scholarly journals How does onchocerciasis-related skin and eye disease in Africa depend on cumulative exposure to infection and mass treatment?

2021 ◽  
Vol 15 (6) ◽  
pp. e0009489
Author(s):  
Natalie V. S. Vinkeles Melchers ◽  
Wilma A. Stolk ◽  
Michele E. Murdoch ◽  
Belén Pedrique ◽  
Marielle Kloek ◽  
...  
Keyword(s):  
Skin Disease ◽  
Health Concern ◽  
Cumulative Exposure ◽  
Eye Disease ◽  
Generic Model ◽  
Large Set ◽  
New Disease ◽  
Disease Module ◽  
Age Patterns ◽  
The Impact

Background Onchocerciasis (river-blindness) in Africa is targeted for elimination through mass drug administration (MDA) with ivermectin. Onchocerciasis may cause various types of skin and eye disease. Predicting the impact of MDA on onchocercal morbidity is useful for future policy development. Here, we introduce a new disease module within the established ONCHOSIM model to predict trends over time in prevalence of onchocercal morbidity. Methods We developed novel generic model concepts for development of symptoms due to cumulative exposure to dead microfilariae, accommodating both reversible (acute) and irreversible (chronic) symptoms. The model was calibrated to reproduce pre-control age patterns and associations between prevalences of infection, eye disease, and various types of skin disease as observed in a large set of population-based studies. We then used the new disease module to predict the impact of MDA on morbidity prevalence over a 30-year time frame for various scenarios. Results ONCHOSIM reproduced observed age-patterns in disease and community-level associations between infection and disease reasonably well. For highly endemic settings with 30 years of annual MDA at 60% coverage, the model predicted a 70% to 89% reduction in prevalence of chronic morbidity. This relative decline was similar with higher MDA coverage and only somewhat higher for settings with lower pre-control endemicity. The decline in prevalence was lowest for mild depigmentation and visual impairment. The prevalence of acute clinical manifestations (severe itch, reactive skin disease) declined by 95% to 100% after 30 years of annual MDA, regardless of pre-control endemicity. Conclusion We present generic model concepts for predicting trends in acute and chronic symptoms due to history of exposure to parasitic worm infections, and apply this to onchocerciasis. Our predictions suggest that onchocercal morbidity, in particular chronic manifestations, will remain a public health concern in many epidemiological settings in Africa, even after 30 years of MDA.

scholarly journals Dexamethasone-Loaded Nanostructured Lipid Carriers for the Treatment of Dry Eye Disease

Pharmaceutics ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 905
Author(s):  
Sangeeta Kumari ◽  
Madhuri Dandamudi ◽  
Sweta Rani ◽  
Elke Behaeghel ◽  
Gautam Behl ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Pilot Scale ◽  
Dry Eye Disease ◽  
Rapid Screening ◽  
Eye Disease ◽  
Topical Steroids ◽  
Nanostructured Lipid Carrier ◽  
The Impact ◽  
Ophthalmic Formulation

Dry eye disease (DED) or keratoconjunctivitis sicca is a chronic multifactorial disorder of the ocular surface caused by tear film dysfunction. Symptoms include dryness, irritation, discomfort and visual disturbance, and standard treatment includes the use of lubricants and topical steroids. Secondary inflammation plays a prominent role in the development and propagation of this debilitating condition. To address this we have investigated the pilot scale development of an innovative drug delivery system using a dexamethasone-encapsulated cholesterol-Labrafac™ lipophile nanostructured lipid carrier (NLC)-based ophthalmic formulation, which could be developed as an eye drop to treat DED and any associated acute exacerbations. After rapid screening of a range of laboratory scale pre-formulations, the chosen formulation was prepared at pilot scale with a particle size of 19.51 ± 0.5 nm, an encapsulation efficiency of 99.6 ± 0.5%, a PDI of 0.08, and an extended stability of 6 months at 4 °C. This potential ophthalmic formulation was observed to have high tolerability and internalization capacity for human corneal epithelial cells, with similar behavior demonstrated on ex vivo porcine cornea studies, suggesting suitable distribution on the ocular surface. Further, ELISA was used to study the impact of the pilot scale formulation on a range of inflammatory biomarkers. The most successful dexamethasone-loaded NLC showed a 5-fold reduction of TNF-α production over dexamethasone solution alone, with comparable results for MMP-9 and IL-6. The ease of formulation, scalability, performance and biomarker assays suggest that this NLC formulation could be a viable option for the topical treatment of DED.

scholarly journals Reproduction in Trypanosomatids: Past and Present

Biology ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 471
Author(s):  
Camino Gutiérrez-Corbo ◽  
Bárbara Domínguez-Asenjo ◽  
María Martínez-Valladares ◽  
Yolanda Pérez-Pertejo ◽  
Carlos García-Estrada ◽  
...  
Keyword(s):  
Low Income ◽  
Phenotypic Diversity ◽  
Natural Populations ◽  
Genetic Exchange ◽  
Health Concern ◽  
Current Debate ◽  
Naturally Occurring ◽  
Experimental Works ◽  
Genomic Recombination ◽  
The Impact

Diseases caused by trypanosomatids (Sleeping sickness, Chagas disease, and leishmaniasis) are a serious public health concern in low-income endemic countries. These diseases are produced by single-celled parasites with a diploid genome (although aneuploidy is frequent) organized in pairs of non-condensable chromosomes. To explain the way they reproduce through the analysis of natural populations, the theory of strict clonal propagation of these microorganisms was taken as a rule at the beginning of the studies, since it partially justified their genomic stability. However, numerous experimental works provide evidence of sexual reproduction, thus explaining certain naturally occurring events that link the number of meiosis per mitosis and the frequency of mating. Recent techniques have demonstrated genetic exchange between individuals of the same species under laboratory conditions, as well as the expression of meiosis specific genes. The current debate focuses on the frequency of genomic recombination events and its impact on the natural parasite population structure. This paper reviews the results and techniques used to demonstrate the existence of sex in trypanosomatids, the inheritance of kinetoplast DNA (maxi- and minicircles), the impact of genetic exchange in these parasites, and how it can contribute to the phenotypic diversity of natural populations.

scholarly journals Does the Type of Exposure to Workplace Violence Matter to Nurses’ Mental Health?

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 41
Author(s):  
Farinaz Havaei
Keyword(s):  
Mental Health ◽  
Workplace Violence ◽  
Violence Exposure ◽  
Mental Health Problems ◽  
Survey Methods ◽  
Health Problems ◽  
Cumulative Exposure ◽  
Post Traumatic Stress ◽  
Indirect Exposure ◽  
The Impact

Workplace violence is a prevalent phenomenon in healthcare, particularly among nursing professionals. Exposure to workplace violence may be direct through firsthand involvement, indirect through secondhand witnessing, or both. Even though implications for victims of workplace violence have been well-studied, less is known about the various types of exposure and their effects on nurse mental health. The purpose of this study is to examine the impact of workplace-violence exposure types on the mental health of nurses, while accounting for the intensity of the incident/s. This study employs an exploratory correlational design with survey methods. Nurses from British Columbia (BC), Canada, were invited by the provincial nurses’ union to complete an electronic survey in Fall 2019. A total of 2958 responses from direct-care nurses in acute-care settings were analyzed using logistic regression. The results showed that mental-health problems increased with cumulative exposure; even though nurses with solely indirect exposure to workplace violence did not report greater mental-health problems, those experiencing solely direct exposure, or both direct and indirect exposure, were two to four times more likely to report high levels of post-traumatic stress disorder (PTSD), anxiety, depression and burnout compared to their counterparts with no exposure. There is an urgent need for better mental-health support, prevention policies and practices that take into account the type of workplace-violence exposure.

scholarly journals Exposure Assessment of Multiple Mycotoxins and Cumulative Health Risk Assessment: A Biomonitoring-Based Study in the Yangtze River Delta, China

Toxins ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 103
Author(s):  
Qingwen Huang ◽  
Keqiu Jiang ◽  
Zhanmin Tang ◽  
Kai Fan ◽  
Jiajia Meng ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Yangtze River ◽  
Yangtze River Delta ◽  
River Delta ◽  
Urine Samples ◽  
Health Concern ◽  
Cumulative Exposure ◽  
The Yangtze River ◽  
Two Samples ◽  
The Yangtze River Delta

The extensive exposure to multiple mycotoxins has been demonstrated in many countries; however, realistic assessments of the risks related to cumulative exposure are limited. This biomonitoring study was conducted to investigate exposure to 23 mycotoxins/metabolites and their determinants in 227 adults (aged 20–88 years) in the Yangtze River Delta, China. Eight mycotoxins were detected in 110 urine samples, and multiple mycotoxins co-occurred in 51/227 (22.47%) of urine samples, with deoxynivalenol (DON), fumonisin B1 (FB1), and zearalenone (ZEN) being the most frequently occurring. For single mycotoxin risk assessment, FB1, ZEN, aflatoxin B1 (AFB1), and ochratoxin A (OTA) all showed potential adverse effects. However, for the 12 samples containing DON and ZEN, in which none had a hazard risk, the combination of both mycotoxins in two samples was considered to pose potential endocrine disrupting risks to humans by hazard index (HI) method. The combined margin of exposure (MOET) for AFB1 and FB1 could constitute a potential health concern, and AFB1 was the main contributor. Our approach provides a blueprint for evaluating the cumulative risks related to different types of mycotoxins and opens a new horizon for the accurate interpretation of epidemiological health outcomes related to multi-mycotoxin exposure.

scholarly journals Breakfast Cereals Intended for Children: Opportunities for Reformulation and Potential Impact on Nutrient Intake

Foods ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1772
Author(s):  
Mariana Santos ◽  
Filipa Matias ◽  
Ana Isabel Rito ◽  
Isabel Castanheira ◽  
Duarte Torres ◽  
...  
Keyword(s):  
Dietary Fiber ◽  
Nutritional Quality ◽  
Saturated Fatty Acids ◽  
World Health ◽  
Health Concern ◽  
Regional Office ◽  
Nutrient Profile ◽  
Dietary Fiber Intake ◽  
Directorate General ◽  
The Impact

Ready-to-eat cereals (RTECs) have become a popular breakfast option claiming to provide important nutrients to children’s diets, despite being a source of excess sugar and, therefore, a health concern. Thus, food reformulation constitutes an important public health strategy that could benefit from inputs provided by nutrient profiling. This study aimed to assess the adequacy of the RTECs for children available in Portuguese supermarkets, applying three nutrient profile models (NPMs)—the nutrient profile model of the World Health Organization’s Regional Office for Europe (WHO-EURO), the profile of the private-sector EU Pledge (EU-Pledge), and the national model developed by the Directorate-General of Health (NPM-PT)—in order to explore the potential for reformulation of the RTECs identified as not adequate and evaluate the impact of RTECs’ reformulation on the nutritional quality of Portuguese children’s diets. In total, 78 RTECs intended for children were assessed and two scenarios—current (not considering reformulation) and alternative (considering reformulation to accomplish the nutrient profile requirements)—were considered to assess the impact of reformulation on nutritional quality. Across all RTECs, only 5.1% could be promoted to children according to the considered NPMs. The most common nutrients requiring reformulation were sugar, saturated fatty acids (SFA), salt, and dietary fiber. The scenarios of reformulation considered could reduce the RTECs average content of total sugars, SFA, and salt by 43%, 8.7%, and 1.1%, respectively, and dietary fiber intake could be increased by 34%. Thus, these results support policies to implement reformulation strategies for developing healthier food products to be promoted to children.

scholarly journals Adolescent depression, early psychiatric comorbidities, and adulthood welfare burden: a 25-year longitudinal cohort study

2021 ◽  
Author(s):  
Iman Alaie ◽  
Richard Ssegonja ◽  
Anna Philipson ◽  
Anne-Liis von Knorring ◽  
Margareta Möller ◽  
...  
Keyword(s):  
Cohort Study ◽  
Early Life ◽  
Adolescent Depression ◽  
Longitudinal Cohort Study ◽  
Health Concern ◽  
Psychiatric Comorbidities ◽  
Longitudinal Cohort ◽  
Transfer Payments ◽  
Social Transfer ◽  
The Impact

Abstract Purpose Depression at all ages is recognized as a global public health concern, but less is known about the welfare burden following early-life depression. This study aimed to (1) estimate the magnitude of associations between depression in adolescence and social transfer payments in adulthood; and (2) address the impact of major comorbid psychopathology on these associations. Methods This is a longitudinal cohort study of 539 participants assessed at age 16–17 using structured diagnostic interviews. An ongoing 25-year follow-up linked the cohort (n = 321 depressed; n = 218 nondepressed) to nationwide population-based registries. Outcomes included consecutive annual data on social transfer payments due to unemployment, work disability, and public assistance, spanning from age 18 to 40. Parameter estimations used the generalized estimating equations approach. Results Adolescent depression was associated with all forms of social transfer payments. The estimated overall payment per person and year was 938 USD (95% CI 551–1326) over and above the amount received by nondepressed controls. Persistent depressive disorder was associated with higher recipiency across all outcomes, whereas the pattern of findings was less clear for subthreshold and episodic major depression. Moreover, depressed adolescents presenting with comorbid anxiety and disruptive behavior disorders evidenced particularly high recipiency, exceeding the nondepressed controls with an estimated 1753 USD (95% CI 887–2620). Conclusion Adolescent depression is associated with considerable public expenditures across early-to-middle adulthood, especially for those exposed to chronic/persistent depression and psychiatric comorbidities. This finding suggests that the clinical heterogeneity of early-life depression needs to be considered from a longer-term societal perspective.

scholarly journals Evaluating the Impact of Intensive Case Management for Severe Vocational Injuries on Work Incapacity and Costs

2021 ◽  
Author(s):  
Rolando Leiva ◽  
Lise Rochaix ◽  
Noémie Kiefer ◽  
Jean-Claude K. Dupont
Keyword(s):  
Treatment Group ◽  
Case Management ◽  
Sick Leave ◽  
Insurance Fund ◽  
Large Set ◽  
Intensive Case Management ◽  
Exact Matching ◽  
Case Management Program ◽  
The Impact ◽  
Permanent Work

AbstractPurpose This study investigates the impact of an intensive case management program on sick leave days, permanent work incapacity levels and treatment costs for severe vocational injuries set up by the French National Insurance Fund in five health insurance districts. Methods The method employed relies on a four-step matching procedure combining Coarsened Exact Matching and Propensity Score Matching, based on an original administrative dataset. Average Treatment effects on the Treated were estimated using a parametric model with a large set of covariates. Results After one-year follow-up, workers in the treatment group had higher sickness absence rates, with 22 extra days, and the program led to 2.7 (95% CI 2.3–3.1) times more diagnoses of permanent work incapacity in the treatment group. With an estimated yearly operational cost of 2,722 € per treated worker, the average total extra treatment cost was 4,569 € for treated workers, which corresponds to a cost increase of 29.2% for the insurance fund. Conclusions The higher costs found for the treatment group are mainly due to longer sick leave duration for the moderate severity group, implying higher cash transfers in the form of one-off indemnities. Even though workers in the treated group have more diagnoses of permanent work incapacity, the difference of severity between groups is small. Our results on longer sick leave duration are partly to be explained by interactions between the case managers and the occupational physicians that encouraged patients to stay longer off-work for better recovery, despite the higher costs that this represented for the insurance fund and the well-documented adverse side effects of longer periods off-work.

scholarly journals The impact of environmental variables on the spread of COVID-19 in the Republic of Korea

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yong Kwan Lim ◽  
Oh Joo Kweon ◽  
Hye Ryoun Kim ◽  
Tae-Hyoung Kim ◽  
Mi-Kyung Lee
Keyword(s):  
Environmental Factors ◽  
Virus Disease ◽  
Environmental Parameters ◽  
Environmental Data ◽  
Republic Of Korea ◽  
Metropolitan Region ◽  
Health Concern ◽  
Ozone Level ◽  
The Republic ◽  
The Impact

AbstractCorona virus disease 2019 (COVID-19) has been declared a global pandemic and is a major public health concern worldwide. In this study, we aimed to determine the role of environmental factors, such as climate and air pollutants, in the transmission of COVID-19 in the Republic of Korea. We collected epidemiological and environmental data from two regions of the Republic of Korea, namely Seoul metropolitan region (SMR) and Daegu-Gyeongbuk region (DGR) from February 2020 to July 2020. The data was then analyzed to identify correlations between each environmental factor with confirmed daily COVID-19 cases. Among the various environmental parameters, the duration of sunshine and ozone level were found to positively correlate with COVID-19 cases in both regions. However, the association of temperature variables with COVID-19 transmission revealed contradictory results when comparing the data from SMR and DGR. Moreover, statistical bias may have arisen due to an extensive epidemiological investigation and altered socio-behaviors that occurred in response to a COVID-19 outbreak. Nevertheless, our results suggest that various environmental factors may play a role in COVID-19 transmission.

scholarly journals Evaluation of an environmentally sustainable UV-assisted water treatment system for the removal of Bacillus globigii spores in water

2017 ◽  
Vol 18 (3) ◽  
pp. 968-975
Author(s):  
R. G. Silva ◽  
J. Szabo ◽  
V. Namboodiri ◽  
E. R. Krishnan ◽  
J. Rodriguez ◽  
...  
Keyword(s):  
Water Treatment ◽  
High Efficiency ◽  
Membrane Filter ◽  
Water Security ◽  
Disinfection Byproducts ◽  
Treatment System ◽  
Health Concern ◽  
Environmentally Sustainable ◽  
Inorganic Substances ◽  
The Impact

Abstract Development of greener water treatment technologies is important for the production of safe drinking water and water security applications, such as decontamination. Chlorine assisted disinfection is common and economical, but can generate disinfection byproducts (DBPs) that may be of health concern. DBPs are formed due to the reaction of chlorine with naturally occurring organic and inorganic substances in water. Currently, various innovative technologies are being developed as alternative approaches for preventing DBPs during water treatment. In this study, we evaluated the effectiveness of a novel combination of high efficiency flow filtration and UV disinfection treatment system for the removal of Bacillus globigii (B. globigii) spores in water. The filtration system consists of a charged membrane filter (CMF) that not only helps to remove suspended particles but also reduces the impact of other impurities including bio organisms. In order to get most performance details, the CMF was evaluated at clean, half-life, and end of life (EOL) conditions along with 100% UV transmittance (UVT). In addition, the effectiveness of the UV system was evaluated as a stand alone system at 100% and 70% EOL intensity. The study was conducted at the US EPA's Test and Evaluation (T&E) Facility in Cincinnati, OH, using B. globigii, a surrogate for B. anthracis spores. This non-chemical environmentally-friendly CMF/UV combination system and the stand alone UV unit showed greater than 6.0 log removal of B. globigii during the tests.

The Importance of Skin Disease as Assessed by “Willingness-To-Pay”

2003 ◽  
Vol 7 (5) ◽  
pp. 369-371 ◽  
Author(s):  
Lauren Parks ◽  
Rajesh Balkrishnan ◽  
Line Hamel-Gariépy ◽  
Steven R. Feldman
Keyword(s):  
Willingness To Pay ◽  
Skin Disease ◽  
Skin Diseases ◽  
Medical Conditions ◽  
Monthly Basis ◽  
Related Quality ◽  
Health Related ◽  
Optimal Resource ◽  
The Impact

Background: To achieve optimal resource allocation in health care, it is necessary to value competing resource uses according to the benefit derived from those uses. Skin disease makes as great an impact as other serious medical conditions when assessed by effects on health-related quality of life. Objective: To confirm the high impact of skin disease by comparing patients' willingness to pay (WTP) to be cured or relieved from symptoms of skin and nonskin conditions. Methods: We searched the published literature on WTP to compare the impact of dermatologic conditions with the impact of other medical conditions. A total of 46 articles were identified of which 10 included information on willingness to pay for cure reported on a monthly basis. Results: WTP for skin diseases fell in the range of $125–260/month and was comparable or higher than all but one of the other identified conditions. Conclusion: Willingness to pay for relief from skin diseases is comparable to that for relief of other serious medical conditions. Skin diseases are associated with a significant adverse impact on patients' lives.

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