Analysis and mapping of harm reduction research in the context of injectable drug use: identifying research hotspots, gaps and future directions.

BACKGROUND: Harm reduction is a crucial approach in addressing the multifaceted challenges of injectable drug use. This paper presents an analysis and mapping of the existing literature on harm reduction research in the context of injectable drug use. By reviewing a comprehensive set of scholarly articles, this study identifies research hotspots, knowledge gaps, and future directions in the field. The findings provide valuable insights for researchers, policymakers, and practitioners to guide future research efforts and inform evidence-based harm reduction interventions. METHODS: Data for the study was obtained from the Scopus database, using keywords and phrases related to harm reduction and injectable drug use. Validation methods were employed to verify the accuracy and comprehensiveness of the search strategy. Data analysis involved identifying growth patterns, key contributors, mapping frequent terms, identifying research hotspots, and identifying emerging research directions. RESULTS: A total of 971 articles were found, with a notable increase from 2015 to 2022. The International Journal of Drug Policy (n = 172, 17.7%) and the Harm Reduction Journal (n = 104, 10.7%) were the most prolific journals, and the United States (n = 558, 57.5%) had the highest number of publications. The Johns Hopkins University (n = 80, 8.5%) was the most prolific institution. Mapping of frequent author keywords revealed the main keywords, including harm reduction, HIV, hepatitis C, and opioid overdose. The highly cited articles cover a broad time span and focus on topics like naloxone distribution, HIV and hepatitis C transmission, while recent articles concentrate on emerging issues such as the impact of the COVID-19 pandemic, fentanyl-related concerns, stigma reduction, and needle and syringe programs. Both sets of articles share a common focus on harm reduction strategies, but recent publications highlight current challenges and developments in the field. CONCLUSIONS: This study provides insights into research landscape on harm reduction in injectable drug use. Research is concentrated in high-income countries, emphasizing the need for more research in low- and middle-income countries. Recent publications focus on emerging challenges like COVID-19 and fentanyl. Research gaps highlight the need for studies in diverse populations, social determinants, program evaluation, and implementation strategies to enhance harm reduction interventions.

Improving Mental Health Outcomes in Patients with Major Depressive Disorder in the Gulf States: A Review of the Role of Electronic Enablers in Monitoring Residual Symptoms.

Up to 75% of individuals with major depressive disorder (MDD) may have residual symptoms such as amotivation or anhedonia, which prevent full functional recovery and are associated with relapse. Globally and in the Gulf region, primary care physicians (PCPs) have an important role in alleviating stigma and in identifying and monitoring the residual symptoms of depression, as PCPs are the preliminary interface between patients and specialists in the collaborative care model. Therefore, mental healthcare upskilling programmes for PCPs are needed, as are basic instruments to evaluate residual symptoms swiftly and accurately in primary care. Currently, few if any electronic enablers have been designed to specifically monitor residual symptoms in patients with MDD. The objectives of this review are to highlight how accurate evaluation of residual symptoms with an easy-to-use electronic enabler in primary care may improve functional recovery and overall mental health outcomes, and how such an enabler may guide pharmacotherapy selection and positively impact the patient journey. Here, we show the potential advantages of electronic enablers in primary care, which include the possibility for a deeper "dive" into the patient journey and facilitation of treatment optimisation. At the policy and practice levels, electronic enablers endorsed by government agencies and local psychiatric associations may receive greater PCP attention and backing, improve patient involvement in shared clinical decision-making, and help to reduce the general stigma around mental health disorders. In the Gulf region, an easy-to-use electronic enabler in primary care, incorporating aspects of the Hamilton Depression Rating Scale to monitor amotivation, and aspects of the Montgomery-Åsberg Depression Rating Scale to monitor anhedonia, could markedly improve the patient journey from residual symptoms through to full functional recovery in individuals with MDD.

Macro and microplastic pollution in Romania: addressing knowledge gaps and potential solutions under the circular economy framework.

Background: This review reveals the role of linear economy prevalence and mismanagement practices in plastic pollution of aquatic and terrestrial environments and related knowledge gaps in Romania while outlining downstream and upstream solutions to reduce plastic pollution and adopt circular economy strategies. Thus, the major aim of this study is the investigation of the stage of scientific knowledge concerning all these demands in the Romanian context. Methodology: This work integrates two main approaches: (i) a bibliometric analysis fed by Web of Science and Scopus databases to reveal the current coverage of peer-reviewed literature related to plastic waste in Romania and (ii) a subject-based review to underline the main themes related to plastic waste management, plastic pollution, and mitigating options in Romania in line with circular economy principles. Results: Reducing plastic pollution requires scientific knowledge, multi-sectoral cooperation, and societal awareness. Following this, the topics of plastic waste and plastic pollution appeared to be under-investigated in the literature considering Romania as a case study and concentrated around the 2020 year, emphasizing, in this way, the trendiness of plastic waste concerns and their management in the current research landscape. Our analysis points out that: (i) Romania is facing massive plastic pollution requiring solid improvements in waste management performances; (ii) few peer-reviewed research studies are performed in Romania for both macro and microplastic concerns with unknown pollution levels in most of its geographical regions; (iii) the plastic waste management is still understudied here, while waste statistics are poorly available at local levels; (iv) the perspectives of circular economy transition are still limited, feeding the plastic pollution in the coming years. Conclusions: Several knowledge gaps are identified and must be covered by future research such as (i) adjusting mismanaged plastic waste levels to regional waste management performances and determining littering rates in urban and rural areas to improve the plastic pollution modeling inputs; (ii) examining plastic pollution associated with landfill sites and waste imports; (iii) assessing the sectoral contributions to macro and microplastic pollution of aquatic environments related to municipalities, tourist destinations, agriculture, etc.; (iv) determining retention levels of plastic in river basins and role of riparian vegetation; (v) analyzing microplastics presence in all types of freshwater environments and interlinkage between macroplastic fragmentation and microplastic; (vi) assessing the plastic loads of transboundary rivers related to mismanagement practices; (vii) determining concentrations of microplastics in air, soil, and other land use ecosystems.

Older workers and extended working life - Managers' experiences and age management.

BACKGROUND: In 2020 the Swedish Government started a gradual raising of the retirement age, but employers have been silent on the issue. Little is known about whether and how they reflect on what it will mean for their organization, or whether they already have, or are going to, make arrangements in order to facilitate and motivate older workers to stay longer. OBJECTIVE: The aim of this study was to explore and describe managers' experiences of older workers and age management in connection with the increase of the retirement age in Sweden. METHODS: Data was collected through semi-structured interviews with fourteen managers from a broad set of organizations in the public and private sectors, and from the Middle and East of Sweden. The transcribed material was analysed in line with qualitative content analysis. RESULTS: The analysis ended up in seven main categories with associated sub-categories: Older Workers, Retirement Ages, Transition Initiatives, Competence Transfer, Competence Development, Increased Retirement Ages, Knowledge Gaps. CONCLUSION: Our findings reveal that there is an ambivalence in addressing the issue of age among the interviewed managers, what we have interpreted and labelled as "silent age discrimination", and it was shown that they do not have elaborated strategies for age management.

Update on human herpesvirus 7 pathogenesis and clinical aspects as a roadmap for future research.

Human herpesvirus 7 (HHV-7) is a common virus that is associated with various human diseases including febrile syndromes, dermatological lesions, neurological defects, and transplant complications. Still, HHV-7 remains one of the least studied members of all human betaherpesviruses. In addition, HHV-7-related research is mostly confined to case reports, while in vitro or in vivo studies unraveling basic virology, transmission mechanisms, and viral pathogenesis are sparse. Here, we discuss HHV-7-related literature linking clinical syndromes to the viral life cycle, epidemiology, and viral immunopathogenesis. Based on our review, we propose a hypothetical model of HHV-7 pathogenesis inside its host. Furthermore, we identify important knowledge gaps and recommendations for future research to better understand HHV-7 diseases and improve therapeutic interventions.

Global indicators of the environmental impacts of invasive alien species and their information adequacy.

Monitoring the extent to which invasive alien species (IAS) negatively impact the environment is crucial for understanding and mitigating biological invasions. Indeed, such information is vital for achieving Target 6 of the Kunming-Montreal Global Biodiversity Framework. However, to-date indicators for tracking the environmental impacts of IAS have been either lacking or insufficient. Capitalizing on advances in data availability and impact assessment protocols, we developed environmental impact indicators to track realized and potential impacts of IAS. We also developed an information status indicator to assess the adequacy of the data underlying the impact indicators. We used data on 75 naturalized amphibians from 82 countries to demonstrate the indicators at a global scale. The information status indicator shows variation in the reliability of the data and highlights areas where absence of impact should be interpreted with caution. Impact indicators show that growth in potential impacts are dominated by predatory species, while potential impacts from both predation and disease transmission are distributed worldwide. Using open access data, the indicators are reproducible and adaptable across scales and taxa and can be used to assess global trends and distributions of IAS, assisting authorities in prioritizing control efforts and identifying areas at risk of future invasions. This article is part of the theme issue 'Ecological novelty and planetary stewardship: biodiversity dynamics in a transforming biosphere'.

Delirium Diagnosis, Complication Recognition, and Treatment Knowledge among Nurses in an Italian Local Hospital: A Cross-Sectional Study.

Delirium, a multifactorial condition with an acute onset and diverse clinical manifestations, poses a significant challenge in the care of hospitalized individuals aged 65 years and older. This study aimed to evaluate the level of knowledge among nursing healthcare personnel regarding the diagnosis, recognition of complications, and treatment of delirium. A paper questionnaire consisting of 18 multiple-choice questions was distributed to nurses in twelve operational units located in four facilities within a local hospital in a specific geographical region under the jurisdiction of the Romagna Local Health Authority in Italy. Out of 194 respondents, the overall acceptance rate was 64.2%. The findings revealed an insufficient understanding of delirium among the nursing staff, with more than 40% of respondents answering incorrectly to five out of nine questions related to delirium knowledge, diagnosis, prevention, and treatment. Notably, gender emerged as a significant determinant, with female participants exhibiting a substantial odds ratio (OR) of 3.50 (p = 0.011 and CI95% = 1.34-9.16) compared to their male counterparts, indicating a higher likelihood of receiving delirium training among females. Furthermore, prolonged tenure within the same work context was associated with a reduced likelihood of receiving delirium training compared to those with less than two years of experience (OR = 0.21, p = 0.034, and CI95% = 0.05-0.89 for 6-10 years of tenure; OR = 0.22, p = 0.038, and CI95% = 0.05-0.92 for over 10 years of tenure). This study underscores the urgent need for enhanced delirium education and improved strategies among nurses to effectively manage patients with delirium. The results advocate regular educational sessions utilizing diverse formats to comprehensively address knowledge gaps among nursing staff. This study was not registered.

Children's subjective uncertainty-driven sampling behaviour.

Are children and adults sensitive to gaps in their knowledge, and do they actively elicit information to resolve such knowledge gaps? In a cross-situational word learning task, we asked 5-year-olds, 6- to 9-year-olds and adults to estimate their knowledge of newly learned word-object associations. We then examined whether participants preferentially sampled objects they reported not knowing the label in order to hear their labels again. We also examined whether such uncertainty-driven sampling behaviour led to improved learning. We found that all age groups were sensitive to gaps in their knowledge of the word-object associations, i.e. were more likely to say they had correctly indicated the label of an object when they were correct, relative to when they were incorrect. Furthermore, 6- to 9-year-olds and adults-but not 5-year-olds-were more likely to sample objects whose labels they reported not knowing. In other words, older children and adults displayed sampling behaviour directed at reducing knowledge gaps and uncertainty, while younger children did not. However, participants who displayed more uncertainty-driven sampling behaviour were not more accurate at test. Our findings underscore the role of uncertainty in driving 6- to 9-year-olds' and adults' sampling behaviour and speak to the mechanisms underlying previously reported performance boosts in active learning.

Knowledge, attitude, and practices about breast cancer among women in a high-altitude sub-Himalayan region: Are we reaching the unreached?

Background: Breast cancer awareness and early detection are critical for reducing the global burden of the disease. This study assessed breast cancer awareness among women in a high-altitude sub-Himalayan region of North India. Materials and Methods: A cross-sectional survey was conducted among women attending the gynecology outpatient clinic in a district hospital. A structured questionnaire was used to collect data on breast cancer knowledge, attitudes, and practices. Participants received posttest health education and counseling on breast cancer prevention strategies. Result: The study included 188 participants with a mean age of 31.0 ± 8.8 years. The findings revealed inadequate knowledge about breast cancer among a significant portion of the cohort. Misconceptions about risk factors, such as breastfeeding, oral contraceptive use, and past wrongdoings, were observed. Only half of the participants believed early-stage breast cancer could be effectively treated. Limited awareness of screening methods, including self-breast examination and mammography, was noted. Barriers to breast self-examination (BSE) included considering it unnecessary and lacking knowledge about its execution. Conclusion: This study highlights insufficient breast cancer awareness in the high-altitude sub-Himalayan region. Targeted interventions, including health campaigns and electronic media, should be prioritized to improve knowledge and promote early detection practices.

Bridging the Gap: A Strategic Approach to Upscale Knowledge Among Diverse Healthcare Providers for Effective Tuberculosis Management in Gujarat, India.

INTRODUCTION: Tuberculosis (TB) remains a global health challenge, particularly in low- and middle-income countries. Knowledge gaps among healthcare providers (HCPs) significantly impact TB management, hindering timely care-seeking and effective interventions. OBJECTIVE: The primary objective was to assess knowledge gaps among 3086 HCPs engaged in the National Tuberculosis Elimination Program (NTEP) implementation in Gujarat, India. The study provided a platform to develop and implement cadre-specific training modules to address identified knowledge deficiencies and enhance TB management. METHODOLOGY: The study was conducted in two phases. Phase one was designed as a cross-sectional assessment to identify the knowledge gaps. Phase two involved the development of cadre-specific training modules based on identified deficiencies in the knowledge, crafted with collaboration from an expert panel. The training impact will be evaluated after completion of the training of all cadres through a comprehensive assessment. RESULTS: Out of 3086 assessed HCPs, 26% scored below the passing benchmark, revealing significant knowledge gaps. The variations were observed among and within the same cadres, with the accredited social health activists (ASHAs) and community health workers showing higher proficiency while pharmacists and medical officers showed lower proficiency. The cadre-specific training modules and training cascade were designed to address these gaps and improve TB-related knowledge and skills. CONCLUSION: The study underscores the critical need for targeted interventions to address knowledge gaps among HCPs involved in TB control. The customized HCP-specific training programs are recommended to enhance knowledge, improve TB management, and contribute to national TB elimination goals.

Pan-Indian Clinical Registry of Invasive Fungal Infections Among Patients in the Intensive Care Unit: Protocol for a Multicentric Prospective Study.

BACKGROUND: Fungal infections are now a great public health threat, especially in those with underlying risk factors such as neutropenia, diabetes, high-dose steroid treatment, cancer chemotherapy, prolonged intensive care unit stay, and so on, which can lead to mycoses with higher mortality rates. The rates of these infections have been steadily increasing over the past 2 decades due to the increasing population of patients who are immunocompromised. However, the data regarding the exact burden of such infection are still not available from India. Therefore, this registry was initiated to collate systematic data on invasive fungal infections (IFIs) across the country. OBJECTIVE: The primary aim of this study is to create a multicenter digital clinical registry and monitor trends of IFIs and emerging fungal diseases, as well as early signals of any potential fungal outbreak in any region. The registry will also capture information on the antifungal resistance patterns and the contribution of fungal infections on overall morbidity and inpatient mortality across various conditions. METHODS: This multicenter, prospective, noninterventional observational study will be conducted by the Indian Council of Medical Research through a web-based data collection method from 8 Advanced Mycology Diagnostic and Research Centers across the country. Data on age, gender, clinical signs and symptoms, date of admission, date of discharge or death, diagnostic tests performed, identified pathogen details, antifungal susceptibility testing, outcome, and so on will be obtained from hospital records. Descriptive and multivariate statistical methods will be applied to investigate clinical manifestations, risk variables, and treatment outcomes. RESULTS: These Advanced Mycology Diagnostic and Research Centers are expected to find the hidden cases of fungal infections in the intensive care unit setting. The study will facilitate the enhancement of the precision of fungal infection diagnosis and prompt treatment modalities in response to antifungal drug sensitivity tests. This registry will improve our understanding of IFIs, support evidence-based clinical decision-making ability, and encourage public health policies and actions. CONCLUSIONS: Fungal diseases are a neglected public health problem. Fewer diagnostic facilities, scanty published data, and increased vulnerable patient groups make the situation worse. This is the first systematic clinical registry of IFIs in India. Data generated from this registry will increase our understanding related to the diagnosis, treatment, and prevention of fungal diseases in India by addressing pertinent gaps in mycology. This initiative will ensure a visible impact on public health in the country. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/54672.

We know a lot about little and little about a lot: A contextualized scoping review on injury prevention in alpine ski racing.

BACKGROUND: Our goal was to summarize and contextualize the available literature on alpine ski racing injury epidemiology, injury etiology, injury prevention measures, injury prevention context, and implementation issues. MATERIALS AND METHODS: We searched four electronic databases using predetermined search terms. We included original studies that assessed injury, injury risk factors, and injury mechanisms, and assessed and reported the effect of an injury prevention measure in alpine ski racing. Two authors independently conducted title-abstract screening, and one performed the full-text review. For data synthesis and categorization, we used the Translating Research into the Injury Prevention Practice framework and a modified and adapted version of the Haddon matrix. RESULTS: Of the 157 included studies, most corresponded to injury epidemiology and etiology, whereas few studies encompassed injury prevention measure development, implementation and evaluation. Preventive interventions targeting equipment, rules and regulations, course design and snow preparation were the most prevalent in the literature. Furthermore, various contextual factors in the current literature have been found, including gender, competition level, countries and federations, and time periods within a season. CONCLUSIONS: We provided an in-depth and comprehensive overview of the current state-of-the-art in the alpine ski racing context. We know a lot about little and little about a lot across all the areas associated with injury prevention in such context. The limitations in the literature yield a road map for designing future injury prevention studies to address the key gaps identified. A more comprehensive context-driven approach throughout all stages of injury prevention would benefit the ultimate implementation of effective preventive strategies.

A scoping review of autism research conducted in Central Asia: Knowledge gaps and research priorities.

LAY ABSTRACT: Very little is known about the status of autism research in Central Asia. Through the library databases, we identified and reviewed 11 scientific studies conducted with autistic people and their families in five Central Asian countries-Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, and Uzbekistan. Of the 11 studies, 10 were conducted in Kazakhstan and 1 in Uzbekistan. Within these limited number of research studies, different topics such as diagnosis, risk factors of autism, biology, and various service and intervention areas were addressed. We identified several knowledge gaps and research priorities to address the needs of autistic people, their families, and professionals in Central Asia.

Prioritizing a research agenda on built environments and physical activity: a twin panel Delphi consensus process with researchers and knowledge users.

BACKGROUND: The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners). METHODS: Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin 'top 10' lists of the most important research needs. RESULTS: From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT. CONCLUSIONS: Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities.

The Arenaviridae Family: Knowledge Gaps, Animal Models, Countermeasures, and Prototype Pathogens.

Lassa virus (LASV), Junin virus (JUNV), and several other members of the Arenaviridae family are capable of zoonotic transfer to humans and induction of severe viral hemorrhagic fevers. Despite the importance of arenaviruses as potential pandemic pathogens, numerous gaps exist in scientific knowledge pertaining to this diverse family, including gaps in understanding replication, immunosuppression, receptor usage, and elicitation of neutralizing antibody responses, that in turn complicates development of medical countermeasures. A further challenge to the development of medical countermeasures for arenaviruses is the requirement for use of animal models at high levels of biocontainment, where each model has distinct advantages and limitations depending on, availability of space, animals species-specific reagents, and most importantly the ability of the model to faithfully recapitulate human disease. Designation of LASV and JUNV as prototype pathogens can facilitate progress in addressing the public health challenges posed by members of this important virus family.

Misconceptions and Knowledge Gaps on Antibiotic Use and Resistance in Four Healthcare Settings and Five European Countries-A Modified Delphi Study.

Misconceptions and knowledge gaps about antibiotics contribute to inappropriate antibiotic use and antimicrobial resistance. This study aimed to identify and prioritize misconceptions and knowledge gaps about antibiotic use from a healthcare professionals' perspective. A modified Delphi study with a predefined list of statements, two questionnaire rounds, and an expert meeting was conducted. The statements were rated by healthcare professionals from France, Greece, Lithuania, Poland, and Spain, and from general practice, out-of-hour services, nursing homes, and pharmacies. A total of 44 pre-defined statements covered the following themes: (1) antimicrobial resistance in general, (2) use of antibiotics in general, (3) use of antibiotics for respiratory tract infections, and (4) use of antibiotics for urinary tract infections. Consensus was defined as ≥80% agreement between the professionals during the second Delphi round. For 30% of the statements, professionals from the four settings together reached consensus. In each setting individually, at least 50% of the statements reached consensus, indicating that there are still many misconceptions and knowledge gaps that need to be addressed. Six educational tools (leaflets, posters, checklists) were developed to address the knowledge gaps and misconceptions. These can be used by patients and healthcare professionals to improve the use of antibiotics in practice.

The Biosafety Research Road Map: The Search for Evidence to Support Practices in the Laboratory-Mpox/Monkeypox Virus.

Introduction: The virus formerly known as monkeypox virus, now called mpoxv, belongs to the Orthopoxvirus genus and can cause mpox disease through both animal-to-human and human-to-human transmission. The unexpected spread of mpoxv among humans has prompted the World Health Organization (WHO) to declare a Public Health Emergency of International Concern (PHEIC). Methods: We conducted a literature search to identify the gaps in biosafety, focusing on five main areas: how the infection enters the body and spreads, how much of the virus is needed to cause infection, infections acquired in the lab, accidental release of the virus, and strategies for disinfecting and decontaminating the area. Discussion: The recent PHEIC has shown that there are gaps in our knowledge of biosafety when it comes to mpoxv. We need to better understand where this virus might be found, how much of it can spread from person-to-person, what are the effective control measures, and how to safely clean up contaminated areas. By gathering more biosafety evidence, we can make better decisions to protect people from this zoonotic agent, which has recently become more common in the human population.

CTD tetramers: a new online tool that computationally links curated chemicals, genes, phenotypes, and diseases to inform molecular mechanisms for environmental health.

The molecular mechanisms connecting environmental exposures to adverse endpoints are often unknown, reflecting knowledge gaps. At the Comparative Toxicogenomics Database (CTD), we developed a bioinformatics approach that integrates manually curated, literature-based interactions from CTD to generate a "CGPD-tetramer": a 4-unit block of information organized as a step-wise molecular mechanism linking an initiating Chemical, an interacting Gene, a Phenotype, and a Disease outcome. Here, we describe a novel, user-friendly tool called CTD Tetramers that generates these evidence-based CGPD-tetramers for any curated chemical, gene, phenotype, or disease of interest. Tetramers offer potential solutions for the unknown underlying mechanisms and intermediary phenotypes connecting a chemical exposure to a disease. Additionally, multiple tetramers can be assembled to construct detailed modes-of-action for chemical-induced disease pathways. As well, tetramers can help inform environmental influences on adverse outcome pathways (AOPs). We demonstrate the tool's utility with relevant use cases for a variety of environmental chemicals (eg, perfluoroalkyl substances, bisphenol A), phenotypes (eg, apoptosis, spermatogenesis, inflammatory response), and diseases (eg, asthma, obesity, male infertility). Finally, we map AOP adverse outcome terms to corresponding CTD terms, allowing users to query for tetramers that can help augment AOP pathways with additional stressors, genes, and phenotypes, as well as formulate potential AOP disease networks (eg, liver cirrhosis and prostate cancer). This novel tool, as part of the complete suite of tools offered at CTD, provides users with computational datasets and their supporting evidence to potentially fill exposure knowledge gaps and develop testable hypotheses about environmental health.

Fifteen research needs for understanding climate change impacts on ecosystems and society in the Norwegian High North.

There is an urgent need to understand and address the risks associated with a warming climate for ecosystems and societies in the Arctic and sub-Arctic regions. There are major gaps in our understanding of the complex effects of climate change-including extreme events, cascading impacts across ecosystems, and the underlying socioecological dynamics and feedbacks-all of which need collaborative efforts to be resolved. Here, we present results where climate scientists, ecologists, social scientists, and practitioners were asked to identify the most urgent research needs for understanding climate change impacts and to identify the actions for reducing future risks in catchment areas in the Norwegian High North, a region that encompasses both Arctic and sub-Arctic climates in northern Norway. From a list of 77 questions, our panel of 19 scientists and practitioners identified 15 research needs that should be urgently addressed. We particularly urge researchers to investigate cross-ecosystem impacts and the socioecological feedbacks that could amplify or reduce risks for society.

Global knowledge gaps on antimicrobial resistance in the human health sector: A scoping review.

OBJECTIVES: To identify and summarize existing global knowledge gaps on antimicrobial resistance (AMR) in human health, focusing on the World Health Organization (WHO) bacterial priority pathogens, Mycobacterium tuberculosis, and selected fungi. METHODS: We conducted a scoping review of gray and peer-reviewed literature, published in English from January 2012 through December 2021, that reported on the prevention, diagnosis, treatment, and care of drug-resistant infections. We extracted relevant knowledge gaps and, through an iterative process, consolidated those into thematic research questions. RESULTS: Of 8409 publications screened, 1156 were included, including 225 (19.5%) from low- and middle-income countries. A total of 2340 knowledge gaps were extracted, in the following areas: antimicrobial research and development, AMR burden and drivers, resistant tuberculosis, antimicrobial stewardship, diagnostics, infection prevention and control, antimicrobial consumption and use data, immunization, sexually transmitted infections, AMR awareness and education, policies and regulations, fungi, water sanitation and hygiene, and foodborne diseases. The knowledge gaps were consolidated into 177 research questions, including 78 (44.1%) specifically relevant to low- and middle-income countries and 65 (36.7%) targeting vulnerable populations. CONCLUSION: This scoping review presents the most comprehensive compilation of AMR-related knowledge gaps to date, informing a priority-setting exercise to develop the WHO Global AMR Research Agenda for the human health sector.