Identification and antimicrobial susceptibility profiles of Campylobacter isolated from camel at municipal abattoirs in eastern Ethiopia.

Campylobacteriosis is an infectious zoonotic disease caused by the genus Campylobacter. The disease is transmitted from animals to humans predominantly through the consumption of contaminated food and water. However, the lack of information on the status of Campylobacter makes it difficult to quantify the role of camel meat in the dissemination of the pathogen. A cross-sectional study was conducted from June 2022 to August 2023 to investigate the occurrence of Campylobacter and associated risk factors and to determine the antimicrobial susceptibility profiles of Campylobacter species from camels slaughtered at municipal abattoirs in the towns of Harar, Babile, Jigjiga and Dire Dawa in eastern Ethiopia. A total of 324 (146 carcass swabs, 146 camel feces and 32 abattoir environmental swab samples) were collected and analyzed using TaqMan real-time PCR and culture techniques following standard procedures. In addition, antimicrobial susceptibility tests were performed using the disk diffusion method for eight antimicrobial agents according to the Clinical Laboratory Standards Institute. The overall prevalence of Campylobacter was 7.7%. Campylobacter was more frequently detected from carcasses and surface contact environmental swabs. We isolated Campylobacter at the genus level from approximately half of the PCR-positive samples, representing 54.2% (13 out of 24) of the total. The isolation levels of C. jejuni and C. coli were also 5.56% and 2.2%, respectively, which varied significantly (p = 0.037) based on sample type and site. The odds of occurrence of C. jejuni in samples collected from abattoir environments was 7.52 times greater than those in carcass and fecal samples. We detected resistance to chloramphenicol (78.6%), followed by amoxicillin (71.4%). However, 93%, 78.6%, and 71.4% of the isolates were susceptible to ceftriaxone, ciprofloxacin, and nalidixic acid, respectively. Multidrug resistance (MDR) was detected in 60% of the isolates. Of these MDR isolates, 9 (75%) were C. jejuni and 3 (25%) were C. coli. This study revealed that a considerable proportion of multidrug-resistant Campylobacter species circulate in both camel meat and abattoir environments. This indicates possible carcass cross-contamination by Campylobacter during slaughtering that can pose a threat to humans and limit therapeutic options, which could be prevented by applying good hygienic practices at abattoirs. Therefore, abattoir workers need to be aware of abattoir hygienic standard operating procedures. Regular coordinated actions should be implemented for the rational use of veterinary and medical drugs at the national level, together with training and awareness of hygienic practices.

Drug development and evidence for lung cancer targeted therapy in Eastern Asia.

The development of targeted drugs in the Eastern Asia region is going through a flourishing stage. With the continuous advancement of technology and medical research, biotechnology companies and research institutions in the region have made significant progress in cancer field. The Eastern Asian region not only actively participates in clinical trials, but is also committed to developing personalized medical plans to meet the diverse genotypes and phenotypes of patients. The governments and enterprises are increasingly valuing innovation, strengthening international cooperation, and promoting drug development. This paper summarizes the development of genetic testing technology, targeted drugs approval, ongoing promising clinical trials in the field of lung cancer and the important progress made by governments in the Eastern Asian region, and proposed key factors that will contribute to the promising future prospects in the region. The targeted drug market in the Eastern Asian region is expected to drive the medical field forward.

Ardisiacrenatasubsp.mukdahanensis, a new subspecies of Primulaceae from Thailand.

A new subspecies, ArdisiacrenataSimssubsp.mukdahanensis Chatan & Promprom (Primulaceae), is described from Mukdahan Province, Thailand. This discovery was made during field studies conducted from 2021 to 2023, during which the authors collected and analysed specimens, comparing them with relevant taxonomic literature and herbarium collections. A.crenatasubsp.mukdahanensis is distinct from its closest relative, A.crenatasubsp.crassinervosa by a combination of morphological traits, such as moderately dense minute hairs on young shoots, abaxial side of young lamina and calyx, peduncles and pedicels; larger flowers (7.0-7.5 mm) that are pure white or pinkish; larger fruits (7-8 mm) and absence of glandular punctation in organs such as lamina, calyx, corolla, anther and fruit. This new subspecies grows in slightly dense dry evergreen forests or open areas near streams and is preliminarily assigned to the Data Deficient (DD) category according to IUCN guidelines.

Assessing the Risk of Postoperative Delirium Through Comprehensive Geriatric Assessment and Eastern Cooperative Oncology Group Performance Status of Elderly Patients With Gastric Cancer.

BACKGROUND: Postoperative delirium is especially common and often problematic among elderly patients undergoing surgery. This study aimed to explore factors that can predict postoperative delirium in elderly patients undergoing gastric cancer surgery. METHODS: This cohort study included 255 patients age 75 years or older who underwent gastric cancer surgery between July 2010 and December 2020. All the patients underwent preoperative comprehensive geriatric assessment (CGA) evaluation by a geriatrician. In addition to the CGA items, this study investigated the association between postoperative delirium and clinicopathologic factors, including Eastern Cooperative Oncology Group performance status (ECOG-PS). RESULTS: The most common postoperative complication was delirium, present in 31 patients (12.2%). The group with delirium was significantly more likely to have ECOG-PS ≥ 2, diabetes mellitus, cardiovascular disease, or cerebral infarction. The CGA showed frailty in the Instrumental Activities of Daily Living scale (IADL), the Mini-Mental State Examination (MMSE), the Vitality Index (VI), and the Geriatric Depression Scale 15 (GDS-15). In the multivariate analysis, the independent risk factors for delirium were ECOG-PS ≥ 2 (P = 0.002) and MMSE-frailty (P < 0.001). Using an MMSE score of ≤ 23 and an ECOG-PS score of ≥ 2 as cutoffs, postoperative delirium was predicted with a sensitivity of 80.7% and a specificity of 74.1%. CONCLUSION: Postoperative delirium might be more easily predicted based on the combination of MMSE and ECOG-PS for elderly patients with gastric cancer undergoing gastrectomy.

Smartphone-Related Neck Pain: A Study Among Saudi Residents in the Eastern Province.

BACKGROUND: The pervasive use of mobile phones has raised concerns about their impact on musculoskeletal health, particularly neck pain. This issue is notably relevant in the Eastern Province of Saudi Arabia, where high mobile phone usage intersects with demographic diversity. While extensive phone use has been linked to neck pain and other musculoskeletal disorders globally, specific data on this issue in the Eastern Province are limited. This study addresses this gap by examining phone use patterns, neck positions, and associated symptoms in the region. METHODS: Using an online, self-administered survey, this cross-sectional study investigated the relationship between phone use and neck pain in the Eastern Province of Saudi Arabia. Participants aged 18 years and older were recruited via social media, community groups, and university networks. The survey collected data on demographics, phone use patterns, neck positions, awareness of health risks, and pain symptoms. It was pre-tested, administered through Google Forms (Google, Mountain View, CA), and available for four weeks. Data were analyzed using descriptive statistics and cross-tabulations with SPSS 26.0 (IBM Corp., Armonk, NY). RESULTS: The study included 400 participants, with 273 females (68.3%) and 127 males (31.8%). Most participants were single (245, 61.3%) and held a university degree (301, 75.3%). Daily phone use varied: 228 participants (57.0%) used their phones for less than five hours daily, while 43 (10.8%) used them for 10-15 hours or more. Neck positions ranged from 0° to 60°, with 168 participants (42.0%) maintaining a 30° angle. Awareness of health risks associated with phone use was high, with 364 participants (91.0%) aware of these risks. Neck pain was reported by 244 participants (61.0%), with additional symptoms including headache (22 participants, 5.5%) and upper back pain (five participants, 1.3%). CONCLUSION: This study found a significant link between prolonged phone use and neck pain in the Eastern Province of Saudi Arabia. Despite high awareness of the risks, many individuals report discomfort. These findings underscore the need for public health interventions and ergonomic education to improve phone use practices and musculoskeletal health.

How likely are Eastern European and central Asian countries to achieve global NCD targets: multi-country analysis.

BACKGROUND: In Europe, mortality rates from noncommunicable diseases (NCDs) among persons 30-69 years of age ("NCD premature mortality rates") have declined significantly, except in twelve countries of Eastern Europe and Central Asia, namely Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine and Uzbekistan. Data on long-term trends in NCD mortality in these countries are limited. We analyzed NCD premature mortality rates, identified change points in NCD mortality trends and forecasted how likely countries are to achieve the global NCD targets, stratified by gender and NCD type. METHODS: We used the 1990-2019 Global Burden of Disease database to analyze NCD trends and identified country-specific change points by using piecewise linear regression. We assessed the likelihood of achieving the global targets for reducing NCD premature mortality rates among persons 30-69 years of age from four NCDs: cancers, diabetes, cardiovascular and chronic respiratory diseases. The global NCD targets are 25% reduction in mortality from 2010 to 2025 (WHO 25X25 target) and 33%-from 2015 to 2030 (SDG 3.4.1). We applied the analysis to both genders and four NCDs. RESULTS: Only Kazakhstan and Russia are likely to achieve the global NCD targets. For Kazakhstan, WHO 25X25 and SDG 3.4.1 global targets for mortality rates were 494.3 and 374.8 per 100,000 population respectively; the corresponding predicted values (PVs) were 360.6 [CI 260.1-461.1] and 245.1 [CI 113.4-376.8]. For Russia, WHO 25X25 and SDG 3.4.1 global targets were 560.5 and 442.8 per 100,000 population respectively; the corresponding PVs were 427.7 [CI 270.3-585.1] and 311.0 [CI 102.8-519.1]. Achieving NCD global targets is less likely for Kyrgyzstan, while it is unlikely for the rest of countries. Most countries had higher mortality rates and slower progress among men compared with women. The likelihood of achieving overall global NCD targets was mainly explained by reduction in cardiovascular mortality. CONCLUSIONS: In most Eastern Europe and Central Asia countries, progress towards achieving NCD global targets is slow, or there's a reverse trend. Further quantitative and qualitative research is needed to understand the underlying reasons. Separate indicators are needed to monitor trends for cancers, diabetes and chronic respiratory diseases.

Vertical heterogeneity enhances network complexity and stability of co-occurrence microbes in the eastern Indian Ocean.

Microbes are core to driving biogeochemical cycles and differ between sun-drenched surface and relatively dark deep oceans. However, their distinct contributions to the organization and association of communities are still remaining elusive. Here, their assembly and co-occurrence stability are systematically researched along the surface and vertical gradients in the eastern Indian Ocean. The distribution of surface microbes was grouped tightly with closer phylogenetic distance and broader niche breadth, and separately from those vertical samples. Clear distance-decay of community similarity was observed in surface microbes with lower richness, while more diverse microeukaryotes and prokaryotes were observed in surface and vertical environments, respectively. Co-occurrence microbes along vertical gradients had a more complex network that was dominated by prokaryotes, while exhibited a lower modularity compared to the surface network. Microbial associations along vertical gradients were more stable and resilient, with lower robustness, higher vulnerability, and a relatively consistent fragmentation. Moreover, prokaryotes contribute greatly to the network topology and stability compared to microeukaryotes in surface environments, emphasizing their distinct functions and survival strategies in maintaining community stability across spatial variations. Environmental selection and community differentiation led to the divergence in organization and potential function of microbes. This study shed light on new perspectives on how marine microbes were associated with and influenced by spatial heterogeneity and their distinct roles in community organization in the face of environmental fluctuations.

Characterization of New Tropicoporus Species (Basidiomycota, Hymenochaetales, Hymenochaetaceae) Discovered in Tamil Nadu, India.

This study aimed to investigate the morphological characteristics and phylogenetic relationships of three new species of Tropicoporus from the southern parts of India. The analyses of the ITS and nLSU regions revealed the novelty of these species, which have been named T. pannaensis, T. subindicus, and T. xerophyticus. All three species possess pileate basidiomes, a monomitic hyphal system in the context, and the presence of cystidioles and setae. However, they differ significantly in their phylogenetic placements and other morpho-taxonomic features. Tropicoporus pannaensis is characterized by a meagrely ungulate basidiome, indistinct zones, and an obtuse margin. Tropicoporus subindicus has a triquetrous basidiome and a radially cracked, crusted pileal surface with an acute margin, while T. xerophyticus is distinguished by an imbricate, perennial basidiome with an abundantly warted pileal surface. A phylogenetic tree is provided to show the placement of the three new species, along with detailed descriptions and illustrations. Additionally, a key for the identification of the Asian species of Tropicoporus is presented.

Insights into the Rising Threat of Carbapenem-Resistant Enterobacterales and Pseudomonas aeruginosa Epidemic Infections in Eastern Europe: A Systematic Literature Review.

BACKGROUND: Antimicrobial resistance is a major global public health challenge, particularly with the rise of carbapenem-resistant Enterobacterales (CRE) and Pseudomonas aeruginosa (CRPA). This study aimed to describe the characteristics of CRE and CRPA infections in Eastern Europe, focusing on Bulgaria, Croatia, Czechia, Greece, Hungary, Poland, Romania, Serbia, Slovakia, and Slovenia. METHODS: Following MOOSE and PRISMA guidelines, a systematic literature review of articles published between 1 November 2017 and 1 November 2023 was conducted using the MEDLINE, Embase, Web of Science, CDSR, DARE, and CENTRAL databases. The search strategy used a combination of free text and subject headings to gather pertinent literature regarding the incidence and treatment patterns of CRE and CRPA infections. A total of 104 studies focusing on infections in both children and adults were included in this review. RESULTS: This review revealed a significant prevalence of carbapenem-resistant Gram-negative isolates and underscored the effectiveness of imipenem/relebactam and ceftazidime/avibactam (CAZ/AVI) against Klebsiella pneumoniae carbapenemase-producing Enterobacterales and of ceftolozane/tazobactam, imipenem/relebactam and ceftazidime/avibactam against non-metallo-ß-lactamase-producing CRPA strains. CONCLUSIONS: This study highlights the urgent need for comprehensive measures to combat the escalating threat of CRE and CRPA infections in Eastern European countries. At the same time, it shows the activity of the standard of care and new antimicrobials against carbapenem-resistant Gram-negative pathogens in Eastern Europe. Clinical real-world data on the treatment of carbapenem-resistant infections in Eastern Europe are needed.

Aflatoxins Levels in Concentrate Feeds Collected from Specialized Dairy Farms and Local Markets in Selected Urban Centers of Eastern Ethiopia.

Aflatoxin constitutes a significant concern for food and feed safety, posing detrimental health risks to both animals and humans. This study aimed to examine the prevalence and concentration of aflatoxins in maize feed, total mixed ration, and wheat bran collected from specialized dairy farms and local markets in three major urban centers in eastern Ethiopia. A total of 180 feed samples were collected from September 2021 to January 2022 in Chiro town, Dire Dawa city, and Harar city. These samples underwent thorough extraction and immunoaffinity clean-up before aflatoxin analysis using HPLC/FLD. The results revealed that AFB1, AFB2, AFG1, AFG2, and TAF contamination was detected in 72.2%, 66.1%, 71.1%, 68.7%, and 82.8% of the feed samples, respectively. The corresponding mean levels of each aflatoxin were 28.15 ± 3.50, 3.3 ± 0.40, 19.87 ± 1.87, 2.7 ± 0.32, and 54.01 ± 4.72 µg/kg, respectively. The occurrence and levels of aflatoxin varied across different study sites and feed types. Notably, feeds from Dire Dawa city exhibited significantly higher mean levels of AFB1 (43.98 ± 5.3 µg/kg), AFB2 (5.69 ± 0.6 µg/kg), AFG1 (32.25 ± 2.7 µg/kg), and AFG2 (5.01 ± 0.5 µg/kg) than feeds from other urban centers did. Additionally, a significantly higher occurrence of AFB1 (29.4%) and AFG1 (28.3%) was detected in feed from Dire Dawa city. Similarly, the total mixed ration (TMR) displayed significantly higher levels of AFB1 (50.67 ± 5.2 µg/kg), AFB2 (4.74 ± 0.6 µg/kg), AFG1 (32.87 ± 2.6 µg/kg), and AFG2 (3.86 ± 0.5 µg/kg) compared to the other feed types. Moreover, a significantly higher occurrence of AFB1 (30.7%) and AFG1 (28.7%) was detected in the TMR. Furthermore, a moderate correlation was observed between the count of aflatoxigenic Aspergillus species and the levels of TAF in the feed samples. Overall, this study underscores the widespread presence of aflatoxin contamination in dairy feeds in eastern Ethiopia, highlighting the urgent need for stringent monitoring and mitigation measures to ensure food and feed safety, as well as public health.

The Art of Waiting Humbly: Women Judges Reflect on Vertical Gender Segregation.

Central and Eastern European countries (CEE), compared to common law countries but also other civil law countries of Europe, are known for a strikingly high representation of women within judiciaries. This, however, does not mean that equality has been achieved, as women judges do not reach leadership positions at the same rate as their male peers. Taking the Czech Republic as a case study, this contribution explores the barriers women judges face within a CEE judiciary and analyses their reflections on their positions. The interviews with women judges show that while they are well aware of what is holding them back, most of them do not perceive the structurally unequal position of men and women in Czech society and in the judiciary as a problem and accept the consequences as being part of women's destiny. This means that the system currently lacks bottom-up incentives and pressure for change.

Examining concordance of sexual-related factors and PrEP eligibility with HIV risk perception among adolescent girls and young women: cross-sectional insights from DREAMS sites in Kenya, Malawi, and Zambia.

BACKGROUND: HIV risk perception is an important cognition for prevention, theoretically engendering service-seeking and risk-reduction behaviors, but its composition remains poorly understood. We examined country-specific correlates of self-appraised HIV exposure risk among sexually active adolescent girls and young women (AGYW, aged 15-24 years) without HIV in Kenya, Malawi, and Zambia. We also explored overlaps between self-appraised HIV exposure risk and pre-exposure prophylaxis (PrEP) eligibility to identify engagement opportunities. METHODS: We analyzed cross-sectional data (2016/2017) to estimate sexual-related correlates of self-appraised HIV exposure risk (likely vs. not, temporally framed as "ever") using log-Poisson models with robust standard errors. For sexual-related factors with an unadjusted p ≤ 0.10, individual adjusted models were fitted, controlling for sociodemographic and cognitive factors with an unadjusted p ≤ 0.10. PrEP eligibility was defined using national guidelines; since conditional criteria are in Malawi's (age-disparate sex + ever-pregnant) and Zambia's (multiple partners + condomless sex) guidelines, we also assessed PrEP eligibility after decoupling these factors. RESULTS: Few AGYW reported likely HIV exposures (Kenya [N = 746]: 15.7%, Malawi [N = 1348]: 46.2%, Zambia [N = 349]: 9.5%) despite ubiquitous HIV risk (98.7%, 99.8%, and 98.9% of Kenyan, Malawian, and Zambian AGYW reported ≥ 1 sexual-related factor). However, the adjusted models found some actual-perceived risk concordance. Positive correlates of self-appraised likely HIV exposures included partner(s)' likely HIV exposure (all countries); partner(s)' unknown HIV status and other partners (Kenya, Malawi); STI symptoms and partner(s) living outside the community (Kenya); non-partner sexual violence (Zambia); and transactional sex, multiple partners, pre-coital alcohol use, and physical/sexual intimate partner violence (Malawi). Per national guidelines, PrEP eligibility criteria differentially identified HIV risk (Kenya: 93.6%, Malawi: 53.3%, Zambia: 44.6%), and self-appraised likely HIV exposures were low among PrEP-eligible AGYW (Kenya: 16.5%, Malawi: 48.5%, Zambia: 18.8%). Decoupling Malawi's and Zambia's conditional PrEP criteria could increase risk identification to > 85% and potential engagement by ~ 70% and ~ 30%, respectively. CONCLUSIONS: AGYW's HIV risk perceptions were mostly influenced by factors beyond their locus of control. Conditional PrEP eligibility criteria may inhibit AGYW's access and uptake in some settings: countries should consider decoupling these factors to minimize barriers. Intersections between autonomy, behaviors, and perceptions among AGYW in gender-inequitable settings warrants further investigation.

Kimboza, a Small Lowland Forest With an Outstanding Herpetofauna Diversity in East Africa.

The Eastern Arc Mountains (EAM) and Coastal forests of Tanzania are renowned for harboring large number of threatened and endemic vertebrate species, yet most of these areas have been partially studied. The Kimboza Nature Forest Reserve (KNFR) is a small forest which is in transition between the EAM and Coastal forests, and among the poorly surveyed areas for amphibians and reptiles. We conducted systematic surveys across the KNFR in 2012 and between 2020 and 2023 using a range of approaches with the aim of establishing a comprehensive and updated list of reptile and amphibian species and assess the contribution of EAM and Coastal forests to the KNFR's herpetofauna. We identified 77 species, 29 amphibians and 48 reptiles, substantially updating previous species lists. Three of these species (Kinyongia magomberae, Trachylepis boulengeri and Philothamnus macrops) represent range extensions from previously known ranges. Fourteen species are endemic to East Africa, 11 of them being restricted to Tanzania. These results make the KNFR the richest forest reserve for herpetofauna per square km in Tanzania, and most similar in its composition to the Coastal, rather than Eastern Arc forests. With the caveats concerning taxonomic uncertainties and the inequalities of sampling intensity across the region, this study shows that the KNFR is an important area that deserves conservation attention. The KNFR, like other Coastal forests, is under significant pressure from anthropogenic activities which call for an urgent action to protect this small but rich forest.

The hidden burden of atopic dermatitis in central and Eastern European countries.

BACKGROUND: Atopic dermatitis (AD) imposes a hidden burden through its negative effects on quality of life and productivity. We aim to estimate this hidden burden in adults and adolescents in Central and Eastern European (CEE) countries. METHODS: We created a burden of disease model to quantify AD's hidden burden. Humanistic burden was calculated by estimating the monetary value of quality-adjusted life years (QALYs) lost, using prevalence data from the Global Burden of Disease study and gross domestic product (GDP) per capita for each country. Indirect economic burden was estimated based on productivity loss from absenteeism and presenteeism, adjusted for labor force participation and unemployment rates. Total hidden burden was determined by combining productivity losses and QALYs lost. RESULTS: QALY loss due to AD ranged from 1,832 to 58,596 annually in CEE countries, equating to 38 million to approximately 1 billion Euros per country. Productivity losses ranged from 3.6 to 148.9 million Euros annually. The total hidden burden of AD represents 0.11% to 0.43% of the GDP. CONCLUSIONS: Our estimates reflect significant differences in population size, prevalence, and economic strength among CEE countries. Adjusting findings to country-specific GDP provided insights into AD's true hidden burden, offering valuable information for decision-making.

Atopic dermatitis (AD), commonly known as eczema, is a widespread skin condition causing itchiness and discomfort. While it is well known that treating eczema costs money and affects patients' health, there is more to its impact than meets the eye. Our study closely examined eczema's 'hidden' effects in Central and Eastern European (CEE) countries, such as its impact on work ability and life enjoyment.We found that eczema's impact is not just about the direct costs of treatment. It also includes how the condition leads to lost workdays and reduced productivity, and more importantly, how it lowers the quality of life for those who have it. This part of eczema's impact, which is not always easy to see or measure, can be just as significant.Our research is important because it shows that when health officials and policymakers think about how to deal with eczema, they need to consider these hidden effects too. Different countries in Central and Eastern Europe experience these effects in varying degrees. By understanding this, healthcare systems can make better decisions about where to put their healthcare resources. For example, they might decide to invest more in treatments or support that can improve the quality of life for people with eczema.In summary, our study highlights the need to look at the full picture of eczema's impact. This includes not only the costs of treatment but also how it affects people's lives in ways that are not always immediately obvious.

Will a government subsidy increase couples' further fertility intentions? A real-world study from a large-scale online survey in Eastern China.

STUDY QUESTION: How many couples with at least one child under 3 years would like to have another one or more child(ren) in Eastern China and will an in-cash subsidy be conducive to couple's fertility intentions? SUMMARY ANSWER: In sum, only 15.1% of respondents had further fertility intentions (FFI) before learning about the subsidy, and the planned in-cash subsidy policy increased respondents' overall FFI by 8.5%. WHAT IS KNOWN ALREADY: Fertility has been declining globally and has reached a new low in China. The reasons why the Chinese three-child policy was under-realized, and how couples will react to a planned monthly ¥1000 (€141.2) subsidy policy, are not fully understood. STUDY DESIGN SIZE DURATION: During January and February 2022, a cross-sectional online survey aiming to understand families' expenses of raising a child under 3 years old, and couples' FFI, was conducted. During the survey period, 272 510 respondents scanned the QR code. This study reports the findings pertaining to questions on respondents' sociodemographic characteristics, household factors, FFI, and changes in intention from negative to positive after learning about the planned in-cash subsidy. After exclusion, 144 893 eligible responses were included. PARTICIPANTS/MATERIALS SETTING METHODS: Respondents' FFI, the effect of a planned ¥1000/month*36 months' in-cash subsidy (€5083.2 in total) on people with a negative FFI before the subsidy, and potential reasons for persistent negative FFI after learning about the subsidy were collected through an anonymous online survey. Stepwise binary logistic regression models were used to select associated factors. The potential fertility rate change and government costs were estimated. A stratified analysis by current child number and sensitivity analysis were also conducted. MAIN RESULTS AND THE ROLE OF CHANCE: In sum, 15.7% (22 804/144 893) of respondents were male, 15.1% of respondents reported a positive FFI, and 10.0% (12 288/123 051) without an FFI at first changed their intention after learning about the planned in-cash subsidy policy. For those who still said 'no FFI', 46.5%, 20.6%, and 14.7% chose pressure on housing status, expenses on children's education, and lack of time or energy for caring for another child as their first reasons. FFI was strongest in participants receiving the most financial support from their parents, i.e. grandparents (OR = 1.73, 95% CI = 1.63-1.84 for the >¥100 000/year group), and weakest in those already having two children (OR = 0.23, 95% CI = 0.22-0.24). For those with no FFI before learning about the subsidy policy, respondents with the highest house loan/rent (>¥120 000/year, OR = 1.27, 95% CI = 1.18-1.36) were more likely to change their FFI from 'No' to 'Yes', and those with the highest household income (>¥300 000/year, OR = 0.65, 95% CI = 0.60-0.71) were least susceptible to the policy. In our study population, about 1843 more births every year and an additional 0.3 children per woman were projected under a conservative estimation. Annual estimated cost at the provincial scale would be ¥817.7 (€115.5) million, about 1.02‰ of the total General Public Budget Revenue in 2022. The findings were generally robust in the stratified analysis and sensitivity analysis. LIMITATIONS REASONS FOR CAUTION: Selection bias and information errors may exist in the online survey responses. The large sample size and detailed further analysis were used to minimize such biases. WIDER IMPLICATIONS OF THE FINDINGS: Fertility intentions in Eastern China are rather low. Policymakers should focus more on financial and childcare burdens for a better realization of the three-child policy, including housing, education and childcare services. An in-cash subsidy, which has never been used in China previously, shows promising potential for increasing FFI. However, the application of such policy should be in line with local conditions for better cost-effectiveness regarding fertility-boosting and fiscal sustainability for the government in the long run. STUDY FUNDING/COMPETING INTERESTS: This work was supported by the National Key Research and Development Plan of China (2019YFC0840702). The authors declare no conflict of interests. TRIAL REGISTRATION NUMBER: N/A.

Decoding Urinary Stones: Compositional Insights and Recurrence Patterns from a Tertiary Care Hospital in Eastern India.

Background and objective Urinary stones are a prevalent medical condition entailing significant health burdens and substantial financial ramifications. Its global prevalence is expected to rise notably, particularly in low-middle-income nations. Understanding the spectrum of diverse urinary stone types is crucial for effective management and prevention. This study aims to elucidate the demographic profiles, clinical types, and recurrence of urinary stone cases at a tertiary care hospital in Eastern India. Methods and materials The clinical data from the electronic medical record of 1,231 patients with urolithiasis who underwent surgery in a tertiary care center in eastern India from January 2015 to November 2022 were retrospectively analyzed. Patient data, including demographic information, clinical records, dietary habits, water intake, and stone recurrence history, were collected. A thorough statistical analysis was conducted to elucidate the associations between patient characteristics, urinary stone composition, and recurrence. Results Among the 1,231 participants, the majority of cases (343 (27.9%)) were in the 31-40 age group, with a higher prevalence in males (876 (71.2%)) than in females (355 (28.8%)). Flank pain or abdominal pain (593 (48.1%)) was the primary complaint, followed by nausea/vomiting (227 (18.5%)). Most stones (922 (74.9%)) were located in the kidney, and calcium oxalate was the predominant stone component (773 (62.8%)). The highest stone recurrence rates were in patients aged between 21-30 years (21 (36.8%)) and 31-40 years (16 (28.0%)). A low non-vegetarian diet and adequate hydration may reduce the likelihood of stone recurrences. Conclusion This study provides insights into the compositional analysis of urinary stones in the eastern Indian population, addressing the causes of their recurrence and management strategies, which are crucial for prevention and effective management. The findings indicate that the early middle-aged group exhibited the highest incidence of urinary stones. We also observed that strict adherence to a low animal protein, along with proper hydration and lifestyle changes, significantly reduced urinary stone recurrence.

Absence of Coxiella burnetii in kangaroo ticks (Amblyomma triguttatum) from a high seroprevalence population of eastern grey kangaroos.

Q fever, caused by Coxiella burnetii, is an important zoonotic and public health concern worldwide. Kangaroos are thought to be a likely wildlife reservoir for C. burnetii in Australia and the kangaroo tick (Amblyomma triguttatum) has often been considered a vector. In this descriptive study of ticks collected from a population of eastern grey kangaroos (Macropus giganteus) with a high serological (84 %) and molecular (65 %) prevalence of C. burnetii in northern New South Wales, a total of 72 A. triguttatum ticks were tested by PCRs targeting the IS1111, htpAB, and com1 genes of the Coxiella genome. Despite the remarkably high prevalence of coxiellosis in the host population, none of the ticks were positive for Coxiella. This finding suggests that the kangaroo tick may not play a significant role in the transmission dynamics of C. burnetii in this particular host population.

The Impact of Ecological Footprint, Urbanization, Education, Health Expenditure, and Industrialization on Child Mortality: Insights for Environment and Public Health in Eastern Europe.

The purpose of this study is to examine the connection between child mortality in Eastern Europe and ecological footprint, urbanization, education, health expenditure, and industrialization. The study acknowledges the significance of understanding how these factors influence the infant mortality rates in this region from 1993 to 2022. The Grossman Health Outcome (H-O) model investigates the theoretical framework. For the existence of the cross-sectional dependency, mixed-order unit root, and cointegration problem, the famous Cross-Sectional Autoregressive Distributed Lag (CS-ARDL) approach is applied. The research also used the Augmented Mean Group (AMG) and Common Correlated Effects Mean Group (CCEMG) to check robustness. The findings illustrated that health expenditure and education lessen the infant mortality rate in Eastern European countries. But ecological footprint, industrialization and unemployment raise the infant mortality rate. According to the CS-ARDL findings, expenditure on healthcare significantly reduces child mortality. Still, the ecological footprint significantly impacts increasing child mortality. However, the AMG and CCEMG models demonstrate that investing in education is the most effective strategy for reducing child mortality. Therefore, the government of Eastern European countries should provide more priorities in the sustainable urbanization, health expenditure, and education sectors. The robustness of the AMG and CCEMG also demonstrated the strength of the CS-ARDL findings. This research paper contributes to SDG 3 by examining the environmental and health factors that influence child mortality in Eastern Europe. Policymakers, public health professionals, and other stakeholders can use the findings to inform the development and implementation of programs that specifically target the identified causes of child mortality.

Using an ecosystem service model to inform restoration planning: A spatially explicit oyster filtration model for Pensacola Bay, Florida.

The development of science-based restoration goals that reflect the primary motivation of stakeholders is a key factor leading to large-scale, long-term restoration successes. The ability to predict the potential ecosystem service delivery from restoration can inform the setting of appropriate goals and facilitate the strategic planning of restoration activities. While recovery of the ecosystem services provided by oyster reefs is a regularly cited reason for undertaking restoration, few examples exist where large-scale oyster habitat restoration plans have been informed using ecosystem service functions. Such an approach is currently being implemented in the Pensacola Bay System, Florida, where a broad coalition of partners and community stakeholders are utilizing a watershed approach to restoring oysters with the aim of restoring oysters for multiple objectives including habitat, ecosystem services, and wild harvest and aquaculture. Through the process of developing a habitat management plan, water filtration was identified as a key ecosystem service by the stakeholders. To support restoration planning we derived a spatially explicit estimate of water filtration services provided by the eastern oyster in the Pensacola Bay system by linking an oyster habitat suitability map to a hydrodynamic-oyster filtration model. This spatially explicit model allowed us to identify the areas where restored oyster reefs have the potential to provide the greatest increase in filtration service as well as provide spatially explicit estimates of the potential filtration provided by oyster habitat restored. Such information is useful in restoration planning and management and for stakeholder engagement, outreach, and education programs.

Urban malaria and its determinants in Eastern Ethiopia: the role of Anopheles stephensi and urbanization.

BACKGROUND: Malaria prevention and control strategies have been hampered by urbanization and the spread of Anopheles stephensi. The spread of this vector into Africa further complicates the already complex malaria situation, that could put about 126 million Africans at risk of infection. Hence, this study aimed to assess the determinants of urban malaria, focusing on the role of urbanization and the distribution of An. stephensi in Eastern Ethiopia. METHODS: A matched case control study was conducted among febrile urban residents of Dire Dawa (malaria positive as cases and negative as a control). A capillary blood sample was collected for parasite identification using microscopic examination and an interviewer administered questionnaire was used to collect additional data. Centers for Disease Control and Prevention miniature light traps (CDC-LT) and Prokopack aspirator were used to collect adult mosquito vectors from the selected cases and control houses to identify the mosquito vector species. Then, the data were exported to STATA for analysis. Conditional logistic regression was done to identify determinants, and principal component Analysis (PCA) was done for some independent variables. RESULTS: This study enrolled 132 cases and 264 controls from urban setting only. Of the 132 cases, 90 cases were positive for Plasmodium falciparum, 34 were positive for Plasmodium vivax and 8 had mixed infections. All cases and controls were similar with regard to their respective age and sex. Travel history (AOR: 13.1, 95% CI 2.8-61.4), presence of eves and holes on walls (AOR: 2.84, 95% CI 1.5-5.5), history of malaria diagnosis (AOR: 2.4, 95% CI 1.1-5.3), owning any livestock (AOR: 7.5, 95% CI 2.4-22.8), presence of stagnant water in the area (AOR: 3.2, 95% CI 1.7-6.1), sleeping under bed net the previous night (AOR: 0.21, 95% CI 0.1-0.6) and knowledge on malaria and its prevention (AOR: 2.2, 95% CI 1.2-4.1) were determinants of urban malaria infection. About 34 adult Anopheles mosquitoes were collected and identified from those selected cases and control houses and 27 of them were identified as An. stephensi. CONCLUSION: Among the cases, the dominant species were P. falciparum. This study identified travel history, house condition, past infection, livestock ownership, stagnant water, bed net use, and malaria knowledge as determinants of infection. This study also found the dominance of the presence of An. stephensi among the collected mosquito vectors. This suggests that the spread of An. stephensi may be impacting malaria infection in the study area. Hence, strengthening urban-targeted malaria interventions should be enhanced to prevent and control further urban malaria infection and spread.