Altered respiratory microbiota composition and functionality associated with asthma early in life

BACKGROUND: The microbiota of the respiratory tract has an important role in maintaining respiratory health. However, little is known on the respiratory microbiota in asthmatic patients among Middle Eastern populations. This study investigated the respiratory microbiota composition and functionality associated with asthma in Emirati subjects. METHODS: We performed 16S rRNA and ITS2-gene based microbial profiling of 40 expectorated sputum samples from adult and pediatric Emirati individuals averaging 52 and 7 years of age, respectively with or without asthma. RESULTS: We report bacterial difference belonging to Bacteroidetes, Firmicutes, Fusobacteria and Proteobacteria phyla between asthmatic and non-asthmatic controls. Similarly, fungal difference belonging to Ascomycota, Basidiomycota phyla and other unclassified fungi. Differential abundance testing among asthmatic individuals with relation to Asthma Control Test show a significant depletion of Penicillium aethiopicum and Alternaria spp., among poorly controlled asthmatics. Moreover, data suggest a significant expansion of Malassezia spp. and other unclassified fungi in the airways of those receiving steroids and leukotriene receptor antagonists’ combination therapy, in contrast to those receiving steroids alone. Functional profiling from 16S data showed marked differences between pediatric asthmatic and non-asthmatic controls, with pediatric asthmatic patients showing an increase in amino acid (p-value < 5.03 × 10− 7), carbohydrate (p-value < 4.76 × 10− 7), and fatty acid degradation (p-value < 6.65 × 10− 7) pathways, whereas non-asthmatic controls are associated with increase in amino acid (p-value < 8.34 × 10− 7), carbohydrate (p-value < 3.65 × 10− 7), and fatty acid (p-value < 2.18 × 10− 6) biosynthesis pathways in concordance with enterotype composition. CONCLUSIONS: These differences provide an insight into respiratory microbiota composition in Emirati population and its possible role in the development of asthma early in life. This study provides important information that may eventually lead to the development of screening biomarkers to predict early asthma development and novel therapeutic approaches

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Validity and Reliability of the Test of Gross Motor Development - 3 in Children Aged 5 to 9 years in Iraq and a Comparison of the Development of Gross Motor Skills of Iranian and Iraqi Children

The aim of the study was to investigate the psychometric properties of the Iraqi version of the Gross Motor Development Test - Third Edition TGMD-3 in Iraqi children aged 5 to 9 years. The second aim of this study was to compare the development of gross motor skills of Iranian and Iraqi children. The participants were selected from 400 people by cluster sampling method from Iraq and were evaluated using TGMD-3 test. Finally, 30 Iraqis in the age group of 8-9 years were randomly selected and compared with a similar group of 30 Iranian children. Cronbach's alpha, Pearson correlation coefficient, factor analysis and t-test were used to analyze the data. Internal consistency reliability coefficients for locomotor, ball skills and total scores were 0.77, 0.85 and 0.87; test-retest reliability coefficients were 0.89, 0.90 and 0.91; inter-rater reliability coefficients were 0.77, 0.85 and 0.88; intera-rater coefficients were 0.66, 0.80 and 0.84, respectively. Also, there was no significant difference between the performance of Iranian and Iraqi children in the subtests of locomotor and ball skills and the total score of gross motor skills (P <0.05). Due to the confirmation of validity and reliability, this test can be used with confidence to evaluate the development of gross motor skills. The results obtained are limited to the Iraqi boy community of 5 to 9 years, and additional studies are needed in the future for use in the girl community and other age groups