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This study aims to study the distribution characteristics of antibiotic resistance in direct-eating food and analysis of Citrobacter freundii genome and pathogenicity. Residual antibiotics and antibiotic resistance genes (ARGs) in the environment severely threaten human health and the ecological environment. The diseases caused by foodborne pathogenic bacteria are increasing daily, and the enhancement of antibiotic resistance of pathogenic bacteria poses many difficulties in the treatment of disease.

In this study, six fresh fruits and vegetable samples were selected for isolation and identification of culturable bacteria and analysis of antibiotic resistance. The whole genome of Citrobacter freundii isolated from cucumber was sequenced and analyzed by Oxford Nanopore sequencing.

The results show that 270 strains of bacteria were identified in 6 samples. From 12 samples of direct food, 2 kinds of probiotics and 10 kinds of opportunistic pathogens were screened. The proportion of Citrobacter freundii screened from cucumber was significantly higher than that from other samples, and it showed resistance to a variety of antibiotics. Whole genome sequencing showed that Citrobacter freundii was composed of a circular chromosome containing signal peptides, transmembrane proteins and transporters that could induce antibiotic efflux, indicating that Citrobacter freundii had strong adaptability to the environment. The detection of genes encoding carbohydrate active enzymes is more beneficial to the growth and reproduction of Citrobacter freundii in crops. A total of 29 kinds of ARGs were detected in Citrobacter freundii, mainly conferring resistance to fluoroquinolones, aminoglycosides, carbapenem, cephalosporins and macrolides. The main mechanisms are the change in antibiotic targets and efflux pumps, the change in cell permeability and the inactivation of antibiotics and the detection of virulence factors and ARGs, further indicating the serious risk to human health.

The detection of genomic islands and prophages increases the risk of horizontal transfer of virulence factors and ARGs, which spreads the drug resistance of bacteria and pathogenic bacteria more widely.

Antibiotics shortages have become an increasingly common problem in Europe because of several reasons, including the offshoring of the production of active pharmaceutical ingredients for many of these products to low production cost countries, such as China and India. The problem has deteriorated because of the Covid-19 crisis that has put most global value chains (GVCs) under great stress. This situation has boosted extensive discussions among academics, practitioners and policymakers on possible changes to the configuration of GVCs. This paper aims to focus specifically on antibiotics supply chains from the perspective of a small country (Sweden), and analyse the pros and cons of backshoring and nearshoring alternatives, as a means to reduce drug shortages.

This work adopts a systemic perspective to capture the implications of reshoring for the different stakeholders involved in the antibiotics field. The present meso-analysis, focusing at the industry level, is based on multiple sources of primary data collected between 2014 and 2021, including participation in policy-related projects and interviews with over 100 representatives of key stakeholders in the antibiotics field.

This paper shows how reshoring can address the problems of drug shortages and reduce availability risk in antibiotics’ GVCs. However, the authors show that no simple and best solution exists because both alternatives of reshoring, i.e. backshoring and nearshoring, entail pros and cons for different stakeholders. The authors conclude with implications for policymakers and managers.

The analysis of pros and cons of both backshoring and nearshoring for various stakeholders offers relevant implications for research on operations and supply management, international business and economics/political science.

This paper looks at reshoring as a policy-driven decision and provides an innovative systemic perspective to analyse the implications for different stakeholders of two reshoring options concerning the antibiotics supply chain.

Bacterial vaginosis (BV) is quite common and linked with serious public health issues such as premature delivery and spread of sexually transmitted infections. The study aims to identify different genital mycoplasmas (GM) in high vaginal swabs (HVS) from adult females in Bahrain.

In total, 401 HVS were collected and cultured on MYCOFAST^® RevolutioN 2 test for identification and antibiotic susceptibility. Polymerase chain reaction (PCR) was performed for detection of Mycoplasma genitalium (Mg), Mycoplasma hominis (Mh) and Ureaplasma species. DNA-probe based detection for Gardnerella, Candida and Trichomonas was performed by BD Affirm Assay. Representative PCR amplicons were sequenced by Sanger sequencing.

In PCR, Ureaplasma sp. was the most common GM, followed by Mg and Mh; the prevalence being 21.2, 5.2 and 1.5%, respectively. On the contrary, 10.7% samples showed positivity for Ureaplasma urealyticum (Uu) and 1.7% for Mh in MYCOFAST^® RevolutioN 2. The concordance rates between MYCOFAST^® RevolutioN 2 and PCR for Mh and Ureaplasma sp. were 97.7 and 84%, respectively. Considering PCR as gold standard, sensitivity, specificity, positive predictive value, and negative predictive value of MYCOFAST^® RevolutioN 2 were 33.3, 98.8, 28.6, 98.9 and 37.7, 96.5, 74.4, 85.2% for Mh and Ureaplasma sp., respectively. The Uu and Mh isolates showed antibiotic-resistance ranging from 53%–58% and 71%–86%, respectively.

The prevalence of Ureaplasma sp. was high. Significant co-occurrence of GM was noticed with BV. MYCOFAST^® RevolutioN 2 had lower detection-rate than PCR, so a combination is suggested for wider diagnostic coverage.

The research reflects on status of prevalence of GM in adult females in Bahrain, and their co-occurrence with bacterial vaginosis. Diagnostic approach with combination of tests is suggested for wider coverage. The research has epidemiologic, diagnostic, and therapeutic implications.

This is the first report from the Kingdom of Bahrain reflecting on burden of GM from this geographic location. The diagnostic efficacy of MYCOFAST^® RevolutionN 2 test and polymerase chain reaction was evaluated for GM detection.

This review aimed to identify and map published studies on self-care practices to manage common acute health conditions in the Philippines.

The authors conducted a scoping review in PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), ProQuest Central, Journal Storage (JSTOR) and the Philippine Council for Health Research and Development – Health Research and Development Information Network (HERDIN). The authors included all studies on self-care practices to manage common acute conditions, namely low back pain, allergic rhinitis, general acute pain, cough, cold, diarrhea, constipation and stress, published up to 2021 in the Philippines. Information on the article type, aim of the study, study design and setting, population characteristics and size, and self-practices employed for the conditions were extracted and synthesized.

The authors identified various self-care practices for acute conditions among the general population and indigenous peoples in the Philippines from 26 studies included in the review: the use of medicines with and without a prescription, appropriate and inappropriate antibiotic use, use of medicinal plants and other traditional and alternative therapies and products, recreational activities and healthy habits and behaviors, and self-management or seeking care from traditional healers (albularyo or manggagamot) or health professionals. A number of considerations influenced their decision on how to manage symptoms, including perceived severity of the condition, availability and perceived effectiveness of treatment, cost, and advice from trusted sources of health information.

The authors searched five major databases and a local research database, but some studies may still have been missed in the review. The review also excluded intervention studies on the outcomes of self-care, which limits the authors' ability to make conclusions on the effectiveness of the different modalities of self-care.

Filipinos engage in a variety of “safe” (or evidence-informed) and “unsafe” (or harmful) self-care practices. While the term “self-care” is not routinely used by the general population and health providers, it is widely enculturated and practiced in the Philippines. Self-care benefits individuals and the health system, but there are also practices that increase risk of adverse outcomes and death including inappropriate antibiotic use, prescription sharing and reuse, and delays in seeking adequate treatment from a health professional. To leverage on self-care in advancing Universal Health Coverage (UHC) goals, the authors recommend a national strategy that provides guidance on how to practice responsible self-care, further research on the effectiveness and safety of alternative medicine and other priority areas, and better integration of self-care in the formal education and health systems. The authors also propose that the research agenda on self-care include acute health conditions, given their impact and burden on health and the economy.

This is the first published review of self-care practices for managing common acute health conditions, which captured practices of various groups and populations including indigenous peoples.

Intense interest has been shown in creating new and effective biocide agents as a result of changes in bacterial isolates, bacterial susceptibility to antibiotics, an increase in patients with burns and wounds and the difficulty of treating infections and antimicrobial resistance. Woven, nonwoven and knitted materials are used to make dressings; however, nonwoven dressings are becoming more popular because of their softness and high absorption capacity. Additionally, textiles have excellent geometrical, physical and mechanical features including three-dimensional structure availability, air, vapor and liquid permeability, strength, extensibility, flexibility and diversity of fiber length, fineness and cross-sectional shapes. It is necessary to treat every burn according to international protocol and along with it has to focus on particular problems of patients and the best possible results.

The objective of this paper is to conduct a thorough examination of research pertaining to the utilization of textiles, as well as alternative materials and innovative techniques, in the context of burn wound dressings. Through a critical analysis of the findings, this study intends to provide valuable insights that can inform and guide future research endeavors in this field.

In the past years, there have been several dressings such as xeroform petrolatum gauze, silver-impregnated dressings, biological dressings, hydrocolloid dressings, polyurethane film dressings, silicon-coated nylon dressings, dressings for biosynthetic skin substitutes, hydrogel dressings, newly developed dressings, scaffold bandages, Sorbalgon wound dressing, negative pressure therapy, enzymatic debridement and high-pressure water irrigation developed for the fast healing of burn wounds.

This research conducts a thorough analysis of the role of textiles in modern burn wound dressings.

Today, coronavirus disease-19 (COVID-19) treatment is an evolving process, and synbiotic administration has been suggested as a new therapeutic strategy. This study aims to investigate the effect of synbiotic supplementation in COVID-19 patients.

In this placebo-controlled trial, 80 patients were randomized to receive oral synbiotic capsule (containing fructooligosaccharide and seven bacterial strains; Lactobacillus (L) casei, L. rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, L. acidophilus, Bifidobacterium longum, L. bulgaricus, each one 109 colony-forming units) or placebo for two months. Inflammatory markers (Interleukin-6 [IL-6], C-reactive protein [CRP], erythrocyte sedimentation rate [ESR]) and white blood cell (WBC) count were evaluated at two timepoints (baseline, two months later). The measured variables were adjusted for confounders and analyzed by SPSS v21.0.

All 80 enrolled patients completed the study. The study adherence was good (approximately 70%). The mean changes for IL-6 were not significant (Δ = −0.6 ± 10.4 pg/mL vs Δ = +11.2 ± 50.3 pg/mL, p > 0.05). There were no significant improvements for CRP, ESR and WBC.

Administration of synbiotics for two months did not improve inflammatory markers in COVID-19 patients.

The purpose of this study was to determine the influence of environmental pH on production of biofilms and virulence genes expression in Pseudomonas aeruginosa.

Among 303 clinical and environmental samples 109 (61 + 48) isolates were identified as clinical and environmental P. aeruginosa isolates, respectively. Clinical samples were obtained from patients in the Al-Yarmouk hospital in Baghdad city, Iraq. Waste water from Al-Yarmouk hospital was used from site before treatment unit to collect environmental samples. The ability of producing biofilm at various pH levels was examined by microtiter plate and the prevalence of Alg D, Psl A and Pel A was determined by quantitative real time-polymerase chain reaction (qRT-PCR).

This study showed that the ability of clinical and environmental isolates to biofilm development was observed in 86.9% and 85.42% of clinical and environmental isolates, respectively. As well as, the environmental P. aeruginosa isolates showed the highest biofilm production at pH 7. Clinical isolates showed the highest genes expression of Alg D, Psl A and Pel A as compared to environmental isolates with pH change. In general, both clinical and environmental isolates formed biofilm and carried AlgD, PslA and PelA genes. Also, alkaline pH was favored for biofilm production.

There are very few studies done to find out the influence of environmental pH on production of biofilms and virulence genes expression in Pseudomonas aeruginosa. This study is unique as it has highlighted the influence of environmental pH on the ability of clinical and environmental isolates to biofilm development and genes expression.

The purpose of this research is to assess the removal of oil spills from the seawater surface as well as the antibacterial activity of ZnFe₂O₄-cetyltrimethylammonium bromide (CTAB, cationic surfactant) magnetic nanoparticles (ZFO-CTAB MNPs).

A CTAB-assisted sol–gel method was used to synthesize ZFO-CTAB MNPs. X-ray powder diffraction and Fourier transform infrared spectroscopy were used for ZFO-CTAB MNPs characterization. Also, the magnetic force and apparent density of ZFO-CTAB MNPs were determined. The oil spill cleanup was investigated by using the gravimetric oil removal (GOR) technique, which used ZFO-CTAB MNPs as oil absorbent material and four oil samples (crude, diesel, gasoline and used oil) as oil spill models. The antibacterial activity of ZFO-CTAB MNPs against Gram-negative bacteria (Pseudomonas aeruginosa, Escherichia coli and Salmonella typhi) was investigated by using the optical density method.

The results revealed that, when the amount of ZFO-CTAB was 0.01 g, gasoline oil had the highest GOR (51.80 ± 0.88 g/g) and crude oil had the lowest (11.29 ± 0.82 g/g). Furthermore, for Escherichia coli, Salmonella typhi and Pseudomonas aeruginosa, ZFO-CTAB MNPs inhibited bacterial growth with a higher percentage (94.24%–95.63%).

The applications of ZFO-CTAB MNPs in the cleanup of oil spills from aqueous solutions, as well as their antibacterial activity. The results showed that ZFO-CTAB MNPs are a promising material for removing oil spills from bodies of water as well as an antibacterial agent against Gram-negative bacterial strains.

Questionnaire studies of knowledge, attitude and practice (KAP) are effective research in the field of health, which have many shortcomings. The purpose of this research is to propose an automatic questionnaire-free method based on deep learning techniques to address the shortcomings of common methods. Next, the aim of this research is to use the proposed method with public comments on Twitter to get the gaps in KAP of people regarding COVID-19.

In this paper, two models are proposed to achieve the mentioned purposes, the first one for attitude and the other for people’s knowledge and practice. First, the authors collect some tweets from Twitter and label them. After that, the authors preprocess the collected textual data. Then, the text representation vector for each tweet is extracted using BERT-BiGRU or XLNet-GRU. Finally, for the knowledge and practice problem, a multi-label classifier with 16 classes representing health guidelines is proposed. Also, for the attitude problem, a multi-class classifier with three classes (positive, negative and neutral) is proposed.

Labeling quality has a direct relationship with the performance of the final model, the authors calculated the inter-rater reliability using the Krippendorf alpha coefficient, which shows the reliability of the assessment in both problems. In the problem of knowledge and practice, 87% and in the problem of people’s attitude, 95% agreement was reached. The high agreement obtained indicates the reliability of the dataset and warrants the assessment. The proposed models in both problems were evaluated with some metrics, which shows that both proposed models perform better than the common methods. Our analyses for KAP are more efficient than questionnaire methods. Our method has solved many shortcomings of questionnaires, the most important of which is increasing the speed of evaluation, increasing the studied population and receiving reliable opinions to get accurate results.

Our research is based on social network datasets. This data cannot provide the possibility to discover the public information of users definitively. Addressing this limitation can have a lot of complexity and little certainty, so in this research, the authors presented our final analysis independent of the public information of users.

Combining recurrent neural networks with methods based on the attention mechanism improves the performance of the model and solves the need for large training data. Also, using these methods is effective in the process of improving the implementation of KAP research and eliminating its shortcomings. These results can be used in other text processing tasks and cause their improvement. The results of the analysis on the attitude, practice and knowledge of people regarding the health guidelines lead to the effective planning and implementation of health decisions and interventions and required training by health institutions. The results of this research show the effective relationship between attitude, practice and knowledge. People are better at following health guidelines than being aware of COVID-19. Despite many tensions during the epidemic, most people still discuss the issue with a positive attitude.

To the best of our knowledge, so far, no text processing-based method has been proposed to perform KAP research. Also, our method benefits from the most valuable data of today’s era (i.e. social networks), which is the expression of people’s experiences, facts and free opinions. Therefore, our final analysis provides more realistic results.