Value of long non-coding RNA HAS2-AS1 as a diagnostic and prognostic marker of glioma / El valor de ARNncl HAS2-AS1 como marcador diagnóstico y pronóstico del glioma

Background: Glioma presents high incidence and poor prognosis, and therefore more effective treatments are needed. Studies have confirmed that long non-coding RNAs (lncRNAs) basically regulate various human diseases including glioma. It has been theorized that HAS2-AS1 serves as an lncRNA to exert an oncogenic role in varying cancers. This study aimed to assess the value of lncRNA HAS2-AS1 as a diagnostic and prognostic marker for glioma. Methods: The miRNA expression data and clinical data of glioma were downloaded from the TCGA database for differential analysis and survival analysis. In addition, pathological specimens and specimens of adjacent normal tissue from 80 patients with glioma were used to observe the expression of HAS2-AS1. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic ability and prognostic value of HAS2-AS1 in glioma. Meanwhile, a Kaplan–Meier survival curve was plotted to evaluate the survival of glioma patients with different HAS2-AS1 expression levels. Results: HAS2-AS1 was significantly upregulated in glioma tissues compared with normal tissue. The survival curves showed that overexpression of HAS2-AS1 was associated with poor overall survival (OS) and progression-free survival (PFS). Several clinicopathological factors of glioma patients, including tumor size and WHO grade, were significantly correlated with HAS2-AS1 expression in tissues. The ROC curve showed an area under the curve (AUC) value of 0.863, indicating that HAS2-AS1 had good diagnostic value. The ROC curve for the predicted OS showed an AUC of 0.906, while the ROC curve for predicted PFS showed an AUC of 0.88. Both suggested that overexpression of HAS2-AS1 was associated with poor prognosis.Conclusions: Normal tissues could be clearly distinguished from glioma tissues based on HAS2-AS1 expression. Moreover, overexpression of HAS2-AS1 indicated poor prognosis in glioma patients.(AU)

Introducción: Los gliomas presentan una alta incidencia y un mal pronóstico, por lo que es necesario un tratamiento más efectivo. Algunos estudios han confirmado que los ARN no codificantes de cadena larga (ARNncl) regulan diferentes enfermedades, entre las que se incluyen los gliomas. Se ha postulado que HAS2-AS1 actúa como un ARNncl, con un efecto oncogénico en diferentes tipos de cáncer. Este estudio tiene como objetivo analizar el valor del ARNncl HAS2-AS1 como marcador diagnóstico y pronóstico de glioma. Métodos: Descargamos los datos clínicos y de expresión de micro-ARN de la base de datos del Atlas del Genoma del Cáncer (TCGA) para realizar el análisis diferencial y de supervivencia. También analizamos la expresión de HAS2-AS1 en muestras patológicas y muestras de tejido adyacente normal de 80 pacientes con glioma. Para analizar la capacidad diagnóstica y el valor pronóstico de HAS2-AS1 en el glioma, recurrimos a la curva ROC. También utilizamos curvas de Kaplan-Meier para evaluar la supervivencia de los pacientes con glioma con diferentes niveles de expresión de HAS2-AS1. Resultados: La expresión de HAS2-AS1 era significativamente mayor en las muestras patológicas que en el tejido normal. Las curvas de supervivencia demostraron que la sobreexpresión de HAS2-AS1 estaba relacionada con una menor supervivencia general y supervivencia libre de progresión. Algunos factores clínico-patológicos de los pacientes con glioma, como el tamaño del tumor y su grado, según la clasificación de la OMS, mostraron una correlación significativa con la expresión de HAS2-AS1 en los tejidos afectados. La curva ROC mostró un área bajo la curva de 0,863, lo que indica que la expresión de HAS2-AS1 posee un importante valor diagnóstico. El área bajo la curva de la supervivencia general estimada fue de 0,906; para la supervivencia libre de progresión estimada, de 0,88. Ambos valores muestran que la sobreexpresión de HAS2-AS1 se asocia con un mal pronóstico...(AU)

Climate crisis risks to elderly health: strategies for effective promotion and response.

The climate crisis significantly impacts the health and well-being of older adults, both directly and indirectly. This issue is of growing concern in Canada due to the country's rapidly accelerating warming trend and expanding elderly population. This article serves a threefold purpose: (i) outlining the impacts of the climate crisis on older adults, (ii) providing a descriptive review of existing policies with a specific focus on the Canadian context, and (iii) promoting actionable recommendations. Our review reveals the application of current strategies, including early warning systems, enhanced infrastructure, sustainable urban planning, healthcare access, social support systems, and community engagement, in enhancing resilience and reducing health consequences among older adults. Within the Canadian context, we then emphasize the importance of establishing robust risk metrics and evaluation methods to prepare for and manage the impacts of the climate crisis efficiently. We underscore the value of vulnerability mapping, utilizing geographic information to identify regions where older adults are most at risk. This allows for targeted interventions and resource allocation. We recommend employing a root cause analysis approach to tailor risk response strategies, along with a focus on promoting awareness, readiness, physician training, and fostering collaboration and benchmarking. These suggestions aim to enhance disaster risk management for the well-being and resilience of older adults in the face of the climate crisis.

Emergency management and sustainability: Understanding the link between disaster and citizen participation for sustainability efforts and climate change.

The goal of this study is to examine how disaster experience influences local government views on citizen participation in addressing issues of sustainability, such as climate change. This study considers concepts such as wicked problems, the social order, the environment, economic development, and citizen participation where sustainability can be considered a solution to help manage and solve the challenges of disaster, like climate change. The data are taken from a 2015 International City/County Management Association national survey that examines the link between disaster and sustainability. The results show that more than half of the respondents do not view public participation as having much of an impact on sustainability; however, we can expect public participation to increasingly impact sustainability efforts as communities experience more disaster. This suggests that emergency management needs to understand public pressures regarding wicked problems, such as climate change, to collectively address the global influence of environmental, economic, and social issues that have local effects on their communities.

Ocean state rising: Storm simulation and vulnerability mapping to predict hurricane impacts for Rhode Island's critical infrastructure.

Predicting the consequences of a major coastal storm is increasingly difficult as the result of global climate change and growing societal dependence on critical infrastructure (CI). Past storms are no longer a reliable predictor of future weather events, and the traditional approach to vulnerability assessment presents accumulated loss in largely quantitative terms that lack the specificity local emergency managers need to develop effective plans and mitigation strategies. The Rhode Island Coastal Hazards Modeling and Prediction (RI-CHAMP) system is a geographic information system (GIS)-based modeling tool that combines high-resolution storm simulations with geolocated vulnerability data to predict specific consequences based on local concerns about impacts to CI. This case study discusses implementing RI-CHAMP for the State of Rhode Island to predict impacts of wind and inundation on its CI during a hurricane, tropical storm, or nor'easter. This paper addresses the collection and field verification of vulnerability data, along with RI-CHAMP's process for integrating those data with storm models. The project deeply engaged end-users (emergency managers, facility managers, and other stakeholders) in developing RI-CHAMP's ArcGIS Online dashboard to ensure it provides specific, actionable data. The results of real and synthetic storm models are presented along with discussion of how the data in these simulations are being used by state and local emergency managers, facility owners, and others.

Manufactured housing communities and climate change: Understanding key vulnerabilities and recommendations for emergency managers.

Manufactured housing communities (MHCs), commonly referred to as mobile home parks, provide an estimated 2.7 million American households with largely unsubsidized, affordable housing. Climate change threatens those who call these communities home by exacerbating known structural and social vulnerabilities associated with this housing type-including but not limited to increased risks to flooding, extreme temperatures, high winds, and wildfires. Climate change requires emergency managers to understand the diverse, integrated, and complex vulnerabilities of MHCs that affect their exposure to climate change risk. This article presents findings from an integrative literature review focused on the climate-related vulnerabilities of these communities described at three levels of scale: household, housing structure, and park community. It then draws on 15 years of engagement and action research with MHC residents and stakeholders in Vermont, including several federally declared flooding disasters, to distill key recommendations for emergency managers for assisting MHCs to prepare for and respond to emergencies. As climate change accelerates, emergency managers can increase efficacy by learning about the MHCs in their jurisdictions by leveraging the best available data to characterize risks, integrating MHCs into planning and mitigation activities, and engaging in conversations with stakeholders, including MHC residents and their trusted partners.

Designing user-centered decision support systems for climate disasters: What information do communities and rescue responders need during floods?

Flooding events are the most common natural hazard globally, resulting in vast destruction and loss of life. An effective flood emergency response is necessary to lessen the negative impacts of flood disasters. However, disaster management and response efforts face a complex scenario. Simultaneously, regular citizens attempt to navigate the various sources of information being distributed and determine their best course of action. One thing is evident across all disaster scenarios: having accurate information and clear communication between citizens and rescue personnel is critical. This research aims to identify the diverse needs of two groups, rescue operators and citizens, during flood disaster events by investigating the sources and types of information they rely on and information that would improve their responses in the future. This information can improve the design and implementation of existing and future spatial decision support systems (SDSSs) during flooding events. This research identifies information characteristics crucial for rescue operators and everyday citizens' response and possible evacuation to flooding events by qualitatively coding survey responses from rescue responders and the public. The results show that including local input in SDSS development is crucial for improving higher-resolution flood risk quantification models. Doing so democratizes data collection and analysis, creates transparency and trust between people and governments, and leads to transformative solutions for the broader scientific community.

Optimal examination for traumatic nerve/muscle injuries in earthquake survivors: a retrospective observational study.

Background: Physiatrists are facing with survivors from disasters in both the acute and chronic phases of muscle and nerve injuries. Similar to many other clinical conditions, neuromusculoskeletal ultrasound can play a key role in the management of such cases (with various muscle/nerve injuries) as well. Accordingly, in this article, a recent single-center experience after the Turkey-Syria earthquake will be rendered. Methods: Ultrasound examinations were performed for various nerve/muscle lesions in 52 earthquake victims referred from different cities. Demographic features, type of injuries, and applied treatment procedures as well as detailed ultrasonographic findings are illustrated. Results: Of the 52 patients, 19 had incomplete peripheral nerve lesions of the brachial plexus (n=4), lumbosacral plexus (n=1), and upper and lower limbs (n=14). Conclusion: The ultrasonographic approach during disaster relief is paramount as regards subacute and chronic phases of rehabilitation. Considering technological advances (e.g., portable machines), the use of on-site ultrasound examination in the (very) early phases of disaster response also needs to be on the agenda of medical personnel.

Social Impacts of the American Red Cross (ARC) Disaster Interventions: A Scoping Review.

The American Red Cross (ARC) self-reports post-disaster efforts annually, potentially biased for public image. The lack of formal reviews of ARC interventions' social impacts further exacerbates the issue. This scoping review aims to address both issues by summarizing and evaluating the social impact of ARC's national disaster interventions. As a secondary objective, this review will also provide important information to guide ARC and other organizations in truly fulfilling their missions. The inclusion criteria involve participants of all age groups, marginalized communities, displaced individuals, and ARC disaster responders. Opinionated statements, except for anecdotes, were excluded. This review involves all United States (US) areas that have been affected by disasters and required assistance from ARC. With no search limits, all evidence was searched on PubMed from July to August 2023. Two stages of screening were conducted by two independent reviewers: title/abstract screening and full-text screening. During each stage, each paper underwent a quality assessment. Disagreements in each stage were resolved before proceeding to the next stage. Through 22 academic papers, the review outlines key themes in ARC comprehensive interventions on disaster preparedness and on-site disaster interventions. However, research gaps were found in ARC recovery interventions, especially their impact on evacuees. This investigation found that ARC makes general efforts to address the needs of communities they assist before, during, and after disasters. Because the results suggest that ARC is moving in the correct direction in reducing the nationwide harm disasters cause, ARC's social impact on studied populations is mostly positive.

Preparing correctional settings for the next pandemic: a modeling study of COVID-19 outbreaks in two high-income countries.

Introduction: Correctional facilities are high-priority settings for coordinated public health responses to the COVID-19 pandemic. These facilities are at high risk of disease transmission due to close contacts between people in prison and with the wider community. People in prison are also vulnerable to severe disease given their high burden of co-morbidities. Methods: We developed a mathematical model to evaluate the effect of various public health interventions, including vaccination, on the mitigation of COVID-19 outbreaks, applying it to prisons in Australia and Canada. Results: We found that, in the absence of any intervention, an outbreak would occur and infect almost 100% of people in prison within 20 days of the index case. However, the rapid rollout of vaccines with other non-pharmaceutical interventions would almost eliminate the risk of an outbreak. Discussion: Our study highlights that high vaccination coverage is required for variants with high transmission probability to completely mitigate the outbreak risk in prisons.

Assessing tropical cyclone risk for improving mitigation strategies in Coastal Odisha, India.

Tropical cyclone causes large-scale devastation and destruction in the coastal plains of India, particularly in Odisha, which is the most cyclone-affected state in the country. Tropical cyclones are projected to be more powerful and widespread due to changing climate. Hence, the risk assessment of tropical cyclone is necessary to identify cyclone-risk areas in coastal Odisha which may help in the mitigation of the damages caused by cyclones. Therefore, this study utilizes geospatial techniques to produce a comprehensive risk map posed by tropical cyclones and to estimate the degree of risk for coastal districts of Odisha. For this, we evaluated the district-level cyclone risk for coastal Odisha using multi-criteria decision-making (MCDM) technique by considering 21 parameters for each of the four components of risk, i.e., exposure, hazard, vulnerability, as well as mitigation capacity. For each criterion, thematic raster map layers were created and weighted using a fuzzy analytical hierarchy process (FAHP). We prepared individual risk component maps using weighted overlay techniques and finally integrated all indices to create the risk map. The study shows that 13% area of the study area comes under a very high-risk zone whereas, 25% area comes under a high-risk zone. The central (Cuttack, northern parts of Khordha, and south-western parts of Jajpur district) and the eastern part (most of the parts of Jagatsinghpur, Kendrapara, and northern parts of Puri district) of the study area come under high to very high tropical cyclone impact zone. Almost 67% of the total area is highly vulnerable to tropical cyclones and mainly concentrated near the shoreline. The applied approach and results can assist the local authorities in identifying vulnerable and hazardous locations and developing workable solutions for the mitigation of revised cyclone threats in the coastal districts of Odisha.

Outbreak of Invasive Serratia marcescens among Persons Incarcerated in a State Prison, California, USA, March 2020-December 2022.

Serratia marcescens is an environmental gram-negative bacterium that causes invasive disease in rare cases. During 2020-2022, an outbreak of 21 invasive Serratia infections occurred in a prison in California, USA. Most (95%) patients had a history of recent injection drug use (IDU). We performed whole-genome sequencing and found isolates from 8 patients and 2 pieces of IDU equipment were closely related. We also identified social interactions among patients. We recovered S. marcescens from multiple environmental samples throughout the prison, including personal containers storing Cell Block 64 (CB64), a quaternary ammonium disinfectant solution. CB64 preparation and storage conditions were suboptimal for S. marcescens disinfection. The outbreak was likely caused by contaminated CB64 and propagated by shared IDU equipment and social connections. Ensuring appropriate preparation, storage, and availability of disinfectants and enacting interventions to counteract disease spread through IDU can reduce risks for invasive Serratia infections in California prisons.

Lessons Learned from Public Health and State Prison Collaborations during COVID-19 Pandemic and Multifacility Tuberculosis Outbreak, Washington, USA.

The large COVID-19 outbreaks in prisons in the Washington (USA) State Department of Corrections (WADOC) system during 2020 highlighted the need for a new public health approach to prevent and control COVID-19 transmission in the system's 12 facilities. WADOC and the Washington State Department of Health (WADOH) responded by strengthening partnerships through dedicated corrections-focused public health staff, improving cross-agency outbreak response coordination, implementing and developing corrections-specific public health guidance, and establishing collaborative data systems. The preexisting partnerships and trust between WADOC and WADOH, strengthened during the COVID-19 response, laid the foundation for a collaborative response during late 2021 to the largest tuberculosis outbreak in Washington State in the past 20 years. We describe challenges of a multiagency collaboration during 2 outbreak responses, as well as approaches to address those challenges, and share lessons learned for future communicable disease outbreak responses in correctional settings.

Exploring Volunteer Pharmacists' Experiences in Responding to 2023 Türkiye Earthquakes: A Qualitative Phenomenological Study.

OBJECTIVE: Pharmacists are vital in disaster response efforts, dispensing essential medications, managing pharmacy services, consulting, and educating survivors regarding their medications. Their contributions, however, are often underrepresented in scientific literature. This study aimed to explore the experiences of pharmacists who provided pharmacy services to meet the pharmaceutical needs of the survivors after 2 major earthquakes in Türkiye in 2023. METHODS: This study adopted a phenomenological approach. Data were collected using semi-structured interviews. Purposive sampling was used to invite pharmacists who provided pharmacy services to survivors. Interview transcripts were analyzed following an inductive, reflexive thematic analysis. RESULTS: In total, 15 pharmacists were interviewed. Four main overarching themes "response to the earthquake," "preparedness for the earthquake," "experiences during service delivery," and "mental and physical experiences" were developed. CONCLUSIONS: From participants' experiences, it is essential to expand the clinical responsibilities of pharmacists and train them in providing wound care, administering immunization, and prescribing. Pharmacists should be integrated as essential members of disaster health teams. International health organizations, nongovernmental organizations, and governments are encouraged to work collaboratively and develop disaster management plans including pharmacists in early responders. This might help mitigate the deficiencies and overcome challenges in health-care systems to provide effective patient-centered care by health professionals and respond effectively to disasters.

Breaking the Chain: Strategies to Stem Adenovirus Spread in Pakistan.

Adenovirus, a common respiratory pathogen, has witnessed a notable rise in incidence rates across various regions in Pakistan. Utilizing epidemiological data and climate records, this research discerns a potential linkage between the burgeoning adenovirus cases and alterations in regional climate patterns. Through statistical analysis and modeling techniques, the study aims to elucidate the relationship between climatic variables, such as temperature, humidity, and precipitation, and the prevalence of adenovirus infections. Understanding these dynamics is crucial for developing effective public health interventions and preparedness strategies to mitigate the impact of adenovirus outbreaks in Pakistan. Furthermore, this research contributes to the broader discourse on the intersection of infectious diseases and climate change, highlighting the need for comprehensive adaptive measures to address emerging health challenges in a changing environment.

Understanding Challenges Women Face in Flood-Affected Areas to Access Sexual and Reproductive Health Services: A Rapid Assessment from a Disaster-Torn Pakistan.

Introduction: According to the Global Climate Risk Index, Pakistan is ranked as the fifth-most vulnerable country to climate change. Most recently, during June-August 2022, heavy torrential rains coupled with riverine, urban, and flash flooding led to an unprecedented disaster in Pakistan. Around thirty-three million people were affected by the floods. More than 2 million houses were damaged, leaving approximately 8 million displaced and approximately 600,000 people in relief camps. Among those, 8.2 million women and 16 million children are the worst affected, with many requiring urgent medical and reproductive healthcare. To plan an efficient healthcare program and a climate-resilient health system, it is crucial to understand the issues that the affected people face during floods. Methodology. This rapid assessment included the population in the most severely affected districts across the four provinces of Pakistan. A mixed methods approach using qualitative and quantitative techniques was utilized. A total of 52 qualitative, in-depth interviews were conducted with community-level healthcare providers, national and provincial government departments, and development partners involved in relief activities. Using a structured questionnaire, the quantitative cross-sectional survey was conducted with a final sample of 422 women, married and unmarried (15-49 years old), residing in the relief camps in the flood-affected areas. The outcome variable of the survey was the access to sexual and reproductive health services faced by the women in the flood-affected districts. Data collection took place four months postfloods during Nov-Dec 2022, while the data analysis was conducted between Dec 2022 and Jan 2023. The quantitative data was analyzed using SPSS (Statistical Package for the Social Sciences) version 20, and qualitative data was analyzed using NVivo 12. Ethical consent was sought from all the participants. Ethical approval was also sought from the ethics committee of the Health Services Academy, Government of Pakistan. Results: The findings indicated that, overall, all the provinces were unprepared for a calamity of such a large magnitude. Access to services and health data reporting from the flood-affected areas was challenging mainly due to a shortage of trained health workforce because of the displacement of a large volume of the health workforce. Overall, equipment, medicines, supplies, and food were scarce. Women residing in the camps were markedly affected, and 84% (375) were not satisfied with the flood relief services provided to them. The floods impacted their monthly income as 30% (132) of respondents started depending on charity postfloods. Almost 77% (344) reported limited access to sexual and reproductive health services and had yet to receive sanitary, hygiene, and delivery kits, while 69% (107 out of 154) of girls stopped schooling postfloods. Almost 77% (112) of the married women reported having a child less than one year of age. Yet, only 30% (44 out of 144 currently married women) were using any form of family planning method-damage to the health facilities affected access to overall maternal care services. Conclusion: The findings concluded that there was no planning for sexual and reproductive health services in the flood-affected areas. Several barriers were identified. The government and development partners needed to prepare to cater to women's needs during the floods. The findings highlight the need for collaborative efforts between the government, civil society, and development partners to address the challenges faced in disaster management and strengthen disaster management capacity.

Climate change and health: rethinking public health messaging for wildfire smoke and extreme heat co-exposures.

With the growing climate change crisis, public health agencies and practitioners must increasingly develop guidance documents addressing the public health risks and protective measures associated with multi-hazard events. Our Policy and Practice Review aims to assess current public health guidance and related messaging about co-exposure to wildfire smoke and extreme heat and recommend strengthened messaging to better protect people from these climate-sensitive hazards. We reviewed public health messaging published by governmental agencies between January 2013 and May 2023 in Canada and the United States. Publicly available resources were eligible if they discussed the co-occurrence of wildfire smoke and extreme heat and mentioned personal interventions (protective measures) to prevent exposure to either hazard. We reviewed local, regional, and national governmental agency messaging resources, such as online fact sheets and guidance documents. We assessed these resources according to four public health messaging themes, including (1) discussions around vulnerable groups and risk factors, (2) symptoms associated with these exposures, (3) health risks of each exposure individually, and (4) health risks from combined exposure. Additionally, we conducted a detailed assessment of current messaging about measures to mitigate exposure. We found 15 online public-facing resources that provided health messaging about co-exposure; however, only one discussed all four themes. We identified 21 distinct protective measures mentioned across the 15 resources. There is considerable variability and inconsistency regarding the types and level of detail across described protective measures. Of the identified 21 protective measures, nine may protect against both hazards simultaneously, suggesting opportunities to emphasize these particular messages to address both hazards together. More precise, complete, and coordinated public health messaging would protect against climate-sensitive health outcomes attributable to wildfire smoke and extreme heat co-exposures.

Digital Response to Physical Crises: The Role of an E-Health Platform in the 2023 Southern Turkey Earthquakes.

The catastrophic earthquakes that struck Southern Turkey in 2023 highlighted the pressing need for effective disaster management strategies. The unprecedented scale of the crisis tested the robustness of traditional healthcare responses and highlighted the potential of e-health solutions. Despite the deployment of Emergency Medical Teams, initial responders - primarily survivors of the earthquakes - faced an enormous challenge due to their lack of training in mass-casualty situations. An e-health platform was introduced to support these first responders, offering tools for drug calculations, case management guidelines, and a deep learning model for pediatric X-ray analysis. This commentary presents an analysis of the platform's use and contributes to the growing discourse on integrating digital health technologies in disaster response and management.