Fascioliasis, only foodborne trematodiasis of worldwide distribution, is caused by Fasciola hepatica and F. gigantica, liver flukes transmitted by freshwater snails. Southern and southeastern Asia is an emerging hot spot of F. gigantica, despite its hitherto less involvement in human infection. In Vietnam, increasing cases have been reported since 1995, whereas only sixteen throughout 1800-1994. A database was created to include epidemiological data of fascioliasis patients from the 63 Vietnam provinces throughout 1995-2019. Case profiles were based on serology, symptoms, eosinophilia, imaging techniques, stool egg finding, and post-specific-treatment recovery. Radio broadcasting about symptoms and costless diagnosis/treatment led patients to hospitals after symptom onset. Yearly case numbers were modelled and spatio-temporally analyzed. Missing data and confounders were assessed. The countrywide spread has no precedent. It started in the central coast, including 53,109 patients, mostly adults and females. Seasonality, linked to vegetable consumption, peaks in June, although the intensity of this peak differs according to relief/climatic zones. Incidence data and logistic regression curves are obtained for the first time in human fascioliasis. Fasciolid hybrids accompanying the spreading F. gigantica flukes, and climate change assessed by risk index correlations, are both ruled out as outbreak causes. Human-guided movements of livestock from an original area prove to be the way used by fasciolids and lymnaeid vectors to expand geographically. Radix viridis, a highly efficient transmitting and colonizing vector, played a decisive role in the spread. The use of irrigated crop fields, widely inhabited by R. viridis, for livestock grazing facilitated the transmission and spread of the disease. General physician awareness and diagnostic capacity improvement proved the successful impact of such knowledge transfer in facilitating and increasing patient infection detection. Information, education and communication to the public by radio broadcasting demonstrated to be very helpful. Fasciola gigantica is able to cause epidemic and endemic situations similar to F. hepatica. The magnitude of the human outbreak in Vietnam is a health wake-up call for southern and southeastern countries of Asia which present the highest human population densities with increasing food demands, uncontrolled livestock inter-country exchange, foreign import practices, and monsoon\'s increasing climate change impact.

Purpose Our study aimed to describe the clinical profile of endogenous endophthalmitis, focusing on patient demographics, infection sources, microbial profiles, clinical outcomes, and factors affecting the final visual outcome. Methods A retrospective review was performed on data from 68 eyes of 60 patients diagnosed with endogenous endophthalmitis and hospitalized in two tertiary hospitals on the East Coast of Peninsular Malaysia from January 2011 to December 2020. The analysis encompassed evaluating patient age, gender, laterality, risk factors, infection origins, presenting and final visual acuity, microbial results, treatment responses, and factors affecting final visual outcomes. Results The average age of the patient cohort was 54.9 ± 13.3 years. Females were more likely to have endogenous endophthalmitis than males (33, 55.0% vs. 27, 45.0%). Twenty-seven patients (45.0%) presented with endogenous endophthalmitis in the left eye, while 25 patients (41.7%) had it in the right eye, and eight patients (13.3%) had bilateral involvement. Most patients had underlying predisposing conditions, predominantly diabetes mellitus (53, 88.3%). Infection sources were identified in 42 patients (70.0%), out of which urinary tract infections account for the majority (11, 18.3%). Klebsiella species(14, 22.7%) were the leading pathogens and were significantly associated with liver abscess cases. In this series, the majority of patients had poor presenting and final visual acuity of worse than 3/60 (56, 82.4% and 53, 77.9%, respectively). Thirty-six eyes (52.9%) underwent vitrectomy, resulting in only four eyes (11.11%) achieving final visual acuity better than 6/12. Presenting visual acuity was identified as the factor contributing to the blind final visual outcome (r = 0.707, p < 0.001). Conclusion Females were found to be more commonly affected by endogenous endophthalmitis than males. Klebsiella species were the most commonly isolated microorganisms and were typically associated with liver abscesses. Urinary tract infection was the most common predisposing factor. A majority of the patients had poor presenting and final visual acuity, in which poor visual acuity is a significant indicator of blind visual outcomes.

BACKGROUND: For healthcare delivery to be optimally effective, health systems must possess adequate levels and we must ensure a fair distribution of human resources aimed at healthcare facilities. We conducted a scoping review to map the current state of human resources for health (HRH) in India and the reasons behind its shortage.
METHODS: A systematic search was conducted in various electronic databases, from the earliest available date till February 2024. We applied a uniform analytical framework to all the primary research reports and adopted the \"descriptive-analytical\" method from the narrative paradigm. Inductive thematic analysis was conducted to arrange the retrieved data into categories based on related themes after creating a chart of HRH problems.
RESULTS: A total of 9675 articles were retrieved for this review. 88 full texts were included for the final data analysis. The shortage was addressed in 30.6% studies (n = 27) whereas 69.3% of studies (n = 61) addressed reasons for the shortage. The thematic analysis of data regarding reasons for the shortage yielded five kinds of HRH-related problems such as inadequate HRH production, job dissatisfaction, brain drain, regulatory issues, and lack of training, monitoring, and evaluation that were causing a scarcity of HRH in India.
CONCLUSIONS: There has been a persistent shortage and inequitable distribution of human resources in India with the rural expert cadres experiencing the most severe shortage. The health department needs to establish a productive recruitment system if long-term solutions are to be achieved. It is important to address the slow and sporadic nature of the recruitment system and the issue of job insecurity among medical officers, which in turn affects their other employment benefits, such as salary, pension, and recognition for the years of service.

UNASSIGNED: The COVID-19 pandemic has drastically altered the dietary patterns of individuals. This study aimed to investigate the changes in the purchase and consumption of fruit and vegetables in Sri Lanka during the COVID-19 pandemic.
UNASSIGNED: An online cross-sectional survey assessed the self-reported changes in fruit and vegetable consumption and purchase using Google forms. Logistic regression analyses were performed to assess the association between decreased consumption of imported fruits and increased home-grown food intake with socio-demographic variables.
UNASSIGNED: Among the 3621 survey respondents, 63.0% and 43.3% reported a decreased intake of imported and local fruits purchased from the market, respectively. Although the overall vegetable consumption has declined, the leafy vegetable consumption has increased by 40.7%. Imported fruit intake has significantly reduced among youngsters, males, respondents living in municipal areas, employed, and those with lower monthly incomes. Among the respondent, 48.9% declared an increased consumption of home-grown fruits or vegetables. Responders living away from Colombo and rural areas were more likely to report a higher intake of home-grown fruits and vegetables (OR 2.021; 95% CI, 1.762-2.318, P < 0.001). Employed males residing in municipal areas were less likely to report an increased intake (OR 0.689; 95% CI, 0.574-0.827, P < 0.001).
UNASSIGNED: Purchase of imported and local fruits from the market has reduced. Although the overall vegetable consumption was decreased, there has been an increase in the consumption of leafy vegetables. Furthermore, consumption of home-grown fruits and vegetables has increased considerably. Well-established food distribution programs are essential in future pandemics to promote healthy eating.

This study explores the application of the DREAM methodology for course assessment in three South East Asian universities aiming to embed sustainability and sustainable development goals (SDGs) in multiple academic disciplines enabled by information and communication technologies (ICTs). A mixing of content and thematic analysis was used, which aligns with the underpinning philosophy of the Diagnosing, Reviewing/Reflecting, Explaining, Assessing, Managing (DREAM) methodology. The DREAM methodology integrates five processes, starting from diagnosing, to reviewing/reflecting, explaining, assessing, and, finally, managing. Results show that merging semantic and latent themes has contributed to uncovering what messages students\' narratives convey and provided a space for focusing both on the surface and explicit meanings of the data as well as on theory building and policy making. They also show the effectiveness of the DREAM methodology in constructing new knowledge and generating meaningful interpretations and suggestions to teacher educators and other academic teaching staff, as well as higher education institutions\' policymakers and planners.

Obtaining representative abortion incidence estimates is challenging in restrictive contexts. While the confidante method has been increasingly used to collect this data in such settings, there are several biases commonly associated with this method. Further, there are significant variations in how researchers have implemented the method and assessed/adjusted for potential biases, limiting the comparability and interpretation of existing estimates. This study presents a standardized approach to analyzing confidante method data, generates comparable abortion incidence estimates from previously published studies and recommends standards for reporting bias assessments and adjustments for future confidante method studies.
We used data from previous applications of the confidante method in Côte d\'Ivoire, Ethiopia, Ghana, Java (Indonesia), Nigeria, Uganda, and Rajasthan (India). We estimated one-year induced abortion incidence rates for confidantes in each context, attempting to adjust for selection, reporting and transmission bias in a standardized manner.
In each setting, majority of the foundational confidante method assumptions were violated. Adjusting for transmission bias using self-reported abortions consistently yielded the highest incidence estimates compared with other published approaches. Differences in analytic decisions and bias assessments resulted in the incidence estimates from our standardized analysis varying widely from originally published rates.
We recommend that future studies clearly state which biases were assessed, if associated assumptions were violated, and how violations were adjusted for. This will improve the utility of confidante method estimates for national-level decision making and as inputs for global or regional model-based estimates of abortion.

Megabranchiella gen. nov. (Ephemeroptera: Baetidae) is established as a new baetid mayfly genus from northern Thailand. Two new species, Megabranchiellascutulata sp. nov. and Megabranchiellalongusa sp. nov., are described. This genus is distinguished from other Baetidae by abdominal segment I, bearing a pair of enlarged, ventrally oriented single gills, covering abdominal sternites II-V; other gills have normal size and are dorsolaterally oriented. The two new species Megabranchiellalongusa sp. nov. and Megabranchiellascutulata sp. nov. can be differentiated by the setation of femur dorsal margin and the shape of abdominal gill I. This mayfly genus was found in flowing water with cobble microhabitats in headwater streams of northern Thailand.

UNASSIGNED: With AMU projected to increase, South East Asia (SEA) is at high risk of experiencing disproportionate health, social, and economic burdens due to antimicrobial resistance (AMR). Our objective was to identify factors influencing AMR in SEA\'s food system and places for intervention by integrating the perspectives of experts from the region to inform policy and management decisions.
UNASSIGNED: We conducted two 6.5 h workshops and two 90-min interviews involving 18 AMR and other disciplinary experts from human, animal, and environment sectors who brainstormed the factors influencing AMR and identified leverage points (places) for intervention. Transcripts and workshop materials were coded for factors and their connections and transcribed into a causal loop diagram (CLD). Thematic analysis described AMR dynamics in SEA\'s food system and leverage points for intervention. The CLD and themes were confirmed via participant feedback.
UNASSIGNED: Participants constructed a CLD of AMR in the SEA food system that contained 98 factors interlinked by 362 connections. CLD factors reflected eight sub-areas of the SEA food system (e.g., government). Seven themes [e.g., antimicrobial and pesticide use and AMR spread (n = 40 quotes)], six \"overarching factors\" that impact the entire AMR system [e.g., the drive to survive (n = 12 quotes)], and 10 places for intervention that target CLD factors (n = 5) and overarching factors (n = 2) emerged from workshop discussions.
UNASSIGNED: The participant derived CLD of factors influencing AMR in the SEA food system demonstrates that AMR is a product of numerous interlinked actions taken across the One Health spectrum and that finding solutions is no simple task. Developing the model enabled the identification of potentially promising leverage points across human, animal, and environment sectors that, if comprehensively targeted using multi-pronged interventions, could evoke system wide changes that mitigate AMR. Even targeting some leverage points for intervention, such as increasing investments in research and capacity building, and setting and enforcing regulations to control antimicrobial supply, demand, and use could, in turn, shift mindsets that lead to changes in more difficult to alter leverage points, such as redefining the profit-driven intent that drives system behavior in ways that transform AMU and sustainably mitigate AMR.

UNASSIGNED: The review aimed at examining patient factors that were associated with the worldwide geographic variation in number of monkeypox cases during the 2022 outbreak.
UNASSIGNED: A systematic search was conducted using Scopus, Google Scholar, and PubMed/MEDLINE, to identify studies published in the year 2022 until 30 September on the 2022 monkeypox outbreak. Studies that described demographics and patient characteristics of the affected populations were eligible. Only countries/regions with the highest and lowest globally reported numbers were included.
UNASSIGNED: A total of 24 eligible studies reported data from the most affected countries in Europe [Spain and UK]; Americas [USA and Brazil]; and the least affected region [South East Asia]. There were no eligible studies reporting data from the Eastern Mediterranean which was allegedly the least affected region. Cases from Europe and the Americas were mostly men having sex with men [MSM], in fourth and fifth decades of life, with a substantial proportion of HIV and sexually transmitted diseases. Sporadic cases among women [sexual, household] and children [household] were identified. Sexual orientation and/or mode of transmission were not clearly stated in most studies from South East Asia.
UNASSIGNED: The 2022 monkeypox outbreak was most obvious in the western part of the globe due mainly to sexual activities among MSM. Low numbers in the east may indicate the influence of the conservative social behaviors. Co-morbidities in the form of HIV and sexually transmitted diseases were identified. Detection of the disease among women and children highlights the importance of adopting appropriate preventive public health measures.

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