Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions

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The paper provides a comprehensive overview of the status of Crimean-Congo hemorrhagic fever (CCHF) in countries across the World Health Organization Eastern Mediterranean Region (WHO EMR).

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The increasing incidence of CCHF disease in the region and its spread to new geographical areas is highlighted.

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Knowledge gaps concerning the burden and circulation of CCHF virus in the WHO EMR are identified.

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A strategic framework is described, which details the research and development work necessary to curb the ongoing and new threats posed by CCHF virus.

Crimean-Congo haemorrhagic fever (CCHF) is the most widespread, tick-borne viral disease affecting humans. The disease is endemic in many regions, such as Africa, Asia, Eastern and Southern Europe, and Central Asia. Recently, the incidence of CCHF has increased rapidly in the countries of the World Health Organization Eastern Mediterranean Region (WHO EMR), with sporadic human cases and outbreaks of CCHF being reported from a number of countries in the region. Despite the rapidly growing incidence of the disease, there are currently no accurate data on the burden of the disease in the region due to the different surveillance systems used for CCHF in these countries. In an effort to increase our understanding of the epidemiology and risk factors for the transmission of the CCHF virus (CCHFV; a Nairovirus of the family Bunyaviridae) in the WHO EMR, and to identify the current knowledge gaps that are hindering effective control interventions, a sub-regional meeting was organized in Muscat, Oman, from December 7 to 9, 2015. This article summarizes the current knowledge of the disease in the region, identifies the knowledge gaps that present challenges for the prevention and control of CCHFV, and details a strategic framework for research and development activities that would be necessary to curb the ongoing and new threats posed by CCHFV.

Non-English languages enrich scientific knowledge: The example of economic costs of biological invasions

We contend that the exclusive focus on the English language in scientific research might hinder effective communication between scientists and practitioners or policy makers whose mother tongue is non-English. This barrier in scientific knowledge and data transfer likely leads to significant knowledge gaps and may create biases when providing global patterns in many fields of science. To demonstrate this, we compiled data on the global economic costs of invasive alien species reported in 15 non-English languages. We compared it with equivalent data from English documents (i.e., the InvaCost database, the most up-to-date repository of invasion costs globally). The comparison of both databases (~7500 entries in total) revealed that non-English sources: (i) capture a greater amount of data than English sources alone (2500 vs. 2396 cost entries respectively); (ii) add 249 invasive species and 15 countries to those reported by English literature, and (iii) increase the global cost estimate of invasions by 16.6% (i.e., US$ 214 billion added to 1.288 trillion estimated from the English database). Additionally, 2712 cost entries - not directly comparable to the English database - were directly obtained from practitioners, revealing the value of communication between scientists and practitioners. Moreover, we demonstrated how gaps caused by overlooking non-English data resulted in significant biases in the distribution of costs across space, taxonomic groups, types of cost, and impacted sectors. Specifically, costs from Europe, at the local scale, and particularly pertaining to management, were largely under-represented in the English database. Thus, combining scientific data from English and non-English sources proves fundamental and enhances data completeness. Considering non-English sources helps alleviate biases in understanding invasion costs at a global scale. Finally, it also holds strong potential for improving management performance, coordination among experts (scientists and practitioners), and collaborative actions across countries. Note: non-English versions of the abstract and figures are provided in Appendix S5 in 12 languages.

Physician knowledge about and perceptions of obesity management

OBJECTIVE

Approximately 35% of US adults are obese. The purpose of this study was to assess the knowledge and practice patterns of primary care physicians (PCPs), endocrinologists (ENDOs), cardiologists (CARDs) and bariatricians (BARIs) regarding obesity.

METHODS

A case vignette survey was distributed to 1625 US-based PCPs, ENDOs, CARDs, and BARIs via email and fax in February 2013. Results were analysed with PASW Statistics 18.

RESULTS

Respondents included 100 PCPs, 100 ENDOs, 70 CARDs, and 30 BARIs. The majority agreed obesity is a disease as defined by the AMA, however, half of PCPs, ENDOs, and CARDs also agreed obesity results from a lack of self-control. Familiarity with select obesity guidelines was low. Nearly all respondents used body mass index for obesity screening. No consensus as to when to initiate weight-loss medication was observed. Many physicians expected a larger weight loss with pharmacotherapy than is realistic (∼ 30%) or were unsure (∼ 22%). A majority of PCPs, ENDOs and CARDs expected less excess weight loss with gastric bypass surgery than is realistic, BARIs had a more reasonable expectation.

CONCLUSIONS

Overall, respondents demonstrated knowledge gaps for obesity guidelines and pathophysiology and generally lacked understanding of obesity medication efficacy, safety and MOA.

Nanoplastics in the oceans: Theory, experimental evidence and real world

This review critically analyses >200 papers collected by searching on Pubmed the word "nanoplastics", a group of emerging contaminants which are receiving growing attention. The present review intends to provide an overview of current knowledge on nanoplastic pollution starting with the theory of polymer degradation, passing to laboratory confirmation of nanoplastic formation and ending with the possible occurrence in sea water samples. Most of the observations proposed focus the attention on polystyrene (PS) because the majority of research knowledge is based on this polymer. Moreover, we thoroughly describe what effects have been observed on different organisms tested in controlled conditions. Nanoplastics formation, fate and toxicity seem to be a very dynamic phenomenon. In light of this, we identify some aspects retained crucial when an ecotoxicological study with nanoplastics is performed and which elements of nanoplastics toxicity could be deeper covered.

Delivering patient-centered care in Parkinson's disease: Challenges and consensus from an international panel

An international panel of movement disorders specialists explored the views and perceptions of people with Parkinson's disease (PD) about their condition and its treatment, including the potential mismatch between the clinician's view of the patient's condition and their own view of what aspects of the disease most affect their daily lives. The initiative was focused on Asian countries, so participants comprised experts in the management of PD from key centers in Asia, with additional insight provided by European and the North American movement disorders experts. Analysis of peer-reviewed publications on patient perceptions of PD and the factors that they consider important to their wellbeing identified several contributing factors to the mismatch of views, including gaps in knowledge of PD and its treatment, an understanding of the clinical heterogeneity of PD, and the importance of a multidisciplinary approach to patient care. The faculty proposed options to bridge these gaps to ensure that PD patients receive the personalized treatment they need to achieve the best possible outcomes. It was considered essential to improve patient knowledge about PD and its treatment, as well as increasing the awareness of clinicians of PD heterogeneity in presentation and treatment response. A multidisciplinary and shared-care approach to PD was needed alongside the use of patient-centered outcome measures in clinical trials and clinical practice to better capture the patient experience and improve the delivery of individualized therapy.

Identification of knowledge gaps in neurosurgery using a validated self-assessment examination: differences between general and spinal neurosurgeons

OBJECTIVE

The practice of neurosurgery requires fundamental knowledge base. Residency training programs and continuing medical education courses are designed to teach relevant neurosurgical principles. Nevertheless, knowledge gaps exist for neurosurgeons and may be different between cohorts of neurosurgeons. The Self-Assessment in Neurological Surgery (SANS) General Examination and Spine Examination are online educational tools for lifelong learning and maintenance of certification. This study examines the gaps in knowledge of spinal neurosurgeons and general neurosurgeons taking SANS.

METHODS

From 2008 to 2010, a total of 165 spinal neurosurgeons completed the 243 available questions of the SANS Spine Examination. Over that same time frame, 993 general neurosurgeons completed the SANS General Spine Examination. Mean scores were calculated and assessed according to 18 major neurosurgical knowledge disciplines. Statistical analysis was carried out to evaluate for significant knowledge gaps among all users and significant differences in performance between spinal neurosurgeons and their general neurosurgeon counterparts.

RESULTS

The mean overall examination score was 87.4% ± 7.5% for spinal neurosurgeons and 71.5% ± 8.9% for general neurosurgeons (P < 0.001). Of the 18 major knowledge categories in SANS, spinal neurosurgeons (n = 165) answered questions incorrectly 15% or greater of the time in five of the categories. The categories of lower performance for spinal neurosurgeons were cerebrovascular, anesthesia and critical care, general clinical, tumor, and trauma. For general neurosurgeons (n = 993), the five knowledge categories with lowest performance were cerebrovascular, epilepsy, peripheral nerve, trauma, and radiosurgery. Although spinal neurosurgeons and general neurosurgeons shared some areas of decreased performance including trauma and cerebrovascular, spine neurosurgeons relatively underperformed in general clinical, anesthesia and critical care, and tumor.

CONCLUSIONS

The SANS Spine Examination demonstrated knowledge gaps in specific categories for spinal surgeons. The knowledge areas of diminished performance differed between spinal and general neurosurgeons. Identification of specific areas of deficiency could prove useful in the design and implementation of educational programs and maintenance of certification.

The missing pieces in the jigsaw and need for cohesive research amidst coronavirus infectious disease 2019 global response

Identifying the research needs and gaps amidst this COVID-19 travelling across the countries is absolutely important for finely improving on the way we think and act. The natural history of the disease as well as viral shedding in different stages of clinical illness needs to be known which helps in triaging the patients in hospital settings. Animal and environmental interface need to be studied for defining the high-risk situations. Transmission dynamics in community or hospital and defining the laboratory criteria for the case confirmation will be most crucial. Gene sequencing and validation and, suitable use of molecular based tests such as real-time polymerase chain reaction (qRT-PCR) should be clearly evaluated for diagnosis and/ or surveillance. The movement control strategy must be defined to prevent secondary transmission in healthcare as well as in community settings. Repurposing of drug molecules is an elegant strategy to develop therapeutics in the case of pandemics quickly. Unproven practices and treatment protocols should invite critical scrutiny on the basis of ethics. Socioeconomic status of the community is also an important determinant for the compliance and sustainable public health measures.

The economic costs, management and regulation of biological invasions in the Nordic countries

A collective understanding of economic impacts and in particular of monetary costs of biological invasions is lacking for the Nordic region. This paper synthesizes findings from the literature on costs of invasions in the Nordic countries together with expert elicitation. The analysis of cost data has been made possible through the InvaCost database, a globally open repository of monetary costs that allows for the use of temporal, spatial, and taxonomic descriptors facilitating a better understanding of how costs are distributed. The total reported costs of invasive species across the Nordic countries were estimated at $8.35 billion (in 2017 US$ values) with damage costs significantly outweighing management costs. Norway incurred the highest costs ($3.23 billion), followed by Denmark ($2.20 billion), Sweden ($1.45 billion), Finland ($1.11 billion) and Iceland ($25.45 million). Costs from invasions in the Nordics appear to be largely underestimated. We conclude by highlighting such knowledge gaps, including gaps in policies and regulation stemming from expert judgment as well as avenues for an improved understanding of invasion costs and needs for future research.

Critical EPICOT items were absent in Cochrane human immunodeficiency virus systematic reviews: a bibliometric analysis

OBJECTIVES

To summarize the current gaps in human immunodeficiency virus (HIV) research evidence, describe the adequacy of reporting "implications for research," and map the number of studies that inform reviews with the prevalence of HIV for each country.

STUDY DESIGN AND SETTING

A bibliometric analyses of HIV reviews in the Cochrane Database of Systematic Reviews with content analysis of the "implications for research" section.

RESULTS

We analyzed 103 high-quality reviews published as of March 2014. They included a median of five studies (min 0 and max 44). Almost all the reviews recommended more trials (89.3%). Limitations in trial design, duration, setting, sample size, and choice of participants were also noted. Reporting of EPICOT+ items was as follows: evidence (35.9%), population (57.3%), intervention (71.8%), comparison (20.4%), outcomes (57.3%), time stamp (34.0%), and disease burden (13.6%). The primary studies were conducted in 67 countries. Six of the top 10 countries in which primary studies were conducted had a high HIV prevalence.

CONCLUSION

Knowledge gaps were identified for research in younger participants, over longer periods, using more pragmatic interventions, conducted in resource-limited settings and incorporating economic evaluations. Implications for research are not always reported according to the EPICOT+ format. Not all countries with a high prevalence of HIV are contributing sufficiently to HIV research.

Global knowledge gaps on antimicrobial resistance in the human health sector: A scoping review

OBJECTIVES

To identify and summarize existing global knowledge gaps on antimicrobial resistance (AMR) in human health, focusing on the World Health Organization (WHO) bacterial priority pathogens, Mycobacterium tuberculosis, and selected fungi.

METHODS

We conducted a scoping review of gray and peer-reviewed literature, published in English from January 2012 through December 2021, that reported on the prevention, diagnosis, treatment, and care of drug-resistant infections. We extracted relevant knowledge gaps and, through an iterative process, consolidated those into thematic research questions.

RESULTS

Of 8409 publications screened, 1156 were included, including 225 (19.5%) from low- and middle-income countries. A total of 2340 knowledge gaps were extracted, in the following areas: antimicrobial research and development, AMR burden and drivers, resistant tuberculosis, antimicrobial stewardship, diagnostics, infection prevention and control, antimicrobial consumption and use data, immunization, sexually transmitted infections, AMR awareness and education, policies and regulations, fungi, water sanitation and hygiene, and foodborne diseases. The knowledge gaps were consolidated into 177 research questions, including 78 (44.1%) specifically relevant to low- and middle-income countries and 65 (36.7%) targeting vulnerable populations.

CONCLUSION

This scoping review presents the most comprehensive compilation of AMR-related knowledge gaps to date, informing a priority-setting exercise to develop the WHO Global AMR Research Agenda for the human health sector.

Sun-health behaviours and attitudes towards sun safety amongst Australian teenagers: a qualitative update

OBJECTIVE

This study aimed to explore current attitudes towards sun protection, and sun-seeking behaviour among young Australian adolescents. It was done as part of a larger project aiming to develop a digital resource to support young people in making informed sun-health decisions.

RESULTS

Ten (4 male, 6 female) adolescents (12-13 years of age) living in Perth (Western Australia) were recruited through a social media-based strategy. Each participant engaged in a semi-structured telephone interview which explored their sun-health decision-making, with interview transcripts assessed qualitatively using NVivo. Three major themes (and eight sub-themes) were identified: (1) 'personal sun health considerations'; (2) 'attitudes towards sun protection'; and (3) 'recommendations'. The importance of sun protection was appreciated by participants. However, females were more diligent in the use of sun protection while males were indifferent. Behaviours were influenced by parental input, the school environment and engagement in sport. Adolescents had limited knowledge of the UV Index and its implications for sun protection, and the health importance of sun-derived vitamin D. Overall, the importance of sun protection was acknowledged but did not consistently translate into sun protective behaviours.

How to Adapt Chemical Risk Assessment for Unconventional Hydrocarbon Extraction Related to the Water System

We identify uncertainties and knowledge gaps of chemical risk assessment related to unconventional drillings and propose adaptations. We discuss how chemical risk assessment in the context of unconventional oil and gas (UO&G) activities differs from conventional chemical risk assessment and the implications for existing legislation. A UO&G suspect list of 1,386 chemicals that might be expected in the UO&G water samples was prepared which can be used for LC-HRMS suspect screening. We actualize information on reported concentrations in UO&G-related water. Most information relates to shale gas operations, followed by coal-bed methane, while only little is available for tight gas and conventional gas. The limited research on conventional oil and gas recovery hampers comparison whether risks related to unconventional activities are in fact higher than those related to conventional activities. No study analyzed the whole cycle from fracturing fluid, flowback and produced water, and surface water and groundwater. Generally target screening has been used, probably missing contaminants of concern. Almost half of the organic compounds analyzed in surface water and groundwater exceed TTC values, so further risk assessment is needed, and risks cannot be waived. No specific exposure scenarios toward groundwater aquifers exist for UO&G-related activities. Human errors in various stages of the life cycle of UO&G production play an important role in the exposure. Neither at the international level nor at the US federal and the EU levels, specific regulations for UO&G-related activities are in place to protect environmental and human health. UO&G activities are mostly regulated through general environmental, spatial planning, and mining legislation.

The ecology of COVID-19 and related environmental and sustainability issues

Around the globe, human behavior and ecosystem health have been extensively and sometimes severely affected by the unprecedented COVID-19 pandemic. Most efforts to study these complex and heterogenous effects to date have focused on public health and economics. Some studies have evaluated the pandemic's influences on the environment, but often on a single aspect such as air or water pollution. The related research opportunities are relatively rare, and the approaches are unique in multiple aspects and mostly retrospective. Here, we focus on the diverse research opportunities in disease ecology and ecosystem sustainability related to the (intermittent) lockdowns that drastically reduced human activities. We discuss several key knowledge gaps and questions to address amid the ongoing pandemic. In principle, the common knowledge accumulated from invasion biology could also be effectively applied to COVID-19, and the findings could offer much-needed information for future pandemic prevention and management.

Opinions and knowledge on globally important foodborne parasites among healthcare professionals at a tertiary teaching hospital in Nigeria

Foodborne diseases are important everywhere in the world, but the level of attention they receive varies by region. We surveyed the current opinions and knowledge regarding the globally most important foodborne parasites (FBP) among healthcare professionals in Abakaliki, Ebonyi State, Nigeria, by conducting a questionnaire survey among healthcare professionals in a tertiary hospital. We focused on the FBP ranked as the top five globally: Taenia solium, Echinococcus granulosus, Echinococcus multilocularis, Toxoplasma gondii, and Cryptosporidium spp., and gathered local expert opinions regarding their importance in Nigeria. Moreover, we surveyed the extent of healthcare community knowledge on transmission, manifestations and pathologies, and prevention of infections with these five FBP. Among the 205 healthcare professionals completing the survey, T. solium was selected as important in Nigeria by 143 (70%), E. granulosus by 91 (44%), E. multilocularis by 62 (30%), T. gondii by 132 (64%), and Cryptosporidium spp. by 123 (60%). Only 44 (21%) of the participants selected at least 15 of the 25 answers to knowledge questions that we considered as correct to select. The proportion selecting at least 15 of the correct answers was not statistically significantly associated with gender nor with experience level. Our results suggest that further education about FBP should target healthcare professionals at all levels.

A Comparative Study of Liver Disease Care in the USA and Urban and Rural China

BACKGROUND

Chronic liver disease is a major cause of morbidity and mortality in the USA and China, but the etiology of liver disease, medical practice, and patient expectations in these two countries are different.

AIMS

To compare patient knowledge about their liver disease, patient satisfaction with liver disease care, and patient medical decision-making preference in the USA and China.

METHODS

Three cohorts of established adult patients with liver disease seen in liver clinics in Ann Arbor, USA, and Beijing (urban) and Hebei (rural), China, completed a survey between May and September 2014.

RESULTS

A total of 990 patients (395 USA, 398 Beijing, and 197 Hebei) were analyzed. Mean liver disease knowledge score (maximum 5) in the USA, Beijing, and Hebei patients was 4.1, 3.6, and 3.0, respectively (p < 0.001). US patients had a greater preference for collaborative decision-making: 71.8 % preferred to make treatment decisions together with the doctor, while most Chinese patients (74.6 % Beijing and 84.8 % Hebei) preferred passive decision-making. Mean satisfaction score (maximum 85) in the USA was higher than in Beijing, which in turn was higher than in Hebei (78.2 vs. 66.5 vs. 60.3, p < 0.001). There was a positive correlation between liver disease knowledge score and satisfaction score (r = 0.27, p < 0.001) and with collaborative medical decision-making (r = 0.22, p < 0.001) when responses from all sites were combined.

CONCLUSIONS

Liver disease knowledge and patient satisfaction were greatest in the USA, followed by Beijing and then Hebei patients. Understanding these differences and associated factors may help to improve patient outcomes.

Microbial mercury methylation in the cryosphere: Progress and prospects

Mercury (Hg) is one of the most toxic heavy metals, and its cycle is mainly controlled by oxidation-reduction reactions carried out by photochemical or microbial process under suitable conditions. The deposition and accumulation of methylmercury (MeHg) in various ecosystems, including the cryospheric components such as snow, meltwater, glaciers, and ice sheet, and subsequently in the food chain pose serious health concerns for living beings. Unlike the abundance of knowledge about the processes of MeHg production over land and oceans, little is known about the sources and production/degradation rate of MeHg in cryosphere systems. In addition, processes controlling the concentration of Hg and MeHg in the cryosphere remains poorly understood, and filling this scientific gap has been challenging. Therefore, it is essential to study and review the deposition and accumulation by biological, physical, and chemical mechanisms involved in Hg methylation in the cryosphere. This review attempts to address knowledge gaps in understanding processes, especially biotic and abiotic, applicable for Hg methylation in the cryosphere. First, we focus on the variability in Hg concentration and mechanisms of Hg methylation, including physical, chemical, microbial, and biological processes, and transportation in the cryosphere. Then, we elaborate on the mechanism of redox reactions and biotic and abiotic factors controlling Hg methylation and biogeochemistry of Hg in the cryosphere. We also present possible mechanisms of Hg methylation with an emphasis on microbial transformation and molecular function to understand variability in Hg concentration in the cryosphere. Recent advancements in the genetic and physicochemical mechanisms of Hg methylation are also presented. Finally, we summarize and propose a method to study the unsolved issues of Hg methylation in the cryosphere.

Analysis and mapping of harm reduction research in the context of injectable drug use: identifying research hotspots, gaps and future directions

BACKGROUND

Harm reduction is a crucial approach in addressing the multifaceted challenges of injectable drug use. This paper presents an analysis and mapping of the existing literature on harm reduction research in the context of injectable drug use. By reviewing a comprehensive set of scholarly articles, this study identifies research hotspots, knowledge gaps, and future directions in the field. The findings provide valuable insights for researchers, policymakers, and practitioners to guide future research efforts and inform evidence-based harm reduction interventions.

METHODS

Data for the study was obtained from the Scopus database, using keywords and phrases related to harm reduction and injectable drug use. Validation methods were employed to verify the accuracy and comprehensiveness of the search strategy. Data analysis involved identifying growth patterns, key contributors, mapping frequent terms, identifying research hotspots, and identifying emerging research directions.

RESULTS

A total of 971 articles were found, with a notable increase from 2015 to 2022. The International Journal of Drug Policy (n = 172, 17.7%) and the Harm Reduction Journal (n = 104, 10.7%) were the most prolific journals, and the United States (n = 558, 57.5%) had the highest number of publications. The Johns Hopkins University (n = 80, 8.5%) was the most prolific institution. Mapping of frequent author keywords revealed the main keywords, including harm reduction, HIV, hepatitis C, and opioid overdose. The highly cited articles cover a broad time span and focus on topics like naloxone distribution, HIV and hepatitis C transmission, while recent articles concentrate on emerging issues such as the impact of the COVID-19 pandemic, fentanyl-related concerns, stigma reduction, and needle and syringe programs. Both sets of articles share a common focus on harm reduction strategies, but recent publications highlight current challenges and developments in the field.

CONCLUSIONS

This study provides insights into research landscape on harm reduction in injectable drug use. Research is concentrated in high-income countries, emphasizing the need for more research in low- and middle-income countries. Recent publications focus on emerging challenges like COVID-19 and fentanyl. Research gaps highlight the need for studies in diverse populations, social determinants, program evaluation, and implementation strategies to enhance harm reduction interventions.

Towards evidence based plastic surgery; how a national research agenda can unite research

We describe the development of the Research Agenda of the Dutch Society for Plastic Surgery, supported and democratically created by plastic surgeons, patients, and other stakeholders. The agenda contains the 10 most relevant knowledge gaps encountered in clinical practice, as prioritized by the abovementioned groups. The aim is to stimulate national collaborations and research networks to initiate trials to answer these knowledge gaps. The agenda will be renewed periodically to stay relevant. We encourage other national and international associations to develop a research agenda within their field, and intensify their research network and improve research quality.

Climate change research in Asia: A knowledge synthesis of Asia-Pacific Network for Global Change Research (2013-2018)

Countering climate challenges requires genuine multi-layered approaches in cooperation with various stakeholders. Spanning 20 years, the Asia-Pacific Network for Global Change Research (APN) has been facilitating the research community to provide regional and grassroots results and solutions, while acting as a mechanism to encourage science-policy-stakeholder dialogue. This paper outlines the relevance of APN projects to IPCC policymaking by laying out knowledge products and lessons learned from the projects. It also narrates how regional research and capacity building assist in responding to the increasing urgency across climate change and the SDGs. A synthesis of project-generated knowledge was garnered from research and capacity development studies conducted under the auspices of APN to identify their scope and level of policy relevance. A combined typology and solution scanning with Likert scale as relevance rating was employed to categorize contribution against key themes of the IPCC sixth assessment report. Findings suggest 115 distinct and relevant projects completed mostly in Southeast Asia, South Asia and Temperate East Asia, with many of them asserting community-based adaptation and mitigation surrounding issues on ecosystems and biodiversity, extreme weather events, water-food-energy nexus, sustainable waste management, and climate education. Findings also show 163 knowledge products in which majority of them (66.87%) were peer-reviewed journal articles, 11.04% were reports, 7.98% were policy briefs, 6.75% were guidelines and tools, 4.91% were books and 2.45% were perspectives and opinions. With the evolving synergies between global climate targets and the SDGs, it is recommended that APN solidify its role in science-policy partnerships and networking by creating improved interlinkages for disseminating knowledge gaps filled and in replicating lessons learned and best practices found in APN knowledge products. In addition to science-policy dialogues and output synthesis, a regular review of APN research and capacity development outcomes will help in realizing these important aspects toward wider policy impact.

[Clinical and diagnostic features of skin cancer on darker skin]

Although the rates of melanoma and nonmelanoma skin cancer are generally lower in people with darker skin tones compared to people with fairer skin tones, there is a higher rate of misdiagnosis and delay in diagnosis in people of color, which in turn increases the risk of a worse treatment outcome for these patients.

Analysis of cyber security knowledge gaps based on cyber security body of knowledge

Due to the increasing number of cyber incidents and overwhelming skills shortage, it is required to evaluate the knowledge gap between cyber security education and industrial needs. As such, the objective of this study is to identify the knowledge gaps in cyber security graduates who join the cyber security workforce. We designed and performed an opinion survey by using the Cyber Security Knowledge Areas (KAs) specified in the Cyber Security Body of Knowledge (CyBOK) that comprises 19 KAs. Our data was gathered from practitioners who work in cyber security organizations. The knowledge gap was measured and evaluated by acknowledging the assumption for employing sequent data as nominal data and improved it by deploying chi-squared test. Analyses demonstrate that there is a gap that can be utilized to enhance the quality of education. According to acquired final results, three key KAs with the highest knowledge gap are Web and Mobile Security, Security Operations and Incident Management. Also, Cyber-Physical Systems (CPS), Software Lifecycles, and Vulnerabilities are the knowledge areas with largest difference in perception of importance between less and more experienced personnel. We discuss several suggestions to improve the cyber security curriculum in order to minimize the knowledge gaps. There is an expanding demand for executive cyber security personnel in industry. High-quality university education is required to improve the qualification of upcoming workforce. The capability and capacity of the national cyber security workforce is crucial for nations and security organizations. A wide range of skills, namely technical skills, implementation skills, management skills, and soft skills are required in new cyber security graduates. The use of each CyBOK KA in the industry was measured in response to the extent of learning in university environments. This is the first study conducted in this field, it is considered that this research can inspire the way for further researches.

Deep-sea ecosystems of the Indian Ocean >1000 m

The Indian Ocean is the third largest of the world's oceans, accounting for ~20 % of the global marine realm. It is geomorphologically complex, hosting a wide variety of ecosystems across basins, trenches, seamounts, ridges, and fracture zones. While modern exploration has contributed significantly to our knowledge of its coastal ecosystems, deeper waters (>1000 m) remain relatively unknown despite accounting for over 90 % of its total area. This study provides the first comprehensive review of the Indian Ocean's diverse deep sea, presenting ecosystem knowledge summaries for each major seafloor feature, contextualised with the broader historical, socioeconomic, geological, and oceanographic conditions. Unsurprisingly, some ecosystems are better characterised than others, from the relatively well-surveyed Java (Sunda) Trench and hydrothermal vents of the Carlsberg, Central and Southwest Indian Ridges, to the unexplored Southeast Indian Ridge and hadal features of the western Indian Ocean. Similarly, there is a large depth discrepancy in available records with a clear bias towards shallower sampling. We identify four outstanding problems to be addressed for the advancement of deep-sea research in the Indian Ocean: 1) inconsistencies in research extent and effort over spatial scales, 2) severe lack of data over temporal scales, 3) unexplored deep pelagic environments, and 4) a need to place the Indian Ocean's deep-sea ecosystems in a global context. By synthesising and championing existing research, identifying knowledge gaps, and presenting the outstanding problems to be addressed, this review provides a platform to ensure this forgotten ocean is prioritised for deep-sea research during the UN Ocean Decade and beyond.

Mapping secondary data gaps for social simulation modelling: A case study of the journeys of Syrian asylum seekers to Europe

Simulation models of social processes may require data that are not readily available, have low accuracy, are incomplete or biased. The paper presents a formal process for collating, assessing, selecting, and using secondary data as part of creating, validating, and documenting an agent-based simulation model of a complex social process, in this case, asylum seekers' journeys to Europe. The process starts by creating an inventory of data sources, and the associated metadata, followed by assessing different aspects of data quality according to pre-defined criteria. As a result, based on the typology of available data, we are able to produce a thematic map of the area under study, and assess the uncertainty of key data sources, at least qualitatively. We illustrate the process by looking at the data on Syrian migration to Europe in 2011-21. In parallel, successive stages of the development of a simulation model allow for identifying key types of information which are needed as input into empirically grounded modelling analysis. Juxtaposing the available evidence and model requirements allows for identifying knowledge gaps that need filling, preferably by collecting additional primary data, or, failing that, by carrying out a sensitivity analysis for the assumptions made. By doing so, we offer a way of formalising the data collection process in the context of model-building endeavours, while allowing the modelling to be predominantly question-driven rather than purely data-driven. The paper concludes with recommendations with respect to data and evidence, both for modellers, as well as model users in practice-oriented applications.