Exploring the coping strategies of women after self-immolation: A qualitative study

BACKGROUND

Women confront a slew of issues following self-immolation, and it is crucial to examine how women react after self-immolation and live with their scars. Therefore, this study was conducted with the aim of exploring the coping strategies of Kurdish women following self-immolation using a qualitative methodology.

METHODS

The conventional content analysis approach was used in this qualitative investigation. Semi-structured face-to-face and phone interviews were conducted with 26 Kurdish women who had self-immolated and were chosen using purposeful sampling and snowballing for this study. To reinforce the research, Guba and Lincoln's trustworthiness criteria were fulfilled.

RESULTS

The data analysis yielded 2 categories, 11 subcategories, and 85 initial codes. Positive coping is one of the categories and subcategories (spirituality, rebuilding their body, psychological rehabilitation, hiding the scars, restoring self-confidence, changing the lifestyle, forming a new life) 2- Negative coping (separation from society, neglecting the body and mind, violence and aggression, staying in the past).

CONCLUSION

Using the capacity of religious organizations to help victims of self-immolation, providing appropriate conditions and facilities to heal the scars caused by self-immolation, and facilitating access to counseling services can provide the conditions for women to better adapt after self-immolation.

Gefitinib derivatives and drug-resistance: A perspective from molecular dynamics simulations

Epidermal-growth factor receptor (EGFR) is a transmembrane tyrosine kinase (TK) with a significant role in cell survival. EGFR is upregulated in various cancer cells and known as a druggable target. Gefitinib is a first-line TK inhibitor used against metastatic non-small cell lung cancer (NSCLC). Despite initial clinical response, a conserved therapeutic effect could not be achieved due to the occurrence of resistance mechanisms. Point mutations in EGFR genes are one of the major causes of rendered tumor sensitivity. To aid in the development of more efficient TKIs, chemical structures of prevailing drugs and their target binding patterns are very important. The aim of the present study was to propose synthetically-accessible gefitinib congeners with enhanced binding fitness to clinically frequent EGFR mutants. Docking simulations of intended molecules identified 1-(4-(3-chloro-4-fluorophenylamino)-7-methoxyquinazolin-6-yl)-3-(oxazolidin-2-ylmethyl) thiourea (23) as a top-binder structure inside G719S, T790 M, L858R and T790 M/L858R-EGFR active sites. Superior docked complexes were subjected to the entire 400 ns molecular dynamics (MD) simulations. Analysis of data revealed the stability of mutant enzymes upon binding to molecule 23. All mutant complexes with the exception of a T790 M/L858R-EGFR, were majorly stabilized through cooperative hydrophobic contacts. Pairwise analysis of H-bonds proved Met793 as the conserved residue with stable H-bond participations as hydrogen bond donor (Frequency 63-96%). Amino acid decomposition analysis confirmed the probable role of Met793 in complex stabilization. Estimated binding free energies indicated the proper accommodation of molecule 23 inside target active sites. Pairwise energy decompositions of stable binding modes revealed the energetic contribution of key residues. Although wet lab experiments are required to unravel the mechanistic details of mEGFR inhibition, MD results provide structural basis for those events that are difficult to address experimentally. The outputs of the current study may assist to design small molecules with high potency to mEGFRs.

Coxiella burnetii Pathogenesis: Emphasizing the Role of the Autophagic Pathway

Coxiella burnetii (C. burnetii), the etiological agent of the Q fever disease, ranks among the most sporadic and persistent global public health concerns. Ruminants are the principal source of human infections and diseases present in both acute and chronic forms. This bacterium is an intracellular pathogen that can survive and reproduce under acidic (pH 4 to 5) and harsh circumstances that contain Coxiella-containing vacuoles. By undermining the autophagy defense system of the host cell, C. burnetii is able to take advantage of the autophagy pathway, which allows it to improve the movement of nutrients and the membrane, thereby extending the vacuole of the reproducing bacteria. For this method to work, it requires the participation of many bacterial effector proteins. In addition, the precise and prompt identification of the causative agent of an acute disease has the potential to delay the onset of its chronic form. Moreover, to make accurate and rapid diagnoses, it is necessary to create diagnostic devices. This review summarizes the most recent research on the epidemiology, pathogenesis, and diagnosis approaches of C. burnetii. This study also explored the complicated relationships between C. burnetii and the autophagic pathway, which are essential for intracellular reproduction and survival in host cells for the infection to be effective.

Tobacco harm reduction in Afghanistan: a recipe for improving smokers' health

Tobacco Harm Reduction (THR) offers a promising approach to addressing the significant burden of smoking in Afghanistan. Over three million Afghans smoke daily, making it a leading cause of preventable deaths in the country. While the previous Afghan government implemented various tobacco cessation policies and strategies, these measures were only partially effective in reducing the number of smokers or smoking-related deaths. In 2021, community-based initiatives in Kabul and Herat started advocating for Tobacco Harm Reduction (THR) as a novel, realistic, and practical approach proven to promote smoking abstinence and minimize tobacco harm. However, implementing THR strategies in Afghanistan faces numerous challenges, including a lack of governmental support, funding issues, unfavorable market conditions, the high cost-effectiveness of THR products, and misconceptions about these products. To effectively promote THR in Afghanistan and overcome these challenges, it will be necessary to implement THR policies that support THR products for smokers, regulate the market for these products, produce them locally with healthcare professional oversight, conduct more engaging advocacy campaigns, and secure domestic sponsors.

Strengthening rural surgery in the Philippines: Essential in achieving universal health care

The Lancet Commission on Global Surgery (LCoGS) launched Global Surgery 2030 to address the surgical services inequities with a bias toward low‐income and middle‐income countries like the Philippines. The same inequity is observed particularly when it comes to the urban‐rural divide. With more than half of the population living in rural areas, access to surgery becomes a major challenge that further impedes the much‐needed health of an economically productive workforce. The Universal Health Care [UHC] Act (RA 11332) of 2019 ensures that all Filipinos have access to quality, cost‐effective, promotive, preventive, curative, rehabilitative, and palliative health services without causing a financial burden. Recognizing the provision of essential surgery, in the context of primary healthcare is important. It should be accessible, continuous, comprehensive, and coordinated at the time of need – parallel to the principle of primary health care. Driven by this concept and experiences, the authors conceptualized and presented the Philippine Rural Surgery model for future development and implementation. This is envisioned to provide essential surgery among local rural primary health care settings that is universal, accessible, cost‐effective and safe. As this is still new in the Philippines, we proposed tenets and recommendations based on WHO Health System Strengthening building blocks to guide stakeholders in creating formal plans towards institutionalization under the principles of UHC. Such access to surgical service in the context of a unique socio‐demography of the Philippines would be essential in attaining the parameters and provisions set by the UHC Act.

COVID-19 AND INSECURITY IN NORTHERN NIGERIA

Northern Nigeria is currently facing a twin crisis of both COVID-19 and insecurity. They have made it difficult for the people to follow government containment efforts to control the pandemic and also have impacted on the socioeconomic and health aspects of the society. We have discussed on the impact of insecurity amid COVID-19 in Northern Nigeria. It is opined that if the insecurity in Northern Nigeria is not tackled, it will expose the region to more escalation of cases and deaths. Thus, it is recommended that proactive steps should be implemented by all stakeholders concerned to tackle insecurity, particularly the government to revive the security architecture, provide an environment for training and retraining of all security personnel and enhancing intelligence gathering to pave the way for resolving this issue.

High-intensity interval training improves fat oxidation during submaximal exercise in active young men

This study aimed to examine the effects of four-weeks high-intensity interval training (HIIT) on fat oxidation responses during submaximal exercise in active young men. For this purpose, 20 active young men (who participated in the exercise three times per week) were divided into two groups, including a training group (age: 19.3±0.48 years, V̇O2peak 2.9±0.35 l/min, n=10) and a control group (age: 19.7±0.67 years, V̇O2peak 2.7±0.26 l/min, n=10). The training group performed high-intensity interval training for three sessions per week. Specifically, each session included 8-11 intensive cycling efforts comprising of 60 s duration. A 75 s low pedalling rate (30 W) was used as an active recovery between the intervals. Furthermore, a V̇O2peak test was performed prior to, at the end of two weeks and after the training period. Also, a 60 min constant cycling protocol was performed at ~60% V̇O2peak, in addition to the V̇O2peak test, before and after the training protocol. To assess plasma free fatty acids and glucose, blood samples were taken during a 60-min aerobic exercise prior to and following the training period. An increase (17.8%) in V̇O2peak was observed for the HIIT group after the training period compared to the control group (P<0.05). The HIIT group performed the 60 min sub-maximal exercise test at a lower percentage of V̇O2peak, and decreases in the respiratory exchange ratio were greater in the HIIT group than in the control group (P<0.05). Compared to the pre-test values and control group results, the HIIT group used less carbohydrate and more lipid oxidation during submaximal exercise (P<0.05). The present study’s results indicate that short-term low volume HIIT can increase aerobic capacity and fat oxidation during submaximal exercise.

Current Status and Structure Activity Relationship of Privileged Azoles as Antifungal Agents (2016-2020)

Fungal infections have major contribution to the infectious related deaths in recent century. The issue has gotten worse with the advent of immunity impairing conditions such as HIV epidemic. Eukaryote nature of fungal pathogens leads to harder eradication than bacterial infections. Given the importance of the problem, considerable efforts have been put on the synthesis and biological assessment of azole-based chemical scaffolds and their bioisosteres. The emergence of validated macromolecular targets within different fungal species inspires structure-based drug design strategies toward diverse azole-based agents. Despite of advantageous features, emergence of drug-resistant fungal species restrict the applicability of current azoles as the first-line antifungal agents. Consequently, it appears advisable to elucidate SARs and chemical biodiversity within antifungal azoles. Current contribution was devoted to a brief look at clinically applied drugs, structure-based classification of azole antifungals and their structure activity relationships (SARs). Reviewed molecules belong to the antifungal structures that were reported throughout 2016-2020.

COVID-19 denial in Turkmenistan veiling the real situation

Coronavirus disease 2019 (COVID-19) emerged in late 2019, with the first case identified in Wuhan City, Hubei Province, China, on 12 December 2019. In order to perceive the comprehensive impact of this pandemic, we have to know that misinformation and denials about COVID-19 have surely exacerbated its diffusion and hindered the response against it. Turkmenistan remains one of the very few countries in the world that lacks reports about emerging cases of the novel coronavirus. Turkmen authorities claim that they have adopted all attainable measures required in order to combat the virus, asserting that COVID-19 has yet to reach their country. Despite the government's reported absence of COVID-19 in the country, rumors, media reports and independent sources suggest the spread of the pandemic in Turkmenistan. By mid-June 2020, the outbreak was referred to as being serious with patients suffering extreme health risks, and following its state of disrepair and unethical practices, many of those anticipated to be COVID-19 infected tend to suffer at home, discouraging any interaction with the healthcare system. The civil society in Turkmenistan, for the time being, takes full part of the government's duty in the process of informing and educating the public regarding the COVID-19 pandemic, and endeavors to keep the government and WHO accountable for behaving in such repressive ways that could lead to rather preventable loss of human life in Turkmenistan. Yet, efforts hang fire before unveiling the real situation, and Turkmenistan's government owning up to the negations and roaming speculations, not only regarding the coronavirus crisis, but every public-related issue itself.

The daunting task of fighting HIV in Afghanistan: Current evidence and future recommendations

The human immunodeficiency virus (HIV), like any other disease, has created great worry in Afghanistan. The country's slew of issues has paved the way for HIV to spread and go unchecked. International groups have banded together to stop the virus's spread since the first case was confirmed in Afghanistan. The cumulative effects of international collaboration have aided in the reduction of cases and improved awareness. Because of their injection use, a large portion of the country's population has been classified as a vulnerable category for HIV infection. Awareness campaigns and international collaboration should be implemented to further limit the spread of HIV.

War Experience, Daily Stressors and Mental Health Among the Inter-taliban Generation Young Adults in Northern Afghanistan: A Cross-Sectional School-Based Study

OBJECTIVES

The specific objectives of the study are to examine the mental health (depression and anxiety) of the first generation of post-Taliban government and compare these measures with its preceding generation, and to assess war experience of the first generation of post-Taliban government. We also wanted to assess the daily stressors and their contribution to the mental health, and to assess mental health as a result of war experiences and daily stressors with respect to demographic measures such as sex, marital status, age, mother's age, birth order, and ethnicities.

METHODS

In a cross-sectional design, 621 high school students, were randomly selected to participate in the study to assess war experience, daily stressors, and mental health among the first generation of young adults under post-Taliban government.

RESULTS

The participants had 17.37 ± 0.9 mean years of ages, 94.8% of them were unmarried. Poor mental health was significantly associated with higher exposure to war, but not with the age of participants (P = 0.08). There was no association between war experiences and the age and ethnicity of our participants (p = 0.9, p = 0.7). Age differences were negligible for daily stressors too (P = 0.07). Daily stressors scores were higher for female than male students (P = 0.02). The majority of young adults surveyed, declared themselves in agreement with statements such as the security situation in Afghanistan makes me frustrated (56%), air pollution as a concern (41%), and not having anyone to talk about what is in their heart (28.8%). Gender differences were highly significant for mental health, as appraised by both The Hopkins Symptoms Checklist (HSCL) -depression and HSCL-anxiety. Girls presented higher rates of depression, anxiety, and daily stressors than boys, and boys presented higher rates of war experiences than girls.

CONCLUSION

War experience, daily stressors, and mental health were irrelevant with age, ethnicity and marital status. Factor such as being the first-born child of the family, higher reported war experiences, and daily stressors all negatively impact mental health. Alongside war and its direct effects, the existing socio-cultural context must be considered as a potential factor mediating the mental health of girls in Afghanistan.

A novel multilayer thin-film membrane with high durability: preparation, characterization, performance investigation

The main aim of this research is the improvement of the performance in desalination of polyamide (PA) thin film composite nanofiltration membranes by modification of nanofibrous polyvinylidene fluoride as a support layer.

Posterior First and Second Cervical Vertebrae Fusion by Screw Fixation Technique using the Modern Pre-fabricated Template Method on Cadaver Samples

Introduction

C1 lateral mass and C2 pedicular screws insertion are used for C1-C2 posterior fusion. Fluoroscopy Guided technique is routinely used for screw placement but it is associated with risk of injury to spinal cord and vertebral artery. 3D printing has developed rapidly in the fields of medicine. It is helpful in improving precise treatment and used for instrumentation in spine. We want to evaluate the accuracy of C1 lateral mass screws and C2 pedicle screws insertion by Pre-Fabricated Template made by three-dimensional (3D) printing.

Materials and methods

Five cervical samples were obtained from cadavers. Based on fine-cut CT scan 3D-images reconstructed and the path of the screws designed by special software. A template produced by 3D-printer from 3D images. After printing the templates, they were fixed on the relevant vertebra in the operation room and based on the template path, C1 lateral mass screw and C2 pedicular screws were inserted. Placement of the screws was evaluated using CT scans post-operatively.

Results

A total of 14 screws were inserted by above-mentioned method. After evaluation with CT scans none of the screws were entered in the spinal canal. Two screws had vertebral artery canal perforation with less than 50% breach. Violation was judged as noncritical and would probably not have resulted in injury to vertebral artery.

Conclusions

The accuracy of C1 lateral mass screw and C2 pedicle screw insertion is acceptable with pre-fabricated template and can provide a useful aid for screw placement.

Sex Workers Should Be Included in COVID-19 Vaccination Efforts

As the COVID-19 pandemic takes its toll on citizens across the globe, more people turn to sex work for survival. Because sex work is inherently physical and intimate, sex workers become defenseless against the virus and act as a bridge for transmitting the virus to their clients and society. Often, sex workers are the victims of violence and homelessness, and are devoid of health-care facilities, including HIV treatment, and are frequently exposed to a large number of individuals as dictated by the nature of their work. Their survival instincts would drive them to take part in their usual job to earn money, despite added health risks, to survive and feed their families. Worldwide, sex workers do not fully benefit from the COVID-19 responses, particularly in health, social, and economic aid assistance and services. Hence, it is essential to include this vulnerable population in the COVID-19 vaccination programs to halt the further spread of the virus.

Bhutan's COVID-19 Vaccination Efforts and the Evolution of COVID-19 Cases in the Aftermath

The COVID-19 pandemic is continuing to ravage countries across the world. It has displaced families and impacted economies around the world. Our fight against the pandemic is never ending, but COVID-19 vaccines offer unique promises and opportunities to win this war. As more and more vaccines are approved for use, many countries including Bhutan have started vaccinating their population against the SARS-CoV2 disease. Bhutan has fully vaccinated 61.5% of its people and 11.2% partially including children aged between 12 and 17 years. The country used many strategies to increase vaccine accessibility and availability such as government's exhaustive efforts to secure enough vaccine doses, careful preparations, use of international partners, and integration of its tradition and culture for wider vaccine acceptance. The protection from vaccines coupled with other public health measures has helped keep the number of COVID-19 cases to a manageable number without straining its health system too much. The success story is a "beacon of hope for the region" as the world looks to rebuild itself from this long exhausting fight against the COVID-19 pandemic.

Food security and COVID-19 in Afghanistan: a two-sided battlefront

Food security is a major element for the sustainability, stability and development of a country. However, despite fundamental efforts in fighting poverty, Afghanistan continues to struggle with food insecurity with a large proportion of its population living below the poverty line. With extreme climates, protracted conflict, and now COVID-19, food insecurity has become rampant and is on the rise in the country. Efforts have been reinforced to mitigate this issue, but a spate of obstacles which seems not to come to an end, has contributed to the deterioration of the situation. With the collaboration and efforts of international organizations, there remains a glimmer of hope to potentially reduce the gravity of the food insecurity in the country. This paper aims to highlight the efforts of Afghanistan in alleviating food insecurity with a focus on the impact of COVID-19 on this issue. It also presents recommendations that may help ameliorate the country’s food security status during and after the pandemic.

Accelerating Indonesian COVID-19 vaccination rollout: a critical task amid the second wave

Coronavirus disease-19 (COVID-19) has been spreading in every part of the world, putting nations at risk with its pandemic status, including Indonesia. COVID-19 vaccine has been deemed as one of the most effective interventions to date for mitigating the spread and mortality from COVID-19. Responding to the situation, the Government of Indonesia (GOI) has allocated the means necessary to procure and distribute COVID-19 vaccines; placing into consideration the unique context of the country, recently categorized as a middle-income country and archipelagic with a population over 270 million. This article aims to present the challenges associated with the distribution of COVID-19 vaccination as well as recommendations to mitigate them, to ensure a timely and effective COVID-19 vaccination program in Indonesia.