Role of geopolitical risk, currency fluctuation, and economic policy on tourist arrivals: temporal analysis of BRICS economies.

The tourism industry is vulnerable to a range of economic and political factors, which can have both short-term and long-term impacts on tourist arrivals. The study aims to investigate the temporal dynamics of these factors and their impact on tourist arrivals. The method employed is a panel data regression analysis, using data from BRICS economies over a period of 1980-2020. The dependent variable is the number of tourist arrivals, while the independent variables are geopolitical risk, currency fluctuation, and economic policy. Control variables such as GDP, exchange rate, and distance to major tourist destinations are also included. The results show that geopolitical risk and currency fluctuation have a significant negative impact on tourist arrivals, while economic policy has a positive impact. The study also finds that the impact of geopolitical risk is stronger in the short term, while the impact of economic policy is stronger in the long term. Additionally, the study shows that the effects of these factors on tourist arrivals vary across BRICS countries. The policy implications of this study suggest that BRICS economies need to develop proactive economic policies that promote stability and encourage investment in the tourism industry.

A targeted approach with nanopore sequencing for the universal detection and identification of flaviviruses.

Nucleic acid test (NAT), most typically quantitative PCR, is one of the standard methods for species specific flavivirus diagnosis. Semi-comprehensive NATs such as pan-flavivirus PCR which covers genus Flavivirus are also available; however, further specification by sequencing is required for species level differentiation. In this study, a semi-comprehensive detection system that allows species differentiation of flaviviruses was developed by integration of the pan-flavivirus PCR and Nanopore sequencing. In addition, a multiplexing method was established by adding index sequences through the PCR with a streamlined bioinformatics pipeline. This enables defining cut-off values for observed read counts. In the laboratory setting, this approach allowed the detection of up to nine different flaviviruses. Using clinical samples collected in Vietnam and Brazil, seven different flaviviruses were also detected. When compared to a commercial NAT, the sensitivity and specificity of our system were 66.7% and 95.4%, respectively. Conversely, when compared to our system, the sensitivity and specificity of the commercial NAT were 57.1% and 96.9%, respectively. In addition, Nanopore sequencing detected more positive samples (n = 8) compared to the commercial NAT (n = 6). Collectively, our study has established a semi-comprehensive sequencing-based diagnostic system for the detection of flaviviruses at extremely affordable costs, considerable sensitivity, and only requires simple experimental methods.

Efficient Isolation and Long-term Red Fluorescent Nanodia-mond Labeling of Umbilical Cord Mesenchymal Stem Cells for the Effective Differentiation into Hepatocyte-like Cells

Abstract Fluorescent nanodiamond (FND) has been used for long-term cell labeling and in vivo cell tracking because they have good at photostability and biocompatibility. In this study, we evaluate the effect of fluorescent nanodiamond labeling on in vitro culture and differentiation of human umbilical cord mesenchymal stem cells (hUCMSCs) into hepatocyte-like cells (HLCs). For hepatic differentiation of hUCMSCs, cells were induced with human hepatocyte growth factor, nicotinamide and Dexamethasone. FND was supplied in two experimental groups with 20 μg/mL and 100 μg/mL in 2 hours. The cell was assessed for FND uptake by laser scan microscopy and flow cytometry methods. The effect of FND on hUCMSCs was evaluated by the cell viability and growth assays as well as the differentiation throughout of morphology alterations or gene expression of anfa-fetoprotein, albumin, and hepatocyte nuclear factor 4α. The results showed that the labeling of hUCMSCs is efficient and easy and there was significant cellular uptake of FND. We did not observe any negative impacts of FND to the cell viability and growth. FND can be utilized for the long-term labeling and tracking of hUCSCs and HLCs in vivo studies.

Impact of quaternary prevention as a brief intervention in medical students' clinical decisions: experience from Vietnam / Impacto da prevenção quaternária como intervenção breve nas decisões clínicas de estudantes de medicina: experiência do Vietnã / Impacto de la prevención cuaternaria como intervención breve en las decisiones clínicas de estudiantes de medicina: experiencia de Vietnam

Objective: to evaluate undergraduate medical students' clinical decision-making process after a brief intervention lecture on quaternary prevention (P4). Methods: quantitative self-controlled intervention study carried out with fifth-year medical students of Pham Ngoc Thach University, Hochiminh city, Vietnam. The medical students were asked to list their eventual interventions based on three different simulated clinical scenarios. The survey was conducted before and after the intervention. Student's propositions were classified into one of the four groups of prevention, according to Jamoulle's model. Results: 115 students participated, resulting in 211 answered sheets. The interventions proposed by the students were mostly centered on prevention groups 1, 2 and 3; the three clinical scenarios partially explained student's intentions of counseling, screening and palliative care. Comparing the data of second phase survey, the intervention was associated with changes in students' aptitude on clinical decision-making, which was especially more important for prevention group 1 (OR = 7.5) and prevention group 4 (OR = 30.05). There was no statistically significant difference in changing students' decision for prevention group 2 (OR = 0.95 p = 0.466) and prevention group 3 (OR = 2.29 p = 0.932). Conclusion: introducing quaternary prevention to the undergraduate medical course can help to steer clinical decisions toward primary prevention and to avoid inappropriate medical interventions.

Objetivo: avaliar o processo de tomada de decisão clínica por estudantes de graduação em medicina após uma breve intervenção sobre prevenção quaternária (P4). Métodos: estudo quantitativo de intervenção autocontrolada realizado com estudantes do quinto ano do curso de medicina da Pham Ngoc Thach University, na cidade de Hochiminh, Vietnam. Os estudantes foram convidados a listar suas eventuais intervenções com base em três diferentes cenários clínicos simulados. A pesquisa foi realizada antes e depois da intervenção. As proposições dos estudantes foram classificadas em um dos quatro grupos de prevenção, de acordo com o modelo de Jamoulle. Resultados: participaram 115 estudantes, resultando em 211 folhas de respostas. As intervenções propostas pelos estudantes foram principalmente centradas nos grupos de prevenção 1, 2 e 3; esses três cenários clínicos explicaram parcialmente as intenções dos estudantes para aconselhamento, rastreamento e cuidados paliativos. Comparando com os dados da segunda fase do estudo, a intervenção foi associada a mudanças na aptidão dos alunos no processo de tomada de decisão clínica, que foi especialmente importante para o grupo de prevenção 1 (OR = 7,5) e para o grupo de prevenção 4 (OR = 30,05). Não houve diferença estatisticamente significativa na mudança de decisão dos alunos para o grupo de prevenção 2 (OR = 0,95 p = 0,466) e para o grupo de prevenção 3 (OR = 2,29 p = 0,932). Conclusão: a introdução da prevenção quaternária no curso de graduação em medicina pode auxiliar a orientar as decisões clínicas em direção à prevenção primária e também a evitar intervenções médicas desnecessárias.

Objetivo: evaluar el proceso de toma de decisiones clínicas hecho por estudiantes de pregrado en medicina después de una breve intervención sobre la prevención cuaternaria (P4). Métodos: Estudio cuantitativo de intervención auto-controlado llevado a cabo con estudiantes de quinto año de medicina de la Pham Ngoc Thach Universidad en la ciudad de Hochiminh, Vietnam. Se pidió a los alumnos que enumerasen sus posibles intervenciones basadas en tres diferentes escenarios clínicos simulados. La encuesta se realizó antes y después de la intervención. Las proposiciones de los estudiantes se clasificaron en uno de los cuatro grupos de prevención, de acuerdo con el modelo de Jamoulle. Resultados: 115 estudiantes participaron, lo que resultó en 211 hojas de respuesta. Las intervenciones propuestas por los alumnos se centraron principalmente en los grupos de prevención 1, 2 y 3; estos tres escenarios clínicos explican parcialmente las intenciones de los estudiantes para la consejería, el cribado/tamizaje y la atención paliativa. En comparación con los datos de la segunda fase del estudio, la intervención se asoció con cambios en la capacidad de los estudiantes en el proceso de toma de decisiones clínicas, que fue especialmente importante para el grupo de prevención 1 (OR = 7,5) y para el grupo de prevención 4 (OR = 30,05). No hubo diferencia estadísticamente significativa en el cambio de decisión de los estudiantes para el grupo de prevención 2 (OR = 0,95 p = 0,466) y para el grupo de prevención 3 (OR = 2,29 p = 0,932). Conclusión: la introducción de la prevención cuaternaria en el pregrado en medicina puede ayudar a guiar las decisiones clínicas hacia la prevención primaria y también para evitar intervenciones médicas innecesarias.

Effectiveness of brief intervention and contact for suicide attempters: a randomized controlled trial in five countries.

OBJECTIVE: To determine whether brief intervention and contact is effective in reducing subsequent suicide mortality among suicide attempters in low and middle-income countries. METHODS: Suicide attempters (n = 1867) identified by medical staff in the emergency units of eight collaborating hospitals in five culturally different sites (Campinas, Brazil; Chennai, India; Colombo, Sri Lanka; Karaj, Islamic Republic of Iran; and Yuncheng, China) participated, from January 2002 to October 2005, in a randomized controlled trial to receive either treatment as usual, or treatment as usual plus brief intervention and contact (BIC), which included patient education and follow-up. Overall, 91% completed the study. The primary study outcome measurement was death from suicide at 18-month follow-up. FINDINGS: Significantly fewer deaths from suicide occurred in the BIC than in the treatment-as-usual group (0.2% versus 2.2%, respectively; chi2 = 13.83, P < 0.001). CONCLUSION: This low-cost brief intervention may be an important part of suicide prevention programmes for underresourced low- and middle-income countries.

Suicide attempts, plans, and ideation in culturally diverse sites: the WHO SUPRE-MISS community survey.

BACKGROUND: The objectives were to assess thoughts about suicide, plans to commit suicide and suicide attempts in the community, to investigate the use of health services following a suicide attempt, and to describe basic socio-cultural indices of the community. METHOD: The community survey was one component of the larger WHO multisite intervention study on suicidal behaviours (SUPRE-MISS). In each site, it aimed at randomly selecting and interviewing at least 500 subjects of the general population living in the catchment area of the emergency department where the intervention component of the study was conducted. Communities of eight SUPRE-MISS sites (in Brazil, China, Estonia, India, Iran, South Africa, Sri Lanka, and Viet Nam) participated plus two additional sites from Australia and Sweden conducting similar surveys. RESULTS: Suicide attempts (0.4-4.2%), plans (1.1-15.6%), and ideation (2.6-25.4%) varied by a factor of 10-14 across sites, but remained mostly within the ranges of previously published data. Depending on the site, the ratios between attempts, plans, and thoughts of suicide differed substantially. Medical attention following a suicide attempt varied between 22% and 88% of the attempts. CONCLUSIONS: The idea of the suicidal process as a continuous and smooth evolution from thoughts to plans and attempts of suicide needs to be further investigated as it seems to be dependent on the cultural setting. There are indications, that the burden of undetected attempted suicide is high in different cultures; an improved response from the health sector on how to identify and support these individuals is needed.