Crumbling the Castle: Targeting DNABII Proteins for Collapsing Bacterial Biofilms as a Therapeutic Approach to Treat Disease and Combat Antimicrobial Resistance

Antimicrobial resistance (AMR) is a concerning global threat that, if not addressed, could lead to increases in morbidity and mortality, coupled with societal and financial burdens. The emergence of AMR bacteria can be attributed, in part, to the decreased development of new antibiotics, increased misuse and overuse of existing antibiotics, and inadequate treatment options for biofilms formed during bacterial infections. Biofilms are complex microbiomes enshrouded in a self-produced extracellular polymeric substance (EPS) that is a primary defense mechanism of the resident microorganisms against antimicrobial agents and the host immune system. In addition to the physical protective EPS barrier, biofilm-resident bacteria exhibit tolerance mechanisms enabling persistence and the establishment of recurrent infections. As current antibiotics and therapeutics are becoming less effective in combating AMR, new innovative technologies are needed to address the growing AMR threat. This perspective article highlights such a product, CMTX-101, a humanized monoclonal antibody that targets a universal component of bacterial biofilms, leading to pathogen-agnostic rapid biofilm collapse and engaging three modes of action—the sensitization of bacteria to antibiotics, host immune enablement, and the suppression of site-specific tissue inflammation. CMTX-101 is a new tool used to enhance the effectiveness of existing, relatively inexpensive first-line antibiotics to fight infections while promoting antimicrobial stewardship.

Dementia: An Overview (Preprint)

BACKGROUND Dementia is a serious terminal and irreversible disease that often does not receive attention from the public compared to other non-communicable diseases. This disease causes a decline in cognitive function in individuals and makes them have to depend on others for 5-20 years of their life span. OBJECTIVE The purpose of this paper is to provide an overview of dementia and other things related to this disease. METHODS The writing method in this article uses a narrative review on several scientific sources and journal articles published in 2011-2021 from several databases such as Google Scholar, CINAHL, ProQuest, PubMed, and EBSCO. RESULTS Dementia is one of the non-communicable diseases that can cause a high burden on individuals, families, communities, and countries as a result of the unproductiveness and total dependence of people with dementia on their surrounding environment due to the decline in body functions that occur. The caregiver burden experienced by caregivers includes physical, psychological, social and financial burdens. Support and assistance from professional health workers for people with dementia as well as caregivers and families can be provided through several efforts such as providing information related to illness, assistance in the care provided, providing counseling to prevent caregiver burdens and other problems, forming support groups for dementia caregivers, and advocacy for people with dementia and their families to get their rights. CONCLUSIONS Change efforts and policy making by the government that are more pro-people with dementia can change the perception that has been in society so far to be more positive and can potentially contribute to people with dementia.

Household financial burden associated with health care for older people in Viet Nam: A cross-sectional survey

Background Population ageing and the associated increase in the health care needs of older people are putting pressure on the health care system in Viet Nam. The country prioritizes health care for older people and has developed financial protection policies to mitigate financial hardship due to out-of-pocket health expenditures (OOPHEs) borne by their households. This study examines the level and determinants of the financial burden of OOPHE among households with people aged ≥60 years in Viet Nam. Methods A cross-sectional household survey was conducted among a sample of 1536 older people living in 1477 households in three provinces representing the North, Central and South regions of Viet Nam during 2019–2020. The financial outcomes were catastrophic health expenditure (CHE), using the World Health Organization's definition, and financial distress due to OOPHE. Multivariate binary logistic regression analysis was employed to determine the factors associated with these outcomes. Results OOPHE for older household members accounted for 86.3% of total household health expenditure. Of households with older people, 8.6% (127) faced CHE, and 12.2% (181) experienced financial distress due to OOPHE. Households were at a higher risk of incurring financial burdens related to health expenditures if they had fewer household members; included only older people; were in rural or remote, mountainous areas; and had older members with noncommunicable diseases. There was no significant association between health insurance coverage and financial burden. However, when older people sought tertiary care or private care, the possibility of a household facing CHE increased. Regardless of the type and level of care, health service utilization by older people results in a higher likelihood of a household encountering financial distress. Conclusions This study reveals that OOPHE for older people can impose substantial financial burdens on households, leading them to face CHE and financial distress. This study provides evidence to justify reforming financial protection policies and introducing policy interventions targeted at better protecting older people and their households from the financial consequences of OOPHE. There is also the need to strengthen the grassroots health facilities to provide primary care closer to home at lower costs, particularly for the management of noncommunicable diseases.

COVID-19 impacts on virtual exchange around the world

The COVID-19 pandemic has simultaneously created both opportunities and challenges for the emerging field of virtual exchange: On one hand, institutional administrators and funding organisations saw virtual exchange as the solution to global learning needs while physical travel was restricted and traditional mobility programmes were suspended. On the other hand, instructors felt overwhelmed by transitioning all of their teaching online, and without physical access to their educational institutions, many students and instructors lacked reliable internet connections or safe places to engage in learning, not to mention the financial burdens of the pandemic. This moderated panel discussion which took place during the IVEC 2020 conference invited diverse perspectives to explore the impacts of the pandemic on virtual exchange in various contexts around the world. Central to the discussion were issues of equity, inclusion and justice: Is virtual exchange truly a more accessible and equitable form of global learning, as it is often promoted to be? In this video contribution, Eva Haug moderates the conversation between Maha Bali, Paulo Goes, and Anita Patankar around the following questions. * How is virtual exchange a solution to global learning during COVID-19? * What have been the two to three most relevant impacts of the pandemic on virtual exchange activity at your institution, in your country, or region of the world? * How can we as a field of practitioners maintain and sustain the current momentum and interest in VE in a post-COVID-19 world? * Can intercultural exchange be apolitical? * If an institution is in a position of power or privilege, how can they create space in virtual exchange for institutions that are less represented? The video recording is accessible on: https://vimeo.com/459415071 (CC BY-NC-NC)

Machine Learning and Its Application in Skin Cancer

Artificial intelligence (AI) has wide applications in healthcare, including dermatology. Machine learning (ML) is a subfield of AI involving statistical models and algorithms that can progressively learn from data to predict the characteristics of new samples and perform a desired task. Although it has a significant role in the detection of skin cancer, dermatology skill lags behind radiology in terms of AI acceptance. With continuous spread, use, and emerging technologies, AI is becoming more widely available even to the general population. AI can be of use for the early detection of skin cancer. For example, the use of deep convolutional neural networks can help to develop a system to evaluate images of the skin to diagnose skin cancer. Early detection is key for the effective treatment and better outcomes of skin cancer. Specialists can accurately diagnose the cancer, however, considering their limited numbers, there is a need to develop automated systems that can diagnose the disease efficiently to save lives and reduce health and financial burdens on the patients. ML can be of significant use in this regard. In this article, we discuss the fundamentals of ML and its potential in assisting the diagnosis of skin cancer.

Quantifying the Costs to Different Funders over Five-Years for Women Diagnosed with Breast Cancer in Queensland, Australia: A Data Linkage Study

Individuals diagnosed with breast cancer have the highest rates of survival among all cancer types. Due to high survival, the costs of breast cancer to different healthcare funders are of interest. This study aimed to describe the cost to public hospital and private health funders and individuals due to hospital and emergency department (ED) admissions, as well Medicare items and pharmaceuticals over five years for Queensland women with breast cancer. We used a linked administrative dataset, CancerCostMod, limited to Queensland female breast cancer diagnoses between July 2011 and June 2013 aged 18 years or over who survived for 5 years (n = 5383). Each record was linked to Queensland Health Admitted Patient Data Collection, Emergency Department Information Systems, Medicare Benefits Schedule, and Pharmaceutical Benefits Scheme records between July 2011 and June 2018. Total costs for different healthcare funders as a result of breast cancer diagnoses were reported, with high costs and service use identified in the first six months following a breast cancer diagnosis. After the first six months post-diagnosis, the financial burdens incurred by different healthcare funders for breast cancer diagnoses in Queensland remain steady over a long period. Recommendations for reducing long term costs are discussed.

Does Closing the Donut Hole Reduce Financial Burdens Among Medicare Part D Beneficiaries?

The Medicare Part D donut hole has been gradually closed since 2010. But it is still unclear how it has impacted the beneficiaries’ relative financial burdens, especially in the later stage of the closing plan. The measurement of catastrophic health expenditure induced by prescription drugs (CHE-Rx) reflects the relative financial burdens to beneficiaries’ household income, which bears more information than the measure of dollar-value expenses or the absolute poverty line used in prior studies. Using the Medical Expenditure Panel Survey 2008-2017 longitudinal national representative data and the method of difference-in-differences, this study found that the donut hole closing policy was associated with more usage of prescription drugs (b=2.84, p=0.023) and a higher likelihood of experiencing CHE-Rx (b=2.4%, p=0.011) among those who fell in the donut holes. Besides, the results show that the donut hole closing policy did not generate any immediate effects on prescription drug usage, CHE, and CHE-Rx. For the first time, this paper examined both the aggregated and marginal impact of the policy implementation, which had closed by an additional 35% between 2013 and 2017, on the relative financial burden among the beneficiaries.

Contribution of adult sex ratio to trauma and reproductive output in large breeding groups of rhesus macaques (Macaca mulatta)

Maintaining stable breeding groups of rhesus macaques (Macaca mulatta) can be challenging due to the complex social dynamics and despotic nature of the species. Trauma from aggression is a common problem in rhesus colonies and can cause social disruption, strain veterinary and animal management resources, and potentially affect reproduction. Previous research has shown that increasing the number of non-natal adult males in a breeding group can improve group stability, reduce trauma, and increase reproduction. Here, we used mixed-effects regression models to examine the effects of sex ratio and other factors on trauma and reproduction at the Yerkes National Primate Research Center using a historical dataset made up of four large rhesus groups over an eleven-year period (2003–2013). As expected, sex ratio was a significant predictor for both trauma and reproduction. However, group age since formation was a stronger predictor of trauma frequency and the amount of space available was a slightly better predictor of reproduction than sex ratio or trauma. These results indicate that improving sex ratios can be a viable management strategy to reduce trauma and improve reproduction, particularly when it is difficult to manipulate the group compositions and/or their housing situations. Reducing trauma is a primary goal for rhesus breeding colonies, as it directly impacts the monkeys' health and psychological well-being. Such improvements are necessary for the ethical treatment and care of the animals themselves, but also to reduce financial burdens and maintain a healthy colony for research purposes.

Long-term repair of porcine articular cartilage using cryopreservable, clinically compatible human embryonic stem cell-derived chondrocytes

Osteoarthritis (OA) impacts hundreds of millions of people worldwide, with those affected incurring significant physical and financial burdens. Injuries such as focal defects to the articular surface are a major contributing risk factor for the development of OA. Current cartilage repair strategies are moderately effective at reducing pain but often replace damaged tissue with biomechanically inferior fibrocartilage. Here we describe the development, transcriptomic ontogenetic characterization and quality assessment at the single cell level, as well as the scaled manufacturing of an allogeneic human pluripotent stem cell-derived articular chondrocyte formulation that exhibits long-term functional repair of porcine articular cartilage. These results define a new potential clinical paradigm for articular cartilage repair and mitigation of the associated risk of OA.