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Background: Adiponectin is an adipocyte-derived hormone that acts as a marker of insulin sensitivity. Bloodspot sampling by fingerstick onto filter paper may increase the feasibility of large-scale studies of the determinants of insulin sensitivity. We first describe the validation of an enzyme-linked immunoassay (ELISA) for quantifying adiponectin from dried blood spots and then demonstrate its application in a large trial (PROBIT). Methods: We quantified adiponectin from 3-mm diameter discs (≈3 µL of blood) punched from dried blood spots obtained from: i) whole blood standards (validation); and ii) PROBIT trial samples (application) in which paediatricians collected blood spots from 13,879 children aged 11.5 years from 31 sites across Belarus. We examined the distribution of bloodspot adiponectin by demographic and anthropometric factors, fasting insulin and glucose. Results: In the validation study, mean intra-assay coefficients of variation (n = 162) were 15%, 13% and 10% for ‘low’ (6.78 µg/ml), ‘medium’ (18.18 µg/ml) and 'high’ (33.13 µg/ml) internal quality control (IQC) samples, respectively; the respective inter-assay values (n = 40) were 23%, 21% and 14%. The correlation coefficient between 50 paired whole bloodspot versus plasma samples, collected simultaneously, was 0.87 (95% CI: 0.78 to 0.93). Recovery of known quantities of adiponectin (between 4.5 to 36 µg/ml) was 100.3–133%. Bloodspot adiponectin was stable for at least 30 months at −80°C. In PROBIT, we successfully quantified fasting adiponectin from dried blood spots in 13,329 of 13,879 (96%) children. Mean adiponectin (standard deviation) concentrations were 17.34 µg/ml (7.54) in boys and 18.41 µg/ml (7.92) in girls and were inversely associated with body mass index, fat mass, triceps and subscapular skin-fold thickness, waist circumference, height and fasting glucose. Conclusions: Bloodspot ELISA is suitable for measuring adiponectin in very small volumes of blood collected on filter paper and can be applied to large-scale studies. [ABSTRACT FROM AUTHOR]

This study investigates political decisions and epidemiological developments. Employing a quantitative approach, this paper examines proportions of votes advocating Brexit with the proportional rates of Covid-19 vaccinations among individuals aged 18 years and above. A discernible pattern suggests a link between lower vaccination rates and pro-Brexit inclinations, validating the theory of disinformation affecting decision-making. This research finds a correlative relationship between political behaviour in voting for Brexit, and epidemiological outcomes measured by the uptake of vaccinations among various urban centres, towns, and local governmental jurisdictions within the United Kingdom. However, the results also show socioeconomic control variables are statistically more significant in predicting vaccination rates. [ABSTRACT FROM AUTHOR]

Wastewater surveillance has been a tool for public health officials throughout the COVID-19 pandemic. Universities established pandemic response committees to facilitate safe learning for students, faculty, and staff. These committees met to analyze both wastewater and clinical data to propose mitigation strategies to limit the spread of COVID-19. This paper reviews the initial efforts of utilizing campus data inclusive of wastewater surveillance for SARS-CoV-2 RNA concentrations, clinical case data from university response teams, and mitigation strategies from Grand Valley State University in West Michigan (population 21,648 students) and Oakland University in East Michigan (population 18,552 students) from November 2020 to April 2022. Wastewater positivity rates for both universities ranged from 32.8 to 46.8%. Peak viral signals for both universities directly corresponded to variant points of entry within the campus populations from 2021 to 2022. It was found that the organization of clinical case data and variability of wastewater testing data were large barriers for both universities to effectively understand disease dynamics within the university population. We review the initial efforts of onboarding wastewater surveillance and provide direction for structuring ongoing surveillance workflows and future epidemic response strategies based on those that led to reduced viral signals in campus wastewater. [ABSTRACT FROM AUTHOR]

Rheumatic and musculoskeletal diseases (RMDs) represent a multitude of degenerative, inflammatory and auto-immune conditions affecting millions of people worldwide. Persons with these diseases may potentially experience severe chronic pain, joint damage, increasing disability and even death. With an increasingly ageing population, the prevalence and burden of RMDs are predicted to increase, placing greater demands on the global practice of rheumatology and related healthcare budgets. Effective treatment of RMDs currently faces a number of challenges in both the developed and developing world, and individual countries may face more specific local challenges. However, limited understanding of the burden of RMDs amongst public health professionals and policy-makers means that these diseases are often not considered a public health priority. The objective of this review is to increase awareness of the RMDs and to identify opportunities to address RMD challenges on both a local and global scale. On 26 September 2014, rheumatology experts from five different continents met at the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD) to discuss and identify some key challenges for the RMDs community today. The outcomes are presented in this review, focusing on access to rheumatology services, diagnostics and therapies, rheumatology education and training and on clinical trials, as well as investigator-initiated and epidemiological research. The long-term vision of the WFRMD is to increase perception of the RMDs as a major burden to society and to explore potential opportunities to improve global and local RMD care. [ABSTRACT FROM AUTHOR]

The American College of Epidemiology (ACE) held its 2022 Annual Meeting, September 8–11, with a conference theme of 'Pandemic of Misinformation: Building Trust in Epidemiology'. The ACE Ethics Committee hosted a symposium session in recognition of the global spotlight placed on epidemiology and public health due to the COVID-19 crisis. The ACE Ethics Committee invited previous Chairs of the Ethics Committee and current President of the International Epidemiological Association to present at the symposium session. This paper aims to highlight the ethical challenges presented during the symposium session. Three speakers with diverse backgrounds representing expertize from the fields of ethics, epidemiology, public health, clinical trials, pharmacoepidemiology, statistics, law, and public policy, covering perspectives from the U.S., Europe, and Southeast Asia were selected to present on the ethical challenges in epidemiology and public health applying a global theme. Dr. D. Weed presented on 'Causation, Epidemiology and Ethics'; Dr. C.M. Pandey presented on the 'Ethical Challenges in the Practice of Digital Epidemiology'; and Dr. J. Acquavella presented on 'Departures from Scientific Objectivity: A Cause of Eroding Trust in Epidemiology.' The collective goal to improve the public's health was a mutually shared theme across the three distinct areas. We highlight the common ethical guidance and principle-based approaches that have served epidemiology and public health in framing and critical analysis of novel challenges, including autonomy, beneficence, justice, scientific integrity, duties to the profession and community, and developing and maintaining public trust; however, gaps remain in how best to address health inequalities and the novel emergence and pervasiveness of misinformation and disinformation that have impacted the health of the global community. We introduce an ethical framework of translational bioethics that places considerations of the social determinants of health at the forefront. The COVID-19 pandemic required an expedited public health response and, at the same time, placed the profession of epidemiology and public health, its system, and structures, under the microscope like never before. This article illustrates that revisiting our foundations in research and practice and orienting contemporary challenges using an ethical lens can assist in identifying and furthering the health of populations globally. [ABSTRACT FROM AUTHOR]

Objective. Data linkage is a very powerful research tool in epidemiology, however, establishing this can be a lengthy and intensive process. This paper reports on the complex landscape of conducting data linkage projects in Australia. Methods. We reviewed the processes, required documentation, and applications required to conduct multi-jurisdictional data linkage across Australia, in 2023. Results. Obtaining the necessary approvals to conduct linkage will likely take nearly 2 years (estimated 730 days, including 605 days from initial submission to obtaining all ethical approvals and an estimated further 125 days for the issuance of unexpected additionally required approvals). Ethical review for linkage projects ranged from 51 to 128 days from submission to ethical approval, and applications consisted of 9-25 documents. Conclusions. Major obstacles to conducting multi-jurisdictional data linkage included the complexity of the process, and substantial time and financial costs. The process was characterised by inefficiencies at several levels, reduplication, and a lack of any key accountabilities for timely performance of processes. Data linkage is an invaluable resource for epidemiological research. Further streamlining, establishing accountability, and greater collaboration between jurisdictions is needed to ensure data linkage is both accessible and feasible to researchers. [ABSTRACT FROM AUTHOR]

Background: Since January 2003, all clinical scientific articles published in the American volume of The Journal of Bone and Joint Surgery (JBJS-A) have included a level-of-evidence rating. The aim of the current study was to evaluate the interobserver agreement among reviewers, with varying levels of epidemiology training, in categorizing the levels of evidence of these clinical studies. Methods: Fifty-one consecutive clinical papers published in the American volume of JBJS were identified by a computerized search of the table of contents from January 2003 through June 2003. Each paper was blinded so that only the title, abstract (without the level of evidence designated), and methods section were provided to the reviewers. The papers were coded and were randomly organized in a binder. Six surgeons graded each blinded paper for (1) the type of study (therapeutic, prognostic, diagnostic test, or economic or decision analysis), (2) the level of evidence (on a scale of I through V), and (3) the subcategory within the particular level of evidence. Three surgeons were members of JBJS American Editorial Board, two surgeons were reviewers for JBJS-A, and one surgeon was an active researcher not formally associated with JBJS-A. The reviewers did not receive any formal training in the application of the classification system, but each was provided with a detailed description of the classification system used by JBJS-A. Intra-class correlation coefficients with 95% confidence intervals were determined for the reviewers' agreement regarding the type of study, level of evidence, and subcategory within the level of evidence. Results: The majority (69%) of the fifty-one included articles were studies of therapy, and 57% of the studies constituted Level-IV evidence. The intraclass correlation coefficients for the agreement among all reviewers with regard to the study type, level of evidence, and subcategory within the level of evidence ranged from 0.61 to 0.75. Reviewers trained in epidemiology demonstrated greater agreement (range in intraclass correlation coefficients, 0.99 to 1.0), across all aspects of the classification system, than did reviewers who were not trained in epidemiology (range in intraclass correlation coefficients, 0.60 to 0.75). Conclusions: These findings suggest that epidemiology and non-epidemiology-trained reviewers can apply the levels- of-evidence guide to published studies with acceptable interobserver agreement. The validity of this system remains a question for future research. [ABSTRACT FROM AUTHOR]

The article presents information on Rhinosinusitis. Rhinosinusitis is a significant health problem which seems to mirror the increasing frequency of allergic rhinitis and which results in a large financial burden on society. The last decade has seen the development of a number of guidelines, consensus documents and position papers on the epidemiology, diagnosis and treatment of rhinosinusitis and nasal polyposis. The diagnosis of rhinosinusitis is made by a wide variety of practitioners, including allergologists, otolaryngologists, pulmonologists, primary care physicians and many others.

Much has been written about the measurement of socio-economic position (SEP) in high-income countries (HIC). Less has been written for an epidemiology, health systems and public health audience about the measurement of SEP in low- and middle-income countries (LMIC). The social stratification processes in many LMIC—and therefore the appropriate measurement tools—differ considerably from those in HIC. Many measures of SEP have been utilized in epidemiological studies; the aspects of SEP captured by these measures and the pathways through which they may affect health are likely to be slightly different but overlapping. No single measure of SEP will be ideal for all studies and contexts; the strengths and limitations of a given indicator are likely to vary according to the specific research question. Understanding the general properties of different indicators, however, is essential for all those involved in the design or interpretation of epidemiological studies. In this article, we describe the measures of SEP used in LMIC. We concentrate on measures of individual or household-level SEP rather than area-based or ecological measures such as gross domestic product. We describe each indicator in terms of its theoretical basis, interpretation, measurement, strengths and limitations. We also provide brief comparisons between LMIC and HIC for each measure. [ABSTRACT FROM AUTHOR]

• Au@Ag core-shell nanoparticles for highly sensitivite SERS assay. • Fabrication of Au@Ag-pLL on glass nanofibrous paper as SERS substrate. • A paper-based SERS nanosensor for the sensitive detection of methamphetamine in sewage. • Evaluation of community-wide illicit drugs consumption ifor wastewater-based epidemiology. Wastewater-based epidemiology (WBE) is a powerful technique for monitoring illicit drugs of abuse in the community. Here, we report upon a surface-enhanced Raman spectroscopy (SERS) sensor for the sensitive and selective detection of methamphetamine based upon the assembly of noble metal core-shell nanoparticles on a bespoke glassy nanofibrous electrospun paper matrix. The hierarchical structure of the fibrous paper, modified with the synthesized Au@Ag core-shells (Au@Ag) gave strong SERS signalling, enabling us to evaluate the community-wide prevalence of methamphetamine in wastewater treatment plants within Beijing. We show that, when normalized for the daily flow of the wastewater treatment plants and for population density, higher mass loads of drugs are generally found in sewage influent from urban areas, implying greater local methamphetamine usage than that in less populated areas. The user-friendly and disposable paper sensors demonstrate the applicability of rapid on-site illicit drug detection, illustrating the application to wastewater-based epidemiology, which has the potential to inform government agencies regarding societal interventions. [ABSTRACT FROM AUTHOR]

A well-structured digital database is essential for any national priority project as it can provide real-time data analysis and facilitate quick decision making. In recent times, particularly after the COVID-19 pandemic, invasive fungal infections (IFIs) have emerged as a significant public health challenge in India, affecting vulnerable population, including immunocompromised individuals. The lack of comprehensive and well-structured data on IFIs has hindered efforts to understand their true burden and optimize patient care. To address this critical knowledge gap, the ICMR has undertaken a Pan-India pioneer initiative to develop a network of Advanced Mycology Diagnostic research centres in different geographical zones of the country (ICMR-MycoNet). Under the aegis of this project, a clinical registry on IFIs in the ICUs is initiated. This process paper presents a detailed account of the steps involved in the establishment of a web-based data entering and monitoring platform to capture data electronically, ensuring robust and secure data collection and management. This system not only allows participating ICMR-MycoNet centres to enter patient information directly into the database using standardized Case Report Form (CRF) but also includes data validation checks to ensure the accuracy and completeness of entered data. It is complemented by a real-time, web-based, and adaptable data visualization platform. This registry aims to provide crucial epidemiological insights, promote evidence-based hospital infection control programs, and ultimately improve patient outcomes in the face of this formidable healthcare challenge. [ABSTRACT FROM AUTHOR]

Breast cancer remains a significant public health issue, being a leading cause of cancer-related mortality among women globally. Timely diagnosis and efficient treatment are crucial for enhancing patient outcomes, reducing healthcare burdens and advancing community health. This systematic review, following the PRISMA guidelines, aims to comprehensively synthesize the recent advancements in computer-aided diagnosis and treatment for breast cancer. The study covers the latest developments in image analysis and processing, machine learning and deep learning algorithms, multimodal fusion techniques and radiation therapy planning and simulation. The results of the review suggest that machine learning, augmented and virtual reality and data mining are the three major research hotspots in breast cancer management. Moreover, this paper discusses the challenges and opportunities for future research in this field. The conclusion highlights the importance of computer-aided techniques in the management of breast cancer and summarizes the key findings of the review. [ABSTRACT FROM AUTHOR]

This article presents the World Health Organization's (WHO) recommendations for the use of varicella and herpes zoster vaccination from the WHO position paper on varicella and herpes zoster vaccines – June 2014, published in the Weekly Epidemiological Record [1] . This position paper summarizes the WHO position on the use of varicella and herpes zoster vaccines. The current document replaces the position paper on the use of varicella vaccines published in 1998 [2] . Footnotes to this paper provide a number of core references. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. This paper reflects the recommendations of WHO's Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its April 2014 meeting. Evidence presented at the meeting can be accessed at http://www.who.int/immunization/sage/previous/en/index.html . [ABSTRACT FROM AUTHOR]

This article presents the World Health Organization's (WHO) recommendations for the use of vaccines against diseases caused by human papillomaviruses (HPV) from the WHO position paper on Human papillomavirus vaccines: WHO position paper – October 2014, recently published in the Weekly Epidemiological Record [1] . This position paper summarizes the most recent developments in the field of HPV vaccines and the WHO position on HPV vaccine schedules in females. This document replaces the first WHO position paper on vaccines against diseases caused by HPV published in 2009 [2] . Footnotes to this paper provide a number of core references. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. This paper reflects the recommendations of WHO's Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its April 2014 meeting. Evidence presented at the meeting can be accessed at http://www.who.int/immunization/sage/previous/en/index.html . [ABSTRACT FROM AUTHOR]

Mercury (Hg) is a chemical of health concern worldwide that is now being acted upon through the Minamata Convention. Operationalizing the Convention and tracking its effectiveness requires empathy of the diversity and variation of mercury exposure and risk in populations worldwide. As part of the health plenary for the 15th International Conference on Mercury as a Global Pollutant (ICMGP), this review paper details how scientific understandings have evolved over time, from tragic poisoning events in the mid-twentieth century to important epidemiological studies in the late-twentieth century in the Seychelles and Faroe Islands, the Arctic and Amazon. Entering the twenty-first century, studies on diverse source-exposure scenarios (e.g., ASGM, amalgams, contaminated sites, cosmetics, electronic waste) from across global regions have expanded understandings and exemplified the need to consider socio-environmental variables and local contexts when conducting health studies. We conclude with perspectives on next steps for mercury health research in the post-Minamata Convention era. [ABSTRACT FROM AUTHOR]

Introduction: The epidemic of gun violence in the United States (US) is exacerbated by frequent mass shootings. In 2021, there were 698 mass shootings in the US, resulting in 705 deaths and 2,830 injuries. This is a companion paper to a publication in JAMA Network Open, in which the nonfatal outcomes of victims of mass shootings have been only partially described. Methods: We gathered clinical and logistic information from 31 hospitals in the US about 403 survivors of 13 mass shootings, each event involving greater than 10 injuries, from 2012-19. Local champions in emergency medicine and trauma surgery provided clinical data from electronic health records within 24 hours of a mass shooting. We organized descriptive statistics of individual-level diagnoses recorded in medical records using International Classification of Diseases codes, according to the Barell Injury Diagnosis Matrix (BIDM), a standardized tool that classifies 12 types of injuries within 36 body regions. Results: Of the 403 patients who were evaluated at a hospital, 364 sustained physical injuries—252 by gunshot wound (GSW) and 112 by non-ballistic trauma—and 39 were uninjured. Fifty patients had 75 psychiatric diagnoses. Nearly 10% of victims came to the hospital for symptoms triggered by, but not directly related to, the shooting, or for exacerbations of underlying conditions. There were 362 gunshot wounds recorded in the Barell Matrix (1.44 per patient). The Emergency Severity Index (ESI) distribution was skewed toward higher acuity than typical for an emergency department (ED), with 15.1% ESI 1 and 17.6% ESI 2 patients. Semi-automatic firearms were used in 100% of these civilian public mass shootings, with 50 total weapons for 13 shootings (Route 91 Harvest Festival, Las Vegas. 24). Assailant motivations were reported to be associated with hate crimes in 23.1%. Conclusion: Survivors of mass shootings have substantial morbidity and characteristic injury distribution, but 37% of victims had no GSW. Law enforcement, emergency medical systems, and hospital and ED disaster planners can use this information for injury mitigation and public policy planning. The BIDM is useful to organize data regarding gun violence injuries. We call for additional research funding to prevent and mitigate interpersonal firearm injuries, and for the National Violent Death Reporting System to expand tracking of injuries, their sequelae, complications, and societal costs. [ABSTRACT FROM AUTHOR]

This article presents the World Health Organization's (WHO) recommendations on the use of hepatitis E vaccine excerpted from the WHO position paper on hepatitis E vaccines – May 2015 recently published in the Weekly Epidemiological Record [1] . The current document is the first WHO position paper on hepatitis E vaccination and focuses primarily on the available evidence concerning the only hepatitis E vaccine that is currently licensed. The position paper gives consideration to the epidemiological features of the disease and assesses the use of the vaccine for public health benefits. Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of the scientific evidence. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. This paper reflects the recommendations of WHO's Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its October 2014 meeting. Evidence presented at the meeting can be accessed at http://www.who.int/immunization/sage/previous/en/index.html . [ABSTRACT FROM AUTHOR]

The American College of Epidemiology held its 2021 Annual Meeting virtually, September 8–10, with a conference theme of 'From Womb to Tomb: Insights from Health Emergencies'. The American College of Epidemiology Ethics Committee hosted a symposium session in recognition of the ethical and social challenges brought to light by the coronavirus disease 2019 pandemic and on the occasion of the publication of the third edition of the classic text, Ethics and Epidemiology. The American College of Epidemiology Ethics Committee invited the book editor and contributing authors to present at the symposium session titled 'Current Ethical and Social Issues in Epidemiology.' The purpose of this paper is to further highlight the ethical challenges and presentations. Three speakers with expertise in ethics, health law, health policy, global health, health information technology, and translational research in epidemiology and public health were selected to present on the social and ethical issues in the current landscape. Dr. S Coughlin presented on the 'Ethical and Social Issues in Epidemiology', Dr. L Beskow presented on 'Ethical Challenges in Genetic Epidemiology', and Dr. K Goodman presented on the 'Ethics of Health Informatics'. New digital sources of data and technologies are driving the ethical challenges and opportunities in epidemiology and public health as it relates to the three emerging topic areas identified: (1) digital epidemiology, (2) genetic epidemiology, and (3) health informatics. New complexities such as the reliance on social media to control infectious disease outbreaks and the introduction of computing advancements are requiring re-evaluation of traditional bioethical frameworks for epidemiology research and public health practice. We identified several cross-cutting ethical and social issues related to informed consent, benefits, risks and harms, and privacy and confidentiality and summarized these alongside more nuanced ethical considerations such as algorithmic bias, group harms related to data (mis)representation, risks of misinformation, return of genomic research results, maintaining data security, and data sharing. We offered an integrated synthesis of the stages of epidemiology research planning and conduct with the ethical issues that are most relevant in these emerging topic areas. New realities exist for epidemiology and public health as professional groups who are faced with addressing population health, and especially given the recent pandemic and the widespread use of digital tools and technologies. Many ethical issues can be understood in the context of existing ethical frameworks; however, they have yet to be clearly identified or connected with the new technical and methodological applications of digital tools and technologies currently in use for epidemiology research and public health practice. To address current ethical challenges, we offered a synthesis of traditional ethical principles in public health science alongside more nuanced ethical considerations for emerging technologies and aligned these with lifecycle stages of epidemiology research. By critically reflecting on the impact of new digital sources of data and technologies on epidemiology research and public health practice, specifically in the control of infectious outbreaks, we offered insights on cultivating these new areas of professional growth while striving to improve population health. [ABSTRACT FROM AUTHOR]

This article presents the WHO recommendations on the use of vaccines against tick-borne encephalitis excerpted from the recently published Vaccines against tick-borne encephalitis: WHO position paper. This is the first WHO position paper on the use of tick-borne encephalitis. It was published in the Weekly Epidemiological Record in June 2011. In this paper, footnotes provide a limited number of core references including references to grading tables that assess the quality of scientific evidence for a few key conclusions; a more comprehensive list of references is offered in the Background document on vaccines and vaccination against tick-borne encephalitis available at http://www.who.int/immunization/sage/6_TBE_backgr_18_Mar_net_apr_2011.pdf. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO''s current position on the use of vaccines in the global context. This paper reflects the recommendations of WHO''s Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its April 2011 meeting. Evidence presented at the meeting can be accessed at http://www.who.int/immunization/sage/previous/en/index.html. [ABSTRACT FROM AUTHOR]

Abstract: This article presents the WHO recommendations on the use of cholera vaccines excerpted from the recently published Cholera vaccines: WHO position paper. This document replaces the WHO position paper on Cholera vaccines published in the Weekly Epidemiological Record in April 2001. Footnotes to this paper provide a limited number of core references; their abstracts as well as a more comprehensive list of references may be found at http://www.who.int/immunization/documents/positionpapers/en/index.html. Grading tables which assess the quality of scientific evidence for key conclusions are also available through this link and are referenced in the position paper. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO''s current position on the use of vaccines in the global context. This updated paper reflects the recent recommendations of WHO''s Strategic Advisory Group of Experts on immunization (SAGE). [Copyright &y& Elsevier]

COVID-19 represents the greatest health crisis in recent human history. To date, it is still difficult to estimate its impact on mortality. This paper investigates the excess crude mortality in 27 European countries. The differences between the values observed in 2020 and 2021 with those predicted by a joinpoint regression model were evaluated. A multi-regression analysis was implemented to assess the relationship between health variables and excess mortality. Europe experienced a marked and surprising (S-value > 52) increase in crude mortality during 2020 (Δ% = +10.0%, 95% CI: [2.5; 18.7]) and 2021 (Δ% = +12.1%, 95% CI: [4.3; 21.2]). The difference between average excesses of Eastern and Western countries was not surprising (S < 2) and had little relevance (ΔE-W = −2.4, 95% CI: [−2; 7]) during 2020 but was more pronounced (S = 15, ΔE-W = +17.2, 95% CI: [11.0; 23.5]) during 2021. Excess crude mortality increased in 2021 (Δ% = +65%, 95% CI: [12.6; 118], S = 5.9). Evidence has been found for a surprising and marked negative linear relationship between COVID-19 vaccinations and excess mortality ("2021 excess mortality = A + BX4", with "A = 58 ± 7, S = 28" and "B = −0.65 ± 0.10, S = 22, Radj2 = 0.65, 95% CI: [0.38; 0.82]). In light of the current literature, these findings provide solid evidence of the substantial role of COVID-19 in the unexpected and marked excess mortality recorded in Europe. COVID-19 vaccinations have appeared to be one of the main determinants for reducing mortality. Future research should explore these aspects in more detail. [ABSTRACT FROM AUTHOR]

This paper explores the concept of translational epidemiology in the context of epidemiologic studies of religious determinants of morbidity and mortality. Despite a research literature of, by now, thousands of published studies, many in top-tier medical and public health journals, some resistance remains to full acceptance of this work. A principal reason may be the failure of investigators to make the case for real-world applications of epidemiologic findings on religious risk or protection for subsequent personal or population health, in keeping with the definition of translational epidemiology. To remedy this, a case is made for a translational epidemiology of religion. Three types of translation are proposed. The first two recall the standard definition of translational medicine as "from bench to bedside," in this instance two types of bedside encounters, pastoral and clinical. The third application is to public health practice, involving multiple public health professions and specialties. As with other substantive topics within psychosocial epidemiology, research on population-health outcomes of religious exposures provides information that can be applied to development of health promotion and disease prevention programs and formulation of health policy. But this can happen only if investigators give more attention to enumerating potential uses of their findings. [ABSTRACT FROM AUTHOR]

Abstract: This article presents the WHO recommendations on the use of pertussis vaccines excerpted from the recently published Pertussis vaccines: WHO position paper. This document replaces the WHO position paper entitled Pertussis vaccines: WHO position paper published in the Weekly Epidemiological Record in January 2005. Footnotes to this paper provide a limited number of core references; their abstracts as well as a more comprehensive list of references may be found at http://www.who.int/immunization/documents/positionpapers/en/index.html. Grading tables which assess the quality of scientific evidence for key conclusions are also available through this link and are referenced in the position paper. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO''s current position on the use of vaccines in the global context. This updated paper reflects the recent recommendations of WHO''s Strategic Advisory Group of Experts on immunization, or SAGE. [Copyright &y& Elsevier]

Abstract:: This article presents the World Health Organizations (WHO) recommendations onthe use of hepatitis A vaccineexcerpted from the WHO position paper on hepatitis A vaccines – June 2012 recently published in the Weekly Epidemiological Record [1]. The current document replaces the position paper on the use of hepatitis A vaccines published in 2000 [2] and incorporates the most recent developments in the field with particular consideration to changes in the epidemiological features of hepatitis A infection in several countries, increased supply of hepatitis A vaccines, and new evidence on their public health benefits. Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of scientific evidence for a few key conclusions. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated positionpapers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO''s current position on the use of vaccines in the global context. This paper reflects the recommendations of WHO''s Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its November 2011 and April 2012 meetings. Evidence presented at these meetings can be accessed at http://www.who.int/immunization/sage/previous/en/index.html. [Copyright &y& Elsevier]

Despite its high mortality rate of approximately 90 % , the Ebola virus disease (EVD) has not received enough attention in terms of in-depth research. This illness has been responsible for over 40 years of epidemics throughout Central Africa. However, during 2014–2015, the Ebola-driven epidemic in West Africa became, and remains, the deadliest to date. Thus, Ebola has been declared one of the major public health issues. This paper aims at exploring the effects of external fluctuations on the prevalence of the Ebola virus. We begin by proposing a sophisticated biological system that takes into account vaccination and quarantine strategies as well as the effect of time lags. Due to some external perturbations, we extend our model to the probabilistic formulation with white noises. The perturbed model takes the form of a system of stochastic differential equations. Based on some non-standard analytical techniques, we demonstrate two main approach properties: intensity and elimination of Ebola virus. To better understand the impact of applied strategies, we deal with the stochastic control optimization approach by using some advanced theories. All of this theoretical arsenal has been numerically confirmed by employing some real statistical data of Ebola virus. Finally, we mention that this work could be a rich basis for further investigations aimed at understanding the complexity of Ebola virus propagation at pathophysiological and mathematics levels. [ABSTRACT FROM AUTHOR]

Cancer registration has been with us for decades surveilling societies for cancer incidence, trends, mortality and survival. Data are used for health care planning but even more so for research in cancer treatment, outcome and prevention - i.e. overall cancer control. With the 70th anniversary of the Cancer Registry of Norway, this paper examines the impact and role of the registry in the past and today for cancer registration and affiliated research in the Nordic countries, as well as scientific peer reviewed productivity. The Nordic collaboration in cancer-registry-based research benefits from previous and actual ongoing activities in Norway. The Cancer Registry of Norway is a prominent independent organization under Oslo University Hospital Trust for registration and registry-based cancer epidemiology, with a multidisciplinary broad-based high quality professional staff. The research portfolio includes regular cancer registration, linkage to external data e.g. occupation, biobanks and clinical data conducting analysis with clear national, Nordic and international relevance. Various threats to the ownership of cancer registries and the derived epidemiology in past, such as organizational changes and loss of independence were avoided in Norway, but the interpretation of data protection following the GDPR today causes delays or may even block the Nordic cancer registry research. [ABSTRACT FROM AUTHOR]

Aim: In this paper, we explore the contextual use of 10 epidemiological terminologies, their significance, and interpretation/misinterpretation in explaining various aspects of the 2019 novel coronavirus disease (COVID-19) pandemic. Methods and Results: We first establish the different purposes of the terms 'pandemic' and 'Public Health Emergency of International Concern.' We then discuss the confusion caused by using the 'case fatality rate' as opposed to 'infection fatality rate' during the pandemic and the uncertainty surrounding the limited usefulness of identifying someone as 'pre-symptomatic.' We highlight the ambiguity in the 'positivity rate' and the need to be able to generate data on 'excess mortality' during public health emergencies. We discuss the relevance of 'association and causation' in the context of the facemask controversy that existed at the start of the pandemic. We point out how the accepted epidemiological practice of discussing 'herd immunity' in the context of vaccines has been twisted to suit the political motive of a public health approach. Given that a high proportion of COVID-19 cases are asymptomatic, we go on to show how COVID-19 has blurred the lines between 'screening/diagnosis' and 'quarantine/isolation,' while giving birth to the new terminology of 'community quarantine.' Conclusions: Applying the lessons learned from COVID-19 to better understand the above terminologies will help health professionals communicate effectively, strengthen the scientific agenda of epidemiology and public health, and support and manage future outbreaks efficiently. [ABSTRACT FROM AUTHOR]

A novel coronavirus (COVID-19) has emerged as a global serious public health issue from December 2019. People having a weak immune system are more susceptible to coronavirus infection. It is a double challenge for people of any age with certain underlying medical conditions including cardiovascular disease, diabetes, high blood pressure and cancer etc. Co-morbidity increases the probability of COVID-19 complication. In this paper a deterministic compartmental model is formulated to understand the transmission dynamics of COVID-19. Rigorous mathematical analysis of the model shows that it exhibits backward bifurcation phenomenon when the basic reproduction number is less than unity. For the case of no re-infection it is shown that having the reproduction number less than one is necessary and sufficient for the effective control of COVID-19, that is, the disease free equilibrium is globally asymptotically stable when the reproduction threshold is less than unity. Furthermore, in the absence of reinfection, a unique endemic equilibrium of the model exists which is globally asymptotically stable whenever the reproduction number is greater than unity. Numerical simulations of the model, using data relevant to COVID-19 transmission dynamics, show that the use of efficacious face masks publicly could lead to the elimination of COVID-19 up to a satisfactory level. The study also shows that in the presence of co-morbidity, the disease increases significantly. [ABSTRACT FROM AUTHOR]

Omicron variants of SARS-CoV-2 have been become the dominant variant family among more than 100 countries and regions around the world. There are still limited data on how inactivated COVID-19 vaccines prevent Omicron-related symptomatic infection, transmission, hospital admission, and death3. Recently, Dawei Yang et al. published a paper in the to explore the effect of inactivated COVID-19 vaccines on Omicron from the perspective of real-world observation data. [ABSTRACT FROM AUTHOR]

This paper argues that machine learning (ML) and epidemiology are on collision course over causation. The discipline of epidemiology lays great emphasis on causation, while ML research does not. Some epidemiologists have proposed imposing what amounts to a causal constraint on ML in epidemiology, requiring it either to engage in causal inference or restrict itself to mere projection. We whittle down the issues to the question of whether causal knowledge is necessary for underwriting predictions about the outcomes of public health interventions. While there is great plausibility to the idea that it is, conviction that something is impossible does not by itself motivate a constraint to forbid trying. We disambiguate the possible motivations for such a constraint into definitional, metaphysical, epistemological, and pragmatic considerations and argue that “Proceed with caution” (rather than “Stop!”) is the outcome of each. We then argue that there are positive reasons to proceed, albeit cautiously. Causal inference enforces existing classification schema prior to the testing of associational claims (causal or otherwise), but associations and classification schema are more plausibly discovered (rather than tested or justified) in a back-and-forth process of gaining reflective equilibrium. ML instantiates this kind of process, we argue, and thus offers the welcome prospect of uncovering meaningful new concepts in epidemiology and public health—provided it is not causally constrained. [ABSTRACT FROM AUTHOR]

The Brazilian Policy of Comprehensive Care for People with Rare Diseases (BPCCPRD) was established by the Ministry of Health to reduce morbidity and mortality and improve the quality of life of people with rare diseases (RD). Several laboratory tests, most using molecular genetic technologies, have been incorporated by the Brazilian Public Health System, and 18 specialised centres have so far been established at university hospitals (UH) in the capitals of the Southern, Southeastern and Northeastern regions. However, whether the available human and technological resources in these services are appropriate and sufficient to achieve the goals of care established by the BPCCPRD is unknown. Despite great advances in diagnosis, especially due to new technologies and the recent structuring of clinical assessment of RD in Brazil, epidemiological data are lacking and when available, restricted to specific disorders. This position paper summarises the performance of a nationally representative survey on epidemiology, clinical status, and diagnostic and therapeutic resources employed for individuals with genetic and non-genetic RD in Brazil. The Brazilian Rare Disease Network (BRDN) is under development, comprising 40 institutions, including 18 UH, 17 Rare Diseases Reference Services and five Newborn Screening Reference Services. A retrospective study will be initially conducted, followed by a prospective study. The data collection instrument will use a standard protocol with sociodemographic data and clinical and diagnostic aspects according to international ontology. This great collaborative network is the first initiative of a large epidemiological data collection of RD in Latin America, and the results will increase the knowledge of RD in Brazil and help health managers to improve national public policy on RD in Brazil. [ABSTRACT FROM AUTHOR]

A key problem in modelling the evolution dynamics of infectious diseases is the mathematical representation of the mechanism of transmission of the contagion which depends upon the way a specific disease is communicated among different populations or subpopulations. Compartmental models describing a finite number of subpopulations can be described mathematically via systems of ordinary differential equations. The same is not possible for populations which exhibit some continuous structure, such as space location, age, etc. In particular when dealing with populations with space structure the relevant quantities are spatial densities, whose evolution in time requires nonlinear partial differential equations, which are known as reaction-diffusion systems. In this paper we are presenting an (somehow historical) outline of our own research programme in mathematical epidemiology, paying particular attention to the role of spatial heterogeneity and dispersal in the population dynamics of infectious diseases. Two specific examples are discussed, which have been the subject of intensive research by the authors of the present paper, i.e. man-environment-man epidemics, and malaria. In addition to the epidemiological relevance of these epidemics all over the world, their treatment requires a large amount of different sophisticate mathematical methods, and has even posed new non trivial mathematical problems, as one can realize from the list of references. One of the most relevant problems faced by the present authors, i.e. regional control, has been emphasized here: the public health concern consists of diminishing the disease in the relevant population, as fast as possible. On the other hand, very often the entire domain of interest for the epidemic, is either unknown, or difficult to manage for an affordable implementation of suitable environmental sanitation programmes. This is the reason why regional control has been proposed; it has been shown that, under suitable modelling assumptions, it is indeed sufficient to implement such programmes only in a given subregion conveniently chosen so to lead to an effective diminishment of the epidemic in the whole habitat; it is evident that this practice may have an enormous importance in real cases with respect to both financial and practical affordability. [ABSTRACT FROM AUTHOR]

Epidemiology can be considered as a responsible public health science the aim of which is to control health problems. One of the most important public health problems is "war". The aim of the present paper, therefore, is threefold: firstly, to determine to what extent war has been investigated from an epidemiological point of view; secondly, what the definition and scope of "war epidemiology" would be; and thirdly, if it would be possible to introduce a new branch of epidemiology entitled "peace epidemiology". In the present study, I have tried to fulfill the aims of the study based on my experiences in war and peace epidemiology and also by reviewing the most relevant websites, documents and papers. Evidence suggests that enough epidemiological studies have not been carried out to determine the sheer public health consequences of war. "War epidemiology" can be defined as "the study of the distribution and determinants of war-related events in specified populations, and the application of this study to the control of war". "Peace epidemiology" is a new branch of epidemiology which "highlights how peace could positively shape our world". Epidemiologists need to produce more scientific evidence about the negative public health consequences of wars and also the positive public health consequences of peace. The ultimate aim of "war epidemiology" is to control war, usually by secondary and tertiary prevention activities. However, the ultimate aim of "peace epidemiology" is to reinforce peace by primary and/or primordial prevention activities. [ABSTRACT FROM AUTHOR]

Out-of-hospital cardiac arrest (OHCA) is a frequent and lethal condition with a yearly incidence of approximately 5000 in Denmark. Thirty-day survival is associated with the patient's prodromal complaints prior to cardiac arrest. This paper examines the odds of 30-day survival dependent on the reported prodromal complaints among OHCAs witnessed by the emergency medical services (EMS). EMS-witnessed OHCAs in the Capital Region of Denmark from 2016-2018 were included. Calls to the emergency number 1-1-2 and the medical helpline for out-of-hours were analyzed according to the Danish Index; data regarding the OHCA was collected from the Danish Cardiac Arrest Registry. We performed multiple logistic regression to calculate the odds ratio (OR) of 30-day survival with adjustment for sex and age. We identified 311 eligible OHCAs of which 79 (25.4%) survived. The most commonly reported complaints were dyspnea (n = 209, OR 0.79 [95% CI 0.46: 1.36]) and 'feeling generally unwell' (n = 185, OR 1.07 [95% CI 0.63: 1.81]). Chest pain (OR 9.16 [95% CI 5.09:16.9]) and heart palpitations (OR 3.15 [95% CI 1.07:9.46]) had the highest ORs, indicating favorable odds for 30-day survival, while unresponsiveness (OR 0.22 [95% CI 0.11:0.43]) and blue skin or lips (OR 0.30, 95% CI 0.09, 0.81) had the lowest, indicating lesser odds of 30-day survival. Experiencing chest pain or heart palpitations prior to EMS-witnessed OHCA was associated with higher 30-day survival. Conversely, complaints of unresponsiveness or having blue skin or lips implied reduced odds of 30-day survival. [ABSTRACT FROM AUTHOR]

John Snow, the London doctor who studied cholera in the 1840s and 1850s, argued in Snow (1856) that water exerted an "overwhelming influence" on mortality in a region of south London during the 1854 outbreak. In a paper re-assessing Snow's analysis, Koch and Denike (2006) claim that "Snow made not merely minor arithmetic errors but more importantly critical, conceptual mistakes that adversely affected his results." The claim of errors and mistakes is incorrect and due to a misreading or misunderstanding of Snow's data and analysis. Koch and Denike apply an inappropriate statistical test to Snow's original data (and do so incorrectly). More importantly, due to the misreading of the historical record they alter the underlying primary-source data, rendering their results invalid. Analysis of the data following Snow's approach but with modern statistical tools strongly supports Snow's claim for the primacy of water in accounting for variation in cholera mortality. • Review a 2006 critique of John Snow's methodology in his 1856 analysis of south London. • Apply modern statistical techniques to re-examine John Snow's south London analysis. • Conclude that Snow's work did not suffer from the claimed methodological problems. • Support and confirm Snow's conclusion that water had an overwhelming effect on mortality. [ABSTRACT FROM AUTHOR]

Yellow Fever (YF) is a viral arbovirosis of Public Health importance. In Brazil, surveillance is focused mainly on detecting epizootic events of Platyrrhini. Herein, we compared the detection and phylogenetic analysis of YF virus in two neotropical primates (NTP), a Callithrix detected in the previous epidemic period (2016–2020), and a Callicebus nigrifons , showing a new introduction of YF in 2023. This paper illustrates the importance of joint actions of laboratory and field teams to ensure quick response to Public Health emergencies, such as the intensification of vaccination of susceptible human populations. [ABSTRACT FROM AUTHOR]

• No data on burns from East African countries with low GDP. • Few burn dedicated data-registries. • Focus on pediatric and urban patients with burns from tertiary centers. Background: Burns are a global public health concern, with the majority of the disease burden affecting low- and middle-income countries. Yet, as suggested by previous publications, there is a widespread belief that literature about burns in low- and middle-income countries is lacking. Therefore, we aimed to assess with a scoping review, the extent of the literature output on burns in East Africa, and to investigate patient demographics, injury characteristics, treatment and outcomes, as reported from the existing publications. Methods: Studies discussing burns in East Africa were identified by searching PubMed / Medline (National Library of Medicine), EMBASE (Elsevier), Global Health Database (EBSCO), and Global Index Medicus on December 12, 2019. Controlled vocabulary terms (i.e., MeSH, EMTREE, Global Health thesaurus terms) were included when available and appropriate. No year restrictions were applied. Results: A total of 1,044 records were retrieved from the database searches, from which 40 articles from 6 countries published between 1993 and 2019 were included in the final review. No studies were found from five East African countries with the lowest GDP. Most papers focused on pediatric trauma patients or tertiary hospital settings. The total number of burn patients recorded was 44,369, of which the mean proportion of males was 56%. The most common cause of injury was scalds (61%), followed by open flame (17%). Mortality rate ranged from 0-67%. The mean length of stay in hospital was between 9-60 d. Conclusions: Burn data is limited in the East African region, with socio-economically weak countries being particularly underrepresented. This scoping review has identified the largest set of literature on burns in East Africa to date, indicating the importance of reviewing data at a regional or local level, as "global" studies tend to be dominated by high-income country data. Data collection in specific registries is needed to better characterize the exact burden of burn injuries in East Africa. [ABSTRACT FROM AUTHOR]

Universal Bacillus Calmette–Guérin (BCG) vaccination is recommended in countries with high tuberculosis (TB) burden. Nevertheless, several countries have ceased universal BCG vaccination over the past 40 years, with scarce comparative epidemiological analyses regarding childhood TB after the policy change. We analysed data on childhood TB in countries that ceased universal BCG vaccination. Data sources included national/international databases, published papers, annual TB reports, and public health authority websites. Childhood TB notification rate increased in one of seven countries with available data. Pulmonary TB and TB lymphadenitis were the main causes of increasing childhood cases, while changes in severe forms of TB cases were minor. Maintaining high vaccine coverage for the target group was a common challenge after shifting selective vaccination. In some countries showing no increase in childhood TB after a BCG policy change, the majority of childhood TB cases were patients from abroad or those with overseas parents; these countries had changed immigration policies during the same period. Heterogeneity in childhood TB epidemiology was observed after ceasing universal BCG vaccination; several factors might obscure the influence of vaccination policy change. Lessons learned from these countries may aid in the development of better BCG vaccination strategies. [ABSTRACT FROM AUTHOR]

Contagious ecthyma (CE) is an infectious disease of small ruminants caused by a parapoxvirus of family Poxviridae subfamily Chordopoxvirinae. The disease is obviously distinguished by an establishment of scabby lesions and ulcerative formation on less hairy areas including muzzle, ears, nostril, and sometimes on genitalia. The disease is endemic in sheep and goats. The virus is transmissible to other ruminants and is a public health concern in humans. Although the disease is known as self-limiting, it may cause a significant economic threat and financial losses due to lower productivity in livestock production. Information with regard to the risk of the disease and epidemiology in most parts of the world is underreported. This paper aims to provide relevant information about the epidemiology of CE in selected regions of Europe, South America, North America, Asia, Africa, and Australia. An in-depth comprehension of virus infection, diagnoses, and management of the disease will enable farmers, researchers, veterinarians, abattoir workers, health personnel, and border controllers to improve their measures, skills, and effectiveness toward disease prevention and control, toward reducing unnecessary economic loss among farmers. A herd health program for significant improvement in management and productivity of livestock demands a well planned extension program that ought to encourage farmers to equip themselves with adequate skills for animal healthcare. [ABSTRACT FROM AUTHOR]

Since December 2019, there has been a global explosion of research on COVID-19. In Canada, the six National Collaborating Centres (NCCs) for Public Health form one of the central pillars supporting evidence-informed decision making by gathering, synthesizing and translating emerging findings. Funded by the Public Health Agency of Canada and located across Canada, the six NCCs promote and support the use of scientific research and other knowledges to strengthen public health practice, programs and policies. This paper offers an overview of the NCCs as an example of public health knowledge mobilization in Canada and showcases the NCCs' contribution to the COVID-19 response while reflecting on the numerous challenges encountered. [ABSTRACT FROM AUTHOR]

Abstract Regulatory policy to protect the public and the environment from radiation is universally based on the linear, no-threshold model (LNT) of radiation effects. This model has been controversial since its inception over nine decades ago, and remains so to this day, but it has proved remarkably resistant to challenge from the scientific community. The LNT model has been repeatedly endorsed by expert advisory bodies, and regulatory agencies in turn adopt policies that reflect this advice. Unfortunately, these endorsements rest on a foundation of institutional inertia and numerous logical fallacies. These include most significantly setting the LNT as the null hypothesis, and shifting the burden of proof onto LNT skeptics. Other examples include arbitrary exclusion of alternative hypotheses, ignoring criticisms of the LNT, cherry-picking evidence, and making policy judgements without foundation. This paper presents an evaluation of the National Council on Radiation Protection and Measurements' (NCRP) Commentary 27, which concluded that recent epidemiological studies are compatible with the continued use of the LNT model for radiation protection. While this report will likely provide political cover for regulators' continued reliance on the LNT, it is a missed opportunity to advance the scientific discussion of the effects of low dose, low dose-rate radiation exposure. Due to its Congressionally chartered mission, no organization is better positioned than the NCRP to move this debate forward, and recommendations for doing so in future reviews are provided. Highlights • The linear no-threshold (LNT) model of radiation effects has fractured the scientific community. • This paper analyzes the latest review of the LNT model, NCRP Commentary 27. • Expert reviews of the LNT model rely on institutional inertia and numerous logical fallacies. • Recommendations to advance this debate in an objective future review are provided. [ABSTRACT FROM AUTHOR]

Background: Leprosy is a chronic infectious disease neglected, caused by Mycobacterium leprae, considered a public health problem because may cause permanent physical disabilities and deformities, leading to severe limitations. This review presents an overview of the results of epidemiological studies on leprosy occurrence in childhood in Brazil, aiming to alert health planners and managers to the actual need to institute special control strategies. Methodology/Principal findings: Data collection consisted of an electronic search for publications in eight databases: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Electronic Library Online (SciELO), PuBMed, Biblioteca Virtual em Saúde (BVS), SciVerse Scopus (Scopus), CAPES theses database, CAPES journals database and Web of Science of papers published up to 2016. After apply selection criteria, twenty-two papers of studies conducted in four different regions of Brazil and published between 2001 and 2016 were included in the review. The leprosy detection rate ranged from 10.9 to 78.4 per 100,000 inhabitants. Despite affecting both sexes, leprosy was more common in boys and in 10-14-year-olds. Although the authors reported a high cure proportion (82–90%), between 1.7% and 5.5% of the individuals developed a disability resulting from the disease. Conclusions/Significance: The findings of this review shows that leprosy situation in Brazilian children under 15 years is extremely adverse in that the leprosy detection rate remains high in the majority of studies. The proportion of cases involving disability is also high and reflects the difficulties and the poor effectiveness of actions aimed at controlling the disease. The authors suggest the development of studies in spatial clusters of leprosy, where beyond the routine actions established, are included news strategies of active search and campaigns and actions of educations inside the clusters of this disease. The new agenda needs to involve the precepts of ethical, humane and supportive care, in order to achieve a new level of leprosy control in Brazil. [ABSTRACT FROM AUTHOR]

Abstract: This article presents the World Health Organizations (WHO) evidence and recommendations for the use of rotavirus vaccination from the WHO position paper on rotavirus vaccines – January 2013 recently published in the Weekly Epidemiological Record [1]. This position paper summarizes the WHO position on the inclusion of rotavirus vaccines in all national immunization programmes and recent developments in the field, in particular the potential of rotavirus vaccines to further reduce mortality by employing more flexible immunization schedules. The current document replaces the position paper on the use of rotavirus vaccines published in 2007 [2]. Footnotes to this paper provide a number of core references. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. This paper reflects the recommendations of WHO's Strategic Advisory Group of Experts (SAGE) on immunization. These recommendations were discussed by SAGE at its April 2012 meeting. Evidence presented at the meeting can be accessed at http://www.who.int/immunization/sage/previous/en/index.html. [Copyright &y& Elsevier]

Public health lessons from one pandemic become the planning assumptions for the next one. Aotearoa New Zealand's 2017 pandemic plan was derived from past experience of influenza. When Covid-19 emerged as a major global health threat, it took time for the realisation to crystallise that this infection was so different from influenza that it required a completely new pandemic response strategy. In this paper we describe how early evidence about SARS-CoV-2 transmission from China led to the adoption of an elimination strategy in Aotearoa New Zealand, making it the first country to choose elimination as a specific policy response. We discuss how further evidence has shaped the selection and design of Covid-19 pandemic control measures such as border restrictions, case and contact management, hygiene practices and use of face masks, physical distancing, and vaccines. This experience demonstrates the need for a different approach to the design of the next national pandemic plan. We identify key early evidence that will be required to develop a flexible and appropriate public health response to a new pandemic threat. We present a framework for a new pandemic plan that aims to learn from the Covid-19 experience by making as few limiting assumptions as possible. [ABSTRACT FROM AUTHOR]

Abstract: Obesity (BMI greater than 30.0 kg/m2) is always a trending public health problem and different studies have linked it to the development of heart diseases. However, overweight (BMI between 25.0 kg/m2 and less than 30.0 kg/m2) has very few studies linking it to the development of heart diseases, coupled with the overweight/obesity paradox phenomena which still causes controversy. Therefore, the purpose of this paper is to determine the relationship between overweight and congestive heart failure/coronary heart diseases in the United States. To determine this relationship, the 2011–2012 National Health and Nutrition Examination Survey (NHANES) dataset, which surveyed 9756 individuals in the United States was utilized. The dataset was analyzed using Software for Statistics and Data Software (STATA) and Pearson's chi-squared test. The p-value using the t-test command in STATA for all these variables was <0.001, which indicated that there is a significant relationship between overweight and congestive heart failure/coronary heart disease across gender, ethnicity, and socioeconomic status. Although the development of congestive heart failure/coronary heart disease in overweight individuals was confirmed with this study, it is surprising to realize that the socioeconomic status of an individual also plays a role. Further research is necessary to determine how a lower or higher socioeconomic status causes overweight leading to heart diseases. [ABSTRACT FROM AUTHOR]

To evaluate the quality of reporting in published randomized controlled trials (RTCs) in the field of fall injuries. The 188 RTCs published between 2001 and 2011, indexed in EMBASE and Medline databases were extracted through searching by appropriate keywords and EMTree classification terms. The evaluation trustworthiness was assured through parallel evaluations of two experts in epidemiology and biostatistics. About 40%-75% of papers had problems in reporting random allocation method, allocation concealment, random allocation implementation, blinding and similarity among groups, intention to treat and balancing benefits and harms. Moreover, at least 10% of papers inappropriately/not reported the design, protocol violations, sample size justification, subgroup/adjusted analyses, presenting flow diagram, drop outs, recruitment time, baseline data, suitable effect size on outcome, ancillary analyses, limitations and generalizability. Considering the shortcomings found and due to the importance of the RCTs for fall injury prevention programmes, their reporting quality should be improved. [ABSTRACT FROM AUTHOR]

Major approaches of the Russian Federation in setting of exposure guidelines to electromagnetic fields (EMF) in occupational and public environments are discussed in this paper. EMF exposure guidelines in Russia are based on the results of hygienic, clinical, physiological, epidemiological and experimental studies and are frequency-dependent. The concept of a threshold principle of occupational and environmental factors due to hazardous exposure effects has been used to set permissible exposure levels of different EMF frequency ranges. The data of experimental studies showed hazardous threshold levels of EMF effects. The main criteria of EMF hazardous exposure evaluated in the experimental study concerned both estimation of threshold levels of chronic (long-term) and acute exposure. Also, this paper contains some recent experimental study data on correlation of long-term radiofrequency and power-frequency EMF exposure effects with regard to time duration, the so-called time-dependence approach. It enables identification of the value of permissible EMF exposure levels depending on exposure duration. This approach is used in occupational exposure guideline setting and requires the introduction of “power exposition” (PE) and “maximal permissible level” (MPL). In general, EMF exposure guidelines are established with regard to possible duration of exposure per day. [ABSTRACT FROM AUTHOR]

A paper published in this journal, 'Measuring the short-term impact of fluoridation cessation on dental caries in Grade 2 children using tooth surface indices,' by McLaren et al had shortcomings in study design and interpretation of results, and did not include important pertinent data. Its pre-post cross-sectional design relied on comparison of decay rates in two cities: Calgary, which ceased fluoridation, and Edmonton, which maintained fluoridation. Dental health surveys conducted in both cities about 6.5 years prior to fluoridation cessation in Calgary provided the baseline. They were compared to decay rates determined about 2.5 years after cessation in a second set of surveys in both cities. A key shortcoming was the failure to use data from a Calgary dental health survey conducted about 1.5 years prior to cessation. When this third data set is considered, the rate of increase of decay in Calgary is found to be the same before and after cessation of fluoridation, thus contradicting the main conclusion of the paper that cessation was associated with an adverse effect on oral health. Furthermore, the study design is vulnerable to confounding by caries risk factors other than fluoridation: The two cities differed substantially in baseline decay rates, other health indicators, and demographic characteristics associated with caries risk, and these risk factors were not shown to shift in parallel in Edmonton and Calgary through time. An additional weakness was low participation rates in the dental surveys and lack of analysis to check whether this may have resulted in selection biases. Owing to these weaknesses, the study has limited ability to assess whether fluoridation cessation caused an increase in decay. The study's findings, when considered with the additional information from the third Calgary survey, more strongly support the conclusion that cessation of fluoridation had no effect on decay rate. Consideration of the limitations of this study can stimulate improvement in the quality of future fluoridation effectiveness studies. [ABSTRACT FROM AUTHOR]

With the development of detection technology, the harm caused by norovirus has been gradually recognized. Norovirus infection is very common in China. In addition, the replication process of Nov is prone to recombination and mutation, resulting in new mutants, which changes the antigenicity of the virus and evades the immune pressure of the population. As a result, the global periodic epidemic of norovirus occurs every few years. Norovirus gastroenteritis has increasingly become an important public health problem in the world. Due to the limitations of the detection methods of Nov, currently, it is not included in the routine detection items of gastroenteritis, which greatly limits the epidemiological study of Nov. therefore, this paper discusses the clinical observation and nursing effect of sporadic norovirus gastroenteritis, so as to provide the basis for the prevention and treatment of sporadic norovirus gastroenteritis. The results showed that the detection rate of norovirus in sporadic cases was 19.66%. The expected VLPs / P particles were not obtained in the experiment, and the HbGA receptor of the outbreak virus could not be determined. However, the nursing effect of the patients with gastroenteritis was better by this method. For the prevention of sporadic norovirus gastroenteritis, we should closely monitor norovirus in marine farms, especially oyster farms and environmental water, in order to predict the emergence of new early mutants and provide early warning for regional sporadic norovirus control and prevention. [ABSTRACT FROM AUTHOR]