What lies beyond 100 years of insulin

ABSTRACT It has been 100 years since the discovery of insulin. This revolutionary treatment saves the lives of millions of people living with diabetes, but much remains to be understood of its mechanisms and roles in homeostasis and disease. To celebrate this centenary, we explore areas of ongoing insulin research in diabetes, metabolic syndrome and beyond. Disease Models & Mechanisms aims to publish high-quality basic and pre-clinical research that advances our understanding of these conditions to facilitate clinical and public health impact.

Understanding the Potential Impact of Different Drug Properties On SARS-CoV-2 Transmission and Disease Burden: A Modelling Analysis

Background The public health impact of the COVID-19 pandemic has motivated a rapid search for potential therapeutics, with some key successes. However, the potential impact of different treatments, and consequently research and procurement priorities, have not been clear. Methods Using a mathematical model of SARS-CoV-2 transmission, COVID-19 disease and clinical care, we explore the public-health impact of different potential therapeutics, under a range of scenarios varying healthcare capacity, epidemic trajectories; and drug efficacy in the absence of supportive care. Results The impact of drugs like dexamethasone (delivered to the most critically-ill in hospital and whose therapeutic benefit is expected to depend on the availability of supportive care such as oxygen and mechanical ventilation) is likely to be limited in settings where healthcare capacity is lowest or where uncontrolled epidemics result in hospitals being overwhelmed. As such, it may avert 22% of deaths in high-income countries but only 8% in low-income countries (assuming R=1.35). Therapeutics for different patient populations (those not in hospital, early in the course of infection) and types of benefit (reducing disease severity or infectiousness, preventing hospitalisation) could have much greater benefits, particularly in resource-poor settings facing large epidemics. Conclusions Advances in the treatment of COVID-19 to date have been focussed on hospitalised-patients and predicated on an assumption of adequate access to supportive care. Therapeutics delivered earlier in the course of infection that reduce the need for healthcare or reduce infectiousness could have significant impact, and research into their efficacy and means of delivery should be a priority.

Public health impact of a US ban on menthol in cigarettes and cigars: a simulation study

IntroductionThe US Food and Drug Administration most recently announced its intention to ban menthol cigarettes and cigars nationwide in April 2021. Implementation of the ban will require evidence that it would improve public health. This paper simulates the potential public health impact of a ban on menthol in cigarettes and cigars through its impacts on smoking initiation, smoking cessation and switching to nicotine vaping products (NVPs).MethodsAfter calibrating an established US simulation model to reflect recent use trends in cigarette and NVP use, we extended the model to incorporate menthol and non-menthol cigarette use under a status quo scenario. Applying estimates from a recent expert elicitation on the behavioural impacts of a menthol ban, we developed a menthol ban scenario with the ban starting in 2021. We estimated the public health impact as the difference between smoking and vaping-attributable deaths and life-years lost in the status quo scenario and the menthol ban scenario from 2021 to 2060.ResultsAs a result of the ban, overall smoking was estimated to decline by 15% as early as 2026 due to menthol smokers quitting both NVP and combustible use or switching to NVPs. These transitions are projected to reduce cumulative smoking and vaping-attributable deaths from 2021 to 2060 by 5% (650 000 in total) and reduce life-years lost by 8.8% (11.3 million). Sensitivity analyses showed appreciable public health benefits across different parameter specifications.Conclusions and relevanceOur findings strongly support the implementation of a ban on menthol in cigarettes and cigars.

Public Health Impact of Environmental Pollution in Areas with Gas Flares

Background: A variety of pollutants are discharged during gas flaring and these are detrimental to animals and the environment. These pollutants are linked to a range of adverse health impacts including cancer, neurological, reproductive and developmental effects. Furthermore, some of the pollutants such as sulphur dioxide cause environmental issues including acid rain as well as the production of greenhouse gases and this contributes to climate change. This article evaluates the public health impact of environmental pollution in areas with gas flares. Methodology: This research followed a mixed method approach of quantitative and qualitative analysis. Descriptive statistics were followed with frequency distribution of respondents to the Likert scaled questions. The nominal knowledge level of respondents was determined from their Likert scaled responses to questions. ANOVA comparisons were made between the subgroups of demographic factors to determine differences in knowledge level. MANOVA was also carried out to determine the influence of educational and social levels as well as duration of stay in the community. Outcome: Evaluation of the nominal knowledge level of respondents determined from Likert scale shows no statistically significant differences between demographic subgroups. Further, ANOVA of nominal knowledge between educational subgroups shows gradient increase but no statistical difference. Conclusion: The community has knowledge on the negative impact of gas flaring. This report increases understanding of community awareness about the effects of gas flares on the environment and health.