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Khem Bahadur Karki,1– 3,* Anil Poudyal,1,* Namuna Shrestha,1 Namra Kumar Mahato,1 Krishna Kumar Aryal,4 Milesh Jung Sijapati,5 Bihungum Bista,1 Nitisha Gautam,1 Ranjeeta Subedi,1 Noor Kutubul Alam Siddiquee,6 Pradip Gyanwali,1 Ulrich Kuch,3 David A Groneberg,3 Anjani Kumar Jha,1 Meghnath Dhimal1,3 1Nepal Health Research Council (NHRC), Kathmandu, Nepal; 2Department of Community Medicine, Maharajgunj Medical Campus, Kathmandu, Nepal; 3Institute of Occupational, Social and Environmental Medicine, Goethe University, Frankfurt am Main, Germany; 4Monitoring Evaluation and Operational Research (MEOR) Project, Abt Associates, Kathmandu, Nepal; 5KIST Medical College, Lalitpur, Nepal; 6Public Health Foundation of India, Bangalore, India*These authors contributed equally to this workCorrespondence: Anil Poudyal Email poudyalanil123@gmail.comBackground: The Global Burden of Diseases Study 2017 predicted that chronic obstructive pulmonary disease (COPD) is the second leading cause of death, the fourth leading cause of premature death, and the third cause for DALYs lost in Nepal. However, data on the population-based prevalence of COPD in Nepal are very limited. This study aims to assess the prevalence of COPD and factors associated with the occurrence of COPD in Nepal.Methods: From a nationally representative, population-based cross-sectional study on chronic non-communicable diseases, the prevalence of COPD and its associated factors was determined. Of 12,557 participants aged over 20 years, 8945 participants completed a questionnaire and spirometry. Eligible participants were also asked to answer a COPD diagnostic questionnaire for screening COPD cases, and if needed underwent pre-bronchodilator and post-bronchodilator spirometry. COPD was defined as a post-bronchodilator FEV1/FVC (forced expiratory volume in 1 s/forced vital capacity) ratio of < 0.70. Multivariate logistic regression was performed to identify factors associated with COPD. Sampling weights were used for all data analyses.Results: The prevalence of COPD in Nepal was 11.7% (95% CI: 10.5% to 12.9 %), which increased with age, and higher in those with a low educational level, those who had smoked ≥ 50 pack-years, persons having a low body mass index (BMI), and residents of Karnali province. Multivariate analysis revealed that being aged 60 years and above, having a low BMI, low educational status, having smoked more than 50 pack-years, provincial distribution, and ethnicity were independent predictors of COPD.Conclusion: COPD is a growing and serious public health issue in Nepal. Factor such as old age, cigarette smoking, low educational attainment, low BMI, ethnicity, and locality of residence (province-level variation) plays a vital role in the occurrence of COPD. Strategies aimed at targeting these risk factors through health promotion and education interventions are needed to decrease the burden of COPD.Keywords: COPD, prevalence, non-communicable diseases, Nepal

Abstract Background Leishmaniasis is a chronic disease that is found in various countries of the world. The aim of the current study was to investigate the impact of leishmaniasis on the world's research output. The present study assessed benchmarking of research output for the period between 1957 and 2006. Using large database analyses, research in the field of leishmaniasis was evaluated. Furthermore, cooperation between different countries was identified. Results The number of publications increased with time. Most publications came from Western countries such as the US, UK or Germany. Interestingly, countries like Brazil and India had a high research output. We found a substantial amount of cooperation between countries. Conclusion Although leishmaniasis is of limited geographic distribution it attracts a wide research interest. The central hub of research cooperation is the USA.

Transient receptor potential vanniloid-1 (TRPV-1) mediates the cough response induced by the pepper extract capsaicin and is expressed in sensory nerves that innervate the airway wall. We determined the expression of TRPV-1 in the airways of patients with chronic persistent cough of diverse causes and with an enhanced capsaicin cough response. We obtained airway mucosal biopsies by fiberoptic bronchoscopy in 29 patients with chronic cough and 16 healthy volunteers without a cough. Immunostaining for nerve profiles with anti--protein gene product (PGP)-9.5 antibody showed no increase in nerve profiles in the airway epithelium of patients with chronic cough; however, with an anti--TRPV-1 antibody, there was a fivefold increase of TRPV-1 staining nerve profiles (p < 0.001). There was a significant correlation between capsaicin tussive response and the number of TRPV-1--positive nerves within the patients with cough. Our findings indicate that TRPV-1 receptors may contribute to an enhanced cough reflex and the cough response in chronic persistent cough of diverse causes. [ABSTRACT FROM AUTHOR]

Background: Positive effects of brace treatments in adolescent idiopathic scoliosis patients on gait were proven., Aim: Therefore, this study examined whether the influence of brace therapy in combination with Schroth therapy influencing the plantar pressure distribution, pre and post intensive rehabilitative inpatient treatment., Design: Prospective cohort study, longitudinal., Setting: Scoliosis rehabilitation clinic "Asklepios Katharina-Schroth-Klinik" (Bad Sobernheim, Germany)., Population: Twenty (14f/6m) patients (12-16 years) had a medically diagnosed moderate idiopathic scoliosis (Cobb angle 20-50°, Median 30°) and an indication for combined brace and Schroth therapy with an inpatient stay (4 weeks) at the Asklepios Katharina Schroth Clinic (Germany)., Methods: At the beginning (T1) and at the end of the stay (T2), the plantar pressure distribution with (A) and without wearing a brace (B) was recorded (walking distance 10 m)., Results: No significant differences between the left and right foot were found at baseline (T1). The T1 - T2 comparison of one foot revealed significant differences (p ≤ 0.05 - 0.001, respectively) for (A): mean pressure right midfoot, loaded area total left foot, left midfoot, left inner ball of foot, right midfoot, impulse total right foot, right midfoot and for (B): mean pressure right midfoot, right outer ball of foot, loaded area total right foot, right heel, right midfoot, impulse right heel, right midfoot, right outer ball of foot., Conclusions: A combined brace and Schroth therapy maintains the initial symmetrical plantar pressure distribution over the duration of four weeks since the significant differences fall within the range of measurement error., Clinical Rehabilitation Impact: The insole measuring system can be used to objectively support therapeutic gait training as part of rehabilitation and to assess insole fitting based on foot shape. Due to its convenient handling and rapid data acquisition, it may be a suitable method for interim or follow-up diagnostics in the treatment of idiopathic scoliosis., (© 2024. The Author(s).)

Background: To reduce smoking uptake in adolescents, the medical students' network Education Against Tobacco (EAT) has developed a school-based intervention involving a face-aging mobile app (Smokerface)., Methods: A two-arm cluster-randomized controlled trial was conducted, evaluating the 2016 EAT intervention, which employed the mobile app Smokerface and which was delivered by medical students. Schools were randomized to intervention or control group. Surveys were conducted at baseline (pre-intervention) and at 9, 16, and 24 months post-intervention via paper & pencil questionnaires. The primary outcome was the difference in within-group changes in smoking prevalence between intervention and control group at 24 months., Results: Overall, 144 German secondary schools comprising 11,286 pupils participated in the baseline survey, of which 100 schools participated in the baseline and at least one of the follow-up surveys, yielding 7437 pupils in the analysis sample. After 24 months, smoking prevalence was numerically lower in the intervention group compared to control group (12.9 % vs. 14.3 %); however, between-group differences in change in smoking prevalence between baseline and 24-months follow-up (OR=0.83, 95 %-CI: 0.64-1.09) were not statistically significant (p = 0.176). Intention to start smoking among baseline non-smokers declined non-significantly in the intervention group (p = 0.064), and remained essentially unchanged in the control group, but between-group differences in changes at the 24-months follow-up (OR=0.88, 0.64-1.21) were not statistically significant (p = 0.417)., Conclusion: While a trend towards beneficial effects of the intervention regarding smoking prevalence as well as intention to start smoking among baseline non-smokers was observed, our smoking prevention trial demonstrated no significant effect of the intervention., Competing Interests: Declaration of Competing Interest TJB programmed the Smokerface App and is therefore formally the owner/rights holder. In 2017, he was offered and accepted 500 Euro per year from another German tobacco prevention charity (ginko Stiftung für Prävention, Germany) to license the Smokerface App for their school-based prevention efforts,with no influence to this study. TJB is also the owner of Smart Health Heidelberg GmbH, a software company which develops digital utehealth apps. Werner Seeger received consulting fees from United Therapeutics, Tiakis Biotech AG, Liquidia, Pieris Pharmaceuticals, Abivax, Pfizer, Medspray BV, outside the submitted work. The other authors declare no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Tobacco companies conduct and fund research. They are not always interested in open-ended research. They promote their interests through public relations campaigns. It's a proven fact that they influence the scientific community by impairing scientific reputation, especially in the case of health-related research., Methods: To obtain a comprehensive picture of research and funding activities of the tobacco industry as well as studies about the tobacco industry, respective scientific articles were analyzed in terms of temporal aspects, research areas, networking, and funding sources using established and advanced bibliometric methods., Results: We found the foci of publications with tobacco industry involvement or funding were mainly in chemistry, toxicology, pharmacology, and agricultural sciences. Health-related scopes occurred much less frequently. In contrast, health and medical sciences were the main focus of publications on the tobacco industry. The Chinese state-owned CNTC was the most research-involved tobacco company and often networked with Chinese academic institutions. Whereas, Western universities, on the other hand, collaborated with tobacco companies to a much lesser extent., Conclusion: Conflicts of interest of researchers or academic institutions with the tobacco industry occur repeatedly. That is highly problematic and should not be ignored by the scientific community. The science and the public should be skeptical about tobacco industry-supported research., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Objectives: N95 or Type II filtering face pieces (FFP2) are often worn during work hours or on public transportation to prevent airborne infection. The aim of this randomized controlled crossover study is to assess the impact of FFP2 induced breathing resistance on pulmonary function, blood gas values and discomfort during walking and stair climbing., Methods: N = 16 healthy adults (24.8 ± 2.2 years; 10 females, ) participated. Interventions included (1) six minutes of walking in a 16-meter-long hallway (612 m) and (2) eight minutes of stair climbing in a two-story staircase (420 stairs), both with and without a FFP2 (> 48 h wash-out). Spiroergometric data (Ventilation, breathing frequency, tidal volume, oxygen uptake and carbon dioxide exhalation (primary outcome), end tidal carbon dioxide- and oxygen pressure) and self-reported response (Perceived exertion, dyspnoea and pain) were assessed during activities. Blood gas analysis (capillary carbon dioxide- (pCO 2 ) (primary outcome) and oxygen partial pressure (pO 2 ), pH, lactate and base excess) was measured immediately after cessation of activities. Manipulation effects (FFP2 versus no mask) were tested using repeated measures analyses of variance., Results: Analysis showed no effect of FFP2 on pCO 2 or other blood-gas parameters but on carbon dioxide exhalation during walking: (mean 1067, SD 209 ml/min) (mean 1908, SD 426 ml/min) (F(15) = 19.5; p < 0.001; η p 2  = 0.566) compared to no mask wearing (mean 1237, SD 173 ml/min; mean 1908, SD 426 ml/min). Ventilation was decreased and dyspnoea was increased by FFP2 during activities. FFP2 led to lower oxygen uptake and lower end tidal oxygen but higher end tidal carbon dioxide during stair climbing., Conclusions: FFP2 decreased ventilation based on slower breathing patterns and led to limitations in pulmonary gas exchange and increased subjective dyspnoea. However, invasive diagnostics revealed no signs of clinically relevant metabolic effects immediately after everyday physical activities., (© 2024. The Author(s).)

Objective: This study investigates if an inpatient rehabilitation therapy (brace therapy and Schroth therapy) for six weeks contributes to an improvement in lung function of the patients., Design: Retrospective study., Setting: Scoliosis rehabilitation clinic "Asklepios Katharina-Schroth-Klinik" (Bad Sobernheim, Germany)., Participants: In 253 female patients a lung function examination was performed at entry and at the end of their inpatient rehabilitation stay. Of these, 61 patients underwent Schroth therapy (group 1); 192 patients underwent the combination of brace and Schroth therapy (group 2)., Intervention: Lung function parameters under the influence of Schroth and Schroth and brace therapy within a rehabilitative stay., Main Measures: The parameters of IVC (inspiratory vital capacity), FVC (forced vital capacity), FEV1 (forced expiratory volume in 1 s) and the Tiffeneau index (FEV/FVC) related to patient-specific reference values were evaluated with regard to potential ventilation disorders., Results: There were significant improvements for IVC +2.56 %, FVC +3.99 %, FEV1 +2.36 % for the first stay (IVC and FVC 2nd, 3rd stay). The comparison of patients with vs. without additional brace therapy showed no significances. For the long-term analysis the parameters approached the reference values of age-matched, healthy female subjects. The greater the Cobb angle in the thoracic region, the significantly worse almost each of the measured parameters are., Conclusion: An inpatient rehabilitation therapy contributes to an improvement in lung function (IVC, FVC and FEV1). A second, and even a third, follow-up stay still led to a measurable improvement in lung function, albeit to a lesser extent., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)