Global Health Commodities Supply Chain in the Era of COVID-19 Pandemic: Challenges, Impacts, and Prospects: A Systematic Review

Background

The COVID-19 pandemic led to the most substantial health crisis in the 21st Century. This pandemic interrupted the supply of essential commodities for human beings. Among the essential commodities for human survival, disruption of the supply of essential health commodities has become a global concern.

Objective

The study aimed to systematically analyze published articles on the challenges, impacts, and prospects of the global health commodities' supply chain in the era of the COVID-19 pandemic.

Methods

A standard searching strategy was conducted in seven research databases to retrieve pertinent articles. Finally, 459 articles were retrieved for further screening, and only 13 articles were selected for final synthesis.

Results

Almost 38.5% of the studies targeted the supply chain of health commodities used to treat HIV, TB, and malaria. Lockdown policies, travel restrictions, lack of transportation, low manufacturing capacity, and rising costs were the significant challenges indicated for the supply interruption of essential health commodities and COVID-19 vaccines. Findings indicated that the supply interruption of essential health commodities leads to a devastating impact on global health.

Conclusion

Global medicine shortages due to the pandemic crisis can have a devastatingly harmful impact on patient outcomes and might result in a devastatingly long-lasting effect on the health of the world community. Supply-related challenges of the COVID-19 vaccine affect countries' ambitions for achieving herd immunity quickly. Monitoring the pandemic's effect on the health commodities' supply system and designing a short-term and long-term resilient health supply chain system that can cope with current and future health catastrophes is pivotal.

Current trends and prospects of surgical techniques for hepatoblastoma

Hepatoblastoma, a common extracranial malignant solid tumor in childhood, is often detected at an advanced stage and is difficult to treat surgically. Despite the availability of multiple comprehensive treatments that can be combined with surgery, hepatoblastoma treatment outcomes remain poor. Surgery is the main treatment strategy for hepatoblastoma, but it faces many challenges, including tumor attachment to surrounding tissues, tumor wrapping or invading of vital organs and tissues, the presence of giant or multiple tumors, distant metastasis, the formation of a tumor thrombus, and significant surgical trauma. In this review, we discuss recent research advances and propose potential strategies for overcoming these challenges. Such strategies may improve the rate of hepatoblastoma resection and local control in children, as well as reduce complications and trauma.

Calcium signals and potential therapy targets in ovarian cancer (Review)

Ovarian cancer (OC) is a deadly disease. The poor prognosis and high lethality of OC are attributed to its high degrees of aggressiveness, resistance to chemotherapy and recurrence rates. Calcium ion (Ca2+) signaling has received attention in recent years, as it appears to form an essential part of various aspects of cancer pathophysiology and is a potential therapeutic target for OC treatment. Disruption of normal Ca2+ signaling pathways can induce changes in cell cycle progression, apoptosis, proliferation and migration and invasion, leading to the development of the malignant phenotype of tumors. In the present review, the main roles of ion channel/receptor/pump‑triggered Ca2+ signaling pathways located at the plasma membrane and organelle Ca2+ transport in OC are summarized. In addition, the potential of Ca2+ signaling as a novel target for the development of effective treatment strategies for OC was discussed. Furthering the understanding into the role of Ca2+ signaling in OC is expected to facilitated the identification of novel therapeutic targets and improved clinical outcomes for patients.

Leveraging genetic diversity to understand monogenic Parkinson's disease's landscape in AfrAbia

Parkinson's disease may be caused by a single highly deleterious and penetrant pathogenic variant in 5-10% of cases (monogenic). Research into these mutational disorders yields important pathophysiological insights. This article examines the phenotype, genotype, pathophysiology, and geographic and ethnic distribution of genetic forms of disease. Well established Parkinson's disease (PD) causal variants can follow an autosomal dominant (SNCA, LRRK2, and VPS35) and autosomal recessive pattern of inheritance (PRKN, PINK1, and DJ). Parkinson's disease is a worldwide condition, yet the AfrAbia population is understudied in this regard. No prevalence or incidence investigations have been conducted yet. Few studies on genetic risk factors for PD in AfrAbia communities have been reported which supported the notion that the prevalence and incidence rates of PD in AfrAbia are generally lower than those reported for European and North American populations. There have been only a handful of documented genetic studies of PD in AfrAbia and very limited cohort and case-control research studies on PD have been documented. In this article, we provide a summary of prior conducted research on monogenic PD in Africa and highlight data gaps and promising new research directions. We emphasize that monogenic Parkinson's disease is influenced by distinctions in ethnicity and geography, thereby reinforcing the need for global initiatives to aggregate large numbers of patients and identify novel candidate genes. The current article increases our knowledge of the genetics of Parkinson's disease (PD) and helps to further our knowledge on the genetic factors that contribute to PD, such as the lower penetrance and varying clinical expressivity of known genetic variants, particularly in AfrAbian PD patients.

Trofinetide for Rett Syndrome: Highlights on the Development and Related Inventions of the First USFDA-Approved Treatment for Rare Pediatric Unmet Medical Need

Rett syndrome (RTT) is a rare disability causing female-oriented pediatric neurodevelopmental unmet medical need. RTT was recognized in 1966. However, over the past 56 years, the United States Food and Drug Administration (USFDA) has authorized no effective treatment for RTT. Recently, Trofinetide was approved by the USFDA on 10 March 2023 as the first RTT treatment. This article underlines the pharmaceutical advancement, patent literature, and prospects of Trofinetide. The data for this study were gathered from the PubMed database, authentic websites (Acadia Pharmaceuticals, Neuren Pharmaceuticals, and USFDA), and free patent databases. Trofinetide was first disclosed by Neuren Pharmaceuticals in 2000 as a methyl group containing analog of the naturally occurring neuroprotective tripeptide called glycine-proline-glutamate (GPE). The joint efforts of Acadia Pharmaceuticals and Neuren Pharmaceuticals have developed Trofinetide. The mechanism of action of Trofinetide is not yet well established. However, it is supposed to improve neuronal morphology and synaptic functioning. The patent literature revealed a handful of inventions related to Trofinetide, providing excellent and unexplored broad research possibilities with Trofinetide. The development of innovative Trofinetide-based molecules, combinations of Trofinetide, patient-compliant drug formulations, and precise MECP2-mutation-related personalized medicines are foreseeable. Trofinetide is in clinical trials for some neurodevelopmental disorders (NDDs), including treating Fragile X syndrome (FXS). It is expected that Trofinetide may be approved for treating FXS in the future. The USFDA-approval of Trofinetide is one of the important milestones for RTT therapy and is the beginning of a new era for the therapy of RTT, FXS, autism spectrum disorder (ASD), brain injury, stroke, and other NDDs.

Challenges and Prospects of Laser Haemorrhoidoplasty in a Low Resource Setting: The LUTH Experience

Background

Haemorrhoids are the most common condition of the anal canal causing significant disability. Traditional excisional haemorrhoidectomy and its various modifications, while effective, may be attended by severe postoperative pain and other complications. Laser haemorrhoidoplasty is reported to be effective with fewer complications and shorter hospital stay.

Objectives

The aim of this study was to report the outcome of intrahaemorrhoidal coagulation with 1470-nm diode laser at the Lagos University Teaching Hospital.

Patients and Methods

The procedures were performed with a radially emitting laser fibre from Biolitec AG-CeramOptec (Bonn, Germany). The duration of symptoms, grade of the haemorrhoids, duration of the procedures, and postoperative complications were evaluated.

Results

Eleven patients had laser haemorrhoidoplasty. There were seven males and four females. The age range was 23-71 years, with a median age of 47 years and an interquartile range (IQR) of 28-57 years. Duration of surgery ranged from 20 to 90 min, with a median of 33 min and IQR of 25-53 min. Postoperative pain was mild in eight patients and moderate in three. Ten patients were discharged as day cases and one 3 days later due to spinal anaesthesia-related headache and acute urinary retention. One patient later had an anal ulcer probably due to too much energy delivered during the procedure, this was managed conservatively. There was no postoperative wound infection, anal incontinence, anal stenosis, subcutaneous abscess, and fistula or recurrence.

Conclusion

The advantages of laser haemorrhoidoplasty make it a readily acceptable form of treatment for haemorrhoids in our setting.

Research progress on the allergic mechanism, molecular properties, and immune cross-reactivity of the egg allergen Gal d 5

Eggs and their products are commonly consumed in food products worldwide, and in addition to dietary consumption, egg components are widely used in the food industry for their antimicrobial, cooking, and other functional properties. Globally, eggs are the second most common allergenic food after milk. However, current research on egg allergy primarily focuses on egg white allergens, while research on egg yolk allergens is not comprehensive enough. Therefore, summarizing and analyzing the important allergen α-livetin in egg yolk is significant in elucidating the mechanism of egg allergy and exploring effective desensitization methods. This paper discusses the incidence, underlying mechanism, and clinical symptoms of egg allergy. This article provides a comprehensive summary and analysis of the current research status concerning the molecular structural properties, epitopes, and immune cross-reactivity of the egg yolk allergen, Gal d 5. Additionally, it examines the effects of various processing methods on egg allergens. The article also offers suggestions and outlines potential future research directions and ideas in this field.

Highlights on the Development, Related Patents, and Prospects of Lenacapavir: The First-in-Class HIV-1 Capsid Inhibitor for the Treatment of Multi-Drug-Resistant HIV-1 Infection

The multidrug-resistant (MDR) human immunodeficiency virus 1 (HIV-1) infection is an unmet medical need. HIV-1 capsid plays an important role at different stages of the HIV-1 replication cycle and is an attractive drug target for developing therapies against MDR HIV-1 infection. Lenacapavir (LEN) is the first-in-class HIV-1 capsid inhibitor approved by the USFDA, EMA, and Health Canada for treating MDR HIV-1 infection. This article highlights the development, pharmaceutical aspects, clinical studies, patent literature, and future directions on LEN-based therapies. The literature for this review was collected from PubMed, authentic websites (USFDA, EMA, Health Canada, Gilead, and NIH), and the free patent database (Espacenet, USPTO, and Patent scope). LEN has been developed by Gilead and is marketed as Sunlenca (tablet and subcutaneous injection). The long-acting and patient-compliant LEN demonstrated a low level of drug-related mutations, is active against MDR HIV-1 infection, and does not reveal cross-resistance to other anti-HIV drugs. LEN is also an excellent drug for patients having difficult or limited access to healthcare facilities. The literature has established additive/synergistic effects of combining LEN with rilpivirine, cabotegravir, islatravir, bictegravir, and tenofovir. HIV-1 infection may be accompanied by opportunistic infections such as tuberculosis (TB). The associated diseases make HIV treatment complex and warrant drug interaction studies (drug-drug, drug-food, and drug-disease interaction). Many inventions on different aspects of LEN have been claimed in patent literature. However, there is a great scope for developing more inventions related to the drug combination of LEN with anti-HIV/anti-TB drugs in a single dosage form, new formulations, and methods of treating HIV and TB co-infection. Additional research may provide more LEN-based treatments with favorable pharmacokinetic parameters for MDR HIV-1 infections and associated opportunistic infections such as TB.

Role of exosomal noncoding RNA in esophageal carcinoma

Esophageal cancer is a common malignant tumor with a high degree of malignancy. Understanding its pathogenesis and identifying early diagnostic biomarkers can significantly improve the prognosis of esophageal cancer patients. Exosomes are small double-membrane vesicles found in various body fluids containing various components (DNA, RNA, and proteins) that mediate intercellular signal communication. Non-coding RNAs are a class of gene transcription products that encode polypeptide functions and are widely detected in exosomes. There is growing evidence that exosomal non-coding RNAs are involved in cancer growth, metastasis and angiogenesis, and can also be used as diagnostic and prognostic markers. This article reviews the recent progress in exosomal non-coding RNAs in esophageal cancer, including research progress, diagnostic value, proliferation, migration, invasion, and drug resistance, provide new ideas for the precise treatment of esophageal cancer.

Metal-Organic Frameworks (MOF)-Assisted Sonodynamic Therapy in Anticancer Applications

Sonodynamic therapy (SDT) has emerged as a promising therapeutic modality for anticancer treatments and is becoming a cutting-edge interdisciplinary research field. This review starts with the latest developments of SDT and provides a brief comprehensive discussion on ultrasonic cavitation, sonodynamic effect, and sonosensitizers in order to popularize the basic principles and probable mechanisms of SDT. Then the recent progress of MOF-based sonosensitizers is overviewed, and the preparation methods and properties (e.g., morphology, structure, and size) of products are presented in a fundamental perspective. More importantly, many deep observations and understanding toward MOF-assisted SDT strategies were described in anticancer applications, aiming to highlight the advantages and improvements of MOF-augmented SDT and synergistic therapies. Last but not least, the review also pointed out the probable challenges and technological potential of MOF-assisted SDT for the future advance. In all, the discussions and summaries of MOF-based sonosensitizers and SDT strategies will promote the fast development of anticancer nanodrugs and biotechnologies.

Application of Nanotechnology in Thrombus Therapy

A thrombus is a blood clot that forms in the lumen of an artery or vein, restricting blood flow and causing clinical symptoms. Thrombosis is associated with many life-threatening cardiovascular diseases. However, current clinical therapeutic technologies still have many problems in targeting, enrichment, penetration, and safety to meet the thrombosis treatment needs. Therefore, researchers devote themselves to developing nanosystems loaded with antithrombotic drugs to address this paradox in recent years. Herein, the existing thrombosis treatment technologies are first reviewed; and then, their advantages and disadvantages are outlined based on a brief discussion of thrombosis's definition and formation mechanism. Furthermore, the need and application cases for introducing nanotechnology are discussed, focusing on thrombus-specific targeted ligand modification technology and microenvironment-triggered responsive drug release technology. Then, nanomaterials that can be used to design antithrombotic nanotherapeutic systems are summarized. Moreover, a variety of drug delivery technologies driven by nanomotors in thrombosis therapy is also introduced. Last of all, a prospective discussion on the future development of nanotechnology for thrombosis therapy is highlighted.

Optimizing Haemophilia Care in Resource-Limited Countries: Current Challenges and Future Prospects

About 75% of persons with hemophilia live in the developing world and do not have access to routine care due to many barriers. There are a lot of challenges associated with hemophilia care in resource-limited settings, ranging from financial to organisational and government commitments. This review discusses some of these challenges and future prospects, while highlighting the important role of the World Federation of Hemophilia in hemophilia patient care. A participative approach involving all stakeholders is key to optimizing care in resource-limited settings.

[On the prospects of the impedance monitoring method for determining the prescription of death coming]

The aim of the scientific work is to analyze the prospects of using the impedance monitoring method to determine the prescription of death coming. The conducted exploratory analysis allows hypothesizing the dependence of impedance values and dispersion factors for the diagnostic zones studies on the postmortem interval; it also suggests that it is possible to determine this interval for the objects (pig corpses) studies with a combination of impedance values and the corresponding factors. Among large mammals, a swine is the closest to a human from the point of analyzing the postmortem period process, and it can be recommended as an adequate human corpse model. When determining the correlation between the postmortem interval and the impedance parameters, it is the simplicity and reproducibility of the method, the absence of expensive equipment, its portability and the rapid receipt of results that allow this method to be applied at the scene, reinforcing traditional forensic methods for determining the prescription of death coming. Interpretation of impedance monitoring results can be used to analyze the biological nature of the postmortem period processes.

Immunotherapy strategies and prospects for acute lung injury: Focus on immune cells and cytokines

Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is a disastrous condition, which can be caused by a wide range of diseases, such as pneumonia, sepsis, traumas, and the most recent, COVID-19. Even though we have gained an improved understanding of acute lung injury/acute respiratory distress syndrome pathogenesis and treatment mechanism, there is still no effective treatment for acute lung injury/acute respiratory distress syndrome, which is partly responsible for the unacceptable mortality rate. In the pathogenesis of acute lung injury, the inflammatory storm is the main pathological feature. More and more evidences show that immune cells and cytokines secreted by immune cells play an irreplaceable role in the pathogenesis of acute lung injury. Therefore, here we mainly reviewed the role of various immune cells in acute lung injury from the perspective of immunotherapy, and elaborated the crosstalk of immune cells and cytokines, aiming to provide novel ideas and targets for the treatment of acute lung injury.

Systemic complications of rheumatoid arthritis: Focus on pathogenesis and treatment

As a systemic autoimmune disease, rheumatoid arthritis (RA) usually causes damage not only to joints, but also to other tissues and organs including the heart, kidneys, lungs, digestive system, eyes, skin, and nervous system. Excessive complications are closely related to the prognosis of RA patients and even lead to increased mortality. This article summarizes the serious complications of RA, focusing on its incidence, pathogenesis, clinical features, and treatment methods, aiming to provide a reference for clinicians to better manage the complications of RA.

A Review: Meridianins and Meridianins Derivatives

Meridianins are a family of indole alkaloids derived from Antarctic tunicates with extensive pharmacological activities. A series of meridianin derivatives had been synthesized by drug researchers. This article reviews the extraction and purification methods, biological activities and pharmacological applications, pharmacokinetic characters and chemical synthesis of meridianins and their derivatives. And prospects on discovering new bioactivities of meridianins and optimizing their structure for the improvement of the ADMET properties are provided.

Advances in brain-heart syndrome: Attention to cardiac complications after ischemic stroke

Neurocardiology is an emerging field that studies the interaction between the brain and the heart, namely the effects of heart injury on the brain and the effects of brain damage on the heart. Acute ischemic stroke has long been known to induce heart damage. Most post-stroke deaths are attributed to nerve damage, and cardiac complications are the second leading cause of death after stroke. In clinical practice, the proper interpretation and optimal treatment for the patients with heart injury complicated by acute ischemic stroke, recently described as stroke-heart syndrome (SHS), are still unclear. Here, We describe a wide range of clinical features and potential mechanisms of cardiac complications after ischemic stroke. Autonomic dysfunction, microvascular dysfunction and coronary ischemia process are interdependent and play an important role in the process of cardiac complications caused by stroke. As a unique comprehensive view, SHS can provide theoretical basis for research and clinical diagnosis and treatment.

Artificial Cells: Past, Present and Future

Artificial cells are constructed to imitate natural cells and allow researchers to explore biological process and the origin of life. The construction methods for artificial cells, through both top-down or bottom-up approaches, have achieved great progress over the past decades. Here we present a comprehensive overview on the development of artificial cells and their properties and applications. Artificial cells are derived from lipids, polymers, lipid/polymer hybrids, natural cell membranes, colloidosome, metal-organic frameworks and coacervates. They can be endowed with various functions through the incorporation of proteins and genes on the cell surface or encapsulated inside of the cells. These modulations determine the properties of artificial cells, including producing energy, cell growth, morphology change, division, transmembrane transport, environmental response, motility and chemotaxis. Multiple applications of these artificial cells are discussed here with a focus on therapeutic applications. Artificial cells are used as carriers for materials and information exchange and have been shown to function as targeted delivery systems of personalized drugs. Additionally, artificial cells can function to substitute for cells with impaired function. Enzyme therapy and immunotherapy using artificial cells have been an intense focus of research. Finally, prospects of future development of cell-mimic properties and broader applications are highlighted.

Research Advances and Prospects of Orphan Genes in Plants

Orphan genes (OGs) are defined as genes having no sequence similarity with genes present in other lineages. OGs have been regarded to play a key role in the development of lineage-specific adaptations and can also serve as a constant source of evolutionary novelty. These genes have often been found related to various stress responses, species-specific traits, special expression regulation, and also participate in primary substance metabolism. The advancement in sequencing tools and genome analysis methods has made the identification and characterization of OGs comparatively easier. In the study of OG functions in plants, significant progress has been made. We review recent advances in the fast evolving characteristics, expression modulation, and functional analysis of OGs with a focus on their role in plant biology. We also emphasize current challenges, adoptable strategies and discuss possible future directions of functional study of OGs.

[Research status and prospects of integration of habitat processing and processing of Chinese medicinal decoction pieces]

The integration of habitat processing and processing of Chinese medicinal decoction pieces(hereinafter referred to as "integration") has changed the traditional processing mode and can ensure the quality of Chinese medicinal decoction pieces from the source. This paper introduced the background of integration from the connotation and denotation of integration, relevant policies and regulations, and variety development. The present situation of integration was analyzed from the existing problems and current research progress, and the development suggestions were proposed. It is considered that although the integration is in line with the development trend of the industry with the advantages of improving the quality and standardizing the management of decoction pieces, there are still some problems, such as the lack of variety selection principles and production technical specifications, imperfect quality control stan-dards in the production process, and inadequate integration of standards and supervision. Therefore, it is suggested to determine the integrated variety selection principles and variety range as soon as possible, establish relevant technical specifications, improve quality control standards in the production process, and strengthen policy guidance and supervision to promote the healthy and orderly development of integration.

Noncoding RNAs and hyperthermic intraperitoneal chemotherapy in advanced gastric cancer

Gastric cancer (GC) is one of the most common malignant tumors globally. About 20-30% of patients with gastric cancer show peritoneal implantation metastasis at the first diagnosis. Peritoneal metastasis is responsible for 70% of deaths of patients with advanced gastric cancer. Although there are many ways to treat advanced gastric cancer, the prognosis of patients with recurrence is unsatisfactory. An auxiliary treatment with hyperthermic intraperitoneal chemotherapy (HIPEC), is an internationally recognized recommended treatment for advanced gastric cancer. A series of clinical trials have shown that HIPEC significantly improves the overall survival of patients with cancer. Compared with the cytoreductive surgery (CRS) alone, HIPEC combined with CRS markedly reduced the rate of peritoneal metastasis in patients with ovarian cancer and colorectal cancer. It has been demonstrated that HIPEC alters transcription of many genes by affecting non-coding RNAs, which may contribute to the suppressive effect of HIPEC on the synthesis of nucleic acids and proteins in cancer cells. This paper reviews the recent advances in understanding the role of non-coding RNAs in tumor invasion and metastasis of advanced gastric cancer. We also consider changes in noncoding RNA levels and other molecules in advanced gastric cancer cases treated with HIPEC. We hope that our review will provide a reference for future research on molecular epidemiology and etiology of advanced gastric cancer and promote precise treatment of this malignancy using HIPEC.

Modelling the perspectives of distance education students towards online learning during COVID-19 pandemic

This study examined perspectives of distance education students on online learning based on their access gadgets (availability and functionality), online presentation or teaching methods, actual use of online learning coupled with its challenges. A quantitative approach and descriptive survey design were adopted for the study. A sample of 1061 was drawn from a study population of 44,134 distance learners across sixteen administrative regions and data collected using a questionnaire. Partial least squares structural equation modelling (PLS-SEM) was used to analyse the hypotheses of the study, and descriptive statistics were deployed to analyse students perceived challenges. The study found a statistically significant relationship between the availability and functionality of online gadgets, availability of online gadgets and online presentation methods, functionality and online presentation methods and functionality and online learning usage. Thus, these factors are necessary for successful online learning. Four main perceived challenges identified were unreliable power/electricity and internet connectivity, lack of collaboration and motivation during online learning. Therefore, it was recommended that steps are taken to resolve the perceived challenges while adopting the blended approach comprising face-to-face and online learning. The blended learning approach would enable students to adjust better and appreciate its usefulness in distance education.

Elucidation of potential challenges and prospects for regional tuberculosis interventions in East and Horn of Africa: a cross-sectional program assessment

Introduction

cross-border mobility of persons with Tuberculosis (TB) is a global public health concern. We aimed at documenting health systems´ potential bottlenecks and opportunities in pulmonary TB continuum of care in cross-border expanses of East and Horn of Africa.

Methods

a cross-sectional program assessment with descriptive analysis of TB services, health staff capacities, diagnostic capacities, data management and reporting, and treatment outcomes. Data were extracted from health facility TB registers and semi-structured key informant interviews conducted in selected 26 cross-border sites within the 7 member states of the Intergovernmental Authority on Development (IGAD) region.

Results

the overall cross-border TB cure rate in the year preceding the study (37%) was way beneath the global target with considerable variations amongst the study countries. The restricted support to the cross-border health facilities was mediated and even exacerbated by expansive distances from the respective capital cities. Restricted geographical access to the facilities by cross-border populations was a longstanding challenge. Substantial staffing gaps, TB service delivery capacity needs and inadequate diagnostics were noticeable. The TB control guidelines were not harmonized between the countries and the inter-country referral systems were either absent or inappreciable, contributing to ineffective cross-border referrals and transfers. The frail linkages between stakeholders were contemptible, but increasing governments´ commitments in tackling infectious diseases were encouraging.

Conclusion

cross-border TB interventions should drive regional TB policies, strategies and programs that sustain countries´ coordination, harmonization of management guidelines, advocacy for increased human resources support, enhanced capacity building of cross-border TB staff, adequate diagnostics equipping of the cross-border health facilities and seamless transfer and referral of patients traversing boundaries.

Prospects of Integrating Gig Economy in the Saudi Arabian Health-care System from the Perspectives of Health-care Decision-makers and Practitioners

Background

Gig economy is an approach in the labor market which is characterized by the prevalence of short-term contracts or freelance work in contrast to permanent jobs. The gig workers are independent workers or temporary contract workers who enter into formal/informal agreements with on-demand companies to provide their services. Rather than employing full-time/permanent employees companies may utilize gig workers as per the demand and work burden, which can minimize the costs incurred in managing permanent employees. However, there is a lack of research on using gig economy in health care, its prospects and the issues involved.

Purpose

The purpose of this study is to identify and evaluate various prospects in integrating gig economy with the Saudi health-care system.

Methods

An online survey questionnaire instrument including 22 prospects under three categories including organizational competitiveness, resource management, and sustainable development was used for collecting data from 712 health-care decision-makers and practitioners in Saudi Arabia. Findings were analyzed using the statistical means and standard deviations for each item in the questionnaire for analyzing the role of each factor in depth, and t-tests were used for comparing the responses between the groups.

Results

T-tests revealed no significant differences among the experts and health-care workers in relation to organizational competitiveness and resource management; however, significant differences in opinions were identified in relation to sustainable development. Individual factors including motivation for Saudization program (mean=4.5, SD=1.15) and creating employment opportunities in rural areas (mean=4.5, SD=1.08), growth in economy (mean=4.4, SD=1.43), increased opportunities for women and disabled (mean=4.4, SD=1.28), and growth in employment (mean=4.3, SD=1.68) were the major prospects identified in relation to the use of gig economy in the Saudi Arabian health-care system.

Conclusion

Gig economy may offer a wide range of benefits in health care, especially sustainable development, effective resource management, and organizational competitiveness.

Overview of Poultry Management as a Key Factor for Solving Food and Nutritional Security with a Special Focus on Chicken Breeding in East African Countries

Simple Summary

The poultry sector in most developing countries is largely based on traditional production systems, which are based on indigenous breeds. Beyond economical, nutritional, socio-cultural, and religious functions, the inherent adaptability of indigenous birds to diverse environmental conditions also provides a unique genetic resource critical for addressing the global challenges of food security in this world impacted by climatic change and human population growth. Nevertheless, until recently, the potential of the indigenous chicken remained largely untapped for no strong reason. In this review, we offer an overview of food and nutritional security with a special focus on chicken breeding in East Africa. We highlighted and combined confirming evidence of production performance, phenotypic variability, and genetic diversity of East African indigenous chicken using both morphological and molecular tools. Previous attempts to improve the productivity of indigenous chicken are highlighted, and possible future breeding plans and areas of immediate research are suggested. Considering how indigenous chicken strongly affects the livelihood of the majority of households, and since the poultry sector is likely to be strongly affected by climate change, we recommended that the prospects of chicken breeding in Africa should create a permanent balance between the competing needs of genetic improvement and the genetic diversity of indigenous chickens.

Abstract

The focus of this review is to offer an overview of food and nutritional security, to identify associated constraints, and propose possible alternative solutions for improving the East African poultry sub-sector in the pursuit of food security, focusing on chicken breeding. To better understand the prospects of the poultry industry, we highlighted and combined confirming evidence of the phenotypic variability and genetic diversity of East African chicken genetic resources using both morphological and molecular tools, as well as performance traits. Furthermore, this work gives a detailed indication of what would be lost if indigenous chicken populations are left to suffer the ongoing massive genetic erosions due to various factors, not limited to indiscriminate crossbreeding. Previous and recent attempts to improve the productivity of indigenous chicken are highlighted, and possible future breeding plans and areas of immediate research are suggested as well. This review concludes that under the prevailing conditions, the village chicken production system appears to be the most imperious production system that needs to be extensively developed ; however, for the sustainability of the industry, the proposed improvement strategies should create a permanent balance between the competing needs of genetic improvement and the genetic diversity of the indigenous chicken genetic resource.

Gig Health vs eHealth: Future Prospects in Saudi Arabian Health-Care System

Introduction

The number of gig workers has been rising across the world, reflecting the growing trend toward the gig economy, which is already functioning in various sectors, such as transport(eg, Uber), technology (eg, Appen), and others (eg, Upwork). However, application of gig economy in health care is underresearched, especially in areas of eHealth that can facilitate various online activities and be outsourced.

Purpose

The purpose of this study was to investigate the gig economy and eHealth in terms of prospects for future health care in Saudi Arabia.

Methods

Analysis of data collected using online semistructured interviews with 19 experts, including executives from ministries of health and information and communications, physicians, and health-care administrative managers was conducted and new empirical insights are offered.

Results

A lack of legal and regulatory frameworks and integrating gig culture into the eHealth system were identified to be the major challenges. Improved operational efficiency of health care, reduced costs, and positive societal impact were identified to be the opportunities and benefits of using the gig economy and eHealth in Saudi Arabia. A strategic framework and an effective regulatory framework are essential for integrating the gig economy into the eHealth system in Saudi Arabia and improving future health care by adopting innovative artificial intelligence and machine-learning technologies.

Conclusion

eHealth has major scope for future health-care operations in Saudi Arabia and use of the gig economy in eHealth may lead to effective management of eHealth operations. More studies are required to evaluate the idea of integrating the gig economy and eHealth and analyze its impact.

Opportunities and Scope for Botanical Extracts and Products for the Management of Fall Armyworm (Spodoptera frugiperda) for Smallholders in Africa

Fall Armyworm (FAW) (Spodoptera frugiperda) is a polyphagous and highly destructive pest of many crops. It was recently introduced into Africa and now represents a serious threat to food security, particularly because of yield losses in maize, which is the staple food for the majority of small-scale farmers in Africa. The pest has also led to increased production costs, and threatens trade because of quarantines imposed on produce from the affected countries. There is limited specific knowledge on its management among smallholders since it is such a new pest in Africa. Some synthetic insecticides have been shown to be effective in controlling FAW, but in addition to the economic, health and environmental challenges of pesticide use insecticide resistance is highly prevalent owing to years of FAW management in the Americas. Therefore, there is a need for the development and use of alternatives for the management of FAW. These include plant-derived pesticides. Here we review the efficacy and potential of 69 plant species, which have been evaluated against FAW, and identify opportunities for use among small-scale maize farmers with a focus on how pesticidal plants might be adopted in Africa for management of FAW. The biological activities were diverse and included insecticidal, insectistatic (causing increased larval duration), larvicidal, reduced growth and acute toxicity (resulting in adverse effects within a short time after exposure). While most of these studies have been conducted on American plant taxa many South American plants are now cosmopolitan weeds so these studies are relevant to the African context.

Towards improved governance for sustainable solid waste management in Lebanon: Centralised vs decentralised approaches

Solid waste management is a multifaceted task that incorporates a diverse set of shareholders and operations. To create a sustainable solid waste management system, governments should select the most advantageous organisational structure, given a country's current setting; contextualising the sector's administrative structure in accordance with a nation's organisational constraints. This research aimed to determine the recommended level of administrative and financial decentralisation for each solid waste management operation and explore the susceptibilities and prospects of each level of governance in Lebanon. Primary data was gathered from environmental experts and concerned organisations using a semi-structured in-depth interview. Results revealed that the optimal model for solid waste management in the case of Lebanon incurs devolving collection, which would assimilate local populations into the decision-making process and reduce opposition towards devised solid waste management plans. Delegation and the construction of centralised treatment facilities is recommended as it incentivises municipal cooperation and permits the installation of methodologies and technologies that reflect the limitations, public attitudes, and waste dynamics of each distinct geographical territory. Deconcentrating disposal would limit the number of landfills constructed and facilitate monitoring. Administrative and constitutional reformations that clearly define the roles and responsibilities of public agencies would reduce the influence of the central authority on peripheral states. The establishment of municipal cooperation models would diminish regional economic disparities by enhancing the level of communication and collaboration between subnational bodies. The performance of decentralised strategies should be continuously monitored to ensure that local administrators are held accountable.

Prospects for Food Fermentation in South-East Asia, Topics From the Tropical Fermentation and Biotechnology Network at the End of the AsiFood Erasmus+Project

Fermentation has been used for centuries to produce food in South-East Asia and some foods of this region are famous in the whole world. However, in the twenty first century, issues like food safety and quality must be addressed in a world changing from local business to globalization. In Western countries, the answer to these questions has been made through hygienisation, generalization of the use of starters, specialization of agriculture and use of long-distance transportation. This may have resulted in a loss in the taste and typicity of the products, in an extensive use of antibiotics and other chemicals and eventually, in a loss in the confidence of consumers to the products. The challenges awaiting fermentation in South-East Asia are thus to improve safety and quality in a sustainable system producing tasty and typical fermented products and valorising by-products. At the end of the “AsiFood Erasmus+ project” (www.asifood.org), the goal of this paper is to present and discuss these challenges as addressed by the Tropical Fermentation Network, a group of researchers from universities, research centers and companies in Asia and Europe. This paper presents current actions and prospects on hygienic, environmental, sensorial and nutritional qualities of traditional fermented food including screening of functional bacteria and starters, food safety strategies, research for new antimicrobial compounds, development of more sustainable fermentations and valorisation of by-products. A specificity of this network is also the multidisciplinary approach dealing with microbiology, food, chemical, sensorial, and genetic analyses, biotechnology, food supply chain, consumers and ethnology.

Retrospective Analysis and Review of the Literature

OBJECTIVES

Stiff left atrial syndrome is an intriguing clinical phenomena characterized by reduced left atrial compliance, pulmonary venous hypertension and exacerbations of volume overload. We conducted a retrospective review of patients diagnosed with stiff left atrial syndrome at our center.

METHODS

All patients admitted to our hospital with volume overload and pulmonary venous hypertension who were diagnosed with stiff left atrial syndrome based on evidence by echocardiogram and right heart catheterization between July 2011 and July 2013 were included in this retrospective review.

RESULTS

Twentythree patients (mean age 73 ± 11 years, 39% male and 61% female) were diagnosed with stiff left atrial syndrome at our center. Thirty-five percent had persistent while 39% had permanent atrial fibrillation. Mean duration of atrial fibrillation was 7.6 ± 2.1 years. Forty-three percent of patients had long standing hypertension. There was no mitral regurgitation in 39% of patients while 48% had mild mitral regurgitation. On right heart catheterization, mean right atrial pressure was 12.6±4.8 mm of Hg, mean pulmonary arterial pressure was 33±7.2 mm of Hg, mean pulmonary capillary wedge pressure was 24.8± 4.2mm of Hg while peak V waves were seen at mean of 37.8± 5.3 mm of Hg. Mean left atrial volume index was 49.8±17.1 mL/m 2. After the initial diagnosis with a two year follow- up, there were no readmissions in 65% of patients who were on appropriate diuretic therapy and had regular clinical visits. Frequent readmissions were seen in 35% of patients inspite of appropriate diuretic therapy. All-cause mortality rate was 4.3% at two year follow up.

CONCLUSION

In patients with stiff left atrial syndrome, the presence of left atrial dilation, long standing atrial fibrillation and hypertension are the key factors associated with pathogenesis and clinical course. Close follow up and monitoring of volume status is essential to prevent hospital readmissions and improve long term prognosis.

A Review: The Bioactivities and Pharmacological Applications of Polygonatum sibiricum polysaccharides

Traditional Chinese Medicine (TCM) has been widely used in China and is regarded as the most important therapeutic. Polygonatum sibiricum (PS), a natural plant used in traditional Chinese medicine, has various functions associated with a number of its components. There are many compositions in PS including polysaccharides, steroids, anthraquinone, alkaloids, cardiac glycosides, lignin, vitamins, various acids, and so on. Of these, polysaccharides play a significant role in PS-based therapeutics. This article summarizes Polygonatum sibiricum polysaccharides (PSP) have many pharmacological applications and biological activities, such as their antioxidant activity, anti-aging activity, an anti-fatigue effect, immunity enhancement effect, antibacterial effect, anti-inflammatory effect, hypolipidemic and antiatherosclerotic effects, anti-osteoporosis effect, liver protection, treatment of diabetes mellitus (DM), anti-cancer effect, and may help prevent Alzheimer’s disease, and so on. This review summarized the extraction method, purification method, compositions, pharmacological applications, biological activities, biosynthesis, and prospects of PSP, providing a basis for further study of PS and PSP.

CRISPR/Cas9 Genome-Editing System in Human Stem Cells: Current Status and Future Prospects

Genome-editing involves the insertion, deletion, or replacement of DNA in the genome of a living organism using “molecular scissors.” Traditional genome editing with engineered nucleases for human stem cells is limited by its low efficiency, high cost, and poor specificity. The CRISPR system has recently emerged as a powerful gene manipulation technique with advantages of high editing efficiency and low cost. Although this technique offers huge potential for gene manipulation in various organisms ranging from prokaryotes to higher mammals, there remain many challenges in human stem cell research. In this review, we highlight the basic biology and application of the CRISPR/Cas9 system in current human stem cell research, discuss its advantages and challenges, and debate the future prospects for human stem cells in regenerative medicine.

Progress and Prospects of CRISPR/Cas Systems in Insects and Other Arthropods

Clustered regularly interspaced short palindromic repeats (CRISPR) and the CRISPR-associated gene Cas9 represent an invaluable system for the precise editing of genes in diverse species. The CRISPR/Cas9 system is an adaptive mechanism that enables bacteria and archaeal species to resist invading viruses and phages or plasmids. Compared with zinc finger nucleases and transcription activator-like effector nucleases, the CRISPR/Cas9 system has the advantage of requiring less time and effort. This efficient technology has been used in many species, including diverse arthropods that are relevant to agriculture, forestry, fisheries, and public health; however, there is no review that systematically summarizes its successful application in the editing of both insect and non-insect arthropod genomes. Thus, this paper seeks to provide a comprehensive and impartial overview of the progress of the CRISPR/Cas9 system in different arthropods, reviewing not only fundamental studies related to gene function exploration and experimental optimization but also applied studies in areas such as insect modification and pest control. In addition, we also describe the latest research advances regarding two novel CRISPR/Cas systems (CRISPR/Cpf1 and CRISPR/C2c2) and discuss their future prospects for becoming crucial technologies in arthropods.

A survey of Japanese quail (Coturnix coturnix japonica) farming in selected areas of Bangladesh

Aim:

To investigate the status, problems and prospects of Japanese quail (Coturnix coturnix japonica) farming in selected areas of Bangladesh.

Materials and Methods:

The study was conducted in 14 districts of Bangladesh, viz., Dhaka, Narayanganj, Munshiganj, Mymensingh, Netrakona, Faridpur, Jessore, Khulna, Satkhira, Kushtia, Bogra, Naogaon, Comilla, and Sylhet during the period from July 2011 to June 2012. A total of 52 quail farmers were interviewed for data collection using a structured questionnaire. Focus group discussions were also carried out with unsuccessful farmers and those want to start quail farming. Workers of quail farms, quail feeds and medicine suppliers, quail eggs and meat sellers were also interviewed regarding the issue.

Results:

Out of 52 farms, 86.5% were operated by male, 67.3% farmers did not receive any training and 92.3% farmers had no earlier experience of quail farming although 58.0% farmers primary occupation was quail farming. Most of the farms (63.4%) were mixed in type having ≤5000 birds of two or three varieties. About 80.7% farms were operated separately round the year with no other poultry and 83.0% farmers wanted to expand their farming. The average pullet weight 145.0±0.12, 110.0±0.07, 120.0±0.22, and 128.0±0.17 g; age at the first lay 46.0±0.04, 42.0±0.31, 42.0±0.09, and 45.2±0.05 days; rearing period 15.0±0.01, 12.0±0.14, 15.0±0.32, and 15.2±0.18 months; culling period 15.5±0.14, 13.0±0.06, 15.0±0.03, and 15.4±0.26 months were for layer, parent stock, hatchery, and mixed farms, respectively. Most of the layer farms had an average egg production of ≤5000/day and net profit BDT 0.75/egg. However, an average number of birds, hatchability and net profit per day-old-chick were ≤5000, 76.8% and BDT 2.75, respectively, in the hatchery. Broiler quails were sold at 30 days with mean weight of 110.8 g and net profit BDT 9.02/bird. The major constraints of quail farming were higher feed price, outbreak of endemic diseases, lack of proper knowledge, farmers training, proper market access, difficulties of parent stock collection, inadequate biosecurity practices, and limited access to veterinary care. Thus, a proper training on quail farming, bio-security management, and government subsidy on feeds could make quail farming sustainable in Bangladesh.

Conclusions:

The study concludes that Japanese quail farming has enormous potentiality and could be an alternative to chicken farming particularly in providing gainful employment, supplementary income and as a valuable source of meat and egg, quail farming should be encouraged and promoted in Bangladesh.

Orthostatic tremor: current challenges and future prospects

This review provides an outlook of orthostatic tremor (OT), a rare adult-onset tremor characterized by subjective unsteadiness during standing that is relieved by sitting or walking. Recent case series with a long-time follow-up have shown that the disease is slowly progressive, spatially spreads to the upper limbs, and other neurological disorders may develop in about one-third of the patients. The diagnosis of OT hinges on the typical history of unsteadiness during standing, which is confirmed by electromyographic findings of a 13–18 Hz tremor that is typically absent during tonic activation while the patient is sitting and lying. Although the tremor is generated by a central oscillator, cerebellar and/or basal ganglia dysfunction are needed for its manifestation (double lesion hypothesis). However, functional neuroimaging findings have not consistently implicated the dopaminergic system in its pathogenesis. Drug treatments have been largely disappointing with no sustained benefits, although thalamic deep brain stimulation has helped some patients. Large-scale follow-up studies, more drug trials, and novel therapies are urgently needed.

Challenges and prospects of food science and technology education: Nepal's perspective

Food science and technology education has been running since four decades in Nepal. There is a very slow improvement in the profession. The job opportunities have always been threatened by insiders and outsiders. Academic institutions, government agencies, and food industries themselves are responsible for the quality of food science professionals. Novel and practical methods of teaching should be followed. The government and private organizations should facilitate the recruitment of food technologists. Constant prodding needs to be done for the establishment of a Council with more authority that could monitor all bodies associated with food science professionals.

Future prospects of monoclonal antibodies as magic bullets in immunotherapy

Monoclonal antibody therapy has become a critical component of clinical treatment procedure for a variety of indications. Therapeutic antibodies have made the transition from conception to clinical reality over the past two decades. Now, many of mAbs are being tested as adjuvant or first-line therapies to determine their efficacy in improving survival. In the future, the information drawn from genomemedical science and genome-informatics, that list the disease-related antigens useful for medical treatment, should be essential to develop the therapy using mAbs. Currently, the more attention is getting paid toward monoclonal antibody therapy. Several monoclonal antibodies, alone and in combination with other conventional therapies, are being tested in phase I and phase II clinical trials at the moment. Monoclonal antibody therapy can be done by using antibody fragments, antibody fusions with effector proteins and intrabodies. The large size and the long half-life of full-length antibody make them an inappropriate tool for radioimmunotherapy. Therefore, scientists produced some antibody fragments including scFv, Diabody and Nanobodies (sdAbs) which have smaller size besides maintaining the binding activity of the full-length molecule. Immunotoxin and Immunocytokines are consisting of toxin and cytokines fused to antibody fragments. An intrabody is produced by entering antibody into the cell and act against intracellular compartments.

Prospects and applications of nanobiotechnology: a medical perspective

BACKGROUND

Nanobiotechnology is the application of nanotechnology in biological fields. Nanotechnology is a multidisciplinary field that currently recruits approach, technology and facility available in conventional as well as advanced avenues of engineering, physics, chemistry and biology.

METHOD

A comprehensive review of the literature on the principles, limitations, challenges, improvements and applications of nanotechnology in medical science was performed.

RESULTS

Nanobiotechnology has multitude of potentials for advancing medical science thereby improving health care practices around the world. Many novel nanoparticles and nanodevices are expected to be used, with an enormous positive impact on human health. While true clinical applications of nanotechnology are still practically inexistent, a significant number of promising medical projects are in an advanced experimental stage. Implementation of nanotechnology in medicine and physiology means that mechanisms and devices are so technically designed that they can interact with sub-cellular (i.e. molecular) levels of the body with a high degree of specificity. Thus therapeutic efficacy can be achieved to maximum with minimal side effects by means of the targeted cell or tissue-specific clinical intervention.

CONCLUSION

More detailed research and careful clinical trials are still required to introduce diverse components of nanobiotechnology in random clinical applications with success. Ethical and moral concerns also need to be addressed in parallel with the new developments.

p53 gene in treatment of hepatic carcinoma: status quo

Hepatocellular carcinoma (HCC) is one of the 10 most common cancers worldwide. There is no ideal treatment for HCC yet and many researchers are trying to improve the effects of treatment by changing therapeutic strategies. As the majority of human cancers seem to exhibit either abnormal p53 gene or disrupted p53 gene activation pathways, intervention to restore wild-type p53 (wt-p53) activities is an attractive anti-cancer therapy including HCC. Abnormalities of p53 are also considered a predisposition factor for hepatocarcinogenesis. p53 is frequently mutated in HCC. Most HCCs have defects in the p53-mediated apoptotic pathway although they carry wt-p53. High expression of p53 in vivo may exert therapeutic effects on HCC in two aspects: (1) High expression of exogenous p53 protein induces apoptosis of tumor cells by inhibiting proliferation of cells through several biologic pathways and (2) Exogenous p53 renders HCC more sensitive to some chemotherapeutic agents. Several approaches have been designed for the treatment of HCC via the p53 pathway by restoring the tumor suppression function from inactivation, rescuing the mutated p53 gene from instability, or delivering therapeutic exogenous p53. Products with p53 status as the target have been studied extensively in vitro and in vivo. This review elaborates some therapeutic mechanisms and advances in using recombinant human adenovirus p53 and oncolytic virus products for the treatment of HCC.