Epidemiology of Obesity in Asia: Challenges and Prevention

Obesity is a complex, multifactorial and largely preventable disease affecting over a third of the world’s population today. In this review, prevalence of childhood and adult obesity, its causes, risk factors, interventions and management in different Asian countries was explored. It has been observed that obesity has grown up as an epidemic and it will intensify in the coming years if appropriate preventive measures are not adopted. Proper policies are needed to be implemented. Additionally, massive nation-wide public awareness programs with better structural infrastructure will be answer to this giant problematic challenge.Keywords: Asia, body mass index; Obesity; Physical Activity; Prevalence; World Health Organization

An Overview on Synthetic Biology: its Classification, Engineering Approaches, and Applications of Synthetic Biology

Synthetic biology is an interdisciplinary field that focuses on living organisms and systems, employing engineering techniques to create innovative biological devices, systems, and components. It represents the convergence of old and new approaches, bridging the gap between chemistry and biology, with synthetic chemistry laying the foundation for its emergence. At its core, synthetic biology aims to develop and engineer biological systems by bringing together engineers and biologists to design and construct novel biomolecular parts, circuits, and pathways. These constructs are then utilized to reconstruct, reanalyze, and reprogram organisms for various purposes. There are five primary categories within synthetic biology: bioengineering, synthetic genome, protocell synthetic biology, unconventional molecular biology, and in silico techniques. Traditionally, four engineering approaches have been employed in synthetic biology, including top-down, parallel, orthogonal, and bottom-up methods. These approaches provide a systematic and rational way of reassembling and reconstructing biological components, enabling the creation of functional biological devices, systems, and organisms with known, useful, and novel functions. Synthetic biology holds the promise of providing efficient solutions to various significant challenges in the modern world, encompassing areas such as chemicals, pharmaceuticals, agriculture, energy, and bioremediation. By leveraging engineering methods in the realm of biology, synthetic biology benefits from over 50 years of molecular biological and functional genomic research, along with advanced technologies that allow for the analysis, synthesis, assembly, modification, and transfer of genetic components into living organisms. In essence, synthetic biology offers an exciting avenue to unlock the potential of biological systems and revolutionize multiple industries through innovative modifications and breakthrough innovations

Varadia, a new helicarionoidean semi-slug genus from India’s Western ghats (Stylommatophora: Helicarionoidea)

We here describe a new Indian helicarionoidean genus, Varadia Bhosale & Raheem gen. nov., containing the single species Varadia amboliensis Bhosale, Thackeray, Muley & Raheem gen. et sp. nov. This new semi-slug is endemic to the northern and central Western Ghats and is primarily a forest living species. We describe and figure the shell, reproductive system, radula, spermatophore and external morphology of this new species, and detail its known distribution. We explore its relationships to other helicarionoideans using phylogenetic analyses of DNA sequence data for part of the ribosomal RNA gene cluster and discuss the morphology of the new genus in relation to other, primarily South Indian, helicarionoidean taxa. Based on characters of the reproductive system, particularly the male genitalia and the gametolytic sac, we provisionally place Varadia gen. nov. in the Macrochlamydinae (Ariophantidae). This is consistent with the results of our molecular phylogenetic analyses. The combination of large size, broad, densely tuberculated shell lobes and a shell with ca 4 whorls and a disproportionately large body whorl makes V. amboliensis gen. et sp. nov. unique among the helicarionoidean taxa of the Western Ghats. The new semi-slug is also highly distinctive in the morphology of its male genitalia

Varadia, a new helicarionoidean semi-slug genus from India’s Western ghats (Stylommatophora: Helicarionoidea)

We here describe a new Indian helicarionoidean genus, Varadia Bhosale & Raheem gen. nov., containing the single species Varadia amboliensis Bhosale, Thackeray, Muley & Raheem gen. et sp. nov. This new semi-slug is endemic to the northern and central Western Ghats and is primarily a forest living species. We describe and figure the shell, reproductive system, radula, spermatophore and external morphology of this new species, and detail its known distribution. We explore its relationships to other helicarionoideans using phylogenetic analyses of DNA sequence data for part of the ribosomal RNA gene cluster and discuss the morphology of the new genus in relation to other, primarily South Indian, helicarionoidean taxa. Based on characters of the reproductive system, particularly the male genitalia and the gametolytic sac, we provisionally place Varadia gen. nov. in the Macrochlamydinae (Ariophantidae). This is consistent with the results of our molecular phylogenetic analyses. The combination of large size, broad, densely tuberculated shell lobes and a shell with ca 4 whorls and a disproportionately large body whorl makes V. amboliensis gen. et sp. nov. unique among the helicarionoidean taxa of the Western Ghats. The new semi-slug is also highly distinctive in the morphology of its male genitalia

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

A Systemic Review of Lumpy Skin Disease Virus (LSDV) And its Emergence in Pakistan

Lumpy skin disease (LSD) is an infectious disease caused by the virus lumpy skin disease virus (LSDV). The family of LSDV is Poxiviridae and the genus Capripoxvirus (CaPV). The GTPV (goat pox virus) and SPPV (sheep pox virus) also belong to the same genus. LSDV causes disease in livestock animals except for dogs. LSDV causes vast economic losses in the country in the livestock industry and dairy industries. LSDV also affects the industries belonging to these industries like the leather industry. The sequence of 21 strains of LSDV were taken from NCBI database and their fasta files were retrieved. After that, phylogenetic analysis was performed using these sequences. This study provides an overall overview of the lumpy skin disease (LSD) its genome, causative agent, transmission, epidemic, molecular characterization, phylogenetic analysis, control, and treatment of the LSDV. We also give a short review of the emergence of LSD in Pakistan

English Vocabulary Teaching Techniques at Secondary Level Schools in the Punjab, Pakistan

The aim of the paper was to identify various English vocabulary teaching techniques employed by teachers in public sector.  The data for that purpose was collected through classroom observations. A total of 20 classes in various public sector schools of Rahimyar District of the Punjab Pakistan were observed. The majority of the teachers were found employing various techniques to teach their students vocabulary of English Language. It was found that the teachers employed the techniques like visual aids, separate Word lists and rules related to the formation of words to teach students unfamiliar lexical items of English language. The pupils were further asked to memorize the word lists with their synonyms and L1 equivalents so that they may perform better in their academic exams

Predictors of oral tobacco use among young adult patients visiting family medicine clinics in Karachi, Pakistan.

Prevalence of cancers associated with the use of oral tobacco (OT) is rising very rapidly and prevention of use is the best option to tackle this scenario. This cross-sectional study estimated the proportion of OT use and predictors associated with its initiation and determined the knowledge, attitude and practices of OT users. A total of 231 young adult Patients (15-30 years age) were interviewed by medical students in family practice clinics in Karachi, Pakistan. OT use was considered as usage of any of the following: betel quid (paan) with tobacco, betel nuts with tobacco (gutkha), and snuff (naswar). Overall, 49.8% (95% CI=43.3-56.2) subjects had used OT at least in one form. Multivariable analysis demonstrated independent association of OT users with secondary education level (adjusted OR=3.6, 95% CI=1.6-8.1) and use of OT by a family member (OR=2.3, 95% CI=1.3-4.0). Among OT users, 37.4% started after being inspired by friends/peer pressure, 60% using for more than 5 years, 53.2 % users reported getting physical/mental comfort from the use of OT while 31.6% tried to quit this habit but failed. We suggest socially and culturally acceptable educational and behavioral interventions for control of OT usage and hence to prevent its associated cancers