Metabolic syndrome and its associated factors in patients with severe mental illness in Malaysia

Background: Mental illness is a huge public health issue. Patients with severe mental illness (SMI) are at risk of developing metabolic syndrome (MetS). Therefore, this cross-sectional study aimed to determine the associations between personal, clinical and lifestyle factors with MetS in patients with SMI. Materials and Methods: 151 patients attending psychiatric outpatient clinics in two government hospitals in Klang Valley participated in this study. The Mini International Neuropsychiatric Interview (MINI) was used to diagnose patients with SMI by a psychiatrist. MetS was defined based on the 2009 Joint Interim Statement (JIS) criteria. Information needed on socio-demographic background, clinical characteristics (types and duration of illness and medication), lifestyle factors (physical activity level, smoking behaviour and alcohol consumption) were collected through a face-to-face interview. Body weight, height, waist circumference, percentage of body fat and blood pressure were measured by the researchers. Blood test results were obtained from the medical records. Result: Nearly half of the respondents (48.3%) had MetS, in which it was higher among males (48.5%), married respondents (61.5%), older age group (66.7%) and schizophrenic patients (50.7%). Overweight (AOR=3.64, 95% CI=1.55-8.58) and obese (AOR=15.06, 95% CI=5.27-43.09) patients were more likely to develop MetS. Moreover, middle-aged and older patients were about 3 times (AOR=3.31, 95% CI=1.38-7.94) and 6 times (AOR=5.65, 95% CI=1.62-19.73), respectively, more likely to develop MetS compared to younger patients. Conclusion: This study demonstrated high prevalence of MetS among patients with SMI. It also highlighted the need of regular assessment of BMI among patients with SMI to prevent MetS

Assessment of Pseudomonas aeruginosa biofilm-forming capacities from drinking water in water vending machine

The establishment of P. aeruginosa with biofilm formation in water vending machines may cause serious health issues to the consumers and its emergence has led to the public’s concern. This study aimed to assess the quality of water vending machines and to evaluate the biological contaminant P. aeruginosa in biofilm capacities. The qualities of the drinking water from a total of fifteen (n = 15) water vending machines at Kota Samarahan were evaluated based on physical and chemical parameters including pH value, turbidity, total of carbon (TOC), total dissolved solid (TDS) and total suspended solid (TSS). The colonies Enterobacteriaceae has been morphology characterized through biochemical tests and P. aeruginosa bacteria was identify through the PCR method. The results of the physical and chemical parameters complies with the authority standard including turbidity values found in conformance with values were lower than 0.1 NTU. Morphological analysis with a total of 66.7% (n = 10) was detected with the presence of Enterobacteriaceae, and a total of 40% (n = 6) of the isolates were found to be P. aeruginosa. This study extended by assessing the potential strength of biofilm formation. The microtiter assay performed in a 96-well polystyrene microtiter plate showed that 83.33% (n = 5) of the bacterial isolates have moderate potential as biofilm producers, while only 16.67% (n = 1) isolates were non-adherent and showed no potential in producing biofilm. The highest OD isolates found occupying moderate biofilm strength was (mean = 0.217) and the lowest moderate biofilm strength was (mean = 0.136). In conclusion, the significance and impact of the study displayed the qualities of water vending machines complies with Food Act 1983, Regulation 360C and Malaysian Drinking Water Quality, Ministry of Health 1983. However, the presence of biological contaminants may raise consumer concerns. This study had successfully assessed the potential strength of P. aeruginosa biofilm collected from water vending machines. Further microbiological assessments should be perform continuously to predict and eliminate any future risks related to water vending machines

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Mediator Acts Upstream of the Transcriptional Activator Gal4

We show that Mediator, a protein originally isolated on the basis of its ability to respond to transcriptional activators, and thought to be regulated by an activator, can also be the master that controls the activator

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Abstracts from the 20th International Symposium on Signal Transduction at the Blood-Brain Barriers

https://deepblue.lib.umich.edu/bitstream/2027.42/138963/1/12987_2017_Article_71.pd

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

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

Assessment of Pseudomonas aeruginosa biofilm-forming capacities from drinking water in water vending machine

The establishment of P. aeruginosa with biofilm formation in water vending machines may cause serious health issues to the consumers and its emergence has led to the public’s concern. This study aimed to assess the quality of water vending machines and to evaluate the biological contaminant P. aeruginosa in biofilm capacities. The qualities of the drinking water from a total of fifteen (n = 15) water vending machines at Kota Samarahan were evaluated based on physical and chemical parameters including pH value, turbidity, total of carbon (TOC), total dissolved solid (TDS) and total suspended solid (TSS). The colonies Enterobacteriaceae has been morphology characterized through biochemical tests and P. aeruginosa bacteria was identify through the PCR method. The results of the physical and chemical parameters complies with the authority standard including turbidity values found in conformance with values were lower than 0.1 NTU. Morphological analysis with a total of 66.7% (n = 10) was detected with the presence of Enterobacteriaceae, and a total of 40% (n = 6) of the isolates were found to be P. aeruginosa. This study extended by assessing the potential strength of biofilm formation. The microtiter assay performed in a 96-well polystyrene microtiter plate showed that 83.33% (n = 5) of the bacterial isolates have moderate potential as biofilm producers, while only 16.67% (n = 1) isolates were non-adherent and showed no potential in producing biofilm. The highest OD isolates found occupying moderate biofilm strength was (mean = 0.217) and the lowest moderate biofilm strength was (mean = 0.136). In conclusion, the significance and impact of the study displayed the qualities of water vending machines complies with Food Act 1983, Regulation 360C and Malaysian Drinking Water Quality, Ministry of Health 1983. However, the presence of biological contaminants may raise consumer concerns. This study had successfully assessed the potential strength of P. aeruginosa biofilm collected from water vending machines. Further microbiological assessments should be perform continuously to predict and eliminate any future risks related to water vending machines