Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically...Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically addresses the difficulties faced in assessing medical care,and the ongoing initiatives to lower the maternal mortality ratio.Methods:Primary studies(published after year 2000)focused on maternal mortality,health determinants,and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases,including Scopus,PubMed,Google Scholar,and Web of Science.These were screened using defined inclusion and exclusion criteria.Data from these studies were extracted and thematically analysed to identify common themes and trends.Results:A total of 21 publications were included in this review comprising 2 qualitative,17 quantitative,and2 mixed study designs.Major health determinants identified in these studies include hypertensive disorders of pregnancy,haemorrhage,and sepsis/septicaemia,contributing as much as 29%,24%,and 14.2%of maternal deaths respectively in over 10%of the reviewed studies.Similarly,social-economic determinants including poverty,maternal education,health system issues and culture significantly impacted the utilization of maternal healthcare services,inadvertently impacting maternal mortality.Despite various maternal health interventions such as the"Abiye"Safe Motherhood Initiative,the Integrated Maternal,Newborn,and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies,early childbearing,unemployment,large family sizes,and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.Conclusion:This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality,its health determinants,and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.展开更多
Chinese medicine,with its rich historical roots and holistic approach,has been a fundamental aspect of healthcare in East Asia and is now gaining global recognition.Founded on centuries of empirical knowledge and phil...Chinese medicine,with its rich historical roots and holistic approach,has been a fundamental aspect of healthcare in East Asia and is now gaining global recognition.Founded on centuries of empirical knowledge and philosophical insight,Chinese medicine draws heavily from classical texts to guide its practices in herbal medicine and acupuncture.Despite its cultural and historical significance,integrating Chinese medicine into global healthcare systems presents challenges,notably the need for evidence-based practices to enhance credibility,ensure patient safety,and foster broader acceptance within the medical community.This paper explores how Chinese medicine can adopt evidence-based practices by incorporating principles of Western medicine into its research methodologies.It reviews the origins and philosophical foundations of Chinese medicine,examining its reliance on classical texts and empirical methods.The paper also highlights the differences between the personalised approach of Chinese medicine,which tailors treatments to individual needs,and the standardised protocols typical of Western medicine.Additionally,it addresses methodological challenges in Chinese medicine research,such as inconsistent diagnostic criteria and insufficient design rigour.To bridge these gaps,innovative research methodologies that respect the unique variability of Chinese medicine are needed.By adopting evidence-based practices and rigorous scientific validation,Chinese medicine can enhance its legitimacy and facilitate its integration into the global healthcare landscape.展开更多
In recent years,the gut microbiota has become an integral research topic in human health owing to its impact on digestion,immunity,metabolic processes,and mental health.The possibilities of microbiome treatment have i...In recent years,the gut microbiota has become an integral research topic in human health owing to its impact on digestion,immunity,metabolic processes,and mental health.The possibilities of microbiome treatment have increased interest in dietary approaches,with a special focus on the intake of fermented foods.This has revived some of the most profound and practical constructs derived from food therapy in Chinese medicine(CM),where food therapy,along with fermented options,actively preserves health and prevents disease.In CM,the spleen and stomach system refers to the postnatal foundation of the body,which controls the processes of chewing,nutrient assimilation,and energy production(qi).The balance between intestinal and overall health is the foundation of psychosomatic well-being and is of utmost importance.Fermented foods can boost the spleen,alleviate stagnant food syndrome,dispel excess fluids,enhance protective functions,and strengthen the immune system.This review aimed to integrate the conceptual and clinical paradigms of CM with those of Western medicine,focusing on the role of fermented foods in gut microbiota regulation.This article discusses prominent fermented foods in CM and their classical functions,alongside the currently available peer-reviewed literature(published within the last 7 years)on their impact on gut flora and other clinical outcomes.Mechanistic considerations regarding the production of probiotics and other active metabolites,such as short-chain fatty acids,and the modulation of the intestinal barrier are discussed.This review also examines multidisciplinary approaches to dietary customs worldwide and outlines the clinical applications of these findings in the context of chronic disease management and gastrointestinal health.展开更多
Chemical exposure during prenatal development has significant implications for both maternal and child health.Compared to blood,saliva is a non-invasive and less resource-intensive,alternative.Given the temporal varia...Chemical exposure during prenatal development has significant implications for both maternal and child health.Compared to blood,saliva is a non-invasive and less resource-intensive,alternative.Given the temporal variability of xenobiotic metabolites(XM),repeated sampling is essential.Therefore,saliva offers a valuable tool for the longitudinal assessment of prenatal exposomes.Despite its potential,no studies have explored saliva for XM measurement.This study pioneered using saliva to assess XM detectability and investigate the associations between prenatal XM and endogenous metabolomes in pregnant women.Saliva samples were analysed using mass spectrometry from 80 pregnant women at 24–34 weeks gestation.Metabolomes and exposomes were annotated using the Human Metabolome and U.S.Environmental Protection Agency databases.Metabolome-XM associations were clustered using Glay community clustering.Linear regression models,adjusted for age,estimated associations between catecholamines and XMs.XM levels were validated in a cohort of women(n=14)with and without preeclampsia.Our study identified 582 metabolomes and 125 XM in saliva,demonstrating its potential as a matrix for exposure measurement.After false discovery rate correction,18109 significant metabolome-XM associations were identified.Community clustering revealed 37 connected clusters,with the largest cluster(238 nodes)enriched in tyrosine and catecholamine metabolism.Food-contactchemicals and food-additives were significantly associated with higher catecholamine and their metabolite levels.Subgroup analyses revealed higher concentrations of these chemicals in women with preeclampsia compared to healthy controls.This study demonstrates that saliva contains valuable molecular data for measuring exposomes.Food-related chemicals were associated with higher catecholamine levels,which may be relevant to the prevalence of hypertensive crises in pregnancy.展开更多
Brown carbon(BrC)has attracted widespread attention because of its strong absorption of solar radiation in the ultraviolet-visible wavelength range,which causes adverse impacts on human health.Originally,BrC was a phy...Brown carbon(BrC)has attracted widespread attention because of its strong absorption of solar radiation in the ultraviolet-visible wavelength range,which causes adverse impacts on human health.Originally,BrC was a physically defined class of substances.However,current research has gradually shifted towards the identification of its chemical groups,because its light-absorbing capability,chemical properties and health effects mainly depend on the chemical composition of its chromophores.Therefore,this review mainly focuses on the chemical understanding of BrC based on chromophores,and the secondary formation mechanism of chromophores,photosensitized reactions,and human health effects of BrC were detailly summarized.Firstly,BrC chromophores are divided into five categories:nitrogen-heterocycles,nitrogen-chain,aromatic species,oligomers and sulfur-containing organic compounds.Different chromophore precursor species exhibit variations,and their formation mechanisms are also distinct.Secondly,BrC can trigger the production of secondary organic aerosol(SOA)precursors or cause SOA growth because BrC is an important component of light-absorbing particles formed during incomplete combustion of biomass and fossil fuels,potentially exerting adverse effects on human health.Finally,developing sufficiently separated methods for BrC and refining algorithms and machine learning can lead to a more effective understanding of the chemical composition of chromophores,thus enabling better evaluation of the atmospheric effects and health impacts of BrC.In all,this review provides new insights into the categories of BrC chromophores and new advance in secondary formation mechanisms,photosensitized reactions,and human health effects on the basis of chemical structures.展开更多
Background Relative energy deficiency in sport(REDs)results from exposure to problematic low energy availability.It is a serious condition affecting the health and athletic performance of up to 80%of elite female athl...Background Relative energy deficiency in sport(REDs)results from exposure to problematic low energy availability.It is a serious condition affecting the health and athletic performance of up to 80%of elite female athletes.REDs is established to have negative short-term effects on reproductive function,but the long-term impact of this condition is unknown.Therefore,we examined the impact of secondary amenorrhea with or without a concurrent diagnosis of REDs on perinatal health outcomes.Methods Postpartum individuals(≥18 years of age)completed an online questionnaire that covered demographics,reproductive history(including a diagnosis of REDs or secondary amenorrhea),and maternal/fetal health outcomes.Logistic regression was used to determine the relationship between previously diagnosed REDs or secondary amenorrhea with perinatal health outcomes.Results A total of 1025 previously pregnant participants completed the survey(33.1±3.4 years,mean±SD).Prior to pregnancy,6.1%had been previously diagnosed with REDs and 20.5%had a history with secondary amenorrhea.Individuals diagnosed with REDs had 3.5-times higher odds of having premature labor(odds ratio,(OR)=3.52,95%confidence interval(95%CI):1.26–9.81)and 2.6-times higher odds of preterm delivery(OR=2.62,95%CI:1.05–6.58)compared to those who had not experienced REDs or secondary amenorrhea.However,in individuals who did not have a history of REDs,secondary amenorrhea did not increase the odds of adverse pregnancy or delivery outcomes.Conclusion A history of REDs,but not secondary amenorrhea,may increase the odds of premature labor and preterm delivery.展开更多
Background and objectives:The ongoing mpox outbreaks have garnered significant attention due to their public health implications,particularly the potential mental health impacts.Despite the growing concern,there has b...Background and objectives:The ongoing mpox outbreaks have garnered significant attention due to their public health implications,particularly the potential mental health impacts.Despite the growing concern,there has been limited exploration of the intersection between mpox and mental health within the research literature.This study aims to conduct a comprehensive bibliometric analysis to examine global research trends,regional distribution,and thematic focus areas related to mpox's psychological and psychiatric implications.Methods:We conducted a bibliometric analysis using Scopus and the Web of Science database.The analysis was carried out using the R-bibliometrics package and involved identifying literature on mpox and mental health,focusing on global research trends,regional distribution,and thematic areas of study.The analysis included 416 documents obtained from 295 sources from January 1,2014 to August 27,2024.Results:Our analysis revealed a growing but unevenly distributed literature on mpox and mental health.Most studies concentrated on the relationship between mpox and conditions such as depression and anxiety,while other psychiatric outcomes remain underexplored.The geographic distribution of research was also uneven,with regions like Europe and the Americas receiving more focus than others.Conclusions:The study highlights the need for more targeted research on the mental health sequelae of mpox,particularly for vulnerable populations and regions that are currently underrepresented in the literature.Future research should include longitudinal studies to assess the long-term effects of mpox on mental health and the development of robust methodologies to establish causality.Integrating mental health considerations into public health responses to mpox outbreaks is crucial,with significant implications for research,policy,and clinical practice.展开更多
To the editor:Peer workers-people with personal experiences of using mental health services,trained to provide support to others currently using similar services--are increasingly integrated into the workforce of ment...To the editor:Peer workers-people with personal experiences of using mental health services,trained to provide support to others currently using similar services--are increasingly integrated into the workforce of mental health systems internationally.展开更多
Background Health promotion(HP)interventions delivered through sports clubs have demonstrated promising outcomes among men,but less is known about which aspects of the interventions work,for whom,and under what circum...Background Health promotion(HP)interventions delivered through sports clubs have demonstrated promising outcomes among men,but less is known about which aspects of the interventions work,for whom,and under what circumstances.This rapid realist review aimed to understand the contexts,mechanisms,and outcomes of HP interventions for men delivered through sports clubs.Methods A systematic literature search was conducted in February 2023 for studies published after 2013 in MEDLINE,Embase,and SPORTDiscus databases.Included studies:(a)were delivered by or in collaboration with sports clubs,(b)targeted men aged 18+years,and(c)reported 1 or more HP outcomes.A grey literature search was also performed.Studies were included in a realist synthesis based on richness and rigor.Hereafter,context-mechanism-outcome(CMO)configurations were developed.Results We identified and screened 3358 studies,finally including 59 studies describing 22 interventions.Most HP interventions were delivered in high income countries,included Caucasian men aged 35-65 years with overweight/obesity,and used professional sports clubs(mostly football)for recruitment and facilities.Quantitative HP outcomes were reported across 19 interventions.Of these 19 interventions,the majority reported on weight(n=18),physical activity(n=12),mental health(n=10),and diet(n=9).We identified 13 CMOs related to how HP interventions affected men's recruitment,engagement,and health behavior maintenance.Conclusion Our findings show that using sports clubs for HP interventions is effective for engaging men.Recruitment was facilitated by leveraging sports clubs’identity,addressing masculinity-related barriers,improving accessibility,and building trust.Engagement was enhanced through shared identity experiences,safe spaces,inclusive competition,and self-efficacy.However,there's limited evidence on behavior maintenance post-intervention,though involving community stakeholders seemed vital.In general,considerations should be made to avoid perpetuating traditional masculine norms,which may exclude some men and reinforce unhealthy behaviors.These findings can guide intervention development,emphasizing the need to harness men's perspectives in the process.展开更多
Background Growing evidence attests to the efficacy of mindfulness-based interventions(MBIs),but their effectiveness for healthcare workers remains uncertain.Aims To evaluate the evidence for MBIs in improving healthc...Background Growing evidence attests to the efficacy of mindfulness-based interventions(MBIs),but their effectiveness for healthcare workers remains uncertain.Aims To evaluate the evidence for MBIs in improving healthcare workers’psychological well-being.Methods A systematic literature search was conducted on Medline,Embase,Cumulative Index for Nursing and Allied Health Literature,PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords‘healthcare worker’,‘doctor’,‘nurse’,‘allied health’,‘mindfulness’,‘wellness’,‘workshop’and‘program’.Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion.R V.4.0.3 was used for data analysis,with the standardised mean difference as the primary outcome,employing DerSimonian and Laird’s random effects model.Grading of Recommendations,Assessment,Development and Evaluation framework was used to evaluate the quality of evidence.Cochrane’s Risk of Bias 2 tool was used to assess the risk of bias in the included studies.Results A total of 27 studies with 2506 participants were included,mostly from the USA,involving various healthcare professions.MBIs such as stress reduction programmes,apps,meditation and training showed small to large effects on anxiety,burnout,stress,depression,psychological distress and job strain outcomes of the participants.Positive effects were also seen in self-compassion,empathy,mindfulness and well-being.However,long-term outcomes(1 month or longer postintervention)varied,and the effects were not consistently sustained.Conclusions MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers.The review also highlights limitations such as intervention heterogeneity,reduced power in specific subgroup analyses and variable study quality.展开更多
To gain a comprehensive understanding of sources and health risks of trace elements in an area of China with high population densities and low PM_(2.5)concentrations,15 trace elements(Al,K,Ca,Ti,V,Cr,Mn,Fe,Ni,Cu,Zn,As...To gain a comprehensive understanding of sources and health risks of trace elements in an area of China with high population densities and low PM_(2.5)concentrations,15 trace elements(Al,K,Ca,Ti,V,Cr,Mn,Fe,Ni,Cu,Zn,As,Sn,Ba,Pb)in PM_(2.5)were monitored from December 2020 to November 2021 in a representative city,Xiamen.The concentrations of trace elements in Xiamen displayed an obvious seasonal variation and were dominated by K,Fe,Al,Ca and Zn.Based on Positive Matrix Factorization analysis,source appointment revealed that the major sources of trace elements in Xiamen were traffic,dust,biomass and firework combustion,industrial manufacture and shipping emission.According to health risk assessment combined with the source appointment results,it indicated that the average noncarcinogenic risk was below the threshold and cancer risk of four hazardous metals(Cr,Ni,As,Pb)exceeded the threshold(10^(-6)).Traffic-related source had almost half amount of contribution to the health risk induced by PM_(2.5)-bound trace elements.During the dust transport period or Spring Festival period,the health risks exceeded an acceptable threshold even an order of magnitude higher,suggesting that the serious health risks still existed in low PM_(2.5)environment at certain times.Health risk assessment reminded that the health risk reduction in PM_(2.5)at southeastern China should prioritize traffic-related hazardous trace elements and highlighted the importance of controlling vehicles emissions in the future.展开更多
In Zanzibar, from the start of the pandemic in March 2020 to the time of sampling in December 2020, SARS-CoV-2 seroprevalence data was limited. We conducted a seroprevalence study to evaluate the magnitude of SARS-CoV...In Zanzibar, from the start of the pandemic in March 2020 to the time of sampling in December 2020, SARS-CoV-2 seroprevalence data was limited. We conducted a seroprevalence study to evaluate the magnitude of SARS-CoV-2 exposure among healthcare workers, school children, and people who attended general markets in Zanzibar. The objectives of the study were to analyse the total antibodies from selected higher-risk population groups in order to determine magnitude in SARS CoV-2 exposure. Blood samples were collected from eligible and consented participants (adults and children), and their serum was analyzed for total antibodies against SARS-CoV-2 using ELISA. A questionnaire was used to collect participants’ demographic and clinical data. The overall SARS-CoV-2 seroprevalence across all age groups was 33%, and a higher seroprevalence was observed in the 40 - 49 years’ age group relative to other ages as well as in those who attended markets. A runny nose (18.8% of participants) was the most frequently reported SARS-CoV-2 infection-related symptom. Multivariable analysis showed significantly higher odds of infection in people living in urban districts. The findings provide insight into SARS-CoV-2 infection among school children, health workers, and people who attended markets in Zanzibar in the early stages of the pandemic. Exposure in these groups might have been influenced by infection and prevention strategies taken by the government, as well as shopping behavior, school overcrowding, and population density in urban settings. The study had methodological limitations, including cross-sectional design. Further, well-designed, longitudinal studies are recommended to understand exposure and transmission at a population level.展开更多
In this editorial,we comment on an article by Alhammad et al that was published in a recent issue of the World Journal of Clinical Cases(Manuscript No.:91134).We specifically focus on the mental health problems caused...In this editorial,we comment on an article by Alhammad et al that was published in a recent issue of the World Journal of Clinical Cases(Manuscript No.:91134).We specifically focus on the mental health problems caused by coronavirus disease 2019(COVID-19),their mechanisms,and targeted rehabilitation strategies.Severe acute respiratory syndrome coronavirus 2,via its spike protein,binds to angiotensin-converting enzyme 2 and other receptors prior to infiltrating diverse cells within the central nervous system,including endothelial cells,neurons,astrocytes,and oligodendrocytes,thereby contributing to the development of mental illnesses.Epidemiological data from 2020 underscored the global upsurge in major depressive and anxiety disorders by 27.6%and 25.6%,respectively,during the pandemic.The commented research show that 30%of post-intensive care unit discharge patients with COVID-19 in the Arabic region exhibited Hospital Anxiety and Depression Scale scores that were indicative of anxiety and depression.While acknowledging psychosocial factors,such as grief and loss,it is crucial to recognize the potential neurological impact of the virus through various mechanisms.Accordingly,interventions that encompass dietary measures,health supplements,and traditional Chinese medicine with neuroprotective properties are necessary.This editorial underscores the urgency to implement comprehensive rehabilitation approaches to address the intricate interplay between COVID-19 and mental well-being.展开更多
Objective This study analyzed how the 10 Global Conferences on Health Promotion have played a significant role in shaping and promoting a worldwide consensus and actions on health promotion,effectively addressing dive...Objective This study analyzed how the 10 Global Conferences on Health Promotion have played a significant role in shaping and promoting a worldwide consensus and actions on health promotion,effectively addressing diverse health challenges that evolved over different periods.Methods The textual analysis method was used in this study and text encoding was conducted to systematically examine the declarations and reports presented by the 10 Global Conferences on Health Promotion held during 1986-2021.We summarized the themes and key achievements,and key vocabulary in the conference declarations was extracted and analyzed to construct the global health promotion consensus and actions.Results The fundamental principles of the conferences are to foster consensus and initiate actions in the realm of health promotion on a global scale.The primary purpose and goal are to promote health from regional to global.Significantly,our findings highlight a transition in the primary actors driving health promotion.It underscores a shift in health promotion from being driven primarily by organizations like the World Health Organization,governments,and international bodies,to a more inclusive approach involving non-governmental organizations and the general public.This development implies that health promotion has evolved into a collective global endeavor,demanding the proactive involvement of various stakeholders,and forging new alliances in public health.Meanwhile,the coronavirus disease 2019(COVID-19)pandemic has further shaped the landscape of health promotion,underscoring the need for intensified focus on areas including disease prevention,health education,and the integration of digital health technologies,and emphasizing the importance of a multidimensional,responsive approach in public health initiatives.Conclusions Sustained collaboration and innovative strategies are pivotal to advancing health promotion globally.Countries,together with public and private entities,should intensify cooperation.Multisectoral collaboration among partners such as healthcare,education,social security,and the industry is vital for health promotion and achieving global health goals.展开更多
Background: Antimicrobial resistance (AMR) is a growing public health concern, with far-reaching consequences for modern medicine. Zambia, like many other low- and middle-income countries, faces significant challenges...Background: Antimicrobial resistance (AMR) is a growing public health concern, with far-reaching consequences for modern medicine. Zambia, like many other low- and middle-income countries, faces significant challenges in addressing AMR. Further, high rates of resistance have been reported among various microorganisms in Zambia. This review paper aims to summarize the current situation of the burden of AMR in Zambia, including the prevalence, risk factors contributing to its emergence and spread, challenges in addressing this issue, and the required solutions to combat this growing public health threat. Additionally, the paper also outlines existing efforts to combat AMR and proposes required solutions and recommendations to address this threat to public health. Materials and Methods: This study employed a comprehensive narrative review design that included studies published from January 2000 to November 2024. The literature search was done using PubMed, Scopus, Web of Science, and Google Scholar. Results: In 2019, 1.27 million deaths were attributed to AMR of which 255,000 were from sub-Saharan Africa. Currently, the burden of AMR in Zambia is not well understood. This study found that the drug resistance index (DRI) in Zambia was 60.9%, demonstrating high resistance rates of pathogens to antimicrobials commonly used in humans and animals. The high DRI indicates the low effectiveness of antibiotics in treatment of infections. Most pathogens with high resistance to antimicrobials include Klebsiella pneumoniae, Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Salmonella species, Enterococcus species, Mycobacterium tuberculosis, Acinetobacter baumannii, and Pseudomonas aeruginosa. Additionally, the study found that there was low awareness, knowledge, attitudes, and suboptimal practices regarding AMR in Zambia. The contributing factors to the emergence and spread of AMR include self-medication practices, overuse and misuse of antimicrobials in humans and animals, non-adherence to treatment guidelines, limited diagnostic capacity, substandard and falsified antimicrobials, and a lack of surveillance of AMR. There is a need to develop strategies to address the identified gaps in Zambia to successfully combat AMR. Conclusion: This study revealed high resistance of microbes to antimicrobials in Zambia. The high prevalence of AMR in Zambia indicates its burden on the country, thereby providing opportunities for further research to quantify this problem. The findings highlight the need for a One Health multi-sectoral approach to address AMR in Zambia, including strengthening surveillance and monitoring, improving antimicrobial stewardship and prescribing practices, enhancing infection prevention and control practices, increasing access to quality healthcare and diagnostic services, promoting public awareness and education, and encouraging research and development of new antimicrobial agents. The proposed solutions and recommendations can serve to strengthen the implementation of the Zambia National Action Plan (NAP) to combat AMR.展开更多
Background:Antimicrobial resistance(AMR)is a global public health threat that requires actions through One Health intervention.This study aims to trace the historical development of One Health research on AMR to provi...Background:Antimicrobial resistance(AMR)is a global public health threat that requires actions through One Health intervention.This study aims to trace the historical development of One Health research on AMR to provide evidence supporting future research and actions.Methods:A bibliometric analysis is conducted with One Health articles in the field of antimicrobial resistance(AMR-OH articles)retrieved from the Web of Science Core Collection(WoSCC).AMR-OH articles refer to articles in the field of AMR that simultaneously involve elements from human health and at least one other domain,including animals,environment,or plants.Three research periods were identified based on the development of global actions in combating AMR.Descriptive analysis of publications,keyword cluster analysis,annual trending topic analysis,and co-authorship analysis were conducted using R software,VOSViewer,and Pajek.Results:The results indicated that the percentage of AMR-OH articles among all AMR articles increased from 5.21%in 1990 to 20.01%in 2023.Key topics in the current AMR-OH articles included the mechanism of AMR,AMR epidemiology,and public health control strategies.Epidemiological research initially focused on human and animal health and then shifted to environmental factors in the third period.Research at the molecular level focused on the mechanisms of AMR transmission in various domains,along with the dynamics and diversity of antibiotic resistance genes(ARGs).The co-authorship analysis suggested a significant increase in cooperation among low-and middle-income countries in the third period.Conclusion:The scope of epidemiological research on AMR has expanded by including human,animal,and environmental areas.Moreover,genetic and molecular level research represents the forefront of this field,offering innovative tools to combat AMR in the future.This study suggests further research to translate existing findings into practical implementation of the One Health strategy,and to support globally consistent action in combating AMR.展开更多
BACKGROUND The concept of positive health(PH)supports an integrated approach for patients by taking into account six dimensions of health.This approach is especially relevant for patients with chronic disorders.Chroni...BACKGROUND The concept of positive health(PH)supports an integrated approach for patients by taking into account six dimensions of health.This approach is especially relevant for patients with chronic disorders.Chronic gastrointestinal and hepatopancreatico-biliary(GI-HPB)disorders are among the top-6 of the most prevalent chronically affected organ systems.The impact of chronic GI-HPB disorders on individuals may be disproportionally high because:(1)The affected organ system frequently contributes to a malnourished state;and(2)persons with chronic GIHPB disorders are often younger than persons with chronic diseases in other organ systems.AIM To describe and quantify the dimensions of PH in patients with chronic GI-HPB disorders.METHODS Prospective,observational questionnaire study performed between 2019 and 2021 in 235 patients with a chronic GIHPB disorder attending the Outpatient Department of the Maastricht University Medical Center.Validated questionnaires and data from patient files were used to quantify the six dimensions of PH.Internal consistency was tested with McDonald’s Omega.Zero-order Pearson correlations and t-tests were used to assess associations and differences.A P value<0.05 was considered significant.RESULTS The GI-HPB patients scored significantly worse in all dimensions of PH compared to control data or norm scores from the general population.Regarding quality of life,participation and daily functioning,GI-HPB patients scored in the same range as patients with chronic disorders in other organ systems,but depressive symptoms(in 35%)and malnutrition(in 45%)were more frequent in patients with chronic GI-HPB disorders.Intercorrelation scores between the six dimensions were only very weak to weak,forcing us to quantify each domain separately.CONCLUSION All six dimensions of PH are impaired in the GI-HPB patients.Malnutrition and depressive symptoms are more prevalent compared to patients with chronic disorders in other organ systems.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
Introduction: In veterinary medicine, with its diverse exposures, employees are at increased risk of sensitization, allergies, and occupational respiratory diseases. Methods: In this cross-sectional study, we investig...Introduction: In veterinary medicine, with its diverse exposures, employees are at increased risk of sensitization, allergies, and occupational respiratory diseases. Methods: In this cross-sectional study, we investigated the lung function of 103 veterinary assistants and nineteen veterinarians in veterinary practices regarding sensitization, atopy, and asthma. All participants completed a questionnaire. We determined specific IgE, and lung function using spirometry and body plethysmography according to the ATS criteria. The results were compared with the reference values of the Global Lung Initiative (GLI) based on the z-score. Subjects with known, physician-confirmed asthma or regular medication use were excluded, leaving 109 subjects. Results: Spirometry and body plethysmography showed repeatable results without artifacts. The median z-score of the Tiffeneau-index and the maximal mid-expiratory flow (MMEF), parameters for identifying obstructive ventilation limitations, were significantly reduced compared to the norm. Manifest obstructive airway disease was found in 6.3% (n = 2/32) atopic and 9.1% (n = 7/77) non-atopic subjects. The TLC z-score showed a normal median and normal distribution. According to the GLI reference values, 4.6% of these values were below the normal (LLN) limit. The analyses showed a relevant influence of atopy status, sensitization to furry animals, and tobacco smoking on the FEV1/FVC ratio. No significant correlations were found between lung function and occupational characteristics. Conclusion: Manifest obstructive lung disease was found in both symptom-free and symptomatic individuals. The study emphasizes the need for close monitoring of sensitized workers to detect early impairment and limit occupational effects on lung function.展开更多
Olfactory receptors are crucial for detecting odors and play a vital role in our sense of smell,influencing behaviors from food choices to emotional memories.These receptors also contribute to our perception of flavor...Olfactory receptors are crucial for detecting odors and play a vital role in our sense of smell,influencing behaviors from food choices to emotional memories.These receptors also contribute to our perception of flavor and have potential applications in medical diagnostics and environmental monitoring.The ability of the olfactory system to regenerate its sensory neurons provides a unique model to study neural regeneration,a phenomenon largely absent in the central nervous system.Insights gained from how olfactory neurons continuously replace themselves and reestablish functional connections can provide strategies to promote similar regenerative processes in the central nervous system,where damage often results in permanent deficits.Understanding the molecular and cellular mechanisms underpinning olfactory neuron regeneration could pave the way for developing therapeutic approaches to treat spinal co rd injuries and neurodegenerative diseases like Alzheimer's disease.Olfa ctory receptors are found in almost any cell of eve ry orga n/tissue of the mammalian body.This ectopic expression provides insights into the chemical structures that can activate olfactory receptors.In addition to odors,olfactory receptors in ectopic expression may respond to endogenous compounds and molecules produced by mucosal colonizing microbiota.The analysis of the function of olfactory receptors in ectopic expression provides valuable information on the signaling pathway engaged upon receptor activation and the receptor's role in proliferation and cell differentiation mechanisms.This review explo res the ectopic expression of olfa ctory receptors and the role they may play in neural regeneration within the central nervous system,with particular attention to compounds that can activate these receptors to initiate regenerative processes.Evidence suggests that olfactory receptors could serve as potential therapeutic targets for enhancing neural repair and recovery following central nervous system injuries.展开更多
文摘Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically addresses the difficulties faced in assessing medical care,and the ongoing initiatives to lower the maternal mortality ratio.Methods:Primary studies(published after year 2000)focused on maternal mortality,health determinants,and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases,including Scopus,PubMed,Google Scholar,and Web of Science.These were screened using defined inclusion and exclusion criteria.Data from these studies were extracted and thematically analysed to identify common themes and trends.Results:A total of 21 publications were included in this review comprising 2 qualitative,17 quantitative,and2 mixed study designs.Major health determinants identified in these studies include hypertensive disorders of pregnancy,haemorrhage,and sepsis/septicaemia,contributing as much as 29%,24%,and 14.2%of maternal deaths respectively in over 10%of the reviewed studies.Similarly,social-economic determinants including poverty,maternal education,health system issues and culture significantly impacted the utilization of maternal healthcare services,inadvertently impacting maternal mortality.Despite various maternal health interventions such as the"Abiye"Safe Motherhood Initiative,the Integrated Maternal,Newborn,and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies,early childbearing,unemployment,large family sizes,and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.Conclusion:This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality,its health determinants,and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.
文摘Chinese medicine,with its rich historical roots and holistic approach,has been a fundamental aspect of healthcare in East Asia and is now gaining global recognition.Founded on centuries of empirical knowledge and philosophical insight,Chinese medicine draws heavily from classical texts to guide its practices in herbal medicine and acupuncture.Despite its cultural and historical significance,integrating Chinese medicine into global healthcare systems presents challenges,notably the need for evidence-based practices to enhance credibility,ensure patient safety,and foster broader acceptance within the medical community.This paper explores how Chinese medicine can adopt evidence-based practices by incorporating principles of Western medicine into its research methodologies.It reviews the origins and philosophical foundations of Chinese medicine,examining its reliance on classical texts and empirical methods.The paper also highlights the differences between the personalised approach of Chinese medicine,which tailors treatments to individual needs,and the standardised protocols typical of Western medicine.Additionally,it addresses methodological challenges in Chinese medicine research,such as inconsistent diagnostic criteria and insufficient design rigour.To bridge these gaps,innovative research methodologies that respect the unique variability of Chinese medicine are needed.By adopting evidence-based practices and rigorous scientific validation,Chinese medicine can enhance its legitimacy and facilitate its integration into the global healthcare landscape.
文摘In recent years,the gut microbiota has become an integral research topic in human health owing to its impact on digestion,immunity,metabolic processes,and mental health.The possibilities of microbiome treatment have increased interest in dietary approaches,with a special focus on the intake of fermented foods.This has revived some of the most profound and practical constructs derived from food therapy in Chinese medicine(CM),where food therapy,along with fermented options,actively preserves health and prevents disease.In CM,the spleen and stomach system refers to the postnatal foundation of the body,which controls the processes of chewing,nutrient assimilation,and energy production(qi).The balance between intestinal and overall health is the foundation of psychosomatic well-being and is of utmost importance.Fermented foods can boost the spleen,alleviate stagnant food syndrome,dispel excess fluids,enhance protective functions,and strengthen the immune system.This review aimed to integrate the conceptual and clinical paradigms of CM with those of Western medicine,focusing on the role of fermented foods in gut microbiota regulation.This article discusses prominent fermented foods in CM and their classical functions,alongside the currently available peer-reviewed literature(published within the last 7 years)on their impact on gut flora and other clinical outcomes.Mechanistic considerations regarding the production of probiotics and other active metabolites,such as short-chain fatty acids,and the modulation of the intestinal barrier are discussed.This review also examines multidisciplinary approaches to dietary customs worldwide and outlines the clinical applications of these findings in the context of chronic disease management and gastrointestinal health.
基金supported by grants from Singhealth Duke-NUS Academic Medicine Research grant(AM/SU035/2020)NMRC Clinician-Scientist Individual Research Grant New Investigator Grant(CNIG20nov-0003).
文摘Chemical exposure during prenatal development has significant implications for both maternal and child health.Compared to blood,saliva is a non-invasive and less resource-intensive,alternative.Given the temporal variability of xenobiotic metabolites(XM),repeated sampling is essential.Therefore,saliva offers a valuable tool for the longitudinal assessment of prenatal exposomes.Despite its potential,no studies have explored saliva for XM measurement.This study pioneered using saliva to assess XM detectability and investigate the associations between prenatal XM and endogenous metabolomes in pregnant women.Saliva samples were analysed using mass spectrometry from 80 pregnant women at 24–34 weeks gestation.Metabolomes and exposomes were annotated using the Human Metabolome and U.S.Environmental Protection Agency databases.Metabolome-XM associations were clustered using Glay community clustering.Linear regression models,adjusted for age,estimated associations between catecholamines and XMs.XM levels were validated in a cohort of women(n=14)with and without preeclampsia.Our study identified 582 metabolomes and 125 XM in saliva,demonstrating its potential as a matrix for exposure measurement.After false discovery rate correction,18109 significant metabolome-XM associations were identified.Community clustering revealed 37 connected clusters,with the largest cluster(238 nodes)enriched in tyrosine and catecholamine metabolism.Food-contactchemicals and food-additives were significantly associated with higher catecholamine and their metabolite levels.Subgroup analyses revealed higher concentrations of these chemicals in women with preeclampsia compared to healthy controls.This study demonstrates that saliva contains valuable molecular data for measuring exposomes.Food-related chemicals were associated with higher catecholamine levels,which may be relevant to the prevalence of hypertensive crises in pregnancy.
基金supported by the National Natural Science Foundation of China(Nos.42020104001,42327806 and 42177354).
文摘Brown carbon(BrC)has attracted widespread attention because of its strong absorption of solar radiation in the ultraviolet-visible wavelength range,which causes adverse impacts on human health.Originally,BrC was a physically defined class of substances.However,current research has gradually shifted towards the identification of its chemical groups,because its light-absorbing capability,chemical properties and health effects mainly depend on the chemical composition of its chromophores.Therefore,this review mainly focuses on the chemical understanding of BrC based on chromophores,and the secondary formation mechanism of chromophores,photosensitized reactions,and human health effects of BrC were detailly summarized.Firstly,BrC chromophores are divided into five categories:nitrogen-heterocycles,nitrogen-chain,aromatic species,oligomers and sulfur-containing organic compounds.Different chromophore precursor species exhibit variations,and their formation mechanisms are also distinct.Secondly,BrC can trigger the production of secondary organic aerosol(SOA)precursors or cause SOA growth because BrC is an important component of light-absorbing particles formed during incomplete combustion of biomass and fossil fuels,potentially exerting adverse effects on human health.Finally,developing sufficiently separated methods for BrC and refining algorithms and machine learning can lead to a more effective understanding of the chemical composition of chromophores,thus enabling better evaluation of the atmospheric effects and health impacts of BrC.In all,this review provides new insights into the categories of BrC chromophores and new advance in secondary formation mechanisms,photosensitized reactions,and human health effects on the basis of chemical structures.
基金funded by a Christenson Professorship in Active Healthy Livingfunded by the Health Sciences TD Bank Undergraduate Research Awardsupport from the FIFA Female Athlete Project
文摘Background Relative energy deficiency in sport(REDs)results from exposure to problematic low energy availability.It is a serious condition affecting the health and athletic performance of up to 80%of elite female athletes.REDs is established to have negative short-term effects on reproductive function,but the long-term impact of this condition is unknown.Therefore,we examined the impact of secondary amenorrhea with or without a concurrent diagnosis of REDs on perinatal health outcomes.Methods Postpartum individuals(≥18 years of age)completed an online questionnaire that covered demographics,reproductive history(including a diagnosis of REDs or secondary amenorrhea),and maternal/fetal health outcomes.Logistic regression was used to determine the relationship between previously diagnosed REDs or secondary amenorrhea with perinatal health outcomes.Results A total of 1025 previously pregnant participants completed the survey(33.1±3.4 years,mean±SD).Prior to pregnancy,6.1%had been previously diagnosed with REDs and 20.5%had a history with secondary amenorrhea.Individuals diagnosed with REDs had 3.5-times higher odds of having premature labor(odds ratio,(OR)=3.52,95%confidence interval(95%CI):1.26–9.81)and 2.6-times higher odds of preterm delivery(OR=2.62,95%CI:1.05–6.58)compared to those who had not experienced REDs or secondary amenorrhea.However,in individuals who did not have a history of REDs,secondary amenorrhea did not increase the odds of adverse pregnancy or delivery outcomes.Conclusion A history of REDs,but not secondary amenorrhea,may increase the odds of premature labor and preterm delivery.
文摘Background and objectives:The ongoing mpox outbreaks have garnered significant attention due to their public health implications,particularly the potential mental health impacts.Despite the growing concern,there has been limited exploration of the intersection between mpox and mental health within the research literature.This study aims to conduct a comprehensive bibliometric analysis to examine global research trends,regional distribution,and thematic focus areas related to mpox's psychological and psychiatric implications.Methods:We conducted a bibliometric analysis using Scopus and the Web of Science database.The analysis was carried out using the R-bibliometrics package and involved identifying literature on mpox and mental health,focusing on global research trends,regional distribution,and thematic areas of study.The analysis included 416 documents obtained from 295 sources from January 1,2014 to August 27,2024.Results:Our analysis revealed a growing but unevenly distributed literature on mpox and mental health.Most studies concentrated on the relationship between mpox and conditions such as depression and anxiety,while other psychiatric outcomes remain underexplored.The geographic distribution of research was also uneven,with regions like Europe and the Americas receiving more focus than others.Conclusions:The study highlights the need for more targeted research on the mental health sequelae of mpox,particularly for vulnerable populations and regions that are currently underrepresented in the literature.Future research should include longitudinal studies to assess the long-term effects of mpox on mental health and the development of robust methodologies to establish causality.Integrating mental health considerations into public health responses to mpox outbreaks is crucial,with significant implications for research,policy,and clinical practice.
基金funded by National Institute for Health Research(NIHR)(RP-PG-1212-20019)。
文摘To the editor:Peer workers-people with personal experiences of using mental health services,trained to provide support to others currently using similar services--are increasingly integrated into the workforce of mental health systems internationally.
基金supported by the 5 Steno Diabetes Centers in Denmark,which are partly funded by the Novo Nordisk Foundation.
文摘Background Health promotion(HP)interventions delivered through sports clubs have demonstrated promising outcomes among men,but less is known about which aspects of the interventions work,for whom,and under what circumstances.This rapid realist review aimed to understand the contexts,mechanisms,and outcomes of HP interventions for men delivered through sports clubs.Methods A systematic literature search was conducted in February 2023 for studies published after 2013 in MEDLINE,Embase,and SPORTDiscus databases.Included studies:(a)were delivered by or in collaboration with sports clubs,(b)targeted men aged 18+years,and(c)reported 1 or more HP outcomes.A grey literature search was also performed.Studies were included in a realist synthesis based on richness and rigor.Hereafter,context-mechanism-outcome(CMO)configurations were developed.Results We identified and screened 3358 studies,finally including 59 studies describing 22 interventions.Most HP interventions were delivered in high income countries,included Caucasian men aged 35-65 years with overweight/obesity,and used professional sports clubs(mostly football)for recruitment and facilities.Quantitative HP outcomes were reported across 19 interventions.Of these 19 interventions,the majority reported on weight(n=18),physical activity(n=12),mental health(n=10),and diet(n=9).We identified 13 CMOs related to how HP interventions affected men's recruitment,engagement,and health behavior maintenance.Conclusion Our findings show that using sports clubs for HP interventions is effective for engaging men.Recruitment was facilitated by leveraging sports clubs’identity,addressing masculinity-related barriers,improving accessibility,and building trust.Engagement was enhanced through shared identity experiences,safe spaces,inclusive competition,and self-efficacy.However,there's limited evidence on behavior maintenance post-intervention,though involving community stakeholders seemed vital.In general,considerations should be made to avoid perpetuating traditional masculine norms,which may exclude some men and reinforce unhealthy behaviors.These findings can guide intervention development,emphasizing the need to harness men's perspectives in the process.
文摘Background Growing evidence attests to the efficacy of mindfulness-based interventions(MBIs),but their effectiveness for healthcare workers remains uncertain.Aims To evaluate the evidence for MBIs in improving healthcare workers’psychological well-being.Methods A systematic literature search was conducted on Medline,Embase,Cumulative Index for Nursing and Allied Health Literature,PsycINFO and Cochrane Central Register of Controlled Trials up to 31 August 2022 using the keywords‘healthcare worker’,‘doctor’,‘nurse’,‘allied health’,‘mindfulness’,‘wellness’,‘workshop’and‘program’.Randomised controlled trials with a defined MBI focusing on healthcare workers and quantitative outcome measures related to subjective or psychological well-being were eligible for inclusion.R V.4.0.3 was used for data analysis,with the standardised mean difference as the primary outcome,employing DerSimonian and Laird’s random effects model.Grading of Recommendations,Assessment,Development and Evaluation framework was used to evaluate the quality of evidence.Cochrane’s Risk of Bias 2 tool was used to assess the risk of bias in the included studies.Results A total of 27 studies with 2506 participants were included,mostly from the USA,involving various healthcare professions.MBIs such as stress reduction programmes,apps,meditation and training showed small to large effects on anxiety,burnout,stress,depression,psychological distress and job strain outcomes of the participants.Positive effects were also seen in self-compassion,empathy,mindfulness and well-being.However,long-term outcomes(1 month or longer postintervention)varied,and the effects were not consistently sustained.Conclusions MBIs offer short-term benefits in reducing stress-related symptoms in healthcare workers.The review also highlights limitations such as intervention heterogeneity,reduced power in specific subgroup analyses and variable study quality.
基金supported by the National Natural Science Foundation of China(No.U22A20578)the Science and Technology Department of Fujian Province(No.2022L3025)+3 种基金the Center for Excellence in Regional Atmospheric Environment Project(No.E0L1B20201)the Chaozhou Science and Technology Plan Project(No.2018GY03)Xiamen Atmospheric Environment Observation and Research Station of Fujian ProvinceFujian Key Laboratory of Atmospheric Ozone Pollution Prevention(Institute of Urban Environment,Chinese Academy of Sciences)。
文摘To gain a comprehensive understanding of sources and health risks of trace elements in an area of China with high population densities and low PM_(2.5)concentrations,15 trace elements(Al,K,Ca,Ti,V,Cr,Mn,Fe,Ni,Cu,Zn,As,Sn,Ba,Pb)in PM_(2.5)were monitored from December 2020 to November 2021 in a representative city,Xiamen.The concentrations of trace elements in Xiamen displayed an obvious seasonal variation and were dominated by K,Fe,Al,Ca and Zn.Based on Positive Matrix Factorization analysis,source appointment revealed that the major sources of trace elements in Xiamen were traffic,dust,biomass and firework combustion,industrial manufacture and shipping emission.According to health risk assessment combined with the source appointment results,it indicated that the average noncarcinogenic risk was below the threshold and cancer risk of four hazardous metals(Cr,Ni,As,Pb)exceeded the threshold(10^(-6)).Traffic-related source had almost half amount of contribution to the health risk induced by PM_(2.5)-bound trace elements.During the dust transport period or Spring Festival period,the health risks exceeded an acceptable threshold even an order of magnitude higher,suggesting that the serious health risks still existed in low PM_(2.5)environment at certain times.Health risk assessment reminded that the health risk reduction in PM_(2.5)at southeastern China should prioritize traffic-related hazardous trace elements and highlighted the importance of controlling vehicles emissions in the future.
文摘In Zanzibar, from the start of the pandemic in March 2020 to the time of sampling in December 2020, SARS-CoV-2 seroprevalence data was limited. We conducted a seroprevalence study to evaluate the magnitude of SARS-CoV-2 exposure among healthcare workers, school children, and people who attended general markets in Zanzibar. The objectives of the study were to analyse the total antibodies from selected higher-risk population groups in order to determine magnitude in SARS CoV-2 exposure. Blood samples were collected from eligible and consented participants (adults and children), and their serum was analyzed for total antibodies against SARS-CoV-2 using ELISA. A questionnaire was used to collect participants’ demographic and clinical data. The overall SARS-CoV-2 seroprevalence across all age groups was 33%, and a higher seroprevalence was observed in the 40 - 49 years’ age group relative to other ages as well as in those who attended markets. A runny nose (18.8% of participants) was the most frequently reported SARS-CoV-2 infection-related symptom. Multivariable analysis showed significantly higher odds of infection in people living in urban districts. The findings provide insight into SARS-CoV-2 infection among school children, health workers, and people who attended markets in Zanzibar in the early stages of the pandemic. Exposure in these groups might have been influenced by infection and prevention strategies taken by the government, as well as shopping behavior, school overcrowding, and population density in urban settings. The study had methodological limitations, including cross-sectional design. Further, well-designed, longitudinal studies are recommended to understand exposure and transmission at a population level.
基金Guangzhou Laboratory Emergency Research Project,No.EKPG21-302.
文摘In this editorial,we comment on an article by Alhammad et al that was published in a recent issue of the World Journal of Clinical Cases(Manuscript No.:91134).We specifically focus on the mental health problems caused by coronavirus disease 2019(COVID-19),their mechanisms,and targeted rehabilitation strategies.Severe acute respiratory syndrome coronavirus 2,via its spike protein,binds to angiotensin-converting enzyme 2 and other receptors prior to infiltrating diverse cells within the central nervous system,including endothelial cells,neurons,astrocytes,and oligodendrocytes,thereby contributing to the development of mental illnesses.Epidemiological data from 2020 underscored the global upsurge in major depressive and anxiety disorders by 27.6%and 25.6%,respectively,during the pandemic.The commented research show that 30%of post-intensive care unit discharge patients with COVID-19 in the Arabic region exhibited Hospital Anxiety and Depression Scale scores that were indicative of anxiety and depression.While acknowledging psychosocial factors,such as grief and loss,it is crucial to recognize the potential neurological impact of the virus through various mechanisms.Accordingly,interventions that encompass dietary measures,health supplements,and traditional Chinese medicine with neuroprotective properties are necessary.This editorial underscores the urgency to implement comprehensive rehabilitation approaches to address the intricate interplay between COVID-19 and mental well-being.
基金This work was supported in part by a research grant from the Ministry of Science and Technology of the People’s Republic of China(Project Number:G2023170020L).
文摘Objective This study analyzed how the 10 Global Conferences on Health Promotion have played a significant role in shaping and promoting a worldwide consensus and actions on health promotion,effectively addressing diverse health challenges that evolved over different periods.Methods The textual analysis method was used in this study and text encoding was conducted to systematically examine the declarations and reports presented by the 10 Global Conferences on Health Promotion held during 1986-2021.We summarized the themes and key achievements,and key vocabulary in the conference declarations was extracted and analyzed to construct the global health promotion consensus and actions.Results The fundamental principles of the conferences are to foster consensus and initiate actions in the realm of health promotion on a global scale.The primary purpose and goal are to promote health from regional to global.Significantly,our findings highlight a transition in the primary actors driving health promotion.It underscores a shift in health promotion from being driven primarily by organizations like the World Health Organization,governments,and international bodies,to a more inclusive approach involving non-governmental organizations and the general public.This development implies that health promotion has evolved into a collective global endeavor,demanding the proactive involvement of various stakeholders,and forging new alliances in public health.Meanwhile,the coronavirus disease 2019(COVID-19)pandemic has further shaped the landscape of health promotion,underscoring the need for intensified focus on areas including disease prevention,health education,and the integration of digital health technologies,and emphasizing the importance of a multidimensional,responsive approach in public health initiatives.Conclusions Sustained collaboration and innovative strategies are pivotal to advancing health promotion globally.Countries,together with public and private entities,should intensify cooperation.Multisectoral collaboration among partners such as healthcare,education,social security,and the industry is vital for health promotion and achieving global health goals.
文摘Background: Antimicrobial resistance (AMR) is a growing public health concern, with far-reaching consequences for modern medicine. Zambia, like many other low- and middle-income countries, faces significant challenges in addressing AMR. Further, high rates of resistance have been reported among various microorganisms in Zambia. This review paper aims to summarize the current situation of the burden of AMR in Zambia, including the prevalence, risk factors contributing to its emergence and spread, challenges in addressing this issue, and the required solutions to combat this growing public health threat. Additionally, the paper also outlines existing efforts to combat AMR and proposes required solutions and recommendations to address this threat to public health. Materials and Methods: This study employed a comprehensive narrative review design that included studies published from January 2000 to November 2024. The literature search was done using PubMed, Scopus, Web of Science, and Google Scholar. Results: In 2019, 1.27 million deaths were attributed to AMR of which 255,000 were from sub-Saharan Africa. Currently, the burden of AMR in Zambia is not well understood. This study found that the drug resistance index (DRI) in Zambia was 60.9%, demonstrating high resistance rates of pathogens to antimicrobials commonly used in humans and animals. The high DRI indicates the low effectiveness of antibiotics in treatment of infections. Most pathogens with high resistance to antimicrobials include Klebsiella pneumoniae, Staphylococcus aureus, Streptococcus pneumoniae, Escherichia coli, Salmonella species, Enterococcus species, Mycobacterium tuberculosis, Acinetobacter baumannii, and Pseudomonas aeruginosa. Additionally, the study found that there was low awareness, knowledge, attitudes, and suboptimal practices regarding AMR in Zambia. The contributing factors to the emergence and spread of AMR include self-medication practices, overuse and misuse of antimicrobials in humans and animals, non-adherence to treatment guidelines, limited diagnostic capacity, substandard and falsified antimicrobials, and a lack of surveillance of AMR. There is a need to develop strategies to address the identified gaps in Zambia to successfully combat AMR. Conclusion: This study revealed high resistance of microbes to antimicrobials in Zambia. The high prevalence of AMR in Zambia indicates its burden on the country, thereby providing opportunities for further research to quantify this problem. The findings highlight the need for a One Health multi-sectoral approach to address AMR in Zambia, including strengthening surveillance and monitoring, improving antimicrobial stewardship and prescribing practices, enhancing infection prevention and control practices, increasing access to quality healthcare and diagnostic services, promoting public awareness and education, and encouraging research and development of new antimicrobial agents. The proposed solutions and recommendations can serve to strengthen the implementation of the Zambia National Action Plan (NAP) to combat AMR.
文摘Background:Antimicrobial resistance(AMR)is a global public health threat that requires actions through One Health intervention.This study aims to trace the historical development of One Health research on AMR to provide evidence supporting future research and actions.Methods:A bibliometric analysis is conducted with One Health articles in the field of antimicrobial resistance(AMR-OH articles)retrieved from the Web of Science Core Collection(WoSCC).AMR-OH articles refer to articles in the field of AMR that simultaneously involve elements from human health and at least one other domain,including animals,environment,or plants.Three research periods were identified based on the development of global actions in combating AMR.Descriptive analysis of publications,keyword cluster analysis,annual trending topic analysis,and co-authorship analysis were conducted using R software,VOSViewer,and Pajek.Results:The results indicated that the percentage of AMR-OH articles among all AMR articles increased from 5.21%in 1990 to 20.01%in 2023.Key topics in the current AMR-OH articles included the mechanism of AMR,AMR epidemiology,and public health control strategies.Epidemiological research initially focused on human and animal health and then shifted to environmental factors in the third period.Research at the molecular level focused on the mechanisms of AMR transmission in various domains,along with the dynamics and diversity of antibiotic resistance genes(ARGs).The co-authorship analysis suggested a significant increase in cooperation among low-and middle-income countries in the third period.Conclusion:The scope of epidemiological research on AMR has expanded by including human,animal,and environmental areas.Moreover,genetic and molecular level research represents the forefront of this field,offering innovative tools to combat AMR in the future.This study suggests further research to translate existing findings into practical implementation of the One Health strategy,and to support globally consistent action in combating AMR.
文摘BACKGROUND The concept of positive health(PH)supports an integrated approach for patients by taking into account six dimensions of health.This approach is especially relevant for patients with chronic disorders.Chronic gastrointestinal and hepatopancreatico-biliary(GI-HPB)disorders are among the top-6 of the most prevalent chronically affected organ systems.The impact of chronic GI-HPB disorders on individuals may be disproportionally high because:(1)The affected organ system frequently contributes to a malnourished state;and(2)persons with chronic GIHPB disorders are often younger than persons with chronic diseases in other organ systems.AIM To describe and quantify the dimensions of PH in patients with chronic GI-HPB disorders.METHODS Prospective,observational questionnaire study performed between 2019 and 2021 in 235 patients with a chronic GIHPB disorder attending the Outpatient Department of the Maastricht University Medical Center.Validated questionnaires and data from patient files were used to quantify the six dimensions of PH.Internal consistency was tested with McDonald’s Omega.Zero-order Pearson correlations and t-tests were used to assess associations and differences.A P value<0.05 was considered significant.RESULTS The GI-HPB patients scored significantly worse in all dimensions of PH compared to control data or norm scores from the general population.Regarding quality of life,participation and daily functioning,GI-HPB patients scored in the same range as patients with chronic disorders in other organ systems,but depressive symptoms(in 35%)and malnutrition(in 45%)were more frequent in patients with chronic GI-HPB disorders.Intercorrelation scores between the six dimensions were only very weak to weak,forcing us to quantify each domain separately.CONCLUSION All six dimensions of PH are impaired in the GI-HPB patients.Malnutrition and depressive symptoms are more prevalent compared to patients with chronic disorders in other organ systems.
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Introduction: In veterinary medicine, with its diverse exposures, employees are at increased risk of sensitization, allergies, and occupational respiratory diseases. Methods: In this cross-sectional study, we investigated the lung function of 103 veterinary assistants and nineteen veterinarians in veterinary practices regarding sensitization, atopy, and asthma. All participants completed a questionnaire. We determined specific IgE, and lung function using spirometry and body plethysmography according to the ATS criteria. The results were compared with the reference values of the Global Lung Initiative (GLI) based on the z-score. Subjects with known, physician-confirmed asthma or regular medication use were excluded, leaving 109 subjects. Results: Spirometry and body plethysmography showed repeatable results without artifacts. The median z-score of the Tiffeneau-index and the maximal mid-expiratory flow (MMEF), parameters for identifying obstructive ventilation limitations, were significantly reduced compared to the norm. Manifest obstructive airway disease was found in 6.3% (n = 2/32) atopic and 9.1% (n = 7/77) non-atopic subjects. The TLC z-score showed a normal median and normal distribution. According to the GLI reference values, 4.6% of these values were below the normal (LLN) limit. The analyses showed a relevant influence of atopy status, sensitization to furry animals, and tobacco smoking on the FEV1/FVC ratio. No significant correlations were found between lung function and occupational characteristics. Conclusion: Manifest obstructive lung disease was found in both symptom-free and symptomatic individuals. The study emphasizes the need for close monitoring of sensitized workers to detect early impairment and limit occupational effects on lung function.
文摘Olfactory receptors are crucial for detecting odors and play a vital role in our sense of smell,influencing behaviors from food choices to emotional memories.These receptors also contribute to our perception of flavor and have potential applications in medical diagnostics and environmental monitoring.The ability of the olfactory system to regenerate its sensory neurons provides a unique model to study neural regeneration,a phenomenon largely absent in the central nervous system.Insights gained from how olfactory neurons continuously replace themselves and reestablish functional connections can provide strategies to promote similar regenerative processes in the central nervous system,where damage often results in permanent deficits.Understanding the molecular and cellular mechanisms underpinning olfactory neuron regeneration could pave the way for developing therapeutic approaches to treat spinal co rd injuries and neurodegenerative diseases like Alzheimer's disease.Olfa ctory receptors are found in almost any cell of eve ry orga n/tissue of the mammalian body.This ectopic expression provides insights into the chemical structures that can activate olfactory receptors.In addition to odors,olfactory receptors in ectopic expression may respond to endogenous compounds and molecules produced by mucosal colonizing microbiota.The analysis of the function of olfactory receptors in ectopic expression provides valuable information on the signaling pathway engaged upon receptor activation and the receptor's role in proliferation and cell differentiation mechanisms.This review explo res the ectopic expression of olfa ctory receptors and the role they may play in neural regeneration within the central nervous system,with particular attention to compounds that can activate these receptors to initiate regenerative processes.Evidence suggests that olfactory receptors could serve as potential therapeutic targets for enhancing neural repair and recovery following central nervous system injuries.