Viral Hepatitis in Dentistry – An overlooked contributor to disease burden and occupational hazard in India

Introduction: Dental professionals are considered to be at high-risk for contacting blood-borne pathogen transmissions. Thus, making it necessary for dentists to be aware on prevention, transmission and management of viral hepatitis. Objective: One day training programs for upskilling dental fraternity were conducted on 11th November 2019 and 11thFebruary 2020. Program also evaluated the Knowledge, Attitude, and Practices (KAP) of dentists regarding infection control practices and oral manifestations of viral hepatitis. Methods: One-day training program viz. “Viral hepatitis in Dentistry” under project Programmed Approach to Knowledge And Sensitization on Hepatitis (PRAKASH) was organized and a cross-sectional study using 20-item-self-reported questionnaire was conducted among participating professionals from six states of India. Identifying information was removed during statistical analysis. Results: Total of 625 dental professionals were trained; of which 470 participated in the KAP study i.e. response rate was calculated to be 75% (470 out of 625). Females represented about 73.2% of the sample(n=470). Sample comprised of experts from all the branches of dentistry. Almost 97% of responders were from private dental institutes or clinics. Mean knowledge score was found to be 4.71 ± 2.04, however when compared with age, knowledge in older professionals > 25 years was higher at 5.00 + 2.10 than participants’ aged<25, 4.57 ± 2.00 (p value = 0.03). Participating professionals seems to be following precautionary practices regarding viral hepatitis in dental clinics in a comparable manner irrespective of their age i.e. mean practice score of 6.81 ± 1.82 in professionals’< 25 years of age and mean practice score 6.81 ± 1.67 in trainees > 25 years. Conclusion: Study raised concerns regarding poor knowledge about infection prevention control and management of viral hepatitis in dental settings. Limited interventions in terms of capacity building programs for dentists on viral hepatitis, highlight the necessity of continued education through such training programs

Hepatitis update program: need of the situation to co-manage viral hepatitis and COVID-19

Background: Government of India has taken several initiatives towards combating viral hepatitis but due to sudden surge in COVID-19 cases resulted in suspension of viral hepatitis program related activities. Moreover, COVID-19 has several liver related complications hence more special precautions are required to manage patients with known liver diseases. Nurses play an important role in management of any disease. However, there is limited knowledge among nurses on co-management of COVID-19 and viral hepatitis. With this background, two-day training program for nursing professionals was conceptualized under the project PRAKASH to educate and train the nurses about co-management of COVID-19 and viral hepatitis.        Methods: A pre-post study was undertaken among nurses who have registered for hepatitis update program. The online link to 25-knowledge related questions along with demographic variables was shared with the registered participants. Paired t test and other statistical analyses were done using SPSS v-21. Level of significance was taken at p<0.05Results: A total of 1151 responses were received out of 1477 trained participants. The mean age of the nursing participants was 32.5±6.95 years. The overall mean knowledge score in the pre-assessment was found to be 15.47±4.13 out of 25, which further increased to 20.72±3.81 in the post-assessment. Gender, type of facility, education, willingness to get trained and prior training related to viral hepatitis were found to be independently associated with pre-knowledge score.Conclusions: Training programs should be encouraged for diseases which are of public health importance and can’t be ignored with respect to increasing burden of COVID-19 cases

The Big Catch-up: Addressing Zero-Dose Children as a Surrogate of Vaccination Disruptions During Public Health Emergencies

The COVID-19 pandemic has significantly disrupted global immunization programs, resulting in a sharp increase in the number of zero-dose children-those who have not received any vaccinations. This disruption poses a critical threat to public health, exacerbating the risk of vaccine-preventable disease outbreaks. This paper investigates the pandemic's impact on routine childhood immunization, with a particular focus on zero-dose children. Through a comprehensive review of data from WHO, UNICEF, Gavi, and key informant interviews, we highlight evidence-based interventions aligned with the strategic framework of the Zero Dose Guidelines. Our findings emphasize the importance of context-specific approaches, particularly in vulnerable settings such as urban slums, remote rural areas, and conflict zones. We identified key thematic areas for intervention: community engagement, health systems strengthening, and technological innovations. These strategies are critical for reaching zero-dose children and rebuilding resilient immunization systems. However, gaps remain in the evidence surrounding the long-term effectiveness and cost-efficiency of these interventions, especially in low- and middle-income countries. This study underscores the urgency of addressing the growing number of zero-dose children through coordinated global efforts like "The Big Catch-Up" campaign, which aims to recover and strengthen immunization coverage worldwide. By focusing on equity, innovation, and tailored strategies, we can mitigate the pandemic’s long-term effects and ensure that no child is left unprotected

Achieving sustainable, environmentally viable, solarized vaccine cold chain system and vaccination program—an effort to move towards clean and green energy-driven primary healthcare in Lebanon

IntroductionLebanon faces severe economic and energy crises, impacting its healthcare system, particularly vaccine storage. Traditional gas or kerosene-powered refrigerators often fail to maintain necessary temperatures for vaccine efficacy. This study explores transitioning to solar direct-drive (SDD) refrigerators to ensure reliable vaccine storage.MethodsA multi-phase methodology was employed, beginning with an inventory assessment of existing cold chain equipment. The implementation involved stepwise replacement of identified refrigerators across health facilities, including Primary Health Care Centers (PHCCs) and dispensaries. Feasibility, cost-effectiveness, and environmental impact were evaluated.ResultsFindings indicate that solarization significantly reduces vaccine wastage, ensures stable temperatures, and cuts operational costs by decreasing dependence on non-renewable energy sources. Over 1,000 SDD units were installed across more than 800 health facilities. Additionally, PHCC solarization improved vaccine preservation and enhanced the resilience of health services overall.DiscussionThe solarization initiative demonstrates the critical role of renewable energy in strengthening healthcare infrastructure, especially in crisis-hit regions. Solar-powered systems provide a reliable and sustainable solution for vaccine storage, reduce carbon footprints, and build public trust in the immunization system. Challenges included geographical and structural limitations, which were addressed through comprehensive planning and collaboration with local stakeholders. Solarization of Lebanon's vaccine cold chain and PHCCs marks a significant step towards sustainable and resilient healthcare infrastructure. The model offers a robust framework for other regions facing similar economic and energy challenges, highlighting the importance of renewable energy solutions in healthcare

Professional Competencies in Computing Education

Competency-based learning has been a successful pedagogical approach for centuries, but only recently has it gained traction within computing. Competencies, as defined in Computing Curricula 2020, comprise knowledge, skills, and professional dispositions. Building on recent developments in competency and computing education, this working group examined relevant pedagogical theories, investigates various skill frameworks, reviewed competencies and standard practices in other professional disciplines such as medicine and law. It also investigated the integrative nature of content knowledge, skills, and professional dispositions in defining professional competencies in computing education. In addition, the group explored appropriate pedagogies and competency assessment approaches. It also developed guidelines for evaluating student achievement against relevant professional competency frameworks and explores partnering with employers to offer students genuine professional experience. Finally, possible challenges and opportunities in moving from traditional knowledge-based to competency-based education were also examined. This report makes recommendations to inspire educators of future computing professionals and smooth students' transition from academia to employment

The SERRATE protein is involved in alternative splicing in <em>Arabidopsis thaliana</em>

Howalternative splicing (AS) is regulated in plants has not yet been elucidated. Previously, we have shown that the nuclear cap-binding protein complex (AtCBC) is involved in AS in Arabidopsis thaliana. Here we show that both subunits of AtCBC (AtCBP20 and AtCBP80) interact with SERRATE (AtSE), a protein involved in the microRNA biogenesis pathway. Moreover, using a high-resolution reverse transcript-ase-polymerase chain reaction AS system we have found that AtSE influences AS in a similar way to the cap-binding complex (CBC), preferentially affecting selection of 50 splice site of first introns. The AtSE protein acts in cooperation with AtCBC: many changes observed in the mutant lacking the correct SERRATE activity were common to those observed in the cbp mutants. Interestingly, significant changes in AS of some genes were also observed in other mutants of plant microRNA biogenesis pathway, hyl1-2 and dcl1-7, but a majority of them did not cor-respond to the changes observed in the se-1mutant. Thus, the role of SERRATE in AS regulation is distinct from that of HYL1andDCL1, and is similar to the regu-lation of AS in which CBC is involved

Level of agreement between frequently used cardiovascular risk calculators in people living with HIV

Objectives The aim of the study was to describe agreement between the QRISK2, Framingham and Data Collection on Adverse Events of Anti‐HIV Drugs (D:A:D) cardiovascular disease (CVD) risk calculators in a large UK study of people living with HIV (PLWH). Methods PLWH enrolled in the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study without a prior CVD event were included in this study. QRISK2, Framingham CVD and the full and reduced D:A:D CVD scores were calculated; participants were stratified into ‘low’ ( 20%) categories for each. Agreement between scores was assessed using weighted kappas and Bland–Altman plots. Results The 730 included participants were predominantly male (636; 87.1%) and of white ethnicity (645; 88.5%), with a median age of 53 [interquartile range (IQR) 49–59] years. The median calculated 10‐year CVD risk was 11.9% (IQR 6.8–18.4%), 8.9% (IQR 4.6–15.0%), 8.5% (IQR 4.8–14.6%) and 6.9% (IQR 4.1–11.1%) when using the Framingham, QRISK2, and full and reduced D:A:D scores, respectively. Agreement between the different scores was generally moderate, with the highest level of agreement being between the Framingham and QRISK2 scores (weighted kappa = 0.65) but with most other kappa coefficients in the 0.50–0.60 range. Conclusions Estimates of predicted 10‐year CVD risk obtained with commonly used CVD risk prediction tools demonstrate, in general, only moderate agreement among PLWH in the UK. While further validation with clinical endpoints is required, our findings suggest that care should be taken when interpreting any score alone

Validation of a Novel Multivariate Method of Defining HIV-Associated Cognitive Impairment

Background. The optimum method of defining cognitive impairment in virally suppressed people living with HIV is unknown. We evaluated the relationships between cognitive impairment, including using a novel multivariate method (NMM), patientreported outcome measures (PROMs), and neuroimaging markers of brain structure across 3 cohorts.Methods. Differences in the prevalence of cognitive impairment, PROMs, and neuroimaging data from the COBRA, CHARTER, and POPPY cohorts (total n = 908) were determined between HIV-positive participants with and without cognitive impairment defined using the HIV-associated neurocognitive disorders (HAND), global deficit score (GDS), and NMM criteria.Results. The prevalence of cognitive impairment varied by up to 27% between methods used to define impairment (eg, 48% for HAND vs 21% for NMM in the CHARTER study). Associations between objective cognitive impairment and subjective cognitive complaints generally were weak. Physical and mental health summary scores (SF-36) were lowest for NMM-defined impairment (P&lt;.05). There were no differences in brain volumes or cortical thickness between participants with and without cognitive impairment defined using the HAND and GDS measures. In contrast, those identified with cognitive impairment by the NMM had reduced mean cortical thickness in both hemispheres (P&lt;.05), as well as smaller brain volumes (P&lt;.01). The associations with measures of white matter microstructure and brain-predicted age generally were weaker.Conclusion. Different methods of defining cognitive impairment identify different people with varying symptomatology and measures of brain injury. Overall, NMM-defined impairment was associated with most neuroimaging abnormalities and poorer selfreported health status. This may be due to the statistical advantage of using a multivariate approach

Depression, lifestyle factors and cognitive function in people living with HIV and comparable HIV-negative controls

We investigated whether differences in cognitive performance between people living with HIV (PLWH) and comparable HIV-negative people were mediated or moderated by depressive symptoms and lifestyle factors. METHODS: A cross-sectional study of 637 'older' PLWH aged ≥ 50 years, 340 'younger' PLWH aged < 50 years and 276 demographically matched HIV-negative controls aged ≥ 50 years enrolled in the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study was performed. Cognitive function was assessed using a computerized battery (CogState). Scores were standardized into Z-scores [mean = 0; standard deviation (SD) = 1] and averaged to obtain a global Z-score. Depressive symptoms were evaluated via the Patient Health Questionnaire (PHQ-9). Differences between the three groups and the effects of depression, sociodemographic factors and lifestyle factors on cognitive performance were evaluated using median regression. All analyses accounted for age, gender, ethnicity and level of education. RESULTS: After adjustment for sociodemographic factors, older and younger PLWH had poorer overall cognitive scores than older HIV-negative controls (P < 0.001 and P = 0.006, respectively). Moderate or severe depressive symptoms were more prevalent in both older (27%; P < 0.001) and younger (21%; P < 0.001) PLWH compared with controls (8%). Depressive symptoms (P < 0.001) and use of hashish (P = 0.01) were associated with lower cognitive function; alcohol consumption (P = 0.02) was associated with better cognitive scores. After further adjustment for these factors, the difference between older PLWH and HIV-negative controls was no longer significant (P = 0.08), while that between younger PLWH and older HIV-negative controls remained significant (P = 0.01). CONCLUSIONS: Poorer cognitive performances in PLWH compared with HIV-negative individuals were, in part, mediated by the greater prevalence of depressive symptoms and recreational drug use reported by PLWH

RA-MAP, molecular immunological landscapes in early rheumatoid arthritis and healthy vaccine recipients

Rheumatoid arthritis (RA) is a chronic inflammatory disorder with poorly defined aetiology characterised by synovial inflammation with variable disease severity and drug responsiveness. To investigate the peripheral blood immune cell landscape of early, drug naive RA, we performed comprehensive clinical and molecular profiling of 267 RA patients and 52 healthy vaccine recipients for up to 18 months to establish a high quality sample biobank including plasma, serum, peripheral blood cells, urine, genomic DNA, RNA from whole blood, lymphocyte and monocyte subsets. We have performed extensive multi-omic immune phenotyping, including genomic, metabolomic, proteomic, transcriptomic and autoantibody profiling. We anticipate that these detailed clinical and molecular data will serve as a fundamental resource offering insights into immune-mediated disease pathogenesis, progression and therapeutic response, ultimately contributing to the development and application of targeted therapies for RA.</p