Climate change, human health, and the exposome: Utilizing OMIC technologies to navigate an era of uncertainty.

Climate change is an anthropogenic phenomenon that is alarming scientists and non-scientists alike. The emission of greenhouse gases is causing the temperature of the earth to rise and this increase is accompanied by a multitude of climate change-induced environmental exposures with potential health impacts. Tracking human exposure has been a major research interest of scientists worldwide. This has led to the development of exposome studies that examine internal and external individual exposures over their lifetime and correlate them to health. The monitoring of health has also benefited from significant technological advances in the field of "omics" technologies that analyze physiological changes on the nucleic acid, protein, and metabolism levels, among others. In this review, we discuss various climate change-induced environmental exposures and their potential health implications. We also highlight the potential integration of the technological advancements in the fields of exposome tracking, climate monitoring, and omics technologies shedding light on important questions that need to be answered.

Evaluating the Effects of Training to Improve Teaching Skills of Health Sciences Educators in Sudan.

Purpose: This evaluation draws evidence on the outcome of learning and teaching courses that were offered to a number of teaching staff (referred to as trainers) of the Academies of Health Sciences, Midwifery Schools and Centre for Continuous Professional Development in Sudan. Methods: The evaluation was a cross-sectional, institution-based study conducted from October 2017 to January 2018 involving qualitative design. It consisted of direct observations of teaching, focus group discussions with students and semi-structured interviews with managers of teaching institutions. Results: The findings of direct observations revealed that the learning and teaching course has positive effects on the trainers' ability to have clear, well-stated learning objectives; their presentation skills; and their use of different teaching methods. Moreover, the observations showed that trainers who attended the learning and teaching course now encourage the students to ask questions and are providing them with timely feedback about their learning. As students were the main beneficiaries for improved teaching, focus group discussions have shown that students were generally satisfied with trainers' performance regarding the stated learning outcomes, curricula design, use of a range of teaching methods and assessment methods. During in-depth interviews, managers of training institutions expressed satisfaction with the trainers' performance regarding the development of training materials, learners' assessment, supervision, and evaluation of training. Conclusion: Short courses on teaching and learning were a valuable investment for trainers, students, and the overall performance of health sciences training institutions. The evaluation revealed that trainers were able to apply what they have learnt. Moreover, students and managers noticed improvement in the performance of trainers in teaching, course delivery and assessment. It is recommended to expand, cascade and institutionalize the short courses on learning and teaching to all states to improve the capabilities of trainers, which would eventually contribute to the production of competent allied health professions in Sudan.

Involvement of Goose Parvovirus in Induction of Angel Wing Syndrome in Muscovy Ducks.

Dietary, environmental, and hereditary causes were reported as causative agents of angel wing syndrome in waterfowl. Since 2017, several Muscovy duck flocks at Behira governorate were found to exhibit this syndrome associated with the clinical symptoms of goose parvovirus (GPV) infection. Four strains of goose parvovirus named HS1-HS4 were isolated and identified from diseased ducks at some of these flocks. Phylogenetic analysis revealed clustering of these strains together and within a distinct monophyletic group in relation to GPV strains of Derzsy's disease and short beak and dwarfism syndrome (SBDS). Nucleotide identities with goose parvovirus strain B of Derzsy's disease were 95.7%-96.6%, and with the strain JS1603 of SBDS they were 96.8%-97.4%. However, nucleotide identities with Muscovy duck parvovirus strain FM were 74.1%-74.6%. The disease was reproduced experimentally via oral-route artificial infection with HS1 strain, and both clinical symptoms of goose parvovirus and angel wing syndrome were observed in the artificially infected Muscovy ducks, but with less severity in geese. This study demonstrated clear evidence for induction of angel wing syndrome, at least partially, with GPV infection in Muscovy duck. To the authors' knowledge, this is the first work to mention a viral cause of angel wing syndrome in waterfowl.

Participación del parvovirus del ganso en la inducción del síndrome de ala de ángel en patos reales. Se han reportado causas dietéticas, ambientales y hereditarias como agentes causales del síndrome de alas de ángel en aves acuáticas. Desde el año 2017, se descubrió que varias parvadas de patos reales en la gobernación de Behira presentaban este síndrome asociado con los síntomas clínicos de la infección por parvovirus del ganso (con las siglas en inglés GPV). Se aislaron e identificaron cuatro cepas de parvovirus de ganso denominadas HS1­HS4 de patos enfermos en algunas de estas parvadas. El análisis filogenético reveló el agrupamiento de estas cepas juntas y dentro de un grupo monofilético distinto con relación con las cepas de parvovirus de ganso asociadas con la enfermedad de Derzsy y el síndrome de pico corto y enanismo (con las siglas en inglés SBDS). Las identidades de nucleótidos con la cepa B del parvovirus de la enfermedad de Derzsy fueron del 95.7 % al 96.6 %, y con la cepa JS1603 del síndrome de pico corto y enanismo fueron del 96.8 % al 97.4 %. Sin embargo, las identidades de nucleótidos con la cepa FM del parvovirus del pato Muscovy fueron del 74.1 % al 74.6 %. La enfermedad se reprodujo experimentalmente a través de una infección artificial por vía oral con la cepa HS1 y se observaron signos clínicos de parvovirus del ganso y del síndrome del ala de ángel en los patos reales infectados artificialmente, pero con menor gravedad en los gansos. Este estudio demostró una clara evidencia de la inducción del síndrome del ala de ángel, al menos parcialmente, con la infección por parvovirus del ganso en el pato real. Según el conocimiento de los autores, este es el primer trabajo que menciona una causa viral del síndrome del ala de ángel en aves acuáticas.

RNA Vaccines against Infectious Diseases: Vital Progress with Room for Improvement.

mRNA vaccines have amassed a strong interest from scientists and nonscientists alike for their potential in treating cancer and curbing the spread of infectious diseases. Their success has been bolstered by the COVID-19 pandemic as mRNA vaccines for the SARS-CoV-2 virus showed unrivaled efficiency and success. The strategy relies on the delivery of an RNA transcript that carries the sequence of an antigenic molecule into the body's cells where the antigen is manufactured. The lack of use of infectious pathogens and the fact that they are made of nucleic acids render these vaccines a favorable alternative to other vaccination modalities. However, mRNA vaccination still suffers from a great deal of hurdles starting from their safety, cellular delivery, uptake and response to their manufacturing, logistics and storage. In this review, we examine the premise of RNA vaccination starting from their conceptualization to their clinical applications. We also thoroughly discuss the advances in the field of RNA vaccination for infectious diseases. Finally, we discuss the challenges impeding their progress and shed light on potential areas of research in the field.

Carbon and Nitrogen Dynamics, and CO2 Efflux in the Calcareous Sandy Loam Soil Treated with Chemically Modified Organic Amendments.

In Saudi Arabia, more than 335,000 tons of cow manure is produced every year from dairy farming. However, the produced cow manure is usually added to the agricultural soils as raw or composted manure; significant nitrogen losses occur during the storage, handling, and application of the raw manure. The recovery of ammonia from cow manure through thermochemical treatments is a promising technique to obtain concentrated nitrogen fertilizer and reducing nitrogen losses from raw manure. However, the byproduct effluents from the recovery process are characterized by different chemical properties from the original raw manure; thus, its impact as soil amendments on the soil carbon and nitrogen dynamics is unknown. Therefore, a 90-day incubation experiment was conducted to study the impact of these effluents on CO2 efflux, organic C, microbial biomass C, available NH4+, and NO3- when added to agricultural soil. In addition to the two types of effluents (produced at pH 9 and pH 12), raw cow manure (CM), composted cow manure (CMC), cow manure biochar (CMB), and control were used for comparison. The application of CM resulted in a considerable increase in soil available nitrogen and CO2 efflux, compared to other treatments. Cow manure biochar showed the lowest CO2 efflux. Cumulative CO2 effluxes of cow manure effluents were lower than CM; this is possibly due to the relatively high C:N ratio of manure effluent. The content of P, Fe, Cu, Zn, and Mn decreased as incubation time increased. Soil microbial biomass C for soil treated with cow manure effluents (pH 12 and 7) was significantly higher than the rest of the soil amendments and control.

Non-ST-Segment Myocardial Infarction Resulting From Thrombotic Saphenous Vein Graft Aneurysm.

Acute coronary syndromes from coronary emboli are rare, but well described in the literature. Saphenous vein grafts (SVG), used in coronary artery bypass grafting surgery, are vessels prone to atherosclerotic occlusion and aneurysmal dilation. Descriptive cases of embolization of these atherosclerotic lesions are lacking. Aneurysmal dilation of SVG conduits provides an area of stagnated flow that can harbor thrombi with embolic potential. This case describes a patient with non-ST-segment myocardial infarction possibly resulting from SVG aneurysm thrombus embolism.

Efficacy of the Newcastle Disease Virus Genotype VII.1.1-Matched Vaccines in Commercial Broilers.

Class II genotype VII Newcastle disease viruses (NDV) are predominant in the Middle East and Asia despite intensive vaccination programs using conventional live and inactivated NDV vaccines. In this study, the protective efficacies of three commercial vaccine regimes involving genotype II NDV, recombinant genotype VII NDV-matched, and an autogenous velogenic NDV genotype VII vaccine were evaluated against challenge with velogenic NDV genotype VII (accession number MG029120). Three vaccination regimes were applied as follows: group-1 received inactivated genotype II, group-2 received inactivated recombinant genotype VII NDV-matched, and group-3 received velogenic inactivated autogenous NDV genotype VII vaccines given on day 7; for the live vaccine doses, each group received the same live genotype II vaccine. The birds in all of the groups were challenged with NDV genotype VII, which was applied on day 28. Protection by the three regimes was evaluated after infection based on mortality rate, clinical signs, gross lesions, virus shedding, seroconversion, and microscopic changes. The results showed that these three vaccination regimes partially protected commercial broilers (73%, 86%, 97%, respectively, vs. 8.6% in non-vaccinated challenged and 0% in non-vaccinated non-challenged birds) against mortality at 10 days post-challenge (dpc). Using inactivated vaccines significantly reduced the virus shedding at the level of the number of shedders and the amount of virus that was shed in all vaccinated groups (G1-3) compared to in the non-vaccinated group (G-4). In conclusion, using closely genotype-matched vaccines (NDV-GVII) provided higher protection than using vaccines that were not closely genotype-matched and non-genotype-matched. The vaccine seeds that were closely related to genotype VII.1.1 provided higher protection against challenge against this genotype since it circulates in the Middle East region. Updating vaccine seeds with recent and closely related isolates provides higher protection.

Effect of COVID-19 Pandemic on the Cardiac Outpatients' Perception of Seeking Medical Advice.

OBJECTIVES: During this unprecedented time of COVID-19 pandemic, it was noticed a decline in cardiovascular cases presentation to the Emergency rooms in many countries, raising many speculations about the reasons and its ramifications. 1 - Identify the reasons during this pandemic that refrain patients from seeking medical care and its impact on stress level and medication adherence. 2 - Emphasize the new role of virtual medicine. METHODS: A quantitative descriptive cross-section survey study of 388 patients. It has been done in the cardiac outpatient department and conducted virtually through telemedicine. RESULTS: Despite this pandemic and its consensuses, the majority of cardiac outpatients will still seek medical advice in case of experiencing symptoms. Nevertheless, the fear of contracting COVID-19 infection, which can alter patient's decisions from visiting the emergency room and the increase in stress level during these challenging times, is genuine and no more an element of guessing. CONCLUSION: The majority of cardiac outpatients will wisely seek medical advice in case of serious cardiac symptoms and are adherent to their medications during this pandemic. Nevertheless, they face many concerns which need to implement a preventive and helping measures to fight the consensuses of COVID-19 such as, patient educations, establishing a hotline to all patients, telemedicine, new phone applications, and delivering medications to patients are essential in such circumstances to ensure continuity of care.

Isolation of a Novel Reassortant Highly Pathogenic Avian Influenza (H5N2) Virus in Egypt.

Highly pathogenic avian influenza (HPAI) H5N1 and H5N8 have become endemic among domestic poultry in Egypt since 2006 and 2016, respectively. In parallel, the low pathogenic avian influenza H9N2 virus has been endemic since 2010. Despite the continuous circulation of these subtypes for several years, no natural reassortant has been detected so far among the domestic poultry population in Egypt. In this study, the HPAI (H5N2) virus was isolated from a commercial duck farm, giving evidence of the emergence of the first natural reassortment event in domestic poultry in Egypt. The virus was derived as a result of genetic reassortment between avian influenza viruses of H5N8 and H9N2 subtypes circulating in Egypt. The exchange of the neuraminidase segment and high number of acquired mutations might be associated with an alteration in the biological propensities of this virus.

Quantitative evaluation of viral interference among Egyptian isolates of highly pathogenic avian influenza viruses (H5N1 and H5N8) with the lentogenic and velogenic Newcastle disease virus genotype VII in specific pathogen-free embryonated chicken eggs model.

BACKGROUND AND AIM: Mixed infections of the highly pathogenic avian influenza virus (HPAIV) and Newcastle disease virus (NDV) are considered the most distressing problem of the poultry industry. The problem arises due to the influence of a hidden virus on the replication of another suspected virus. Consequently, misdiagnosis of the real cause of disease may become a source of infection for other healthy stock by transmission and dissemination of the hidden virus. This study aimed to determine the impact of HPAIV and NDV on each other in a specific pathogen-free embryonated chicken egg (SPF-ECE) model. MATERIALS AND METHODS: HPAIVs (H5N1 and H5N8) and NDVs [avirulent NDV [avNDV] and velogenic NDV [vNDV]) were inoculated into the allantois cavity of SPF-ECE with graded titers (2, 3, and 4 log10 EID50) at 24 and 48 h of incubation, followed by the collection of allantoic fluid. A quantitative reverse transcription real-time polymerase chain reaction was used to determine the viral RNA copies of both viruses. RESULTS: Obvious interference was reported on the growth of NDVs when co-inoculated with AIVs. NDV RNA titers reduction ranged from <3 to 5 log10 to complete suppression, but slight interference with the growth of AIVs occurred. H5N1 RNA titers showed <1-2 log10 reduction when co-inoculated with vNDV compared with the H5N1 control. The interference impact of H5N8 was more powerful than that of H5N1, while vNDV showed more resistance for interference than the avNDV strain. On the other hand, interference of AIVs was not observed except when vNDV was inoculated before H5N1. The interfering impact was increased after 48 h of inoculation, whereas no titer of avNDV was detectable. CONCLUSION: AIV strains had a powerful effect on NDV growth, regardless of which infection occurred first.

Multiple introductions of reassorted highly pathogenic avian influenza viruses (H5N8) clade 2.3.4.4b causing outbreaks in wild birds and poultry in Egypt.

Recently, an increased incidence of outbreaks of highly pathogenic avian influenza (HPAI) H5N8 in poultry linked to infected migratory birds has been reported from different European, Asian and African countries. In Egypt, incursion of HPAI H5N8 virus of clade 2.3.4.4b has been recently registered. Full genomic characterization of 3 virus isolates from wild birds and poultry (backyard and commercial farm sectors) showed high nucleotide similarity among the HA, NA, M, and NS gene segments of the three Egyptian HPAI H5N8 viruses, indicating that they are descendants of a common ancestral virus. However, the analyzed Egyptian H5N8 viruses revealed distinct genotypes involving different origins of the PB2, PB1, PA and/or NP segments. In genotype-1 represented by strain A/common-coot/Egypt/CA285/2016 the PB2 and NP segments showed closest relationship to H5N6 and H6N2 viruses, recently detected in Italy. The second is replacement of PB1 and NP genes A novel reassortant, represented by strain A/duck/Egypt/SS19/2017, showed an exchange of PB1 and NP genes which might have originated from H6N8 or H1N1 and H6N2 viruses. Finally, replacement of PA and NP genes characterized strain A/duck/Egypt/F446/2017. Bayesian phylogeographic analyses revealed that Egyptian H5N8 viruses are highly likely derived from Russian 2016 HPAI H5N8 virus (A/great_crested_grebe/Uvs-Nuur_Lake/341/2016 (H5N8)) and the reassortment likely occurred before incursion to Egypt.