Cytokine Release Syndrome and Treatment in COVID-19

The emergent outbreak of coronavirus disease 2019 (COVID-19) is a global health problem and has been recognized as a pandemic. Although COVID-19 leads to mild flu-like symptoms in most patients, the disease may cause frequently fatal, severe complications, such as acute respiratory distress syndrome and cytokine release syndrome. In these patients, defects in lymphocytic cytolytic activity trigger the proinflammatory cytokine cascade, and then "cytokine storm” begins. As a result, it leads to uncontrolled active macrophage entry into the tissues and hemophagocytosis. Here, the responses of host cells, cytokine release syndrome and the therapeutic approaches to alleviate the cytokine storm in COVID-19 will be reviewed.

Mechanism-based approaches of 1,3,4 thiadiazole scaffolds as potent enzyme inhibitors for cytotoxicity and antiviral activity

Significant progress in understanding cancer pathogenesis, it remains one of the leading causes of death after cardiovascular diseases. Similarly viral infections have emerged from wildlife or re-emerged, generating serious threats to the global health. As a result, there is an urgent need for the development of novel, more effective anticancer and antiviral therapeutics. Scientists, medicinal chemists and researchers are continuously finding novel targets, mechanisms and molecules against theses severe and dangerous infections. Therefore, ongoing extensively study and research emphasizes 1,3,4 thiadiazole pharmacophore have versatile pharmacological actions. Due to mesoionic behaviour of 1,3,4 thiadiazole pharmacophore allows to enter and easily cross biological membrane which allow to interact various biological proteins. In this review study an attempt has been made of various mechanisms involved in cancer and viral prevalence with updated studies done so far. This review study also findings the role of 1,3,4 thiadiazole motif in the management of various cancers and viral infection. This study also highlighting research statics on clinical trials and various patents containing 1,3,4 thiadiazole derivatives. © 2022 The Author(s)

Making global health ‘work': Frontline workers' labour in research and interventions

This Special Issue of Global Public Health draws on the concept of ‘body work' among those employed to support operationalising, researching, and implementing global health while in direct contact with the bodies of others. This collection brings into sharp focus the specific forms of labour of those occupying positions as frontline workers - those who make global health work. Making Global Health Work includes authors from diverse backgrounds, disciplines, and geographies. Through compelling ethnographies, qualitative interviews, and focus group discussions, they explore ‘body work' globally, including: Afghanistan, Bangladesh, Ethiopia, India, Indonesia, Kenya, Malawi, Myanmar, Nigeria, Nepal, Pakistan, Sierra Leone, South Sudan, Tanzania, Thailand, The Democratic Republic of the Congo (DRC), The Gambia, Vietnam, and Zimbabwe. These papers demonstrate that proximity to, and work on, the bodies of others engenders specific forms of (physical, emotional, mental, social, ethical, and political) labour, which occur not only in emergencies and pandemics, but also throughout the quotidian practice of global health. Making Global Health Work provides insights into the provision of maternal healthcare, treatment of multidrug resistant tuberculosis, rapid HIV testing programmes, sleeping sickness and polio eradication campaigns, mass drug administration clinical trials, epidemic preparedness and response, and the management and care of dead bodies. These papers argue for greater attention by global health actors on frontline workers in management of the complexities involved in making global health work.

The outbreak of monkeypox: A clinical overview

The development of new zoonotic diseases such as coronavirus disease 2019 (COVID-19) and monkeypox that can cause epidemics and high mortality rates have significantly threatened global health security. However, the increasing number of people with no immunity to poxvirus because of the end of the smallpox vaccination programme has created a vulnerable population for the monkeypox outbreak. On 23 July 2022, it was announced that the World Health Organization's director-general has determined that the multicountry outbreak of monkeypox constitutes a Public Health Emergency of International Concern. The monkeypox virus is an orthopoxvirus that causes a disease with symptoms similar to smallpox but less severe. Many unanswered questions remain regarding monkeypox's pathogenesis, transmission and host reservoir. There is currently no evidence that transmission by individuals can sustain zoonotic infections during human- to- human transmissions;the continued emergence of these pathogens highlights the interconnectedness of animals and humans. The increasing number of monkeypox cases outside the endemic region has highlighted the need for effective global capacity building to prevent the spread of the disease and its impact on global health security. The priority now is to stop the spread of the disease and protect frontline healthcare workers and the most vulnerable individuals. This article aims to comprehensively analyse the various aspects of the transmission and epidemiology of monkeypox. It also explores possible diagnostic techniques, therapeutics and prevention strategies. A key recommendation is that primary care and public health professionals are expected to increase their efforts to be vigilant and contain any potential outbreaks.

Reimagining diaspora diplomacy during the COVID-19 crisis in India

Diasporas are organized groups motivated by common cultural, ideological, political and religious values and common concerns for their countries of origin. Diaspora diplomacy has gained prominence worldwide, particularly in India, spurred by harrowing images of deaths and devastation due to the COVID-19 pandemic. A new generation of diaspora professionals modeled as social entrepreneurs uses collaborative and non-profit models to establish relationships with their counterparts to facilitate medical services and research. Teleradiology and telepsychiatry facilitate communication between diaspora members and their counterparts. We propose a common telehealth platform to standardize advice given by the Indian diaspora in the Global North as protocols change rapidly in acute pandemics. Consideration should be given to the well-known digital divide in India and other low- and middle-income countries. We advocate for diaspora members to train themselves in the art of global health diplomacy, to promote transparency and accountability in the collection of funds and a mandatory provision of outcome measurement by independent monitors rather than through social media. In the long run, Indian-Americans should play an active role in strengthening the domain of public health, which has historically been neglected in India, by focusing on the country's long-term infrastructure needs. The lessons learned from various diaspora efforts should be independently evaluated and recorded as best practice for future pandemics and humanitarian crises. © The Author(s) 2022. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Pandemics, health diplomacy, and peacebuilding 1

The articles in this special issue address such questions as: How do states approach global health issues? How have they utilized health diplomacy and for what purposes? What are the principal challenges? How do pandemics affect conflict, and vice versa? Has health diplomacy effectively addressed global health concerns particularly in conflict-torn societies? This special issue contributes to our understanding of pandemics, health diplomacy, and peace by highlighting issues associated with responses to global health issues and health diplomacy. The articles offer novel perspectives for analyzing the prospects for global health and security. © The Author(s) 2023.

Climate Change and Otolaryngology-Head and Neck Surgery

The COVID-19 pandemic has illustrated that global events can have a profound impact on our health systems. While the pandemic is unprecedented, it does underscore the need to prepare for future global health concerns. Climate change is a looming threat with significant consequences for otolaryngologists and our patients. In this commentary, we discuss the need to assess our preparedness for climate change as well as the importance of reflecting on our responsibility to minimize our footprint.

Estimation of the serial interval of monkeypox during the early outbreak in 2022

With increased transmissibility and novel transmission mode, monkeypox poses new threats to public health globally in the background of the ongoing COVID-19 pandemic. Estimates of the serial interval, a key epidemiological parameter of infectious disease transmission, could provide insights into the virus transmission risks. As of October 2022, little was known about the serial interval of monkeypox due to the lack of contact tracing data. In this study, public-available contact tracing data of global monkeypox cases were collected and 21 infector-infectee transmission pairs were identified. We proposed a statistical method applied to real-world observations to estimate the serial interval of the monkeypox. We estimated a mean serial interval of 5.6 days with the right truncation and sampling bias adjusted and calculated the reproduction number of 1.33 for the early monkeypox outbreaks at a global scale. Our findings provided a preliminary understanding of the transmission potentials of the current situation of monkeypox outbreaks. We highlighted the need for continuous surveillance of monkeypox for transmission risk assessment. © 2022 Wiley Periodicals LLC.

Human rights and the COVID-19 pandemic: a retrospective and prospective analysis

When the history of the COVID-19 pandemic is written, the failure of many states to live up to their human rights obligations should be a central narrative. The pandemic began with Wuhan officials in China suppressing information, silencing whistleblowers, and violating the freedom of expression and the right to health. Since then, COVID-19's effects have been profoundly unequal, both nationally and globally. These inequalities have emphatically highlighted how far countries are from meeting the supreme human rights command of non-discrimination, from achieving the highest attainable standard of health that is equally the right of all people everywhere, and from taking the human rights obligation of international assistance and cooperation seriously. We propose embedding human rights and equity within a transformed global health architecture as the necessary response to COVID-19's rights violations. This means vastly more funding from high-income countries to support low-income and middle-income countries in rights-based recoveries, plus implementing measures to ensure equitable distribution of COVID-19 medical technologies. We also emphasise structured approaches to funding and equitable distribution going forward, which includes embedding human rights into a new pandemic treaty. Above all, new legal instruments and mechanisms, from a right to health treaty to a fund for civil society right to health advocacy, are required so that the narratives of future health emergencies—and people's daily lives—are ones of equality and human rights. © 2023 Elsevier Ltd

Developing Next-Generation Protein-Based Vaccines Using High-Affinity Glycan Ligand-Decorated Glyconanoparticles

Major diseases, such as cancer and COVID-19, are frightening global health problems, and sustained action is necessary to develop vaccines. Here, for the first time, ethoxy acetalated dextran nanoparticles (Ace-Dex-NPs) are functionalized with 9-N-(4H-thieno[3,2-c]chromene-2-carbamoyl)-Siaα2−3Galβ1−4GlcNAc (TCCSia-LacNAc) targeting macrophages as a universal vaccine design platform. First, azide-containing oxidized Ace-Dex-NPs are synthesized. After the NPs are conjugated with ovalbumin (OVA) and resiquimod (Rd), they are coupled to TCCSia-LacNAc-DBCO to produce TCCSia-Ace-Dex-OVA-Rd, which induce a potent, long-lasting OVA-specific cytotoxic T-lymphocyte (CTL) response and high anti-OVA IgG, providing mice with superior protection against tumors. Next, this strategy is exploited to develop vaccines against infection by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The receptor-binding domain (RBD) of the SARS-CoV-2 spike protein is the main target for neutralizing antibodies. The TCCSia-Ace-Dex platform is preferentially used for designing an RBD-based vaccine. Strikingly, the synthetic TCCSia-Ace-Dex-RBD-Rd elicited potent RBD-neutralizing antibodies against live SARS-CoV-2 infected Vero E6 cells. To develop a universal SARS-CoV-2 vaccine, the TCCSia-Ace-Dex-N-Rd vaccine carrying SARS-CoV-2 nucleocapsid protein (N) is also prepared, which is highly conserved among SARS-CoV-2 and its variants of concern (VOCs), including Omicron (BA.1 to BA.5);this vaccine can trigger strong N-specific CTL responses against target cells infected with SARS-CoV-2 and its VOCs. © 2022 The Authors. Advanced Science published by Wiley-VCH GmbH.

Monkeypox outbreaks in the context of the COVID-19 pandemic: Network and clustering analyses of global risks and modified SEIR prediction of epidemic trends

Background: Ninety-eight percent of documented cases of the zoonotic disease human monkeypox (MPX) were reported after 2001, with especially dramatic global spread in 2022. This longitudinal study aimed to assess spatiotemporal risk factors of MPX infection and predict global epidemiological trends. Method: Twenty-one potential risk factors were evaluated by correlation-based network analysis and multivariate regression. Country-level risk was assessed using a modified Susceptible-Exposed-Infectious-Removed (SEIR) model and a risk-factor-driven k-means clustering analysis. Results: Between historical cases and the 2022 outbreak, MPX infection risk factors changed from relatively simple [human immunodeficiency virus (HIV) infection and population density] to multiple [human mobility, population of men who have sex with men, coronavirus disease 2019 (COVID-19) infection, and socioeconomic factors], with human mobility in the context of COVID-19 being especially key. The 141 included countries classified into three risk clusters: 24 high-risk countries mainly in West Europe and Northern America, 70 medium-risk countries mainly in Latin America and Asia, and 47 low-risk countries mainly in Africa and South Asia. The modified SEIR model predicted declining transmission rates, with basic reproduction numbers ranging 1.61–7.84 in the early stage and 0.70–4.13 in the current stage. The estimated cumulative cases in Northern and Latin America may overtake the number in Europe in autumn 2022. Conclusions: In the current outbreak, risk factors for MPX infection have changed and expanded. Forecasts of epidemiological trends from our modified SEIR models suggest that Northern America and Latin America are at greater risk of MPX infection in the future. Copyright © 2023 Gao, Zhou, Liang, Jiao, Wheelock, Jiao, Ma, Zhang, Guo, Luo, Liang and Xu.

The impact of delayed access to COVID-19 vaccines in low- and lower-middle-income countries

IntroductionA majority of low-income (LIC) and lower-middle-income countries (LMIC) were unable to achieve at least 10% population coverage during initial vaccine rollouts, despite the rapid development of the coronavirus disease 2019 (COVID-19) vaccines. Nearly three years into this pandemic, evaluating the impact of inequities in vaccine access, uptake, and availability is long overdue. We hypothesized that a delay in receiving COVID-19 vaccines was associated with an increased toll on cumulative cases and mortality. Furthermore, this relationship was modified by the size of a country's economy. MethodsWe performed an ecological study assessing these relationships, in which a country's economic standing was assessed by world bank income classification, gross domestic product based on the purchasing power parity (GDP PPP) per capita category, and crude GDP PPP. ResultsCountries with the smallest economies reported first vaccination much later than larger economies on all three rankings, as much as 100 days longer. Among low-income countries, a one-day increase until the first vaccination was associated with a 1.92% (95% CI: 0.100, 3.87) increase in cumulative cases when compared to high-income countries (p = 0.0395) when adjusting for population size, median age, and testing data availability. Similarly, among the lowest GDP PPP countries a one-day increase until the first vaccination was associated with a 2.73% (95% CI: 0.100, 5.44) increase in cumulative cases when compared to the highest GDP PPP countries (p = 0.0415). When modeling cumulative mortality, effects in the same direction and magnitude were observed, albeit statistically non-significant. ConclusionEconomic standing modified the effects of delayed access to COVID-19 vaccination on cumulative cases and mortality, in which LMICs tended to fare worse in outcomes than high-income countries despite the eventual rollout of vaccines. These findings highlight the importance of prioritizing equitable and timely access to COVID-19 vaccines across all countries, irrespective of economic size. Future studies should examine the impacts that vaccine inequities had on local transmission dynamics.

Global law, policy, and governance for effective prevention and control of COVID-19: A comparative analysis of the law and policy of Pakistan, China, and Russia

Global health governance is a developing system in this complex institutional regime. The local and regional health policies sometimes challenge global health governance due to diverse discourse in various countries. In the wake of COVID-19, global health governance was reaffirmed as indifferent modules to control and eliminate the pandemic;however, the global agencies later dissected their own opinion and said that "countries must learn to live with a pandemic.” Given the controversial statement, this research focuses on the strong and effective policies of the Russian Federation, Pakistan, and China. The research uses the law and governance results and newly developed policies of the three countries formed under the global health policies. The conclusion is based on the statement that in order to live with the pandemic, strong health measures are required at each level. Copyright © 2023 Bilawal Khaskheli, Wang, Hussain, Jahanzeb Butt, Yan and Majid.

The role of the European Union in global health: The EU's self-perception(s) within the COVID-19 pandemic

The COVID-19 pandemic is challenging the international system and the regional order in which the European Union (EU) aims to re-define its role in global health. The article seeks to tease out the role of the EU amidst the COVID-19 crisis by outlining three key dimensions: self-perception, external perception and performance. The paper contributes to the broader understanding of the EU's role in global health through a focus on its self-perception. This is examined by the conduct of interviews with EU representatives in 2021 and the analysis of EU press releases with reference to global health from 2014 to mid-March 2021. The results show that the EU mainly draws from a donor and provider role leaving a facilitating, partner or normative role underdeveloped – except for the EU's leading role in the context of the World Health Organisation. The COVID-19 pandemic is a driver for a more ambitious global political role. However, the main challenges identified by EU representatives constitute a lack of capacities and resources, insufficient backing by EU member states and a lack of coordination. The strongest EU conception in global health is seen when policy actions are based on multiple roles ranging from a provider and partner to a facilitating or normative role. © 2021

Exploring Indigenous Traditional Healing programs in Canada, Australia, and New Zealand: A scoping review

Objective: To explore and catalog ways Indigenous Traditional Healing practices are supported within the mainstream healthcare system through policies and programs in Canada, Australia, and New Zealand. Data Sources: A scoping review was conducted, guided by the PRISMA extension for Scoping Reviews. Databases for sources of information include CINAHL, Medline, Embase, Web of Science, Public Health ProQuest, Global Health EBSCO, iPortal, and grey literature. Study Selection: 2 reviewers screened the titles and s of the studies for inclusion against the selection criteria independently. Studies that met the inclusion criteria were transferred to Covidence for further and full-text review. Data Extraction: Of a total of 2,017 articles identified, 22 met the inclusion criteria for data extraction for this scoping review. Data items extracted include study title, authors, year of publication, publication type, publication source, support policy or program, health system or service, Indigenous Traditional Healing practices, and significant findings. Data Synthesis: 2 categories emerged from the analysis of the source of evidence. That is, healthcare systems and services with programs and policies supporting Indigenous Traditional Healing practices, and ways Indigenous Traditional Healing was adopted and utilized within the identified support programs. Conclusions: This study demonstrated the various ways Indigenous Traditional Healing practices are supported within the mainstream healthcare systems in Canada, Australia, and New Zealand. Indigenous Traditional Healing practices can be utilized as either the primary choice of treatment, to support Western biomedical treatment or through the adoption of Indigenous Traditional knowledge within the mainstream healthcare system. © 2022

47. Cultural Connection and Mental Health for American Indian Adolescents

Purpose: American Indian and Alaska Native (AI/AN) adolescents face significant physical and mental health disparities. These inequities result from historical and intergenerational traumas, which are the cumulative, permeating effects that impact individuals and communities who share a specific identity. Currently there is a paucity of research focusing on the mental health of AI/AN youth as well as the relationship between mental health and cultural connection. This project assesses the relationship between cultural identity (ethnic identity and tribal affiliation) and outcomes associated with mental health (loneliness, friendships, emotional support, and sleep) for AI/AN adolescents. It also aims to understand the impact of the COVID-19 pandemic on stress management for AI/AN adolescents. Methods: 12 to 18 year old adolescents from the Lumbee Tribe of North Carolina participated in this mixed-methods study. The project involved two phases informed by the principles of community-based participatory research. Phase 1, discussed in this , involved surveys using validated instruments to assess cultural connection, mental health outcomes, stress management, and resilience among participants. Phase 2 involves semi-structured interviews with adolescents. Results: Of 123 AI/AN youth who completed the survey, 54.5% (N=67) were 15-18 years old with mean age of 14.9 (SD=2.0). 61% (N=75) were assigned female at birth, 56% (N=70) identified as female, and 4.1% (N=5) identified as non-binary. Mean tribal affiliation (TA) and ethnic identity (EI) scores suggest strong cultural connection among participants (TA: mean 3.1/5, SD 0.6;EI: 3.4/5, SD 0.9). Sleep quality (mean 2.63/5) and positive stress management (mean 2.06/5) were low, suggesting room for improvement. Bivariate analysis and logistic regressions demonstrated moderate positive correlations between ethnic identity and friendship, ethnic identity and emotional support, tribal affiliation and friendship, and tribal affiliation and emotional support. Conclusions: Results highlight that AI/AN adolescents in this sample have a moderate-strong connection with culture, marked by ethnic identity and tribal affiliation. They also demonstrate the impact of cultural connection on mental health for AI/AN adolescents. Phase 2 will draw upon Phase 1 findings to further understand the relationship between cultural connection and mental health outcomes, and to promote community-driven interventions emphasizing inherent strengths and resiliencies identified through qualitative interviews of AI/AN youth. Data related to cultural connection and mental health outcomes may also be used to set the framework for policy formulation which may allow for increased funding and programming addressing mental health for AI/AN youth. Sources of Support: This research received support from the UNC Chapel Hill Office of Global Health.

Short-term association between COVID-19 related deaths, hospitalized patients and air pollution during the first lockdown in the four largest cities in Germany

Identifying risk factors of coronavirus disease 2019 (COVID-19) for its clinical course became important during the current global health crisis. This study explores the relationship between ambient air quality and the clinical course of COVID-19 during the first German lockdown. Daily air pollutant concentrations (PM10, O3 and NO2) and confirmed COVID-19-related hospital cases and deaths in the four largest German cities are used for multivariate regression analysis to study the correlation of air pollutants with COVID-19-related hospitalised or ICU patients and deaths. A significant positive association of O3 with patients and deaths is observed. NO2 shows a positive correlation with hospitalised and ICU patients. A 10 µg/m3 increase in O3 is linked to a 27% (95% CI: 15% to 39%) increase of COVID-19-related deaths. However, PM10 is associated with a decrease in deaths. Altogether, these findings indicate that air pollutants seem to have a significant influence on the course of COVID-19 infections. © 2022 Informa UK Limited, trading as Taylor & Francis Group.