The present review critically examines the role of neglected and underutilized crops(NUCs)in enhancing the resilience of South Asian cropping systems and diets in the context of climate change and nutritional challeng...The present review critically examines the role of neglected and underutilized crops(NUCs)in enhancing the resilience of South Asian cropping systems and diets in the context of climate change and nutritional challenges.This analysis reveals that integrating NUCs,such as millets,sorghums,amaranth,and indigenous legumes,into existing cropping systems can significantly improve the climate resilience,dietary diversity,and ecological sustainability of the food systems.These crops exhibit superior tolerance to abiotic stress and offer higher nutritional density compared to staple cereals,such as rice and wheat.However,their adoption faces challenges,including limited research investment,fragmented value chains,etc.We further identify that complementary cropping strategies and climate-smart agriculture(CSA)practices can optimize resource use while boosting smallholder farmers’income.NUCs are pivotal for the transformation of exist cropping systems towards nutrition-sensitive and climate-resilient agricultural and food systems.Strategic integration of NUCs can simultaneously address food insecurity,biodiversity loss,and rural poverty.Yet,unlocking their potential requires coordinated efforts in genetic improvement,market development,and policy frameworks tailored to regional contexts.This synthesis provides a comprehensive roadmap for policy-makers,researchers,and farmers to leverage NUCs as“Future Smart Food”.By bridging agronomic,nutritional,and socioeconomic perspectives,this study highlights the transformative potential of NUCs in achieving Sustainable Development Goals(SDGs)across South Asian countries.展开更多
Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 million cases globally and approximately four million disability-adjusted life years lost annually.More than one-fifth of thes...Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 million cases globally and approximately four million disability-adjusted life years lost annually.More than one-fifth of these cases are attributed to Ancylostoma ceylanicum,an emerging zoonotic health issue in the Asia-Pacific region.This review presents key research gaps regarding the epidemiology,diagnosis,control,prevention and elimination of A.ceylanicum and other canine zoonotic hookworms as neglected health threats.A.ceylanicum is the second most prevalent human hookworm in the region;it is the most common hookworm among dogs and cats-reservoirs of zoonotic infections.Previous population genetic and phylogenetic analyses revealed that A.ceylanicum has three possible transmission dynamics:zoonotic,animal-only,and human-only pathways.The actual burden of zoonotic ancylostomiasis in most endemic countries remains unknown due to the use of parasitological techniques(e.g.,Kato-Katz thick smear and floatation techniques)that have reduced diagnostic performance and do not allow accurate species identification in helminth surveys.The emergence of benzimidazole resistance in soil-transmitted helminths(STHs),including hookworms,is a concern due to the protracted implementation of mass drug administration(MDA).Resistance is conferred by single nucleotide polymorphisms(SNPs)that occur in theβ-tubulin isotype 1 gene.These mutations have been reported in drug-resistant A.caninum but have not been found in A.ceylanicum in the field.A.ceylanicum remains understudied in the Asia-Pacific region.The zoonotic nature of the parasite warrants investigation of its occurrence in human and animal reservoir hosts to understand the dynamics of zoonotic transmission in different endemic foci.The detection of benzimidazole resistance-associated SNPs in zoonotic hookworms from Asia-Pacific countries has yet to be thoroughly explored.Considering the high level of hookworm endemicity in the region,the circulation of resistant isolates between humans and animals potentially presents a significant One Health threat that can undermine current MDA and proposed animal deworming-based control efforts.展开更多
Neglected and underutilized species of plants(NUS)have been identified by the Food and Agriculture Organization as valuable resources for fighting poverty,hunger and malnutrition as they can help make agricultural pro...Neglected and underutilized species of plants(NUS)have been identified by the Food and Agriculture Organization as valuable resources for fighting poverty,hunger and malnutrition as they can help make agricultural production systems more sustainable and resilient.Adaptation of NUS to changing environments over several millennia has rendered most of these plants resistant to pests and climate change.In this paper,we explore the potential values of some of the Mayan fruit trees justifying conservation efforts in their native habitats.Our research was primarily based on a scoping review using Google Scholar.We considered articles published in English,Spanish and Portuguese.Our review rendered two sets of articles including those focusing on the nutritional and medicinal properties of NUS and their products,and those focusing on their uses in traditional medicine.Both sets of papers strongly support arguments for conservation of NUS.Additionally,our scoping review expands and includes a case study on the conservation of NUS,highlighting the critical role of civil society on how it can spearhead rescue efforts of botanical resources through the creation of what is possibly the first arboretum of its kind in the Americas.Among the project's key selling points was not only the rescue of an important component of Yucatan's cultural heritage but its nutritional value as well as its potential medicinal properties.Our paper is not prescriptive on how to preserve or even commercially exploit NUS.It is intended as a thought-provoking piece on the potential of a One Health approach as a multi-sectoral platform to support conservation efforts,while stimulating greater interest in the subject and encouraging more action from the academic and pharmaceutical sectors as well as civil society.展开更多
Egypt has been plagued by many neglected tropical diseases since Pharaonic time.These diseases are Schistosomiasis.soil transmitted helminthiasis,lymphatic filariasis.leishmaniasis and fascioliasis beside the epiderma...Egypt has been plagued by many neglected tropical diseases since Pharaonic time.These diseases are Schistosomiasis.soil transmitted helminthiasis,lymphatic filariasis.leishmaniasis and fascioliasis beside the epidermal parasitic skin diseases.Indeed,theses disease still persist as public health problem in the country by the influence of demographic,socioeconomic and environmental obstacles.This study seeks for understanding the contribution of each factor in each obstacle in neglected tropical diseases perpetuation which in turn could help the governorate in planning integrated control strategies.It was found that poverty,unregulated urbanization and inadequate sanitation are important socioeconomic factors that have great effect on the transmission dynamics of the disease.The environmental factors which affect the epidemiology of these diseases in the counln are scarcity of water,construction of dams,land reclamation for agriculture beside the climate factors.Unfortunately.the panic increase in the population growth rale minimizes the efforts done by the governorate to elevate the public health services.These conditions also affect the transmission of epidermal parasitic skin diseases including scabies,head lice and hookworm—related cutaneous larva migrans.The control programs and the recommendations to combat the diseases were discussed.The present study showed that the ecological factors affecting each neglected tropical disease in Egypt are somewhat similar which makes it worthy to develop an integrated control approaches aiming at improving the leading factors of neglected tropical diseases circulation in the country.展开更多
To the editor,Hepatic capillariasis is a serious parasitic zoonosis caused by the tissue-dwelling nematode Capillaria hepatica(C.hepatica).Humans are an accidental host;human infection is acquired by ingesting food or...To the editor,Hepatic capillariasis is a serious parasitic zoonosis caused by the tissue-dwelling nematode Capillaria hepatica(C.hepatica).Humans are an accidental host;human infection is acquired by ingesting food or water contaminated with infective eggs.Hepatic capillariasis may cause clinical signs and symptoms of varying intensity from mild to severe,with a possible fatal outcome.The typical manifestations are persistent fever,hepatomegaly,and eosinophilia[1].展开更多
Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 milion cases globally and approximately four million disability-adjusted life years lost annually.More than one-fth of these c...Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 milion cases globally and approximately four million disability-adjusted life years lost annually.More than one-fth of these cases are attrib-uted to Ancylostoma ceylanicum,an emerging zoonotic health issue in the Asia-Pacific region.This review presents key research gaps regarding the epidemiology,diagnosis,control,prevention and elimination of A.ceylanicum and other canine zoonotic hookworms as neglected health threats.A.ceylanicum is the second most prevalent human hook-worm in the region;it is the most common hookworm among dogs and cats-reservoirs of zoonotic infections.Previous population genetic and phylogenetic analyses revealed that A.ceylanicum has three possible transmis-sion dynamics:zoonotic,animal-only,and human-only pathways.The actual burden of zoonotic ancylostomiasis in most endemic countries remains unknown due to the use of parasitological techniques(e.g.,Kato-Katz thick smear and floatation techniques)that have reduced diagnostic performance and do not allow accurate species identifica-tion in helminth surveys.The emergence of benzimidazole resistance in soil-transmitted helminths(STHs),includ-ing hookworms,is a concern due to the protracted implementation of mass drug administration(MDA).Resistance is conferred by single nucleotide polymorphisms(SNPs)that occur in theβ-tubulin isotype 1 gene.These mutations have been reported in drug-resistant A.caninum but have not been found in A.ceylanicum in the field.A.ceylanicum remains understudied in the Asia-Pacific region.The zoonotic nature of the parasite warrants investigation of its occur-rence in human and animal reservoir hosts to understand the dynamics of zoonotic transmission in different endemic foci.The detection of benzimidazole resistance-associated SNPs in zoonotic hookworms from Asia-Pacific countries has yet to be thoroughly explored.Considering the high level of hookworm endemicity in the region,the circulation of resistant isolates between humans and animals potentially presents a significant One Health threat that can under-mine current MDA and proposed animal deworming-based control efforts.展开更多
<b><span>Purpose</span></b><b><span>: </span></b><span>The purpose </span><span>of </span><span>this study was to define a treatment protoc...<b><span>Purpose</span></b><b><span>: </span></b><span>The purpose </span><span>of </span><span>this study was to define a treatment protocol in which a non-vascularized endosteal fibular strut graft, a corticocancellous grafts and a locking plate construct </span><span>are</span><span> used for stabilization of the delayed and neglected proximal humerus fractures and to report its outcome. </span><b><span>Patients & Methods</span></b><b><span>:</span></b><b><span> </span></b><span>Eleven patients (6 females and 5 males) with delayed, neglected proximal humerus fractures were included in this study,</span><span> </span><span>conducted between March 2015 </span><span>and </span><span>December 2019.</span><span> </span><span>Average age of the patients was 57 years (range: 41 to 67 yrs). All patients were treated with the debridement, decortication and shingling of the bone at the site of the fracture followed by using an endosteal fibular strut graft, corticocancellous bone grafts and stabilization with locking plate. The patients were followed</span><span> </span><span>up for a mean time of 16.3 months (range: 13 </span><span>to </span><span>40 months). The patient outcomes were evaluated using the Disabilities of the Arm, Shoulder, and Hand Questionnaire, and the modified scoring system of Constant and Murley. </span><b><span>Results</span></b><b><span>:</span></b><b><span> </span></b><span>Union at the fracture site was achieved in all patients at a mean </span><span>of </span><span>8.5 months (range: 6 to 11 months). The DASH score improved from an average pre-operative score of 71.1 (range: 64 to 78) to an average post-operative score of 25.2 (range: 21 to 35) at the final follow-up. Albeit with a small sample size of n</span><span> </span><span>=</span><span> </span><span>11, this difference was found to be statistically significant (p</span><span> </span><span><</span><span> </span><span>0.05). The CM score improved from an average pre-operative score of 33.2 (range: 20 to 48) to an average post-operative score of 66.8 (range: 59 to 72) at the final follow-up. This difference was also found to be statistically significant in this patient cohort (p</span><span> </span><span><</span><span> </span><span>0.05). The results were excellent in 3 patients, good in 6 and moderate in 2. </span><b><span>Conclusions</span></b><b><span>:</span></b><b><span> </span></b><span>An endosteal fibular strut, subperiosteally placed cortico-cancellous grafts with a locking plate fixation helps in biological healing of neglected fractures of proximal humerus.</span>展开更多
Background: Neglected clubfoot in this series is defined as untreated equino-cavo-adducto-varus in older children or adults. Relapsed clubfoot is the residual deformity that remains after single or multiple surgical i...Background: Neglected clubfoot in this series is defined as untreated equino-cavo-adducto-varus in older children or adults. Relapsed clubfoot is the residual deformity that remains after single or multiple surgical interventions. Severely neglected clubfoot rarely exists today in developed countries, except in some emigrants from low- and middle-income countries. Acute surgical management with corrective mid-foot osteotomy and elongation of the Achilles tendon has an excellent functional outcome. Objective: To assess the functional outcome of acute correction of neglected Talipes-quinoa-varus deformity in adults. Methods: This is a cross-sectional, hospital–based multi-centric study. Forty patients were included in this study. Midfoot osteotomy and elongation of the Achilles tendon were performed on all patients. Data was collected using a questionnaire and the functional outcome has been assessed using the American Orthopedic Foot and Ankle Society Score (AOFAS). This score was measured before surgery and one year after surgery. Results: the mean age was 19.9 ± 4.7 years. Males were 25 (62.5%) and females were 15 (37.5%). The mean preoperative AOFAS score was 37.7 ± 7.1 (poor). This score improved to 80.7 ± 13.7 (good to excellent), two years after surgery. However, this indicates a significant change in the functional outcome after the operation (p value Conclusion: acute correction of neglected and relapsed TEV with elongation of the Achilles tendon and single midfoot osteotomy has excellent functional outcome as assessed by AOFAS Score. The satisfaction with this procedure is impressive. The younger age population showed better outcomes with this procedure.展开更多
Objective:To examine the choice of healthcare providers for treating kala azar(KA) in Nepal. Methods:Information was collected from clinically diagnosed KA patients seeking care from public hospitals located in KA end...Objective:To examine the choice of healthcare providers for treating kala azar(KA) in Nepal. Methods:Information was collected from clinically diagnosed KA patients seeking care from public hospitals located in KA endemic districts.The survey collected information from more than 25 percent of total KA cases in the country.For empirical estimation of probability of choosing a provider-type as a first contact healthcare provider,a multinomial logit model was defined with five alternative options with self care as the reference category.Results:The empirical model found that price of medical care services,income of households,knowledge of patients on KA and KA treatment,borrowing money,age of patient,perceived quality of provider types,etc.determine the likelihood of seeking care from the alternative options considered in the analysis.All variables have expected signs and are con.vstent with earlier studies.The price and income elasticity were found to be very high indicating that poorer households are very sensitive to price and income changes,even for a severe disease like KA.Using the empirical models, we have analyzed two policy instruments:demand side financing and interventions to improve the knowledge index about KA.Conclusions:Due to high price elasticity of KA care and high spillover effects of KA on the society,policy makers may consider demand side financing as an instrument to encourage utilization of public hospitals.展开更多
The WHO reports that billions of people and animals in tropical and subtropical regions are affected by helminthiasis as neglected tropical disease. It is predominant in underdeveloped areas;nevertheless, the increase...The WHO reports that billions of people and animals in tropical and subtropical regions are affected by helminthiasis as neglected tropical disease. It is predominant in underdeveloped areas;nevertheless, the increase in the number of travelers and migrants has made this infection more common. The current mass drug treatment produces severe side effects and many strains of helminths are resistant to them. None of the chemotherapeutic drugs meets the ideal requirements of anthelmintics, such as broad spectrum of activity, single dose cure, free from side effect and cost-effectiveness. Today, many researchers are screening the traditional herbal system in search of the anthelmintic herbal constituents which overcome all the problems of synthetic drugs. Several researchers proclaim anthelmintic activity of herbal medicines by using different experimental models. The present review demonstrates natural product drug discovery, outlining potential of herbal constituents from natural sources as natural leads against helminthiasis.展开更多
AIM To evaluate the effectiveness of the Ponseti method for initial correction of neglected clubfoot cases in multiple centers throughout Nigeria.METHODS Patient charts were reviewed through the International Clubfoot...AIM To evaluate the effectiveness of the Ponseti method for initial correction of neglected clubfoot cases in multiple centers throughout Nigeria.METHODS Patient charts were reviewed through the International Clubfoot Registry for 12 different Ponseti clubfoot treatment centers and 328 clubfeet(225 patients)met inclusion criteria.All patients were treated by the method described by Ponseti including manipulation and casting with percutaneous Achilles tenotomy as needed.RESULTS A painless plantigrade foot was obtained in 255 feet(78%)without the need for extensive soft tissue release and/or bony procedures.CONCLUSION We conclude that the Ponseti method is a safe,effective and low-cost treatment for initial correction of neglected idiopathic clubfoot presenting after walking age.Longterm follow-up will be required to assess outcomes.展开更多
Here, we present the clinical and radiological results of three neglected volar metacarpophalangeal dislocations in 2 patients, which were treated with open reductions 10 and 24 mo after the dislocations. There was a ...Here, we present the clinical and radiological results of three neglected volar metacarpophalangeal dislocations in 2 patients, which were treated with open reductions 10 and 24 mo after the dislocations. There was a mean of a 20°(range 10°-30°) limitation of extension and a 53.3°(range 30°-70°) limitation of flexion preoperatively. Postoperatively, there was no limitation of extension(at 8 and 12 mo) in any of the fingers. In terms of flexion, one finger had full function, one had a 10° and the last one had a 30° limitation of flexion. Two of the fingers presented anesthesia preoperatively, which improved to hypesthesia postoperatively. One finger had hypesthesia, which improved postoperatively. During surgery, a ruptured dorsal capsule was found to have interposed into the joint, making closed reduction impossible. Our experience with these two patients demonstrated that, even in neglected cases, open reduction using an isolated dorsal approach may result in satisfactory clinical andradiological outcomes.展开更多
The adoption of Sustainable Development Goals(SDGs)under Agenda 2030 is one of the most ambitious ventures by the United Nations for the betterment of humanity.The SDGs are a comprehensive and holistic approach to mak...The adoption of Sustainable Development Goals(SDGs)under Agenda 2030 is one of the most ambitious ventures by the United Nations for the betterment of humanity.The SDGs are a comprehensive and holistic approach to making the lives of humans,not only the current human population but even future generations,worth living and celebrating.SDGs aim to end poverty,hunger,and inequities,provide everyone with clean water,energy,and an environment,and make the planet more peaceful,just,and habitable[1].展开更多
The corticospinal tract（CST）is an essential motor pathway in the human brain：particularly,it is essential for fine hand movements（Jang,2014）.Stroke patients can show more severe weakness when a partial injury of ...The corticospinal tract（CST）is an essential motor pathway in the human brain：particularly,it is essential for fine hand movements（Jang,2014）.Stroke patients can show more severe weakness when a partial injury of the CST is combined with apraxia.展开更多
The Yi are the largest and most disadvantaged ethnic minority population in southwestern China. This region contains over eight million Yi, with approximately 2.4 million living in the Liangshan Yi Autonomous Prefectu...The Yi are the largest and most disadvantaged ethnic minority population in southwestern China. This region contains over eight million Yi, with approximately 2.4 million living in the Liangshan Yi Autonomous Prefecture （Liangshan） in Sichuan Province. Liangshan is located along one of the main drug trafficking routes from the ＇Golden Triangle＇ to northwest and central China, making it one of the largest illicit drug production and distribution centers in China.展开更多
BACKGROUND Congenital knee dislocation(CKD)is a rare condition,which accounts for 1%of congenital hip dislocations.It can present as an isolated condition or coexist with other genetic disorders.Treatment options incl...BACKGROUND Congenital knee dislocation(CKD)is a rare condition,which accounts for 1%of congenital hip dislocations.It can present as an isolated condition or coexist with other genetic disorders.Treatment options include serial casting,percutaneous quadriceps recession,and V-Y quadricepsplasty(VYQ).The pathogenesis and hereditary patterns of CKD are not fully understood,with most cases being familial.CKD is usually managed immediately after birth.However,in this report,the patient was neglected for 2 years.CASE SUMMARY A 2-year-old girl with bilateral CKD after birth presented to our hospital after failed serial casting;the patient had seizures and limited access to healthcare because of her family’s low socioeconomic status.Her birth was noted for a breech presentation accompanied by oligohydramnios.The delivery took a long time,requiring immediate medical interventions.As an infant,she had chronic diseases,including a small patent ductus arteriole,multicystic dysplastic kidney disease,and epilepsy.She was found to have a bilateral knee dislocation of approximately-90°on hyperextension.A multidisciplinary team was involved,and medical care was optimized.She underwent VYQ plus semitendinosus and sartorius transfer.After four postoperative follow-ups,her knees were regaining mobility,and she could walk for 2-3 steps without assistance.CONCLUSION This report highlights the importance of early intervention and recommends extensive studies of the management in similar cases.展开更多
In order to characterize neglected and underutilized legumes seeds (NULs), prospection, collection and characterization were carried out in five administrative regions from Cote d’Ivoire. Two thousand and fifty-four ...In order to characterize neglected and underutilized legumes seeds (NULs), prospection, collection and characterization were carried out in five administrative regions from Cote d’Ivoire. Two thousand and fifty-four accessions were collected. NULs cultivation is done mainly by women (88.1% compared to 11.9% of men). Productors distinguish 22 morphotypes of NULs based on seeds shapes, colors and patterns. Morphological traits of the collected morphotypes revealed a significant phenotypic polymorphism. Quantitative analyses showed a clear structure of accessions;three main groups were revealed. The first group contains accessions with large and thick seeds, but a low index shape opposite to group II with high index shape. Seeds of group III are characterized by small width and thickness, but a high shape index. Analyses of qualitative traits revealed five groups characterized by heterogeneous or homogeneous coloured integument, inked or elevated edge of hilum, presence or absence of eye.展开更多
The myodural bridge is a dense connective tissue connecting muscles and ligaments to the spinal dura mater.Some researchers believe that the myodural bridge may play vital physiological roles.Previously,the myodural b...The myodural bridge is a dense connective tissue connecting muscles and ligaments to the spinal dura mater.Some researchers believe that the myodural bridge may play vital physiological roles.Previously,the myodural bridge has been shown in five different groups of mammals.Bats are nocturnal and the only mammals that can perform a true and sustained flight;whereas tree shrews(Tupaia belangeri)are arboreal mammals that often climb to a high altitude of about 10000 feet.Both animals have life styles that are different from other previously studied mammals.The study of these two animals will further shed light on the existence of the myodural bridge in mammals.展开更多
Introduction: Hamate dislocation is an uncommon injury, and there are only 17 reported cases in the literature. Ten of them are isolated injuries, and in 7 cases the hamate dislocation is a part of other injuries of t...Introduction: Hamate dislocation is an uncommon injury, and there are only 17 reported cases in the literature. Ten of them are isolated injuries, and in 7 cases the hamate dislocation is a part of other injuries of the hand. Hamate dislocation can be caused by both direct and indirect forces, or as a part of complex injury of the wrist and hand. Case Report: A case report of a 26-year-old man who presented with a machine injury to his hand with a volar hamate dislocation which was initially missed in the Emergency department as a volar lacerated wound of the hand and was subsequently discovered in the Orthopaedic clinic 6 weeks later. Conclusion: This is only the second report in literature of a neglected hamate dislocation being surgically treated and the 18th reported case of a hamate dislocation over the last 130 years. The direction of dislocation depends on the direction of force applied. Surgical treatment with fixation is optimal even for neglected cases. There was no incidence of avascular necrosis of hamate reported, reflecting the almost equal volar and dorsal blood supply of the hamate.展开更多
文摘The present review critically examines the role of neglected and underutilized crops(NUCs)in enhancing the resilience of South Asian cropping systems and diets in the context of climate change and nutritional challenges.This analysis reveals that integrating NUCs,such as millets,sorghums,amaranth,and indigenous legumes,into existing cropping systems can significantly improve the climate resilience,dietary diversity,and ecological sustainability of the food systems.These crops exhibit superior tolerance to abiotic stress and offer higher nutritional density compared to staple cereals,such as rice and wheat.However,their adoption faces challenges,including limited research investment,fragmented value chains,etc.We further identify that complementary cropping strategies and climate-smart agriculture(CSA)practices can optimize resource use while boosting smallholder farmers’income.NUCs are pivotal for the transformation of exist cropping systems towards nutrition-sensitive and climate-resilient agricultural and food systems.Strategic integration of NUCs can simultaneously address food insecurity,biodiversity loss,and rural poverty.Yet,unlocking their potential requires coordinated efforts in genetic improvement,market development,and policy frameworks tailored to regional contexts.This synthesis provides a comprehensive roadmap for policy-makers,researchers,and farmers to leverage NUCs as“Future Smart Food”.By bridging agronomic,nutritional,and socioeconomic perspectives,this study highlights the transformative potential of NUCs in achieving Sustainable Development Goals(SDGs)across South Asian countries.
基金supported by a Postgraduate Study Support Grant from the Faculty of Medicine,Khon Kaen University.
文摘Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 million cases globally and approximately four million disability-adjusted life years lost annually.More than one-fifth of these cases are attributed to Ancylostoma ceylanicum,an emerging zoonotic health issue in the Asia-Pacific region.This review presents key research gaps regarding the epidemiology,diagnosis,control,prevention and elimination of A.ceylanicum and other canine zoonotic hookworms as neglected health threats.A.ceylanicum is the second most prevalent human hookworm in the region;it is the most common hookworm among dogs and cats-reservoirs of zoonotic infections.Previous population genetic and phylogenetic analyses revealed that A.ceylanicum has three possible transmission dynamics:zoonotic,animal-only,and human-only pathways.The actual burden of zoonotic ancylostomiasis in most endemic countries remains unknown due to the use of parasitological techniques(e.g.,Kato-Katz thick smear and floatation techniques)that have reduced diagnostic performance and do not allow accurate species identification in helminth surveys.The emergence of benzimidazole resistance in soil-transmitted helminths(STHs),including hookworms,is a concern due to the protracted implementation of mass drug administration(MDA).Resistance is conferred by single nucleotide polymorphisms(SNPs)that occur in theβ-tubulin isotype 1 gene.These mutations have been reported in drug-resistant A.caninum but have not been found in A.ceylanicum in the field.A.ceylanicum remains understudied in the Asia-Pacific region.The zoonotic nature of the parasite warrants investigation of its occurrence in human and animal reservoir hosts to understand the dynamics of zoonotic transmission in different endemic foci.The detection of benzimidazole resistance-associated SNPs in zoonotic hookworms from Asia-Pacific countries has yet to be thoroughly explored.Considering the high level of hookworm endemicity in the region,the circulation of resistant isolates between humans and animals potentially presents a significant One Health threat that can undermine current MDA and proposed animal deworming-based control efforts.
文摘Neglected and underutilized species of plants(NUS)have been identified by the Food and Agriculture Organization as valuable resources for fighting poverty,hunger and malnutrition as they can help make agricultural production systems more sustainable and resilient.Adaptation of NUS to changing environments over several millennia has rendered most of these plants resistant to pests and climate change.In this paper,we explore the potential values of some of the Mayan fruit trees justifying conservation efforts in their native habitats.Our research was primarily based on a scoping review using Google Scholar.We considered articles published in English,Spanish and Portuguese.Our review rendered two sets of articles including those focusing on the nutritional and medicinal properties of NUS and their products,and those focusing on their uses in traditional medicine.Both sets of papers strongly support arguments for conservation of NUS.Additionally,our scoping review expands and includes a case study on the conservation of NUS,highlighting the critical role of civil society on how it can spearhead rescue efforts of botanical resources through the creation of what is possibly the first arboretum of its kind in the Americas.Among the project's key selling points was not only the rescue of an important component of Yucatan's cultural heritage but its nutritional value as well as its potential medicinal properties.Our paper is not prescriptive on how to preserve or even commercially exploit NUS.It is intended as a thought-provoking piece on the potential of a One Health approach as a multi-sectoral platform to support conservation efforts,while stimulating greater interest in the subject and encouraging more action from the academic and pharmaceutical sectors as well as civil society.
文摘Egypt has been plagued by many neglected tropical diseases since Pharaonic time.These diseases are Schistosomiasis.soil transmitted helminthiasis,lymphatic filariasis.leishmaniasis and fascioliasis beside the epidermal parasitic skin diseases.Indeed,theses disease still persist as public health problem in the country by the influence of demographic,socioeconomic and environmental obstacles.This study seeks for understanding the contribution of each factor in each obstacle in neglected tropical diseases perpetuation which in turn could help the governorate in planning integrated control strategies.It was found that poverty,unregulated urbanization and inadequate sanitation are important socioeconomic factors that have great effect on the transmission dynamics of the disease.The environmental factors which affect the epidemiology of these diseases in the counln are scarcity of water,construction of dams,land reclamation for agriculture beside the climate factors.Unfortunately.the panic increase in the population growth rale minimizes the efforts done by the governorate to elevate the public health services.These conditions also affect the transmission of epidermal parasitic skin diseases including scabies,head lice and hookworm—related cutaneous larva migrans.The control programs and the recommendations to combat the diseases were discussed.The present study showed that the ecological factors affecting each neglected tropical disease in Egypt are somewhat similar which makes it worthy to develop an integrated control approaches aiming at improving the leading factors of neglected tropical diseases circulation in the country.
基金supported by Henan Major Public Research Project(No.2008-145)Henan Medical Science and Technology(No.201003006)
文摘To the editor,Hepatic capillariasis is a serious parasitic zoonosis caused by the tissue-dwelling nematode Capillaria hepatica(C.hepatica).Humans are an accidental host;human infection is acquired by ingesting food or water contaminated with infective eggs.Hepatic capillariasis may cause clinical signs and symptoms of varying intensity from mild to severe,with a possible fatal outcome.The typical manifestations are persistent fever,hepatomegaly,and eosinophilia[1].
文摘Zoonotic hookworm infections remain a significant public health problem,causing nearly 500 milion cases globally and approximately four million disability-adjusted life years lost annually.More than one-fth of these cases are attrib-uted to Ancylostoma ceylanicum,an emerging zoonotic health issue in the Asia-Pacific region.This review presents key research gaps regarding the epidemiology,diagnosis,control,prevention and elimination of A.ceylanicum and other canine zoonotic hookworms as neglected health threats.A.ceylanicum is the second most prevalent human hook-worm in the region;it is the most common hookworm among dogs and cats-reservoirs of zoonotic infections.Previous population genetic and phylogenetic analyses revealed that A.ceylanicum has three possible transmis-sion dynamics:zoonotic,animal-only,and human-only pathways.The actual burden of zoonotic ancylostomiasis in most endemic countries remains unknown due to the use of parasitological techniques(e.g.,Kato-Katz thick smear and floatation techniques)that have reduced diagnostic performance and do not allow accurate species identifica-tion in helminth surveys.The emergence of benzimidazole resistance in soil-transmitted helminths(STHs),includ-ing hookworms,is a concern due to the protracted implementation of mass drug administration(MDA).Resistance is conferred by single nucleotide polymorphisms(SNPs)that occur in theβ-tubulin isotype 1 gene.These mutations have been reported in drug-resistant A.caninum but have not been found in A.ceylanicum in the field.A.ceylanicum remains understudied in the Asia-Pacific region.The zoonotic nature of the parasite warrants investigation of its occur-rence in human and animal reservoir hosts to understand the dynamics of zoonotic transmission in different endemic foci.The detection of benzimidazole resistance-associated SNPs in zoonotic hookworms from Asia-Pacific countries has yet to be thoroughly explored.Considering the high level of hookworm endemicity in the region,the circulation of resistant isolates between humans and animals potentially presents a significant One Health threat that can under-mine current MDA and proposed animal deworming-based control efforts.
文摘<b><span>Purpose</span></b><b><span>: </span></b><span>The purpose </span><span>of </span><span>this study was to define a treatment protocol in which a non-vascularized endosteal fibular strut graft, a corticocancellous grafts and a locking plate construct </span><span>are</span><span> used for stabilization of the delayed and neglected proximal humerus fractures and to report its outcome. </span><b><span>Patients & Methods</span></b><b><span>:</span></b><b><span> </span></b><span>Eleven patients (6 females and 5 males) with delayed, neglected proximal humerus fractures were included in this study,</span><span> </span><span>conducted between March 2015 </span><span>and </span><span>December 2019.</span><span> </span><span>Average age of the patients was 57 years (range: 41 to 67 yrs). All patients were treated with the debridement, decortication and shingling of the bone at the site of the fracture followed by using an endosteal fibular strut graft, corticocancellous bone grafts and stabilization with locking plate. The patients were followed</span><span> </span><span>up for a mean time of 16.3 months (range: 13 </span><span>to </span><span>40 months). The patient outcomes were evaluated using the Disabilities of the Arm, Shoulder, and Hand Questionnaire, and the modified scoring system of Constant and Murley. </span><b><span>Results</span></b><b><span>:</span></b><b><span> </span></b><span>Union at the fracture site was achieved in all patients at a mean </span><span>of </span><span>8.5 months (range: 6 to 11 months). The DASH score improved from an average pre-operative score of 71.1 (range: 64 to 78) to an average post-operative score of 25.2 (range: 21 to 35) at the final follow-up. Albeit with a small sample size of n</span><span> </span><span>=</span><span> </span><span>11, this difference was found to be statistically significant (p</span><span> </span><span><</span><span> </span><span>0.05). The CM score improved from an average pre-operative score of 33.2 (range: 20 to 48) to an average post-operative score of 66.8 (range: 59 to 72) at the final follow-up. This difference was also found to be statistically significant in this patient cohort (p</span><span> </span><span><</span><span> </span><span>0.05). The results were excellent in 3 patients, good in 6 and moderate in 2. </span><b><span>Conclusions</span></b><b><span>:</span></b><b><span> </span></b><span>An endosteal fibular strut, subperiosteally placed cortico-cancellous grafts with a locking plate fixation helps in biological healing of neglected fractures of proximal humerus.</span>
文摘Background: Neglected clubfoot in this series is defined as untreated equino-cavo-adducto-varus in older children or adults. Relapsed clubfoot is the residual deformity that remains after single or multiple surgical interventions. Severely neglected clubfoot rarely exists today in developed countries, except in some emigrants from low- and middle-income countries. Acute surgical management with corrective mid-foot osteotomy and elongation of the Achilles tendon has an excellent functional outcome. Objective: To assess the functional outcome of acute correction of neglected Talipes-quinoa-varus deformity in adults. Methods: This is a cross-sectional, hospital–based multi-centric study. Forty patients were included in this study. Midfoot osteotomy and elongation of the Achilles tendon were performed on all patients. Data was collected using a questionnaire and the functional outcome has been assessed using the American Orthopedic Foot and Ankle Society Score (AOFAS). This score was measured before surgery and one year after surgery. Results: the mean age was 19.9 ± 4.7 years. Males were 25 (62.5%) and females were 15 (37.5%). The mean preoperative AOFAS score was 37.7 ± 7.1 (poor). This score improved to 80.7 ± 13.7 (good to excellent), two years after surgery. However, this indicates a significant change in the functional outcome after the operation (p value Conclusion: acute correction of neglected and relapsed TEV with elongation of the Achilles tendon and single midfoot osteotomy has excellent functional outcome as assessed by AOFAS Score. The satisfaction with this procedure is impressive. The younger age population showed better outcomes with this procedure.
基金support for the survey was provided by UNICEF/ UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases(TDR),Geneva
文摘Objective:To examine the choice of healthcare providers for treating kala azar(KA) in Nepal. Methods:Information was collected from clinically diagnosed KA patients seeking care from public hospitals located in KA endemic districts.The survey collected information from more than 25 percent of total KA cases in the country.For empirical estimation of probability of choosing a provider-type as a first contact healthcare provider,a multinomial logit model was defined with five alternative options with self care as the reference category.Results:The empirical model found that price of medical care services,income of households,knowledge of patients on KA and KA treatment,borrowing money,age of patient,perceived quality of provider types,etc.determine the likelihood of seeking care from the alternative options considered in the analysis.All variables have expected signs and are con.vstent with earlier studies.The price and income elasticity were found to be very high indicating that poorer households are very sensitive to price and income changes,even for a severe disease like KA.Using the empirical models, we have analyzed two policy instruments:demand side financing and interventions to improve the knowledge index about KA.Conclusions:Due to high price elasticity of KA care and high spillover effects of KA on the society,policy makers may consider demand side financing as an instrument to encourage utilization of public hospitals.
文摘The WHO reports that billions of people and animals in tropical and subtropical regions are affected by helminthiasis as neglected tropical disease. It is predominant in underdeveloped areas;nevertheless, the increase in the number of travelers and migrants has made this infection more common. The current mass drug treatment produces severe side effects and many strains of helminths are resistant to them. None of the chemotherapeutic drugs meets the ideal requirements of anthelmintics, such as broad spectrum of activity, single dose cure, free from side effect and cost-effectiveness. Today, many researchers are screening the traditional herbal system in search of the anthelmintic herbal constituents which overcome all the problems of synthetic drugs. Several researchers proclaim anthelmintic activity of herbal medicines by using different experimental models. The present review demonstrates natural product drug discovery, outlining potential of herbal constituents from natural sources as natural leads against helminthiasis.
文摘AIM To evaluate the effectiveness of the Ponseti method for initial correction of neglected clubfoot cases in multiple centers throughout Nigeria.METHODS Patient charts were reviewed through the International Clubfoot Registry for 12 different Ponseti clubfoot treatment centers and 328 clubfeet(225 patients)met inclusion criteria.All patients were treated by the method described by Ponseti including manipulation and casting with percutaneous Achilles tenotomy as needed.RESULTS A painless plantigrade foot was obtained in 255 feet(78%)without the need for extensive soft tissue release and/or bony procedures.CONCLUSION We conclude that the Ponseti method is a safe,effective and low-cost treatment for initial correction of neglected idiopathic clubfoot presenting after walking age.Longterm follow-up will be required to assess outcomes.
文摘Here, we present the clinical and radiological results of three neglected volar metacarpophalangeal dislocations in 2 patients, which were treated with open reductions 10 and 24 mo after the dislocations. There was a mean of a 20°(range 10°-30°) limitation of extension and a 53.3°(range 30°-70°) limitation of flexion preoperatively. Postoperatively, there was no limitation of extension(at 8 and 12 mo) in any of the fingers. In terms of flexion, one finger had full function, one had a 10° and the last one had a 30° limitation of flexion. Two of the fingers presented anesthesia preoperatively, which improved to hypesthesia postoperatively. One finger had hypesthesia, which improved postoperatively. During surgery, a ruptured dorsal capsule was found to have interposed into the joint, making closed reduction impossible. Our experience with these two patients demonstrated that, even in neglected cases, open reduction using an isolated dorsal approach may result in satisfactory clinical andradiological outcomes.
文摘The adoption of Sustainable Development Goals(SDGs)under Agenda 2030 is one of the most ambitious ventures by the United Nations for the betterment of humanity.The SDGs are a comprehensive and holistic approach to making the lives of humans,not only the current human population but even future generations,worth living and celebrating.SDGs aim to end poverty,hunger,and inequities,provide everyone with clean water,energy,and an environment,and make the planet more peaceful,just,and habitable[1].
基金supported by the DGIST R&D Program of the Ministry of Science,ICT and Future Planning(15-BD-0401).SHJ designed this study,collected and analyzed data,and revised the paper.CHC participated in study design and data collection.WHJ participated in data collection and analysis and wrote the paper
文摘The corticospinal tract（CST）is an essential motor pathway in the human brain：particularly,it is essential for fine hand movements（Jang,2014）.Stroke patients can show more severe weakness when a partial injury of the CST is combined with apraxia.
基金supported by the Global Fund for AIDS program,China(Grant CSO-2012-YAN-39)
文摘The Yi are the largest and most disadvantaged ethnic minority population in southwestern China. This region contains over eight million Yi, with approximately 2.4 million living in the Liangshan Yi Autonomous Prefecture （Liangshan） in Sichuan Province. Liangshan is located along one of the main drug trafficking routes from the ＇Golden Triangle＇ to northwest and central China, making it one of the largest illicit drug production and distribution centers in China.
文摘BACKGROUND Congenital knee dislocation(CKD)is a rare condition,which accounts for 1%of congenital hip dislocations.It can present as an isolated condition or coexist with other genetic disorders.Treatment options include serial casting,percutaneous quadriceps recession,and V-Y quadricepsplasty(VYQ).The pathogenesis and hereditary patterns of CKD are not fully understood,with most cases being familial.CKD is usually managed immediately after birth.However,in this report,the patient was neglected for 2 years.CASE SUMMARY A 2-year-old girl with bilateral CKD after birth presented to our hospital after failed serial casting;the patient had seizures and limited access to healthcare because of her family’s low socioeconomic status.Her birth was noted for a breech presentation accompanied by oligohydramnios.The delivery took a long time,requiring immediate medical interventions.As an infant,she had chronic diseases,including a small patent ductus arteriole,multicystic dysplastic kidney disease,and epilepsy.She was found to have a bilateral knee dislocation of approximately-90°on hyperextension.A multidisciplinary team was involved,and medical care was optimized.She underwent VYQ plus semitendinosus and sartorius transfer.After four postoperative follow-ups,her knees were regaining mobility,and she could walk for 2-3 steps without assistance.CONCLUSION This report highlights the importance of early intervention and recommends extensive studies of the management in similar cases.
文摘In order to characterize neglected and underutilized legumes seeds (NULs), prospection, collection and characterization were carried out in five administrative regions from Cote d’Ivoire. Two thousand and fifty-four accessions were collected. NULs cultivation is done mainly by women (88.1% compared to 11.9% of men). Productors distinguish 22 morphotypes of NULs based on seeds shapes, colors and patterns. Morphological traits of the collected morphotypes revealed a significant phenotypic polymorphism. Quantitative analyses showed a clear structure of accessions;three main groups were revealed. The first group contains accessions with large and thick seeds, but a low index shape opposite to group II with high index shape. Seeds of group III are characterized by small width and thickness, but a high shape index. Analyses of qualitative traits revealed five groups characterized by heterogeneous or homogeneous coloured integument, inked or elevated edge of hilum, presence or absence of eye.
文摘The myodural bridge is a dense connective tissue connecting muscles and ligaments to the spinal dura mater.Some researchers believe that the myodural bridge may play vital physiological roles.Previously,the myodural bridge has been shown in five different groups of mammals.Bats are nocturnal and the only mammals that can perform a true and sustained flight;whereas tree shrews(Tupaia belangeri)are arboreal mammals that often climb to a high altitude of about 10000 feet.Both animals have life styles that are different from other previously studied mammals.The study of these two animals will further shed light on the existence of the myodural bridge in mammals.
文摘Introduction: Hamate dislocation is an uncommon injury, and there are only 17 reported cases in the literature. Ten of them are isolated injuries, and in 7 cases the hamate dislocation is a part of other injuries of the hand. Hamate dislocation can be caused by both direct and indirect forces, or as a part of complex injury of the wrist and hand. Case Report: A case report of a 26-year-old man who presented with a machine injury to his hand with a volar hamate dislocation which was initially missed in the Emergency department as a volar lacerated wound of the hand and was subsequently discovered in the Orthopaedic clinic 6 weeks later. Conclusion: This is only the second report in literature of a neglected hamate dislocation being surgically treated and the 18th reported case of a hamate dislocation over the last 130 years. The direction of dislocation depends on the direction of force applied. Surgical treatment with fixation is optimal even for neglected cases. There was no incidence of avascular necrosis of hamate reported, reflecting the almost equal volar and dorsal blood supply of the hamate.
