The association between FLAIR vascular hyperintensities and outcomes in patients with border zone infarcts treated with medical therapy may vary with the infarct subtype.

RATIONALE AND OBJECTIVES: Fluid-attenuated inversion recovery vessel hyperintensities (FVHs) reflect the haemodynamic state and may aid in predicting the prognosis of border zone (BZ) infarct patients. This study was to explore the relationship between FVHs and functional outcomes for different BZ infarct subtypes following medical therapy administration. MATERIALS AND METHODS: Consecutive patients with ischemic stroke were retrospectively enrolled and classified into internal BZ (IBZ) infarct, cortical BZ (CBZ) infarct and mixed-type infarct patients. FVHs were quantified using the FVH-Alberta Stroke Program Early CT Score (ASPECTS) system, and the scores were used to divide the patients into low-FVH (0-3) and high-FVH (4-7) groups. The FVH location and the cerebrovascular stenotic degree were recorded. Logistic regression was performed to identify risk factors for poor outcomes (modified Rankin scale score ≥3). RESULTS: A total of 207 BZ infarct patients (IBZ, n = 130; CBZ, n = 52; mixed-type, n = 25) were included. The FVH score was positively correlated with cerebrovascular stenosis (r = 0.332, P < 0.001) in all patients. A high FVH score was associated with poor outcomes in all (OR 2.568, 95% CI (1.147 to 5.753), P = 0.022) and in CBZ infarct patients (OR 9.258, 95% CI 1.113 to 77.035), P = 0.040). FVH-diffusion-weighted imaging (DWI) mismatch was not significantly associated with outcomes in the entire patient group or in any subgroup. CONCLUSIONS: A high FVH score is associated with poor long-term outcomes in patients with CBZ infarcts but not in those with IBZ or mixed-type infarcts.

Pathways for accidental biocontrol: The human-mediated dispersal of insect predators and parasitoids.

Introductions of insect predators and parasitoids for biological control are a key method for pest management. Yet in recent decades, biological control has become more strictly regulated and less frequent. Conversely, the rate of unintentional insect introductions through human activities is rising. While accidental introductions of insect natural enemies can potentially have serious ecological consequences, they are challenging to quantify as their movements go largely unobserved. We used historical border interception records collected by the US Department of Agriculture from 1913 to 2018 to describe the diversity of entomophagous insects transported unintentionally, their main introduction pathways, and trends in host specificity. There were 35,312 interceptions of insect predators and parasitoids during this period, representing 93 families from 11 orders, and 196 species from these families. Commodity associations varied, but imported plants and plant products were the main introduction pathway. Most interceptions originated with commodities imported from the Neotropical, Panamaian, and Western Palearctic regions. Among the intercepted species, 27% were found in material originating from more than one country. Two thirds of species were polyphagous host generalists. Furthermore, 25% of species had already been introduced intentionally as biological control agents internationally, and 4.6% have documented negative impacts on native biodiversity or human society. Most of the intercepted species that have not established in the United States are host generalists or have at least one known host species available. The unintentional transport of diverse natural enemy insects has the potential to cause substantial ecological impacts, both in terms of controlling pests through accidental biocontrol and disrupting native communities. Characterizing the insects being transported and their introduction pathways can inform biosecurity practices and management.

Harmonizing digital trade for sustainable stride: Unveiling the industrial pollution reduction effect of China's cross-border E-commerce comprehensive pilot zones.

As a key export-oriented economy, China faces significant challenges to its green economic development due to industrial pollution. While digital trade is crucial for sustainable development, its impact on industrial pollution has not been studied. This paper addresses this gap by adopting prefecture-level data from 2005 to 2021 and using a staggered difference-in-differences model to assess the impact of comprehensive pilot zones policy of cross-border e-commerce (CBEC) on industrial sulfur dioxide pollution. The findings indicate that CBEC significantly reduces industrial sulfur dioxide emission intensity, with the effect growing stronger over time. The effect is particularly notable in eastern and western regions, large cities, cities with underdeveloped digital infrastructure, and cities with lower pollution. Mechanism analysis reveals that CBEC lowers industrial emission intensity by driving structure upgrading, fostering green innovation, and advancing digital transformation. This paper emphasizes that the government can expedite the green transformation of the economy by integrating digital trade with industry.

Frontiers of Neurodegenerative Disease Treatment: Targeting Immune Cells in Brain Border Regions.

Neurodegenerative diseases (NDs) demonstrate a complex interaction with the immune system, challenging the traditional view of the brain as an "immune-privileged" organ. Microglia were once considered the sole guardians of the brain's immune response. However, recent research has revealed the critical role of peripheral immune cells located in key brain regions like the meninges, choroid plexus, and perivascular spaces. These previously overlooked cells are now recognized as contributors to the development and progression of NDs. This newfound understanding opens doors for pioneering therapeutic strategies. By targeting these peripheral immune cells, we may be able to modulate the brain's immune environment, offering an alternative approach to treat NDs and circumvent the challenges posed by the blood-brain barrier. This comprehensive review will scrutinize the latest findings on the complex interactions between these peripheral immune cells and NDs. It will also critically assess the prospects of targeting these cells as a ground-breaking therapeutic avenue for these debilitating disorders.

Tao and Rap2l ensure proper Misshapen activation and levels during Drosophila border cell migration.

Collective cell migration is fundamental in development, wound healing, and metastasis. During Drosophila oogenesis, border cells (BCs) migrate collectively inside the egg chamber, controlled by the Ste20-like kinase Misshapen (Msn). Msn coordinates the restriction of protrusion formation and contractile forces within the cluster. Here, we demonstrate that Tao acts as an upstream activator of Msn in BCs. Depleting Tao significantly impedes BC migration, producing a phenotype similar to Msn loss of function. Furthermore, we show that the localization of Msn relies on its citron homology (CNH) domain, which interacts with the small GTPase Rap2l. Rap2l promotes the trafficking of Msn to the endolysosomal pathway. Depleting Rap2l elevates Msn levels by reducing its trafficking into late endosomes and increases overall contractility. These data suggest that Tao promotes Msn activation, while global Msn protein levels are controlled via Rap2l and the endolysosomal degradation pathway. Thus, two mechanisms ensure appropriate Msn levels and activation in BCs.

First imported Cases of MPXV Clade Ib in Goma, Democratic Republic of the Congo: Implications for Global Surveillance and Transmission Dynamics.

The ongoing national mpox outbreak in the Democratic Republic of the Congo has resulted in more >30,000 suspected cases in the country from January 2023 to August 2024. While these historic case totals have been driven by primarily by zoonosis, the emergence of Clade Ib monkeypox virus (MPXV), which is connected to more sustained human-to-human transmission, has been associated with increasing public health impacts in eastern DRC. First identified in South Kivu province, Clade Ib MPXV has been identified in multiple non-endemic East African countries for the first time. In DRC, there have been concerns over broader Clade Ib expansion in the country that could further complicate containment and mitigation responses. Here, we report the first introductions of Clade Ib into North Kivu province, including within internal displacement camps, with suspected close contact transmission that includes non-intimate contacts and children. These findings demonstrate that mpox case investigations and community messaging campaigns should include considerations for non-sexual contact-mediated transmission of Clade Ib that includes children <15 years.

Assessing exit screening of SARS-CoV-2 in Japan: an analysis of the airport screening data of passengers from the United Kingdom, 2020-2022.

BACKGROUND: Japan implemented strict border control measures and all incoming passengers were subject to entry screening with reverse transcription-polymerase chain reaction or antigen testing. From late 2020, exit screening within 72 h of departure to Japan also became mandatory. In this study, we evaluated the effectiveness of the exit screening policy in Japan by analyzing airport screening data from October 2020 to April 2022. METHODS: In addition to assessing entry screening data over time of passengers from the United Kingdom, we examined the prevalence of coronavirus disease 2019 (COVID-19) in the United Kingdom based on the Office of National Statistics infection survey. We constructed a statistical model that described entry screening positivity over time using Office of National Statistics prevalence data as the explanatory variable. Ideally, the time-dependent patterns of entry screening and Office of National Statistics prevalence data should resemble each other; however, we found that, sometimes, they were different and regarded the difference to statistically partly reflect the effectiveness of exit screening. RESULTS: The average proportion positive in one month before mandatory exit screening was implemented among Japanese passengers was 0.67% (95% confidence interval [CI]: 0.45, 0.98), whereas the proportion positive decreased to 0.49% (95% CI: 0.21, 1.15) in the first month of exit screening. Adjusting for time-dependent prevalence at the origin, we concluded that exit screening contributed to reducing passenger positivity by 59.3% (95% CI: 19.6, 81.3). The overall positivity values among passengers during the Delta and Omicron variant periods were 3.46 times and 1.46 times that during the pre-Delta variant period, respectively. CONCLUSIONS: We used a simplistic statistical model and empirical data from passengers arriving in Japan from the United Kingdom to support that exit screening helped to reduce the proportion positive by 59%. Although the proportion positive later increased considerably and precluded preventing the introduction of imported cases, submitting a certificate for a negative test result contributed to reducing the positivity among travelers.

CUREMA project: a further step towards malaria elimination among hard-to-reach and mobile populations.

BACKGROUND: In most countries engaged on the last mile towards malaria elimination, residual transmission mainly persists among vulnerable populations represented by isolated and mobile (often cross-border) communities. These populations are sometimes involved in informal or even illegal activities. In regions with Plasmodium vivax transmission, the specific biology of this parasite poses additional difficulties related to the need for a radical treatment against hypnozoites to prevent relapses. Among hard-to-reach communities, case management, a pillar of elimination strategy, is deficient: acute malaria attacks often occur in remote areas, where there is limited access to care, and drugs acquired outside formal healthcare are often inadequately used for treatment, which typically does not include radical treatment against P. vivax. For these reasons, P. vivax circulation among these communities represents one of the main challenges for malaria elimination in many non-African countries. The objective of this article is to describe the protocol of the CUREMA study, which aims to meet the challenge of targeting malaria in hard-to-reach populations with a focus on P. vivax. RESULTS: CUREMA is a multi-centre, international public health intervention research project. The study population is represented by persons involved in artisanal and small-scale gold mining who are active and mobile in the Guiana Shield, deep inside the Amazon Forest. The CUREMA project includes a complex intervention composed of a package of actions: (1) health education activities; (2) targeted administration of treatment against P. vivax after screening against G6PD deficiency to asymptomatic persons considered at risk of silently carrying the parasite; (3) distribution of a self-testing and self-treatment kit (malakit) associated with user training for self-management of malaria symptoms occurring while in extreme isolation. These actions are offered by community health workers at settlements and neighbourhoods (often cross-border) that represent transit and logistic bases of gold miners. The study relies on hybrid design, aiming to evaluate both the effectiveness of the intervention on malaria transmission with a pre/post quasi-experimental design, and its implementation with a mixed methods approach. CONCLUSIONS: The purpose of this study is to experiment an intervention that addresses both Plasmodium falciparum and P. vivax malaria elimination in a mobile and isolated population and to produce results that can be transferred to many contexts facing the same challenges around the world.

[Impact of border control measures on public health center operations and staffing at international airports during the emergence of the SARS-CoV-2 B.1.1.529 (Omicron) variant of concern].

Objective　Ota City, located in southeastern Tokyo, including Haneda Tokyo International Airport, has numerous scattered lodging facilities. Shortly after the first case of SARS-CoV-2 B.1.1.529 (Omicron) variant was reported abroad, the Japanese government strengthened border control measures, including quarantine procedures and public health official involvement, for incoming travelers. This study aims to propose effective and efficient border control measures to prevent future outbreaks of emerging and re-emerging infectious diseases.Methods　Border control measures implemented between November 2021 and mid-January 2022 were analyzed from three perspectives: chronological changes in government notifications, the situation of in-flight contacts and Omicron cases, and the support system for coronavirus-disease 2019 control department of the Ota City Public Health Center. Additionally, a questionnaire survey was conducted among public health centers with jurisdiction over the top four international airports. This survey aimed to assess the effectiveness of the support system, evaluate cooperation with related organizations, identify common issues faced by public health concerns, and gather suggestions for improvements in future border control measures.Results　The definition and treatment of in-flight contacts of Omicron-positive individuals were initially outlined on November 30, 2021, and underwent frequent revisions until January 14, 2022. Between December 1, 2021, and January 12, 2022, only one Omicron case was identified among the 470 tests conducted on in-flight contacts. However, out of 136 additional domestic specimens collected (including 57 positives for genetic analysis), 40 were confirmed Omicron positive. The results of the questionnaire survey across the four public health centers largely mirrored the issues and suggestions identified by Ota City officials. A significant portion of these issues arose from managing temporary non-Japanese residents staying near international airports.Conclusion　Border control measures should be implemented to delay the domestic spread of the virus. In this reason, it is crucial to avoid placing an undue burden on public health officials responsible for handling domestic infections. Since response policies and target definitions may need to adapt to unknown pathogens, they may be changed frequently, baffling the officials; however, a system for collecting real-time data from frontline sites and making evidence-based decisions is essential. Additionally, deploying liaisons from national and prefectural governments to focal points of emergency response would strengthen the support system by promoting unified instructions and information sharing.

Racial/ethnic differences in the clinical presentation and survival of breast cancer by subtype.

Background: Breast cancer (BC) affects racial and ethnic groups differently, leading to disparities in clinical presentation and outcomes. It is unclear how Hispanic ethnicity affects BC outcomes based on geographic location and proximity to the United States (U.S.)/Mexico border. We hypothesized that the impact of race/ethnicity on BC outcomes depends on geographic location and country of origin within each BC subtype. Methods: We analyzed BC data from the Texas Cancer Registry by race/ethnicity/birthplace according to BC subtype (luminal A/luminal B/human epidermal growth factor receptor 2 [HER2]/triple-negative breast cancer[TNBC]). Other covariates included age, geographic location (U.S., Mexico), residency (border, non-border), treatments, and comorbidities. Crude and adjusted effects of race/ethnicity and birthplace on overall survival (OS) were analyzed using Cox regression methods. Results: Our analysis of 76,310 patient records with specific BC subtypes revealed that Hispanic and non-Hispanic Black (NHB) patients were diagnosed at a younger age compared with non-Hispanic White (NHW) patients for all BC subtypes. For the 19,748 BC patients with complete data on race/ethnicity/birthplace/residency, Hispanic patients had a higher mortality risk in the Luminal A subtype, regardless of birthplace, whereas U.S.-born Hispanics had a higher risk of death in the TNBC subtype. In contrast, NHB patients had a higher mortality risk in the Luminal A and HER2 subtypes. Residence along the U.S./Mexico border had little impact on OS, with better outcomes in Luminal A patients and worse outcomes in Luminal B patients aged 60-74 years. Conclusion: Race/ethnicity, geographic birth location, and residency were significant predictors of survival in BC. Migration, acculturation, and reduced healthcare access may contribute to outcome differences.

Lessons learned: drive-through COVID-19 clinic testing during an adaptive epidemic response and a point-of-care test assessment of a computer-read rapid lateral flow immunoassay with fluorescence-based detection.

Background. The COVID-19 pandemic demonstrated a need for robust SARS-CoV-2 test evaluation infrastructure to underpin biosecurity and protect the population during a pandemic health emergency.Gap statement. The first generation of rapid antigen tests was less accurate than molecular methods due to their inherent sensitivity and specificity shortfalls, compounded by the consequences of self-testing. This created a need for more accurate point-of-care SARS-CoV-2 detection methods.Aim. Here we present the lessons-learned during the COVID-19 emergency response in Western Australia including the detailed set-up, evaluation and operation of rapid antigen test in a state-run drive-through sample collection service during the COVID-19 pandemic after the strict border shutdown ended.Methods. We report a conformity assessment of a novel, second-generation rapid antigen test (Virulizer) comprising a technician-operated rapid lateral flow immunoassay with fluorescence-based detection.Results. The Virulizer rapid antigen test demonstrated up to 100% sensitivity (95% CI: 61.0-100%), 91.94% specificity (95% CI: 82.5-96.5%) and 92.65% accuracy when compared to a commercial PCR assay method. Wide confidence intervals in our series reflect the limits of small sample size. Nevertheless, the Virulizer assay performance was well-suited to point-of-care screening for SARS-CoV-2 in a drive-through clinic setting.Conclusion. The adaptive evaluation process necessary under changing pandemic conditions enabled assessment of a simple sample collection and point-of-care testing process, and showed how this system could be rapidly deployed for SARS-CoV-2 testing, including to regional and remote settings.

Health effects and user perceptions of the US Customs and Border Patrol One™ mobile application: A qualitative analysis among asylum seekers at the Mexico-US border.

Background: The number of migrants at the Mexico-US border has increased to historic levels, and frequently changing immigration policy impacts this population as they await entry into the US. This study evaluated the usability and health effects of the Customs and Border Protection (CBP) One™ mobile application among asylum seekers near the US port of entry in Reynosa, Mexico. Methods: We conducted semi-structured qualitative interviews with 20 asylum seekers in Reynosa, Mexico, in February 2023. Our objective was to explore the subjective experiences of migrants, usability of CBP One™, and presence of perceived health effects from using the application. Interviews were conducted until saturation occurred, transcribed verbatim into Word, coded in NVivo using a validated, team-based coding methodology, and analyzed according to internal domains, external domains, and health effects regarding CBP One™. Results: Twenty participants originated from eight countries throughout Latin America and the Caribbean. In total, 18 subthemes were identified among internal, external, and effects domains. Internal themes included a confusing application interface (80%), technical malfunction (60%), and perceived racial bias from the photo-capture features (15%). External themes challenging CBP One™ use included unavailable appointment slots (80%), inequity and inaccessibility (35%), and inadequate internet (25%). Most perceived effects were negative (85%), including worsening mental health effects (40%), exacerbation of pre-existing physical conditions (35%), and forgoing health expenditures to pay for internet (25%). Conclusions: Our findings suggest that asylum seekers at the Reynosa port of entry perceive CBP One™ negatively, with detrimental effects towards their mental and physical health. This study highlights how immigration policy can influence health and suggests that more creative and humane approaches are needed for people seeking asylum at the Mexico-US border.

Morphometric analysis of the mental foramen in a Syrian population by using cone-beam computed tomography.

INTRODUCTION: Anatomical knowledge is crucial for addressing diagnostic challenges, ensuring safe procedures, and avoiding potential risks. Among the various mandibular anatomical landmarks, the mental foramen (MF) is particularly significant for dental procedures, especially surgeries. Therefore, it is essential to conduct a comprehensive radiographic evaluation of this region before performing such procedures. The purpose of this study was to investigate the size of MF and the distances from its border to the alveolar crest (AC) and to the inferior border of the mandible (IBM) in a selected Syrian population by using cone-beam computed tomography (CBCT), and to detect any statistically significant effect of individuals' factors, such as sex, age, dental status, and side on these anatomical parameters. MATERIAL AND METHODS: The study retrospectively analyzed 200 CBCT scans (400 hemimandibles) from 104 females and 96 males, grouped into three age categories: 20-35, 36-50, and 51-65years. The hemimandibles were classified based on dental status into three groups: dentate, partially edentate, and completely edentate, and by side as right or left. RESULTS: The study revealed that the average horizontal and vertical diameters of MF were (3.48±0.75mm) and (3.01±0.75mm), respectively. Additionally, the average distances D1 (MF-AC) and D2 (MF-IBM) were (11.01±3.68mm) and (12.51±1.56mm) respectively. The study's findings indicated that age and dental status had a statistically significant effect on all the parameters studied, except for the horizontal diameter. Furthermore, sex had a statistically significant effect on all the parameters, while the side had no effect on any of the parameters investigated. CONCLUSIONS: The results of this study suggest that an understanding of the morphometry of the mental foramen is essential for clinicians, which may assist them in performing dental procedures more safely and achieving successful local anesthesia. Moreover, individual factors should be taken into consideration.

Detection and Genetic Characterization of Border Disease Virus (BDV) Isolated from a Persistently Infected Sheep in a Migratory Flock from Rajasthan State, Northwestern India.

Border disease virus (BDV) causes significant economic losses in sheep farming worldwide. In India, BDV has not yet been studied in sheep migrating for summer pasturing. This study aimed to determine the extent of BDV infection in migratory sheep and provide genetic characteristics of BDV. Blood and serum samples from 90 lambs of a migratory sheep flock (600) in Central India were collected and subjected to molecular detection, phylogenetic analysis and virus neutralization test (VNT). We detected BDV in two lambs through real-time RT-PCR, while 64.4% (58/90) of in-contact lambs had BDV neutralizing antibodies. One apparently healthy lamb was found to be persistently infected with BDV. Phylogenetic analysis of 5'-UTR and Npro genes and the concatenated datasets typed the BDV isolate from PI sheep as BDV-3 genotype. However, it showed a closer relationship with BDV-3 strains from China than the previously reported Indian BDV-3 strains. This is the first report on the detection of BDV persistently infected migratory sheep in India. Additionally, we provided evidence of genetic variability among BDV-3 strains in India. The findings improve our understanding of epidemiology and genetic characteristics of BDV in India and highlight the potential risks associated with the traditional practice of sheep migration for summer pasturing.

Characterizing HIV-1 transmission by genetic cluster analysis among newly diagnosed patients in the China-Myanmar border region from 2020 to 2023.

Cluster analysis of HIV sequence can provide insights into viral transmission patterns in border regions. This study aims to illuminate the HIV-1 subtype distribution and transmission dynamics among newly diagnosed individuals in Dehong prefecture, a region along the China-Myanmar border. Among 948 participants with pol gene sequences, 36 HIV-1 subtypes were identified, with URFs (18.8%, 178/948) being the dominant strain, followed by CRF01_AE (18.5%, 175/948) and CRF07_BC (10.9%, 103/948). Additionally, 287 sequences (30.3%, 287/948) were grouped into 91 clusters, 31 of which contained both Chinese and Burmese individuals. Multivariable logistic regression indicated that men who have sex with men (MSM), CD4 + cell count of 200∼499, and 500 cells/µl and above, and CRF01_AE were risk factors for entering the network. Through the Chord diagram, we found frequent transmission relationships among heterosexual China male group, especially those over 35 years of age. Additionally, the correlation between heterosexual Myanmar female group and heterosexual China male group among cross-risk groups deserved to be emphasized. Furthermore, the network exhibited a growing trend over time, with the largest active transmission cluster identified in Ruili county. In conclusion, the HIV-1 subtype landscape in Dehong has become increasingly complex, and the region has faced risks of transmission from both domestic and international sources. Targeted intervention strategies should be implemented for MSM, heterosexual Chinese middle-aged and elderly men, and heterosexual Burmese young adults to mitigate these risks. These findings provided evidence-based insights for local government to formulate coordinated transnational intervention approaches.

Colchicine Prevents Cardiac Rupture in Mice with Myocardial Infarction by Inhibiting P53-Dependent Apoptosis.

Cardiac rupture is a fatal complication following myocardial infarction (MI) and there are currently no effective pharmacological strategies for preventing this condition. In this study, we investigated the effect of colchicine on post-infarct cardiac rupture in mice and its underlying mechanisms.We induced MI in mice by permanently ligating the left anterior descending artery. Oral colchicine or vehicle was administered at a dose of 0.1 mg/kg/day from day 1 to day 7 after MI. Cultured neonatal cardiomyocytes and fibroblasts were exposed to normoxia or anoxia and treated with colchicine.Colchicine significantly improved the survival rate (colchicine, n = 46: 82.6% versus vehicle, n = 42: 61.9%, P < 0.05) at 1 week after MI. Histological analysis revealed colchicine significantly reduced the infarct size and the number of macrophages around the infarct area. Colchicine decreased apoptosis in the myocardium of the border zone and cultured cardiomyocytes and fibroblasts as assessed by TUNEL assay. Colchicine also attenuated the activation of p53 and decreased the expression of cleaved-caspase 3 and bax, as assessed by Western blotting.Colchicine prevents cardiac rupture via inhibition of apoptosis, which is attributable to the downregulation of p53 activity. Our findings suggest that colchicine may be a prospective preventive medicine for cardiac rupture, however, large clinical trials are required.

Current situation and influencing fctors of oral frailty for community-dwelling older adults in the northeastern border areas of China: A cross-sectional study.

OBJECTIVES: Unique lifestyle and cultural factors in China may lead to distinct patterns of risk factors for oral frailty among older adults, especially in regions inhabited by northeastern border minority groups. METHODS: From July to November 2023, a convenience sampling method was employed to select older adults from three communities in Yanji City as the subjects. Data were collected by a set of questionnaires. RESULTS: A total of 478 older adults were included, revealing a prevalence rate of 71.6 % for oral frailty. Factors influencing were found to include age, ethnicity, gender, income, number of chronic diseases, body mass index, drinking, physical frailty, sleep disorders, and attitudes towards aging (p < 0.05). CONCLUSIONS: There is a higher prevalence of oral frailty. It is crucial to prioritize the oral health issues of older adults with high-risk factors and implement targeted intervention measures to reduce and control the occurrence and progression of oral frailty.

A New Self-Expandable Metallic Stent with Low Axial Force and a High Axial Force Zero-Border Shows a Very Low Perforation Rate in Malignant Colorectal Obstruction: A Japanese Multicenter Prospective Study.

Background: Recently, there has been a significant increase in the utilization of self-expandable metallic stents (SEMSs) for treating malignant colorectal obstructions through colorectal stenting. The mechanical properties of SEMSs are usually considered to affect clinical outcomes of patients with malignant colorectal obstructions. Methods: This single-arm, prospective, multicenter study of SEMS with a lower axial force and high axial force zero-border included 200 patients with malignant colorectal obstruction. Technical and clinical success, stent patency, and adverse events associated with SEMS placement were evaluated. Results: One patient was excluded, and 199 patients were evaluated. The treatment intent was bridge-to-surgery in 129 and palliation in 70 patients. Technical and clinical success rates were 99.5% and 97.0%, respectively. The percentage of the ColoRectal Obstruction Scoring System scores of 3 or higher improved significantly from 19.2% before placement to 93.9% after placement. Clinical success was not achieved in five patients due to insufficient stent expansion in four patients and stent occlusion in one patient. Only one patient underwent emergency surgery for perforation of the proximal colon, far from where the stent was placed; the rescue procedure was not performed, despite no improvement in proximal dilatation due to insufficient stent expansion. Among the palliation cohort, 15 patients received chemotherapy, including molecular-targeted agents such as bevacizumab. There were no fatal cases related to stent placement. Conclusions: For management of malignant colorectal obstruction, this newly developed SEMS with low axial force and a high axial force zero-border showed high technical and clinical success rates, and an extremely low perforation rate (0.5%).

A Cross-Border Biorisk Toolkit for Healthcare Professionals.

The COVID-19 pandemic posed significant challenges to public health, exposing first responders to high biosafety risks during medical assistance and containment efforts. The PANDEM-2 study aimed to address these critical biosafety issues by emphasising the importance of frequently updated, harmonised guidelines. This study reviewed scientific publications, lessons learned, and real-world experiences from the COVID-19 pandemic to identify biorisk gaps in three critical areas: (i) patient transportation and management, (ii) sample handling and testing, and (iii) data management and communication by laboratory staff. At the onset of the pandemic, first responders faced several challenges, including the rapid expansion of emergency medical services, conversion of non-medical structures, increased internal and cross-border transport of infected patients, frequent changes in biosafety protocols, and a shortage of personal protective equipment. In response, this study developed a versatile and easily adaptable toolkit, including biosafety guidance and recommendations linked to updated national and international online repositories. It establishes the groundwork for a minimum standard that can be tailored to various pandemic response scenarios, using monkeypox as a fictive test case. The toolkit enables rapid access to updated information via QR codes and mobile devices, improving biorisk response by providing an adaptable and standardised approach for caregivers involved in national and cross-border responses.