Echinococcosis poses a significant threat to public health. The Chinese government has implemented prevention and control measures to mitigate the impact of the disease. By analyzing data from the Chinese Center for Disease Control and Prevention and the State Council of the People’s Republic of China, we found that implementation of these measures has reduced the infection rate by nearly 50% between 2004 to 2022 (from 0.3975 to 0.1944 per 100,000 person-years). Nonetheless, some regions still bear a significant disease burden, and lack of detailed information limites further evaluation of the effects on both alveolar and cystic echinococcosis. Our analysis supports the continuing implementation of these measures and suggests that enhanced wildlife management, case-based strategies, and surveillance systems will facilitate disease control.

This case study examined the hypothesis that longer outdoor time results in normal vision and refractive status, using unique genetically informative kinships. The participants were the members of 29-year-old doubly exchanged monozygotic male twin pairs from Bogotá, Colombia, in South America. Comprehensive ophthalmological examinations, including uncorrected and corrected visual acuity, refraction and keratometry, and visual life history interviews were undertaken; all examinations were conducted by two ophthalmologists blind to the hypothesis, relatedness, and rearing status of the four participants. Normal uncorrected vision and refractive status were present in the two rural-raised, unrelated brothers, relative to their urban-raised counterparts. Uncorrected visual acuities were 20/160 and 20/200 for the city-raised twins and 20/20 and 20/30 for the country-raised twins. Premature birth, low birth weight, computer use, and reading time could not explain these differences. It was concluded that time spent outdoors appears to be a significant factor in the development of myopia, reinforcing extant findings via a novel experimental approach.

We performed a systematic review and meta-analysis on the prevalence and factors associated with Schistosoma mansoni infection in Brazil. We searched the PubMed, Web of Science and Latin-American and Caribbean System on Health Sciences Information (LILACS) databases, scientific publications articles, according to The PRISMA Statement, from 2000 to 2016. A total of 27 studies were included according to the established criteria. The prevalence of S. mansoni infection varied widely, from 0·1 to 73·1%, based on Kato-Katz technique. Of the identified studies, 42·9% were performed in the state of Minas Gerais, and 33·3% were performed in the northeast region of Brazil. We identified sex, age, education level, family income, contact with water and the presence of the intermediate host snail as major risk factors associated with infection. The meta-analysis summarized a high prevalence rate pooled for Schistosoma mansoni. On the other hand, the analysis of the subgroup showed a highly significant reduction of the prevalence rate after control measures. The epidemiological factors evidenced in the studies show the influence of environmental and social conditions on the occurrence of schistosomiasis.

Background: Globally, falls in older people are a leading cause of injury-related mortality and morbidity. Cognitive impairment is a well-known risk factor for falls in this population group. While there is now a large body of evidence to support effective interventions for falls reduction across care settings, very little is known about interventions in the vulnerable, but increasing population of cognitively impaired community-dwelling older people. Therefore, the purpose of this systematic review is to investigate interventions designed to reduce falls in community-dwelling, cognitively impaired older adults.

Methods: A literature search of databases was conducted to identify original research published in English, which met predefined inclusion and exclusion criteria for effective (non-pharmacological) falls prevention interventions in cognitively impaired community-dwelling people over 65 years of age. Data from the selected papers were extracted into data extraction tables and analyzed according to study characteristics, measures, results, and quality.

Results: The review identified 11 studies providing data from 1,928 participants. Interventions included exercise, health assessment and management of risk, multi-component and cognitive behavioral programs, and hip protectors as falls risk reduction strategies. Seven of the selected studies showed an intervention effect in decreasing falls risk; however, only two of these showed a significant improvement in physical performance measures specifically in a cognitively impaired group.

Conclusions: The diversity of interventions, study designs, populations, and quality of the studies, which met inclusion criteria, resulted in conflicting evidence and inconclusive results for falls prevention interventions in this highly complex population.

This paper presents mathematical models for tuberculosis and its dynamics under theimplementation of the direct observation therapy strategy (DOTS) in Nigeria. The models establishconditions for the eradication of tuberculosis in Nigeria based on the fraction of detectedinfectious individuals placed under DOTS for treatment. Both numerical and qualitative analysisof the models were carried out and the effect of the fraction of detected cases of active TB on thevarious epidemiological classes is investigated. The results showed that, provided that the fractionof detected infectious individuals exceeded a critical value, there exists a globally stable diseasefree equilibrium. However, if this critical detection level is not reached, the disease-free equilibriumwill be unstable even with the very high probability successful treatment under DOTS. Theresults showed that DOTS expansion in Nigeria must include significant increase in the detectionrate of infectious individuals; otherwise the effect in reducing the incidence in Nigeria will notbe achieved disregarding the tremendous efforts in any other direction, and the huge number ofundetected cases will make DOTS insignificant with respect to tuberculosis control.

Prior field studies and modelling analyses have individually highlighted the importance of age-specific and spatial heterogeneities on the risk for schistosomiasis in human populations. As long-term, large-scale drug treatment programs for schistosomiasis are initiated in subSaharan Africa and elsewhere, optimal strategies for timing and distribution of therapy have yet to be fully defined on the working, district-level scale, where strong heterogeneities are often observed among sublocations. Based on transmission estimates from recent field studies, we develop an extended model of heterogeneous schistosome transmission for distributed human and snail population clusters and age-dependent behaviour, based on a ‘mean worm burden+snail infection prevalence’ formulation. We analyse its equilibria and basic reproduction patterns and their dependence on the underlying transmission parameters. Our model allows the exploration of chemotherapy-based control strategies targeted at high-risk behavioural groups and localities, and the approach to an optimal design in terms of cost. Efficacy of the approach is demonstrated for a model environment having linked, but spatially-distributed, populations and transmission sites.

Nasal bleeding is one of the commonest emergencies that place medical staff at risk of blood contamination during management. A sizeable proportion of incidents have been reported where blood splashes in the facial area caused such contamination, and the exposed conjunctivae are potential sites for transmission of human immunodeficiency viruses (HIV). We present a simple self-made device named the ‘Double Bag’, which is highly effective in preventing blood spraying during the management of epistaxis. It was designed to be used while treating epistaxis or removing nasal packing after surgery, when transient bleeding is expected.

Objective: To define the relative benefits of screening for diabetes and improved treatment programs and ways of improving the efficiency of screening for a population-based cohort derived from the Third National Health and Nutrition Examination Survey (NHANES III).

Methods: A Markov decision model is used to estimate microvascular benefits of glucose control for four different screening and treatment scenarios, including either universal screening or improved glucose control of known diabetic subjects, neither, or both.

Results: A population cohort of subjects with recent onset of diabetes (<5 years) was derived from NHANES III (of whom close to half were unaware that they had diabetes). In this population-based cohort, the total benefit achievable by universal screening and improved treatment (limiting HbA1c to less than 9%) is a reduction of about 30,000 cases of blindness over the lifetime of the cohort. Screening alone results in 7% of this benefit, and improved treatment alone provides 65%. Screening a targeted group of patients with three or more risk factors for developing diabetes would reduce the number of required fasting glucose measurements needed by 82% and provide 50% of the total benefit of screening the entire population with a fasting glucose measurement.

Conclusions: Morbidity from type 2 diabetes can be most effectively reduced by developing ways to modestly improve the glycemic control of known diabetic subjects, particularly those with high A1c's and early onset of disease. Targeting can significantly reduce the number of persons who need to be screened with a fasting blood test while preserving a large component of the benefit of screening.

Dimenhydrinate is an inexpensive antihistaminic drug, that is frequently used as an anti-emetic during anaesthesia. The popularity of the drug is contrasted by the lack of modern studies concerning its efficacy in reducing the incidence of post-operative nausea and vomiting. Thus, dimenhydrinate was compared with placebo in this prospective, randomized, double-blind study. One hundred and thirty-three female in-patients were studied. They were stratified according to the type of surgery (laparoscopic cholecystectomy, thyroid resection or knee arthroscopy) to ensure an homogenous distribution in both groups. General anaesthesia was induced with etomidate, fentanyl, vecuronium and maintained with enflurane in N2O/O2. Neuromuscular block was reversed with pyridostigmine/atropine. Patients in the dimenhydrinate group (n=67) received 62 mg dimenhydrinate intravenously after induction of anaesthesia. Placebo patients (n=66) received saline. Administration of dimenhydrinate (and placebo) was repeated three times during the 48-h study to mitigate the short half-life of the drug. Post-operative analgesia and anti-emetic rescue medication was standardized. Episodes of vomiting, retching and the need for additional anti-emetics were recorded. Nausea was assessed using a 10-cm visual analogue scale. Post-operative nausea and vomiting was rated as ‘none’, ‘mild’, ‘moderate’ and ‘severe’ using a fixed scoring algorithm. There were no differences between the two groups with regard to biometric data, type of surgery and distribution of risk factors for developing post-operative nausea and vomiting. In the dimenhydrinate group, more patients remained completely free from post-operative nausea and vomiting compared with placebo (dimenhydrinate: 38.8%; placebo:15.1%; P=0.004). The incidence of severe post-operative nausea and vomiting was also reduced from 39.4% to 14.9%. No relevant side effects were observed. Intra-operative dimenhydrinate, followed by three further administrations after surgery, reduces the incidence and the severity of post-operative nausea and vomiting without side effects. However, there still remained an unacceptable high number of patients who were not prevented completely from experiencing post-operative nausea and vomiting.

The effectiveness of some modifications of the Caldwell-Luc standard procedure in the prevention of postoperative mid-facial sensitivity disorders was investigated in a prospective comparative study at the ENT Department, Faculty of Medicine, University of Athens, Greece, from 1986–1992. Sixty-nine maxillary sinuses were operated on in 61 patients suffering from benign pathological conditions. The modifications concerned the type of mucoperiosteal incision and the site and size of the created anterior antrostomy. Only 8.7 per cent of the sinuses operated on by the modified technique presented with post-operative disorders whereas among those operated on by the classical technique, the ratio climbed to 33 per cent. In view of the findings of this study, the modifications applied can be valuable in treating non-extensive maxillary sinus disease with minimal post-operative sensitivity disorders.