Development, implementation, and evaluation of an innovative clinical trial operations training program for Africa (ClinOps).

Background: Africa's involvement in clinical trials remains very low. Although the crucial role of training initiatives in building clinical trial capacity in Africa has been documented, current efforts fall short as they lack alignment with local contexts. This study aimed to design, develop, implement, and evaluate an innovative clinical trial operations training program for Africa.

Assessing the use of geospatial data for immunization program implementation and associated effects on coverage and equity in the Democratic Republic of Congo.

Background: The National Expanded Program on Immunization in the Democratic Republic of the Congo implemented a program in 9 Provinces to generate georeferenced immunization microplans to strengthen the planning and implementation of vaccination services. The intervention aimed to improve identification and immunization of zero-dose children and overall immunization coverage.

Methods: This study applies a mixed-methods design including survey tools, in-depth interviews and direct observation to document the uptake, use, and acceptance of the immunization microplans developed with geospatial data in two intervention provinces and one control province from February to June 2023.

Ten pressure points in primary care during COVID-19: findings from an international narrative review.

Background: Strong primary care (PC) services are the foundation of high-performing health care systems and can support effective responses to public health emergencies. Primary care practitioners (PCPs) and PC services played crucial roles in supporting global health system responses to the COVID-19 pandemic. However, these contributions have come at a cost, impacting on PC services and affecting patient care.

A step towards understanding plastic complexity: Antimony speciation in consumer plastics and synthetic textiles revealed by XAS.

We identified the antimony species present in a wide variety of plastic samples by X ray absorption spectroscopy (XAS) at the Sb L-edge. The samples contained different concentrations of antimony (Sb), ranging from PET bottles in which Sb compounds are used as catalysts, with concentrations around 300 mg/kg, to electrical equipment in which the element is used as a flame retardant, with concentrations of several tens of thousands of mg/kg. Although the shape of the spectra at the L-edge is quite similar for all Sb reference materials, we were able to identify antimony glycolate or acetate in PET bottles, bound organic Sb in c-PET trays and senarmontite in electrical materials as the main Sb components.

Characteristics of children and adolescents with multidrug-resistant and rifampicin-resistant tuberculosis and their association with treatment outcomes: a systematic review and individual participant data meta-analysis.

Background: There are few data on the treatment of children and adolescents with multidrug-resistant (MDR) or rifampicin-resistant (RR) tuberculosis, especially with more recently available drugs and regimens. We aimed to describe the clinical and treatment characteristics and their associations with treatment outcomes in this susceptible population.

Methods: We conducted a systematic review and individual participant data meta-analysis.

Discovery of the First Efficacious Adenosine 2A Receptor Negative Allosteric Modulators for High Adenosine Cancer Immunotherapies.

Inhibition of the adenosine 2A receptor (AR) is recognized as a promising immunotherapeutic strategy but is challenged by the ubiquity of AR function in the immune system. To develop a safe yet efficacious immunotherapy, the discovery of a novel negative allosteric modulator (NAM) was preferred. Leveraging an in-house, sensitive, high-throughput screening cellular assay, novel AR NAM scaffolds were identified, followed by an extensive structure-activity relationship (SAR) study, leading to the discovery of potent 2-amino-3,5-dicyanopyridine derivatives.

Resting-state electroencephalographic rhythms depend on sex in patients with dementia due to Parkinson's and Lewy Body diseases: An exploratory study.

Parkinson's disease with dementia (PDD) and dementia with Lewy bodies (DLB) are more prevalent in males than females. Furthermore, they typically showed abnormally high delta (< 4 Hz) and low alpha (8-10 Hz) rhythms from resting-state electroencephalographic (rsEEG) activity. Here, we hypothesized that those abnormalities may depend on the patient's sex.

Sand and dust storms: a growing global health threat calls for international health studies to support policy action.

Sand and dust storms increasingly threaten global environmental and public health. To date, 150 countries are directly affected, with more than 100 classified as non-dust source regions. With climate change, these storms are expected to become more frequent and severe.

Exploring the connection between climatic conditions and genetic properties of Abies alba Mill., including warm and summer-dry Mediterranean environments.

Abies alba Mill. is a prominent European tree species predominantly inhabiting cool and humid montane environments. However, paleoecological evidence reveals that during the Eemian and mid-Holocene, A.

Controlling the stability of monodisperse phospholipid-coated microbubbles by tuning their buckling pressure.

Hypothesis: Monodisperse phospholipid-coated microbubbles, with a size and resonance frequency tuned to the ultrasound driving frequency, have strong potential to enhance sensitivity, efficiency, and control in emerging diagnostic and therapeutic applications involving bubbles and ultrasound. A key requirement is that they retain their gas volume and shell material during physiologic pressure changes and withstand the overpressure during intravenous injection. The shell typically comprises a mixture of a phospholipid (e.

Assessment of scattered and leakage radiation from ultra-portable X-ray systems in chest imaging: An independent study.

Ultraportable (UP) X-ray devices are ideal to use in community-based settings, particularly for chest X-ray (CXR) screening of tuberculosis (TB). Unfortunately, there is insufficient guidance on the radiation safety of these devices. This study aims to determine the radiation dose by UP X-ray devices to both the public and radiographers compared to international dose limits.

Romosozumab Improves Tissue Thickness-Adjusted Trabecular Bone Score in Women With Osteoporosis and Diabetes.

Context: Trabecular bone score (TBS), a gray-level texture index derived from lumbar spine (LS) dual-energy x-ray absorptiometry (DXA) scans, is decreased in patients with diabetes and is associated with increased fracture risk, independent of areal bone mineral density (aBMD), but potentially influenced by abdominal fat tissue.

Objective: Evaluate effect of romosozumab (210 mg monthly) for 12 months followed by alendronate (70 mg weekly) for 24 months vs alendronate alone (70 mg weekly) for 36 months on LS aBMD and TBS in women with type 2 diabetes (T2D) enrolled in the ARCH study.

Methods: This post hoc analysis included women from ARCH who had T2D at baseline and LS DXA scans at baseline and ≥1 postbaseline visit (romosozumab-to-alendronate, n = 165; alendronate-to-alendronate, n = 195).

Corrigendum to "Schwann Cell Metabolic Activity in Various Short-Term Holding Conditions: Implications for Improved Nerve Graft Viability".

[This corrects the article DOI: 10.1155/2012/742183.].

Strengthening National Immunization Technical Advisory Groups: Twelve Years of Progress (2012-2023).

Introduction: Well-functioning National Immunization Technical Advisory Groups (NITAGs) are valuable contributors to decision-making processes in the complex immunization policy arena. This paper describes the progress made globally on the establishment and strengthening of these key advisory groups and discusses some of their strengths, challenges, and opportunities.

Methods: The data submitted annually by countries to the World Health Organization (WHO) via the WHO/UNICEF Joint Reporting Form (JRF) were analyzed, comparing the NITAG functionality criteria in 2012 and 2023.

Immunogenicity, Efficacy, and Effectiveness of Two-Dose and Shorter Schedules of Hepatitis E Vaccine: A Systematic Review.

: Hepatitis E virus (HEV) is a leading cause of acute viral hepatitis in adults. The schedule for HEV 239, the only approved anti-HEV vaccine, consists of three doses at 0, 1, and 6 months, which is unsuitable for use in emergency and outbreak situations where quick protection is desired. We, therefore, undertook a systematic review of data on immunogenicity, efficacy, and effectiveness of alternative accelerated schedules.

Exploring Antibacterial Properties of Marine Sponge-Derived Natural Compounds: A Systematic Review.

The rise in multidrug-resistant (MDR) bacteria has prompted extensive research into antibacterial compounds, as these resistant strains compromise current treatments. This resistance leads to prolonged hospitalization, increased mortality rates, and higher healthcare costs. To address this challenge, the pharmaceutical industry is increasingly exploring natural products, particularly those of marine origin, as promising candidates for antimicrobial drugs.

Pharmacometabolomics Enables Real-World Drug Metabolism Sciences.

: Pharmacogenomics (PGx) has revolutionized personalized medicine, notably by predicting drug responses through the study of the metabolic genotype of drug-metabolizing enzymes. However, these genotypes rely heavily on the availability and completeness of drug metabolism information and do not account for (all) "phenoconversion" factors, like drug-drug interactions and comorbidities. To address these limitations, a more phenotypic approach would be desirable, for which pharmacometabolomics (PMx) could be useful by studying and elucidating drug metabolism in patient samples, such as blood and urine.

Exploring Multi-Pathology Brain Segmentation: From Volume-Based to Component-Based Deep Learning Analysis.

Detection and segmentation of brain abnormalities using Magnetic Resonance Imaging (MRI) is an important task that, nowadays, the role of AI algorithms as supporting tools is well established both at the research and clinical-production level. While the performance of the state-of-the-art models is increasing, reaching radiologists and other experts' accuracy levels in many cases, there is still a lot of research needed on the direction of in-depth and transparent evaluation of the correct results and failures, especially in relation to important aspects of the radiological practice: abnormality position, intensity level, and volume. In this work, we focus on the analysis of the segmentation results of a pre-trained U-net model trained and validated on brain MRI examinations containing four different pathologies: Tumors, Strokes, Multiple Sclerosis (MS), and White Matter Hyperintensities (WMH).

A Novel, Cell-Compatible Hyaluronidase Activity Assay Identifies Dextran Sulfates and Other Sulfated Polymeric Hydrocarbons as Potent Inhibitors for CEMIP.

Hyaluronan (HA) levels are dynamically regulated homeostatically through biosynthesis and degradation. HA homeostasis is often perturbed under disease conditions. HA degradation products are thought to contribute to disease pathology.

Synthesizing the Evidence Base to Enhance Coordination between Humanitarian Mine Action and Emergency Care for Casualties of Explosive Ordnance and Explosive Weapons: A Scoping Review.

Background: Humanitarian mine action (HMA) stakeholders have an organized presence with well-resourced medical capability in many conflict and post-conflict settings. Humanitarian mine action has the potential to positively augment local trauma care capacity for civilian casualties of explosive ordnance (EO) and explosive weapons (EWs). Yet at present, few strategies exist for coordinated engagement between HMA and the health sector to support emergency care system strengthening to improve outcomes among EO/EW casualties.

3D modeling to predict vascular involvement in resectable pancreatic adenocarcinoma.

Background: Current management of patients with borderline resectable pancreatic adenocarcinoma (BR-PDAC) depends on the degree of involvement of the major arterial and venous structures. The aim of this study was to evaluate 3D segmentation and printing to predict tumor size and vascular involvement of BR-PDAC to improve pre-operative planning of vascular resection and better select patients for neoadjuvant therapy.

Methods: We retrospectively evaluated 16 patients with BR-PDAC near vascular structures who underwent pancreatoduodenectomy (PD) with or without vascular resection between 2015 and 2021.

Long-term Clinical Outcomes After Syndesmosis Fixation With K-wires in Ankle Fractures With Syndesmotic Instability.

Background: Syndesmotic instability is a significant concern in the management of unstable ankle fractures, occurring in approximately 10% to 13% of these cases. Early recognition and stabilization of syndesmotic injuries are essential to ensure optimal long-term outcomes. Several techniques are currently in use, often involving complex procedure and/or costly devices.

Multidrug efflux pumps of show selectivity for their natural substrates.

Antibiotic-resistant Gram-negative bacteria are an increasing threat to human health. Strategies to restore antibiotic efficacy include targeting multidrug efflux pumps by competitive efflux pump inhibitors. These could be derived from natural substrates of these efflux systems.