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This study aimed to review the current literature exploring the utility of noninvasive ocular imaging for the diagnosis of peripheral artery disease (PAD). Our search was conducted in early April 2022 and included the databases Medline, Scopus, Embase, Cochrane, and others. Five articles were included in the final review. Of the five studies that used ocular imaging in PAD, two studies used retinal color fundus photography, one used optical coherence tomography (OCT), and two used optical coherence tomography angiography (OCTA) to assess the ocular changes in PAD. PAD was associated with both structural and functional changes in the retina. Structural alterations around the optic disc and temporal retinal vascular arcades were seen in color fundus photography of patients with PAD compared to healthy individuals. The presence of retinal hemorrhages, exudates, and microaneurysms in color fundus photography was associated with an increased future risk of PAD, especially the severe form of the disease. The retinal nerve fiber layer (RNFL) was significantly thinner in the nasal quadrant in patients with PAD compared to age-matched healthy individuals in OCT. Similarly, the choroidal thickness in the subfoveal region was significantly thinner in patients with PAD compared to controls. Patients with PAD also had a significant reduction in the retinal and choroidal circulation in OCTA compared to healthy controls. As PAD causes thinning and ischemic changes in retinal vessels, examination of the retinal vessels using retinal imaging techniques can provide useful information about early microvascular damage in PAD. Ocular imaging could potentially serve as a biomarker for PAD. PROSPERO ID: CRD42022310637.
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Disco Óptico , Doença Arterial Periférica , Humanos , Tomografia de Coerência Óptica/métodos , Fotografação/métodos , Doença Arterial Periférica/diagnóstico por imagem , Biomarcadores , Vasos Retinianos/diagnóstico por imagemRESUMO
Chitosan, a valuable biopolymer, has traditionally been derived from marine sources. However, exploring fungal alternatives offers a sustainable supply. This research investigates the potential of chitosan production from fungal sources, focusing on the optimization of abiotic factors using two novel Penicillium strains (IITISM-ANK1 and IITISM-ANK2) isolated from dry aged sludge. Box-Behnken model and standard statistical analysis were deployed to develop an equation predicting the effect of carbon and nitrogen sources, pH, and temperature on chitosan production. Batch experiments validate the model's accuracy under optimized conditions. The results indicate that mixed organic and inorganic nitrogen sources in the form of peptone, nitrate, and ammonium salts enhanced chitosan yield in both isolates. At optimal conditions for the chitosan production of IITISM-ANK2 and IITISM-ANK1 were found to be 293.29 mg/L and 325.01 mg/L, with the degree of deacetylation of over 74 % which is a critical parameter for chitosan quality. Thus, these isolates can be used as a potent microbe for industrial chitosan production and contribute to advancing sustainable chitosan production and its potential industrial applications.
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Quitosana , Penicillium , Nitrogênio , Compostos Orgânicos , NitratosRESUMO
The study aimed to evaluate the potential of a novel isolated ureolytic Enterobacter hormaechei IITISM-SA3 in cadmium bioremoval through MICP. The optimization and modelling of the biotic and abiotic factors affecting the process of mineralization were also performed. In addition, the underlying mechanism of MICP-driven Cd mineralization under microbial-inclusive and cell-free conditions was revealed and supported through the characterization of the bio-precipitates obtained using various characterization techniques. The results indicated that the isolate could remove 97.18% Cd2+ of 11.4 ppm under optimized conditions of 36.86 h, pH 7.63, and biomass dose of 1.75 ml. Besides, the presence and absence of bacterial cells were found to influence both the morphologies and crystalline structures of precipitates. The precipitates obtained under microbial-inclusive conditions showed typical rhombohedral crystalline structures of the composition comprising CaCO3, CdCO3, and 0.67Ca0.33CdCO3. However, the crystalline nature of the precipitate reduced to a nano-sized granular structure in cell-free media. Unlike the cadmium mineralization process under microbial-inclusive media, where bacterial cells serve as nucleation sites for crystallization, the carbonate precipitation effectively captures Cd2+ through co-precipitation, chemisorption, or alternative mechanisms involving interactions between metal ions and CaCO3 under cell-free conditions. The findings presented suggest that using cell-free culture supernatant enriched with carbonate ions provides an avenue that could be harnessed for sustainable metal remediation.
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Cádmio , Carbonato de Cálcio , Enterobacter , Carbonato de Cálcio/química , Cádmio/química , Precipitação Química , Carbonatos/químicaRESUMO
This study aimed to examine the existing literature that investigated the effectiveness of optical coherence tomography (OCT) and optical coherence tomography angiography (OCT-A) as a biomarker for idiopathic intracranial hypertension (IIH). Our search was conducted on January 17th, 2024, and included the databases, Medline, Scopus, Embase, Cochrane, Latin American and Caribbean Health Sciences Literature (LILACS), International Standard Randomized Controlled Trial Number (ISRCTN) registry, and the International Clinical Trials Registry Platform (ICTRP). Our final review included 84 articles. In 74 studies, OCT was utilized as the primary ocular imaging method, while OCT-A was employed in two studies including eight studies that utilized both modalities. Overall, the results indicated that IIH patients exhibited significant increases in retinal nerve fiber layer (RNFL) thickness, total retinal and macular thickness, optic nerve head volume, and height, optic disc diameter and area, rim area, and thickness compared to controls. A significant correlation was observed between cerebrospinal fluid (CSF) pressure and OCT parameters including RNFL thickness, total retinal thickness, macular thickness, optic nerve head volume, and optic nerve head height. Interventions aimed at lowering CSF pressure were associated with a substantial improvement in these parameters. Nevertheless, studies comparing peripapillary vessel density using OCT-A between IIH patients and controls yielded conflicting results. Our systematic review supports OCT as a powerful tool to accurately monitor retinal axonal and optic nerve head changes in patients with IIH. Future research is required to determine the utility of OCT-A in IIH.
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Pseudotumor Cerebral , Tomografia de Coerência Óptica , Humanos , Pseudotumor Cerebral/diagnóstico por imagem , Biomarcadores/líquido cefalorraquidiano , Retina/diagnóstico por imagem , Retina/patologiaRESUMO
The toxic and persistent nature of cadmium (Cd) in the environment has become a matter of concern with its drastic increase in the concentrations over past few decades. Among the various techniques, the microbial remediation has been accepted as an effective decontamination tool for environmental applications, which is sustainable over a period of time. The Cd decontamination potential of the microbes depends on various internal and external factors that play a crucial role in selection of the microbes for application in a particular environment. Thus, it is important to understand the role of these factors for optimal application of the microbes. This study provides an insight into the mechanisms involved between the microbes and the environmental Cd. The study also briefly reviews the mathematical models that have been used to predict the remediation potential of the microbes and the kinetics involved during the process. A critical analysis of the recent advancements in the techniques for use of bacteria, fungi, and algal cells to remove Cd has been also presented in the manuscript.
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Recuperação e Remediação Ambiental , Poluentes do Solo , Cádmio/análise , Bactérias , Fungos , Poluentes do Solo/análise , SoloRESUMO
The polio endgame strategy calls for ending the use of and removal of all Sabin vaccines globally given the risks of generation and spread of cVDPVs. With the successful eradication of wild poliovirus type 2 in 2015, the process of removing type 2 Sabin vaccines began with the switch from tOPV to bOPV across national vaccination programs. Following the tOPV to bOPV switch in April/May 2016, monovalent type 2 OPV (mOPV2) has been put into use in response to detected cVDPV2 polioviruses outbreaks. Between 31 May 2016 and 30 Jun 2020, 453 million doses of mOPV2 were provided to 21 countries to conduct 235 campaigns to respond to cVDPV2 outbreaks and high-risk events. However, the use of this vaccine paradoxically reintroduces live attenuated type 2 poliovirus into the populations and the environment, therefore, poses a risk for the emergence of new VDPV2s. Thus, it is critical to carefully and appropriately manage all in-country mOPV2 stocks utilized in outbreak response to minimize this risk. In this article, we examine the performance of mOPV2 vaccine management utilized for various outbreak responses after the switch.We present the major challenges faced and the lessons learned, to improve technical guidance and future response activities. Performance varied significantly across countries in terms of each of the activity areas evaluated. There were major gaps, especially in terms of vaccine accountability, and in many instances large numbers of vials went unaccounted presenting additional risk for further VDPV2 emergences. We have shown that especially at the beginning of implementation, insufficient attention has been given to mOPV2 vaccine management. Enhanced focus on mOPV2 vaccine management in line with the lessons learned presented in this paper should be a priority for public health programs and countries to consider and adapt in future VDPV2 responses as well as potential future activities associated with eventual complete withdrawal & cessation of OPV.These experiences can also be extended to other vaccines for which strict stock management and containment measures are required.
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Poliomielite , Poliovirus , Humanos , Vacina Antipólio Oral/uso terapêutico , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Vacinação , Vacina Antipólio de Vírus Inativado , Surtos de Doenças/prevenção & controle , Saúde GlobalRESUMO
BACKGROUND: Between 2013 and 2014, the Horn of Africa countries experienced a severe and prolonged outbreak of polio viruses. It started in one district in Somalia but quickly became a national and even international disaster, crossing international boundaries into Kenya and Ethiopia. This paper documents experiences in the establishment and contributions of the Polio Communication Network (PCN) to the polio outbreak response in the outbreak countries of Somalia, Kenya and Ethiopia from 2013 to 2015. PROCESS: The establishment of the PCN network of partnerships and technical assistance was designed to implement a strategic communication response. Various strategies were used to establish the PCN. Some of these strategies included partnerships with faith-based organizations; involvement of local leaders in microplanning; social mobilization committees and research, monitoring, evaluation and documentation structures. MAJOR OUTCOMES: PCN contributions through sustained high levels of community awareness of polio rounds were demonstrated. The contributions of the context-sensitive approaches included significant gains in reaching traditionally missed, hard-to-reach, pastoral communities with polio information, improved communication capacity, and successful closure of the outbreak within the expected timeline. This PCN experience provides important communication lessons relevant to polio eradication and other public health programmes. The focus on building capacity in areas such as monitoring, and data collection generated social data that led to the communication approaches making a significant impact. PCN contributed to a better understanding of the behavioral and environmental factors affecting the demand for, and uptake of, health services in the HoA which can be extended to most of the countries in the HoA with the same demographic and epidemiological realities. CONCLUSION: The use of the PCN helped bring the 2013-2014 polio outbreak under control and illustrates how the PCN can help drive progress towards the realization of the agenda of the universal health coverage and vision 2030 agenda in the African Region and elsewhere.
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BACKGROUND: Using a survey conducted during the 2013-2014 polio outbreak in Somalia, this study examines attitudinal and knowledge-based threats to oral polio vaccine acceptance and commitment. Findings address a key gap, as most prior research focuses on endemic settings. METHODS: Between November 19 and December 21, 2013, we conducted interviews among 2003 caregivers of children under 5â¯years in select districts at high risk for polio transmission. Within each district, sample was drawn via a multi-stage cluster design with random route household selection. We calculated the percentage of caregivers who could not confirm recent vaccination and those uncommitted to future vaccination. We compared these percentages among caregivers with varying knowledge and attitudes, focusing on variables identified as threats in endemic settings, using controlled and uncontrolled comparisons. We also examined absolute levels of threat variables. RESULTS: Only 10% of caregivers could not confirm recent vaccination, but 32% were uncommitted to future vaccination. Being unvaccinated or uncommitted were related to multiple threat variables. For example, compared with relevant counterparts, caregivers were more likely to be unconfirmed and uncommitted if they did not trust vaccinators "a great deal" (unconfirmed: 9% vs. 2%; uncommitted: 49% vs. 28%), which is also true in endemic settings. Unlike endemic settings, symptom knowledge was related to commitment while rumor awareness was low and unrelated to past acceptance or commitment. Levels of trust and perceptions of OPV effectiveness were high, though perceptions of community support and awareness of logistics were lower. CONCLUSIONS: As in endemic settings, outbreak responses will benefit from communications strategies focused on enhancing trust in vaccinators, institutions and the vaccine, alongside making community support visible. Disease facts may help motivate acceptance, and enhanced logistics information may help facilitate caregiver availability at the door. Quelling rumors early may be important to prevent them from becoming threats.