Clustered regularly interspaced palindromic repeats-cas9-based strategies towards HIV eradication: A literature review.

OBJECTIVE: Despite Human Immunodeficiency Virus (HIV) being a major global health burden, no currently available therapy can eliminate it. One of the major challenges in developing treatment is the presence of latent HIV reservoirs. On the other hand, development of Clustered Regularly Interspaced Palindromic Repeats-Cas9 (CRISPR-Cas9) has made genome editing possible and thus can be used to address HIV latency and successfully treat HIV. This literature review aims to identify and appraise existing CRISPR-Cas9 strategies that address HIV treatment, particularly during latency. METHODS: The PubMed Database was used to retrieve relevant articles. This review included articles that mentioned the use of CRISPR-Cas9 as a treatment for HIV and are written in English and/or Indonesian language. RESULTS: The included studies (n = 17) showed that the CRISPR-Cas9 system can be utilized to disrupt the HIV-1 genome to inhibit viral reproduction and virulence. This system can be further optimized by combining several CRISPR-Cas9 systems. However, the use of CRISPR-Cas9 may cause HIV resistance, particularly to its guide RNA. This technique has also never been applied in vivo, thus more research is needed before wider implementation. A limitation of this review is the lack of data regarding CRISPR-Cas9 systems quality in some studies, thus limiting appraisal. CONCLUSIONS: While the use of CRISPR-Cas9 to cure HIV seems promising, further studies regarding CRISPR-Cas9 quality, potential for development of gRNA-resistant HIV-1 strains and in vivo demonstration of the techniques are needed to progress this concept toward HIV eradication.

Anxiety and its risk factors among non-Japanese residents living in Japan undergoing COVID-19 situation: A cross-sectional survey.

INTRODUCTION: In the context of collective efforts taken in Japan to control the spread of COVID-19, the state of emergency and social distancing have caused a negative impact on the mental health of all residents, including foreign communities in Japan. This study aimed to evaluate the level of anxiety and its associated factors among non-Japanese residents residing in Japan during the COVID-19 pandemic. METHODS: A web-based survey in 13 languages was conducted among non-Japanese residents living in Japan during the COVID-19 situation. The State-Trait Anxiety Inventory assessed the level of anxiety-State (STAI-S) scores prorated from its six-item version. The multivariable logistic regression using the Akaike Information Criterion (AIC) method was performed to identify the associated factors of anxiety among participants. RESULTS: From January to March 2021, we collected 392 responses. A total of 357 valid responses were analyzed. 54.6% of participants suffered from clinically significant anxiety (CSA). In multivariable logistic model analysis, the CSA status or the high level of anxiety was associated with three factors, including having troubles/difficulties in learning or working, decreased sleep duration, and decreased overall physical health (p<0.05). CONCLUSION: Our study suggests several possible risk factors of anxiety among non-Japanese residents living in Japan undergoing the COVID-19 pandemic, including the troubles or difficulties in learning or working, the decrease in sleep duration, and the decrease in overall physical health.

Langya virus outbreak: current challenges and lesson learned from previous henipavirus outbreaks in China, Australia, and Southeast Asia.

Background and aims: A new novel virus, Langya virus (LayV), was detected in China in August 2022, 3 years after the COVID-19 pandemic. LayV is similar to the previously discovered Mojiang henipavirus. Other zoonotic henipaviruses include the Hendra and Nipah viruses. The emergence of the zoonotic Langya virus is attributed to climate change and wildlife encroachment, as LayV is detected in shrews. Those who are infected in China showed various symptoms, but no deaths have been recorded yet. This review aims to shed light on the current state of Langya virus outbreak, its infection control efforts, and the remaining challenges that need to be addressed to curb the outbreak. Methods: We utilized online publication databases such as PubMed, Google Scholar, and Scopus in writing this review article. Results: A surveillance study on thirty-five febrile patients in Eastern China identified the Langya virus outbreak. The current efforts from the Chinese government and health authorities to reduce the transmission and spread of Langya virus such as isolation and characterization of LayV, challenges associated with the increase in cases of LayV, and trackable recommendations such as strengthening the healthcare system in China, sensitization of people about risks associated with Langya virus outbreaks, creating an intensive surveillance system network, etc. were discussed. Conclusion: It is germane and pertinent that the Chinese government and health authorities continue to intensify efforts against Langya virus and address the challenges to effectively reduce transmission.

Adaptation of health systems to climate change-related infectious disease outbreaks in the ASEAN: Protocol for a scoping review of national and regional policies.

BACKGROUND: The Association of South-East Asian Nations (ASEAN) member states (AMS) are among the countries most at risk to the impacts of climate change on health and outbreaks being a major hotspot of emerging infectious diseases. OBJECTIVE: To map the current policies and programs on the climate change adaptation in the ASEAN health systems, with particular focus on policies related to infectious diseases control. METHODS: This is a scoping review following the Joanna Briggs Institute (JBI) methodology. Literature search will be conducted on the ASEAN Secretariat website, government websites, Google, and six research databases (PubMed, ScienceDirect, Web of Science, Embase, World Health Organization (WHO) Institutional Repository Information Sharing (IRIS), and Google Scholar). The article screening will be based on specified inclusion and exclusion criteria. Policy analysis will be conducted in accordance with the WHO operational framework on climate-resilient health systems. Findings will be analyzed in the form of narrative report. The reporting of this scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). ETHICS AND DISSEMINATION: Ethical approval is not required for this study as this is a scoping review protocol. Findings from this study will be disseminated through electronic channels.

Can Thailand achieve COVID-19 herd immunity?

The COVID-19 outbreak has had a great impact on the social, economic, and health systems of Thailand. A variety of measures to curb the spread of the disease were implemented since the beginning of the pandemic, including a strict national lockdown protocol. The Thai government aimed to achieve herd immunity through an efficient vaccination programme. Initially, vaccine supply shortage and a lack of vaccine options plagued the health system, but this has since been improved. Continuous monitoring of the situation through research is being carried out to assess the level of immunity among the population whereby the current general recommendation is presently a fourth booster dose for adults. Hurdles towards achieving herd immunity remain. One such issue is the low level of vaccine literacy among those that are unvaccinated or inadequately vaccinated. Another obstacle is the sizeable rate of hesitancy towards getting booster doses. Achieving herd immunity in the Thai population would require multilateral cooperation, improved health promotion to target population groups, such as older adults, and a developed distribution system for those with limited access, such as those in the rural areas.

Accelerating Indonesian COVID-19 vaccination rollout: a critical task amid the second wave.

Coronavirus disease-19 (COVID-19) has been spreading in every part of the world, putting nations at risk with its pandemic status, including Indonesia. COVID-19 vaccine has been deemed as one of the most effective interventions to date for mitigating the spread and mortality from COVID-19. Responding to the situation, the Government of Indonesia (GOI) has allocated the means necessary to procure and distribute COVID-19 vaccines; placing into consideration the unique context of the country, recently categorized as a middle-income country and archipelagic with a population over 270 million. This article aims to present the challenges associated with the distribution of COVID-19 vaccination as well as recommendations to mitigate them, to ensure a timely and effective COVID-19 vaccination program in Indonesia.

Dengue and COVID-19 infections in the ASEAN region: a concurrent outbreak of viral diseases.

Member countries of the Association of Southeast Asian Nations (ASEAN) have faced dengue outbreaks for decades, and the region has one of the highest rates of dengue globally. Outbreaks continue to occur concurrently with the coronavirus disease 2019 (COVID-19) pandemic in the 10 ASEAN countries. Both infectious diseases pose a tremendous burden in these countries related to both infection control and the economy. Increases in the number of dengue cases occurred in part due to disruptions in the pathogen-host-vector relationship caused by changes in human behaviour in response to the COVID-19 pandemic. The spread of dengue was further aggravated by the implementation of lockdowns and social distancing policies. These measures limited the coverage of dengue preventive programs and delayed the medical management of both diseases due to co-infection and misdiagnosis. It is of the utmost importance for the population to remain aware of both diseases, and dengue vector control strategies must be devised to properly address outbreaks using digitalization and remote surveillance. Similarly, critical triage algorithms and further research are also needed to combat co-infection and misdiagnosis. Controlling the spread of COVID-19 though vaccination should also be undertaken to reduce the impact of the pandemic.

Strengthening Virology Research in the Association of Southeast Asian Nations: Preparing for Future Pandemics.

The Association of Southeast Asian Nations (ASEAN) region is known to be a global hotspot to viral outbreaks because of many factors. To limit the impact of future outbreaks, it is crucial for the ASEAN governments to strengthen regional virology research capacity. The ASEAN governments have collaborated in several virology initiatives, with the most recent being the establishment of the ASEAN Regional Center for Public Health Emergencies and Emerging Diseases. However, several challenges, including technology disparities, nationalistic tendencies, and the lack of public acceptance toward virus sharing, need to be addressed to maximize the region's collaboration potential in virology research. We recommend the governments to 1) prioritize the strengthening of research capacities; 2) develop stronger cooperation and possible centralization of efforts on top of national capacities; 3) develop an equitable and secure research framework; and 4) improve the public awareness regarding the importance of regional public health responses.

Yemen's triple emergency: Food crisis amid a civil war and COVID-19 pandemic.

Yemen has been termed as the world's worst humanitarian crisis by the United Nations. About 20.1 million (more than 50% of population) Yemenis are facing hunger and 10 million are severely food insecure according to reports by the World Food Programme. With the spread of COVID-19, the situation in Yemen has worsened and humanitarian aid from other countries has become the basis of life for hundreds of thousands of Yemenis after the threat of famine. Yemen is practically one of the poorest countries in the world. It has structural vulnerabilities that have developed over a protracted period of conflict and poor governance and more than 50% live in starving, they suffer for getting one meal a day. To prevent a total collapse of Yemen's food crises, the government and the international community should act now more decisively.

Increased Estradiol Levels Effect on Leptin Expression in Midluteal Endometrial Tissue of Macaca Nemestrina (Southern Pig-Tailed Macaques).

Objective: To measure the effect of serum estradiol (E2) levels on leptin expression in Macaca nemestrina (southern pig-tailed macaque) endometrial tissue. Materials and methods: This study used paraffin-embedded midluteal phase endometrial tissue blocks of Macaca nemestrina from previous study. Included subjects were 15 female macaques of reproductive age (8-10 years) with a previous history of producing offspring, which were divided into four groups: groups administered with 30 IU, 50 IU, and 70 IU r-FSH (intervention group), and no r-FSH (control group). The stimulation was done following GnRH agonist long protocol. Staining was done using immunohistochemistry. Leptin expression was measured using immunohistochemistry (IHC) Profiler plugin of ImageJ software and counted semi-quantitatively as Histological Score (Hscore). Results: Correlation between E2 concentration to stromal leptin expression was observed (p=0.043). Conclusion: Serum estradiol concentration is found to be correlated with leptin expression in Macaca nemestrina, suggesting a mechanism of decreasing endometrial receptivity among women undergoing controlled ovarian hyperstimulation.

Gene Therapy for Angelman Syndrome: Contemporary Approaches and Future Endeavors.

BACKGROUND: Angelman Syndrome (AS) is a congenital non inherited neurodevelopmental disorder. The contemporary AS management is symptomatic and it has been accepted that gene therapy may play a key role in the treatment of AS. OBJECTIVE: The purpose of this study is to summarize existing and suggested gene therapy approaches to Angelman syndrome. METHODS: This is a literature review. Pubmed and Scopus databases were researched with keywords (gene therapy, Angelman's syndrome, neurological disorders, neonates). Peer-reviewed studies that were closely related to gene therapies in Angelman syndrome and available in English, Greek, Ukrainian or Indonesian were included. Studies that were published before 2000 were excluded and did not align with the aforementioned criteria. RESULTS: UBE3A serves multiple roles in signaling and degradation procedures. Although the restoration of UBE3A expression rather than targeting known activities of the molecule would be the optimal therapeutic goal, it is not possible so far. Reinstatement of paternal UBE3A appears as an adequate alternative. This can be achieved by administering topoisomerase-I inhibitors or reducing UBE3A antisense transcript (UBE3A-ATS), a molecule which silences paternal UBE3A. CONCLUSION: Understanding UBE3A imprinting unravels the path to an etiologic treatment of AS. Gene therapy models tested on mice appeared less effective than anticipated pointing out that activation of paternal UBE3A cannot counteract the existing CNS defects. On the other hand, targeting abnormal downstream cell signaling pathways has provided promising rescue effects. Perhaps, combined reinstatement of paternal UBE3A expression with abnormal signaling pathways-oriented treatment is expected to provide better therapeutic effects. However, AS gene therapy remains debatable in pharmacoeconomics and ethics context.