Climate Change, Exposome Change, and Allergy: A Review.

Climate change is a major threat to human respiratory health and associated allergic disorders given its broad impact on the exposome. Climate change can affect exposure to allergens, such as pollen, dust mites, molds, as well as other factors such as temperature, air pollution, and nutritional factors, which synergistically impact the immune response to these allergens. Exposome change can differentially exacerbate allergic reactions across subgroups of populations, especially those who are more vulnerable to environmental stressors. Understanding links between climate change and health impacts can help inform how to protect individuals and vulnerable populations from adverse health effects.

A growing threat: Investigating the high incidence of benzimidazole fungicides resistance in Iranian Botrytis cinerea isolates.

Effective management of fungicide application programs requires monitoring the profile of resistant populations of Botrytis cinerea, given its high-risk nature. This research aimed to examine the sensitivity of 200 B. cinerea isolates collected from different plant species and regions across Iran towards thiophanate-methyl and carbendazim fungicides. To distinguish between susceptible and resistant isolates, the discriminatory dose assay was employed, followed by the selection of representative isolates from each group for EC50 analysis. To identify potential modifications in codon 198 of the ß-tubulin gene in B. cinerea resistant isolates, the researchers employed the PCR-RFLP diagnostic method. More than two-thirds of the isolates exhibited a varying degree of resistance to MBC fungicides, even in farms where the application of these fungicides had not taken place in recent years. After treatment with the BsaI enzyme, the PCR product of sensitive isolates displayed two bands measuring 98 and 371 bp, while only one band of 469 bp was identified in resistant isolates. The study also evaluated whether resistance to fungicides could affect the pathogenicity and mycelial growth of the isolates. The findings showed no significant difference between the resistant and sensitive groups in terms of these factors, indicating that resistance does not come at a cost to the pathogen's fitness. Considering the high incidence of resistance and the absence of negative consequences on fitness, it is recommended to exercise caution in the employment of benzimidazole fungicides as part of B. cinerea management strategies.

Development of a global index measuring national policy commitments to HIV prevention and treatment among people who inject drugs.

BACKGROUND: People who inject drugs (PWID) around the world are disproportionately affected by the HIV epidemic. National policy responses to the epidemic heavily influence risk factors for HIV acquisition among this key group. Prior efforts to monitor national policy responses to HIV/AIDS among PWID were limited both in scope and coverage. In this paper we develop and validate the HIV-PWID Policy Index (HPPI) to benchmark and monitor national commitments to HIV prevention and treatment among PWID. METHODS: Composite indicator was constructed employing fuzzy multilayer data envelopment analysis (FMLDEA). Model inputs based on data from 105 countries included 27 variables measured across six conceptual domains, including needle and syringe programs, opioid substitution treatment, testing and counseling, information and education, monitoring and evaluation, and legal and policy climate. RESULTS: According to the HPPI, which ranges from 0 to 1, the top performing countries in policy commitments to HIV prevention and treatment among PWID were Spain (0.988), Switzerland (0.982), Luxembourg (0.970), Moldova (0.970), and Kyrgyzstan (0.945), whereas the poorest performing included Nicaragua (0.094), Japan, (0.094), Cape Verde (0.097), Syria (0.174), and Benin (0.185). Regionally, commitment to HIV services targeting PWID was highest among European countries (0.81) and lowest among African countries (0.50), with Oceania (0.76), Asia (0.66), and the Americas (0.56) in the mid-range. Subregional differences were even more prominent, with West and Central European nations (0.84) and Central American nations (0.22) earning the highest and lowest HPPI scores, respectively. CONCLUSIONS: The HPPI documented substantial national and regional variation in policy responses to the HIV epidemic among PWID. Our analysis also revealed that many countries have limited HIV/AIDS data collection and monitoring capabilities. Continued enhancement and standardization of global HIV/AIDS monitoring efforts are therefore vital to articulated national and international benchmarking and performance assessment goals.

The effectiveness of negative pressure wound therapy as a novel management of diabetic foot ulcers: an overview of systematic reviews.

BACKGROUND: Diabetic foot ulcer (DFU) is one the serious disabling conditions in patients with diabetes. Several approaches are available to manage DFU including Negative Pressure Wound Therapy (NPWT). The objective of this overview is systematically reviewing the related reviews about the effectiveness, safety, and cost benefits of NPWT interventions. METHODS: In October 2018, electronic databases including Medline, Embase, Scopous, Web of Science, the Cochrane Library and Google scholar were searched for systematic reviews about the NPWT's effectiveness and safety in DFUs. The Assessment of Multiple Systematic Reviews 2 (AMSTAR2) checklist was used for the appraisal of the systematic reviews. According to this checklist the studies were categorized as high, moderate, low and critically low quality. RESULTS: The electronic searches yielded 6889 studies. After excluding duplicates and those not fellfield the inclusion criteria, 23 systematic reviews were considered. The sample size of the reviews ranged between 20 and 2800 patients published since 2004 to 2018. Twenty systematic reviews (86.95%) included only randomized clinical trials (RCT). Regarding the AMSTAR-2 checklist, 7 studies were assigned to high quality, 8 were categorized as low quality and 8 studies belonged to the critically low quality groups. Accordingly, three, two and one out of seven high quality studies approved the effectiveness, safety and cost benefit of the NPWT therapy, respectively. However, some of them declared that there is some flaws in RCTs designing. CONCLUSION: This overview illustrated that either systematic reviews or the included RCTs had wide variety of quality and heterogeneity in order to provide high level of evidence. Hence, well-designed RCTs as well as meta-analysis are required to shade the light on different aspects of NPWT.

Drinking water fluoride and blood pressure? An environmental study.

The relationship between intakes of fluoride (F) from drinking water and blood pressure has not yet been reported. We examined the relationship of F in ground water resources (GWRs) of Iran with the blood pressure of Iranian population in an ecologic study. The mean F data of the GWRs (as a surrogate for F levels in drinking water) were derived from a previously conducted study. The hypertension prevalence and the mean of systolic and diastolic blood pressures (SBP & DBP) of Iranian population by different provinces and genders were also derived from the provincial report of non-communicable disease risk factor surveillance of Iran. Statistically significant positive correlations were found between the mean concentrations of F in the GWRs and the hypertension prevalence of males (r = 0.48, p = 0.007), females (r = 0.36, p = 0.048), and overall (r = 0.495, p = 0.005). Also, statistically significant positive correlations between the mean concentrations of F in the GWRs and the mean SBP of males (r = 0.431, p = 0.018), and a borderline correlation with females (r = 0.352, p = 0.057) were found. In conclusion, we found the increase of hypertension prevalence and the SBP mean with the increase of F level in the GWRs of Iranian population.

Renewable-surface sol-gel derived carbon ceramic electrode fabricated by [Ru(bpy)(tpy)Cl]PF6 and its application as an amperometric sensor for sulfide and sulfur oxoanions.

A highly sensitive and fast responding sensor for the determination of thiosulfate, sulfite, sulfide and dithionite is described. It consists of a chemically modified carbon ceramic composite electrode (CCE) containing [Ru(bpy)(tpy)Cl]PF6 complex that was constructed by the sol-gel technique. A reversible redox couple of Ru(II)/Ru(III) was observed as a solute in acetonitrile solution and as a component of carbon based conducting composite electrode. Electrochemical behavior and stability of modified CCE were investigated by cyclic voltametry, the apparent electron transfer rate constant (kappa(S)) and transfer coefficient (a) were determined by cyclic voltametry which were about 28 s(-1) and 0.43 respectively. Electrocatalytic oxidation of S(2-), SO3(2-), S2O4(2-) and S2O3(2-) were effective at the modified electrode at significantly reduced overpotentials and in the pH range 1-11. Optimum pH values for amperometric detection of thiosulfate, dithionite, sulfide and sulfite are 7, 9, 2 and 2. Under the optimized conditions the calibration curves are linear in the concentration ranges 1-500, 3-80, 2-90 and 1-100 microM for S2O3(2-), SO3(2-), S2- and S2O4(2-) determination. The detection limit (signal to noise is 3) and sensitivity are 0.5 and 12, 2.8 and 6, 1.6 and 8, and 0.65 microM and 80 nA microM(-1) for thiosulfate, sulfite, sulfide and dithionite detection. The modified carbon ceramic electrode doped with Ru-complex shows good reproducibility, a short response time (t < 2 s), remarkable long term stability (> 6 month) and especially good surface renewability by simple mechanical polishing (RSD for eight successive polishing is 2%). The advantages of this sulfur compound amperometric detector based on ruthenium doped CCE are high sensitivity, inherent stability at a broader pH range, excellent catalytic activity, less expense and simplicity of preparation in comparison with recently published papers. This sensor can be used as a chromatographic detector for analysis of sulfur derivatives.