Use of evidence to support healthy public policy: a policy effectiveness-feasibility loop

Public policy plays a key role in improving population health and in the control of diseases, including non-communicable diseases. However, an evidence-based approach to formulating healthy public policy has been difficult to implement, partly on account of barriers that hinder integrated work between researchers and policy-makers. This paper describes a “policy effectiveness–feasibility loop” (PEFL) that brings together epidemiological modelling, local situation analysis and option appraisal to foster collaboration between researchers and policy-makers. Epidemiological modelling explores the determinants of trends in disease and the potential health benefits of modifying them. Situation analysis investigates the current conceptualization of policy, the level of policy awareness and commitment among key stakeholders, and what actually happens in practice, thereby helping to identify policy gaps. Option appraisal integrates epidemiological modelling and situation analysis to investigate the feasibility, costs and likely health benefits of various policy options. The authors illustrate how PEFL was used in a project to inform public policy for the prevention of cardiovascular diseases and diabetes in four parts of the eastern Mediterranean. They conclude that PEFL may offer a useful framework for researchers and policy-makers to successfully work together to generate evidence-based policy, and they encourage further evaluation of this approach

An Epidemiological and Multidrug Resistance Study for E. coli Isolated from Urinary Tract Infection (Three Years of Study)

ان الاصابة بجراثيم الايشيريشيا القولونية (E. coli) هي احد المشاكل الرئيسة التي تؤدي الى اصابة الجهاز البولي في العالم. هذه البكتريا بامكانها من تطوير المقاومة ضد مجموعة واسعة من مضادات البكتريا. ان التقصي ونظام المراقبة والاستتراتيجية الفعالة سوف يسهل بشكل كبير من اختيار العلاج المناسب للسيطرة على انتشار البكتريا. تهدف الدراسة الحالية الى الكشف عن وبائية الاصابة والعوامل الخطرة المتعلقة ببكتريا الايشيريشيا القولونية الممرضة للجهاز البولي وانماط المقاومة للمضادات الحيوية.  تم جمع عينات من الادرار (من دفعة الادرار الوسطية) من 1585 مريض لديهم علامات سريرية للاصابة بالجهاز البولي (225 ذكور و 1360 اناث)  دخلوا الى مستشفى زاخو للطوارئ في مدينة زاخو في اقليم كردستان العراق من تاريخ كانون الثاني 2016 ولغاية كانون الاول 2018. تم زرع العينات في اكار الدم والماكونكي وتم حضن اللاطباق المزروعة بدرجة حرارة  37  °م لمدة 24 ساعة. ان تشخيص جراثيم الايشيريشيا القولونية تم بناءا على تفاعل التصبيغ بصبغة كرام والخصائص المستعمرية والفحوصات الكيميائية الحيوية وفقا للمعايير والتوجيهات المتبعة. تم فحص جميع العزلات لنمط المضادات الحيوية باستخدام طريقة نشر القرص بناء على إلارشادات والمعايير المختبرية والسريرية. بينت النتائج انه من بين 1585 عينة كانت 1026 عينة (64.7 %) ايجابية لاصابة جرثومية للجهاز البولي, وكانت باعلى مستوى خلال عام 2016 (83.6 %) (P< 0.0001). كما كان معدل الاصابة في الاناث بالايشيريشيا القولونية  اعلى معنويا من الذكور (P< 0.0001) . وبشكل عام, كانت نسبة الاصابة بالايشيريشيا القولونية بمعدل 21.1% من مجموع الاصابات ونسبتها كانت اعلى خلال عام 2016 (22.9%). كما بينت الدراسة ان نسبة اصابة الاناث كانت اعلى (21.4%) مقارنة بالذكور (18.5%) (P=0.4946). بالاضافة الى ذلك ,خلال ثلاث سنوات من الدراسة (2016, 2017 و 2018), فأن معدل الاصابة بالايشيريشيا القولونية كانت عند اعلى مستوى في الصيف (أيار) وكانت في اعلى مستوى في شهري شباط وايار من العام 2016, كما ان المجموعة العمرية من 20 الى 39 سنة كانت الاكثر اصابة لدى النساء بمعدل (46%)  من مجمل اصابات الاناث, بينما كانت الفئة العمرية من 70 – 74 سنة هي الاقل بمعدل الاصابة (1%) لدى الذكور والاناث. لقد كشفت الدراسة ان نسبة عالية (80.56 %) من الايشيريشيا القولونية المقاومة لمضادات حيوية متعددة وبنسبة عالية لمجاميع المضادات الحيوية البيتا لاكتامز والماكروليدات. كانت نسبة حساسية عالية للمضادين الحيويين اميبنم و ميروبينم. في الختام, ان الاستخدام الخاطئ والمفرط للمضادات الحيوية ستزيد من معدل المقاومة لبكتريا الايشيريشيا القولونية, ولهذا السبب من الضروري الاستخدام الصحيح للمضادات الحيوية المتوفرة. كما أن البرامج التعليمية والمراقبة الدورية لحساسية المضادات الحيوية ضرورية لتقليل نسبة مقاومة المضادات الحيويةUropathogenic E. coli (UPEC) is problematic and still the leading cause of urinary tract infections worldwide. It is developed resistance against most antibiotics. The investigation, surveillance system, and efficient strategy will facilitate selecting an appropriate treatment that could control the bacterial distribution. The present study aims to investigate the epidemiology and associated risk factors of uropathogenic E. coli and to study their antibiotic resistance patterns. 1585 midstream urine specimens were collected from symptomatic urinary tract infections (UTI) patients (225 males and 1360 females) admitted to Zakho emergency hospital, Zakho, Kurdistan Region, Iraq from January 2016 until the end of December 2018. Specimens were inoculated on blood and MacConkey plates and incubated at 37оC for 24 hours. Uropathogenic E. coli was diagnosed based on gram staining, colony characteristics, and standard biochemical tests in accordance with local standards and guidelines. All isolates were screened for their antibiogram pattern using the disk diffusion method based on the Clinical and Laboratory Standards Institute guidelines. The results showed that out of 1585 urine specimens, 1026 (64.7%) were UTIs positive with a statistically higher rate in 2016 (83.6%) (P< 0.0001). The UTIs frequency in females was significantly higher than males (P< 0.0001). Generally, the uropathogenic E. coli represented 21.1% with the highest level in 2016 (22.9%). The uropathogenic E. coli rate was higher, statistically not significant, in females (21.4%) than males (18.5%) (P=0.4946). Additionally, through the three years of study, uropathogenic E. coli (UPEC) was in high frequency in February and May 2016. The female’s age group from 20 to 39 years was the most vulnerable (46%) form total infected females, while those from 70-74 years (1%) were the least susceptible in males and females. A high percentage (80.56 %) of multidrug resistance E. coli isolates was observed with high resistance against -lactamase and macrolides antibiotics. However, higher sensitivity was towards imipenem and meropenem. In conclusion, the wrong and overuse of antibiotics will increase the resistance rate of E. coli. For this reason, proper use of available antibiotics is necessary. Also, the educational programs and periodic monitoring of antimicrobial suscep­tibility are essential for reducing the antibiotic resistance rate

Glass transition temperature variation, cross-linking and structure in network glasses

We give general topological rules which very accurately predict the chemical trends in glass transition temperature $T_g$ variation as a function of cross-linking. In multicomponent glasses, these chemical trends permit to distinguish homogeneous compositions (random network) from inhomogeneous ones (local phase separation). The stochastic origin of the Gibbs-Di Marzio equation is predicted at low connectivity and the analytical expression of its parameter emerges naturally from the calculation.Comment: 5 pages, Revtex, accepted for publication in Europhysics Letters, 2 figures not included, available at http://www.gcr.jussieu.fr/matthieu.htm#Researc

The Glucocorticoid Receptor and Certain KRÜPPEL-Like Transcription Factors have the Potential to Synergistically Stimulate Bovine Herpesvirus 1 Transcription and Reactivation from Latency

Bovine herpesvirus 1 (BoHV-1), an important bovine pathogen, establishes life-long latency in sensory neurons within trigeminal ganglia (TG). Stress, as mimicked by the synthetic corticosteroid dexamethasone, consistently induces reactivation in calves latently infected with BoHV-1. Dexamethasone induces expression of several transcription factors in TG neurons during early stages of reactivation, including Krüppel-like transcription factors (KLF): KLF4, KLF6, KLF15, and promyelocytic leukemia zinc finger. Furthermore, the glucocorticoid receptor (GR) is consistently detected in TG neurons expressing viral regulatory proteins during reactivation from latency. The viral immediate early transcription unit 1 (IEtu1) promoter that drives expression of two viral transcription factors (bICP0 and bICP4) contains two GR response elements (GREs) and is stimulated by DEX. KLF15 and the GR form a feed forward transcription loop that synergistically stimulates productive infection and IEtu1 promoter activity. New studies demonstrate the GR and KLF6 synergistically stimulate productive infection and IEtu1 promoter activity if the GREs are intact. Furthermore, the GR and KLF6 interact with wild-type GREs within the IEtu1 promoter, but not GRE mutants. These studies suggest that certain KLF family members and the GR can convert a silent viral genome in latently infected neurons into an actively transcribing genome during reactivation from latency

A Survey of Volunteered Open Geo-Knowledge Bases in the Semantic Web

Over the past decade, rapid advances in web technologies, coupled with innovative models of spatial data collection and consumption, have generated a robust growth in geo-referenced information, resulting in spatial information overload. Increasing 'geographic intelligence' in traditional text-based information retrieval has become a prominent approach to respond to this issue and to fulfill users' spatial information needs. Numerous efforts in the Semantic Geospatial Web, Volunteered Geographic Information (VGI), and the Linking Open Data initiative have converged in a constellation of open knowledge bases, freely available online. In this article, we survey these open knowledge bases, focusing on their geospatial dimension. Particular attention is devoted to the crucial issue of the quality of geo-knowledge bases, as well as of crowdsourced data. A new knowledge base, the OpenStreetMap Semantic Network, is outlined as our contribution to this area. Research directions in information integration and Geographic Information Retrieval (GIR) are then reviewed, with a critical discussion of their current limitations and future prospects

Holographic dual of the Standard Model on the throat

We apply recent techniques to construct geometries, based on local Calabi-Yau manifolds, leading to warped throats with 3-form fluxes in string theory, with interesting structure at their bottom. We provide their holographic dual description in terms of RG flows for gauge theories with almost conformal duality cascades and infrared confinement. We describe a model of a throat with D-branes at its bottom, realizing a 3-family Standard Model like chiral sector. We provide the explicit holographic dual gauge theory RG flow, and describe the appearance of the SM degrees of freedom after confinement. As a second application, we describe throats within throats, namely warped throats with discontinuous warp factor in different regions of the radial coordinate, and discuss possible model building applications.Comment: 46 pages, 21 figures, reference adde

A cost effectiveness analysis of salt reduction policies to reduce coronary heart disease in four Eastern Mediterranean countries.

BACKGROUND: Coronary Heart Disease (CHD) is rising in middle income countries. Population based strategies to reduce specific CHD risk factors have an important role to play in reducing overall CHD mortality. Reducing dietary salt consumption is a potentially cost-effective way to reduce CHD events. This paper presents an economic evaluation of population based salt reduction policies in Tunisia, Syria, Palestine and Turkey. METHODS AND FINDINGS: Three policies to reduce dietary salt intake were evaluated: a health promotion campaign, labelling of food packaging and mandatory reformulation of salt content in processed food. These were evaluated separately and in combination. Estimates of the effectiveness of salt reduction on blood pressure were based on a literature review. The reduction in mortality was estimated using the IMPACT CHD model specific to that country. Cumulative population health effects were quantified as life years gained (LYG) over a 10 year time frame. The costs of each policy were estimated using evidence from comparable policies and expert opinion including public sector costs and costs to the food industry. Health care costs associated with CHDs were estimated using standardized unit costs. The total cost of implementing each policy was compared against the current baseline (no policy). All costs were calculated using 2010 PPP exchange rates. In all four countries most policies were cost saving compared with the baseline. The combination of all three policies (reducing salt consumption by 30%) resulted in estimated cost savings of $235,000,000 and 6455 LYG in Tunisia;$39,000,000 and 31674 LYG in Syria; $6,000,000 and 2682 LYG in Palestine and$1,3000,000,000 and 378439 LYG in Turkey. CONCLUSION: Decreasing dietary salt intake will reduce coronary heart disease deaths in the four countries. A comprehensive strategy of health education and food industry actions to label and reduce salt content would save both money and lives

The Spectral Measurement of Scattered Radiation From a Clinical Linear Accelerator Using a CZT Detector

The study of the induced radioactivity following radiotherapy with high energy X-rays from medical linear accelerator. Patient equivalent phantom made of Polymethyl methacrylate (PMMA) of 30x30x27 cm size irradiated with 15 MV X-rays from Versa HD medical linear accelerator form Elekta. Induced radioactive and ambient dose rates were measured at 0.25, 0.5 and 1 m from beam center using GR1® spectrometry with Cadmium Zinc Telluride (CZT) detectors having energy resolution less than 2%. Spectrum analysis was performed using MultiSpect software. The measured spectrum showed 511 keV annihilation photons possibly as a result of positron emitter of which most likely candidates are 62Cu(T1/2: 9.7 min), 64Cu (T1/2: 12.7 h )  and 57Ni  (T1/2:  35.6 h) and a  peak at ≈ 1780 keV that could be attributed 28Al and 214Bi radioisotope. Ambient photon dose rates post radiotherapy treatment ranged 660 µGyh-1at o.5 m to 41 µGyh-1at 1 m. These values agree well with the results presented in the literature. Keywords: Radiotherapy; Activation Products; Gamma spectrometry; Occupational exposure; Medical Linear Accelerator. DOI: 10.7176/ALST/83-05 Publication date: November 30th 2020

Induced secondary metabolites from the endophytic fungus Aspergillus versicolor through bacterial co-culture and OSMAC approaches

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Editorial: Methods and application in cardiovascular and smooth muscle pharmacology: 2021

Despite significant advances in basic, translational, and clinical research tackling heart disease, cardiovascular pathologies remain among the leading causes of mortality and morbidity worldwide, being responsible for one-third of global deaths as estimated by the WHO (Organization, 2021). The complexity of risk factors and pathways underlying the development of cardiovascular disorders (CVDs) limits the efficacy of a given therapeutic intervention and necessitates combined pharmacological approaches, as well as lifestyle modification to provide a reasonable health impact (Arnett et al., 2019). Be that as it may, there remains a considerable room for scientific inquiry in pursuit of novel and more refined avenues to prevent, diagnose, mitigate, and reverse different forms of cardiovascular ailment, as well as optimize patient management. Indeed, such a need for research in this field was even further emphasized as the world faced heightened health challenges during the COVID-19 pandemic with cardiovascular complications being among the most serious consequences of SARS-CoV-2 infection (Wehbe et al., 2020)