show that the mitigation effect is more pronounced in cities with strong fiscal support, cities with abundant human capital, and cities with high R&D expenditure. Based on these novel findings, this study provides some policy implications for achieving better mitigation effects. [ABSTRACT FROM AUTHOR]

Background: Diarrheal disease is a major public health problem among under-five children globally. In Ethiopia, it is the second cause of hospital admission and death among children under five years.Objectives: To assess the prevalence of diarrhea, feeding practice, and associated factors among children under five years in Bereh District, Oromia Special Zone Surrounding Finfine, Ethiopia.Methods: A community-based cross-sectional study was conducted among children less than 5 years old in Bereh District from May 15 to 29, 2021. A systematic random sampling technique was used to select a total of 455 study participants. Descriptive statistics were used to measure the prevalence of diarrhea as well as to summarize other study variables. A binary logistic regression model with an adjusted odds ratio and a 95% confidence interval (CI) was used to declare the associated factors with childhood diarrhea.Results: The prevalence of diarrhea was 17.3% in the past 15 days preceding the study period. About 53.4% of the mothers/caregivers were engaged in poor child feeding practices. Age of children [AOR = 9.146, 95% CI (2.055, 40.707)], birth order [AOR = 0.137, 95% CI (0.057, 0.329)], total family size [AOR: 5.042, 95% CI (2.326, 10.931)], not EBF [AOR: 4.723, 95% CI (1.166, 19.134)], prepare child foods separately [AOR: 0.252, 95% CI (0.091, 0.701)], feeding child immediately after cooking, handwashing method, and source of drinking water were significantly associated with under-five diarrhea.Conclusions: The prevalence of diarrhea among children under five is high. More than half of the participants were engaged in poor IYCF practice. Action targeting the factors associated with diarrhea should be taken to improve under-five child's health. [ABSTRACT FROM AUTHOR]

Indonesia is one of the largest sources of migrant workers in Southeast Asia. Presently, these workers are vulnerable to COVID-19 due to the prolonged migration process, which requires them to relocate from their villages to another country and back to Indonesia on completion of their working contract. Therefore, this study describes and discusses the vulnerability of Indonesian migrant workers (IMWs) to the pandemic at various phases of the migration process. It is related to the implementation and practice of health protocols, ignorance and indifference to the dangers and transmission of the virus, and also to the national vaccination program. The analysis is based on the review of literature studies, such as studies related to the topic, international and national regulations on migrant workers, and official data and statistics published by the Indonesian government. The materials and data were collected from search engines such as Google Search and Google Scholar and also relevant published reports available. Several policies have been implemented by the government of Indonesia and other destination countries where the prospective IMWs intend to work, to protect and prevent the transmission of COVID-19. However, there is still a contagion among IMWs willing to leave abroad and those returning home after completing their employment contract. Therefore, both countries need to be responsible for each migration process, specifically related to providing health protection, increasing awareness of the danger and transmission of the virus, and applying polymerase chain reaction (PCR) tests and COVID-19 vaccination for migrant workers. [ABSTRACT FROM AUTHOR]

Background: Oxidative stress plays a key role in the pathogenesis of respiratory diseases; however, studies on antioxidant vitamins and respiratory outcomes have been conflicting. We evaluated whether lower serum levels of vitamins A, C, D, and E are associated with respiratory morbidity and mortality in the U.S. adult population.Methods: We conducted a pooled analysis of data from the 1988-1994 and 1999-2006 National Health and Nutrition Examination Survey (participants aged ≥ 20 years). We estimated covariate-adjusted odds ratios (aOR) per interquartile decrease in each serum vitamin level to quantify associations with respiratory morbidity, and covariate-adjusted hazard ratios (aHR) to quantify associations with respiratory mortality assessed prospectively through 2015. Vitamin supplementation and smoking were evaluated as potential effect modifiers.Results: Lower serum vitamin C increased the odds of wheeze among all participants (overall aOR: 1.08, 95% CI: 1.01-1.16). Among smokers, lower serum α-tocopherol vitamin E increased the odds of wheeze (aOR: 1.11, 95% CI: 1.04-1.19) and chronic bronchitis/emphysema (aOR: 1.13, 95% CI: 1.03-1.24). Conversely, lower serum γ-tocopherol vitamin E was associated with lower odds of wheeze and chronic bronchitis/emphysema (overall aORs: 0.85, 95% CI: 0.79-0.92 and 0.85, 95% CI: 0.76-0.95, respectively). Lower serum vitamin C was associated with increased chronic lower respiratory disease (CLRD) mortality in all participants (overall aHR: 1.27, 95% CI: 1.07-1.51), whereas lower serum 25-hydroxyvitamin D (25-OHD) tended to increase mortality from CLRD and influenza/pneumonia among smokers (aHR range: 1.33-1.75). Mortality from influenza/ pneumonia increased with decreasing serum vitamin A levels in all participants (overall aHR: 1.21, 95% CI: 0.99-1.48). In pooled analysis, vitamin C deficiency and 25-OHD insufficiency were associated with mortality from influenza/pneumonia, increasing mortality risk up to twofold.Conclusions: Our analysis of nationally representative data on over 34,000 participants showed that lower serum levels of vitamins A, C, D, and α-tocopherol vitamin E are associated with increased respiratory morbidity and/or mortality in U.S. adults. The results underscore the importance of antioxidant vitamins in respiratory health. [ABSTRACT FROM AUTHOR]

Background: Although studies have investigated the association between early‐life exposure to fine particulate matter (PM2.5) and childhood asthma/wheezing, results are inconsistent and the susceptible exposure window remains largely unknown. Methods: A prospective birth cohort study was conducted to recruit pregnant women during their early pregnancy, and to follow up them and their children up to 3–4 years old. Diagnosis of asthma/wheezing was extracted from children's medical records. A spatiotemporal land‐use regression (ST‐LUR) model was used to assess maternal exposure to PM2.5 during pregnancy and their children's exposure after birth. The Cox proportional hazards model and accelerated failure time model (for violation of proportional hazards assumption) were applied to estimate the effects of prenatal and postnatal exposures to PM2.5 on the risk of childhood asthma/wheezing. Results: A total of 3725 children were included, and 392 children (10.52%) were diagnosed with asthma/wheezing. Both prenatal and postnatal exposures to PM2.5 were positively associated with the risk of asthma/wheezing. Each interquartile range (IQR) increment in PM2.5 exposure during the entire pregnancy (4.8 μg/m3) and the period from birth to the end of follow‐up (1.5 μg/m3) was associated with adjusted hazard ratios (HRs) of 1.44 [95% confidence interval (CI): 1.13, 1.85] and 2.74 (95% CI: 2.59, 2.91), respectively. Subgroup analyses showed greater HRs for PM2.5 exposures during the pseudoglandular stage (6–16 gestational weeks [GWs]: IQR = 4.8 μg/m3, HR = 1.10, 95% CI: 1.02, 1.18) and canalicular stage (16–24 GWs: IQR = 4.8 μg/m3, HR = 1.13, 95% CI:1.03, 1.23) than other stages, and also showed significant effects in the first three‐year period after birth (IQR = 1.5 μg/m3, HR = 2.37, 95% CI: =2.24, 2.51). Conclusion: Higher prenatal and postnatal PM2.5 exposures may increase the risk of childhood asthma/wheezing. The pseudoglandular stage, canalicular stage, and the first three years after birth may be key susceptible to exposure windows. [ABSTRACT FROM AUTHOR]

Introduction: Whether you benefit from high‐quality urban environments, such as those rich in green and blue spaces, that may offer benefits to allergic and respiratory health depends on where you live and work. Environmental inequality, therefore, results from the unequal distribution of the risks and benefits that stem from interactions with our environment. Methods: Within this perspective, this article reviews the evidence for an association between air pollution caused by industrial activities, traffic, disinfection‐by‐products, and tobacco/e‐cigarettes, and asthma in children. We also discuss the proposed mechanisms by which air pollution increases asthma risk, including environmental epigenetic regulations, oxidative stress, and damage, disrupted barrier integrity, inflammatory pathways, and enhancement of respiratory sensitization to aeroallergens. Results and conclusions: Environmental air pollution is a major determinant of childhood asthma, but the magnitude of effect is not shared equally across the population, regions, and settings where people live, work, and spend their time. Improvement of the exposure assessment, a better understanding of critical exposure time windows, underlying mechanisms, and drivers of heterogeneity may improve the risk estimates. Urban conditions and air quality are not only important features for national and local authorities to shape healthy cities and protect their citizens from environmental and health risks, but they also provide opportunities to mitigate inequalities in the most deprived areas where the environmental burden is highest. Actions to avoid exposure to indoor and outdoor air pollutants should be complementary at different levels—individual, local, and national levels—to take effective measures to protect children who have little or no control over the air they breathe. [ABSTRACT FROM AUTHOR]

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Atopic dermatitis (AD) is a globally prevalent skin inflammation with a particular impact on children. Current therapies for AD are challenged by the limited armamentarium and the high heterogeneity of the disease. A novel promising therapeutic target for AD is the microbiota. Numerous studies have highlighted the involvement of the skin and gut microbiota in the pathogenesis of AD. The resident microbiota at these two epithelial tissues can modulate skin barrier functions and host immune responses, thus regulating AD progression. For example, the pathogenic roles of Staphylococcus aureus in the skin are well-established, making this bacterium an attractive target for AD treatment. Targeting the gut microbiota is another therapeutic strategy for AD. Multiple oral supplements with prebiotics, probiotics, postbiotics, and synbiotics have demonstrated promising efficacy in both AD prevention and treatment. In this review, we summarize the association of microbiota dysbiosis in both the skin and gut with AD, and the current knowledge of the functions of commensal microbiota in AD pathogenesis. Furthermore, we discuss the existing therapies in manipulating both the skin and gut commensal microbiota to prevent or treat AD. We also propose potential novel therapies based on the cutting-edge progress in this area. [ABSTRACT FROM AUTHOR]

Indoor microbiome exposure is important for asthma development, but current studies characterize the microbiome at the genus or above levels due to technical limitations. We aim to profile bacterial and fungal composition and concentration at the species level and assess its potential health effects. Four hundred sixty-three students from 8 junior high schools in Terengganu, Malaysia, were surveyed for asthma symptoms. Full-length PacBio amplicon sequencing and qPCR were conducted to quantify the absolute microbial concentration in the vacuum dust of the selected classroom. In total, 1358 bacterial and 358 fungal species were characterized, and drastic compositional variation was observed among classrooms. Three-level linear regression analyses revealed that taxa richness in Cyanobacteria were negatively associated with asthma (FDR < 0.001). The absolute concentration of Nocardioides exalbidus was protectively associated with asthma, and four bacteria species were positively associated with asthma (FDR < 0.1). Interestingly, all five species were recently isolated and characterized in Asian countries and never reported to associate with asthma. Indoor NO2 and formaldehyde concentration were associated with the overall bacterial community variation and fungal richness, respectively (p < 0.05). No environmental characteristics were directly associated with asthma, but indoor relative humidity, CO2 concentration, and weight of vacuum dust were associated with the asthma-related species (p < 0.05), suggesting a potential indirect health effect on students. This is the first study to characterize indoor microbiome and asthma-associated microorganisms at the species level, representing a region-specific microbiome exposure pattern in a tropical Asian country. [ABSTRACT FROM AUTHOR]

Asthma and COPD overlap (ACO) is characterized by patients presenting with persistent airflow limitation and features of both asthma and COPD. It is associated with a higher frequency and severity of exacerbations, a faster lung function decline, and a higher healthcare cost. Systemic inflammation in COPD and asthma is driven by type 1 T helper (Th1) and Th2 immune responses, respectively, both of which may contribute to airway remodeling in ACO. ACO-related biomarkers can be classified into four categories: neutrophil-mediated inflammation, Th2 cell responses, arachidonic acid-eicosanoids pathway, and metabolites. Gene–environment interactions are key contributors to the complexity of ACO and are regulated by epigenetic mechanisms, including DNA methylation, histone modifications, and non-coding RNAs. Thus, this review focuses on the link between epigenetics and ACO, and outlines the following: (I) inheriting epigenotypes without change with environmental stimuli, or epigenetic changes in response to long-term exposure to inhaled particles plus intermittent exposure to specific allergens; (II) epigenetic markers distinguishing ACO from COPD and asthma; (III) potential epigenetic drugs that can reverse oxidative stress, glucocorticoid insensitivity, and cell injury. Improved understanding of the epigenetic regulations holds great value to give deeper insight into the mechanisms, and clarify their implications for biomedical research in ACO. [ABSTRACT FROM AUTHOR]

The article reviews recent literature on the effects of host manipulation by the parasite Toxoplasma gondii (prevalent in about a third of the world's population) on perception, cognition, and behavior of humans, and on the changes in their physical appearance and personality characteristics. I argue that the mind-affecting parasite paradigm offers many research opportunities for management sciences, especially for organizational psychology and neuroscience. The article summarizes the parasite's physiological mechanisms of affecting the host; highlights important behavioral effects of the infection in humans; and speculates on the possible impacts on skills and careers of employees and managers, organizational dynamics, intercultural management, and gender work roles. The conclusion shows limitations of the presented speculations and possible directions for future research on Toxoplasma's effect on organizational dynamics. [ABSTRACT FROM AUTHOR]

Background: Campylobacteriosis, is a zoonotic bacterial disease observed with a rising worldwide. It is becoming the most commonly recognized cause of bacterial gastroenteritis in under-five mortality in recent years. This study was done to determine the prevalence and determinants of Campylobacter infection among under-fives with acute watery diarrhea. Methods: This institutional-based cross-sectional study was conducted at governmental and private health institutions in Hawassa city. All outpatient under-five children who met the inclusion criteria from April 2021 to August 2021 were enrolled in this study. Demographic and clinical data were obtained using a standardized data collection tool. Stool samples were collected from each participant with a sterile container and inoculated on a campylobacter agar media. The isolates were identified by using biochemical tests and a disc diffusion technique was performed to determine the antimicrobial sensitivity patterns of the isolates. Data were entered and analyzed using SPSS version 21. Descriptive and Logistic regression analysis was applied to determine the determinants of Campylobacter infection. P-value < 0.05 was considered statistically significant. Results: A total of 235 under-five children were enrolled in this study with a 100% response rate. Of these 130 (55.3%) and 105(44.7%) were males and females respectively with the age range of 2 months to 60 months with the mean age of 25 months. The majority of the 150 (63.2%) were rural residents. Of 235 under-fives with acute watery diarrhea, 16 (6.8%) patients were found to have Campylobacter infection with (95% CI, 3.8–10.2%). Consumption of pasteurized milk (AOR: 0.12; 95% CI 0.02–0.75, P<0.05), presence of domestic animals like cats, hens, and cows (AOR: 0.09: 95% CI 0.01–0.67, P<0.05), absence of handwashing practice before food preparation (AOR: 3.63, 95% CI 1.15–11.46, P<0.05) showed significant association with campylobacter infection. The antimicrobial susceptibility patterns of the isolated bacteria were 100% sensitivity to Azithromycin, Chloramphenicol, and Gentamicin, however; it was 100% resistant to Cephalothin. The associations of socio-demographic, environmental, and behavioral factors were compared and consumption of unpasteurized milk, the presence of domestic animal like the cat was significantly associated. Conclusion: Campylobacter infection showed a comparatively low prevalence in under-fives with acute watery diarrhea. In this study contact with cats, consumption of unpasteurized milk were associated with Campylobacter infection. The treatment approach of Campylobacter infection must consider the sensitivity profile of antibiotics as indicated in the study. We, therefore, recommend further studies to determine the species responsible for Campylobacter infection with other co-morbidities and the susceptibility pattern for each species to indicate appropriate antibiotic therapy. [ABSTRACT FROM AUTHOR]

Accurate forecasting of air pollutant PM2.5(particulate matter with diameter less than 2.5 µm) is beneficial to society. However, the non-linear spatio-temporal correlations, multi-feasible forecast values and incomplete training data due to stochasticity make it challenging for discriminative deep learning approaches to forecasting PM2.5 data. In this paper, a generative modeling approach is proposed to overcome the challenges in forecasting PM2.5 data by considering it as an ill-posed inverse problem. To strengthen its applicability, the proposed approach is theoretically validated. Furthermore, based on the proposed generative modeling, an Autoencoder-based generative adversarial network (GAN) named Air-GAN is developed. Air-GAN combines a convolutional neural network- long short-term memory (CNN-LSTM) based Encoder with a conditional Wasserstein GAN (WGAN) to capture non-linear correlations in the data distribution via inverse mapping from the forecast distribution. The condition vector to conditional WGAN is the novelty in Air-GAN, which employs this inverse learning and allows the WGAN's Generator to generate accurate forecast estimates from noise distribution. The condition vector is composed of two elements: (1) the category label of the best correlated meteorological parameter with the PM2.5 data, assigned using an efficient classifier and (2) the output of the CNN-LSTM-based Encoder which is the latent representation of the forecast. The extensive evaluation of Air-GAN for predicting the real-time PM2.5 data of Delhi demonstrates its superior performance with an average inference error of 5.3 µg/m3, which achieves 31.7% improvement over the baseline approaches. The improved performance of Air-GAN demonstrates its efficiency to forecast stochastic PM2.5 data by generalizing to out-of-distribution data. [ABSTRACT FROM AUTHOR]

Objective: Dysphonia is one of the most common side effects of long-term inhaler therapy containing corticosteroids in asthma or asthma–chronic obstructive pulmonary disease overlap (ACO) patients. This common, often reversible side effect is due to the structural changes in the vocal folds resulting from steroid deposition. This study determines the structural changes and voice profile of patients on long-term inhaler therapy by videostroboscopy and perceptual voice profile analysis. It also determines the duration, formulation, and drug delivery system producing the least side effects during therapy. Study Design: Prospective case-control study. Setting: Tertiary care hospital. Methods: In total, 196 patients diagnosed with moderate to severe asthma or ACO were divided into cases (patients on at least 6-month combination inhaler therapy) and controls (newly diagnosed patients not on inhaler therapy) and recruited in the study. They were assessed by videostroboscopy for structural changes and GRBAS (grade of hoarseness, roughness, breathiness, asthenia, and strain) perceptual scale for voice profile changes. Results: The prevalence of dysphonia was significantly higher in cases (62.2%) than controls (27.6%). Prevalence of laryngeal structural changes and voice profile changes were higher in cases. The prevalence of dysphonia and structural changes among cases was much lower when a spacer was used (P <.001). Conclusion: This study adds evidence to the long-term side effects of combination inhaler therapy containing corticosteroids on the larynx as demonstrated by videostroboscopy and perceptual voice profile analysis. It also propagates the use of spacers in drug delivery to reduce the prevalence of side effects during long-term inhaler therapy. [ABSTRACT FROM AUTHOR]

Environmental exposure plays a major role in the development of allergic diseases. The exposome can be classified into internal (e.g., aging, hormones, and metabolic processes), specific external (e.g., chemical pollutants or lifestyle factors), and general external (e.g., broader socioeconomic and psychological contexts) domains, all of which are interrelated. All the factors we are exposed to, from the moment of conception to death, are part of the external exposome. Several hundreds of thousands of new chemicals have been introduced in modern life without our having a full understanding of their toxic health effects and ways to mitigate these effects. Climate change, air pollution, microplastics, tobacco smoke, changes and loss of biodiversity, alterations in dietary habits, and the microbiome due to modernization, urbanization, and globalization constitute our surrounding environment and external exposome. Some of these factors disrupt the epithelial barriers of the skin and mucosal surfaces, and these disruptions have been linked in the last few decades to the increasing prevalence and severity of allergic and inflammatory diseases such as atopic dermatitis, food allergy, allergic rhinitis, chronic rhinosinusitis, eosinophilic esophagitis, and asthma. The epithelial barrier hypothesis provides a mechanistic explanation of how these factors can explain the rapid increase in allergic and autoimmune diseases. In this review, we discuss factors affecting the planet's health in the context of the 'epithelial barrier hypothesis,' including climate change, pollution, changes and loss of biodiversity, and emphasize the changes in the external exposome in the last few decades and their effects on allergic diseases. In addition, the roles of increased dietary fatty acid consumption and environmental substances (detergents, airborne pollen, ozone, microplastics, nanoparticles, and tobacco) affecting epithelial barriers are discussed. Considering the emerging data from recent studies, we suggest stringent governmental regulations, global policy adjustments, patient education, and the establishment of individualized control measures to mitigate environmental threats and decrease allergic disease. [ABSTRACT FROM AUTHOR]

Background: Improper human waste management is a major health problem in most developing countries, including Ethiopia. In Ethiopia, the majority of the population used unimproved sanitation facilities and practiced open defecation. This problem is significantly higher in the rural parts of the country. Objective: The aim of this study was to assess latrine utilization and associated factors among Community Led Total Sanitation (CLTS) implemented and non-implemented kebeles in Tullo District, West Hararghe, and Eastern Ethiopia. Methods: A community-based comparative cross-sectional study design was conducted in 740 households in 3 kebeles Community Led Total Sanitation implemented and 3 kebeles non-Community Lead Total Sanitation implemented for comparison. Study units were selected using a multi-stage sampling technique. The data was cleaned and coded before being entered into Epi-data version 3.1 and analyzed with the Statistical Package for the Social Sciences version 20. Logistic regression analysis was used to assess the association between dependent and independent variables. Result: In this study, the overall prevalence of latrine utilization in the study area was 415 (56.1%) (95% CI = 52.6%, 59.9%). Of them, 243 (65.7%) (95% CI = 60.4%, 70.3%) and 172 (46.5%) (95% CI = 41.3%, 51.7%) of participants in the CLTS and non CLTS kebeles were utilized latrine, respectively. In CLTS implemented kebeles, literate (AOR = 3.66; 95% CI: 1.53, 8.73), households being visited by health extension worker (AOR = 11.72; 95% CI: 4.01, 34.31), households being graduated as model family(AOR = 7.56, 95% CI: 2.79, 20.44), ⩾2 years by years of latrine owning (AOR = 12.10, 95% CI: 3.21, 45.64), >6 meters distance of toilet to home (AOR = 27.43, 95%CI: 8.43, 89.29),Latrine with hand washing (AOR = 2.93, 95%CI: 1.19, 7.17), latrine with superstructure (AOR = 6.54, 95% CI: 2.04, 20.98) were significantly associated with latrine utilization, while in non CLTS implemented kebeles, literate (AOR = 25.78, 95% CI: 13.35, 49.78), medium wealth status(AOR = 4.87, 95% CI: 2.10, 11.29), poor wealth status(AOR = 2.51, 95% CI: 1.26, 5.01) were significantly associated with latrine utilization. Conclusion: The findings of this study revealed that more of the rural households had utilized latrines in CLTS implemented kebeles than non-CLTS implemented' kebeles. So, it is recommended that the district health office increase the latrine utilization rate through the effective and sustainable implementation of the CLTS approach. [ABSTRACT FROM AUTHOR]

Susceptibility to asthma is complex and heterogeneous, as it involves both genetic and environmental insults (pre- and post-birth) acting in a critical window of development in early life. According to the Developmental Origins of Health and Disease, several factors, both harmful and protective, such as nutrition, diseases, drugs, microbiome, and stressors, interact with genotypic variation to change the capacity of the organism to successfully adapt and grow in later life. In this review, we aim to provide the latest evidence about predictive risk and protective factors for developing asthma in different stages of life, from the fetal period to adolescence, in order to develop strategic preventive and therapeutic interventions to predict and improve health later in life. Our study shows that for some risk factors, such as exposure to cigarette smoke, environmental pollutants, and family history of asthma, the evidence in favor of a strong association of those factors with the development of asthma is solid and widely shared. Similarly, the clear benefits of some protective factors were shown, providing new insights into primary prevention. On the contrary, further longitudinal studies are required, as some points in the literature remain controversial and a source of debate. [ABSTRACT FROM AUTHOR]