Environmental Drivers of Antimicrobial Resistance in Low and Middle-Income Countries: The Impacts of a Changing World.

This letter highlights the impact of environmental drivers on antimicrobial resistance (AMR) in low and middle-income countries (LMICs) and highlights the need for a comprehensive approach to address this global health threat. Key factors, such as agricultural practices, wastewater treatment, and pollution, contribute to the development and spread of resistant pathogens. Utilizing the One Health approach, the paper emphasizes the importance of promoting responsible antimicrobial use, strengthening public health systems, investing in innovative research, and raising public awareness. By understanding and addressing these environmental drivers, we can work toward safeguarding global health and ensuring a sustainable future.

Preferences, Acceptability and Usage of Mobile Health Applications Among Undergraduate Nursing Students: A Multisite, Cross-Sectional Survey.

Introduction and objective: Mobile health applications (mHealth) can bring revolutionary changes to health care by making it more accessible, cost-effective, and efficient. The successful adoption of mHealth is largely determined by its acceptance by providers and end users. The acceptance of mHealth among nursing students, who are the future nurses, needs to be understood. This study aimed to determine the preferences, acceptability, and usage of mHealth applications among undergraduate nursing students. Methods: A descriptive cross-sectional study was conducted in two selected universities in southern and northern India. A convenience sample of 567 undergraduate nursing students was recruited for the study. The data were collected using a structured questionnaire via Google Forms. Results: mHealth applications were presently used by 32.9% of the students. The most common types of mHealth applications used were diet related (27.6%) and lifestyle related (23.4%). The majority of nursing students were willing to use mobile phones for consulting health professionals (78.8%) for prevention and management of health and disease. (83.1%), and for emergencies (73.3%). While more than half of the students were willing to recommend mHealth applications for patients, those students who were using two or more mHealth apps were more likely to recommend the same for the patients. Conclusion: The results of the study highlight about the usage of mobile health applications among the nursing students. The students consider mHealth applications to be useful for delivering health-related services to end users. The study underscores the need to sensitize students about the possible usage of mHealth in healthcare delivery.

The role of digital health in revolutionizing healthcare delivery and improving health outcomes in conflict zones.

The provision and planning for healthcare delivery in conflict is a pressing imperative. Healthcare within these environments is naturally complex, given the entanglement of affected populations, militaries and oft-deteriorating public services. The field of digital health, placed at the intersection of healthcare and technology, has the power to revolutionize healthcare delivery and improve health outcomes worldwide. Its impact is particularly significant in conflict zones, where it can address the unique challenges faced by these regions. Violence, damaged infrastructure, restricted mobility, forced migration, and overstretched healthcare facilities are all hallmarks of conflict zones that demand novel approaches to addressing them. Health care delivery is being revolutionized by the introduction of digital health technology in conflict zones, which are improving access, emergency response capacities, health information management, and mental health assistance. Doctors and aid organizations can more easily overcome challenges and reach out to underserved populations in these regions because to digital technological improvements. Recent decades have seen a shift in the nature of conflict, and with it, a corresponding shift in the range of digital health solutions available to address geographical, epidemiological, and clinical gaps. The purpose of this letter is to inquire into the application of digital health in conflict zones and its potential to lessen the pressing healthcare needs of affected communities.

Knowledge, Attitudes, and Willingness of Healthcare Workers in Iraq's Kurdistan Region to Vaccinate against Human Monkeypox: A Nationwide Cross-Sectional Study.

Although human monkeypox infections had not been recorded in the Kurdistan region of Iraq as of August 2023, the rapid growth of cases worldwide and the detection of monkeypox in neighboring Middle Eastern nations call for careful planning and timely response measures. Educating and empowering frontline healthcare workers (HCWs) so that they can act to curb the spread of monkeypox infections are core elements of primary prevention and protecting public health. Therefore, this study aimed to assess HCWs' knowledge and attitudes about monkeypox and their willingness to vaccinate against monkeypox. By employing a convenience sampling method, an online survey was disseminated via Google Forms between 1 November 2022 and 15 January 2023. The researchers utilized regression analyses to ascertain the factors associated with the three parameters: knowledge, attitude, and the willingness to vaccinate. A total of 637 HCWs were included in the analysis (ages ranged between 21 and 51 years). The mean overall scores were 8.18 of a max score of 16 (SD 3.37), 3.4 of 5 (SD 1.37), and 2.41 of 5 (SD 1.25) for knowledge, attitude, and willingness to vaccinate, respectively. A multivariate logistic regression analysis demonstrated that HCWs who had heard about monkeypox before 2022 rather than later had a higher level of knowledge (AOR: 4.85; 95% CI: 2.81-8.36; p < 0.001). In addition, those who had newly joined the workforce or had less than 1 year experience in practice had more positive attitudes about curbing monkeypox (AOR: 0.35; 95% CI: 0.20-0.59; p < 0.01) than those who practiced for longer. No significant predictors of willingness to vaccinate against monkeypox were identified. The research revealed that HCWs exhibited a relatively low level of monkeypox knowledge. They also had poor attitudes towards monkeypox vaccination and were therefore reluctant to receive the vaccines. Imparting knowledge about the infectious disease can cultivate better awareness and attitudes among HCWs as to their roles in mitigating the spread of an epidemic in the foreseeable future.

France Reports Rise in Severe Neonatal Infections Caused by a New Enterovirus (Echovirus-11) Variant.

The surge in severe neonatal sepsis cases caused by a novel variant of Echovirus 11 (E-11) in France and several European countries has sparked concern. The affected infants, mostly premature and twins, displayed rapid clinical decline within days after birth, presenting symptoms akin to septic shock with hepatic impairment and multi-organ failure. Laboratory findings revealed profound coagulopathy, low platelet counts, and acute renal failure, indicating severe disease progression. Genetic analysis identified a distinct recombinant E-11 lineage, previously unseen in France before July 2022. Despite its novelty, the exact pathogenicity remains uncertain. Although the World Health Organization downplaying immediate public health risks, the absence of a robust global surveillance program hinders accurate prevalence assessment. To mitigate the impact of this novel E-11 variant, establishing robust surveillance, refining diagnostic capabilities, and exploring therapeutic interventions such as intravenous immunoglobulin (IVIg) and pocapavir are imperative for effective management and prevention strategies.

Synthesis of Silver Nanoparticles from Aeromonas caviae for Antibacterial Activity and In Vivo Effects in Rats.

Silver nanoparticles (AgNPs) have excellent antimicrobial properties, as they can inhibit multidrug-resistant (MDR) pathogens. Furthermore, bio-AgNPs have potential applications in medicine due to their low toxicity and high stability. Here, AgNPs were synthesized from the biomass of Aeromonas caviae isolated from a sediment sample and subsequently characterized. The UV-Vis spectra of AgNPs in aqueous medium peaked at 417 nm, matching their plasmon absorption. The X-ray diffraction analysis (XRD) pattern of AgNPs showed four peaks at 2θ values, corresponding to Ag diffraction faces. Absorption band peaks at 3420.16, 1635.54, and 1399.43 cm-1 were identified by Fourier-transform infrared spectroscopy (FTIR) analysis as belonging to functional groups of AgNP-associated biomolecules. Transmission electron microscopy (TEM) and scanning electron microscopy (SEM) showed that the nanoparticles are spherical and pseudospherical, with sizes of 15-25 nm. Agar well diffusion minimal inhibitory concentration (MIC) assays were used to assess the antibacterial activity of the nanoparticles against MDR pathogens. AgNPs exhibited antibacterial activity against MDR bacteria. Two groups of albino rats received intraperitoneal injections of AgNPs at 15 mg/kg or 30 mg/kg for 7 days. Blood, kidney, and liver samples were collected to investigate hematological, biochemical, and histopathological alterations. Administered AgNPs in rats fluctuated in liver and kidney function parameters. The ultrastructural impacts of AgNPs were more prominent at higher doses. The results proved the easy, fast, and efficient synthesis of AgNPs using A. caviae isolates and demonstrated the remarkable potential of these AgNPs as antibacterial agents. Nanotoxicological studies are required to identify the specific dose that balances optimal antibacterial activity with minimal toxicity to human health.

Environmental Health Risks After the 2023 Turkey-Syria Earthquake and Salient Mitigating Strategies: A Critical Appraisal.

A 7.8-magnitude earthquake in Turkey and Syria, followed by a 7.6-magnitude earthquake, caused over 50 000 deaths and over 100 000 injuries. The immediate physical injuries were severe, but the health repercussions, including the strain on healthcare services and the possibility of disease outbreaks, were equally concerning. Infections due to multidrug resistant microbes were also a matter of concern. Earthquake has caused not only loss of property and physical damage but also has a great negative impact on the mental health of the people. It is associated with serious psychological trauma. Moreover, the risk of malnutrition also became evident. Food aid and nutritional supplements can reduce the risk of malnutrition, but they are not a long-term solution. Establishment of sustainable food systems and restoration of agricultural productions are essential. Other demanding issues like derth of access to essential services related to health care, chances of child birth related complications following earthquake also need to be addressed. Emerging crises and disasters (conflicts, pandemics, epidemics), in addition to pre-existing conditions (collapsed health facilities, cold winter conditions, destruction of lifeline infrastructures, overcrowding in emergency shelters, poor sanitation, and unfavorable socio-economic conditions), may further exacerbate the already precarious public health situation and significantly delay the recovery process. The early warning and protection against the development of infectious diseases in earthquake-affected areas depend on good disease surveillance at the local and regional levels, which has been proposed as one of several techniques for prevention and management of infectious diseases in these areas. Our article outlines high-level approaches to reduce the risk of health issues among victims of Turkey and Syria.

The Impact of ChatGPT on the Nursing Profession: Revolutionizing Patient Care and Education.

The nursing field has undergone notable changes over time and is projected to undergo further modifications in the future, owing to the advent of sophisticated technologies and growing healthcare needs. The advent of ChatGPT, an AI-powered language model, is expected to exert a significant influence on the nursing profession, specifically in the domains of patient care and instruction. The present article delves into the ramifications of ChatGPT within the nursing domain and accentuates its capacity and constraints to transform the discipline.

Monkeypox (mpox) in immunosuppressed patients.

The World Health Assembly declared that smallpox had been completely eradicated from the human population in 1980. Monkeypox, a zoonosis native to damp forested regions in West and Central Africa, is the illness that is most comparable to smallpox clinically and immunologically. Both illnesses could be prevented by the smallpox vaccine. Although the monkeypox virus is a less effective human disease than the smallpox virus, it could now spread among human populations if smallpox had not been eradicated and population-wide immunity had not been developed. A health warning on severe monkeypox in people who are immunocompromised due to Human Immunodeficiency virus (HIV) and other illnesses was released by the U.S. Centers for Disease Control and Prevention (CDC) on September 29, 2022. The advise does not specifically include primary immunodeficiency, but it does define other immunocompromising disorders as "having autoimmune disease with immunodeficiency as a clinical component". The documented severe signs of monkeypox include widespread rashes with secondary fungal or bacterial skin infections or tissue death (necrosis), intestine obstruction, and difficulties with the heart, lungs, urinary system, and nervous system. Both those with healthy immune systems and those with weakened immune systems, such as those who are immunosuppressed, older people, children, etc., have encountered serious health issues, but the latter group is more likely to do so. According to the advisory, "of the people with severe monkeypox manifestations for whom CDC has been consulted, the majority have had HIV with CD4 counts 200 cells/ml, indicating substantial immunosuppression". The current article goes into great detail about monkeypox disease occurring in immunocompromised patients and preventive guidelines.

Knowledge, Attitude and Worry in the Kurdistan Region of Iraq during the Mpox (Monkeypox) Outbreak in 2022: An Online Cross-Sectional Study.

The rapid spread of monkeypox (mpox) has been declared as a public health emergency of international concern (PHEIC). The present study aimed to assess the knowledge, attitude, and worry levels of the general population in the Kurdistan region of Iraq regarding the ongoing mpox multi-country outbreak. An online cross-sectional survey was conducted between 27-30 July 2022, using a convenience sampling method. The questionnaire was adapted from previous studies addressing the same topic. The independent Student's t-test, one-way ANOVA, and logistic regression were used to assess possible factors associated with knowledge, attitude, and worry toward mpox. A total of 510 respondents were included in the final analysis. The participants showed a moderate level of mpox knowledge, a neutral attitude towards mpox, and a relatively moderate worry level. The logistic regression analysis showed that age, gender, marital status, religion, level of education, and place of residence were associated with mpox knowledge; however, the significant variables in the multivariate regression analysis were gender, religion, level of education, and residential area. Gender and residential area were associated with attitudes toward mpox; however, the significant variables in the multivariate regression analysis were gender and residential areas. The worry toward mpox was influenced by gender, marital status, religion, and place of residence, yet the significant variables in the multivariate regression analysis were gender, religion, educational level, and residential area. In conclusion, the Kurdish population had moderate knowledge, a neutral attitude, and a moderate level of worry about mpox. Considering the continuous rapid rise in mpox cases in several countries, and its possible risk as pandemic amid the ongoing COVID-19 pandemic, proactive control measures, adequate disease prevention strategies, and preparedness plans need to be formulated and immediately implemented to tackle the appearance of fears among people, and to safeguard the mental health of the public.