RESUMO
Telemedicine is being applied in assisted reproduction technology (ART) to provide remote consultations, monitoring and support for patients. This study aimed to evaluate the potential advantages of telemedicine in ART treatment in the form of virtual consultations. Studies in which patients were using telemedicine during ART treatment were identified from four scientific databases (PudMed, EMBASE, Scopus, Web of Science). The success of fertility treatments was compared between telemedicine and in-office care, and patient satisfaction with ART through telemedicine was assessed. Eleven studies, comprising 4697 patients, were identified. Quality assessment (Joanna Briggs Institute Critical Appraisal and revised Cochrane risk-of-bias tools) revealed an acceptable risk of bias for both randomized controlled trials and observational studies. Using a fixed-effects model, telemedicine was comparable to in-person care regarding the pregnancy rate achieved (odds ratio 1.02, 95% confidence intervals 0.83-1.26, Pâ¯=â¯0.83). A Q-test suggested that all the included studies were homogeneous. Patients who received telemedicine during fertility treatment reported a high level of satisfaction (91%, 95% confidence intervals 80-96%). Egger's test confirmed that no publication bias was found. Telemedicine could serve as a complementary tool during fertility treatment to facilitate patients' satisfaction and overcome some practical problems without compromising treatment outcomes. Future studies should continue exploring the potential applications of telemedicine in assisted reproduction.
Assuntos
Satisfação do Paciente , Técnicas de Reprodução Assistida , Telemedicina , Humanos , Feminino , Gravidez , Taxa de GravidezRESUMO
OBJECTIVES: The purpose of this study was to develop and provide initial psychometric support for the Racially Biased Reasoning Scale-Police (RBias-Police). The vignette-based RBias-Police is designed to capture rigid racially biased beliefs. The items focus on police interactions with people of color as this is a particularly emotional-laden issue in the United States that signifies deeper racial and social intolerance. METHOD: Data from a combined sample of 1,156 participants were collected through Mechanical Turk for two interrelated studies. In the first study, we used matrix sampling and exploratory structural equation modeling to explore the factor structure of RBias-Police. In the second study, we conducted confirmatory factor analysis and explored the construct validity with theoretically relevant concepts. RESULTS: In Study 1, we found that 10 items with three factors solution captured the data across each of the six vignettes: (a) Minimization of Racism, (b) Target Apathy, and (c) Target Blaming. In Study 2, findings from confirmatory factor analysis supported that the three-factor model was a good fit to the data. The RBias-Police factors were positively related to color-blind racial ideology and the general belief in a just world in theoretically expected ways. CONCLUSIONS: Across two studies, our findings provide initial psychometric support for the RBias-Police; this new measure captures both affective and cognitive dimensions of biased reasoning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Assuntos
Polícia , Racismo , Humanos , Estados Unidos , Pigmentação da Pele , Racismo/psicologia , Grupos Raciais/psicologia , PsicometriaRESUMO
Twenty novel Mn, Fe, and Cu complexes of ethylene cross-bridged tetraazamacrocycles with potentially copolymerizable allyl and benzyl pendant arms were synthesized and characterized. Multiple X-ray crystal structures demonstrate the cis-folded pseudo-octahedral geometry forced by the rigidifying ethylene cross-bridge and show that two cis coordination cites are available for interaction with substrate and oxidant. The Cu complexes were used to determine kinetic stability under harsh acidic and high-temperature conditions, which revealed that the cyclam-based ligands provide superior stabilization with half-lives of many minutes or even hours in 5 M HCl at 50-90 °C. Cyclic voltammetry studies of the Fe and Mn complexes reveal reversible redox processes indicating stabilization of Fe2+/Fe3+ and Mn2+/Mn3+/Mn4+ oxidation states, indicating the likelihood of catalytic oxidation for these complexes. Finally, dye-bleaching experiments with methylene blue, methyl orange, and rhodamine B demonstrate efficient catalytic decolorization and allow selection of the most successful monomeric catalysts for copolymerization to produce future heterogeneous water purification materials.
RESUMO
PM2.5 exposure data are important for air quality management. Optimal planning and determination of locations where PM2.5 is continuously monitored are important for urban areas in Ho Chi Minh City (HCMC), a megacity with specific environmental problems. Objectives of the study to propose an automatic monitoring system network (AMSN) to measure outdoor PM2.5 concentrations in HCMC using low-cost sensors. Data related to the current monitoring network, population, population density, threshold reference standards set by the National Ambient Air Quality Standard (NAAQS) and the World Health Organisation (WHO), and inventory emissions from various sources, both anthropogenic and biogenic, were obtained. Coupled WRF/CMAQ models were used to simulate PM2.5 concentrations in HCMC. The simulation results were extracted from the grid cells, from which the values of points exceeding the set thresholds were determined. The population coefficient was calculated to determine the corresponding total score (TS). Optimisation of the monitoring locations was statistically performed using Student's t-test to select the official locations for the monitoring network. TS values ranged from 0.0031 to 3215.9. The TSmin value was reached in the Can Gio district and the TSmax value was reached in SG1. Based on the t-test results, 26 initial locations were proposed for a preliminary configuration, from which 10 optimal monitoring sites were selected to develop the AMSN of outdoor PM2.5 concentration measurements in HCMC towards 2025.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Material Particulado , Humanos , Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Cidades , Monitoramento Ambiental/métodos , Material Particulado/análiseRESUMO
PURPOSE: To investigate the effects of goal-directed fluid therapy (GDFT) or conventional fluid therapy (CFT) in improving postoperative outcomes in patients undergoing colorectal surgeries. DESIGN: Evidence-Based Review. METHODS: Following the guidelines outlined in the PRISMA statement, a comprehensive search was conducted using PubMed, Elsevier ScienceDirect, Oxford Academic, EBSCO, Google Scholar, Cochrane Library, and gray literature. Only randomized controlled studies and preappraised evidence such as systematic review with meta-analysis examining the effects of GDFT and CFT in colorectal surgery were included. The quality appraisal of the literature was conducted using the proposed algorithm described in the Johns Hopkins Nursing Evidence-Based Practice Evidence Level and Quality Guide. FINDINGS: Two systematic reviews with meta-analyses and four randomized controlled trials (RCT) involving 2018 patients were included in this review. Overall, the use of GDFT did not shorten the hospital length of stay (LOS), reduce 30-day mortality, lower overall morbidity rates, or decrease incidence of postoperative ileus. Additionally, the return of bowel function was not improved using GDFT or CFT. However, when GDFT was implemented within enhanced recovery after surgery (ERAS) programs, there was a significant reduction in hospital LOS. . When GDFT was used in a non-ERAS patient care setting, there was a significant reduction in overall morbidity rate and faster time to first flatus. All studies included in the review were categorized as Level I and rated Grade A, implying strong confidence in the true effects of GDFT on all outcome measures in the review. CONCLUSIONS: The benefits of GDFT in colorectal surgery are still unclear. Considerable heterogeneity based on the types of GDFT devices, patient outcome parameters, and fluid protocols limit the application to clinical practice. Furthermore, there was limited data on the effects of GDFT in high-risk patients for colorectal surgery.
Assuntos
Cirurgia Colorretal , Procedimentos Cirúrgicos do Sistema Digestório , Humanos , Hidratação/métodos , Objetivos , Tempo de Internação , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Ethylene cross-bridged tetraazamacrocycles are known to produce kinetically stable transition metal complexes that can act as robust oxidation catalysts under harsh aqueous conditions. We have synthesized ligand analogs with single acetate pendant arms that act as pentadentate ligands to Mn, Fe, Co, Ni, Cu, and Zn. These complexes have been synthesized and characterized, including the structural characterization of four Co and Cu complexes. Cyclic voltammetry demonstrates that multiple oxidation states are stabilized by these rigid, bicyclic ligands. Yet, redox potentials of the metal complexes are modified compared to the "parent" ligands due to the pendant acetate arm. Similarly, gains in kinetic stability under harsh acidic conditions, compared to parent complexes without the pendant acetate arm, were demonstrated by a half-life seven times longer for the cyclam copper complex. Due to the reversible, high oxidation states available for the Mn and Fe complexes, the Mn and Fe complexes were examined as catalysts for the bleaching of three commonly used pollutant model dyes (methylene blue, methyl orange, and Rhodamine B) in water with hydrogen peroxide as oxidant. The efficient bleaching of these dyes was observed.
Assuntos
Complexos de Coordenação , Ciclamos , Elementos de Transição , Complexos de Coordenação/química , Cristalografia por Raios X , Etilenos/química , Ligantes , OxirreduçãoRESUMO
BACKGROUND: Robust serological assays are essential for long-term control of the COVID-19 pandemic. Many recently released point-of-care (PoCT) serological assays have been distributed with little premarket validation. METHODS: Performance characteristics for 5 PoCT lateral flow devices approved for use in Australia were compared to a commercial enzyme immunoassay (ELISA) and a recently described novel surrogate virus neutralization test (sVNT). RESULTS: Sensitivities for PoCT ranged from 51.8% (95% confidence interval [CI], 43.1%-60.4%) to 67.9% (95% CI, 59.4%-75.6%), and specificities from 95.6% (95% CI, 89.2%-98.8%) to 100.0% (95% CI, 96.1%-100.0%). ELISA sensitivity for IgA or IgG detection was 67.9% (95% CI, 59.4%-75.6%), increasing to 93.8% (95% CI, 85.0%-98.3%) for samples >14 days post symptom onset. sVNT sensitivity was 60.9% (95% CI, 53.2%-68.4%), rising to 91.2% (95% CI, 81.8%-96.7%) for samples >14 days post symptom onset, with specificity 94.4% (95% CI, 89.2%-97.5%). CONCLUSIONS: Performance characteristics for COVID-19 serological assays were generally lower than those reported by manufacturers. Timing of specimen collection relative to onset of illness or infection is crucial in reporting of performance characteristics for COVID-19 serological assays. The optimal algorithm for implementing serological testing for COVID-19 remains to be determined, particularly in low-prevalence settings.
Assuntos
Infecções por Coronavirus/sangue , Pneumonia Viral/sangue , Algoritmos , Anticorpos Antivirais/sangue , Austrália/epidemiologia , Betacoronavirus/isolamento & purificação , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Ensaio de Imunoadsorção Enzimática , Humanos , Imunoglobulina A/sangue , Imunoglobulina G/sangue , Testes de Neutralização/métodos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Prevalência , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , SARS-CoV-2 , Testes Sorológicos/métodos , Testes Sorológicos/normasRESUMO
OBJECTIVES: To design and evaluate 3D-printed nasal swabs for collection of samples for SARS-CoV-2 testing. DESIGN: An iterative design process was employed. Laboratory evaluation included in vitro assessment of mock nasopharyngeal samples spiked with two different concentrations of gamma-irradiated SARS-CoV-2. A prospective clinical study compared SARS-CoV-2 and human cellular material recovery by 3D-printed swabs and standard nasopharyngeal swabs. SETTING, PARTICIPANTS: Royal Melbourne Hospital, May 2020. Participants in the clinical evaluation were 50 hospital staff members attending a COVID-19 screening clinic and two inpatients with laboratory-confirmed COVID-19. INTERVENTION: In the clinical evaluation, a flocked nasopharyngeal swab sample was collected with the Copan ESwab and a mid-nasal sample from the other nostril was collected with the 3D-printed swab. RESULTS: In the laboratory evaluation, qualitative agreement with regard to SARS-CoV-2 detection in mock samples collected with 3D-printed swabs and two standard swabs was complete. In the clinical evaluation, qualitative agreement with regard to RNase P detection (a surrogate measure of adequate collection of human cellular material) in samples collected from 50 hospital staff members with standard and 3D-printed swabs was complete. Qualitative agreement with regard to SARS-CoV-2 detection in three pairs of 3D-printed mid-nasal and standard swab samples from two inpatients with laboratory-confirmed SARS-CoV-2 was also complete. CONCLUSIONS: Using 3D-printed swabs to collect nasal samples for SARS-CoV-2 testing is feasible, acceptable to patients and health carers, and convenient.
Assuntos
Técnicas de Laboratório Clínico/instrumentação , Infecções por Coronavirus/diagnóstico , Técnicas de Diagnóstico do Sistema Respiratório/instrumentação , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Impressão Tridimensional , Adulto , Betacoronavirus/isolamento & purificação , COVID-19 , Teste para COVID-19 , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nasofaringe/virologia , Pandemias , SARS-CoV-2Assuntos
Algoritmos , Cromossomos Humanos X , Feto/metabolismo , Monossomia/diagnóstico , Mosaicismo , Diagnóstico Pré-Natal , Adulto , Aberrações Cromossômicas/estatística & dados numéricos , Cromossomos Humanos X/genética , Reações Falso-Positivas , Feminino , Feto/patologia , Humanos , Testes para Triagem do Soro Materno/métodos , Testes para Triagem do Soro Materno/estatística & dados numéricos , Monossomia/genética , Mosaicismo/estatística & dados numéricos , Mães/estatística & dados numéricos , Gravidez , Diagnóstico Pré-Natal/métodos , Diagnóstico Pré-Natal/estatística & dados numéricos , Síndrome de Turner/diagnóstico , Síndrome de Turner/epidemiologiaRESUMO
Importance: Because of increased suicide rates among Black youth in the past 2 decades, there is a dire need for research on suicidal ideation and risk factors in this population. Objective: To examine the direct and indirect associations between online racial discrimination and suicidal ideation through posttraumatic stress disorder symptoms among Black adolescents living in the US, with consideration of potential differential associations by gender and age. Design, Setting, and Participants: This cross-sectional study used data drawn from the first wave of the National Survey of Critical Digital Literacy. Black adolescents aged 11 to 19 years were selected from a nationally representative probability-based sample. Data were collected from October 2020 to December 2020 and analyzed from August 2021 to October 2021. Main Outcomes and Measures: Hypotheses of the current study were formulated during research design and grounded in empirical literature. The individual online racial discrimination subscale (Online Victimization Scale), the UCLA Child/Adolescent posttraumatic stress disorder Reaction Index for DSM-5, and an item from the second edition of the Children's Depression Inventory were used to assess constructs. Mediation was assessed through mediation models with path analyses using structural equation modeling. Results: Among a total 525 participants, 265 were girls (50.5%) and 251 were boys (47.8%); the mean (SD) age was 14.8 (2.5) years. Findings from structural equation modeling analysis indicated that individual online racial discrimination was associated with posttraumatic stress disorder symptoms (ß = 0.49, SE = 0.06, P < .001), and posttraumatic stress disorder symptoms were associated with suicidal ideation (ß = 0.51, SE = 0.06, P < .001). Posttraumatic stress disorder was identified as a full mediator between online racial discrimination and suicide (ß = 0.25, SE = 0.04, P < .001). No differences by gender or age were found. Furthermore, no significant direct association between online racial discrimination and suicidal ideation was found. Conclusions and Relevance: This study found an association between individual online racial discrimination and posttraumatic stress disorder symptoms and between posttraumatic stress disorder symptoms and suicidal ideation. These risk factors are important to consider in continuing studies of the cause of suicidal ideation for Black adolescents in the US.
Assuntos
Racismo , Transtornos de Estresse Pós-Traumáticos , Suicídio , Masculino , Feminino , Criança , Humanos , Adolescente , Ideação Suicida , Estudos Transversais , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologiaRESUMO
Objective This study aims to identify factors associated with mosaicism in human embryos at Hung Vuong Hospital. Methods We performed a retrospective analysis of data from 2018 to 2022, approved by the Hung Vuong Hospital Ethics Committee (CS/HV/23/15). We analyzed variables such as demographic characteristics, clinical measurements, and in-vitro fertilization (IVF) cycle outcomes to investigate their relationship with embryo mosaicism. Results A total of 73 couples undergoing IVF with preimplantation genetic testing (PGT) were included in the analysis. Among 308 embryos, 98 (31.8%) were mosaic, 124 (40.3%) were euploid, and 86 (27.9%) were aneuploid. Univariable analysis revealed that female age was significantly associated with increased odds of mosaicism (odd ratio (OR) = 1.11, 95% confidence interval (CI): 1.04 - 1.19, p = 0.003). Male age demonstrated a marginal association with mosaicism (OR = 1.05, 95% CI: 1.00 - 1.11, p = 0.07). Other factors, including body mass index (BMI), anti-Mullerian hormone (AMH) levels, blood types, and sperm quality, were not significantly associated with mosaicism. In the multivariable analysis, controlling for both female and male age, female age showed a trend toward significance (OR = 1.12, 95% CI: 1.02 - 1.23, p = 0.02), while male age showed no significant effect (OR = 0.99, 95% CI: 0.92 - 1.06, p = 0.75). Conclusions The findings suggest that female age is a critical factor influencing the occurrence of mosaicism in embryos. Further research is needed to fully understand the mechanisms underlying mosaicism in human embryos.
RESUMO
Key clinical message: In in vitro fertilization (IVF), laser offers several advantages. In this study, we employed laser to eliminate the zona pellucida of a contaminated embryo. This approach helps to rescue embryo with bacterial contamination, and improve embryo-endometrium interaction. Abstract: To present a case report on the removal of a contaminated zona pellucida from an embryo of patient with a history of recurrent implantation failure (RIF), which was followed by a successful live birth. We present the case of a 34-year-old patient with a history of 3 years of infertility who underwent in vitro fertilization. During the culture process, the embryos became contaminated, leading to three failed implantations. Despite the aneuploidy of the embryo and the implementation of a washing technique, the contamination persisted. In the final attempt, the contaminated zona pellucida was successfully removed using laser, followed by embryo transfer, resulting in a live birth. We provided detailed clinical information, including patient demographics, infertility history, ovarian response, evidence of bacterial contamination, embryo development, treatment protocols, and outcomes. Laser excision of the zona pellucida is a safe and effective method for addressing bacterial infection in embryos.
RESUMO
[This corrects the article DOI: 10.7759/cureus.52256.].
RESUMO
Objective Recurrent implantation failure (RIF) is a significant challenge in assisted reproduction. Genratest has emerged as a potential tool to identify the displaced window of implantation (WOI). This study aimed to evaluate the impact of this test on the pregnancy outcomes of RIF patients. Methods A retrospective analysis was conducted on 143 RIF patients who were categorized into two groups: the personalized embryo transfer (pET, n=69) group and standard embryo transfer (sET, n=74) group. The main measured outcomes were clinical pregnancy, ongoing pregnancy, miscarriage, and live birth rates. Results Genratest effectively diagnoses the displaced WOI in 90% of RIF patients. The pET group exhibited a higher rate of clinical pregnancy (n=36/69, 52.2%) compared to the sET group (n=35/74, 47.3%), but this difference was not statistically significant (p=0.679). Ongoing pregnancy rates were comparable between the pET (n=28/69, 40.6%) and the sET (n=30/74, 40.5%) groups (p=0.996). Live birth rates showed no statistically significant difference between the two groups (n=26/69, 37.7% versus n=22/74, 29.7%, p=0.407). Miscarriage rates were similar in both groups (n=9/69, 13% versus n=11/74, 14.9%, p=0.942). Conclusions pET based on the results of the Genratest did not show a significant improvement in pregnancy outcomes, including clinical pregnancy, ongoing pregnancy, live birth, or miscarriage rates. Further research is needed to identify the role of Genratest in RIF patients.
RESUMO
BACKGROUND: Avian influenza (AI) is a contagious disease that causes illness and death in poultry and humans. High pathogenicity AI (HPAI) H5N6 outbreaks commonly occur in Quang Ninh province bordering China. In June 2021, the first HPAI H5N8 outbreak occurred at a Quang Ninh chicken farm. OBJECTIVES: This study examined the risk factors associated with HPAI H5N6 and H5N8 outbreaks in Quang Ninh. METHODS: A retrospective case-control study was conducted in Quang Ninh from Nov 2021 to Jan 2022. The cases were households with susceptible poultry with two or more clinical signs and tested positive by real-time reverse transcription polymerase chain reaction. The controls were households in the same village as the cases but did not show clinical symptoms of the disease. Logistic regression models were constructed to assess the risk factors associated with HPAI outbreaks at the household level. RESULTS: There were 38 cases with H5N6 clade 2.3.4.4h viruses (n = 35) and H5N8 clade 2.3.4.4b viruses (n = 3). Compared to the 112 controls, raising poultry in uncovered or partially covered ponds (odds ratio [OR], 7.52; 95% confidence interval [CI], 1.44-39.27), poultry traders visiting the farm (OR, 8.66; 95% CI, 2.7-27.69), farms with 50-2,000 birds (OR, 3.00; 95% CI, 1.06-8-51), and farms with ≥ 2,000 birds (OR, 11.35; 95% CI, 3.07-41.94) were significantly associated with HPAI outbreaks. CONCLUSIONS: Combining biosecurity measures, such as restricting visitor entry and vaccination in farms with more than 50 birds, can enhance the control and prevention of HPAI in Quang Ninh and its spread across borders.
Assuntos
Vírus da Influenza A Subtipo H5N8 , Influenza Aviária , Doenças das Aves Domésticas , Animais , Humanos , Influenza Aviária/epidemiologia , Estudos Retrospectivos , Estudos de Casos e Controles , Vietnã/epidemiologia , Surtos de Doenças/veterinária , Surtos de Doenças/prevenção & controle , Aves Domésticas , GalinhasRESUMO
OBJECTIVE: To describe the experiences of perinatal Black, Indigenous, and other People of Color (BIPOC) women in healthcare interactions. METHODS: We conducted eight virtual focus groups with perinatal BIPOC women across the USA from November 2021 to March 2022. A semi-structured interview protocol was used, and focus groups were audio recorded and transcribed verbatim. Our team used reflexive thematic analysis to analyze the qualitative data and describe our findings. RESULTS: Three latent themes emerged related to racial trauma in healthcare interactions: (1) observations and experiences of anti-Black bias, (2) experiences of dismissal of pain and withholding of care, particularly among Black and Latinx patients, and (3) common race-based traumatic experiences across all BIPOC women, including a consistent lack of bodily autonomy and deferral to White people for decision-making. Recommendations from participants included more transparent communication and greater empathic care for all patients, with calls to specifically address anti-Black bias in healthcare treatment. CONCLUSION: The study's findings suggest that perinatal healthcare needs to reduce mental stress and exposure to racial trauma for perinatal BIPOC women. This study offers a discussion of implications for future training for healthcare providers and implications for addressing systemic racial disparities in perinatal mental health.
Assuntos
Atenção à Saúde , Pigmentação da Pele , Gravidez , Feminino , Humanos , Serviços de Saúde , Saúde Mental , BrancosRESUMO
Understanding how parents, and other primary caregivers, perceive and experience early childhood programs and services is essential for identifying family-centered facilitators and barriers to service utilization. Therefore, this paper aims to explore parent knowledge of and experiences with community efforts of an early childhood system in Illinois: the All Our Kids Early Childhood Networks (AOK Networks). Our research team conducted focus group interviews with 20 parents across four Illinois counties. A semi-structured interview guide was used to examine parent perceptions of an early childhood system's community efforts in promoting the health and well-being of children aged from birth to five. Thematic network analysis was used to analyze all focus group data. Parents indicated three salient themes, including: (1) comprehensive information sharing practices, (2) diverse service engagement, and (3) barriers to service access. Overall, parents reported general satisfaction with the quality of available services and provided feedback regarding identified areas of need to increase the accessibility and utilization of local services. Engaging parents as partners is essential to the effective implementation of family-centered early childhood services. Families are the experts of their lived experiences, and incorporating their voices in program development and evaluation efforts works to increase positive child and family outcomes.
RESUMO
Ho Chi Minh City (HCMC) is changing and expanding quickly, leading to environmental consequences that seriously threaten human health. PM2.5 pollution is one of the main causes of premature death. In this context, studies have evaluated strategies to control and reduce air pollution; such pollution-control measures need to be economically justified. The objective of this study was to assess the socio-economic damage caused by exposure to the current pollution scenario, taking 2019 as the base year. A methodology for calculating and evaluating the economic and environmental benefits of air pollution reduction was implemented. This study aimed to simultaneously evaluate the impacts of both short-term (acute) and long-term (chronic) PM2.5 pollution exposure on human health, providing a comprehensive overview of economic losses attributable to such pollution. Spatial partitioning (inner-city and suburban) on health risks of PM2.5 and detailed construction of health impact maps by age group and sex on a spatial resolution grid (3.0 km × 3.0 km) was performed. The calculation results show that the economic loss from premature deaths due to short-term exposure (approximately 38.86 trillion VND) is higher than that from long-term exposure (approximately 14.89 trillion VND). As the government of HCMC has been developing control and mitigation solutions for the Air Quality Action Plan towards short- and medium-term goals in 2030, focusing mainly on PM2.5, the results of this study will help policymakers develop a roadmap to reduce the impact of PM2.5 during 2025-2030.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Humanos , Poluentes Atmosféricos/análise , Material Particulado/análise , Poluição do Ar/análise , Cidades , Exposição Ambiental/análise , ChinaRESUMO
In early 2020, the Medical Biology Laboratory of the Pasteur Institute of Cambodia isolated an unusually high number of fluoroquinolone-resistant Salmonella enterica subspecies enterica serovar Paratyphi A strains during its routine bacteriological surveillance activities in Phnom Penh, Cambodia. A public-health investigation was supported by genome sequencing of these Paratyphi A strains to gain insights into the genetic diversity and population structure of a potential outbreak of fluoroquinolone-resistant paratyphoid fever. Comparative genomic and phylodynamic analyses revealed the 2020 strains were descended from a previously described 2013-2015 outbreak of Paratyphi A infections. Our analysis showed sub-lineage 2.3.1 had remained largely susceptible to fluoroquinolone drugs until 2015, but acquired chromosomal resistance to these drugs during six separate events between late 2012 and 2015. The emergence of fluoroquinolone resistance was rapidly followed by the replacement of the original susceptible Paratyphi A population, which led to a dramatic increase of fluoroquinolone-resistant blood-culture-confirmed cases in subsequent years (2016-2020). The rapid acquisition of resistance-conferring mutations in the Paratyphi A population over a 3 year period is suggestive of a strong selective pressure on that population, likely linked with fluoroquinolone use. In turn, emergence of fluoroquinolone resistance has led to increased use of extended-spectrum cephalosporins like ceftriaxone that are becoming the drug of choice for empirical treatment of paratyphoid fever in Cambodia.
Assuntos
Febre Paratifoide , Salmonella paratyphi A , Humanos , Salmonella paratyphi A/genética , Febre Paratifoide/epidemiologia , Fluoroquinolonas/farmacologia , Fluoroquinolonas/uso terapêutico , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Sorogrupo , Camboja/epidemiologia , Filogenia , Farmacorresistência Bacteriana/genética , Surtos de DoençasRESUMO
The COVID-19 pandemic has necessitated the rapid development and implementation of whole-genome sequencing (WGS) and bioinformatic methods for managing the pandemic. However, variability in methods and capabilities between laboratories has posed challenges in ensuring data accuracy. A national working group comprising 18 laboratory scientists and bioinformaticians from Australia and New Zealand was formed to improve data concordance across public health laboratories (PHLs). One effort, presented in this study, sought to understand the impact of the methodology on consensus genome concordance and interpretation. SARS-CoV-2 WGS proficiency testing programme (PTP) data were retrospectively obtained from the 2021 Royal College of Pathologists of Australasia Quality Assurance Programmes (RCPAQAP), which included 11 participating Australian laboratories. The submitted consensus genomes and reads from eight contrived specimens were investigated, focusing on discordant sequence data and findings were presented to the working group to inform best practices. Despite using a variety of laboratory and bioinformatic methods for SARS-CoV-2 WGS, participants largely produced concordant genomes. Two participants returned five discordant sites in a high-Cτ replicate, which could be resolved with reasonable bioinformatic quality thresholds. We noted ten discrepancies in genome assessment that arose from nucleotide heterogeneity at three different sites in three cell-culture-derived control specimens. While these sites were ultimately accurate after considering the participants' bioinformatic parameters, it presented an interesting challenge for developing standards to account for intrahost single nucleotide variation (iSNV). Observed differences had little to no impact on key surveillance metrics, lineage assignment and phylogenetic clustering, while genome coverage <90â% affected both. We recommend PHLs bioinformatically generate two consensus genomes with and without ambiguity thresholds for quality control and downstream analysis, respectively, and adhere to a minimum 90â% genome coverage threshold for inclusion in surveillance interpretations. We also suggest additional PTP assessment criteria, including primer efficiency, detection of iSNVs and minimum genome coverage of 90â%. This study underscores the importance of multidisciplinary national working groups in informing guidelines in real time for bioinformatic quality acceptance criteria. It demonstrates the potential for enhancing public health responses through improved data concordance and quality control in SARS-CoV-2 genomic analysis during pandemic surveillance.