Climate Change and Water Security

Climate change is an actual fact setting off an imbalance in many living systems. Among these affected systems, water is a major essential element in the globe and in every existing living being. Therefore, several complications have been stated to occur, following water scarcity and water flood in many regions of the world, which make of them a global major threat of water security. The global disease burden is an additional factor that appeals to serious interventions worldwide in order to alleviate the water scarcity and water flood-related effects.

PERBANDINGAN PEMERIKSAAN TINJA METODE SEDIMENTASI DENGAN METODE NATIF DALAM MENDETEKSI SOIL TRANSMITTED HELMINTH

Soil Transmitted Helminth (STH) is the most common intestinal parasific infection and in one of the contributors to the global disease burden. Diagnosis of Soil Transmitted Helminth desease can be done using sedimentation method and natif method. This study aims to find out the differences in sedimentation methods and natif methods in deteting Soil Transmitted Helminth Type of research conducted ind true experimental form. This research was conducted on March 27-29, 2021 at the Microbiology Laboratory of Muhammadiyah Institute of Health and Technology Palembang which numbered 35 respondents. The results obtained in this study were as many as 2 positive samples and 33 negative samples. In sample 1 there are 2 types of eggs Soil Transmitted Helminth namely eggs Ascaris lumbricoides and Trichuris trichiura on sedimentation method and natif method, while in sample 5 there are eggs Ascaris lumbricoides only on the natif method. The results of the research data were conduted using an alternative test Wilcoxon with a value of P = 0.317 means there is no difference that signifikan.the conclusion of this study was obtained by the examination that there is no difference in sedimentation with natiif method.

Antibiotic Treatment, Mechanisms for Failure, and Adjunctive Therapies for Infections by Group A Streptococcus

Group A Streptococcus (GAS; Streptococcus pyogenes) is a nearly ubiquitous human pathogen responsible for a significant global disease burden. No vaccine exists, so antibiotics are essential for effective treatment. Despite a lower incidence of antimicrobial resistance than many pathogens, GAS is still a top 10 cause of death due to infections worldwide. The morbidity and mortality are primarily a consequence of the immune sequelae and invasive infections that are difficult to treat with antibiotics. GAS has remained susceptible to penicillin and other β-lactams, despite their widespread use for 80 years. However, the failure of treatment for invasive infections with penicillin has been consistently reported since the introduction of antibiotics, and strains with reduced susceptibility to β-lactams have emerged. Furthermore, isolates responsible for outbreaks of severe infections are increasingly resistant to other antibiotics of choice, such as clindamycin and macrolides. This review focuses on the challenges in the treatment of GAS infection, the mechanisms that contribute to antibiotic failure, and adjunctive therapeutics. Further understanding of these processes will be necessary for improving the treatment of high-risk GAS infections and surveillance for non-susceptible or resistant isolates. These insights will also help guide treatments against other leading pathogens for which conventional antibiotic strategies are increasingly failing.

Global disease burden of uncorrected refractive error among adolescents from 1990 to 2019

Background To estimate the global disease burden of uncorrected refractive error (URE) among adolescents and assess the contributions of various risk factors to disability-adjusted life-years (DALYs) due to URE. Methods Global, regional and country-level DALY numbers and rates due to URE among adolescents were acquired from the Global Burden of Disease Study 2019 database. Human Development Index (HDI), Socio-Demographic Index (SDI) and other country-level data were obtained from other open databases as potential indicators. Regression analysis was used to evaluate associations between DALY rates among adolescents and potential predictors. Results Global DALYs due to URE among adolescents rose by 8% between 1990 and 2019 but moderately decreased by 4.8% during this period after adjusting for population size. Female adolescents showed higher DALY rates. DALY rates sharply increased from 5 to 9 years of age, then rose more slowly, reaching a plateau before 20 years of age. Country-level DALY rates in 2019 were positively associated with HDI, SDI, and urbanization rates but negatively correlated with primary school dropout rates. Higher disease burden of adolescents visually impaired from URE was associated with lower primary school dropout rates (β = − 0.257, 95% CI − 0.376 to − 0.138, P < 0.001) and higher urbanization rates (β = 0.257, 95% CI 0.067 to 0.256, P = 0.001). Conclusions Higher socioeconomic status, urbanization rates and education levels are associated with a heavier disease burden of URE among adolescents. The findings of this study can provide a reference for policy making on resource allocation for URE prevention and control in teenagers.

Knee-High Devices Are Gold in Closing the Foot Ulcer Gap: A Review of Offloading Treatments to Heal Diabetic Foot Ulcers

Diabetic foot ulcers (DFU) are a leading cause of the global disease burden. Most DFUs are caused, and prolonged, by high plantar tissue stress under the insensate foot of a person with peripheral neuropathy. Multiple different offloading treatments have been used to try to reduce high plantar tissue stress and heal DFUs, including bedrest, casting, offloading devices, footwear, and surgical procedures. The best offloading treatments are those that balance the benefits of maximizing reductions in high plantar tissue stress, whilst reducing the risks of poor satisfaction, high costs and potential adverse events outcomes. This review aimed to summarize the best available evidence on the effects of offloading treatments to heal people with DFUs, plus review their use in clinical practice, the common barriers and solutions to using these treatments, and discuss promising emerging solutions that may improve offloading treatments in future. Findings demonstrate that knee-high offloading devices, non-removable or removable knee-high devices worn for all weight-bearing activities, are the gold standard offloading treatments to heal most patients with DFU, as they are much more effective, and typically safer, quicker, and cheaper to use compared with other offloading treatments. The effectiveness of offloading treatments also seems to increase when increased offloading mechanical features are incorporated within treatments, including customized insoles, rocker-bottom soles, controlled ankle motion, and higher cast walls. However, in clinical practice these gold standard knee-high offloading devices have low rates of prescription by clinicians and low rates of acceptance or adherence by patients. The common barriers resulting in this low use seem to surround historical misperceptions that are mostly dispelled by contemporary evidence. Further, research is now urgently required to close the implementation gap between the high-quality of supporting evidence and the low use of knee-high devices in clinical practice to reduce the high global disease burden of DFU in future.

858 Transoral Robotic Surgery: Comparing the Geography of Research Publications with The Global Burden of Disease

Introduction Transoral robotic surgery (TORS) is increasingly used for the resection of oropharyngeal tumours. It is unclear if there is equitable access to this innovative technique worldwide, specifically in areas of greatest need. This study aimed to map the geographic distribution of publications on TORS and compare this to global disease burden. Method Systematic searches identified all studies of TORS from inception to 2018. The country of origin of each study was identified. The incidence and age standardised rate (ASR) of oropharyngeal cancer for each country was obtained from The Global Cancer Observatory (GLOBOCAN) database. World Bank classifications of countries by income level were obtained. Results A total of 132 studies were identified. The majority (96%) were published in high-income countries, 2% in lower-middle, and 2% in upper-middle income countries. Eighty-nine were published in the USA, the country with the second-highest incidence of oropharyngeal cancer worldwide (13% of total), but 20th by ASR. The greatest incidence was in India (21%), however this was the source of only 2% of studies. Of the ten countries with the highest incidence, eight were represented in published studies, in comparison to four of the top 10 by ASR. Conclusions There is evident disparity in the geographical distribution of published studies of TORS. This disparity may represent unequal access to surgical technologies, or a lack of evaluation of the technology in different healthcare settings. This may impact the generalisability of research findings. Equitable access to novel surgical technologies is ethical and can help address global disease burden.

1096 Robot-Assisted Minimally Invasive Oesophagectomy: Comparing the Geography of Research Publication with The Global Burden of Disease

Introduction Robot-assisted minimally invasive oesophagectomy (RAMIE) is increasingly used in the management of oesophageal tumours. It is unclear if there is equitable access to this innovative technique worldwide, specifically in areas of greatest need. This study aimed to map the geographic distribution of publications on RAMIE and compare this to global disease burden. Method Systematic searches identified all studies of RAMIE from inception to 2020. The country of origin of each study was identified. The incidence and age standardised rate (ASR) of oesophageal cancer for each country was obtained from The Global Cancer Observatory (GLOBOCAN) database. World Bank classifications of countries by income level were obtained. Results A total of 103 studies were identified. The majority (81%) were published in high-income countries, 15% in upper-middle, and 5% in lower-middle income countries. Thirty-four were published in the USA, the country with the fifth-highest incidence of oesophageal cancer worldwide, but 90th by ASR. The greatest incidence was in China (54% of global incidence) but was the source of only 15% of studies. Of the ten countries with the highest incidence, five were represented in published studies, in comparison to one of the top 10 by ASR. Conclusions There is evident disparity in the geographical distribution of published studies of RAMIE. This disparity may represent unequal access to surgical technologies, or a lack of evaluation of the technology in different healthcare settings. This may impact the generalisability of research findings. Equitable access to novel surgical technologies is ethical and can help address global disease burden.

Common cause vs dynamic mutualism: an empirical comparison of two theories of psychopathology in two large longitudinal cohorts

Mental disorders are highly prevalent, and among the leading causes of global disease burden. To respond in a timely and effective manner, a strong understanding of the structure of psychopathology and its development is critical. We compared the ability of two competing frameworks, the dynamic mutualism theory and the common cause theory, to explain the development of individual differences in psychopathology. We formalized these theories into statistical models, and applied them to two domains of psychopathology, at two different developmental periods, using two large developmental cohorts: the p factor (i.e. general psychopathology) from early to late adolescence (N = 1,482), and major depressive disorder in middle adulthood and old age (N = 6,443). The development of the p factor was better explained by a mutualistic account. In contrast, the evidence for the development of major depression was more ambiguous. Our results support a multicausal approach to understanding psychopathology and showcase the value of translating theories into testable statistical models for understanding developmental processes in clinical sciences.