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.

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.

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.

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.

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.

An Investigation into Equine Nutrition Knowledge and Educational Needs of Equine Veterinarians.

This study investigated equine nutrition knowledge and educational needs of licensed veterinarians in the United States who were exclusively or predominately equine practitioners. It found veterinarians regard their peers as an important resource of nutritional knowledge, ranking ahead of all other sources except a PhD equine nutritionist. Interestingly, only 21% of veterinarians felt good about their knowledge level in equine nutrition after graduating from veterinary school. Although veterinarians in this study reported equine nutrition to be an area of weakness, 75% had not pursued continuing education in the field of nutrition within the last year. Additionally, they devoted only 65 minutes per year on average to improving their knowledge of equine nutrition, yet the majority (82.2%) had been providing nutritional advice to clients. This study revealed that time spent practicing veterinary medicine increases (p < .001) a veterinarian's self-perceived knowledge level of equine nutrition, shifting from just below average after graduation from veterinary school to just above average at the time of this study. The majority (70%) of veterinarians in this study believe nutrition is very important in their practice philosophy, and 71% showed interest in taking online continuing education courses; thus, curriculum should be developed and offered in areas of need as identified by this study. These areas include insulin resistance, equine gastric ulcer syndrome, equine metabolic syndrome, performance horses, equine pituitary pars intermedia dysfunction, equine polysaccharide storage myopathy, and arthritis/joint pain, along with how to assess nutritional status during general wellness examinations.

Nursing experiences in antimicrobial optimisation in the intensive care unit: A convergent analysis of a national survey.

BACKGROUND: Recent evidence highlights the need for an interdisciplinary approach to antimicrobial stewardship (AMS). Nursing involvement in optimising antimicrobials in the intensive care unit (ICU) remains understudied. OBJECTIVE: The objective of this study was to explore nurses' perceptions and experiences of antimicrobial optimisation or stewardship in ICUs in Australia. METHODS: An anonymous web-based survey was deployed nationally in early 2021 through two ICU nursing networks. Associations between survey responses were analysed descriptively and by using nonparametric tests (with statistical significance established at p ≤ 0.05). Free-text survey responses underwent qualitative thematic analysis. Interpretation and reporting of quantitative and qualitative data were integrated. RESULTS: A total of 226 ICU nurses completed the survey. The majority (197/226; 87%) responded that lack of education limits engagement in AMS. Only 13% (30/226) reported the presence of AMS education and training for nurses in their ICUs. Only about half (108/226; 48%) of the nurses were confident to question prescribers when they considered that the antimicrobial prescribed was unnecessary, with nurses in senior roles more likely to do so than nurses providing bedside care (p < 0.05). Gaps in education (including unfamiliarity with AMS roles), noninclusive antimicrobial discussions, moral distress, and potential workload burden were seen as potential barriers/challenges to engagement. CONCLUSION: The multifactorial barriers identified that inhibit nurses from performing AMS tasks could be addressed by strengthening interprofessional education at all levels and by applying practical AMS interventions that are inclusive for nursing participation. A purposeful culture change that fosters psychological safety and collaborative practice is paramount to supporting nurses in these roles.

Analysis of cyber security knowledge gaps based on cyber security body of knowledge.

Due to the increasing number of cyber incidents and overwhelming skills shortage, it is required to evaluate the knowledge gap between cyber security education and industrial needs. As such, the objective of this study is to identify the knowledge gaps in cyber security graduates who join the cyber security workforce. We designed and performed an opinion survey by using the Cyber Security Knowledge Areas (KAs) specified in the Cyber Security Body of Knowledge (CyBOK) that comprises 19 KAs. Our data was gathered from practitioners who work in cyber security organizations. The knowledge gap was measured and evaluated by acknowledging the assumption for employing sequent data as nominal data and improved it by deploying chi-squared test. Analyses demonstrate that there is a gap that can be utilized to enhance the quality of education. According to acquired final results, three key KAs with the highest knowledge gap are Web and Mobile Security, Security Operations and Incident Management. Also, Cyber-Physical Systems (CPS), Software Lifecycles, and Vulnerabilities are the knowledge areas with largest difference in perception of importance between less and more experienced personnel. We discuss several suggestions to improve the cyber security curriculum in order to minimize the knowledge gaps. There is an expanding demand for executive cyber security personnel in industry. High-quality university education is required to improve the qualification of upcoming workforce. The capability and capacity of the national cyber security workforce is crucial for nations and security organizations. A wide range of skills, namely technical skills, implementation skills, management skills, and soft skills are required in new cyber security graduates. The use of each CyBOK KA in the industry was measured in response to the extent of learning in university environments. This is the first study conducted in this field, it is considered that this research can inspire the way for further researches.

Pathways to cures for multiple sclerosis: A research roadmap.

BACKGROUND: Multiple Sclerosis (MS) is a growing global health challenge affecting nearly 3 million people. Progress has been made in the understanding and treatment of MS over the last several decades, but cures remain elusive. The National MS Society is focused on achieving cures for MS. OBJECTIVES: Cures for MS will be hastened by having a roadmap that describes knowledge gaps, milestones, and research priorities. In this report, we share the Pathways to Cures Research Roadmap and recommendations for strategies to accelerate the development of MS cures. METHODS: The Roadmap was developed through engagement of scientific thought leaders and people affected by MS from North America and the United Kingdom. It also included the perspectives of over 300 people living with MS and was endorsed by many leading MS organizations. RESULTS: The Roadmap consist of three distinct but overlapping cure pathways: (1) stopping the MS disease process, (2) restoring lost function by reversing damage and symptoms, and (3) ending MS through prevention. Better alignment and focus of global resources on high priority research questions are also recommended. CONCLUSIONS: We hope the Roadmap will inspire greater collaboration and alignment of global resources that accelerate scientific breakthroughs leading to cures for MS.

The economic costs, management and regulation of biological invasions in the Nordic countries.

A collective understanding of economic impacts and in particular of monetary costs of biological invasions is lacking for the Nordic region. This paper synthesizes findings from the literature on costs of invasions in the Nordic countries together with expert elicitation. The analysis of cost data has been made possible through the InvaCost database, a globally open repository of monetary costs that allows for the use of temporal, spatial, and taxonomic descriptors facilitating a better understanding of how costs are distributed. The total reported costs of invasive species across the Nordic countries were estimated at $8.35 billion (in 2017 US$ values) with damage costs significantly outweighing management costs. Norway incurred the highest costs ($3.23 billion), followed by Denmark ($2.20 billion), Sweden ($1.45 billion), Finland ($1.11 billion) and Iceland ($25.45 million). Costs from invasions in the Nordics appear to be largely underestimated. We conclude by highlighting such knowledge gaps, including gaps in policies and regulation stemming from expert judgment as well as avenues for an improved understanding of invasion costs and needs for future research.

Nitrogen cycling in pastoral livestock systems in Sub-Saharan Africa: knowns and unknowns.

Pastoral systems are the dominant livestock production system in arid and semiarid regions of sub-Saharan Africa (SSA). They are often the only form of agriculture that can be practiced due to unfavorable climate and soil fertility levels that prevent crop cultivation. Pastoralism can have negative impacts on the environment, including land degradation, greenhouse gas emissions and other gases to the atmosphere, soil erosion, water pollution and biodiversity loss. Here, we review the current knowledge on nitrogen (N) cycling, storage, and loss pathways, with an emphasis on identification of N emission hotspots. Our review reports a large uncertainty in the amount of N lost as ammonia from excreta and manure storage, as well as N losses via nitrate and DON leaching. We also found that another major N loss pathway (18%), soil N2 emissions, has not yet been measured. In order to summarize the available information, we use a virtual pastoral farm, with characteristics and management practices obtained from a real farm, Kapiti Research Station in Kenya. For outlining N flows at this virtual farm, we used published data, data from global studies, satellite imagery and geographic information system (GIS) tools. Our results show that N inputs in pastoral systems are dominated by atmospheric N deposition (˜80%), while inputs due to biological nitrogen fixation seems to play a smaller role. A major N loss pathway is nitrogen leaching (nitrate > DON) from pastures (33%). Cattle enclosures (bomas), where animals are kept during night, represent N emissions hotspots, representing 16% of the total N losses from the system. N losses via ammonia volatilization and N2 O were four and three orders of magnitude higher from bomas than from the pasture, respectively. Based on our results, we further identify future research requirements and highlight the urgent need for experimental data collection to quantify nitrogen losses from manure in animal congregation areas. Such information is needed to improve our understanding on N cycling in pastoral systems in semiarid regions and to provide practical recommendations for managers that can help with decision-making on management strategies in pastoral systems in semiarid savannas.

A review and meta-analysis of collaborative research prioritization studies in ecology, biodiversity conservation and environmental science.

Collaborative research prioritization (CRP) studies have become increasingly popular during the last decade. By bringing together a diverse group of stakeholders, and using a democratic process to create a list of research priorities, these methods purport to identify research topics that will better meet the needs of science users. Here, we review 41 CRP studies in the fields of ecology, biodiversity conservation and environmental science that collectively identify 2031 research priorities. We demonstrate that climate change, ecosystem services and protected areas are common terms found in the research priorities of many CRP studies, and that identified research priorities have become less unique over time. In addition, we show that there is a considerable variation in the size and composition of the groups involved in CRP studies, and that at least one aspect of the identified research priorities (lexical diversity) is related to the size of the CRP group. Although some CRP studies have been highly cited, the evidence that CRP studies have directly motivated research is weak, perhaps because most CRP studies have not directly involved organizations that fund science. We suggest that the most important impact of CRP studies may lie in their ability to connect individuals across sectors and help to build diverse communities of practice around important issues at the science-policy interface.

Applying science to pressing conservation needs for penguins.

More than half of the world's 18 penguin species are declining. We, the Steering Committee of the International Union for Conservation of Nature Species Survival Commission Penguin Specialist Group, determined that the penguin species in most critical need of conservation action are African penguin (Spheniscus demersus), Galápagos penguin (Spheniscus mendiculus), and Yellow-eyed penguin (Megadyptes antipodes). Due to small or rapidly declining populations, these species require immediate scientific collaboration and policy intervention. We also used a pairwise-ranking approach to prioritize research and conservation needs for all penguins. Among the 12 cross-taxa research areas we identified, we ranked quantifying population trends, estimating demographic rates, forecasting environmental patterns of change, and improving the knowledge of fisheries interactions as the highest priorities. The highest ranked conservation needs were to enhance marine spatial planning, improve stakeholder engagement, and develop disaster-management and species-specific action plans. We concurred that, to improve the translation of science into effective conservation for penguins, the scientific community and funding bodies must recognize the importance of and support long-term research; research on and conservation of penguins must expand its focus to include the nonbreeding season and juvenile stage; marine reserves must be designed at ecologically appropriate spatial and temporal scales; and communication between scientists and decision makers must be improved with the help of individual scientists and interdisciplinary working groups.

Aplicación de Ciencia en las Necesidades de Conservación Urgentes para los Pingüinos. Resumen Más de la mitad de las 18 especies de pingüinos del mundo están disminuyendo. Nosotros, el Comité Directivo de la Unión Internacional para la Conservación de la Naturaleza, Grupo de Especialistas en Pingüinos, determinamos que las especies de pingüinos con necesidades críticas de conservación son el pingüino africano (Spheniscus demersus), el pingüino de las Galápagos (Spheniscus mendiculus) y el pingüino de ojos amarillos (Megadyptes antipodes). Debido a que sus poblaciones son pequeñas o están declinando rápidamente, estos pingüinos requieren colaboración científica e intervención política inmediatas. También utilizamos un método de clasificación por pares para priorizar las necesidades de investigación y conservación para todas las especies de pingüinos. Entre las 12 áreas de investigación que identificamos, las más prioritarias fueron: cuantificación de las tendencias poblacionales, estimación de las tasas demográficas, predicción de las patrones de cambio ambiental y mejora del conocimiento de las interacciones con pesquerías. Las mayores necesidades de conservación fueron: optimizar la planificación marina espacial, mejorar la colaboración de las partes interesadas y desarrollar planes de manejo de desastres y de acción para cada especie. Coincidimos en que, para mejorar la traducción de la ciencia en la conservación efectiva de los pingüinos, la comunidad científica y los organismos financiadores deben reconocer la importancia de la investigación a largo plazo y apoyarla; la investigación sobre pingüinos y su conservación debe expandir su enfoque para incluir la época no reproductiva y la etapa juvenil; las reservas marinas deben ser diseñadas a escalas espaciotemporales ecológicamente apropiadas; y la comunicación entre científicos y tomadores de decisiones debe mejorar con la ayuda de científicos individuales y grupos de trabajo interdisciplinario.

Climate change research in Asia: A knowledge synthesis of Asia-Pacific Network for Global Change Research (2013-2018).

Countering climate challenges requires genuine multi-layered approaches in cooperation with various stakeholders. Spanning 20 years, the Asia-Pacific Network for Global Change Research (APN) has been facilitating the research community to provide regional and grassroots results and solutions, while acting as a mechanism to encourage science-policy-stakeholder dialogue. This paper outlines the relevance of APN projects to IPCC policymaking by laying out knowledge products and lessons learned from the projects. It also narrates how regional research and capacity building assist in responding to the increasing urgency across climate change and the SDGs. A synthesis of project-generated knowledge was garnered from research and capacity development studies conducted under the auspices of APN to identify their scope and level of policy relevance. A combined typology and solution scanning with Likert scale as relevance rating was employed to categorize contribution against key themes of the IPCC sixth assessment report. Findings suggest 115 distinct and relevant projects completed mostly in Southeast Asia, South Asia and Temperate East Asia, with many of them asserting community-based adaptation and mitigation surrounding issues on ecosystems and biodiversity, extreme weather events, water-food-energy nexus, sustainable waste management, and climate education. Findings also show 163 knowledge products in which majority of them (66.87%) were peer-reviewed journal articles, 11.04% were reports, 7.98% were policy briefs, 6.75% were guidelines and tools, 4.91% were books and 2.45% were perspectives and opinions. With the evolving synergies between global climate targets and the SDGs, it is recommended that APN solidify its role in science-policy partnerships and networking by creating improved interlinkages for disseminating knowledge gaps filled and in replicating lessons learned and best practices found in APN knowledge products. In addition to science-policy dialogues and output synthesis, a regular review of APN research and capacity development outcomes will help in realizing these important aspects toward wider policy impact.

The missing pieces in the jigsaw and need for cohesive research amidst coronavirus infectious disease 2019 global response.

Identifying the research needs and gaps amidst this COVID-19 travelling across the countries is absolutely important for finely improving on the way we think and act. The natural history of the disease as well as viral shedding in different stages of clinical illness needs to be known which helps in triaging the patients in hospital settings. Animal and environmental interface need to be studied for defining the high-risk situations. Transmission dynamics in community or hospital and defining the laboratory criteria for the case confirmation will be most crucial. Gene sequencing and validation and, suitable use of molecular based tests such as real-time polymerase chain reaction (qRT-PCR) should be clearly evaluated for diagnosis and/ or surveillance. The movement control strategy must be defined to prevent secondary transmission in healthcare as well as in community settings. Repurposing of drug molecules is an elegant strategy to develop therapeutics in the case of pandemics quickly. Unproven practices and treatment protocols should invite critical scrutiny on the basis of ethics. Socioeconomic status of the community is also an important determinant for the compliance and sustainable public health measures.

Assessment of knowledge gaps and perceptions about COVID-19 among health care workers and general public-national cross-sectional study.

BACKGROUND AND AIMS: COVID-19 has impacted everyone's life and livelihood in one way or the other. Individual response to measures taken to control the rapid spread of this disease depend on their knowledge and perceptions. Hence, we proposed to evaluate responses about COVID-19 among the health care workers (HCWs) as well as general public participants (GPPs). MATERIAL AND METHODS: This was a cross-sectional, observational survey conducted during the peak of the pandemic. The 35-items questionnaire was prepared using Google forms and distributed through e-mails and social media. RESULTS: The 1,026 responses comprised of 558 HCWs (54.4%) and 468 GPPs (45.6%). The most reliable source of information was TV news for 43% GPPs, whereas it was HCWs/Local health authorities for 36.8% HCWs. HCWs had sufficient knowledge regarding COVID-19, while it was relatively low among GPPs (average correct response 65% and 53%, respectively). Intra-group analysis with respect to age, sex, qualification, and socioeconomic status showed that knowledge about mode of transmission by airborne aerosols was significantly low with respect to qualification among GPPs while younger age group (<40 years) HCWs had significantly more knowledge about mode of transmission and asymptomatic carriers. Paranoia of contracting the infection was significantly higher in GPPs with upper and middle socioeconomic status and younger HCWs. CONCLUSION: HCWs had moderate level of knowledge, whereas GPPs had low to moderate knowledge, with large scope of improvement in both groups. Continued education, both at professional and community level will not only be helpful but also necessary to improve knowledge, avert negative attitudes and control the devastating pandemic.

How to Adapt Chemical Risk Assessment for Unconventional Hydrocarbon Extraction Related to the Water System.

We identify uncertainties and knowledge gaps of chemical risk assessment related to unconventional drillings and propose adaptations. We discuss how chemical risk assessment in the context of unconventional oil and gas (UO&G) activities differs from conventional chemical risk assessment and the implications for existing legislation. A UO&G suspect list of 1,386 chemicals that might be expected in the UO&G water samples was prepared which can be used for LC-HRMS suspect screening. We actualize information on reported concentrations in UO&G-related water. Most information relates to shale gas operations, followed by coal-bed methane, while only little is available for tight gas and conventional gas. The limited research on conventional oil and gas recovery hampers comparison whether risks related to unconventional activities are in fact higher than those related to conventional activities. No study analyzed the whole cycle from fracturing fluid, flowback and produced water, and surface water and groundwater. Generally target screening has been used, probably missing contaminants of concern. Almost half of the organic compounds analyzed in surface water and groundwater exceed TTC values, so further risk assessment is needed, and risks cannot be waived. No specific exposure scenarios toward groundwater aquifers exist for UO&G-related activities. Human errors in various stages of the life cycle of UO&G production play an important role in the exposure. Neither at the international level nor at the US federal and the EU levels, specific regulations for UO&G-related activities are in place to protect environmental and human health. UO&G activities are mostly regulated through general environmental, spatial planning, and mining legislation.

Assessment of Condition and Medication Knowledge Gaps Among Atrial Fibrillation Patients: A Systematic Review and Meta-analysis.

Background: Patient education facilitates construction of a correct illness representation, improves beliefs about medications, and improves knowledge, factors that have been associated with better adherence. Objective: Our objective was to characterize the published literature about atrial fibrillation (AF) patients' disease and medication knowledge to identify knowledge gaps and misconceptions to inform AF patient education strategies. Methods: Following PRISMA guidelines, we searched PubMed, EMBASE, CINAHL, and PsychINFO from inception to May 2018 for studies that assessed AF patients' knowledge about their condition and medications. For quantitative studies, we extracted the proportion of participants who provided correct answers to the questions asked about their condition, medications, or risk of stroke. We classified data for related questions into knowledge domains. A random-effects meta-analysis was conducted for each knowledge domain. A domain was considered a knowledge gap if the pooled mean proportion of participants who demonstrated knowledge of it was ≤50%, regardless of CI. Qualitative data were summarized narratively. Results: A total of 21 studies were included. AF- and stroke-related knowledge gaps and misconceptions included the following: AF can be asymptomatic, AF can predispose to heart failure, women are at a higher risk of stroke, the definition of ischemic stroke, and patients' awareness of their diagnosis. Medication-related knowledge gaps were antithrombotic-drug interactions, antithrombotic-food interactions, vitamin K content of foods, the term INR (international normalized ratio) and its interpretation, and the required actions in case of a missed dose. Conclusion and Relevance: This systematic review identified several AF patient knowledge gaps about their condition and its treatment that can inform the development of AF patient education programs.

State of the science review of the health effects of inorganic arsenic: Perspectives for future research.

Human exposure to inorganic arsenic (iAs) is a global health issue. Although there is strong evidence for iAs-induced toxicity at higher levels of exposure, many epidemiological studies evaluating its effects at low exposure levels have reported mixed results. We comprehensively reviewed the literature and evaluated the scientific knowledge on human exposure to arsenic, mechanisms of action, systemic and carcinogenic effects, risk characterization, and regulatory guidelines. We identified areas where additional research is needed. These priority areas include: (1) further development of animal models of iAs carcinogenicity to identify molecular events involved in iAs carcinogenicity; (2) characterization of underlying mechanisms of iAs toxicity; (3) assessment of gender-specific susceptibilities and other factors that modulate arsenic metabolism; (4) sufficiently powered epidemiological studies to ascertain relationship between iAs exposure and reproductive/developmental effects; (5) evaluation of genetic/epigenetic determinants of iAs effects in children; and (6) epidemiological studies of people chronically exposed to low iAs concentrations.

Ten-year assessment of the 100 priority questions for global biodiversity conservation.

In 2008, a group of conservation scientists compiled a list of 100 priority questions for the conservation of the world's biodiversity. However, now almost a decade later, no one has yet published a study gauging how much progress has been made in addressing these 100 high-priority questions in the peer-reviewed literature. We took a first step toward reexamining the 100 questions to identify key knowledge gaps that remain. Through a combination of a questionnaire and a literature review, we evaluated each question on the basis of 2 criteria: relevance and effort. We defined highly relevant questions as those that - if answered - would have the greatest impact on global biodiversity conservation and quantified effort based on the number of review publications addressing a particular question, which we used as a proxy for research effort. Using this approach, we identified a set of questions that, despite being perceived as highly relevant, have been the focus of relatively few review publications over the past 10 years. These questions covered a broad range of topics but predominantly tackled 3 major themes: conservation and management of freshwater ecosystems, role of societal structures in shaping interactions between people and the environment, and impacts of conservation interventions. We believe these questions represent important knowledge gaps that have received insufficient attention and may need to be prioritized in future research.