Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 8.547
Filtrar
1.
PLoS Negl Trop Dis ; 16(9): e0010775, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36170270

RESUMO

BACKGROUND: Understanding the burden of snakebite is crucial for developing evidence-informed strategies to pursue the goal set by the World Health Organization to halve morbidity and mortality of snakebite by 2030. However, there was no such information in the Association of Southeast Asian Nations (ASEAN) countries. METHODOLOGY: A decision analytic model was developed to estimate annual burden of snakebite in seven countries, including Malaysia, Thailand, Indonesia, Philippines, Vietnam, Lao PDR, and Myanmar. Country-specific input parameters were sought from published literature, country's Ministry of Health, local data, and expert opinion. Economic burden was estimated from the societal perspective. Costs were expressed in 2019 US Dollars (USD). Disease burden was estimated as disability-adjusted life years (DALYs). Probabilistic sensitivity analysis was performed to estimate a 95% credible interval (CrI). PRINCIPAL FINDINGS: We estimated that annually there were 242,648 snakebite victims (95%CrI 209,810-291,023) of which 15,909 (95%CrI 7,592-33,949) were dead and 954 (95%CrI 383-1,797) were amputated. We estimated that 161,835 snakebite victims (69% of victims who were indicated for antivenom treatment) were not treated with antivenom. Annual disease burden of snakebite was estimated at 391,979 DALYs (95%CrI 187,261-836,559 DALYs) with total costs of 2.5 billion USD (95%CrI 1.2-5.4 billion USD) that were equivalent to 0.09% (95%CrI 0.04-0.20%) of the region's gross domestic product. >95% of the estimated burdens were attributed to premature deaths. CONCLUSION/SIGNIFICANCE: The estimated high burden of snakebite in ASEAN was demonstrated despite the availability of domestically produced antivenoms. Most burdens were attributed to premature deaths from snakebite envenoming which suggested that the remarkably high burden of snakebite could be averted. We emphasized the importance of funding research to perform a comprehensive data collection on epidemiological and economic burden of snakebite to eventually reveal the true burden of snakebite in ASEAN and inform development of strategies to tackle the problem of snakebite.


Assuntos
Mordeduras de Serpentes , Antivenenos/uso terapêutico , Ásia Sudeste/epidemiologia , Efeitos Psicossociais da Doença , Humanos , Mordeduras de Serpentes/epidemiologia , Mordeduras de Serpentes/terapia , Tailândia
2.
Proc Natl Acad Sci U S A ; 119(39): e2112341119, 2022 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-36122224

RESUMO

Urbanization is rapidly transforming much of Southeast Asia, altering the structure and function of the landscape, as well as the frequency and intensity of the interactions between people, animals, and the environment. In this study, we explored the impact of urbanization on zoonotic disease risk by simultaneously characterizing changes in the ecology of animal reservoirs (rodents), ectoparasite vectors (ticks), and pathogens across a gradient of urbanization in Kuching, a city in Malaysian Borneo. We sampled 863 rodents across rural, developing, and urban locations and found that rodent species diversity decreased with increasing urbanization-from 10 species in the rural location to 4 in the rural location. Notably, two species appeared to thrive in urban areas, as follows: the invasive urban exploiter Rattus rattus (n = 375) and the native urban adapter Sundamys muelleri (n = 331). R. rattus was strongly associated with built infrastructure across the gradient and carried a high diversity of pathogens, including multihost zoonoses capable of environmental transmission (e.g., Leptospira spp.). In contrast, S. muelleri was restricted to green patches where it was found at high densities and was strongly associated with the presence of ticks, including the medically important genera Amblyomma, Haemaphysalis, and Ixodes. Our analyses reveal that zoonotic disease risk is elevated and heterogeneously distributed in urban environments and highlight the potential for targeted risk reduction through pest management and public health messaging.


Assuntos
Carrapatos , Urbanização , Animais , Ásia Sudeste , Cidades , Humanos , Murinae , Ratos , Zoonoses/epidemiologia
3.
BMC Ecol Evol ; 22(1): 110, 2022 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-36127636

RESUMO

The banteng (Bos javanicus) is an endangered species within the wild Asian Bos complex, that has traditionally been subdivided into three geographically isolated subspecies based on (i) mainland Southeast Asia (B. j. birmanicus), (ii) Java (B. j. javanicus), and (iii) Borneo (B. j. lowi). However, analysis of a single Bornean banteng mitochondrial genome generated through a genome skimming approach was used to suggest that it may actually represent a distinct species (Ishige et al. in Mitochondrial DNA A DNA Mapp Seq Anal 27(4):2453-4. http://doi.org/10.3109/19401736.2015.1033694 , 2016). To explore this hypothesis further, we leveraged on the GenBank (NCBI) raw read sequencing data originally used to construct the mitochondrial genome and reconstructed its nuclear genome at low (0.2×) coverage. When analysed in the context of nuclear genomic data representing a broad reference panel of Asian Bos species, we find the Bornean banteng affiliates strongly with the Javan banteng, in contradiction to the expectation if the separate species hypothesis was correct. Thus, despite the Bornean banteng's unusual mitochondrial lineage, we argue there is no genomic evidence that the Bornean banteng is a distinct species.


Assuntos
Genoma Mitocondrial , Genômica , Animais , Ásia Sudeste , Bornéu , Bovinos , Genoma Mitocondrial/genética
4.
Zootaxa ; 5154(3): 355-364, 2022 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-36095616

RESUMO

Thick-thumbed bats of the genus Glischropus are currently composed of four recognized species from Southeast Asia, two of which were described in recent times. Among these species, G. aquilus is endemic to Sumatra, G. javanus is restricted to western Java, whereas G. bucephalus is widely distributed north to the Isthmus of Kra and G. tylopus is widespread south to this zoogeographic boundary. Two recently collected Glischropus specimens from Meghalaya state in north-eastern India extend the known distribution range of the genus westward into South Asia by ca. 1000 km. Morphological examination of these specimens and comparison with all known species in this genus revealed marked differences in colouration, dental characters and bacular traits. We therefore describe the Meghalaya specimens as a new species. The discovery of the new species from a forest patch adjacent to Nongkhyllem Wildlife Sanctuary from where another specialized bamboo-dwelling species (Eudiscopus denticulus) was reported recently also underscore the importance of the area from a conservation point of view.


Assuntos
Quirópteros , Animais , Ásia Sudeste , Índia
6.
Zootaxa ; 5182(1): 93-100, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36095696

RESUMO

Three species of the genus Trachyphloeosoma Wollaston are described, illustrated and compared with related species: T. ales spec. n. from Taiwan, T. david spec. n. from China, Fujian province and T. philippinense spec. n. from the Philippines.


Assuntos
Besouros , Gorgulhos , Animais , Ásia Sudeste , Filipinas
7.
PLoS One ; 17(9): e0274433, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36107927

RESUMO

Smoke haze due to vegetation and peatland fires in Southeast Asia is a serious public health concern. Several approaches have been applied in previous studies; however, the concepts and interpretations of these approaches are poorly understood. In this scoping review, we addressed issues related to the application of epidemiology (EPI), health burden estimation (HBE), and health risk assessment (HRA) approaches, and discussed the interpretation of findings, and current research gaps. Most studies reported an air quality index exceeding the 'unhealthy' level, especially during smoke haze periods. Although smoke haze is a regional issue in Southeast Asia, studies on its related health effects have only been reported from several countries in the region. Each approach revealed increased health effects in a distinct manner: EPI studies reported excess mortality and morbidity during smoke haze compared to non-smoke haze periods; HBE studies estimated approximately 100,000 deaths attributable to smoke haze in the entire Southeast Asia considering all-cause mortality and all age groups, which ranged from 1,064-260,000 for specified mortality cause, age group, study area, and study period; HRA studies quantified potential lifetime cancer and non-cancer risks due to exposure to smoke-related chemicals. Currently, there is a lack of interconnection between these three approaches. The EPI approach requires extensive effort to investigate lifetime health effects, whereas the HRA approach needs to clarify the assumptions in exposure assessments to estimate lifetime health risks. The HBE approach allows the presentation of health impact in different scenarios, however, the risk functions used are derived from EPI studies from other regions. Two recent studies applied a combination of the EPI and HBE approaches to address uncertainty issues due to the selection of risk functions. In conclusion, all approaches revealed potential health risks due to smoke haze. Nonetheless, future studies should consider comparable exposure assessments to allow the integration of the three approaches.


Assuntos
Poluentes Atmosféricos , Incêndios , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Ásia Sudeste/epidemiologia , Saúde Pública , Medição de Risco
8.
Front Public Health ; 10: 958021, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36159302

RESUMO

The persistent rise of pandemics across the globe in recent times has led to the prescription of several collaborative preventive strategies to reduce the effect that the pandemic has on public health. Consistent monitoring and surveillance appear to be the only available approach to detecting and classifying the issues of public health threats. Global pandemic threats demand public co-operation to take preventive actions at a personal level so that the risk of infectious diseases can be contained. Said that, this study explored the influence of awareness of precaution measures (APM), concerns about coronavirus disease 2019 (COVID-19) (CAC), knowledge of COVID-19 (KOC), and perceived risk (PRK) on preventive behavior (PRB), as well as the effect of age and gender on the relationships among the studied variables. Quantitative data were collected from 551 university students across Malaysia and Vietnam through field survey and online survey, respectively. The data collection was performed from 13 March to 23 March 2020. Partial least square structural equation modeling (PLS-SEM) was employed for data analysis. The multiple group analysis (MGA) technique was applied to compare the data retrieved from the respondents based on age and gender. The results revealed that APM, CAC, KOC, and PRK on PRB significantly influenced PRB toward COVID-19. In light of the two personal factors, age and gender, significant variances were noted for age and KOC, while PRK on PRB on the PRB toward COVID-19. Based on the study outcomes, APM emerged as the most significant predictor of PRB, followed by PRK on PRB, and CAC. Since a large fraction of the world reside in rural areas and have high-level interaction with animals, the provision of education at all level can harness the attitude to adopt PRB toward COVID-19. As such, policymakers need to work with the young generation so that the latter may serve as change agents to spread the message of taking precautions and adopting effective PRB toward COVID-19.


Assuntos
COVID-19 , Ásia Sudeste , COVID-19/epidemiologia , COVID-19/prevenção & controle , Comportamentos Relacionados com a Saúde , Humanos , SARS-CoV-2 , Estudantes , Universidades
9.
Microb Pathog ; 170: 105693, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35940443

RESUMO

Nipah virus (NiV), an emerging zoonotic virus, has been associated with several outbreaks with high death rates, mainly in South and Southeast Asia. NiV is responsible for Encephalitis and systemic vasculitis, and occasionally respiratory diseases accompanied by it. Though fruit bats are the natural source of NiV, it can be transmitted in a zoonotic manner directly or via an intermediate host (e.g., a pig or horse). Several studies explore the viral mechanism of disease progressions and its overall pathogenesis. However, understanding the pathogenesis and disease dynamics is necessary to develop therapeutic options and vaccines. Thus, in this review, we provide a comprehensive update on the emerging understanding of the pathogenesis of NiV.


Assuntos
Quirópteros , Infecções por Henipavirus , Vírus Nipah , Animais , Ásia Sudeste , Surtos de Doenças , Infecções por Henipavirus/epidemiologia , Cavalos , Suínos
10.
PLoS One ; 17(8): e0272966, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36037160

RESUMO

Species of colourful arboreal snails of the genus Amphidromus from Southeast Asia commonly exhibit high intraspecific variation in shell morphology. Although highly polymorphic Amphidromus specimens with different colouration have been collected at the same locality and were revealed to possess similar genital organs, there is yet no morphometric or DNA analyses of these different shell morphs. This study is the first to reveal that both striped and stripeless morphs of A. cruentatus from Laos and Vietnam belong to the same mitochondrial (COI and 16S rRNA) lineage. Although the shell colouration between the striped and stripeless morphs is markedly different, morphometric and shell outline-based analyses indicated an overall similarity in shell shape. We also revised the systematics of A. cruentatus, in which we treated similar related species, namely A. eudeli, A. fuscolabris, A. thakhekensis, A. gerberi bolovenensis, A. goldbergi, A. pengzhuoani, A. eichhorsti and A. pankowskiae as junior synonyms of A. cruentatus. Amphidromus daoae, A. anhdaoorum, A. stungtrengensis, A. yangbayensis and A. yenlinhae, which were formerly regarded as junior synonyms, are considered as species different from A. cruentatus based on shell morphology and morphometric analyses. Preliminary phylogenetic analyses also retrieved some Amphidromus species groups as distinct mitochondrial lineages.


Assuntos
Polimorfismo Genético , Caramujos , Animais , Ásia Sudeste , Filogenia , RNA Ribossômico 16S/genética
11.
Front Public Health ; 10: 910055, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35991011

RESUMO

Applications of systems thinking in the context of Health Policy and Systems Research have been scarce, particularly in Low- and Middle-Income Countries (LMICs). Given the urgent need for addressing implementation challenges, the WHO Alliance for Health Policy and Systems Research, in collaboration with partners across five global regions, recently initiated a global community of practice for applied systems thinking in policy and practice contexts within LMICs. Individual one on one calls were conducted with 56 researchers, practitioners & decision-makers across 9 countries in Southeast Asia to elucidate key barriers and opportunities for applying systems thinking in individual country settings. Consultations presented the potential for collaboration and co-production of knowledge across diverse stakeholders to strengthen opportunities by applying systems thinking tools in practice. While regional nuances warrant further exploration, there is a clear indication that policy documentation relevant to health systems will be instrumental in advancing a shared vision and interest in strengthening capacities for applied systems thinking in health systems across Southeast Asia.


Assuntos
Política de Saúde , Pesquisa sobre Serviços de Saúde , Ásia Sudeste , Humanos , Pobreza , Pesquisadores
12.
Front Public Health ; 10: 863323, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35991032

RESUMO

Mental health has become a growing concern in the wake of the COVID-19 pandemic. We sought to determine the prevalence of mental health symptoms 18 months after the pandemic's declaration. Our cross-sectional study conducted among 18- to 65-year-old adults (N = 33,454) in October 2021 using the Depression, Anxiety and Stress Scales (DASS-21) found a high prevalence of severe to extremely severe anxiety (49%), depression (47%) and stress (36%) symptoms in Malaysia, Indonesia, Thailand, and Singapore. Multiple logistic regression showed that female and non-binary genders were associated with increased odds of severe/extremely severe symptoms of anxiety (female: aOR 1.44 [95% CI 1.37-1.52]; non-binary aOR 1.46 [1.16-1.84]), depression (female: aOR 1.39 [1.32-1.47]; non-binary aOR 1.42 [1.13-1.79]), and stress (female: aOR 1.48 [CI 1.40-1.57]; non-binary aOR 1.42 [1.12-1.78]). In all three symptom domains, the odds of severe/extremely severe symptoms decreased across age groups. Middle- and high-income respondents had lower odds of reporting severe/extremely severe anxiety (middle-income: aOR 0.79 [0.75-0.84]; high-income aOR 0.77 [0.69-0.86]) and depression (middle-income: aOR 0.85 [0.80-0.90]; high-income aOR 0.84 [0.76-0.94]) symptoms compared to low-income respondents, while only middle-income respondents had lower odds of experiencing severe/extremely severe stress symptoms (aOR 0.89 [0.84-0.95]). Compared to residents of Malaysia, residents of Indonesia were more likely to experience severe/extremely severe anxiety symptoms (aOR 1.08 [1.03-1.15]) but less likely to experience depression (aOR 0.69 [0.65-0.73]) or stress symptoms (aOR 0.92 [0.87-0.97]). Respondents living in Singapore had increased odds of reporting severe/extremely severe depression symptoms (aOR 1.33 [1.16-1.52]), while respondents residing in Thailand were more likely to experience severe/extremely severe stress symptoms (aOR 1.46 [1.37-1.55]). This study provides insights into the impacts of the COVID-19 pandemic on the point prevalence of psychological distress in Southeast Asia one and a half years after the beginning of the pandemic.


Assuntos
COVID-19 , Pandemias , Adolescente , Adulto , Idoso , Ansiedade/epidemiologia , Ásia Sudeste/epidemiologia , COVID-19/epidemiologia , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
13.
Nat Commun ; 13(1): 4955, 2022 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-36002452

RESUMO

Most intensive human activities occur in lowlands. However, sporadic reports indicate that human activities are expanding in some Asian highlands. Here we investigate the expansions of human activities in highlands and their effects over Asia from 2000 to 2020 by combining earth observation data and socioeconomic data. We find that ∼23% of human activity expansions occur in Asian highlands and ∼76% of these expansions in highlands comes from ecological lands, reaching 95% in Southeast Asia. The expansions of human activities in highlands intensify habitat fragmentation and result in large ecological costs in low and lower-middle income countries, and they also support Asian developments. We estimate that cultivated land net growth in the Asian highlands contributed approximately 54% in preventing the net loss of the total cultivated land. Moreover, the growth of highland artificial surfaces may provide living and working spaces for ∼40 million people. Our findings suggest that highland developments hold dual effects and provide new insight for regional sustainable developments.


Assuntos
Asiáticos , Ecossistema , Ásia , Ásia Sudeste , Humanos
14.
Nat Commun ; 13(1): 4380, 2022 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-35945197

RESUMO

Emerging diseases caused by coronaviruses of likely bat origin (e.g., SARS, MERS, SADS, COVID-19) have disrupted global health and economies for two decades. Evidence suggests that some bat SARS-related coronaviruses (SARSr-CoVs) could infect people directly, and that their spillover is more frequent than previously recognized. Each zoonotic spillover of a novel virus represents an opportunity for evolutionary adaptation and further spread; therefore, quantifying the extent of this spillover may help target prevention programs. We derive current range distributions for known bat SARSr-CoV hosts and quantify their overlap with human populations. We then use probabilistic risk assessment and data on human-bat contact, human viral seroprevalence, and antibody duration to estimate that a median of 66,280 people (95% CI: 65,351-67,131) are infected with SARSr-CoVs annually in Southeast Asia. These data on the geography and scale of spillover can be used to target surveillance and prevention programs for potential future bat-CoV emergence.


Assuntos
COVID-19 , Quirópteros , Vírus da SARS , Animais , Ásia Sudeste/epidemiologia , Evolução Molecular , Humanos , Filogenia , Estudos Soroepidemiológicos
15.
Sci Rep ; 12(1): 13805, 2022 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-35963964

RESUMO

Building energy intensity (BEI) has been used to assess a building's overall energy performance. However, the energy performance, CO2 footprint and electricity costs due to lighting in buildings are currently required to assist relevant authorities to develop, revise and implement energy-efficient lighting policies that are effective and acceptable for the country. This work presents an estimation approach for lighting in commercial buildings in Southeast Asia and its decarbonisation pathway for benchmarking. Application of this approach to a selected library in Brunei Darussalam showed that an energy-efficient light-emitting diode (LED) lighting system would make the building greener. We projected reductions in lighting energy consumption by 6.7 times (3.98 kWh/m2/year), its associated CO2 emissions by 8 times (0.59 kg CO2/m2/year) and electricity costs by 8.7 times (B$7.07/m2/year) by 2050 if existing lamps in the library are retrofitted with LED lamps.


Assuntos
Dióxido de Carbono , Iluminação , Ásia Sudeste , Dióxido de Carbono/análise , Custos e Análise de Custo , Eletricidade
16.
Diabetes Metab Syndr ; 16(8): 102583, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35952510

RESUMO

BACKGROUND: The growing prevalence of lipid disorder in Southeast Asia (SEA) resulted in an increase in clinical and epidemiological studies on dyslipidemia in the region. Thus, there is a need to summarize the existing evidence from the literature. AIMS: This paper determined the research landscape of dyslipidemia in SEA. This study also identified the socioeconomic facilitators of scientific productivity in dyslipidemia research in SEA. METHODS: A database search of dyslipidemia literature in SEA countries was performed using the Scopus database. Bibliographic information was obtained, and network visualization of collaboration among countries and keywords was created using VOSviewer software. RESULTS: This bibliometric analysis showed a continuous increase in published articles in SEA, most of which were from universities and hospitals in Thailand, Singapore, Malaysia, and Indonesia. The usual topics of dyslipidemia research in SEA include epidemiology, pathophysiology, comorbidities and complications, and treatment options for dyslipidemia. Research & development expenditure (total citations: p = 0.037; h-index: p = 0.031) and researchers in R&D (total citations: p = 0.005; h-index: p = 0.017) were positively correlated with citations and h-index for dyslipidemia publications from SEA countries. Moreover, the number of research collaborations within SEA and worldwide was positively correlated with the total publications, citations, and h-index of SEA countries for their dyslipidemia research outputs. CONCLUSION: In summary, this bibliometrics study showed an increasing trend of dyslipidemia research in SEA countries. Policymakers and administrators should invest more in dyslipidemia studies to propose better strategies in curbing the prevalence of this condition in SEA.


Assuntos
Pesquisa Biomédica , Dislipidemias , Ásia Sudeste , Bibliometria , Humanos , Fatores Socioeconômicos
17.
Toxins (Basel) ; 14(8)2022 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-36006229

RESUMO

Raw feed materials are often contaminated with mycotoxins, and co-occurrence of mycotoxins occurs frequently. A total of 250 samples i.e., rice bran and maize from Cambodia, Laos, Myanmar, and Thailand were analysed using state-of-the-art liquid chromatography-mass spectrometry (LC-MS/MS) for monitoring the occurrence of regulated, emerging, and masked mycotoxins. Seven regulated mycotoxins - aflatoxins, ochratoxin A, fumonisin B1, deoxynivalenol, zearalenone, HT-2, and T-2 toxin were detected as well as some emerging mycotoxins, such as beauvericin, enniatin type B, stachybotrylactam, sterigmatocystin, and masked mycotoxins, specifically zearalenone-14-glucoside, and zearalenone-16-glucoside. Aspergillus and Fusarium mycotoxins were the most prevalent compounds identified, especially aflatoxins and fumonisin B1 in 100% and 95% of samples, respectively. Of the emerging toxins, beauvericin and enniatin type B showed high occurrences, with more than 90% of rice bran and maize contaminated, whereas zearalenone-14-glucoside and zearalenone-16-glucoside were found in rice bran in the range of 56-60%. Regulated mycotoxins (DON and ZEN) were the most frequent mycotoxin combination with emerging mycotoxins (BEA and ENN type B) in rice bran and maize. This study indicates that mycotoxin occurrence and co-occurrence are common in raw feed materials, and it is critical to monitor mycotoxin levels in ASEAN's feedstuffs so that mitigation strategies can be developed and implemented.


Assuntos
Aflatoxinas , Micotoxinas , Oryza , Zearalenona , Aflatoxinas/análise , Ásia Sudeste , Cromatografia Líquida/métodos , Contaminação de Alimentos/análise , Glucosídeos , Micotoxinas Mascaradas , Micotoxinas/análise , Espectrometria de Massas em Tandem/métodos , Zea mays , Zearalenona/análise
18.
Int J Antimicrob Agents ; 60(4): 106659, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35988665

RESUMO

INTRODUCTION: Bloodstream infections (BSIs) are a leading cause of sepsis, which is a life-threatening condition that significantly contributes to the mortality of bacterial infections. Aminoglycoside antibiotics such as gentamicin or amikacin are essential medicines in the treatment of BSIs, but their clinical efficacy is increasingly being compromised by antimicrobial resistance. The aminoglycoside apramycin has demonstrated preclinical efficacy against aminoglycoside-resistant and multidrug-resistant (MDR) Gram-negative bacilli (GNB) and is currently in clinical development for the treatment of critical systemic infections. METHODS: This study collected a panel of 470 MDR GNB isolates from healthcare facilities in Cambodia, Laos, Singapore, Thailand and Vietnam for a multicentre assessment of their antimicrobial susceptibility to apramycin in comparison with other aminoglycosides and colistin by broth microdilution assays. RESULTS: Apramycin and amikacin MICs ≤ 16 µg/mL were found for 462 (98.3%) and 408 (86.8%) GNB isolates, respectively. Susceptibility to gentamicin and tobramycin (MIC ≤ 4 µg/mL) was significantly lower at 122 (26.0%) and 101 (21.5%) susceptible isolates, respectively. Of note, all carbapenem and third-generation cephalosporin-resistant Enterobacterales, all Acinetobacter baumannii and all Pseudomonas aeruginosa isolates tested in this study appeared to be susceptible to apramycin. Of the 65 colistin-resistant isolates tested, four (6.2%) had an apramycin MIC > 16 µg/mL. CONCLUSION: Apramycin demonstrated best-in-class activity against a panel of GNB isolates with resistances to other aminoglycosides, carbapenems, third-generation cephalosporins and colistin, warranting continued consideration of apramycin as a drug candidate for the treatment of MDR BSIs.


Assuntos
Amicacina , Colistina , Aminoglicosídeos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Ásia Sudeste , Hemocultura , Carbapenêmicos , Cefalosporinas , Colistina/farmacologia , Farmacorresistência Bacteriana Múltipla , Gentamicinas , Bactérias Gram-Negativas , Testes de Sensibilidade Microbiana , Nebramicina/análogos & derivados , Pseudomonas aeruginosa , Tobramicina
19.
Singapore Med J ; 63(5): 268-273, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-36043277

RESUMO

INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is increasingly performed in patients with severe aortic stenosis. A novel dual-filter system to reduce cerebral embolism during TAVI recently became available. We aimed to assess the feasibility, safety, and clinical and neurocognitive outcomes of TAVI with cerebral protection in Asian patients. METHODS: 40 consecutive patients undergoing TAVI with cerebral protection were enrolled. All procedures were performed via femoral access using the self-expanding Evolut R/PRO or Portico, or the balloon-expandable SAPIEN 3 bioprostheses. Baseline characteristics, procedural and clinical outcomes were recorded. Cognition was assessed at baseline and 30 days using the abbreviated mental test (AMT). RESULTS: The mean age of the patients (75% male) was 76.4 ± 8.4 years. TAVI was uncomplicated in all patients. The filter device was successfully deployed in 38 (95.0%) patients without safety issues. There was no stroke or death at 30 days, and the survival rate at nine months was 95.0%. There was no overall cognitive change (baseline vs. 30-day AMT: 9.2 ± 1.1 vs. 9.0 ± 1.5, p = 0.12), and only 1 (2.5%) patient developed impaired cognition at 30 days. Patients with a decreased AMT score at 30 days were significantly older than those without (82.1 ± 4.5 vs. 74.4 ± 7.7 years, p = 0.019). All patients with decreased AMT scores were aged ≥ 76 years. CONCLUSION: In this early Asian experience of TAVI under cerebral protection, the filter device was successfully deployed in 95% of patients, with 100% procedural success. There were no filter-related complications and no stroke or mortality at 30 days. Overall cognition was preserved, although increased age was associated with a decline in AMT score.


Assuntos
Estenose da Valva Aórtica , Próteses Valvulares Cardíacas , Acidente Vascular Cerebral , Substituição da Valva Aórtica Transcateter , Idoso , Idoso de 80 Anos ou mais , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/cirurgia , Ásia Sudeste , Feminino , Próteses Valvulares Cardíacas/efeitos adversos , Humanos , Masculino , Desenho de Prótese , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Substituição da Valva Aórtica Transcateter/efeitos adversos , Substituição da Valva Aórtica Transcateter/métodos , Resultado do Tratamento
20.
Environ Sci Technol ; 56(18): 13284-13293, 2022 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-36040952

RESUMO

Land use change (LUC) induced by biofuel production could lead to greenhouse gas (GHG) emissions, which potentially increase biofuel's carbon intensity. Among the sources of LUC-related emissions for soy biodiesel, the contribution from peatland loss to agricultural plantations in Southeast Asia remains uncertain. Here, we analyzed LUC in Malaysia and Indonesia and modeled its impacts on the GHG emissions of soy biodiesel produced in the United States. It shows that oil palm plantations have more than doubled over 2001-2016 and the area of palm-on-peatlands (PoP) has expanded 3.7 times. Over new palm plantations, the share of PoP is about 19% regardless of time and location and the emission factor (EF) for peatland-to-palm conversion is estimated to be 41.5 Mg CO2 ha-1 yr-1. With these updates on PoP and EF, the contribution of peatland loss (0.7-5.1 g CO2e MJ-1) to biodiesel emissions is only 40-65% of previous estimates, which reduces discrepancies among model simulations used by different agencies. Based on emerging evidence on LUC and related carbon changes, our analysis reexamines regional peatland loss and its impacts on LUC emissions modeling and provides new insights into the estimation of LUC impacts on biofuels' carbon intensity.


Assuntos
Gases de Efeito Estufa , Ásia Sudeste , Biocombustíveis , Carbono , Dióxido de Carbono/análise , Estados Unidos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...