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Fulltext Global monitoring of antimicrobial resistance based on metagenomics analyses of urban sewage

Hendriksen RS, Munk P, Njage P, van Bunnik B, McNally L, Lukjancenko O, et al.

Nat Commun, 2019 03 08;10(1):1124.
PMID: 30850636 DOI: 10.1038/s41467-019-08853-3

Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use metagenomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AMR genes between Europe/North-America/Oceania and Africa/Asia/South-America. Antimicrobial use data and bacterial taxonomy only explains a minor part of the AMR variation that we observe. We find no evidence for cross-selection between antimicrobial classes, or for effect of air travel between sites. However, AMR gene abundance strongly correlates with socio-economic, health and environmental factors, which we use to predict AMR gene abundances in all countries in the world. Our findings suggest that global AMR gene diversity and abundance vary by region, and that improving sanitation and health could potentially limit the global burden of AMR. We propose metagenomic analysis of sewage as an ethically acceptable and economically feasible approach for continuous global surveillance and prediction of AMR.

Matched MeSH terms: Europe
The economic burden of chronic obstructive pulmonary disease (COPD) in Europe: results from a systematic review of the literature

Rehman AU, Hassali MAA, Muhammad SA, Harun SN, Shah S, Abbas S

Eur J Health Econ, 2020 Mar;21(2):181-194.
PMID: 31564007 DOI: 10.1007/s10198-019-01119-1

OBJECTIVES: To find the economic burden of COPD and to identify the key cost drivers in the management of COPD patients across different European countries.
BACKGROUND: COPD is a major cause of mortality and morbidity and is associated with considerable economic burden on the individual and society. It limits the daily activities and working ability of the patients.
METHODOLOGY: We conducted a systematic search of PUBMED, SCIENCE DIRECT, Cochrane CENTRAL, SCOPUS, Google Scholar and SAGE Premier Databases to find scientific research articles evaluating the cost of COPD management from patient and societal perspective.
RESULTS: Estimated per patient per year direct cost in Norway, Denmark, Germany, Italy, Sweden, Greece, Belgium, and Serbia was €10,701, €9580, €7847, €7448, €7045, €2896, €1963, and €2047, respectively. Annual per patient cost of work productivity loss was highest in Germany as €5735 and lowest in Greece as €998. It was estimated as €4824, €2033 and €1298 in Bulgaria, Denmark and Sweden, respectively. Several factors found associated with increasing cost of COPD management that include but not limited to late diagnosis, severity of disease, frequency of exacerbation, hospital readmissions, non-adherence to the therapy and exposure to COPD risk factors.
CONCLUSION: Minimizing the COPD exacerbations and controlling the worsening of symptoms may potentially reduce the cost of COPD management at any stage.

Matched MeSH terms: Europe
Fulltext Uterine artery embolisation for symptomatic fibroids: the University of Malaya Medical Centre experience

Subramaniam R, Vijayananthan A, Omar S, Nawawi O, Abdullah B

Biomed Imaging Interv J, 2010 Jul-Sep;6(3):e27.
PMID: 21611045 MyJurnal DOI: 10.2349/biij.6.3.e27

Transcatheter uterine artery embolisation (UAE) for the treatment of symptomatic fibroids has been performed in several centres in the United States, Western Europe and Asia with promising results. This study reports the authors' experience with UAE at the University Malaya Medical Centre.

Matched MeSH terms: Europe
The importance of worldwide governance indicators for transitions toward sustainable bioenergy industry

Alsaleh M, Abdul-Rahim AS, Abdulwakil MM

J Environ Manage, 2021 Sep 15;294:112960.
PMID: 34116310 DOI: 10.1016/j.jenvman.2021.112960

This study examined the impact of worldwide governance indicators on the sustainability of the bioenergy industry in selected European countries for the period 1996-2018. Applying the Fixed Effect (FE) Model, the results reveal that the bioenergy industry can significantly grow by improving the quality of worldwide governance indicators in European countries, especially in Western European Countries (WEC). Government effectiveness, rule of law, regulatory quality, and voice and accountability are found to be increasing the growth of the bioenergy industry. Precisely, the results further show that the magnitude of the effect of government effectiveness, voice and accountability, and Gross Domestic Product (GDP) on bioenergy output is higher in Western European Countries (WEC) as compared to the Central and Eastern European Countries (CEEC). Also, the findings further elaborate that the significant positive impact of regulatory quality and rule of law on bioenergy output is higher in CEEC countries compared to the WEC countries. The finding implies that the growth of the bioenergy industry in European countries can be effectively increased by improving the practice and quality of worldwide governance indicators. The study recommends for European countries to increase the efficiency of worldwide governance in their bioenergy industry to increase the sustainability of bioenergy production and reduce Dioxide Carbon (CO2) emissions. Policymakers in these countries should also invest more in worldwide governance to increase its effectiveness and transparency in the bioenergy industry. The authorities should equally emphasize the effectiveness and transparency of worldwide governance indicators to attain bioenergy security and lessen the dependence on fossil fuels.

Matched MeSH terms: Europe
Fulltext Triple-Band Reconfigurable Monopole Antenna for Long-Range IoT Applications

Yahya MS, Soeung S, Singh NSS, Yunusa Z, Chinda FE, Rahim SKA, et al.

Sensors (Basel), 2023 Jun 06;23(12).
PMID: 37420526 DOI: 10.3390/s23125359

In this study, a novel reconfigurable triple-band monopole antenna for LoRa IoT applications is fabricated on an FR-4 substrate. The proposed antenna is designed to function at three distinct LoRa frequency bands: 433 MHz, 868 MHz, and 915 MHz covering the LoRa bands in Europe, America, and Asia. The antenna is reconfigurable by using a PIN diode switching mechanism, which allows for the selection of the desired operating frequency band based on the state of the diodes. The antenna is designed using CST MWS® software 2019 and optimized for maximum gain, good radiation pattern and efficiency. The antenna with a total dimension of 80 mm × 50 mm × 0.6 mm (0.12λ0×0.07λ0 × 0.001λ0 at 433 MHz) has a gain of 2 dBi, 1.9 dBi, and 1.9 dBi at 433 MHz, 868 MHz, and 915 MHz, respectively, with an omnidirectional H-plane radiation pattern and a radiation efficiency above 90% across the three frequency bands. The fabrication and measurement of the antenna have been carried out, and the results of simulation and measurements are compared. The agreement among the simulation and measurement results confirms the design's accuracy and the antenna's suitability for LoRa IoT applications, particularly in providing a compact, flexible, and energy efficient communication solution for different LoRa frequency bands.

Matched MeSH terms: Europe
Updates on chikungunya epidemiology, clinical disease, and diagnostics

Sam IC, Kümmerer BM, Chan YF, Roques P, Drosten C, AbuBakar S

Vector Borne Zoonotic Dis, 2015 Apr;15(4):223-30.
PMID: 25897809 DOI: 10.1089/vbz.2014.1680

Chikungunya virus (CHIKV) is an Aedes-borne alphavirus, historically found in Africa and Asia, where it caused sporadic outbreaks. In 2004, CHIKV reemerged in East Africa and spread globally to cause epidemics, including, for the first time, autochthonous transmission in Europe, the Middle East, and Oceania. The epidemic strains were of the East/Central/South African genotype. Strains of the Asian genotype of CHIKV continued to cause outbreaks in Asia and spread to Oceania and, in 2013, to the Americas. Acute disease, mainly comprising fever, rash, and arthralgia, was previously regarded as self-limiting; however, there is growing evidence of severe but rare manifestations, such as neurological disease. Furthermore, CHIKV appears to cause a significant burden of long-term morbidity due to persistent arthralgia. Diagnostic assays have advanced greatly in recent years, although there remains a need for simple, accurate, and affordable tests for the developing countries where CHIKV is most prevalent. This review focuses on recent important work on the epidemiology, clinical disease and diagnostics of CHIKV.

Matched MeSH terms: Europe/epidemiology
Fulltext Smart and Climate-Smart Agricultural Trends as Core Aspects of Smart Village Functions

Adesipo A, Fadeyi O, Kuca K, Krejcar O, Maresova P, Selamat A, et al.

Sensors (Basel), 2020 Oct 22;20(21).
PMID: 33105622 DOI: 10.3390/s20215977

Attention has shifted to the development of villages in Europe and other parts of the world with the goal of combating rural-urban migration, and moving toward self-sufficiency in rural areas. This situation has birthed the smart village idea. Smart village initiatives such as those of the European Union is motivating global efforts aimed at improving the live and livelihood of rural dwellers. These initiatives are focused on improving agricultural productivity, among other things, since most of the food we eat are grown in rural areas around the world. Nevertheless, a major challenge faced by proponents of the smart village concept is how to provide a framework for the development of the term, so that this development is tailored towards sustainability. The current work examines the level of progress of climate smart agriculture, and tries to borrow from its ideals, to develop a framework for smart village development. Given the advances in technology, agricultural development that encompasses reduction of farming losses, optimization of agricultural processes for increased yield, as well as prevention, monitoring, and early detection of plant and animal diseases, has now embraced varieties of smart sensor technologies. The implication is that the studies and results generated around the concept of climate smart agriculture can be adopted in planning of villages, and transforming them into smart villages. Hence, we argue that for effective development of the smart village framework, smart agricultural techniques must be prioritized, viz-a-viz other developmental practicalities.

Matched MeSH terms: Europe; European Union
Fulltext The whole genome sequence data analyses of a Mycobacterium tuberculosis strain SBH321 isolated in Sabah, Malaysia, belongs to Ural family of Lineage 4

Jani J, Mustapha ZA, Ling CK, Hui ASM, Teo R, Ahmed K

Data Brief, 2020 Dec;33:106388.
PMID: 33102655 DOI: 10.1016/j.dib.2020.106388

In 2019, 10 million new cases of tuberculosis have been reported worldwide. Our data reports genetic analyses of a Mycobacterium tuberculosis strain SBH321 isolated from a 31-year-old female with pulmonary tuberculosis. The genomic DNA of the strain was extracted from pure culture and subjected to sequencing using Illumina platform. M. tuberculosis strain SBH321 consists of 4,374,895 bp with G+C content of 65.59%. The comparative analysis by SNP-based phylogenetic analysis using maximum-likelihood method showed that our strain belonging to sublineage of the Ural family of Europe-America-Africa lineage (Lineage 4) and clustered with M. tuberculosis strain OFXR-4 from Taiwan. The whole genome sequence is deposited at DDBJ/ENA/GenBank under the accession WCJH00000000 (SRR10230353).

Matched MeSH terms: Europe
Fulltext Whole genome sequencing data and analysis of a rifampicin-resistant Mycobacterium tuberculosis strain SBH162 from Sabah, Malaysia

Jani J, Mustapha ZA, Jamal NB, Stanis CS, Ling CK, Avoi R, et al.

Data Brief, 2019 Oct;26:104445.
PMID: 31534995 DOI: 10.1016/j.dib.2019.104445

A Mycobacterium tuberculosis strain SBH162 was isolated from a 49-year-old male with pulmonary tuberculosis. GeneXpert MDR/RIF identified the strain as rifampicin-resistant M. tuberculosis. The whole genome sequencing was performed using Illumina HiSeq 4000 system to further investigate and verify the mutation sites of the strain through genetic analyses namely variant calling using bioinformatics tools. The de novo assembly of genome generated 100 contigs with N50 of 156,381bp. The whole genome size was 4,343,911 bp with G + C content of 65.58% and consisted of 4,306 predicted genes. The mutation site, S450L, for rifampicin resistance was detected in the rpoB gene. Based on the phylogenetic analysis using the Maximum Likelihood method, the strain was identified as belonging to the Europe America Africa lineage (Lineage 4). The genome dataset has been deposited at DDBJ/ENA/GenBank under the accession number SMOE00000000.

Matched MeSH terms: Europe
Fulltext Polymer-free sirolimus-eluting stent use in Europe and Asia: Ethnic differences in demographics and clinical outcomes

Krackhardt F, Waliszewski M, Wan Ahmad WA, Kočka V, Toušek P, Janek B, et al.

PLoS One, 2020;15(1):e0226606.
PMID: 31929543 DOI: 10.1371/journal.pone.0226606

BACKGROUND: The objective of this study was to assess regional and ethnic differences in an unselected patient population treated with polymer-free sirolimus-eluting stents (PF-SES) in Asia and Europe.
METHODS: Two all-comers observational studies based on the same protocol (ClinicalTrials.gov Identifiers: NCT02629575 and NCT02905214) were combined for data analysis to assure sufficient statistical power. The primary endpoint was the accumulated target lesion revascularization (TLR) rate at 9-12 months.
RESULTS: Of the total population of 7243 patients, 44.0% (3186) were recruited in the Mediterranean region and 32.0% (2317) in central Europe. The most prominent Asian region was South Korea (17.6%, 1274) followed by Malaysia (5.7%, 413). Major cardiovascular risk factors varied significantly across regions. The overall rates for accumulated TLR and MACE were low with 2.2% (140/6374) and 4.4% (279/6374), respectively. In ACS patients, there were no differences in terms of MACE, TLR, MI and accumulated mortality between the investigated regions. Moreover, dual antiplatelet therapy (DAPT) regimens were substantially longer in Asian countries even in patients with stable coronary artery disease as compared to those in Europe.
CONCLUSIONS: PF-SES angioplasty is associated with low clinical event rates in all regions. Further reductions in clinical event rates seem to be associated with longer DAPT regimens.

Matched MeSH terms: Europe
Fulltext Plasma polyphenols associated with lower high-sensitivity C-reactive protein concentrations: a cross-sectional study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort

Harms LM, Scalbert A, Zamora-Ros R, Rinaldi S, Jenab M, Murphy N, et al.

Br J Nutr, 2020 Jan 28;123(2):198-208.
PMID: 31583990 DOI: 10.1017/S0007114519002538

Experimental studies have reported on the anti-inflammatory properties of polyphenols. However, results from epidemiological investigations have been inconsistent and especially studies using biomarkers for assessment of polyphenol intake have been scant. We aimed to characterise the association between plasma concentrations of thirty-five polyphenol compounds and low-grade systemic inflammation state as measured by high-sensitivity C-reactive protein (hsCRP). A cross-sectional data analysis was performed based on 315 participants in the European Prospective Investigation into Cancer and Nutrition cohort with available measurements of plasma polyphenols and hsCRP. In logistic regression analysis, the OR and 95 % CI of elevated serum hsCRP (>3 mg/l) were calculated within quartiles and per standard deviation higher level of plasma polyphenol concentrations. In a multivariable-adjusted model, the sum of plasma concentrations of all polyphenols measured (per standard deviation) was associated with 29 (95 % CI 50, 1) % lower odds of elevated hsCRP. In the class of flavonoids, daidzein was inversely associated with elevated hsCRP (OR 0·66, 95 % CI 0·46, 0·96). Among phenolic acids, statistically significant associations were observed for 3,5-dihydroxyphenylpropionic acid (OR 0·58, 95 % CI 0·39, 0·86), 3,4-dihydroxyphenylpropionic acid (OR 0·63, 95 % CI 0·46, 0·87), ferulic acid (OR 0·65, 95 % CI 0·44, 0·96) and caffeic acid (OR 0·69, 95 % CI 0·51, 0·93). The odds of elevated hsCRP were significantly reduced for hydroxytyrosol (OR 0·67, 95 % CI 0·48, 0·93). The present study showed that polyphenol biomarkers are associated with lower odds of elevated hsCRP. Whether diet rich in bioactive polyphenol compounds could be an effective strategy to prevent or modulate deleterious health effects of inflammation should be addressed by further well-powered longitudinal studies.

Matched MeSH terms: Europe
Summary of avian influenza activity in Europe, Asia, Africa, and Australasia, 2002-2006

Alexander DJ

Avian Dis, 2007 Mar;51(1 Suppl):161-6.
PMID: 17494548

Between December 2003 and January 2004 highly pathogenic avian influenza (HPAI) H5N1 infections of poultry were declared in China, Japan, South Korea, Laos, Thailand, Cambodia, Vietnam, and Indonesia. In 2004 an outbreak was reported in Malaysia. In 2005 H5N1 outbreaks were recorded in poultry in Russia, Kazakhstan, Mongolia, Romania, Turkey, and Ukraine, and virus was isolated from swans in Croatia. In 2004 HPAI H5N1 virus was isolated from smuggled eagles detected at the Brussels Airport and in 2005 imported caged birds held in quarantine in England. In 2006 HPAI was reported in poultry in Iraq, India, Azerbaijan, Pakistan, Myanmar, Afghanistan, and Israel in Asia; Albania, France, and Sweden in Europe; and Nigeria, Cameroon, and Niger in Africa; as well as in wild birds in some 24 countries across Asia and Europe. In 2003, over 25,000,000 birds were slaughtered because of 241 outbreaks of HPAI caused by virus of H7N7 subtype in the Netherlands. The virus spread into Belgium (eight outbreaks) and Germany (one outbreak). HPAI H5N2 virus was responsible for outbreaks in ostriches in South Africa during 2005. HPAI H7N3 virus was isolated in Pakistan in 2004. Low-pathogenicity avian influenza (LPAI) H5 or H7 viruses were isolated from poultry in Italy (H7N3 2002-2003; H5N2 2005), The Netherlands (H7N3 2002), France (H5N2 2003), Denmark (H5N7 2003), Taiwan (H5N2 2004), and Japan (H5N2 2005). Many isolations of LPAI viruses of other subtypes were reported from domestic and wild birds. Infections with H9N2 subtype viruses have been widespread across Asia during 2002-06.

Matched MeSH terms: Europe/epidemiology
Annelies Allain: Pioneer of the International Code of Marketing of Breastmilk Substitutes

Arendt M, Allain A

J Hum Lact, 2019 Feb;35(1):15-20.
PMID: 30517831 DOI: 10.1177/0890334418812075

Annelies Allain has been at the forefront of global efforts to support and promote breastfeeding for more than 30 years. Her accomplishments continue to affect all of us who work with breastfeeding families. Born in the Netherlands in 1945, Annelies Allain-van Elk received a scholarship and completed a BA from the University of Minnesota, Duluth, USA. Back in Europe, she obtained a BA in French language and literature (University of Geneva, Switzerland) as well as a translator's diploma. After 4 years working in West Africa and visits to South America, she returned to Geneva to obtain an MA in development studies. She is fluent in English, French, and Dutch and has working knowledge of Spanish, Portuguese, Italian, and German. Ms. Allain was a co-founder of IBFAN (1979) and the coordinator of IBFAN Europe (1980-1984). In 1984, she moved to Penang, Malaysia, and IBFAN work soon took over as a full-time job. She was instrumental in developing the Code Documentation Centre (1985) and by 1991 it became a foundation (ICDC) registered in the Netherlands. Subsequently, the Centre has trained over 2,000 officials from 148 countries about the International Code, making it the world's top International Code implementation institution. Among her many other education and advocacy activities, Ms. Allain was a co-founder of WABA (1990) and for many years has been a consultant with UNICEF and WHO's Western Pacific Regional Office on International Code implementation and monitoring. In this interview she provides a firsthand account of how most of the major global breastfeeding protection efforts influencing our current situation came into being. (This is a verbatim interview: MA = Maryse Arendt; AA = Annelies Allain.).

Matched MeSH terms: Europe
The ongoing cut-down of the Amazon rainforest threatens the climate and requires global tree planting projects: A short review

Peng W, Sonne C, Lam SS, Ok YS, Alstrup AKO

Environ Res, 2020 02;181:108887.
PMID: 31732170 DOI: 10.1016/j.envres.2019.108887

The Amazon rainforest has sustained human existence for more than 10,000 years. Part of this has been the way that the forest controls regional climate including precipitation important for the ecosystem as well as agroforestry and farming. In addition, the Amazon also affects the global weather systems, so cutting down the rainforest significantly increases the effects of climate change, threatening the world's biodiversity and causing local desertification and soil erosion. The current fire activities and deforestation in the Amazon rainforest therefore have consequences for global sustainability. In the light of this, the current decisions made in Brazil regarding an increase in Amazon deforestation require policy changes if the global ecosystems and biodiversity are not to be set to collapse. There is only one way to move forward and that is to increase efforts in sustainable development of the region including limitation in deforestation and to continuously measure and monitor the development. The G7 countries have offered Brazil financial support for at least 20 million euros for fighting the forest fires but the president denies receiving such financial support and says that it is more relevant to raise new forests in Europe. In fact, this is exactly what is happening in Denmark and China in order to reduce climate change. Such activities should be global and include South America, Europe, Africa and Asia where deforestation is important issue. Forest restoration reduces climate change, desertification, and preserves both the regional tropical and global environment if the wood is not burned at a later stage but instead used in e.g. roads as filling material. Changes are therefore needed through improved international understanding and agreements to better avoid the global climate changes, from cutting down the precious rainforest before it is too late as rainforest cannot be re-planted.

Matched MeSH terms: Europe
An analysis of suicide and undetermined deaths in 17 predominantly Islamic countries contrasted with the UK

Pritchard C, Amanullah S

Psychol Med, 2007 Mar;37(3):421-30.
PMID: 17176500

Suicide is expressly condemned in the Qu'ran, and traditionally few Islamic countries have reported suicide. Undetermined deaths are classified by the World Health Organization (WHO) as Other Violent Deaths (OVD) in ICD-9, or Other External Causes (OEC) in ICD-10. It has been suggested that to avoid under-reporting of suicides, both formal suicide verdicts and OVD should be considered together because OVD may contain 'hidden' suicides.

Matched MeSH terms: Europe/epidemiology
Fulltext European polygenic risk score for prediction of breast cancer shows similar performance in Asian women

Ho WK, Tan MM, Mavaddat N, Tai MC, Mariapun S, Li J, et al.

Nat Commun, 2020 07 31;11(1):3833.
PMID: 32737321 DOI: 10.1038/s41467-020-17680-w

Polygenic risk scores (PRS) have been shown to predict breast cancer risk in European women, but their utility in Asian women is unclear. Here we evaluate the best performing PRSs for European-ancestry women using data from 17,262 breast cancer cases and 17,695 controls of Asian ancestry from 13 case-control studies, and 10,255 Chinese women from a prospective cohort (413 incident breast cancers). Compared to women in the middle quintile of the risk distribution, women in the highest 1% of PRS distribution have a ~2.7-fold risk and women in the lowest 1% of PRS distribution has ~0.4-fold risk of developing breast cancer. There is no evidence of heterogeneity in PRS performance in Chinese, Malay and Indian women. A PRS developed for European-ancestry women is also predictive of breast cancer risk in Asian women and can help in developing risk-stratified screening programmes in Asia.

Matched MeSH terms: Europe/epidemiology
A case of plasmoquin idiosyncrasy

Ashby CF

Malayan Medical Journal, 1928;3:148.

Matched MeSH terms: Europe/ethnology
Fulltext Two multinational, observational surveys investigating perceptions of beauty and attitudes and experiences relating to aesthetic medical procedures

Redaelli A, Siddiqui Syed S, Liu X, Poliziani M, Erbil H, Prygova I, et al.

J Cosmet Dermatol, 2020 Nov;19(11):3020-3031.
PMID: 32153099 DOI: 10.1111/jocd.13349

BACKGROUND: Data on opinions and experiences of aesthetic medical procedures outside the United States and Western Europe are scarce.
AIMS: This study aimed to survey users and non-users of aesthetic procedures in countries where this information is less readily available, to understand attitudes and perceptions relating to beauty.
PATIENTS/METHODS: Two independent internet-based observational surveys were conducted. Survey 1: individuals from Colombia, Lebanon, Malaysia, Russia and Turkey who were 'users' or 'non-users' of aesthetic medical procedures. Survey 2: individuals from Colombia, Russia, Thailand, Turkey and the United Arab Emirates who were 'users' of non-surgical aesthetic treatments.
RESULTS: Surveys 1 and 2 were completed by 300 and 160 individuals, respectively, most of whom were female (94.0% and 99%). Overall, respondents rated the eyes and smile as the most pleasing male and female facial features. Most participants (mean 82.6%; range 75%-100%) believed maintaining a healthy lifestyle was important for ageing gracefully, and over one-third (36.0%; 28%-47%) believed men age more gracefully than women. The emphasis respondents placed on the importance of physical attributes vs inner feelings, internal beauty and self-confidence varied between countries. Users were often more positive about aesthetic medical procedure outcomes than non-users. Adequate information, good physician communication (including managing treatment expectations), treatment recommendations based on patient need and good aftercare improved treatment satisfaction.
CONCLUSIONS: The eyes and smile were key features of attractiveness, but maintaining a healthy lifestyle was consistently considered an important factor for ageing gracefully. Ensuring patients are well informed was a major determinant of treatment satisfaction.

Matched MeSH terms: Europe
Ethnic variability in dementia: results from Singapore

Ampil ER, Fook-Chong S, Sodagar SN, Chen CP, Auchus AP

Alzheimer Dis Assoc Disord, 2005 Oct-Dec;19(4):184-5.
PMID: 16327344

The diversity of Singapore's population affords a unique opportunity to study ethnic variability in the dementias. We sought to explore the effects of ethnicity on the frequency of Alzheimer disease and vascular dementia in a large Singaporean sample. A total of 357 patients were studied: 190 with vascular dementia and 167 with Alzheimer disease. Vascular dementia was more common among Chinese and Malays, whereas Alzheimer disease was more common in Indians and Eurasians. Factors that may contribute to the observed ethnic variability in dementia etiologies include differential frequency of the ApoE-e4 allele, frequency of vascular risk factors, lifestyle choices, and cultural attitudes toward health care utilization.

Matched MeSH terms: Europe/ethnology
Fulltext Contribution of Arab countries to pharmaceutical wastewater literature: a bibliometric and comparative analysis of research output

Zyoud SH, Zyoud SH, Al-Jabi SW, Sweileh WM, Awang R

Ann Occup Environ Med, 2016;28:28.
PMID: 27382475 DOI: 10.1186/s40557-016-0117-0

BACKGROUND: Recently, the pharmaceutical manufacturing industry has been growing rapidly in many countries in the world, including in Arab countries. Pharmaceuticals reach aquatic environments and are prevalent at small concentrations in wastewater from the drug manufacturing industry and hospitals. Such presence also occurs in domestic wastewater and results from the disposal of unused and expired medicines. Therefore, the objective of this study was to analyze and compare the quantity and quality of publications made by researchers in Arab countries on pharmaceutical wastewater.
METHODS: To retrieve documents related to pharmaceutical wastewater, we used the Scopus database on November 21, 2015. All documents with terms related to pharmaceutical wastewater in the title or abstract were analysed. Results obtained from Arab countries were compared with those obtained from Turkey, Iran and Israel.
RESULTS: Globally, a total of 6360 publications were retrieved while those from Arab countries, Iran, Turkey and Israel, were 179, 113, 96 and 54 publications respectively. The highest share of publications belonged to Kingdom of Saudi Arabia (KSA) with a total of 47 (26.2 %) publications, followed by Egypt (38; 21.2 %), Tunisia (17; 9.5 %) and Morocco (16; 8.9 %). The total number of citations was 1635, with a mean of 9.13 and a median (inter quartile range) of 3 (1.0-10.0). The study identified 87 (48.6 %) documents with 32 countries of international collaboration with Arab countries. It was noted that Arab researchers collaborated mainly with authors in Western Europe (54; 30.2 %), followed by authors from the Asiatic region (29; 16.2 %) and Northern America (15; 8.4 %). The most productive institution was King Saud University, KSA (13; 7.3 %), followed by the National Research Centre, Egypt (10; 7.3 %).
CONCLUSIONS: This study showed that KSA has the largest share of productivity on pharmaceutical wastewater research. Bibliometric analysis demonstrated that research productivity, mainly from Arab countries in pharmaceutical wastewater research, was relatively lagging behind. More research effort is required for Arab countries to catch up with those of non-Arab Middle Easter countries on pharmaceutical wastewater research.

Matched MeSH terms: Europe

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